Doug Casey on the Crisis “Medicare for All” Will Cause

Via International Man

medicare for all

International Man: Medical-care spending in the United States is more than double that of any other developed country. The extra spending doesn’t amount to better quality care or a healthier American population.

What’s your take on the US system as a whole?

Doug Casey: It’s full of problems. And they’re likely to get worse.

First of all, it’s highly politicized. Almost nothing can be done without government approval. It’s becoming more and more like your local DMV.

The system revolves around the FDA. In theory, it should protect the consumer, but in fact it does the opposite. The FDA should be renamed the Federal Death Authority, because it kills more people every year than the Defense Department does in a typical decade.

Why do I say that? For one thing, it takes 10 years for a new drug to be approved, and it averages not just $1 billion dollars, but now more than $2 billion for the typical drug to be approved—and only very few are ever approved. That’s because there’s only a minimal risk to the FDA in not approving them but a huge risk that they’ll be embarrassed if something goes wrong with one that is approved.

Second, the whole system is very bureaucratized. When you go to a doctor’s office, you’ll notice that probably half the staff is not engaged in delivering medical services. They’re shuffling papers: insurance forms, regulatory forms, and various cover-your-ass records.

Third, the medical system is law driven more than science driven. Doctors have to be very careful about what they say and do; the society has become very litigious. One of the major expenses of being a doctor is malpractice insurance. Particularly for some specialties.

There are thousands of lawyers in the US who specialize in suing doctors for real or imagined mistakes. For that reason, some specialists pay hundreds of thousands of dollars per year for their malpractice insurance.

Because of the dangers of being sued, doctors are practically forced to engage in defensive medicine. They prescribe all kinds of tests that don’t make sense, but they figure that it’s better to be safe than sorry—not for the patient’s sake but for the sake of a potential lawsuit.

All of this started with Franklin Delano Roosevelt. During World War II, he installed wage and price controls, and it was impossible for companies to give raises to workers. So they substituted benefits for cash, namely employer-paid medical insurance. One of the many disastrous distortions FDR cranked into the US economy.

On the bright side, despite these things, medical care has gotten much better because of advances in science and technology. The cost of medical care should have and would have been dropping—like the cost of computers—if not for State intervention. But that’s beside the point we’re discussing.

International Man: You’ve often emphasized the importance of using words properly. What are your thoughts on the term “health care?”

Doug Casey: Health care is something that you provide for yourself with proper diet, exercise, and lifestyle choices. Nobody—certainly not an insurer or the government—can provide health care. What they can do, at most, is cover a portion of your medical expenses should you have a serious injury or illness.

There’s a big difference.

It’s a subtle corruption of the language to call “medical insurance” “health insurance.” It doesn’t insure your health. All it does is cover medical expenses. But they like to use the term “health care” because it sounds friendly and loving. “We’ll care for your health.” That sounds great! Sign me up! “Medical,” however, implies surgery, dangerous drugs, hospitals, and pain.

It’s a euphemism, and like all euphemisms, it’s dishonest. Health care or health insurance should always be called “medical insurance,” because it will at best cover your medical expenses. Calling it “health care” and saying it’s “free” is just dishonest marketing.

International Man: Most Americans are insured privately by their employer or through self-purchased coverage.

About 34% of Americans are insured through a government plan such as Medicare or Medicaid.

If the quality of medical care in the US is unsatisfactory, why is the conversation centered on insurance? Are we missing the point?

Doug Casey: To start with, the 34% of Americans who are “insured” through a government plan aren’t actually insured. They’re not paying market-based premiums based on actuarial tables—considering age, preexisting conditions, and the like—intended to spread the risk of serious sickness or injury.

Medicare and Medicaid are actually welfare programs. They have nothing to do with insurance. Using that term gives them and those who use them undeserved respect.

Medicaid is one hundred percent welfare, and Medicare is mostly a welfare program. They shouldn’t be termed “insurance.”

The important point is that they shouldn’t exist. Why should the State cover a person’s medical costs? If it should, maybe it should also cover their food, shelter, and clothing—oh, wait, I forgot, it does. And even the cost of their cellphones. But cars are also important. When someone’s car stops working, shouldn’t that be covered as well?

How about their dog? How about farm animals?

Is somebody else’s bad health a mortgage on my life?

Bad things happen. That’s why you buy insurance. If you can’t afford insurance, that means you managed your life badly. It’s not up to strangers to kiss it all and make it better for you.

Most diseases and many injuries are a result of people not taking care of themselves. They overeat, don’t exercise, use alcohol and drugs, and engage in bad lifestyles. Those are moral failures. I don’t want to pay for those people’s moral failures. Neither should you.

International Man: Over 59 million Americans are on Medicare. Bernie Sanders and other presidential candidates have made “Medicare for all” one of their biggest campaign promises.

What type of care can Americans expect to receive in a single-player system, with national coverage for all?

Doug Casey: It would mean disastrous and degenerating care.

They like to bring up Canada and Britain as examples—and they’re very good examples.

The medical systems of both countries are in crisis. If you need an operation, it can be delayed for many months, sometimes more than a year. Forget about something that’s noncritical. The reason is simple: When you have scarce commodities like a doctor’s time and medical equipment, they have to be rationed.

There are three ways you can ration a commodity. By dollars, time, or political connections. In other words, you can pay for it and get it when you want it. Or you can wait in line—for who knows for how long. Or if you’re a VIP with friends in high places, you’re moved to the front of the line.

In places like Canada and Britain, you hardly have a choice. The single payer determines if you get treated, when you get treated, and how you get treated.

Furthermore, if something is “free,” which care from a single payer supposedly is—although it’s paid for by taxes—everybody wants as much as they can get. And as with any free good, people won’t economize.

Certain people are going to live at the doctor’s office. It’s going to turn some people into hypochondriacs. The idea of Medicare for all—or for that matter, Medicare for oldsters—is stupid and uneconomic from every point of view. More important, it’s morally depraved, because it uses the State to force some people—namely doctors and productive people—to pay for those who were too imprudent to provide for their own care.

As a fringe benefit, it will destroy the medical system. Doctors will wind up as veritable government employees. That will discourage them from spending six years and hundreds of thousands to learn their trade. There will be a lot more demand but a much smaller supply of doctors. At the same time, the amount of capital available for developing new drugs, new technology, and basic research will collapse. Why? All governments today are running gigantic deficits. This is likely to get much worse. They’ll put off the important in favor of the urgent, and the results are inevitable.

International Man: Bernie Sanders’ Medicare-for-all plan would cost $97.5 trillion over the next decade.

The US government debt has already reached astronomical levels. How is it possible to pay for this?

Doug Casey: It’s not possible. It’s a swindle and a lie.

There are three possible explanations. These people can’t do simple arithmetic, they’re purposefully lying, or they’re crazy. It may be all three.

Let’s look at this, however, not from a philosophical but from a practical point of view. If you’re sick or get into an accident and you don’t have your own insurance, what are your options?

If you need an expensive procedure and can’t afford US prices, there are lots of places where you can get high quality medical care other than the in United States. Lots of Americans routinely go to Latin America for dental work at from 10% to 50% of US costs.

It’s called “medical tourism.”

Thailand is probably the best location for serious stuff. The medical care you can get there is equal in quality to that in the US, more pleasant, and about 20–25% of the cost. If I needed a serious operation and I didn’t have insurance, I’d get on a plane to Bangkok.

If I were paying for insurance myself, I would get the highest possible deductible. I don’t want to trade dollars with an insurance company for basic and trivial things. I’m interested in insurance for only truly major medical expenses. That’s what most people should do.

But suppose you just don’t have any money. One possibility is to hope that charity will cover your bills.

Incidentally, before Social Security and welfare programs like Medicaid, there were hundreds of beneficial societies in the US. They sorted out which of the afflicted were deserving and helped them. Few, like Lions, Rotary, and Kiwanis, remain. Most of them were made redundant by government welfare programs.

If you don’t have money or insurance, and charity isn’t a practical option? If you have friends, maybe your friends will help you.

If you don’t have friends, why not? I’d suggest it may be because you’re actually not a good person or at least not a very valuable person. If someone is without friends, it’s because they are viewed as liabilities, not assets, by those who know them. They suffer from serious moral flaws—they lie, cheat, steal, are violent, lazy, or have other vices. If they have no friends to help them out, why should a stranger?

We all have to die at some point. Nobody wants to think about it, of course. Or perhaps even believe it will happen to us personally. From a strictly ethical point of view, nobody should be narcissistic enough to try to make the continuation of his life a mortgage on everybody else’s life.

Let me give you an example of what I mean. If you see a person, a bum, dying on a street corner, would you give a dollar to save his life? Many people would. Would you?

How about $10? OK, what about $100? I’m not so sure.

Maybe the world’s better off if the bum dies—there’s a reason he’s a bum. The reason will have something to do with a bad character. Would you give him $1,000? Some would, I suppose, out of some kind of guilt or perhaps to make themselves feel righteous. $10,000? Nobody would do it, unless they were both wealthy and interested in conducting a social experiment.

I’m saying this idea that human life is priceless is ridiculous and destructive. We put a price on human life all the time, depending on who it is and the circumstances. And we should. In the example of the bum I just gave, we’ve determined that some stranger is likely worth only a few dollars.

Just the other day I got an email from someone in Aspen who’s a member of a luncheon group I attend. Most of the guys are typical Aspen rich guys. One member, who’s in temporary (I presume) financial straits, wrote that his dog has a type of operable cancer. But it’s an expensive operation, and he can’t afford to pay for it.

He’s asked the guys at the luncheon group and his other friends to contribute to the cost of the surgery.

I have zero doubt he’ll raise the money. I don’t believe in charity, for reasons I’ve spelled out in the past. But I sent him a hundred dollars.

I wouldn’t, however, send anything to someone in the Third World with a problem (not to mention the fact it’s probably a scam run by some Nigerians). There are roughly 7.5 billion people on this planet. They all have problems and would all like $100.

But I sent him $100 for his dog. Why?

The fact that I did might generate further good feelings between us. (He seems like a decent guy, although I don’t know him well.) If I had just sent it into the ether for the medical care of some person in Africa, as opposed to this man’s dog, I know I’d be getting nothing back for it. In fact, maybe the African is a member of Boko Haram and would want to kill me just on general principles. This is one of many reasons giving money to “charity” is usually a mistake. Giving to an individual, even as a test of their character, is much wiser

Frankly, sometimes you value the life of a dog more than the life of some poor person outside of your circle. And sometimes you should. If it were my dog, there’d be no question about it.

That’s what this whole thing about insurance, Medicare, and a single-payer system is all about. It’s up to individuals—not State bureaucrats, not “the system”—to decide who lives and who dies. Including you yourself.

Editor’s Note: Misguided economic ideas are advancing rapidly in the US. In all likelihood, the public will vote itself more and more “free stuff” until it causes an economic crisis.

With the increasing prospect socialists will soon gain power in the US, and it’s all coming to climax. That’s precisely why bestselling author Doug Casey and his colleagues just released a free PDF report that explains what could come next and what you can do about it. Click here to download it now.

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24 Comments
Hardscrabble Farmer
Hardscrabble Farmer
December 5, 2019 7:55 am

First of all it’s clearly a misnomer, it won’t be “for all” only for those who cannot afford real care. You think a Senator is going to go to the local hospital with his Medicare card? Let’s not act stupid.

What it means is hoovering up all the scraps of money and assets not tied down in order to help spread the cost of treating the hordes- or better yet, postponing the treatment of the hordes (that’s us) in order to siphon off more wealth. On top of it you can social credit score medical treatment to encourage submission to our betters.

“Well Mr. Farmer, it looks like we won’t be able to sew that finger back on because you don’t think we landed on the Moon. How dare you. Please wipe up the mess under the chair before you leave.”

Everything they touch they destroy and you are on the hook for the damages.

Old Timer
Old Timer
  Hardscrabble Farmer
December 5, 2019 8:29 am

Good observation Farmer, I had to chuckle. I trade with a local Amish group in our area and when really getting to know them one figures out that they are communist in many ways. That being said, I told one of them one day that I personally do not believe that they ever put man on the moon, and I attempted to explain in depth why. Well, that bit of heresy that I spewed spread like wildfire among them and now I am treated somewhat cool, and mysteriously, their prices have elevated on products and services. Now I am certainly not walking around with my bottom lip pooched out, as that kind of nonsense flows off me like water off a ducks back, but it has given me quite a bit to ponder. Then I read your post. Many thoughts, Thanks.

yahsure
yahsure
December 5, 2019 8:24 am

Every article by this Casey guy, he is either out of touch with reality or just says stupid shit. I picture Washington filled with people who think like him.

Hardscrabble Farmer
Hardscrabble Farmer
  yahsure
December 5, 2019 8:49 am

On a hunch I went and looked for some images of Mr Casey and was not surprised.

CS Lewis called them “Men without chests” but in his case it would be “Man without shoulders”.

Not sure which is worse, but both share the same disability. It leads to an equally misshapen perception of the world around them.

M G
M G
  Hardscrabble Farmer
December 5, 2019 11:18 am

Now you’ve gone and “dissed” Casey just when I was sure I was on the road to charming a donation to JQ!

Dutch
Dutch
  yahsure
December 5, 2019 12:14 pm

Casey is so full of shit. He says Medicare is really a welfare program. By law we and our employers are forced to pay for it. I have been working since 1964 – I’ve paid into Medicare for 54 years (at 70 I’m still working, and still paying in).

My Medicare Part B is about $130 month + $99 for Advantage plan = $229 a month.

About 25% of Medicare is spent on last year of life.

Iska Waran
Iska Waran
  Dutch
December 5, 2019 12:42 pm

That’s just a semantics issue. If you define “welfare” as something spent on the undeserving, I’d agree with your objection. If you define it as something paid by the government no matter how much you’d “paid in”, then he’s right on that point (and wrong on many others). It’s not like you have some giant HSA account that you’ve been funding since 1964 that you can pass on to your heirs.

James the Deplorable Wanderer
James the Deplorable Wanderer
  Iska Waran
December 6, 2019 9:00 pm

Agreed – there isn’t some HSA account called “Iska’s Medicare” that you could check a balance in, and if sufficient, schedule a procedure.
But that’s just it – it SHOULD have been set up that way. Along with a “donation” provision – Agnes Grady in FL needs a gall bladder operation, but only has $500 left in her Medicare account. If you WANT to donate $XX towards Agnes’ operation costs, please choose $XX and check HERE to authorize a donation from your account to hers.
By making it all commingled and unaccountable, a socialist / communist goal – ‘from each according to their abilities, to each according to the needs” – along with an overhead charge is assessed to each working American. FDR was a socialist / communist warlord who caused irreparable harm to the country. Americans are generous, I imagine 8 or 9/10 times Agnes would get funded.
We once understood these things – read David Crockett’s speech on pensions for Revolutionary War widows for a good example. “We did not enter into such a contract when he was alive, and cannot enter into one now he is dead”.

Anonymous
Anonymous
December 5, 2019 8:29 am

“If they would rather die…they had better do it and decrease the surplus population”–Ebenezer Scrooge.
Maybe Doug Casey should consider changing his name this Christmas season.

overthecliff
overthecliff
December 5, 2019 8:53 am

I’m outraged that LGBTQS are criticizing Buttplug about his previous support of the Salvation Army. They must realize that he is not only a flaming Faggot but he is also a Christian Conservative.

Anonymous
Anonymous
December 5, 2019 9:26 am

Casey sounds like a shill for the corporate for profit healthcare system. Healthcare ‘insurance ‘ is nothing more than a protection racket. Worried how to pay for ‘ Medicare for all ‘?….No problem , just get the money from the same place that bailed out Wall Street , funded wars in the Middle East and gives the Pentagon $760 BILLION a year…..if they got money to piss away on those things , they most definitely have money to piss away on some poor schmucks healthcare…

Iska Waran
Iska Waran
  Anonymous
December 5, 2019 10:20 am

I agreed. The whole healthcare+insurance system is a system of collusion to force people to overpay for insurance. My intensive care invoice from a few years ago (from an accident) was $116,000, but once it was processed by insurance it magically turned into $14,000 – of which insurance paid $8,400 and I paid my $5,600 deductible. So the invoice sent to me was $102,000 of fraud and bullshit – the sole purpose of which is to scare the shit out of people into paying through the ass for insurance. I just enrolled for 2020 family coverage (with moderately high deductibles) and the premium is $23,500/year. I’d consider moving to Canada if they didn’t say “aboot” when they mean “about”.

Ten years ago I would have said “if you think it’s expensive now, just wait until it’s free”. (Hardy har har har.) Ten additional years of worsening graft has changed my mind. It’s not that I’m now entirely convinced that Single Payer is cheaper or better or more fair. It’s that I’m at the point of saying “fuck ‘em.” I’d prefer to let the government fuck it up than let these corporate sociopaths continue to ass-rape people of modest means.

Within the last few days I was talking with someone who’d been a health insurance corporate executive. He moved into a different industry for a few years but says he has to get back into healthcare because there’s so much money there.

Iska Waran
Iska Waran
  Anonymous
December 5, 2019 10:37 am

And another thing… the fact that what’s covered by insurance varies so much leads prescribers of medicines to have no idea of what costs they might be inflicting on people. Almost all types of medicines have a generic version that works perfectly well in 95% of situations. So pharma’s “solution” to profits escaping their grasp is to tweak the potion a tiny bit or sell a time-released version of the exact same medicine so that they can re-patent it and charge 10-20 times as much. Then they spend millions on advertising campaigns and conventions to teach their salespeople how to increase utilization of the newer, costlier version of the same drug. Doctors often prescribe the latest version that might be infinitesimally incrementally “better” (thinking insurance might cover it) and it’s only if you say “hey Doc, I can’t afford this $700/month” that they’ll say “I guess you can use this one that’s $45 and is basically the same”. And of course, if the medicine is for your kid, a lot of people will practically be paralyzed with guilt for even thinking they can’t afford the designer version.

In places like England they use more of the tried-and-true medicines and less of the novelty ones. Sounds perfectly rational to me.

DFJ150
DFJ150
December 5, 2019 10:25 am

Bravo, Mr. Casey. No one else has dared to expose the truth about the cost of developing new medications. The FDA “approval process” mandates 4-phase trials and strictly limits what is acceptable in terms of side effects (ALL meds have some). Pharmaceutical companies make there first dollar on a new med only after the 12 year/$2 billion+ process is completed. Now the left (and the right) want to artificially constrain prices and kill the R&D process. Kiss any new or more effective meds goodbye. Not mentioned are the ~19 formulations the make it part way through this regulatory juggernaut, only to be rejected, resulting in significant investment with zero return. Streamline the process, and enact meaningful tort reform to diminish frivolous lawsuits, and the cost of medications will drop dramatically. Also, importing meds from countries which do not abide by patent laws (many of which contain no active ingredients) destroys any incentive to develop important medications by US based companies. Good luck curing your Round-Up induced Non-Hodgkins Lymphoma with aspirin!

Iska Waran
Iska Waran
  DFJ150
December 5, 2019 11:21 am

Would it be too much to ask that pharmaceutical companies not charge Americans more than what they charge in other countries for the exact same medicine?

M G
M G
December 5, 2019 11:13 am

I think these two anecdotes are interesting comparison and contrast. And, this is not a judgment, but an observation.

1 In the example of the bum I just gave, we’ve determined that some stranger is likely worth only a few dollars.

2Just the other day I got an email from someone in Aspen who’s a member of a luncheon group I attend. Most of the guys are typical Aspen rich guys. One member, who’s in temporary (I presume) financial straits, wrote that his dog has a type of operable cancer. But it’s an expensive operation, and he can’t afford to pay for it.

He’s asked the guys at the luncheon group and his other friends to contribute to the cost of the surgery.

I have zero doubt he’ll raise the money. I don’t believe in charity, for reasons I’ve spelled out in the past. But I sent him a hundred dollars.

He doesn’t believe in charity, yet he sent a hundred for the dog.

He should send $100 to TBP because we read and comment and (generally) don’t diss his stuff here.

(See what I did there, Yo? Subtle reminder about the fundraising, but potentially clever enough to inspire Casey to send a donation!)

M G
M G
  M G
December 5, 2019 10:28 pm

Doug? It would help your credibility (and mine) here at TBP if you would send Quinn a hundred dollars and tell him it was because I made you laugh and generally we don’t diss you.

Articles of Confederation
Articles of Confederation
December 5, 2019 2:03 pm

Burn the healthcare system to the ground.

http://market-ticker.org/akcs-www?post=237536

Iska Waran
Iska Waran
  Articles of Confederation
December 5, 2019 6:05 pm

Denninger says burn the whole system down. Fine with me. His (short) article shows that the healthcare-insurance industrial complex won’t tolerate even enforcement of existing law, much less common sense reforms. Let government take it over and fuck it up in a different way. I don’t give a fuck. More and more conservative people are quietly coming to the same conclusion. I’ve had conservative, upper middle class Republican people take me aside and whisper “I’m starting to think that maybe Single Payer wouldn’t be so bad”. When it comes to healthcare, we no longer have a choice between socialism and a free market. It’s socialism versus the Mafia.

Articles of Confederation
Articles of Confederation
  Iska Waran
December 5, 2019 11:25 pm

It’s just purely fucking nuts, isn’t it? Is there an industry in this country that isn’t on the take? Do they not get that the music is about to stop and they are going to be hanging high?

The existing system is doomed or UHC is doomed. What lovely options.

M G
M G
  Articles of Confederation
December 6, 2019 4:24 am

Here’s what happened when the credit collection agency sent us a letter saying our remaining balance of our medical bill had been sent to “collection.”

We sent them a copy of the letter from the Veterans Administration and a copy of the regulation and guess what?

They didn’t care. Haha… my husband had to explain to the idiot at the collection agency that FEDERAL law specifically prevented my being “balance billed” beyond what Tricare or the VA would pay.

They still didn’t care.

The collections agent didn’t quite understand English. The laws mean nothing to people who can’t read them.

His manager could read. The nasty letters stopped.

However, the medical companies still try to “balance bill” beyond the negotiated payment.

EVERY. TIME.

Next time I have to print the letter, I’ll get the regulation number for any of you former military folks who don’t know about it.

Donkey
Donkey
December 6, 2019 7:19 am

True story: I had a herniated disc (C4-C5). 2 surgeons told me I needed surgery. I decided to go to a chiropractor instead. 3 months later, I’m goo to go. I get a bill for $600 in the mail. I sent a letter to the insurance company telling them if this bill is sent to me 1 more time or if I see it on my credit report, I’m suing their Drs. and the insurance company for malpractice. Never. Saw. That. Bill. Again.

This was 12 years ago.

Articles of Confederation
Articles of Confederation
  Donkey
December 7, 2019 12:06 am

Let me tell you something, WIP. When this sucker blows, any medical “professional” who isn’t a nurse is going to be last in line if they need anything from me. If they wish to increase their spot in line, they can serve the needy now, like they should have done pre-SHTF.

Fuck ’em with a rusty chainsaw. Sideways. Especially the hospital adminstrator con artists and paper pushers. They either get out there NOW and activate in favor of a free market, or a Scarlet Letter future it shall be.