Contrarian Economics – Page 7 – The Moral Healthcare Blog

In Norway, Start-ups Say Ja to Socialism

At one point, I asked Wiggo Dalmo why he was still working so hard to expand his company: Why not just have a nice life—especially given that the authorities would take a hefty chunk of whatever additional money he made? “For me personally, building something to change the world is the kick,” he says. “The worst thing to me is people who chose the easiest path. We should use our wonderful years to do something on this earth.”

When I got back to the United States, I had a beer with Bjørn Holte, the CEO of bMenu, whom I’d first met in Oslo. It was early November—days after the congressional elections—and Holte had just arrived in New York City, where he is opening a new office. We talked about the commercial real estate market, the amazing cultural diversity in a city that has twice as many people as his entire country, and the current debate in the United States about the role of government. Holte was fascinated by this last topic, particularly the angry opposition to President Obama’s health care reform package. “It makes me laugh,” he says. “Americans don’t understand that you can’t have a functioning economy if people aren’t healthy.”

Holte’s American subsidiary pays annual health care premiums that make his head spin—more than $23,000 per employee for a family plan—and that make the cost of employing a software developer in the United States substantially higher than it is in Norway, even after taxes. (For a full breakdown, see “Making Payroll.”) Holte is no pinko—he finds many aspects of Norwegian socialism problematic, particularly regulations about hiring and firing—but when he looks at the costs and benefits of taxes in each country, he sees no contest. Norway is worth the cost.

This issue of Inc. ended up in my mailbox instead of my subscribing neighbor’s. Divine providence, clearly.

You will be shocked, I know, that there are hard working people who are not Americans and that there are other health systems that don’t hobble businesses.

Healthcare Compensation Still Strong

New survey results from Executive Compensation 2010/2011 show that hospital CEOs earn an average $353,900 per year, (CEOs at not-for-profits average $225,400; at home care facilities, $282,300 a year; at physician clinics, $254,000; at behavioral health facilities, $241,300; and at long-term care facilities, $235,700.

These executives, physicians, and skilled clinicians undoubtedly would make a strong argument that they deserve the salaries they’re getting. Besides, it’s what the market is paying, and it’s hard to blame anyone for earning as much money as he or she can.

However, let’s put this in perspective. According to the U.S. Census Bureau, 4.1% of U.S. households had an income between $150,000 and $200,000 in 2009, and 3.9% had an income of $200,000 or higher, while 11% of U.S. households earn between $15,000 to $25,000 annually. The median household income in the U.S. that year was $50,221.

I threw this in the ‘contrarian economics’ category because it has the 2009 income data.

The Great Divergence In Pictures: A visual guide to income inequality.

Tremendous. PLEASE go look at this!

AlterNet: Ayn Rand, Hugely Popular Author and Inspiration to Right-Wing Leaders, Was a Big Admirer of Serial Killer

If you knew Ayn Rand was a bit whacked, you had no idea…

So what, and who, was Ayn Rand for and against? The best way to get to the bottom of it is to take a look at how she developed the superhero of her novel, Atlas Shrugged, John Galt. Back in the late 1920s, as Ayn Rand was working out her philosophy, she became enthralled by a real-life American serial killer, William Edward Hickman, whose gruesome, sadistic dismemberment of 12-year-old girl named Marion Parker in 1927 shocked the nation. Rand filled her early notebooks with worshipful praise of Hickman.

According to biographer Jennifer Burns, author of Goddess of the Market, Rand was so smitten by Hickman that she modeled her first literary creation — Danny Renahan, the protagonist of her unfinished first novel, The Little Street — on him.What did Rand admire so much about Hickman?

His sociopathic qualities: “Other people do not exist for him, and he does not see why they should,” she wrote, gushing that Hickman had “no regard whatsoever for all that society holds sacred, and with a consciousness all his own. He has the true, innate psychology of a Superman. He can never realize and feel ‘other people.'”This echoes almost word for word Rand’s later description of her character Howard Roark, the hero of her novel The Fountainhead: “He was born without the ability to consider others.”

Job Growth under Presidents D vs R

This is from Jed Lewison at DailyKos

Intellectual conservatism, RIP – Salon.com

Neoconservatism – Salon.com

I was once a young neoconservative. The word meant something different then, before it was hijacked by extremists by Michael Lind

A nice article on the history of neoconservatism – not what I thought – but I brought it here for this great quote:

Ultimately Milton Friedman and other free-market ideologues did far more damage to America than the carnival freaks of the counterculture.

Love it!

Paying for Reform – Updated

I was asked recently, how will we pay for reform. Tom Coburn, on Sermo.com, asked physicains to support him not supporting us physicians in asking for repeal of SGR with its $250 billion dollar price tag. I don’t know when he had this sudden change of heart, feeling physicians should not get paid more for Medicare patients, but hey…

The other question was about the overall price tag of HR 3200, somewhere in the neighborhood of $100 billion a year, or $1 trillion over ten years.

[Cross posted at DailyKos.]
No problem. First and best answer: REPEAL THE BUSH TAX CUTS!
http://www.usnews.com/blogs/john-farrell/2009/04/15/no-tea-party-protests-for-teddy-roosevelt-republican-champion-of-the-income-tax.html

They were bad economics, bad public policy, and bad morally.

UPDATE: Susie Madrak at Crooks and Liars summarizes a Citizens for Tax Justice report on the disaster that the Bush Tax cuts were and are:

I’d advise listening to the two EXCELLENT “This American Life” episodes on HC reform:
http://cmhmd.blogspot.com/2009/10/this-american-life-hc-reform-part-2.html

Follow the links, download the MP3’s and you can make audio CDs for the car.

There are lots of answers in there, but I’ll give you a few easy ones:

1.) McAllen, TX and EOL Care:

http://cmhmd.blogspot.com/2009/05/annals-of-medicine-cost-conundrum.html

That’s actually two, practice variation and EOL care.

2.) Prescription co-pays: $10 for a $20 prescription, $30 for a $600 prescription. (Unless you have a coupon from the manufacturer to make the $30 copay $0.00 – the second TAL episode explains this.)

3.) George Lundberg has a few ideas:
http://cmhmd.blogspot.com/2009/08/health-care-blog-how-to-rein-in-medical.html

4.) Uwe Reinhardt has a modest proposal:
http://healthaffairs.org/blog/2009/07/24/a-modest-proposal-on-payment-reform/

5.) Wendell Potter, too:
http://www.time.com/time/politics/article/0,8599,1920893,00.html

6.) Administrative costs:
http://cmhmd.blogspot.com/2009/07/health-affairs-2-articles-on-cost-of.html

Bottom line is, as has been suggested before, passing the bill is going to be half the battle, implementing reform in a way that is most beneficial to patients at the least cost to us as a society is next up.

But let’s get everyone taken care of first, and avoid the 18K to 45K people dying EVERY YEAR due to lack of access to health care and THEN we’ll deal with reducing costs. Turns out, if you read the Gawande article, they may be by doing the exact same things.

And finally, $1 trillion over ten years is $100 billion a year, and we spend $2.5 trillion a year on HC already, so that is very little money in the grand scheme of national economics. So, as Uwe would say, “Go explain to God why you cannot do this. He will laugh at you.”

Cheers,http://cdn.crooksandliars.com/files/uploads/2009/09/nationaldebt_42d6b.jpg

New Nationalism – Roosevelt Speeches – 1912

New Nationalism – Roosevelt Speeches – 1912
I’m listening to a biography of TR, “A Lion in the White House,” and there is a lot about this speech given by Roosevelt at Osawatomie, Kansas on August 31, 1910.

He makes me sound like Rush Limbaugh. Here are a few quotes:

“Labor is prior to, and independent of, capital. Capital is only the fruit of labor, and could never have existed if labor had not first existed. Labor is the superior of capital, and deserves much the higher consideration.”
If that remark was original with me, I should be even more strongly denounced as a Communist agitator than I shall be anyhow. It is Lincoln’s. I am only quoting it; and that is one side; that is the side the capitalist should hear.
Now, let the working man hear his side. “Capital has its rights, which are as worthy of protection as any other rights…. Nor should this lead to a war upon the owners of property. Property is the fruit of labor; . . . property is desirable; is a positive good in the world.”
And then comes a thoroughly Lincolnlike sentence: “Let not him who is houseless pull down the house of another, but let him work diligently and build one for himself, thus by example assuring that his own shall be safe from violence when built.”
It seems to me that, in these words, Lincoln took substantially the attitude that we ought to take; he showed the proper sense of proportion in his relative estimates of capital and labor, of human rights and property rights. Above all, in this speech, as in many others, he taught a lesson in wise kindliness and charity; an indispensable lesson to us of today. But this wise kindliness and charity never weakened his arm or numbed his heart. We cannot afford weakly to blind ourselves to the actual conflict which faces us to-day. The issue is joined, and we must fight or fail.

…………..

Now, this means that our government, national and State, must be freed from the sinister influence or control of special interests. Exactly as the special interests of cotton and slavery threatened our political integrity before the Civil War, so now the great special business interests too often control and corrupt the men and methods of government for their own profit. We must drive the special interests out of politics. That is one of our tasks to-day. Every special interest is entitled to justice – full, fair, and complete – and, now, mind you, if there were any attempt by mob-violence to plunder and work harm to the special interest, whatever it may be, and I most dislike and the wealthy man, whomsoever he may be, for whom I have the greatest contempt, I would fight for him, and you would if you were worth your salt. He should have justice. For every special interest is entitled to justice, but not one is entitled to a vote in Congress, to a voice on the bench, or to representation in any public office. The Constitution guarantees protections to property, and we must make that promise good But it does not give the right of suffrage to any corporation. The true friend of property, the true conservative, is he who insists that property shall be the servant and not the master of the commonwealth; who insists that the creature of man’s making shall be the servant and not the master of the man who made it. The citizens of the United States must effectively control the mighty commercial forces which they have themselves called into being. There can be no effective control of corporations while their political activity remains. To put an end to it will be neither a short nor an easy task, but it can be done. We must have complete and effective publicity of corporate affairs, so that people may know beyond peradventure whether the corporations obey the law and whether their management entitles them to the confidence of the public. It is necessary that laws should be passed to prohibit the use of corporate funds directly or indirectly for political purposes; it is still more necessary that such laws should be thoroughly enforced. Corporate expenditures for political purposes, and especially such expenditures by public-service corporations, have supplied one of the principal sources of corruption in our political affairs.
…………..

Moreover, I believe that the natural resources must be used for the benefit of all our people, and not monopolized for the benefit of the few, and here again is another case in which I am accused of taking a revolutionary attitude. People forget now that one hundred years ago there were public men of good character who advocated the nation selling its public lands in great quantities, so that the nation could get the most money out of it, and giving it to the men who could cultivate it for their own uses. We took the proper democratic ground that the land should be granted in small sections to the men who were actually to till it and live on it. Now, with the water-power with the forests, with the mines, we are brought face to face with the fact that there are many people who will go with us in conserving the resources only if they are to be allowed to exploit them for their benefit. That is one of the fundamental reasons why the special interest should be driven out of politics.
Of all the questions which can come before this nation, short of the actual preservation of its existence in a great war, there is none which compares in importance with the great central task of leaving this land even a better land for our descendants than it is for us, and training them into a better race to inhabit the land and pass it on. Conservation is a great moral issue for it involves the patriotic duty of insuring the safety and continuance of the nation. Let me add that the health and vitality of our people are at least as well worth conserving as their forests, waters, lands, and minerals, and in this great work the national government must bear a most important part.

……………

In every wise struggle for human betterment one of the main objects, and often the only object, has been to achieve in large measure equality of opportunity. In the struggle for this great end, nations rise from barbarism to civilization, and through it people press forward from one stage of enlightenment to the next. One of the chief factors in progress is the destruction of special privilege. The essence of any struggle for healthy liberty has always been, and must always be, to take from some one man or class of men the right to enjoy power, or wealth, or position, or immunity, which has not been earned by service to his or their fellows. That is what you fought for in the Civil War, and that is what we strive for now.

…..

We grudge no man a fortune which represents his own power and sagacity, when exercised with entire regard to the welfare of his fellows. Again, comrades over there, take the lesson from your own experience. Not only did you not grudge, but you gloried in the promotion of the great generals who gained their promotion by leading the army to victory. So it is with us. We grudge no man a fortune in civil life if it is honorably obtained and well used. It is not even enough that it should have gained without doing damage to the community. We should permit it to be gained only so long as the gaining represents benefit to the community. This, I know, implies a policy of a far more active governmental interference with social and economic conditions in this country than we have yet had, but I think we have got to face the fact that such an increase in governmental control is now necessary.