MANUFACTURED THEFT: Birds' eggs yes, health care $$$$ no!

MONDAY, JUNE 26, 2017

Part 1—Chomsky's thesis in action:
We humans!

Despite embarrassing limitations observable through the annals of time, we can develop a ton of information— though only in situations where the sharing of facts and information is culturally allowed.

This noteworthy fact came to mind as we read Friday morning's Washington Post. On page A3, the Post reported the latest facts about the various shapes of the eggs laid by different species of birds.

Youngish Ben Guarino had received the assignment, and he had hammered it out. He seemed a good choice for the task.

No, we don't do name jokes here. But before arriving at the Post, Guarino had been an associate editor at a news org named The Dodo!

Now, his editors had assigned him the task of keeping the public informed. In reaction, Guarinoa had produced a clean, crisp, highly informative, fact-festooned news report.

Why do the eggs of various birds display so many different shapes? According to the Post's report, scientists have aggressively studied the question and have acquired some good solid facts.

Banner-width headline included, the Post was now reporting those facts:
GUARINO (6/23/17): Why are birds' eggs shaped like eggs? Scientists say they've figured it out.

If a Hollywood exec dreamed up an egg, it would look like a chicken's: immensely popular, with an unblemished complexion. But the universe of wild bird eggs is far weirder and more diverse than the oval products on the supermarket shelf. Hummingbirds lay eggs shaped like Tic Tac mints—"perfect little ellipses," per ornithologist and evolutionary biologist Mary C. Stoddard. Sandpiper eggs come to peaks, in the manner of teardrops. Owls plop out tight spheres not unlike table-tennis balls.

A team of evolutionary biologists, physicists and applied mathematicians says it knows why eggs come in so many different models. In a report published in the journal Science on Thursday, the scientists linked egg shapes to birds' flight behavior. Stronger fliers, like swallows, had elongated or pointy eggs. Birds that couldn't fly so far or fast had rounder, more symmetric ones.

"Eggs are not just something we buy at the grocery store and cook up in an omelet," said Stoddard, an author of the new research and a professor at Princeton University. The story of eggs is the story of vertebrate life on land, she explained...
Hummingbird eggs are like Tic Tac mints? We pictured our favorite, the late Ed McMahon:

"I did not know that," he surely would have said.

Guarino presented a full-length report about the various shapes of eggs. After citing a howler by Aristotle, he described what we humans frequently do, though only in situations where knowledge and information are culturally allowed:
GUARINO: Stoddard and her colleagues took a more refined approach than dead Greek philosophers. They photographed 50,000 eggs representing 1,400 bird species, all specimens housed at the Museum of Vertebrate Zoology at the University of California at Berkeley.

They mapped the bird eggs on a spectrum, from the spherical and symmetrical to the elongated and pointy. If there exists a Platonic ideal of a bird egg, an ovum shaped most like all the others, it is not laid by a chicken but by a small warbler called the graceful prinia. Prinia eggs, Stoddard said, are slightly more oblong but "substantially more asymmetric."

What's more, egg shapes really aren't about the shell, she and her colleagues found. Rather, the filmy membrane just beneath the shell dictates the overall shape of the egg. When a bird begins creating an egg, the animal pumps the egg through an oviduct, a passageway of glands like a factory line.

[...]

Armed with the knowledge that organ shape played a crucial role, the scientists scoped out the relationship of eggs across the bird family tree. "In this final mega-analysis, we were able to test for the first time, on a global scale, these different hypotheses," such as the effect of flight ability or cliff-dwelling behaviors.
The Post's report continued from there. All in all, Stoddard's team had busted its ascots compiling this flotilla of facts. The Washington Post now reported those facts, just as a paper should so.

This is what big newspapers do—but only in the types of cases where knowledge of facts is allowed.

The Post was sharing all the facts about the shapes of eggs. That said, there are major topics concerning which the Post won't perform this way.

Neither will your favorite stars on corporate liberal cable. By apparent common consent, there are certain topics concerning which the most basic facts will be disappeared, in accordance with the group dynamic which lays the egg known as Hard Pundit Law.

Way back in 1988,
Edward Herman and Noam Chomsky described this counterintuitive process through their use of the term "manufactured consent." Presumably, this helps explain why you rarely see Chomsky quoted in the Post.

In what areas will the Washington Post work to conceal basic facts? One such bill may come due this week. We refer to the general topic of American health care and, more specifically, to the question of health care spending and "costs."

By way of background, we liberals face a possible embarrassment of historic proportions this week. As Kevin Drum explained last Friday, the Republican Senate may pass a bill which would, with the assent of the House and Donald J. Trump, dismantle Obamacare.

This giant embarassment may not occur, but it certainly could. If it does, it will mean that the liberal world has been left for dead by the craziest person who ever got within a hundred miles of the Oval Office, and by his helpmates in Congress.

You're going to see many pseudo-discussions of this matter this week. On your favorite cable channels, your favorite corporate stars will offer endless speculations about the way some Republican solons may vote.

Rachel will be mugging and clowning, helping you learn to adore her more fully. But on cable news, and in the Washington Post, you won't be exposed to the data shown below, which underlie ever syllable uttered in this gong-show pseudo-debate:
Per capita spending, health care, 2015
United States: $9451
Canada: $4608
Australia: $4420
France: $4407
Japan: $4150
United Kingdom: $4003
Finland: $3984
Those data are among the most striking found anywhere in the world. They're among the world's most revealing data—and they're among the least reported.

They form the background to everything occurring this week. Presumably for that reason, you aren't allowed to see those data, or to hear them discussed.

In all the discussions of health care this week, you won't encounter those data. According to Herman and Chomsky, public consent is being manufactured with respect to health care spending. On that basis, discussion of those remarkable data isn't allowed to occur.

Peculiar, ain't it? In Friday's Washington Post, you were buried beneath a pile of facts about the shapes of eggs. The newspaper told you what we've learned from the latest "mega-analysis."

But how strange! All last week, you didn't see those remarkable data about health care spending. Over the course of the past many years, presentation of those astonishing data hasn't been allowed.

The liberal world may absorb one of the most appalling defeats in American political history this week. (Or not. If we do, we will remain serenely sure of the brilliance of our own side.)

As we stare down the barrel of that debacle, those basic data about health care spending are kept from public view. Chomsky explained this long ago, which explains why he isn't allowed.

Why aren't we being shown those data? Why doesn't Rachel share them with us, along with her repeated complaints about the fact that Governor Bentley liked touching his girl friend's breasts?

If we're allowed breasts and the eggs of birds, why can't we get those astonishing data? We'll be exploring that question all week.

Spoiler alert:

To all appearances, Noam Chomsky—he isn't "Chomsky the God"—answered that question decades ago. In this case, the process Chomsky described has served to enable a giant, massive and very large case of manufactured theft.

Tomorrow: Elisabeth Rosenthal and the language of corporate crime

33 comments:

  1. How much do cars cost in the US compared to other countries (for the same or comparable models)? Is that manufactured theft too? How much is college tuition in the US compared to certain European countries or even Latin American countries? Is that manufactured theft. How much are hotel rooms -- some in Europe are much costlier than in the US. Is that manufactured theft in reverse?

    Perhaps instead of just listing a set of numbers and expecting an emotional reaction to them, Somerby might provide some actual discussion of why the numbers are what they are. But that might require some knowledge of economics. It might require some understanding of how our health care system works compared to the systems in those other countries. It might require us to understand the tradeoffs and choices we have made compared to those who live elsewhere. And that might require Somerby to invest some effort in something besides watching Maddow.

    Cue hardindr who believe everything will be fine if we just lower the salaries of those ratty doctors and nurses. Because who wouldn't be perfectly delighted to work in health care at a lower salary!

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    1. If you think comparable cars cost twice as much in Europe as they do in the US, then I've got a bridge to sell you in Brooklyn.

      College is very expensive in the US (like healthcare), not sure how it compares to college in Europe. Would be very interesting topic to investigate. Please read this book, highlighted by Somerby several years ago... https://www.amazon.com/Higher-Education-Colleges-Wasting-Kids/dp/031257343X

      No, everything would not be fine if we cut doctors and dentists pay in the US (not sure about nurses pay), but it would be a good start to start saving money in an underperforming healthcare system. I still await an explanation for why it is okay for doctors in the US to earn TWICE the OECD median for the services they render. Even by cutting doctors pay in half, they would still be in high income/high prestige jobs, and could still easily pay back their student loans.

      We could save more than cutting doctors/dentist pay by getting rid of market distortions like patent monopolies for pharmaceuticals and medical devices. Dean Bakers we could save around $300 B USD/year by public funding pharmaceutical/medical device research, much more than the $40 B USD/year by cutting doctors pay in half (I think we should to both). Why don't you want us to save a lot of money on healthcare, so we can spend it on other stuff?

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    2. College is free in much of Europe.

      I have explained several times why doctors here are paid more than in Europe, where medical training is FREE. Doctors defer income earning ability for years longer than other workers, which means they also defer starting a family, buying a house, etc. And no, they cannot easily pay back loans of $200,000 or more on half the average doctor's salary (which would be about $100,000) and still buy a house and start a family. You are being unfair. Further, the pressure to specialize would remain and there would still be shortage of doctors willing to do primary care, which pays half what specialists earn. Then there is the "yuck" factor, which arises because many procedures are unpleasant, people in pain are difficult to deal with, and most of health care arises out of end-of-life illnesses which stress families and concern difficult decisions that doctors must guide patients through. It is not a fun job. Who would do it for the amount you think doctors should be paid? Then there is the FACT that med students must get high grades in science courses to be admitted to med school. American students do not like science and math. Those who do can earn far more by going into finance or computer science, without getting their hands dirty. If you reduce the incentives further there will be even fewer science-qualified graduates seeking admission to med schools (just as occurred in education), and the quality of care will decline because the competence of those who seek medical training will decline. Then there is the problem that medical personnel do not wish to live in rural areas or remote cities. These places pay a premium because doctors don't want to live there, but the people who do live there still require care. So they pay very high salaries to staff their hospitals and clinics. Then there are the costs associated with running a practice, especially high malpractice insurance. High fees pay for those new digitized record keeping systems and other government compliance record-keeping mandated by ACA. Or did you expect that to come out of the doctor's salary too?

      You don't know the first thing about why doctors are paid what they are. You keep ignoring my explanations because they don't fit with your preconceived ideas about how easy it would be to just make cuts. Many doctors donate services to clinics and they waive patient billing and do their part of help those in need. Most donate to tax deductible charities. Many take a year or two off to serve with organizations like Doctors without Borders. They do this because they care about people and want to help them. It is the primary motivation for those who become doctors. But you think they are greedy self-serving leeches on a system committing theft. I see what doctors do and how they work and find your comments here offensive.

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    3. College is not "free" in Europe. College is often not paid for by students, but by taxpayers who subsidize their education (which can be a good thing). In the UK, at least, students do pay for a portion of their education through fees.

      At a median salary of $125 k USD/year, a physician in the US would earn a lifetime income of $3.75 M USD over a thirty year career in medicine. That is more than enough to pay back the entirety of the cost of medical school and whatever other student loans the doctor might have, which are paid back over a series of decades.

      None of your explanations wash. Doctors are the highest paid and wealthiest of all the professionals in the US. A median income of $250 k USD/year means that many, many doctors in the US (including GPs) are earning much more than this. Even with malpractice insurance, doctors do very well for themselves. I want to make it easier for us to import well qualified doctors from other countries (while compensating other countries for importing their doctors) to help to lower the doctor shortage and reduce the expense of doctors pay. I also think we make it easier for people to become physicians in the US, and deskill some of the things doctors are traditionally only allowed to do in the US, and allow NP and RNs to do more of what doctors do.

      Doctors in the other OECD countries are wiling to do the job for much less money, and they still have to put up with all the unpleasantness you mention with the job. Are they more stupid, ignorant, or foolish than US doctors?

      I do not deny that doctors in the US have altruistic motives, but through out their history in the US doctors have been very entrepreneurial and focused on practice building. They have established powerful lobbying institutions like the AMA to ensure that they can control the supply of doctors in the US through residencies and keep their incomes high. The AMA has been the strongest lobby against affordable medical care in the US for almost a hundred years.

      What should doctors be paid in the US? Well, I want the market to decide, but without all the distortions that medical lobbies like the AMA introduce. If it's good enough for automobile and textile workers, then it's good enough for doctors as well.

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    4. Anon. @ 10:09: Once again, Bob does not present policy analysis. His purpose here is to question why there is "Manufactured Consent," and why our "liberal" pundits avoid the subject of health care.

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    5. They don't avoid the subject of health care. They just don't print Somerby's favorite numbers. As if those numbers were the best way of analyzing health care spending.

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    6. The AMA is working hard to defeat ACHA and supported ACA. That's how corrupt and awful they are!

      The highest paid professionals are on wall street. You know that. Foreign doctors can work in the US but they must complete an American residency so that they learn US regulations and how to work within our bureaucracy and learn the standard of care in the US. There are differences in approved drugs and procedures across different countries, differences in who may do what under what circumstances. Some foreign training is excellent and some is substandard. Residencies are supervised and permit evaluation of each individual's competence to practice according to US standards. You think this is unnecessary, but cost is not the only factor involved in deciding who may provide care in situations where patients do not have the ability to shop around and cannot evaluate the credentials of their providers. This isn't about controlling the supply of doctors or protecting jobs (there are shortages of doctors across the US), but about controlling the standard of care in order to avoid malpractice.

      Your comparison to auto and textile workers makes no sense because most medical workers belong to unions. Doctors, as professionals, belong to a professional organization, just as CPA's, lawyers, professors, and other kinds of professionals do. The purpose of the AMA is not to keep salaries high by limiting jobs. The belief is ignorant. It is to protect against the pseudoscience, charlatanry and preying on public vulnerability represented by incompetent and untrained hucksters who take advantage of fears of patients. We are only 100 years from a past in which anyone could hang out a shingle and offer "services" that often made conditions worse and did nothing to help. We are entering the era of evidence-based medicine in which practices are tested empirically and a standard of care is established that will benefit those who need care. That is infinitely preferable. Unless you regulate training and practice, you are opening the door to the bad old days. But to you, only the costs seem to matter.

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    7. The highest paid professionals (those who have a professional terminal degree) in the US are doctors.

      We can pick the best trained doctors who wish to immigrate into the US. If some foreign doctors are not quite up to our standards, some additional training could be required. We only need to allow 50,000 physicians to immigrate to the US a year to have an impact on doctors' pay in the US, not an astronomical number.

      This book might change your view on the AMA's role in thwarting affordable, universal medical care for all Americans. https://www.goodreads.com/book/show/1084654.Harry_S_Truman_versus_the_Medical_Lobby

      Have you ever heard of this? https://en.wikipedia.org/wiki/Operation_Coffee_Cup

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    8. In my experience most doctors are financially motivated and intellectually lazy.

      (full disclosure, a remarkably close family member taught physics to med students at a well respected university and found those students to among the worst, worse than engineering students even.)

      When I visit a doctor they are basically highly paid, internet search re-affirmers.

      http://www.amednews.com/article/20100104/business/301049966/7

      I interact with a lot of doctors through a common hobby, these are highly competitive and arrogant people absolutely consumed with making more money. Mocking their patients is a common occurrence.

      MSF (Doctors Without Borders) was actually started by French doctors, and not many American doctors volunteer, when they do it is brief. MSF struggles with dealing with American greed every day:

      http://www.huffingtonpost.com/2014/10/29/obama-doctors-without-borders_n_6068634.html

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    9. Since we are dealing with anecdotes and stereotypes, bet they were surgeons and you were playing golf. If they were mocking their patients to their faces you would have a point. Teachers laugh at their students. Are they in it for the money too?

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    10. "If they were mocking their patients to their faces you would have a point"?

      Game, set, and match then, or $500,000 anyway. LINK

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    11. What does this have to do with anything?

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  2. Noam Chomsky is 88. He is saying things like the Republican party is worse than ISIS. By all means, lets all start paying more attention to him. He is an idiot, trying to stay relevant by saying inflammatory things. No one takes him seriously these days, no matter what his previous reputation might have been. It is easy to pretend to be relevant when you don't have any requirement to make real sense in the real world. Unhelpful. If this is who Somerby is chasing, no wonder he is unsatisfied with everyone he reads.

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    1. Does ISIS pose an existential threat to humanity? Let me help you out @10:16 AM- Obviously not. How about the Republican Party, does it and its Movement Conservatism component pose an existential threat to the future of mankind? As it happens, if you think about it, there actually is an arguable case to be made that: yes, it does pose just such an extraordinary threat.

      LINK

      [QUOTE] Noam Chomsky says the Republican Party is 'more dangerous than Isis'

      The US Republican Party is “the most dangerous organisation in human history”, Noam Chomsky has said.

      The academic and author made the claim during an interview with the BBC.

      “It’s an outrageous statement and when I said it, I said ‘Look, this is a very outrageous statement’”. he said. “But it’s true.”

      Asked by Newsnight host Evan Davis whether the party was really worse than an organisation like Isis, the author and academic replied:

      “Is Isis dedicated to trying to destroy the prospects for organised human existence?

      “What does it mean to say not only are we not doing anything about climate change but we’re trying to accelerate the race to the precipice?

      “It doesn’t matter whether they genuinely believe it or not… if the consequence of that is ‘let’s use more fossil fuels, let’s refuse to subsidise developing countries, let’s eliminate regulations that reduce greenhouse gases’. If that’s the consequence, that’s extremely dangerous.”

      The academic has previously claimed the Republicans are “overwhelmingly” committed to destroying human life on earth.

      Asked about the consequences of Donald Trump’s presidency, Mr Chomsky replied: “The main damage he’ll do is to the world, and it’s already happening.

      "The most significant aspect of the Trump election – and it’s not just Trump, it’s the whole Republican Party – is their departing from the rest of the world on climate change. [END QUOTE]

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    2. Equating Repubs with ISIS is emotionally manipulative. I dislike people who communicate that way.

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    3. Chomsky says ISIS and the Republican Party are not equivalent dangers. What you dislike @6:33 PM is someone daring to point out, explicitly, what is the entirely sound position regarding the magnitude of the climate change crisis, the position which upsets the sense of well being you derive from the alternative narrative you have been trained to accept.

      Maybe you're a Clinton cultist. Hard not to think back to the criticism a politician got on another occasion when he again tried to introduce this same reality into the national conversation, that time at the November 14, 2015 second Democratic presidential debate

      LINK

      [QUOTE]
      JOHN DICKERSON: Senator Sanders, you said you wanna rid the planet of ISIS. In the previous [debate] you said the greatest threat to national security was climate change. Do you still believe that?

      BERNIE SANDERS: Absolutely. In fact, climate change is directly related to the growth of terrorism. And if we do not get our act together and listen to what the scientists say you're gonna see countries all over the world-- this is what the C.I.A. says, they're gonna be struggling over limited amounts of water, limited amounts of land to grow their crops. And you're gonna see all kinds of international conflict.... [END QUOTE]

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    4. I don't know how many ISIS terrorists are in the United States right now, but they don't seem to be doing very much.
      OTOH, we have a Republican administration, a Republican Senate, A Republican House, 31 Republican governors, 32 Republican controlled state legislatures, hundreds of right wing think tanks, thousands of right wing blogs, and billions of right wing dollars all working, for the most part, for a common cause. And the are here right now, and immensely powerful.
      Be afraid.

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  3. Dowd did her usual Democrat bashing. Crickets from Somerby.

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  4. This is important: http://cannonfire.blogspot.com/2017/06/election-fraud.html

    Dowd, Somerby, others all want to treat Trump as the legitimately elected president. He isn't. The most important issue today is not health care -- that is Somerby's distraction. It is election fraud. Unless we address it, the Republicans are ISIS and they are dancing to the Kremlin's tune.

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  5. We pay twice as much -- at least -- for healthcare as they do in the rest of the civilized world.

    It's a per-capita number.

    It is a number that predates the impact of Obamacare.

    That means that before Obamacare we were paying double what the rest of the civilized world was paying for healthcare -- and unlike the rest of the civilized world a great many of us were entirely uninsured.

    We know (that is to say, we know, if we have engaged in in the research to determine facts that, like those of cost, are routinely denied to us by corporate media) -- we know that beyond the cost numbers, health outcomes in the USA are not better than in the rest of the civilized world.

    We're paying far, far more.

    And we're getting less.

    Those numbers have not been updated to reflect the impact of Obamacare on total cost versus other nations, but there's little reason to think they've changed materially.

    What Obamacare *has* done is bring far more people under the general umbrella of insurance by enrolling the uninsured and by stopping denials for so-called "pre-existing conditions."

    While those changes are actually quite positive, they haven't resulted in the political wall against repeal that Democrats anticipated. What was supposed to happen was that people would rebel against anyone taking away what Obamacare had given.

    But in practice those changes have not risen to the challenge. Too many people have found that insurance "coverage" means very little when your deductibles, co-pays and out-pocket costs prevent you from being able to actually use that coverage.

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    1. While high deductibles are an issue, the complaints are overblown and often insincere. People can choose to pay higher premiums to get lower deductibles, but if they would rather spend their money on other things and get a cheap health plan with a high deductible then they are protected from the number one cause of bankruptcy prior to the ACA, health care costs. There are also other provisions in the ACA that help them, like free preventive screening and free physicals.

      Of news reports about "real Americans" complaining about the ACA, when read carefully you find out most of those people are Republicans complaining about how "others" are getting free health care.

      Gallup has Obamacare support at 55%, even Republican support is up 10 points to 17%. While higher, that low Republican support shows it is a partisan issue for them, a very very low integrity approach to an important issue.

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  6. Reducing healthcare costs per capita to half the current rate would bankrupt many if not most healthcare providers and tank the stock market when those companies failed. $1.6 trillion would be taken from the healthcare industry, perhaps to be spent elsewhere, perhaps not. Either way the 18% of the economy that is the healthcare sector would be decimated along with millions of related jobs in the sector itself and in education and others. Costs can't be reduced without exposing how weak our economy is.

    Perhaps we should also consider the possibility that the PPP metric has serious flaws.

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    1. That's ridiculous and untrue. How familiar are you with the giant profits made in the revenue cycle billing, pharmaceutical, imaging equipment, and hospital supply industries? There are tons of people employed (at good salaries, mind you) siphoning off the $$ that we are forced to pay into the health care system by the insurance giants and pharmaceutical cartels that control it.

      Bringing up doctors' salaries is a red herring. That's not what is making U.S. healthcare so expensive.

      But yes, lots of those jobs I mentioned would probably go away, or at least they'd have to take a haircut on their ill-deserved highly profitable bonus structures only made possible by the false economy of the corporate insurance game.

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    2. Salaries account for less than 8% of health care costs. Cutting salaries won't save much.

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    3. If you run the numbers from the Bureau of Labor Statistics website you'll see that wages for the 12.36 million who work directly in healthcare make a total of about $766 billion, or about a quarter of national healthcare spending of roughly $3 or $3.2 trillion. I don't think this includes people who work for big companies that are in the healthcare sector.

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    4. 12:06 PM writes:

      [QUOTE] Either way the 18% of the economy...would be decimated along with millions of related jobs in the sector itself and in education and others. Costs can't be reduced without exposing how weak our economy is. [END QUOTE]

      That reads like the implicit corporate argument for never ending a big (cold or hot) war.

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    5. It does, doesn't it. Now try convincing not just representatives, but also their voters, of ending this war when this war also provides for a good portion of their jobs and their children's jobs. Not only that, but ending this war also destroys their retirement savings.

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  7. Yes, lots of those jobs which people want will go away. The people who want those jobs also go to expensive universities to get those jobs. They'll no longer be doing that if those jobs are not available or are quite so rewarding. So you have both the healthcare and the education sectors being dead set against reducing revenues for healthcare. How much of the economy is completely wasteful? Apparently quite a bit. Who with the power to do so has any incentive whatsoever to change this? None. It would completely wreck the system and reveal many nasty economic truths that would imperil the world view of the elite. Won't happen until it completely fails.

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  9. "It is not just that US healthcare is expensive, with price tags often far higher than those in other developed countries. We know that. At this point, Americans face astronomical prices that quite simply defy the laws of economics and -- as each of the above patients noted when they contacted me -- of decency and common sense.

    Any plan to solve America's health care mess must confront this reality: Our prices for tests, drugs, hospitalizations and procedures -- old or new -- have gone up dramatically year by year, and are vastly higher than in other developed countries. Indeed, prices for similar interventions in other countries have often declined.

    Why? The United States -- more or less alone among developed countries -- has no direct mechanism to rationalize prices for medical encounters, to insure they are at least nominally related to value. Worse still, we alone effectively allow businesses -- mostly for-profit -- to set the asking price. And, as these examples show, price and value have in many cases become completely uncoupled, allowing price to travel into the stratosphere."

    Elisabeth Rosenthal

    Why US health care costs defy common sense

    on CNN website

    http://www.cnn.com/2017/06/26/opinions/us-health-care-prices-rosenthal-opinion/index.html

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  10. From 2012, NPR's All Things Considered

    "SIEGEL: When you add up the doctors and hospitals we visit, the technicians and nurses who care for us, the receptionists who check us in, the people who file our claims, mop our hospital rooms, we are talking about a huge chunk of society. And since we're going to be hearing lots of talk about that chunk in the coming days and how we pay for all this, we thought we'd spend some time today describing it. We can't be comprehensive, but here are some features of the U.S. health care sector. First, it is huge.

    TONY CARNEVALE: The American health care system is the big guy on the block.

    SIEGEL: That is Tony Carnevale, a labor economist at Georgetown University.

    CARNEVALE: It is 16 million jobs. It is superseded in size by retail, but that makes sense. There are a lot more malls and stores than there are hospitals and dentist offices, but only by retail and wholesale. And it is a sector of very good jobs, really. It's what's replaced manufacturing.

    SIEGEL: It's more than one-sixth of our gross domestic product. And Tony Carnevale says it employs one American worker in eight.

    CARNEVALE: What is outstanding about the health care workforce is the extent to which it's female and the extent to which it's female at higher wage levels and higher education levels. This is in much the same way the manufacturing workforce - the old industrial economy - was a boy's economy. The health care economy - the post-industrial economy - is a woman's economy.

    SIEGEL: And it's an educated person's economy.

    CARNEVALE: And an educated person's economy.

    SIEGEL: People, obviously, who are doctors, have M.D.s, but there are also a lot of people with certificates and associate degrees from community colleges in there.

    CARNEVALE: Health care is the most credentialed industry, apart from education itself, in the American economy.

    SIEGEL: Our health care sector, it's always said, accounts for a bigger share of the U.S. economy than just about any other country's health care sector accounts for it. Still true?

    CARNEVALE: Still true. The Europeans are pushing 10 percent. They're at about nine in terms of the overall size of health care as a share of their GDP in general. We're at 17, and projections 10 years out say we're going to be at 20, maybe more than that.

    SIEGEL: That health care could exceed one-fifth of the economy in terms of GDP.

    CARNEVALE: That is correct. That either means that we get an awful lot more health care, or we get a lot of health care that's awfully expensive. And generally, it's about 50-50. We get a lot more health care, and the health care we get a lot more of is more expensive.

    SIEGEL: Tony Carnevale told me that when the Labor Department counts jobs in the health care sector, surprisingly they don't count people who work for pharmaceutical companies or health insurance companies. Even so, health care's share of our workforce and our economy keeps on growing.

    CARNEVALE: It's growing like crazy. In some ways, it's out of control."

    Want to reduce healthcare costs? Well if you do you're disempowering WOMEN and the EDUCATED and the CREDENTIALED!
    Absolutely no one in the powers that be would touch any of those third rails. The price will just keep going up and up folks.

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