Tag Archives: Boomer Bust

I had a great uncle who practiced medicine from the turn of the century until the mid 20th century. In the last chapter of his book “Doctor Do Tell” dealing mostly with his experience delivering medical care to the people of rural Wisconsin……he warned of the evils of “socialized medicine”. Much has changed since the time he practiced….including the willingness of health care providers to be “paid in pickles”. The evils of non “socialized medicine” have become crystal and painfully clear.
The present health care system based on the idea that competition brings about the best result is a failure if for no other reason that there is and will not be true competition. Nationalized health care can minimize system costs….if design and operation remained focused on the goal of efficient, results oriented care measured by and paying for results. A single payer system that assures and pays for results oriented care (as opposed to pay per procedure) is probably the only way that a nation can bring about maximum care per dollar expended. The only logical single payer is government. If a clear goal (as mentioned above) was the standard to which any plan was held….much better product (our health care) could be brought about for all.

Except that not everyone is going to use all they did (or should have) put in. My mother will turn 99 early next year. She is in an assisted living center that costs thousands monthly, but uses just a small fraction of the services the price is meant to cover. This is good thing. Others use much, much more than they ever did (or could have) put in.

The only solution is something based on the underlying concept of insurance. Many put in
X and a fewer number take out Y. Even in countries where there is universal government provided healthcare, the concept is the same with taxes substituted for the bulk of premiums.

The problem in the US is that the insurance paradigm is private and discretionary. Not everyone has to pay in, so healthier lower cost people opt out at a disproportionately high rate. The insurance companies are profit driven, so left to their own they simply do not want to cover those who represent a higher risk.

Average life span in the US is into the 70s. That means both individuals and companies have to think very long term to justify the equation. In a system where participation is discretionary, and the actuarial pool is private and focused on making shareholders and executives happy the following quarter, the actuarial numbers will not to add up.

Human nature simply does not work well in multi-decade time frames. Only an external entity can make the health care actuarial equation work. The ACA is bending the curve, but it is a poor mishmash trying to influence an inherently unworkable model based on private insurance and discretionary participation.

It is only strange if you try to equate health care with consumer goods. Same basic problem as trying to force market principles to “control” health care costs. It is not a market or a consumer good, and should not be.

Most members of Congress may not like it, but could easily afford, good private health insurance. To really understand they should be forced to live six months or a year in the shoes of someone who either cannot afford the insurance, or can buy insurance but not possibly handle a $5000 deductible.

The sad irony is that far more than enough money is actually being spent on health care in the U.S by citizens, employers and the government to provide excellent health care for everyone. It is the ridiculous wasteful way that we collect, allocate, bill and distribute the pool of money that is the problem.

Growing up, technology was touted as a way to make life easier for the next generation. We have arrived!

Thanks for putting a face on the other side of the immigration issue. Our country benefited greatly economically from immigration in the past. We can benefit now while helping many people at the same time.

I wonder if we as a nation can get past the frustration of extreme political self-interest and see through the pandering on the part of some candidates.

I’m hopeful but concerned.

Good point!
While there are many perspectives that can be taken on this topic, this is certainly one with a positive side effect. – Whilst I don’t think that this is the main motivation for the German government, it could indeed prove true and benefit Germany in a few years … if they succeed on integration.

On Point. One other factor in Germany’s favor is the effectiveness with which they assimilated a less skilled East Germany population back in so efficiently and effectively. We must make education and training of the new immigrants a priority so they can help our economy grow, and not just to perform low skilled low paying jobs.

As with most European countries, meetings etiquette in Germany relies on professionalism, good business sense and formality. Bearing the above in mind, together with a positive attitude will ensure good results.

Right on target. Thanks for the article. Thought: The experts who have never bought oe sold a business,,, are they experts?

Good article. The truth is that a business, any business, is not worth what the owner think is worth, and is not worth what the buyer think is worth; it is somewhere in between, but how do you convince both parties of that?

There is no question about the difficulty in the Main Street market. Another strategy besides fading into the night is to find someone to pass it on to. That likely means finding someone years in advance, nurturing them and at some point starting to share equity. Having said that, I fully recognize that many small businesses are not in a market where a successor is easy to find. While I own a small software company, it is not so easy to find someone willing to start work at 3 AM so there are fresh bagels ready by 6 AM. Thank goodness there are such folks.