Poyhonen's Blog

stories and commentary

Archive for the ‘New Ideas’ Category

Health Care Reform Helps Insurance Companies Profit

We could subsidize Health Care service providers:

The cost of giving every licensed physician $100,000 would only be $90 billion per year.  This sounds ridiculous and expensive.  Ninety billion dollars spent with no detailed government oversight. People would have to pay co-pays and buy medical insurance without Government assistance.  Poor folk would get the same care without a lot of paperwork.  Dissolving Medicare and Medicaid would allow a free market to sell services for about fifty bucks a month per person. Yes, current payroll deductions would continue in order to augment compensation for all medical personnel relegating catastrophic health insurance to be bundled with car and home insurance schemes.


No one seems to like the idea of giving tax dollars to doctors, nurses, and healthcare professionals.  No…, no, no, we can’t do that–our politicians, (and voters), would rather give insurance companies your tax dollars.  The enlightened goal is to provide everyone with a ‘plan’.  We are fated to accept the voters demand for subsidized health care insurance.

Payment of your medical bills gives dividends to stockholders and companies who are in business to make a profit.  They need to give higher dividends, don’t they?  After all, the yearly compensation for the Aetna CEO was a paltry twenty-seven million in 2016.  Stock options helped a lot.

Our health plans subsidize insurance companies in order for them to make money from your illness.  Sounds harsh, doesn’t it?  Your medical bill – if you can figure it out – includes profit for the stockholders, compensation for insurance sales persons, insurance executives pay, insurance buildings, advertising costs, and finally – your doctor’s salary.  The bookkeeping and bureaucratic overhead alone adds only about thirty percent to your bill.  The government argues that their portion of overhead is low.  That bears some truth because the bureaucratic efforts are made by the providers, (more on that later).  The government must ensure the fair and correct spending of your taxpayer dollars and their oversight requires massive record keeping and the development of forms.  Just remember–the government is here to help… to help…to help.

Some details collected from Justfacts.com:

Roughly, 60 minutes of paperwork are performed for every hour of emergency department care, 36 minutes of paperwork for every hour of surgery and acute inpatient care, 30 minutes of paperwork for every hour of skilled nursing care, and 48 minutes of paperwork for every hour of home health care. “Each time a physician orders a test or a procedure, the physician documents the order in the patient’s record. But the government requires additional documentation to prove the necessity for the test or procedure.”

  • “Many forms … must be completed daily by clinical staff to submit to the government to justify the care provided to skilled nursing facility patients.”
  • Medicare and Medicaid “rules and instructions” are more than 130,000 pages (three times larger than the IRS code and its associated regulations), and “medical records must be reviewed by at least four people to ensure compliance” with Medicare program requirements.
  • “A Medicare patient arriving at the emergency department is required to review and sign eight different forms—just for Medicare alone.”
  • “Each time a patient is discharged, even if only from the acute unit of the hospital to the on-site skilled nursing unit, multiple care providers must write a discharge plan for the patient. This documentation, as long as 30 pages, applies to all patients, regardless of the complexity of care received within the hospital or required post-hospital setting.”
  • In addition to regulation by state and local agencies and private accrediting organizations, hospitals are regulated by nearly 30 federal agencies.

Our government cannot think about giving tax dollars to health care professionals when paper pushers are more necessary to guarantee profits for insurance companies.  The massive government database contains items for every illness to include getting bitten by a duck or walking into a lamppost. They even have an item designation for walking into a lamppost for the second time.  Yes, the government will document your lamppost ‘problem’.

Who pays for all this?  You do.  Does the doctor really make out financially?  The admin persons at the hospital can make more than a surgeon.  Do you want that Admin professional in the operating room?  Don’t worry – admin is always there in spirit.  Someone must ensure the stockholders make a profit.  Is your deductible paid?  How much will the government kick in?  Does the patient ‘plan’ ensure this procedure is cost effective?  Everyone should be concerned with the last statement.  What happens if the procedure is not cost effective?   Does the cost/benefit/risk analysis allow a bone marrow transplant for a patient deemed terminal, (without one)?  Ask the insurance company or hospital admin – the only case I know of concerns a deceased mother of two who did not meet the criteria.

Whatever health care system you like should exclude stockholder dividends.  Your bill should not include a dividend to stockholders gambling on making money from your illness.  Some CEO should not be making millions each year by managing insurance schemes that profit from people requiring medical attention.  People are actually demanding government-sponsored monopolies because politicians tell them there is nowhere else to go and no other method of eliciting professional service.

All hospitals, including Non-profits, currently absorb the costs of services provided to the poor.  (Insurance covers costs in order to make a profit and do not include non-paying patients).  For example: According to the research by the research of Craig Garthwaite, Tal Gross and Matthew J. Notowidigdo, the cost of each poor patient in Tennessee is over a thousand dollars.  The hospitals lose money unless Medicaid shares the burden.  Your taxes pay for that as well.

A single payer plan will allow the Government to ‘help’ everyone by raising taxes and dictating the costs of all benefits.  ‘Medicare for all’ is a mantra for single payer advocates.  Sounds good, doesn’t it?  Cuba and Canada enjoy the benefits of single payer.  You may experience Canadian relatives taking residence in the USA in order to get medical attention but such activities would never happen if Our government took over health care and dictated the compensation to all medical providers.  Our government has a proven and cost effective record of … ‘helping’.  You can relax and feel secure when your doctor enters the operating room and tells you, “I’m from the government.  I’m here to help.”  Hopefully, you can understand the language used.

Twenty percent of our doctors currently come from foreign countries and there is a predicted shortage of doctors in our future but never fear – government insurance schemes will provide succor and it will only cost a couple TRILLION dollars.  Of course, we may have to deal with the government directing our lifestyles in order to keep premiums low and profits, um, manageable. Drinking soft drinks and eating meat may become as unhealthy as owning guns.  Government mandated bicycles could replace electric cars and who would want to go to school for 14 years to become a low paid doctor employed by the government?  A small increase in taxes, perhaps an extra TRILLION, might cover the expense but don’t worry, we can always raise taxes.

Now may we discuss subsidizing the providers instead of subsidizing insurance companies run for profit and controlled by government bureaucrats?

Health Care and the Government

leave a comment »

Not approving Ryan Care was a narrow escape from an increasingly intrusive government that seems bent on controlling every aspect of American lives.

Most people would prefer to see a doctor when they have an illness or physical complaint. They would not willingly take a sick child to an insurance outlet or government building unless they had no choice. (Imagine taking a feverish baby to the DMV for treatment). Yet when you enter the doctor’s office and notice all the busy people that greet you from behind a desk – what do you think they are doing? They are filling out forms and documenting your access to insurance companies and government agencies who dictate the cost of your visit and the care you are entitled to receive.

Countries having high levels of subsidized health care, France and Italy are good examples; require that everyone pay into the government health fund. In America we all pay 1.45% of income, (hiked by an employer tax of an additional 1.45%), into our Medicare system but only people getting Social Security get the benefits. In 2015 the American Hospital Insurance Trust Fund garnered 275 Billion in taxes and spent 646 billion in services for only 15% of the population, (according to AARP).

So the illustration here is that we already have a universal insurance system that is paid into by every worker but the benefits are only distributed to retired people and the outlays for this insurance scheme exceed the inputs by about 371 billion dollars a year. The numbers get MUCH worse as they are analyzed to include every citizen.

Consider, for a moment, what insurance is supposed to provide. Health insurance is supposed to pay for the professional services, equipment, and drugs provided by licensed physicians and hospitals. In order to Control prices and services the government and insurance companies create rules, regulations, and make an effort at price fixing procedures. They require immense databases to achieve these goals and you can appreciate the health code designation of being bitten by a duck as just another line item under their scrutiny. If you think that is a bit complicated, there is another entry for walking into a lamp post. Too much? How about the designation of having walked into a lamp post for the second time?

Clearly we have too many ducks, lamp posts, and regulatory constrictions that are meant to control costs but inadvertently end up controlling lives and behavior.

Since the insurance is supposed to pay for professionals – take a look at what we could do with the 275 billion collected every year:

Give every licensed physician $100,000 …. .90 billion per year.

Give every registered nurse $30,000 ……… 90 billion per year.

Give every hospital $17 million………….…95 billion per year.

I just ran out of Medicare funds at 275 billion but our government spends over 646 billion on Medicare and adds another 546 billion with Medicaid, (2015 numbers). Where does this money come from? The general fund supplies the extra largess – – in case anyone is noticing our country currently has 20 Trillion in debt.

Well what if we doubled the tax rate for Medicare and now garnered an extra 275 billion for:

$75,000 for every licensed Nurse Practitioner…..…..8.3 billion per year.

$45,000 for every Physician Assistant………………3.2 billion per year.

Drug subsidies………………………………….….263 billion per year.

There – everyone in the USA would now be covered to some extent and to receive the subsidies all the accepting parties would have to do is not turn away any citizen from medical services. The government would no longer be in an insurance business where they have proven to be incredibly inept. The Government involvement would be relegated to a disbursement of collected funds to health professionals. The savings in paperwork, regulating, and oversight would actually save about 30% over current medical costs dictated by insurance. If the extra taxes are too big a burden consider paying the extra 275 billion from the general fund while still reducing the overhead by over half a trillion dollars per year.

Nothing is free, however, and the amounts mentioned will still not cover the total expenses. An average doctor’s earnings are about 160,000 per year and how will they make an income – not to mention the pay of specialists who spent years in getting certified?


Let doctors, hospitals, drug venders, and specialists charge whatever they desire in the form of co-pays. Some doctors in Kansas are charging $50.00 per month for adults and $10.00 a month for children to cover all medical services and they negotiate a discount of over 80% for drugs used by members who pay the monthly service fee. (Only 100 patients would be needed to add 60,000 per year but facilities and staff are still an expense that requires income). Catastrophic insurance can be purchased to cover the large co-pays that may be demanded for major medical services like cancer treatments, transplants, significant surgeries, expensive drugs, or continuing services like dialysis.

In the future, one might see catastrophic health insurance ‘bundled’ with car and home insurance plans. Medicare, Medicaid, and Obamacare would be gone. Only the Medicare tax would remain. Paperwork would be an addition to the IRS tax form.

There is more the government could do of course – Allow health employees, doctors, assistants, etc. to pay minimal or no taxes for example. Tax free health saving accounts and catastrophic insurance sales across state lines could be allowed and perhaps, someday, be offered by employers that allow employees to carry the account privately or onward to new employers.

And what about the poor people who get sick but have no job, pay no taxes, and have no catastrophic health insurance? The poor will always be with us – that is why we paid the doctors up front. No citizen will be denied service by those who promise first to do no harm.

This style of funding should also spur an interest in more people willing to become doctors which are currently predicted to be 90,000 short by 2025.

Concrete and predictable medical costs have proven to be elusive when payments are made by governments and insurance companies. If someone else is paying – the billing is of little consequence to the patient. In this subsidized system, transparent costs would allow patients to seek the best service at the lowest co-pay. No two hospitals charge alike and most patients only get solid costs after services have been rendered.

No one would like to take a car to a mechanic, who never provides an accurate estimate of charges unless they knew someone else was paying, (insurance company). Fortunately, mechanic mistakes can be expensive but are not usually life threatening. Medical services, conversely, are given very little latitude where judgments fail to achieve desired results. Complex problems are weighed in terms of outcome and risks to the patient vs. costs, profits and risks to the insurance providers. Health providers do make mistakes but such errors are often the product of being human where, in the end, we all return to the manufacturer.

How to Repeal and Replace Obamacare and Avoid All the Complaints

leave a comment »

Think about the complaints and concerns instigated by the dire thought of repealing Obamacare:

People would lose the free services provided by Obamacare.

The Government would lose tax income provided by Obamacare taxes.

Democrats will complain and spin any replacement concepts as insufficient – and probably racist.


My suggestion is to consider Replacing Obamacare before repealing the act, mandates, and taxes.

Replacing Obamacare with a concrete system would allow all supporters and detractors to review the efficacy of the replacement – before – dissolving Obamacare.  The concerns of replacement aspects will be answered, improvements can be made, and costs can be determined so that health services can be available before the ACA collapses due to an inherent poor design seemingly created for income redistribution rather than health care. The added bureaucracy is astonishing, (and adds about 30% to the cost of health care).


The largest issue in this method is cost.  The government would be paying for two health systems during the SHORT time allowed for a comprehensive review.  Still, the added cost can be justified as the price of getting the new system right.  One might note that paying for the medical costs of disadvantaged folk is likely to be a cost in both systems so that should not be considered an additional expense.

The second largest issue is also cost – in terms of lost revenue gained by ACA taxing of citizens already taxed by Medicare.


Politically oriented complaints and accusations, name calling, and reports comprised of misinformation and ‘spin’ will be provided by many politicians and media pundits more concerned with gaining self serving power than serving citizens.  Such is the divisive state provided by the last decade of politicians and this proclivity will not suddenly disappear, however, logical and sincere debate should be encouraged for a short period.  Creating another 2000 page series of laws crammed into an Act cannot be allowed.


Sounds simple – well, no – but I believe the concept is more reasonable that Repeal and Replace.

What do you think?

Ideas to Support Draining the Swamp

leave a comment »

  1. Delete 30% of all civil service positions.
  2. Limit new regulations and laws to only 2 pages of documentation.
  3. Move the United Nations to a Montana wilderness area. Beautiful setting and a boom for construction in Montana. Attendant countries, diplomats, and administrators would have to pay the local economy for buildings, homes, airports, transportation, and energy. (The current UN building can be employed as a homeless shelter).
  4. Many of those laid off civil service workers can be temporarily employed by deleting or reducing existing written laws to conform to the two page rule. All federal laws should be written so any common citizen can understand the content and desired results of the laws and regulations.
  5. Combine Homeland Security with the FBI and reduce/replace the two top management tiers of most agencies, (CIA, NSA, FTC, EPA, FCC, DIA, DEA, etc.).
  6. Delete BLM, and return 80% of all current Federal lands to the States.
  7. Make English our national language and stop printing other languages at taxpayers’ expense.
  8. Fund inner city Pod transportation for an infrastructure upgrade that will be the envy of the world. (The construction will also provide good jobs for depressed areas and one way to improve inner city problems is to offer a method of escape not provided by local government).
  9. Curtail Request for Changes in existing and future government contracts and ensure that knowledgeable professionals perform design, (not necessarily some military ranking officer with little or no understanding of technical issues). Review the contract process in its entirety. I would suggest a review of the Lockheed Skunk works process that built the SR-71 in 20 months, (1962 and it is still the highest flying, fastest man operated airplane ever built).
  10. Cut existing agency contracts by 50%. Seems harsh but there really is a LOT of fat and it is growing. The personnel cuts in suggestion number 1 will help in this regard. Some contracts may expire under this edict. Good. Rewrite the requirements and issue another contract at a more reasonable price.
  11. Sell unused government buildings or give them away – stop maintaining them.
  12. Exile many criminals instead of incarcerating them – (violence related crimes). Rehabilitate others that demonstrate merit. Long prison terms deserve exile instead of incarceration.  This ‘out of the box’ list comprises only twelve areas of potential improvements. Such changes cannot all be accomplished immediately or simultaneously because of the massive disruption that will be caused by thousands of people losing jobs but when the draining begins, it must be done with a full commitment to lowering the cost and adverse effects of a bloated government. Many more bipartisan opportunities exist. What are yours?

Arguing with Ideologues

with 10 comments

Any discussion with an ideologue about an opposing point of view may appear futile because there seems no possible prospect of changing an ideologue’s dogmatic belief in their self-serving opinion. Every argument you offer will be dismissed as a distortion, your facts will be disclaimed as dishonest, and even your sources will be criticized or smeared. It may seem that continuing such avenues of conflict offer little enlightenment and perhaps the best alternative would be to simply ignore the ideologue and their entire line of thought as something to have been derived from a person brainwashed by misinformation and propaganda. Their arguments could also appear to be the result of a successful training indoctrination program for weak and/or susceptible minds but there is no way of confirming such a disparaging evaluation without stepping into the ideologue’s source of information and becoming susceptible to the same techniques that oppose your own point of view.

To not accept the risk of reviewing the sources of opposing beliefs, however, virtually guarantees you will find your next ideologue in a mirror. Avoiding this debacle requires that you must always allow antagonists an opportunity to discover the truth for themselves instead of coercing them, cornering them with clever words, logic, or even insults – to succumb to your view of reality. Dominating another should never be the goal of an argument.

Nevertheless, we often argue with the wrong person. Submit your statement and be sure to investigate the opposing view and be honest about applying an uncluttered analysis of opposing information and logic. Your analysis should question every point of view. When you have the information needed for an argument – include the logic of all sides you can imagine, provide the facts, and have a discussion with the only person capable of changing your mind – that is yourself.

Written by poyhonen

July 22, 2016 at 8:45 pm

Suggestion for the UCMJ

leave a comment »

No military member shall be punished or suffer reprisal in any manner for refusing an order to harm any American Citizen. The acceptance or refusal of such an order is entirely the choice of the individual soldier.

Written by poyhonen

July 4, 2016 at 10:54 pm

The Ideologue Commitment

leave a comment »

Climate is changing and we argue about the cause; one side provides scientific studies to establish that the man caused element of climate change is a hoax while the other side purchases science to report an existential threat to all of humanity. The arguments of either side can be quite convincing but observations of the ideologue commitment to man caused global warming can be reviewed by the actions of its proponents who proclaim what we must do in order to curtail imminent destruction. Unfortunately the ‘we’ portion of their solution falls upon ‘you’, while their adherents make fortunes spreading gloom and doom, building sea side resorts, and flying private jets about the world in order to spread their philosophy that demands you to stop using energy. Their solution is ‘Stop’.

They want you to stop using, transporting, or even collecting any carbon based fuels. You should be compelled to do this based upon past ‘science based’ predictions of events that have never come to pass. Yet the climate change community continues to push their agenda, promising more and even greater doom unless you turn out your lights, stop using electricity, and stop driving an automobile.  They promise that the next prediction will indeed, turn out to be true – or perhaps the next one.

So what is one to do? One suggested resolution concluding that all the arguments can be resolved by simply surrendering to the self proclaimed wisdom of the ideologue and adhering to the actions proposed by the proponents of man caused global warming. Farmers should stop using fossil fuels to feed ideologues. Food transported to the ideologue grocery using fossil fuels needs to stop. What components make a battery that ideologues desire? How are iron, nickel, and lead mined? Are any solar cells made without the use of fossil fuels?

Merely using more efficient devices is not enough of a submission to ideologue demands. Building clean power plants and providing safe pipelines is an inadequate capitulation – not using fossil fuels in any capacity is the primary only solution. Unfortunately, the ideologues want you to stop using electricity, heating your homes, and feeding your children from groceries stocked by trucks travelling from farms that use tractors and modern production concepts, while they enjoy the lifestyle provided by plentiful energy. Their lights remain on, while you pay for their commitment.

Can global warming advocates be asked to adhere to the principals they demand to place upon the rest of humanity before a complete surrender of civilization is condoned?

The arguments will be quickly resolved when the ideologues commit themselves to their own philosophy.