| Massachusetts Health Care System: A Model for Failure Posted: 05 Apr 2012 01:56 PM PDT Here is an interesting email from reader "George" on his experiences with Romneycare. Hello Mish
Here is my personal experience with socialized medical care in Massachusetts.
I've spent the last three years traveling the globe. Prior, I worked at State Street. I was working on an overly complex billion dollar swap fund which contained every paper asset known to mankind. Thus, it lost money. I hated the office, the office politics, and the sheer stupidity of mega corporate America.
I quit and decided to travel the globe for three years or until I found something I was passionate about. It was also a period for self-actualization, and personal growth.
I would have no income for the foreseeable future. I had 70K saved up. As a Massachusetts resident I am required to be insured meeting criteria X,Y and Z, or you face tax penalties.
However, I didn't need, or want the one size fits all insurance schemes in Massachusetts. I needed a high deductible, low premium "disaster," plan in case I had cancer or other life altering sicknesses.
I wanted to couple that with my travel insurance plan (Medex Assist). For minor things, broken legs, swimmer's ear etc, my travel insurance would cover it all.
Health care, in other parts of the world is much, much cheaper. You can pay cash for everything and it doesn't affect your bottom line. For example, a brain MRI at a luxurious five star hospital in Bangkok (think Hilton or Ritz Carleton) is only $50.00. Moreover, many of the doctors are trained in the West. To top it off, Eastern medical schools are catching up very quickly.
My lifestyle was not very synergistic with the one size fits all mandated health insurance schemes in Massachusetts. The light bulb went off and I considered purchasing the coverage in Florida where I could buy coverage tailored to my specific needs.
However, under Massachusetts law, I wasn't allowed to purchase health care across state borders, as I was a MA resident. However, I can purchase plans covering me in other places, Thailand, Costa Rica, the Bahamas, even Cuba.
I've used private health care clinics in Laos, Thailand, Indonesia, Costa Rica, South Africa, and The Bahamas and Texas. I return to Boston periodically to see family and friends, change my travel gear, supply up, passport pages etc. When I come back I often get a general checkup.
The health care in Massachusetts is so distanced from reality it's awe inspiring. There is no such thing as a cash price, or cash discount. The prices and services rendered have almost no correlation.
The "socialized" system in MA is now extremely overloaded. Doctors are overloaded with the "free" patients. They have no time to relax, listen or learn. It's a slow but fundamental degradation in doctor-patient time, and quality. This leads to an increase in misdiagnosed patients, maligned regulation and never ending state and federal imposition towards your personal health care, via policy, regulation and mandates.
Ironically it's all named in the effort to better care and reduce costs. It's absolutely amazing, that the worse things become, the more irrational the solutions, and arguments become.
The millionaires of the world no longer travel to America for care. They go elsewhere. Where don't they go? Socialized systems like Denmark, Canada etc. They go where service, value, and quality are held highly. Where markets are free of onerous regulation.
Traveling the world has broadened my perspective immensely, to the point where I, unfortunately, may not call American soil my home anymore. The barriers to entry from a bureaucratic standpoint are endless for small budding entrepreneurs. I'd much rather setup shop here in the Bahamas, not that, that in itself isn't loaded with it's own set of problems.
There are simple and effective solutions to bringing costs down. Ideas like allowing consumers to purchase insurance across state lines. Allowing foreign competition into the drug market increases domestic efficiency and lowers cost. There's a long list of rational and logical ways to fix the market. Let it be. Health care is not a unique market.
However, as usual, Washington, lobbyists, and the powers that be don't want real structural change that will improve long term conditions. Thus the US system will remain a complete failure across the board.
George
1st Row in front of the Conch Shack
The Bahamas One thing for sure is our current system does not work, Obamacare does not work, and Romneycare does not work. Of course Obamacare and Romenycare are the same thing. Please see Obama Delivers Warning to Supreme Court on Healthcare; If Obamacare Goes Down Who Is To Blame? Who Loses If Not Struck Down? Mathematically Speaking, Obamacare Cannot Survive for further discussion. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com
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| Another Bad Day for Spanish Bonds, 10-Yr Yield Hits 5.85%, Settles at 5.75% Posted: 05 Apr 2012 09:50 AM PDT Spanish government bonds are taking another dive today with yields rising again.  Chart from Bloomberg. Place your bets on when yields soar above 6%. I suggest it will not be long. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com
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| Crunch Time for Greece (Case for Bank Holiday and Eurozone Exit Now): Disbursements to Greece by the EFSF and IMF "Conditional on Compliance with Conditionality" Posted: 05 Apr 2012 12:12 AM PDT If the second half of the title to this post seems silly, it is because it is silly. However, " disbursements to Greece by the EFSF and the IMF will still be conditional on compliance with conditionality" is an exact quote from The Second Economic Adjustment Programme for Greece, March 2012 by the European Commission. I advise not attempting to read the document. It is a mere 195 PDF pages long. However, a tip of the hat to reader Brett who did manage to slog through the entire document to discover that gem on PDF page 55. Brett also discovered some rather interesting facts regarding Greece's inability to make needed bond rollovers. Brett writes ... Hello Mish
I have spared you having to read the attached 195 page sleeping pill and I have discovered a major problem.
The first disbursement to Greece was on March 20. Disbursements are paid quarterly and no sooner, which effectively means that June 20 is the earliest next disbursement due date. Greece was originally supposed to receive 74 billion in the first tranche,(Page 56 on the document), it received 7.5 billion. Someone needed to put the decimal point one place to the right.
We know Greece is insolvent and it raided University accounts held at the Bank of Greece to effect the March bond swap. We know the bond swap offer (450 million Euro) for issue XS0147393861 was rejected and is payable on May 15 (6 Weeks to go). Somehow it has to pay this before the next tranche.
Of the 7.4 billion it received in the first tranche a Greek government official stated that "Greece would use this money to pay 4.66 billion euros to the European Central Bank and other eurozone national central banks for the capital amount of a three-year bond that expired yesterday".
This leaves 2.74 billion over 3 months to survive with. Even if you believe the 1% deficit for 2012 forecast (complete nonsense on page 99) Greece is in arrears 1.25 billion per month. This consumes entirely the remaining distributed money from the EU & IMF. Plus there is 5.2 billion Euros of Treasury bills due in April and May.
Greece 26-Week T-Bills
Greece 13-Week T-Bills
Below is my favorite line from the document.
However, the disbursements to Greece by the EFSF and the IMF will still be conditional on compliance with conditionality.
Why even bother?
Regards
Brett March Bond Swap Greece did manage to make the March bond swap but only by raiding University accounts held at the Bank of Greece. I was aware of this but have not commented on it yet. Now is as good a time as any. The Slog covered this on March 26 in EXCLUSIVE: GREEK GOVERNMENT ROBBED PUBLIC INSTITUTIONS TO COMPLETE BOND SWAP The illegally denied default of Greece entered a dramatic new phase this afternoon with the revelation by mainstream Greek public health website Health News that, shortly before midnight on March 8th – the eve of Greece's psi completion on Friday March 9th – on average 70% of public utility funds in various large, interest-bearing accounts at the Bank of Greece were raided. These included most of the State's regional hospital budgets, various universities and (it is alleged) at least one utility company.
The shortfalls came to light late last week and this morning as various hospital purchasing cheques in particular began to bounce. The monies – estimated by one source to total some 1.4 billion euros – appear to have been used to pay off the tiny minority of private sovereign creditors who, under the original terms of their bond purchase, were entitled come what may to full payment of the bond's yield entitlement.
Setting aside the amoral audacity of this act, it does yet again raise the issue of a Greece so utterly lacking in any real funds in the real world, that to pay off a minute proportion of the bondholders it had to resort to such a desperate measure. On March 28, The Slog wrote GREEK EMBEZZLEMENT UPDATE: SLOGPOST VINDICATED BY ATHENS NEWS REPORT. From Athens News:
'Six of the country's universities say they face immediate closure after the recent bondswap reduced their assets to zero. An emergency meeting of university rectors on Tuesday heard that only 33m euros remained of 120m euros that 17 Greek universities had deposited with the Bank of Greece for their operating expenses, while six university accounts were now completely empty meaning they would soon be unable to stay open.' What Assets Can Greece Raid Now? I thought there was a strong chance Greece would declare a bank holiday in March. It did not happen. Easter, this weekend, is also a reasonable bet, but I will not go far as to say it is a likelihood. Regardless, somehow Greece needs to come up with money for April 20 and May 12 redemptions. Is there another rabbit in the hat? I really do not know, but I do know that hats cannot hold an infinite supply of rabbits. I also know that the last trade date on Greek 1-year bonds was at 1,143% way back on March 9.  That should not inspire confidence in Greece or in rabbits. Mike "Mish" Shedlock http://globaleconomicanalysis.blogspot.com
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