Heroic Oklahoma Doctors & Surgeons vs. Obamacare and Soviet-Style Administration

Oh, this is good. You’re going to watch every second of this 6-minute video and at the end, you’re going to clap.

I told you way back in November of 2007 to Fuck Obama and His Stupid Bitch. I meant it. And I was right. Healthcare “reform.” Laf.

…Oh, and make sure to notice all the pens Obama is obliged to sign that bill with. Who do you suppose those are going to?

And oh, again, if you’re in Oklahoma, go give these heroes at the Surgery Center of Oklahoma your business.

Update: A nice little Flame War erupted over on the FreetheAnimal Facebook Page over this post. Most likely because of how I characterized it with a quote. Jesus, I love it when that happens. Nothing like a good Bottom Blow now and then.

Richard Nikoley

I'm Richard Nikoley. Free The Animal began in 2003 and as of 2021, contains 5,000 posts. I blog what I wish...from health, diet, and food to travel and lifestyle; to politics, social antagonism, expat-living location and time independent—while you sleep—income. I celebrate the audacity and hubris to live by your own exclusive authority and take your own chances. Read More


  1. Andrew on November 15, 2012 at 11:44

    Jon Stewart uses the c-word on the Daily Show:

    I guess now Melissa McEwen has to start another attack website?

  2. Nikhil Hogan on November 15, 2012 at 12:39

    Richard, you should definitely check out the American Association of Physicians and Surgeons. G. Keith Smith regularly gives presentations there and has said that the organization really leads the fight for health freedom in the US (

    Also, you might find this Vermont Health Care freedom ad funny 😉

    Here is the doctor who wrote the ad talking about his fight in Vermont.

    I think what most people are not getting is that huge non-profit mega hospitals are doing their best to crush competition and charge enormous medical bills. It’s counter-intuitive because when people think “for profit”, they think evil money-greedy doctors but the opposite is the case.

    • Richard Nikoley on November 15, 2012 at 15:21


      That AAPS site has the video in this post embedded on their site, now.

  3. marie on November 15, 2012 at 09:10

    I love the analysis of the costs under the current system, showing how the multiple levels of administration in a traditional provider raise the cost sometimes exponentially, having argued this quite recently.
    The alternative provided by this clinic is admirable.
    The link to obamacare however threw me for a loop. The film argues repeatedly that with insurance there is no incentive to lower costs….so insurance companies per se like to pay higher costs?
    Wasn’t Competition the reason Private insurance companies were given free reign here back during the Nixon administration? Competition is supposed to keep prices down….for me but not for thee?
    Richard, damn it, the link to Obamacare in the film is a non sequitur.
    Not to mention, they are saying any insurance is bad, Period.
    I don’t support Obamacare, its a compromise that gives the worst of both worlds in my view. But not because Insurance itself is bad.

    • Richard Nikoley on November 15, 2012 at 10:30

      “The link to obamacare however threw me for a loop. The film argues repeatedly that with insurance there is no incentive to lower costs….so insurance companies per se like to pay higher costs?”


      “Competition is supposed to keep prices down”

      The problem is that everyone uses the word “insurance” when it’s not health insurance but a health maintenance program (but people won’t understand the distinction in a video like that). It’s the difference between having a policy with a deductible to get your car fixed after an accident and a “policy” that covers you for tire changes, oil changes, tune-ups, nicks & scratches, brake linings, normal wear and tear. Imagine what it would cost to have a policy where every time you had the slightest concern about your car, you got to go in and have 15 minutes with a car mechanic? And, since he knows you don’t give a shit about the price because someone else is paying it, what do you suppose happens?

      Suppose further that every single car mechanic/body shop in the country is an enormous institution like a hospital or a group of hospitals or care centers with enormous top-down administrators, administrative costs, red tape, government regulations, and on & on. If you’re an “insurance” company, what do you do? Just quit the market or do you deal with the market such as it is?

      Sure, insurance companies would like to pay out less (and they do in auto repair because all of the repair places are small business and insurance companies trade referrals—lowering marketing costs—for preferential repair rates), but they do not have the leverage because the whole deal is now baked into the cake.

      But it’s the fault of the moron public, and really, the evil public in this regard. How convenient is it to be afforded unlimited services and never have to worry or concern yourself with the cost of PRODUCING those services. This is the crux of the matter. It’s anti-human, anti-rational, and anti-1+1=2.

      • marie on November 15, 2012 at 16:41

        I see where you’re coming from, but I don’t agree with some of the assumptions, like the idea that most or even many people’s health insurance is so comprehensive.
        Actually, I don’t know anyone with that kind of insurance. Most people I know either have a very high deductible or they have an “80-20” plan where they pay 20 percent up to a maximum out of pocket. Not only that, but the insurance companies have caps on the costs that they will cover for various procedures. So if the patient’s provider is charging more, well it’s up to the patient.
        All of this means that the patients Already have incentive to look for lower cost providers.
        And then, the libertarians behind this video were self-contradictory, because ‘private’ insurance, compared to ‘government’ insurance, is supposed to be competitive….only it hasn’t seemed to work out that way, which they’ve neatly avoided addressing.
        So what I was aiming at is that the Reason and therefore the Solution to sky-high costs isn’t Health insurance itself. It’s how it’s run in this country, aka goverment-industry corruption/corporatism at it’s best.
        Tiens, that’s a great send-up to launch into how government warps any market, yes?!
        I’d do it, but I’m sleepy now 🙂

      • Richard Nikoley on November 15, 2012 at 18:15

        Hmm, that’s weird, because I don’t know a single person who has an employer provided (and let’s face it, that’s the aim here, to have employers pay and 90% + of people work) who doesn’t have a gold-plated plan, including the 30 employees I used to have in my company—small co-pays on visits and scripts.

        I looked into all the options, health savings plans and such, over and over, but the savings in cost was never worth it for me to burden my employees with. I’d save a few buck (don’t recall the numbers but very minuscule), the employee would put into a plan and pay everything up to a catastrophic level, but their premiums were not reduced by much of a lot.

        I concluded—after looking over and over and over because nothing made sense—that health savings accounts are a scam for insurance companies to make even more money. Most of my employees were in their 20s.

        I would just love for a few of the idealistic crunchers around here to spend actual time actually paying for employee health care, like in writing a monthly check.


        Marie, I think you like people paying for your health care, as you’ve already posted about. So let’s just be honest.

      • Jscott on November 15, 2012 at 18:41

        I am interested in this statement, “health savings accounts are a scam for insurance companies to make even more money.”

      • marie on November 15, 2012 at 19:24

        Well that really is weird. Is it different for small business than corporations?
        Because you see, going from the examples 0f Xerox, Kodak, IBM, HewlettPackard (to name the ones in my ‘industry’ where colleagues would compared notes regularly on insurance and other ‘benefits’) the big corporations have been off-loading more and more of the cost on their employees. When I left Xerox, they were covering about 1/2 the monthly premium…for a regular plan. Those ‘gold plated’ ones were on the menu alright every fall, but the only ones who could afford them were the top executives (not even the mid-level ones) because…the company paid for it.
        It’s the same story in academia.
        And by the way….that 1/2 the company pays today on average in large corporations’ insurance plans, it’s part of the employee’s ‘overall compensation’ , aka it’s part of his salary. The employee is paying all of it.
        So this idealistic cruncher IS paying for all of health care coverage.
        The only advantage to these plans is that you are a member of a larger pool than if you did it individually and so the company plans have lower premiums than individual plans.
        As for honesty, come off your high horse!
        I do not want ‘others’ to pay for it. I Do want to pay the lower amount that I get to pay for being a member of the largest insurance pool possible…with the least administration costs at the Provider’s end because there aren’t multiple insurers with multiple coverages and multiple repayment rates etc.
        No, I don’t expect that would work for a very large country like the states, already systemically corrupt and getting worse. It does work well for the smaller, northern countries.

      • marie on November 15, 2012 at 19:32

        It works well for these countries for the same reason that anything government-run works better in smaller, more directly accountable units.
        The problem is government, as in having one, period.
        Of course it’s a bigger problem the bigger the country and the bigger the government.
        You know well where I fall on this, so yes, let’s be honest, don’t bust my chops because I called out the self-contradictory illogical arguments of your pet video.
        It is fine in naming the administrative costs and as an example of what small independent providers can do. That’s where it ends. The rest is rank nonsense.

      • marie on November 15, 2012 at 20:14

        Oh, and if you’re going to spur me to wake up enough to argue with you, I want a beer!
        Ok, I guess that means you get to call me a whore….but Then I want a beer 🙂 🙂

      • Richard Nikoley on November 15, 2012 at 20:30

        Yea, let me expound a bit.

        Way before I had money to buy insurance I called up doctors and got someone to help me for cash. Then, I bought insurance but in 1995 or so, it was dirt cheap as I recall for a Blue Cross policy where I paid everything up to about $2k in any 12-month period, then they pay the rest of everything within that 12-month period and everything for any particular condition that might extend beyond.

        I hope that’s clear. Anyone feel free to better explain how a real insurance policy and not a health maintenance plan works.

        Anyway, from day one in 1998 when I hired my first employee, I set up health insurance and a 401K, which I matched dollar-dollar (that too eventually changed, perniciously, due to myself being in the 401K and in order to keep it valid and not have contributions returned, I actually had to LOWER what I matched to employees—I’m telling you, never listen to someone in these matters who has never actually signed a paycheck from an account they own). I digress.

        I went happily along with the standard employer paid deal with enormous costs, increasing all the time, year by year, at every contract renewal. Then I heard about HSA deals and it made sense. Way lower premium, employee has skin in the game—the idea is that they then have to decide whether to spend that savings on a runny nose, save it for later or in the end, get the money back altogether.

        Problem was, at least for our size of company, the premiums made zero sense and I looked at it hard, very hard. many questions. I would be going from gold plated health care where employees paid like $10 co-pay for a visit, $100 for hospital or something like that, $10 for a prescription, something like that. So all of a sudden, I have to explain to employees how they are going to have to pay out of their savings for everything up to 2K, which I was willing to do to turn the tide, but the actual difference in premium to the company was miniscule. Don’t recall the numbers but it’s on the order of OK, instead of $10k per month, $8,500. And the employee—20-yr-olds, mostly—are paying for everything they got before for those small co-pays.

        I could not in good conscience do that to save a thousand bucks or two per month.

        Does that make sense?

      • marie on November 15, 2012 at 20:45

        Yes actually, it does. Thank you. Small business gets a bum deal to being with… and a Conscientious small business owner will get the worst end of the stick. That sucks.

      • Richard Nikoley on November 15, 2012 at 22:02

        “Is it different for small business than corporations?”

        I have no idea. I ran a business with 20-30 employees over a long period of time and covered 100% of the health insurance premium. It had no relation to hourly pay or salary.

        Maybe you ought to work for a small business, or start one.

      • Richard Nikoley on November 15, 2012 at 22:03


      • Richard Nikoley on November 15, 2012 at 22:07

        ” don’t bust my chops because I called out the self-contradictory illogical arguments of your pet video.”

        Oh, is that what you did? Really? I missed noticing an argument. Seriously. I have no idea.

        Tell me, Marie. What are those surgeons in Oklahoma doing wrong?

      • Elenor on November 16, 2012 at 04:13

        The vid didn’t mention what this surgery center does about patients who can’t or won’t PAY for their surgery… (I’m reminded on private schools, who pick-and-choose their students and then say: “See? EVERY school can achieve this level of educated children, if only they want to!” Only if you can throw away the ones who can’t or won’t do! It’s not a process problem, it’s a purchasing/raw materials problem!)

        I’m torn. I love the idea of transparency in pricing. I’m one of those home-owners/business-owners without insurance, paying WAY more than I can possibly afford for a night in the ER with a kidney stone (ending in an $8,000+ bill!). They didn’t DO anything except pain meds (blessed, blessed pain meds!) and a CAT scan to diagnose. (Treatment would come later through some other doctor… Couldn’t afford that, but I had a scrip for more pain meds so I could (had to) wait till I passed the stone…)

        And I don’t GET to say, screw it, I can’t pay, so I won’t pay. No, no, *I* get to pay more than “my fair share” (or more, even, than actual costs!) because the hospital sticks it to the (home-owner) uninsured to make up for the negotiated fees of the insurance co’s. My CAT scan cost twice what an insured person’s does, because *I* don’t get a negotiated cheap price… I pay full-price (and then some) for everything because they CAN charge me that!

        “I do not want ‘others’ to pay for it. I Do want to pay the lower amount that I get to pay for being a member of the largest insurance pool possible”

        Whatinthehell do you think insurance IS except other people paying for your care?!? If YOU get to pay the lower amount, who do you think gets to pay the larger amount to make up for it?!?

      • shelley on November 16, 2012 at 07:23

        Elenor – kidney stones suck!! And I could have provided you with my neighbor’s name down the road who could have provided those blessed pain meds for way cheaper than $8k (one of the downsides of living in FL, the land of pain meds).

        I wonder if my previously minor kidney stones were a result of my periodic high protein, LC binges. In light of this, I have traded 5-10 extra lbs and make sure I eat enough carbs in order to avoid the potential of a repeat of kidney stones. I have also started drinking a Natural Calm magnesium drink every night or so as a prevention since I read somewhere that the Mg offsets the Ca. On the plus side of Mg, I realize that I never really slept.

        As an aside, I regard this “alternative” medicine as a positive in comparison with our current drain on healthcare because if we can fix it by home remedies then we all win!

      • marie on November 16, 2012 at 08:23

        Richard, you’ve addressed the small business aspect twice in response to me, I’ll take the first, thoughtful response., thanks Again. What, did you soak up some Johnny Walker in the couple of hours between responses one and two and decide to bang the table? You Still owe me a beer. 🙂
        I also explained what insurance is really like in big corporations and academia, there is nothing all-encompassing or gold-plated about it, the employee is essentially paying the whole cost since it’s part of their ‘compensation package’ and they have caps and deductibles and 80-20 plans and copays that make it important for them to ‘shop around’. So the whole idea that it’s the insured that allow the high costs because they have no incentive to shop around is DOA.
        Yes, the video does make the argument that having insurance is the problem. A few times.
        As for what the Oklahoma surgeons are doing wrong, nothing, I’ve said it’s admirable and that the video was good at showing that.

      • Richard Nikoley on November 16, 2012 at 08:35

        “You Still owe me a beer.”

        I already gave you a 🙂 back on that, only it was out of line with the thread because the nesting limit had been reached and everything stacks up chronologically after that. But its THERE! 🙂

      • marie on November 16, 2012 at 08:43

        What the hell do You think insurance is? The insured Are paying for it, through the nose, and On Average (across everyone in the pool) any one person pays More than they use for their care, otherwise the insurance company wouldn’t be making any profit !
        As for hospitals charging you More because you’re uninsured, maybe that’s in your area, I wouldn’t know. I do know that in my area they charge less, a lot less, for the uninsured. That also seems to be the case with friends in various urban or suburban areas. It makes your assumption that in general the uninsured are somehow covering the insureds costs untenable.

      • marie on November 16, 2012 at 08:46

        Richard, I see it now. Merci, cheri 😉

      • Richard Nikoley on November 16, 2012 at 09:55

        Marie, Elenor.

        Insurance is a calculated distribution. The idea is that you spread the cost of your misfortune over a long span of time by paying monthly and when it’s all said and done, the vast majority of people have paid some measure more than actual cost, in exchange for the convenience and peace of mind that they won’t be hit with an enormous bill at one time they have no hope of paying.

        At the extremes of the distribution are those who win and lose big on that deal: those who pay a little and reap a lot from a huge downfall and those who pay in all their lives and never needed it.

        This works in excellent fashion in markets like homeowners, auto, etc., which are pretty excellent bargains. For instance, in 2003 me purchased a vacation home in the mountains, the homeowner’s insurance was $600 for the first year, six week later the place burned, and it cost the company about $150,000. I don’t know how much I’ve paid in auto-insurance over the years in total, and other than smallish claims here and there, I did get hugely rear-ended once—and it was a new SUV—and the repair bill was about $12,000. While in France, a girlfriend totaled the Corvette I shipped over. Another 12-13K or something like that. So, for me, homeowners and auto have been marvelous services.

        Health “insurance” isn’t insurance at all. It’s health maintenance. So imagine what my homeowners and auto would cost if I it included a top down cleaning every few months, repaintings, tire changes, oil changes, etc. etc.

        This is the CRITICAL distinction virtually nobody ever talks about. And that is: we aren’t talking about insurance. There is no way to distribute a business profit model and this is why government has to step in and this is why ultimately, it requires the theft Wooo adores.

      • Richard Nikoley on November 16, 2012 at 10:39

        “The vid didn’t mention what this surgery center does about patients who can’t or won’t PAY for their surgery… (I’m reminded on private schools, who pick-and-choose their students and then say: “See? EVERY school can achieve this level of educated children, if only they want to!” Only if you can throw away the ones who can’t or won’t do! It’s not a process problem, it’s a purchasing/raw materials problem!)”

        Elanor. Their prices are right on the web. Go check them out and then tell me they are doing business for the elite, as though they’re some cosmetic surgery center in West Hollywood.

      • marie on November 16, 2012 at 10:51

        Richard, yes, that’s how I understand insurance too. My only contention is this idea that health insurance is different animal, health maintenance. That to me, btw, was a nifty marketing term that insurance companies used to appear to be your friend. The reason I don’t believe it is because of my own experience of course and that of colleagues across several large corporations.
        It would be interesting to find out what percentage of insured people today have any of these gold-plated health maintenance plans that pay for everything and apparently at no additional cost to the insured or at a small fixed cost and with no pay schedule for different procedures, no caps per procedure, no lifetime caps, no in-service providers fee schedule vs.out-of service providers fees, no 80-20 plans, etc.

      • shelley on November 16, 2012 at 11:01

        Richard – I’ll add to your health maintenance by giving an example: my children’s pediatrician told me that I was expected to bring my boys in every year and that I was being negligent for the past two years, to which I told her there was no reason to come in since they weren’t sick so I didn’t see a purpose. But she said, we need to keep track of their growth to ensure everything is going as planned.

        I think mainstream doctors are also culpable for confusing the lines on health insurance for catastrophic events and health maintenance which is better suited for home remedies and walk-in cash clinics.

      • Jscott on November 16, 2012 at 16:13

        ON HSA…

        Then I heard about HSA deals and it made sense. Way lower premium, employee has skin in the game—the idea is that they then have to decide whether to spend that savings on a runny nose, save it for later or in the end, get the money back altogether.

        Understood. We had that same issue years back. Rules have changed a bit. Plus, with so many in my industry being 1099 people the strategy is a bit different (and easier for employers).

        From a personal standpoint I do an HSA coupled with a High Deductible plan.

        -$3,100 bucks a year tax free into an account that I can invest or play with a bit and use for health issues (though they stripped the OTC stuff which blows).
        -If I do not use the money it rolls over plus the next year’s $3,100.
        -If I do spend up to the deductible it moves to 100 percent coverage no max.

        Of course, there are the loopholes of loopholes that they can get out of paying. I do not visit the doc much outside of blood testing (I use some of my HSA for that) and other experiments. As I age things might need to change.

        The closest other plan I could find was the same amount (about) yearly as my HSA But there were maximums and if you did not utilize services you had nothing to show for it. Which, it seems to me, encourages people to visit the doc for anything right up until their EOY calendar date rolls around. Would not want that medicine on a payment plan go to waste after all!

        Outside of rules constantly changing, the only downside is that you lose 300 bucks a month (or whatever you decide you can put in) in discretionary spending. Unless I am blind to something.

        Not sure what will be happening now with all this.

      • Ann on November 18, 2012 at 12:34

        Marie – agreed. Our insurance costs have increased steadily over the years. The company my husband works for shops around as well, changing plans every few years, whether we like it or not, and our benefits have declined while our cost keep multiplying. In addition to that, our employer contributes less each year, and the insurance companies come up with new policies for fewer things they cover, while adding additional charges every year. Now, in addition to co-pays and deductibles, this year we have had a $4500. “co-insurance” amount we had to pay, which effectively raised our deductible to $5000. this year.

        I guess it wouldn’t be so bad, as we have a livable income, but with gas prices continually on the rise and food prices skyrocketing all the time, things like that make it really hard to enjoy a good quality of life. Not only are we continuing to cut costs every year to meet the limits of an income that only increases by 2% per year, but it makes the future seem like an even more worrying place than it already is.

        I said to my husband once “why can’t we just take what the company offers us as an insurance contribution, put it into a savings account, matching the funds ourselves, and then spend the money on the healthcare needs we see fit? He told me that the employees had already asked that question and the company told them that most of the contribution went to “administrative” costs, and that what they would give us would only be around $25. per month.


        So why on paper are they able to claim they are contributing a little over $500. per month, and we have to call that “income”???

        Richard, I don’t expect you to feel for those who don’t have insurance, as from reading this blog for a while I really think you are fairly “dog-eat-dog” about social issues. However, I do get peaked when I hear people make comments such as

        “why should I be forced to pay for all the diabetics and people with arthritis and heart disease that should have known better and didn’t do what they should have?”

        Well, I for one don’t blame a lot of those folks, because I know plenty that were following the crappy orders of their crappy doctors who probably still insist they eat a “balanced diet” complete with “healthy whole grains” and prescribe high-carb diets for diabetics. You can definitely blame plenty of costs on doctors being taught that it’s just as good to prescribe a pill to “treat” the problem rather than to use good dietary advice before hand and “prevent” the problem. Until this country goes back to square one and changes the grip pharmaceutical companies and corporate food have over the A.M.A. and our medical schools, we are screwed from the ground up.

        So yeah, with things the way they are for so many struggling families, the “99%” you might say, I am ready to try a different system. What we saw in the video was very uplifting, but lets face it – it’s just not how most American medicine works-

      • Richard Nikoley on November 18, 2012 at 15:35

        “Richard, I don’t expect you to feel for those who don’t have insurance, as from reading this blog for a while I really think you are fairly “dog-eat-dog” about social issues.”

        I’m not dog-eat-dog at all. I just think healthcare ought to me a market, like auto repair or home repair.

        If it was, there would be insurance that works, just as auto insurance and homeowner’s works marvelously and is pretty easily affordable for most people.

  4. Audrey on November 15, 2012 at 10:12

    Christ, it’s so slanted, Richard. It’s just a Libertarian hit piece.

    You really believe anything you hear, as long as it fits in your paradigm.

    Did it really not occur to you that the cost structure of a tiny surgery center SPECIFICALLY DESIGNED by its doctor-owners to self-deal high profit patients might be a bit different from that of the neighboring full-service hospital that’s required by law to run a full ER, regardless of ability to pay?

    Didn’t think so.

    By the way, not to hurt your brain or anything, but you might be surprised to know who came up with “Obamacare”:

    • Richard Nikoley on November 15, 2012 at 10:23


      So you like Nixon? Is that your stupid point?

      Nixon was a shitbag and if memory serves, I have a “Fuck Romney” post up somewhere. Bush too. I may have missed King the 1st, though. Sweet guy. He cries easily.

      You binary thinkers crack me up.

      Now, Audrey, here’s what I want to know, because I really loath stupid posturing bullshit. What do you have against The Oklahoma Surgery Center and its in-house surgeons, not to mention the surgeons who work in other hospitals but still do surgery there.

      “Did it really not occur to you that the cost structure of a tiny surgery center SPECIFICALLY DESIGNED by its doctor-owners to self-deal high profit patients might be a bit different from that of the neighboring full-service hospital that’s required by law to run a full ER, regardless of ability to pay?”

      Gawd how stupid. Go right now to your yellow pages. Tell me how many pages of auto repair shops and body shops there are. This is the whole point of the deal. Medical care, food, drugs, government, and virtually everything…DOES NOT SCALE.

      This IS the point. …Though you’re welcome to persist in your perpetually unworkable fantasies. Because you are just dumb.

    • Richard Nikoley on November 15, 2012 at 10:52

      BTW, Audrey. I’m anxious to know how how a few “tiny surgery center[s]” in, say, NYC, Chicago, Dallas, SF, Miami, LA, etc. wouldn’t work?

      “self-deal high profit patients ”

      See, that right there is your very, very stupid lie. Their profits are whatever they are, but they come—obviously to anyone but an abject moron—from lowering costs. I know, it’s one of those mundane business thingies that’s so outdated. Much easier to lobby government to institutionalize everything and nobody has to worry about costs, thanks to Gutenberg.

      If you watched the video, you can plainly see how the price of a procedure can be orders of magnitude higher, like 6, 7, 10 times or more. Doesn’t sway YOU. No way.

      “required by law to run a full ER”

      Yea, so let’s have an enormously bloated system that includes taking anyone and everyone’s temperature at no cost, so we can run an ER.

      Dr. Doug McGuff, call your office.

    • Bets on November 15, 2012 at 13:20

      What, Wooo? Are you saying carpal tunnel surgery isn’t a major procedure? Next you’ll be pissing all over botox injections!

      The Libertarian Way:

      (1) Privatize Profit

      (2) Socialize Costs

      (3) Take victory lap

      (4) And if anything goes wrong, CALL 911!!!!

      • Richard Nikoley on November 16, 2012 at 16:12

        “(2) Socialize Costs”

        Find me an actual libertarian who was for a single one of the “too big to fail” bailouts.

    • Richard Nikoley on November 15, 2012 at 15:17

      “but none of them can accomplish what real hospitals can.”

      “Can that doctor do a heart transplant? Nope.”

      OK, everybody out of the pool. No more diving practice today. Sorry, you can’t do triples, so I’m giving up.

      Jesus. The mind boggles.

      How in the world did anything get done before organized theft?

    • Elenor on November 16, 2012 at 04:22

      Woo: “And as you said the whole model falls apart when it comes to emergency cases, because as human beings we need to … do something if people are going to die.”

      Whew! Guessing YOU have never been in through an ER, have you? Where illegals with a cold, or a baby with rash come in for “free” care? Where the ER is mandated not just to treat true emergencies, but to treat WHOEVER comes in, for whatever they want?! Emergency or not?! Intention to pay or not? Shit that idiot Romney actually said that folks without insurance could go get treatment in an ER “for a couple hundred bucks”! (Try $8,000+ for a simple – and untreated! – diagnosis of a kidney stone! THAT was an actual medical emergency: I thought it was an ready-to burst appendix; and I used to be Medical Affairs Director for an ambulance corps… I KNOW when symptoms need emergency care!)

      Woo: “make ERs more efficient and lest wasteful, though.”

      It’s not about waste — unless it’s the careless waste caused by people pretending to need emergency care so they can avoid the bill! Certainly the legal system needs some kind of … emergency care…. but until we stop requiring ERs to treat anyone and everyone regardless of ability to pay… and regardless of whether or not their presenting symptoms are an emergency, this cannot be fixed!

  5. Audrey on November 15, 2012 at 10:34

    It’s not scale, genius. They are creaming off the profit and letting the public cover the expensive stuff. Then they’re shooting their bullshit “documentaries” where they pretend to be efficient.

    Yes, you can get a security guard from Joe’s Security Guards cheaper than it costs to put a cop on the street. That’s because the security guard from Joe’s is a moron who doesn’t have to meet any standards — but most of all, it’s because when the going gets tough, the security guard from Joe’s CALLS 911 when anything real happens.

    But you keep on enjoying your wild man fantasies, Richard. Don’t strain that brain!

    • Richard Nikoley on November 15, 2012 at 13:20


      You are simply too stupid to toss any pearls before your swineness.

      Feel free to follow the comment thread, though.

  6. Jack Kruse on November 15, 2012 at 11:38

    My hospital fought me ten years to get my cases all done in their facility and I would not do it. This video is epic truth. The real story is even more shocking. Soon that will be out in the sunshine too.

    • Richard Nikoley on November 15, 2012 at 12:49

      Thank you Jack.

      I have zero doubt in the world that this is truth and would be echoed by more honest physicians and surgeons than could be easily counted.

      The entire morass of the thing is baked into the cake, as I described in my comment response to marie in this thread. This could be a way out or even partially out. For many years before I had enough money to buy a catastrophic policy, I always opened the Yellow Pages, called doctors and negotiated for a service. This was up until 2001, and it began when I left the navy in 1999, so 12 years I went it alone for things like plantar warts, knee injuries from bad hang glider landings, and a bunch of other stuff. It can be done and the essential problem is that people have been taken out of the cost equation, which works for everyone but the patients.

      • rob on November 15, 2012 at 13:26

        I had gold-plated health maintenance insurance until 1995 (working for the government), then paid the bill for a small group plan for a few years which totally reamed me (started a small business), then went to catastrophic, I just wish there were more options in the catastrophic area. As I get older my need for health insurance becomes less and I would like the option of a higher deductible but the options from solid companies are limited in my state.

        I think a reasonably intelligent person can and should put a little effort into researching their situation before resorting to medical professionals, if you are paying something towards the cost of the medical services then I think you will naturally do that.

        When I had the gold-plated insurance I once went to a doctor when I had the flu. I was getting paid to be sick, and the doctor visit cost me nothing, so I thought “What the hell.”

        The doctor’s consultation consisted of him telling me:

        1. You know you have the flu
        2. You know there is nothing I can do for you
        3. You exposed me and my staff to the flu anyway

        A lot of people would think “That doctor was a jerk,” when in fact I was being the jerk, I was taking advantage of his services because there was no out of pocket cost, I was being a selfish asshole.

        Now I tend to do some research and give some thought to the matter before I seek assistance from medical professionals, and the result imo has been appreciation, doctors and nurses like it when I do not waste their time, they like it when there is actually something they can do to help me.

        As opposed to “I have the flu, make it go away, and by the way your time doesn’t cost me anything.”

      • Elenor on November 16, 2012 at 04:27

        Rob: “reasonably intelligent person”

        Ha. All 18 of us?!

        (A big) Part of the problem is: most people are too stupid or too lazy to learn anything about their health! Even many, probably most, of our paleo brothers and sisters, willing to learn a ton about food and health, know pretty much nothing about triaging symptoms to determine what level of medical care might be required. Partly because the insurance system has trained them out of it (as you wrote: go to the doc even though you know there’s no reason…) and partly because they just don’t know and aren’t interested in learning… And our paleo folks start OUT way smarter than the average human!

      • shelley on November 16, 2012 at 07:29

        Elenor – “Rob: “reasonably intelligent person”

        Ha. All 18 of us?!”

        Ha. I just watched Idiocracy for the first time – there were only two! An absolutely stupid movie, but I must admit that I look at people a whole lot differently now and feel justified when I think most are as stupid as a bag of rocks.

      • Jack Kruse on November 15, 2012 at 14:38

        Rich I went back on my hard drive and found this you might be interested in:

        Hospital Affiliated Docs Paid More
        Biloine W. Young • Tue, Sep 18th, 2012

        A Wall Street Journal report, reported by writer Molly Gamble August 27 in Becker’s Health Care, puts the cabash on the idea that a hospital’s acquisition of physician practices increases efficiency. The report states that there has been a fivefold increase, since 2000, in the number of hospital-employed specialists who see patients in hospitals. The number of employed primary care doctors has gone up to 40% in the same time period.

        The report states that doctors employed by hospitals generally receive a higher reimbursement because hospitals can negotiate larger reimbursement rates with commercial payers due to their stronger market power. According to the report, Medicare pays more for certain procedures if they are performed at a hospital.

        The Becker’s report states that a 15-minute visit to a physician may cost Medicare about $70 at an independent practice whereas it will cost closer to $124 if it is billed as a hospital-outpatient service. The report cites prices from WellPoint, Inc. for spine MRIs in Nevada where the procedure costs $319 to $742 at a freestanding clinic, but $1,591 to $2,226 at a hospital.

        Becker’s quotes Juan Davila, senior vice president for network management at Blue Shield of California, as saying, “there is a tangible, or sometimes really, really high increase in what we pay doctors once a group links up with a hospital system.” Richard Umbdenstock, CEO of the American Hospital Association, said, “You put a hospital name on something, and the expectations change immediately,” according to the report.

        There you go……….

      • Richard Nikoley on November 15, 2012 at 15:33


        It’s just really cannibal pot hysteria. Who goes into the pot and who gets to feast. The government is all about enticing people into believing that no matter what, they get to feast and no matter what, there will always be enough in the pot.

  7. michael on November 15, 2012 at 11:49

    The system is clearly broken. Obamacare is only going to make things worse (companies leaving the country or downsizing for health costs which will obviously add to unemployment). One could argue that these may be the cost of implementing the health system, but “free” health care is only going to compound the real issue here. This is discussed in the video, it’s INSURANCE! I’m not talking about accidental insurance like one most likely has on their vehicle or house, these may be overpriced, but they save someone major pain in the event of something out of their control (and people pay this insurance out of pocket, not through some universal smoke screen like people with full health care). It’s insurance on what I’d call maintenance items, that it truly the problem.

    Having private centers like the one in the vid seems like a good start, but I fear is not a complete solution to the problem, and that’s HEALTH. People maintain their car (oil,tires, general maint) b/c they know if they don’t the car will break, and will have to be fixed out of pocket. Switch over to health and it boggles my mind how “maintaining proper health” is not at the utmost of importance in daily life. When you have some magical sugar daddy (health care) paying for your consistent screw ups, you will never learn.

    Here’s a simplistic view of what needs to happen;
    1)Have more private practices like the one in the vid educate the public on how much things really cost.
    2)If one must insist on a national health care system, make it for out of control emergencies and body defects (both from birth & our polluted world). Yes, this will get mucky, as everybody will try cheat the system, but fuck, people have to understand all money comes from you. The less you try cheat the system, the less taxes we would be paying. Extra money at the end of the year for if we smarten up.
    3)All other health needs need to be covered by the individual. If I get sick, or become unhealthy, it’s my fault, and others should not have to pay for my negligence.

    This should lead to wages going up, b/c companies will be pay lower insurance costs, and the whole system will only work if people have incentive to not use their wage increase on “realistic health costs”

    The whole system depends on being healthy (which by the looks of things, the country does not want). I personally enjoy being healthy, it’s important to me, but putting that aside, if you told me I have the option of having money to go on a couple vacations or purchase something currently out of budget, or use the money to fix things in my body I’ve ignored over the year (which I could have been maintaining during the year), it’s an easy decision which I’d choose.

    Here’s to health and our future.

    • Richard Nikoley on November 15, 2012 at 14:58

      “I’m not talking about accidental insurance like one most likely has on their vehicle or house, these may be overpriced, but they save someone major pain in the event of something out of their control (and people pay this insurance out of pocket, not through some universal smoke screen like people with full health care). It’s insurance on what I’d call maintenance items, that it truly the problem.”

      Bingo. I discussed this is the reply to Marie.

      As to the rest of it, humans are pretty competent at managing costs, shopping for bargains, etc. They just need to know what the costs are and life needs to remain costly, if you know what I mean.

      • marie on November 15, 2012 at 16:44

        Not really Richard, see new reply in that thread.

      • Richard Nikoley on November 15, 2012 at 18:21

        No, really. I did discuss it in the reply.

      • marie on November 15, 2012 at 19:50


  8. Joshua on November 15, 2012 at 12:38

    That was kind of weak for a flame war. Definitely not enough to keep me warm at night.

    You keep saying bottom blow… sounds… nevermind.

    It’s not your job, of course, but it wouldn’t hurt to briefly describe or link to an explanation of why US health care is indeed nearly twice as expensive as other nations’. I assume that it’s obvious to you that
    -the regulations surrounding health care add huge amounts of cost
    -that our tort system is hugely friendly to initiators of lawsuits
    -that the REAL customer (patient) has been so monetarily far removed from the service providers that the market is broken,
    but I understand that it’s not exactly intuitive to people who grew up with the assumption that Godfather Government is supposed to take care of everybody.

    Note to anybody reading: don’t EVER EVER EVER let anybody get away with calling US health care a “free market”. It is anything but. US healthcare is indeed dysfunctional, but blaming that dysfunction on the free-ness of the market is ignorant and absolutely counterproductive.

    • Richard Nikoley on November 15, 2012 at 15:07

      OK, Joshua.

      A “bottom blow” is a Navy ship term, actually, specific to steam ships with boilers. Boilers make steam (1,200 psi superheated in our case). The construction of a boiler is such that you have a big “mud drum” at the bottom and a smaller steam drum at top. with the pipes running between the two and atomized burning fuel oil under pressure in the chamber is what makes go-go.

      Thing is, we paid meticulous attention to water chemistry, to protect the pipes from corrosion. Still, over time, water leeches sediment which settles in the mud drum at the bottom. Every day or every few days, we open a valve at the bottom of that drum that goes right out the side of the ship, and you dn’t need to pump because it’s at 1200 psi. All the sludge and sediment from the bottom of the drum/barrel gets blown right out.

      Bottom blow. Best metaphor ever for a whole lot of things.

    • Richard Nikoley on November 15, 2012 at 15:11

      Christ, Wooo.

      Too way all over the place, conflation galore, astute mixed with ignorant. Least you didn’t slam those good folks in Oklahoma doing something valuable and different. You can actually go to their website and see the actual cost for every surgical procedure they do.

      I’m going to just be satisfied you din’t do that.

      • Richard Nikoley on November 16, 2012 at 15:18

        “could never ever ever ever”

        Where have we all heard that before. It’s funny how we never learn that it’s always always always bullshit and in fact, over time, most dreams and aspirations of things to come one day that get shot down by never ever ever turn out to have undershot the reality.

        And no, I’m not talking about science fiction.

  9. Joshua on November 15, 2012 at 12:55

    “Freemarket sorts it out”. Okay, we tried it at the beginning of the industrial revolution, of allowing employeers to do whatever they wanted to workers: kids dying in factories and people basically being worked to death didn’t work out then, either, and so labor laws and unions and things like that came into play.
    You know how things started to get safer after OSHA was formed? Yeah – that didn’t happen. Things had been getting safer all along. Work got safer and more pleasant because we got richer. We got richer because we got more efficient.

    I actually don’t give two shits about a “market” but I think that freedom will help us sort things out. Health care is not free, and acting like we can make it free is a recipe for disaster.

    By the way, when it comes to health care, I’d rather have the French system than the English or Canadian systems. The patient still has SOME authority there.

  10. Lorenzo on November 15, 2012 at 15:30

    I don’t find this video to be an indictment of hospitals so much as of insurers. After all, every extra dollar they pay to the hospital actually comes out of their pockets. And they should have much greater expertise to determine what is and isn’t really needed. Yet they focus on which procedures, and which drugs, instead of how much the drugs or procedures cost. If you are looking for stupidity I think you can find plenty there.

    • Richard Nikoley on November 15, 2012 at 16:32


      Look beyond. Insurance companies are not loosing money. Costs are out of control. So what’s going on?

      I know, but can you and others figure it out?

      • Lorenzo on November 15, 2012 at 18:00

        They may not be losing money, but they certainly aren’t making as much as they ethically could.

  11. Dainon on November 15, 2012 at 15:43

    This only works under the assumption that employer provided health care is required.

    Why is it? Why isn’t health care actually insurance? Why isn’t it individually purchased? Because inertia following salary limits-with-reclassifying-benefits that occurred around WWII. This is the direct result of bad taxation policy, under the guise of ‘helping’ people.

    “Companies refuse to offer benefits so they can increase their profit”. This wouldn’t be an issue if insurance was purchased by individuals (even if it meant higher wages for the employees, which they could choose how to spend), as all labor would then be a marginal cost. The agreed upon part of all economic theories is that when price increases quantity demanded decreases for normal goods.

    The flip side of this is what many companies affiliated with the United Ironworkers’ Union (an example with which I am familiar) do: Whenever their is a demand increase, they increase existing employees to 55+ hours per week (even though 40-55 hour labor is time and a half and 55+ is double time). This work rate can run 40 or more weeks per year. This is done because adding an additional employee’s benefit package is more expensive than the overtime, even ignoring the lower production rates at the higher work hours.

    So yes, quality of life for workers has decreased, but as much for reasons you don’t acknowledge; one of the main issues is an increase in overhead costs per employee.

    • Richard Nikoley on November 15, 2012 at 16:49

      “following salary limits-with-reclassifying-benefits that occurred around WWII.”

      Dainon. Shut up. I’m doing everything I can to keep Woo ignorant because it’s fun.

      (no, she has no idea how employer health care came to be in the first place, AS AN END AROUND GOVERNMENT. But, y’know, I’ve only been at this stuff for 20 years.)

  12. MC on November 15, 2012 at 17:18


    “The health care problem is not black and white, as if it is just *as simple* as making people responsible for their own bills. That’s going to be part of the solution, and it’s not because the free market solves everything, but quite the opposite – Ironically, *less* corporatism/capitalism is the reason the bill is able to be lower.”

    MC: Corporatism is not capitalism for one thing. Without government paying for these bills or forcing others to pay, you think a corporation can charge $400 for a steroid injection or whatever? Corporations + Government = Fascism. Not capitalism. I hate how people have no clue as to what capitalism is.

    “Obamacare is basically telling employeers they aren’t allowed to rip off the public anymore by making them part time or per day workers and simply not insuring them. This scam has been going on the past few decades, you know – employeers refuse to offer their employees benefits so as to increase their profits. They can’t do that anymore. This does not build anything like a healthy society, where we allow our corporations to just exploit labor and treat them like disposable objects they can throw away with.”

    MC: Why should others have to give you benefits. The benefits you get is that you get paid to work when they hire you. Nobody owes you a job.

    ““Freemarket sorts it out”. Okay, we tried it at the beginning of the industrial revolution, of allowing employeers to do whatever they wanted to workers: kids dying in factories and people basically being worked to death didn’t work out then, either, and so labor laws and unions and things like that came into play.”

    MC: No, the reason why kids worked in factories was because people were too poor to not have their kids work in factories. It’s not like society and parents hated children and thought of nothing better to do then to send their kids to work in a factory. It was necessity. And you know what got kids out of working in factories? Technology and Capital. Increased productivity from workers, is what allowed for society to get wealthier. Wealthier societies don’t need to send their kids to factories because they are wealthy. Improved working conditions are also a product of increased capital and technology.

    Capitalism is why America became wealthy, increased productivity = a better standard of living for the workers + a wealthier society. They were able to purchase more with their salaries, so they didn’t need to send their kids to work anymore, and could now do something like send them to school.

    If you pay attention to the history of the industrial revolution, you will see how society got wealthier throughout the 19th century. It had nothing to do with unions or labor laws.

    • Richard Nikoley on November 15, 2012 at 18:48


      Please stop trying to cure Woo’s unbridled ignorance in terms of the history of trade capital, markets, entrepreneurism, government seeing a good thing and taking control, etc. etc.

      Smart but ignorant people are fun to watch. I’ve been a fan for 20 years. Guess what often happens?

      OK then, go ahead.

      • MC on November 16, 2012 at 17:31

        “Guess what often happens?”

        I have no idea what happens. I just hate to see people not know their terms, not know their history, and think they can rewrite it to suit whatever nonsense they want people to believe. It’s like hearing Obama speak, and knowing just enough to call him out on his bullshit, and just enough to get frustrated when they clap for his bullshit.

        Plus I’m just young enough to still try and change the ignorant. Give me a few years, and I’ll see where it takes me.

      • Richard Nikoley on November 16, 2012 at 18:01


        What often happens, not always but frequently enough that if you’er patient–or they are with you continually slamming them–their position hedges and hedges and changes over time. Been at this a long time and I’ve seen it enough to keep me at it.

        My motto: You’ll come to me.

        They say that you can’t reason a person out of a position they didn’t reason themselves into, but it’s not wholly true. In the short term, yes. Over a long time, not always. People do change their minds.

    • AndrewS on November 16, 2012 at 10:11

      What kids got out of working in factories was *not dying*. Instead of starving to death, they got to work hard labor.

      • Richard Nikoley on November 16, 2012 at 11:38

        Stop it. And by all means, do not reference how mortality went down dramatically with the advent of textile factories, making clothes accessible, as well as durable enough to be washed, such that people no longer wore the equivalent of a pathogen incubator, infecting themselves and people around them.

        And also, don’t mention how young teenagers didn’t typically leave home and family anymore, often never to be heard from again.

      • Richard Nikoley on November 16, 2012 at 15:25

        You are obviously unfamiliar with the notion of “you can’t get there from here.”

      • gallier2 on November 17, 2012 at 00:11

        I’m on Woo’s side here, what AndrewS and you just said is monstruous. That’s like saying slavery was a good thing because now ‘dem niggers can enjoy to be in the o’ so rich ‘murrica.

        And btw, “you can’t get there from here.” is exactly what you did, by insinuating that “child slavery” is what made clean clothes possible.

      • marie on November 17, 2012 at 01:11

        Och, I hate to say it, but Richard and AndrewS are…right.
        It’s not that child slavery made clean clothes possible and so Others benefited from it. Yeah, that would be monstrous.
        It’s that the child laborers and all laborers benefited, actually. You see, child labor wasn’t invented during the Industrial revolution. Child mortality actually went Down during the revolution, as did mortality overall. There was in fact a population explosion.
        The old Dickensian view is shocking alright, but only because many people weren’t aware of how harsh and brutal living conditions were for poor families Before the industrial revolution, when they were more spread out. They came in droves to the city because, awful as it was, it gave them better living, or any living at all, for that matter.
        Now though, they were visible. Books were written. Plays. Acts proposed in parliament (finally!).
        It was a poor, sad sight, no doubt, but it was remarkably better than before factories and it kept getting better. More people survived. The population explosion speaks for itself, I think. Also, real wages went up something like two-fold in England in the mid-1800s (if I remember my ‘modern european history’ from, o.k., a long time ago 🙂
        Life was always awful (well, nasty, brutish and short) for most people. The industrial revolution made that starkly visible with more people flocking to cities, but at the same time it improved that life.
        Or so I’ve ‘always thought’, which means that of course I may be wrong. Some numbers would probably be good. Anyone know any good references on-line?

      • Richard Nikoley on November 17, 2012 at 01:56

        The Indusrial Revolution is precisely what ended child forced labor as a way of life in the west.

      • marie on November 17, 2012 at 02:06

        Yes, so I thought. Standards of living actually started to rise, more families could afford to keep their kids out of productive labor to later and later ages, prices of goods and of food went down (well, except during the Napoleonic wars). In fact, isn’t there a ‘break’ from the Malthusian doomsday effected by the Industrial revolution regarding food production and population rises? Without the efficiencies, we wouldn’t have had the ability to feed a growing population…

      • gallier2 on November 17, 2012 at 05:34

        Sorry, but complete BS (unfortunately I have only french resources to back up my claims, notably Marion Sigaud and Henri Guillemin). You were fed some post-hoc propaganda to justify the exploitation of the plebs, aka as reformation and enlightenment. I know it’s a bold claim and I won’t be able to convince you, because it would put everything you (marie and Richard) learnt about the Revolutions/Catholicism/Protestantism/Enlightnment on its head. Especially latter is exceptionnally misunderstood, but as they were the victors in their fight against catholicism, they happen to have been the writers of the history, exagerating the negative of the church (inquisition, jesuits) and downplaying their dark side (you should read what montruosities people like Voltaire, that old weapons and slave trade dealer have written).
        PS: One sample of Voltaire, Napoleon’s preferred citation: “ un pays bien organisé est celui où le petit nombre fait travailler le grand nombre, est nourri par lui, et le gouverne ”, hardly democratic.

      • Richard Nikoley on November 17, 2012 at 05:44

        Thanks Marie. You basically shot my whole quiver there. Online sources could be found I’m sure. My enlightenment in the area came way back in France when I read a ton. Not sure if I have those sources and more and if they do they’re in storage somewhere.

      • Richard Nikoley on November 17, 2012 at 05:57

        In simple terms, industrialization is the market and productive economic engine that began the process of moving beyond human slavery in general. The operation of plant and machinery seems to require skilled adult workers, you see.

        I fear that Gallier2 is simply not going to face the reality that in general these changes over time were generally pragmatic in nature, not moral. We just backfill with our piety hundreds of years later from a computer on a worldwide connected network.

      • gallier2 on November 17, 2012 at 06:30

        Oh, I know full well that these changes were pragmatic in nature, not moral. That’s the whole fucking problem in the first place.
        The industrialization would have been possible even without enslavement of the worker class. It would have meant less outrageous profiteering by the ruling class, but also less blood spill in later uprising. The ruling classes (land nobility and church) before the revolutions had to justify their actions in law framework built by tradition and christian morality. The revolutions have put the merchants (bourgeoisie d’affaire) in charge and that is a fundamental error imo.
        The best illustration to what the enlightnement can lead to is Napoleon. He was the incarnation of that mindset, put in place by the bankers, pursuing nothing else than personal profit (aka as individual freedom). My problem with that philosophy is the slippery slope it enables. People like you, who I know to be decent from the private correspondance we had, know intuitively that there are limits to ones freedom (i.e. the freedom of your peers). But given to psychopaths (like Napolean probably was) it is horribly dangerous.

      • gallier2 on November 17, 2012 at 06:33

        Btw, 1 year ago I would have concurred completely with your point of view. Now that I have discovered the work of people like Marion Sigaut, Alain Soral, Henri Guillemin I had to revise a lot of things I thought I knew (about history). A bit like when one discovers that everything you knew about nutrition has been bold lies.

      • marie on November 17, 2012 at 06:54

        Damn it my gallic friend, an online reference or two was what I was asking for, not a library! 🙂
        Intriguing of course, I’m off to hunt down these works, merci bien.
        Then maybe I can follow what you and Richard are discussing.

      • MC on November 17, 2012 at 16:39

        If you get rid of child labor in undeveloped countries, those children are still going to need an income. Where do you suggest they get it from?

        You take away the option they chose, and all you end up with is beggers and prostitutes. I’ll say it again: technology, and capital. You want to free people, you give them the tools to do it themselves. You cannot change politics and somehow make people wealthy (unless the reason they aren’t wealthy in the first place is because of politics, ie government stealing, government banks causing inflation, etc)

      • Richard Nikoley on November 17, 2012 at 16:47

        “The problem with socialism is that eventually, you run out of other people’s money.” -Thatcher

      • Richard Nikoley on November 17, 2012 at 18:03

        ….Alright, just arrived at my destination. We’ll be here until Tuesday then head to SoCal for the holiday. Not sure how much time I want to spend on this. So this will constitute my reply for all the foregoing.

        I’ve read deeply into the history of the industrial revolution and the enlightenment and it’s one of the reasons I don’t really read much history anymore, but only reviews of works here & there. Why? Because all human being are biased. I actually begrudgingly list history in my Anarchy series and one of the authoritarian based low-quality knowledge deals.

        “The victor writes the history.”

        Now, while there are clear egregious examples of revisionism, such as the Holocaust deniers—and in the news the last few days, a current prof at a major US academic institution who denies the atrocities of the Soviet Union in general and Stalin specifically—revisionism, manipulation, bias, agenda is, I think, rampant in the entire field of history and probably has been for a long time.

        Micro history is great, where they dig in, read letters, look at real personal stuff, etc. But let me ask you: do you necessarily have an accurate idea of what’s really going on if you were in a dark room for 20 years and given only letter from some influential people, laws passed, a few other things? Do you even have what would amount to an historically accurate view even today, right out in the open? There are a million views, everyone biased. Which one you gonna pick so excuse me if I have a bit of a laf when people treat history written in a book as though it’s somehow gospel. Micro history, while interesting, just doesn’t scale to the macro any more that the interesting micro-economic experiences of a firm or two or three give you an accurate picture of macro economic conditions and most particularly, the basis upon which firms are making decisions (all over the map).

        So what to do? What I do is look at things in the widest possible integration and context. I have no problem pinning atrocities of bad things on single individuals who did atrocities and bad things. But most often what I find is a historian—or those enamored of him—pick a few examples of the worst behavior and then set about to generalize in wide swaths and that was what is was ALL about. Not to mention the proclivity of people, myself included, to glom onto NEW REVELATIONS THAT CHANGE EVERYTHING!!!!

        Bah, Humbug. I’m becoming a skeptical cynic in my older age.

        We all have blood on our hands if you consider that the things that got us from there to here included institutionalized human sacrifice, slavery child exploitation, rape and slavery and on and on.

        And yet we’re here and history taken in the very wide is a story of continued enlightenment, breeding technology, capital accumulation and utilization and the cycle continues.

        I could go on, but: all actions are individual actions. There is no such thing as collective action.

      • Contemplationist on November 24, 2012 at 00:54

        If you are any sort of utilitarian even a weak one, the slavery-was-good argument you posted should hold up quite nicely. Repugnant, isn’t it? Makes you sick? Alright, why? Please make sure your reply addresses the actual victims/beneficiaries of this topic – the descendants of the slaves. I don’t give a shit whether you think I was spawned from a goat.

  13. shelley on November 16, 2012 at 03:30

    I have generally always worked for corporations with great insurance plans with the understanding that it was a portion of my pay but I hoped that they would have more advantage with getting a better plan than I would as an individual. Over the years, I have definitely changed my mind.

    First, I don’t need mental care, I don’t need alcohol care, I no longer need pregnancy care – why should I be forced to pay for those? Out-of-pockets become more and more, and the question I have is that when the bill comes due why can you negotiate away 2/3 of the out-of-pocket bill if you pay immediately? Why was I charged so much to begin with if they’re so quick to write-off 2/3?

    I think overall we would be so much better if individuals were solely responsible for any insurance, if they so desired, and entirely responsible for all medical/healthcare costs. It would encourage preventive steps to stay healthy, and it would certainly bring medical costs down to a reasonable level if we could each select doctors/hospitals/procedures/medications.

    Individual responsibility would ultimately, however, stop this silly notion we have that the government owes us our healthcare when we retire. This system seems unsustainable to me especially as we live longer while having an assortment of long-term medical maintenance. How many people save a portion of their income allocated for a time in our lives when we absolutely know we are going to need some kind of medical attention? For all the takers, no, that’s ok, I guess there will always be some working sucker who is paying into the system and by god the government owes me!

    • Richard Nikoley on November 16, 2012 at 05:12


      Absolutely. When you advertise that healthcare will be there for one and all at any price, then you’re going to get it at ANY price. Any HIGH price. It’s not even a market, anymore.

  14. shelley on November 16, 2012 at 03:42

    @Woo – ‘Obamacare is basically telling employeers they aren’t allowed to rip off the public anymore by making them part time or per day workers and simply not insuring them. This scam has been going on the past few decades, you know – employeers refuse to offer their employees benefits so as to increase their profits. They can’t do that anymore. This does not build anything like a healthy society, where we allow our corporations to just exploit labor and treat them like disposable objects they can throw away with.’

    this is a really incredibly stupid thought. Do you really think employers refuse to offer employees benefits to increase their profits? If you do happen to be working for a company where you feel exploited, then first I’d say, quit and find another job. There that was an easy solution. Second, companies that offer benefits, especially the amount of benefits found in a corporation, are a part of your “package” – they always figure that if your salary is $100k / year you can additionally add another 1/3 of your salary attributable to your benefits. You don’t get that shit for nothing. You can either get the salary and no benefits, which is what I prefer now, or you get a smaller salary with their offered benefits.

  15. shelley on November 16, 2012 at 03:48

    @ Woo – Also, you thinking: ‘What we have observed in america is a regression of quality of life for workers, and incentives like this is just a small step to restore the quality of life and sort of society we used to be working toward until it got lost to aggressive international corporatism.’

    you are way too focused on thinking that others owe you a quality of life. They don’t owe you jack. If you feel or even know that American workers have experienced a regression in their quality of life then YOU change it for yourself – why would you force a corporate to change for you?

    We have only experienced a decline in the eyes of people who expect others to provide for them. Provide for yourself and I guarantee you will not feel exploited.

  16. Elenor on November 16, 2012 at 04:59

    Woo: “which is including mandating insurers cover their employee”

    You DO know that “employer-provided health insurance” was a stop-gap measure to adjust for some OTHER ham-handed governmental idiocy, right? When wages were “controlled,” companies offered health insurance as enticement? Then it never went away…

    Woo: “my mother’s bill for 3 days of anticoagulation therapy and nothing else was almost half a million dollars”

    Okay, so if what you seem to believe is corporate theft and waste were gone, and your mother’s 3-days cost only a quarter of a million dollars and not a half a million, then what?! There is no enough money on the planet to pay for everyone’s health care. (Not even every legal American’s health care!) All that whining about death panels?! There HAVE to be death panels, because we cannot possibly come up with enough money to stave off death from *natural* causes — and heart attacks and cancer and and and … in OLD people IS natural causes!!

    Is that harsh? You betch! Nature is red in tooth and claw…. and old folks getting sick and dying in a normal, natural part of Nature. You CANNOT justify spending a half or a quarter million dollars on the care of one older person (and I am one, and I do include myself). Especially not when you’re asking businesses to carry the costs!

    Woo: “Obamacare is basically telling employers they aren’t allowed to rip off the public anymore by making them part time or per day workers and simply not insuring them. This scam has been going on the past few decades, you know — employers refuse to offer their employees benefits so as to increase their profits.”

    Yup, you’ve never owned a business… Employers are “ripping off the public” by trying to stay in business when providing cradle to… well, hiring to firing… health insurance is bankrupting the company?! You read Mother Jones much? Participate the class warfare propaganda much?! Sheesh.

    • MC on November 16, 2012 at 17:40

      You mean those corporate “gajillionaires” that funded his campaign?

      • Richard Nikoley on November 16, 2012 at 18:05

        Shush, MC. You’re ruining it. Those people spout slogans and plattitudes that gets everyone all teary eyed and by God, that COUNTS for something.

  17. shelley on November 16, 2012 at 05:32

    @Woo – Oh boy, you must really have your panties in a wad now due to the following corporate announcement:

    “Hostess Brands will move promptly to lay off most of its 18,500-member workforce…..The company cited increasing pension and medical costs for employees as one of the drivers behind its latest filing.”

    God forbid, a company that’s not allowed to make a profit while paying increasing pension and medical costs for its disposable employees! So on one hand, Woo, you can say – good, I’m glad they won’t be poisoning innocent peeps with their crappy food; and on the other, you can say – they are shits for putting 18,500 people out of work and no longer having freaking HEALTHCARE!!

    Read and weep – this isn’t the first company and certainly not the last that decide to quit putting up with minion shit.

    • Richard Nikoley on November 16, 2012 at 17:45

      I gave him a minute. What an idiot.

      Wonder how many paychecks he’s ever signed. Wonder how many P&Ls he’s ever run.

      Envyers are gonna envy. He drips with it.

      • Jscott on November 16, 2012 at 20:59

        “Wonder how many paychecks he’s ever signed. Wonder how many P&Ls he’s ever run”

        I think this a poor argument? When one quits signing and running how long can one still make the argument?

        Within a few years a person becomes out of touch. Something to think about.

    • Richard Nikoley on November 16, 2012 at 17:49

      ….not to mention naming himself “amazing” while dissing someone that built a business that employs thousands.

      Perhaps there’s a silver lining, though. When pizza delivery costs $40 because the college student delivery guy has to have employer health care, people might stop or severely curtail pizza consumption. There you go. And why stop there. $10 Big Macs. Of course, this isn’t likely to result in any people simply not having a job because it costs more to employ them than they’re worth.

      • marie on November 16, 2012 at 20:00

        Richard, Wooo, Shelley , “when pizza delivery costs $40….”.
        Wait, wait!
        It’s the fault of the greedy lazy-assed employees who want health insurance for nothing.
        No, it’s the fault of the greedy lazy-assed consumer who wants ready-made meals for nothing!
        No, it’s the majority of company-plan insured who have (mythical) gold-plated plans and are driving the costs.
        No, it’s the poor using emergency rooms for every little thing!
        No, it’s the greedy employers holding back on insurance for higher profits (um…though it’s part of compensation and the employee actually pays for it)
        No, it’s….some nice socio-economic or demographic group we can hate! Pick one!
        And the beat goes on…..
        It’s NOT that the government/industry (is there a distinction?), that is, any violently backed authority Wants us all at each other’s throats?
        No, never that.
        None of the claims as to what “the other guy is getting” are manufactured? They makes sense when one pokes at them?
        Not even after reading right here from various people who have insurance that :
        -it is nothing like gold-plated, it’s mostly catastrophic (rob, Jscott – maybe others, I stopped following for a bit)
        -and paid out-of pocket , even for people in big companies (my comments above and Shelly’s too)
        even then, the arguments keep centering around what anyone ‘deserves’ , entitlement mentalities, and phantom gold-plated plans ruining ‘the market’.
        That era of comprehensive insurance as lure in a competitive labor market is what, 20-30 years past? Maybe they have it still in some government positions (yes, of course in Congress).
        In large corporations, health insurance is really insurance and it’s part of the “compensation package”, it’s ain’t free, you can have more salary and no insurance or less salary and one of a variety of decidedly non-gold plated plans (though the gold-plated are on the ‘menu’ every selection cycle – see what you can have too if you become an executive? – lick boots here —>).
        But STILL it’s the fault of some part of the population, or best yet, it’s the fault of nearly everyone who has these amazing health maintenance plans?!
        That concept was WHOLLY INVENTED to fight the idea of government insurance during the Clinton years. See, if ‘we’ have this great system, all this selection (not tied to in-network providers, nope, not us) and with full access (no payment schedules for procedures nor any caps, nope, not us….) etc etc…well, ‘we’ would rightly be terribly scared of a government-run system.
        Right this way folks, set-’em up to knock ’em down.
        It’s a freaking carnival circus in this country when it comes to health insurance arguments.

      • marie on November 16, 2012 at 20:03

        O.k., so maybe that was a wee bit of a rant. See Wooo? You’re inspiring 😉

      • Richard Nikoley on November 16, 2012 at 21:15

        Do you know what HMO stands for, marie?

      • Jscott on November 16, 2012 at 21:17


        My issue with insurance (that was phonetic) is…Ah who cares.

        In the usa I have the cards on the river. My best choice in healthcare is with high deductible and HSA.

        (Show me different and I will change)

        I do not think the USA is the best thing ever. I do not care about that. I care about what I think is best. I will find the stream that will take me there.

        Until then, with healthcare I will go HSA high deductible and medical tourism. I will adjust to whatever wherever because I will not die until I am dead. Fuck em if they can not take a joke.

        Richard included.

      • marie on November 16, 2012 at 21:49

        Sure, they’re supposed to be my ‘friend’.
        I don’t buy their marketing term because my experience and that of the people I know says otherwise(just look at the anecdotal evidence – most people who have insurance have some version of catastrophic, ie. “real’ insurance).
        Then, there’s the simple reasoning of insurance as well.
        They wouldn’t be making money as ‘health maintenance’ organizations if health maintenance meant some type of all-encompassing coverage. All it means is that in some of their plans (and you are paying for the privilege) they cover part of gym costs and regular annual check-ups….because their actuarial tables say that people are healthier if they do these things. So their cost is lower/profit higher. That’s all.

    • Richard Nikoley on November 16, 2012 at 17:54

      Wooo, you suggested someone take a metabolism course or something at a community college. You ought to sign up for a micro-economics course. Then take a business accounting course. And if you actually start a business and actually have to make payroll ever two weeks, you just might begin to get a clue token.

      And by the way, those huge executive salaries? Adjusted for the size of the company, they are only about 50% more that way back. Here’s another thing. If you chart executive compensation, it matches the chart of the S&P 500 almost to a cunt hair. I can link up the 70 or so Vanerbilt U study if anyone likes.

      • Jscott on November 16, 2012 at 21:03

        I can always use more data to get information. So, link em up. It might provide for some new discussion. This other shit is getting old.

        Employees verses people not in the trenches (you included Richard as you said you are getting out–or done got out).

      • Richard Nikoley on November 16, 2012 at 21:28

        No, it’s not done yet. It’ll take another year or so to wind down completely.

        I have a number of pots of stew brewing. The blog and even the books are relatively smal stuff in comparison.

        I got pushed out. Dealing with 50 separate regulatory jurisdictions, 50 different licensing requirements, 50 different bonds, $250K of lawyer bills on average yearly, just for the permission to keep 30 people in jobs.

      • Richard Nikoley on November 16, 2012 at 21:32

        The comment thread with the eventual link and page citations to that study begins here:

  18. EatLessMoveMoore on November 16, 2012 at 14:11

    Deleting comments critical of Kruse? What the hell, Richard? The guy has a lot of nerve even showing his face (so to speak).

    • Richard Nikoley on November 16, 2012 at 14:20

      What’s done is done. I am not going there. To the extent Jack wishes to contribute to a discussion here, which he has done 2-3 times in a few posts and ONLY in a matter where he has first hand experience, i.e., the healthcare industry, then he’s welcome. If people wish to argue or debate with him on the subject of those contributions that’s fair game. The past is done with and that’s my final and absolute decree on the matter.

      • Joshua on November 16, 2012 at 15:18

        but! but!

        It’s not like there are at least two posts discussing criticisms of Kruse with over 1500 comments attached to them. And it’s not like these two posts are prominently linked to on this very page.

        And even if they were, that’s not good enough! We must rehash everybody’s misdeeds whenever they show up. Every time. No exceptions. Also, I think we should start with ourselves.

        When I was four, there was this one time when I…

      • Richard Nikoley on November 16, 2012 at 15:22

        Ha, I thought you were going to end that last sentence with Band Camp.

      • EatLessMoveMoore on November 16, 2012 at 15:45

        I’d say Kruse’s misdeeds are in their own special category.

      • Richard Nikoley on November 16, 2012 at 17:40

        Can we all please just drop this? Seriously. Jack has been scrupulously circumspect in his few contributions here and it has involved strictly the posts on the health care system. I can not understand the mentality of not allowing a person an attempt at any measure of redemption.

      • EatLessMoveMoore on November 16, 2012 at 18:28

        Yeah. Apologizing to Evelyn and Melissa – now that would be an attempt at redemption.

      • Richard Nikoley on November 16, 2012 at 19:10

        Those two cunts can go fuck themselves all day long.

        How’s that?

      • Jscott on November 16, 2012 at 21:07

        I love someone saying, “Fuck, I am sorry. Not sure where to start. I can start at sorry.”

        That has not happened.

        I like your approach with past being bast. Busting other people that feel slimed? You get paid to owe more. Book two.

  19. Galina L. on November 18, 2012 at 17:34

    I just came back from Russia where I was dealing with my mom health issues (nothing catastrophic) during my long stay there. So I can’t help but compare situations here and there. The list is quite long and I am not sure it may be interesting to anyone.
    Just couple things I want to say first – regardless of the history how things turned the way things are now, America became the world wide preserve for Pharmaceutical companies and it will be impossible to turn around quickly if at all . People here take daily an enormous amount of very expensive pills and expect to receive expensive treatments like knee surgery in order to be able to run marathones after 50 . The whole system is build around it here, and it is very difficult to change the existing pattern in general.
    In places with not very reliable health care people expect from hospitals less and feel more responsible for their own health. In US we expect too much from our doctors and rarely question the standard of care.

  20. Kayumochi on March 7, 2013 at 09:57

    Hey, I’ve had it both ways: in Japan under their reasonably priced, market-based, universal healthcare system and here in the USA. And with an indolent cancer. And I have the option of returning to Japan. Not sure what I will do in the long-run but I prefer the sensible Japanese system to the healthcare system found here.

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