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One of our biggest worries is that we might be becoming more like America. The US Health System (if that is not an oxymoron) rightly frightens the life out of us – we, at least, have some semblance of a national health system. Medicare may not be perfect, but God save us from the US system! 〓〓〓〓〓〓〓〓〓〓〓 ★카톡:kodak8★텔레그램:Komen68★ 〓〓〓〓〓〓〓〓〓〓〓 There were parts of this book that gave me slight cause for hope – it did seem like he might try to do something about education, and might even help people retrain to get better jobs. His criticisms of corporate America’s disproportionate influence on politics due to the money it was able to pour in was reassuring, if only because he noticed it might be a problem.” 골드워시, 도리도리, 바오메이, 블루위저드, 섹스드롭, 엑스터시판매, 요힘빈,

Suddenly being her age seemed great. She didn't have to look perfect. Hooray And think of all the senior discounts she had to look forward to not to mention Social Security Medicare and Medicaid. So what if she was afraid of getting old Big whoopdedoowho wasn't She wasn't alone everybody her age was in the same boat. She was going to relax and just let herself get older. Who cared if she wore twoinch heels instead of 3andahalf inch heels her feet hurt and not only that she was going to have a piec eof cake once in a while and she wasn't going to go anywhere she didn't feel like going anymore either. Bring on the Depends And the bunion pads and the Metamucil. And if she liked pretty music and old movies so what She wasn't hurting anyone. Hazel had always said "If you're still breathing you're ahead of the game." And she'd been right. Life itself was something to look forward to and so for whatever time she had left she was going to enjoy every minute wrinkles and all. What a concept

One of our biggest worries is that we might be becoming more like America. The US Health System (if that is not an oxymoron) rightly frightens the life out of us – we, at least, have some semblance of a national health system. Medicare may not be perfect, but God save us from the US system! 〓〓〓〓〓〓〓〓〓〓〓 ★카톡:kodak8★텔레그램:Komen68★ 〓〓〓〓〓〓〓〓〓〓〓 There were parts of this book that gave me slight cause for hope – it did seem like he might try to do something about education, and might even help people retrain to get better jobs. His criticisms of corporate America’s disproportionate influence on politics due to the money it was able to pour in was reassuring, if only because he noticed it might be a problem.” 골드워시, 도리도리, 바오메이, 블루위저드, 섹스드롭, 엑스터시판매, 요힘빈,

One of our biggest worries is that we might be becoming more like America. The US Health System (if that is not an oxymoron) rightly frightens the life out of us – we, at least, have some semblance of a national health system. Medicare may not be perfect, but God save us from the US system! 〓〓〓〓〓〓〓〓〓〓〓 ★카톡:kodak8★텔레그램:Komen68★ 〓〓〓〓〓〓〓〓〓〓〓 There were parts of this book that gave me slight cause for hope – it did seem like he might try to do something about education, and might even help people retrain to get better jobs. His criticisms of corporate America’s disproportionate influence on politics due to the money it was able to pour in was reassuring, if only because he noticed it might be a problem.” 골드워시, 도리도리, 바오메이, 블루위저드, 섹스드롭, 엑스터시판매, 요힘빈,

So Medicare decided to pay hospitals like ours for internship and residency training programs, get it? It’s a win-win, as they say—the hospital gets patients cared for by interns and residents around the clock,people like us who live on site, and whose stipend is a bloody fraction of what the hospital would pay full-time physicians. And Medicare delivers health care to the poor.

On Rachel's show for November 7, 2012: We're not going to have a supreme court that will overturn Roe versus Wade. There will be no more Antonio Scalias and Samuel Aleatos added to this court. We're not going to repeal health reform. Nobody is going to kill medicare and make old people in this generation or any other generation fight it out on the open market to try to get health insurance. We are not going to do that. We are not going to give a 20% tax cut to millionaires and billionaires and expect programs like food stamps and kid's insurance to cover the cost of that tax cut. We'll not make you clear it with your boss if you want to get birth control under the insurance plan that you're on. We are not going to redefine rape. We are not going to amend the United States constitution to stop gay people from getting married. We are not going to double Guantanamo. We are not eliminating the Department of Energy or the Department of Education or Housing at the federal level. We are not going to spend $2 trillion on the military that the military does not want. We are not scaling back on student loans because the country's new plan is that you should borrow money from your parents. We are not vetoing the Dream Act. We are not self-deporting. We are not letting Detroit go bankrupt. We are not starting a trade war with China on Inauguration Day in January. We are not going to have, as a president, a man who once led a mob of friends to run down a scared, gay kid, to hold him down and forcibly cut his hair off with a pair of scissors while that kid cried and screamed for help and there was no apology, not ever. We are not going to have a Secretary of State John Bolton. We are not bringing Dick Cheney back. We are not going to have a foreign policy shop stocked with architects of the Iraq War. We are not going to do it. We had the chance to do that if we wanted to do that, as a country. and we said no, last night, loudly.

So let me get this straight – this is a long sentence. We are going to be gifted with a health care plan that we are forced to purchase, and fined if we don’t, which reportedly covers 10 million more people without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman doesn’t understand it, passed by Congress, that didn’t read it, but exempted themselves from it, and signed by a president who smokes, with funding administered by a treasury chief who didn’t pay his taxes, for which we will be taxed for four years before any benefits take effect, by a government which has bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese and financed by a country that is broke. So what the blank could possibly go wrong?

One of our biggest worries is that we might be becoming more like America. The US Health System (if that is not an oxymoron) rightly frightens the life out of us – we, at least, have some semblance of a national health system. Medicare may not be perfect, but God save us from the US system! 〓〓〓〓〓〓〓〓〓〓〓 ★카톡:kodak8★텔레그램:Komen68★ 〓〓〓〓〓〓〓〓〓〓〓 There were parts of this book that gave me slight cause for hope – it did seem like he might try to do something about education, and might even help people retrain to get better jobs. His criticisms of corporate America’s disproportionate influence on politics due to the money it was able to pour in was reassuring, if only because he noticed it might be a problem.” 골드워시, 도리도리, 바오메이, 블루위저드, 섹스드롭, 엑스터시판매, 요힘빈,

New Rule: Just because a country elects a smart president doesn't make it a smart country. A couple of weeks ago, I was asked on CNN if I thought Sarah Palin could get elected president, and I said I hope not, but I wouldn't put anything past this stupid country. Well, the station was flooded with emails, and the twits hit the fan. And you could tell that these people were really mad, because they wrote entirely in CAPITAL LETTERS!!! Worst of all, Bill O'Reilly refuted my contention that this is a stupid country by calling me a pinhead, which (a) proves my point, and (b) is really funny coming from a doody-face like him. Now, before I go about demonstration how, sadly, easy it is to prove the dumbness that's dragging us down, let me just say that ignorance has life-and-death consequences. On the eve of the Iraq War, seventy percent of Americans thought Saddam Hussein was personally involved in 9/11. Six years later, thirty-four percent still do. Or look at the health-care debate: At a recent town hall meeting in South Carolina, a man stood up and told his congressman to "keep your government hands off my Medicare," which is kind of like driving cross-country to protest highways. This country is like a college chick after two Long Island iced teas: We can be talked into anything, like wars, and we can be talked out of anything, like health care. We should forget the town halls, and replace them with study halls. Listen to some of these stats: A majority of Americans cannot name a single branch of government, or explain what the Bill of Rights is. Twenty-four percent could not name the country America fought in the Revolutionary War. More than two-thirds of Americans don't know what's in Roe v. Wade. Two-thirds don't know what the Food and Drug Administration does. Some of this stuff you should be able to pick up simply by being alive. You know, like the way the Slumdog kid knew about cricket. Not here. Nearly half of Americans don't know that states have two senators, and more than half can't name their congressman. And among Republican governors, only three got their wife's name right on the first try. People bitch and moan about taxes and spending, but they have no idea what their government spends money on. The average voter thinks foreign aid consumes more twenty-four percent of our budget. It's actually less than one percent. A third of Republicans believe Obama is not a citizen ad a third of Democrats believe that George Bush had prior knowledge of the 9/11 attacks, which is an absurd sentence, because it contains the words "Bush" and "knowledge." Sarah Palin says she would never apologize for America. Even though a Gallup poll say eighteen percent of us think the sun revolves around the earth. No, they're not stupid. They're interplanetary mavericks. And I haven't even brought up religion. But here's one fun fact I'll leave you with: Did you know only about half of Americans are aware that Judaism is an older religion than Christianity? That's right, half of America looks at books called the Old Testament and the New Testament and cannot figure out which came first. I rest my case.

A couple, both age seventy-eight, went to a sex therapist’s office. The doctor asked, “What can I do for you?” The man said, “Will you watch us have sexual intercourse?” The doctor looked puzzled, but agreed. When the couple finished, the doctor said, “There’s nothing wrong with the way you have intercourse,” and charged them $50. The couple asked for another appointment and returned once a week for several weeks. They would have intercourse, pay the doctor, then leave. Finally, the doctor asked, “Just exactly what are you trying to find out?” The old man said, “We’re not trying to find out anything. She’s married and we can’t go to her house. I’m married and we can’t go to my house. The Holiday Inn charges $93 and the Hilton Inn charges $108. We do it here for $50, and I get $43 back from Medicare.

One of our biggest worries is that we might be becoming more like America. The US Health System (if that is not an oxymoron) rightly frightens the life out of us – we, at least, have some semblance of a national health system. Medicare may not be perfect, but God save us from the US system! 〓〓〓〓〓〓〓〓〓〓〓 텔 - KrTop "코리아탑" 〓〓〓〓〓〓〓〓〓〓〓 There were parts of this book that gave me slight cause for hope – it did seem like he might try to do something about education, and might even help people retrain to get better jobs. His criticisms of corporate America’s disproportionate influence on politics due to the money it was able to pour in was reassuring, if only because he noticed it might be a problem.

Our plutocracy, whether the hedge fund managers in Greenwich, Connecticut, or the Internet moguls in Palo Alto, now lives like the British did in colonial India: ruling the place but not of it. If one can afford private security, public safety is of no concern; to the person fortunate enough to own a Gulfstream jet, crumbling bridges cause less apprehension, and viable public transportation doesn’t even compute. With private doctors on call and a chartered plane to get to the Mayo Clinic, why worry about Medicare?

It is a veritable revolving door of jobs between the USDA and Big Ag and Big Food. Americans should insist on the establishment of a new Department of Food run through the Department of Health and Human Services, which is paying for the consequences of harmful dietary recommendations through Medicare and Medicaid. In

The twin shocks of 9/11 and the Great Recession seem mentally to have unhinged a portion of the American people and much of the political class. The following years were consumed by crazy arguments about the president’s birth certificate, death panels, and voters shouting that the government must get its hands off their government-provided Medicare.

They chose to spend money the government didn’t have,” Pastor Pete said. “They chose to let the country get into ridiculous debt. They chose to expect a lavish lifestyle, like a perfect retirement where they’d have plenty. So they demanded more and more from the government, like Social Security and Medicare, to make sure their high expectations about retirement would come true.

But then something unexpected happened. Donald Trump, a real estate mogul and television celebrity who did not need the Koch donor network’s money to run, who seemed to have little grasp of the goals of this movement, entered the race. More than that, to get ahead, Trump was able to successfully mock the candidates they had already cowed as “puppets.” And he offered a different economic vision. He loved capitalism, to be sure, but he was not a libertarian by any stretch. Like Bill Clinton before him, he claimed to feel his audience’s pain. He promised to stanch it with curbs on the very agenda the party’s front-runners were promoting: no more free-trade deals that shuttered American factories, no cuts to Social Security or Medicare, and no more penny-pinching while the nation’s infrastructure crumbled. He went so far as to pledge to build a costly wall to stop immigrants from coming to take the jobs U.S. companies offered them because they could hire desperate, rightless workers for less. He said and did a lot more, too, much that was ugly and incendiary. And in November, he shocked the world by winning the Electoral College vote.

The impact of second-class treatment on black people’s bodies is devastating. It is manifested not only in the black–white death gap but also in the drastic measures required when chronic disease is left unmanaged. Black patients are less likely than whites to be referred to kidney and liver transplant wait lists and are more likely to die while waiting for a transplant.68 If they are lucky enough to get a donated kidney or liver, blacks are sicker than whites at the time of transplantation and less likely to survive afterward. “Take a look at all the black amputees,” said a caller to a radio show I was speaking on, identifying the remarkable numbers of people with amputated legs you see in poor black communities as a sign of health inequities. According to a 2008 nationwide study of Medicare claims, whites in Louisiana and Mississippi have a higher rate of leg amputation than in other states, but the rate for blacks is five times higher than for whites.69 An earlier study of Medicare services found that physicians were less likely to treat their black patients with aggressive, curative therapies such as hospitalization for heart disease, coronary artery bypass surgery, coronary angioplasty, and hip-fracture repair.70 But there were two surgeries that blacks were far more likely to undergo than whites: amputation of a lower limb and removal of the testicles to treat prostate cancer. Blacks are less likely to get desirable medical interventions and more likely to get undesirable interventions that good medical care would avoid.

If husband took his retirement benefit after FRA and widow takes the survivor’s benefit at or after her own FRA, she will, indeed, receive his actual retirement benefit—his full retirement benefit inclusive of his Delayed Retirement Credits. As it happens, this may be even more than the check he was receiving each month. Why? Because his monthly Medicare Part B premium may have been withheld from his monthly Social Security check and of course those premiums no longer need to be paid.

If you decide to defer your benefits, the odds are you will need to file for Medicare before you file for Social Security. Medicare, of course, often seems as complicated as Social Security. That’s a book for another day. For now, just make sure that you file for Medicare alone and do not accidentally file for your Social Security benefit, too. Take your time. Make sure you understand ahead of time anything you sign or are asked to sign.

The second bomber went after a Tennessee Republican state senator who’d voted down the Medicare expansion, despite his campaign promise to make sure that “every Tennessean who wants insurance will get insurance.

As an investor, you pay lower capital gains taxes on any property sale profits. As a dealer, you pay higher ordinary income tax rates plus self-employment taxes (Social Security and Medicare). If you do get stuck in this dealer category, you’ll probably be eligible for the 20 percent deduction, so check with your tax preparer.

People employ what economists call “rational ignorance.” That is, we all spend our time learning about things we can actually do something about, not political issues that we can’t really affect. That’s why most of us can’t name our representative in Congress. And why most of us have no clue about how much of the federal budget goes to Medicare, foreign aid, or any other program. As an Alabama businessman told a Washington Post pollster, “Politics doesn’t interest me. I don’t follow it. … Always had to make a living.” Ellen Goodman, a sensitive, good-government liberal columnist, complained about a friend who had spent months researching new cars, and of her own efforts study the sugar, fiber, fat, and price of various cereals. “Would my car-buying friend use the hours he spent comparing fuel-injection systems to compare national health plans?” Goodman asked. “Maybe not. Will the moments I spend studying cereals be devoted to studying the greenhouse effect on grain? Maybe not.” Certainly not —and why should they? Goodman and her friend will get the cars and the cereal they want, but what good would it do to study national health plans? After a great deal of research on medicine, economics, and bureaucracy, her friend may decide which health-care plan he prefers. He then turns to studying the presidential candidates, only to discover that they offer only vague indications of which health-care plan they would implement. But after diligent investigation, our well-informed voter chooses a candidate. Unfortunately, the voter doesn’t like that candidate’s stand on anything else — the package-deal problem — but he decides to vote on the issue of health care. He has a one-in-a-hundred-million chance of influencing the outcome of the presidential election, after which, if his candidate is successful, he faces a Congress with different ideas, and in any case, it turns out the candidate was dissembling in the first place. Instinctively realizing all this, most voters don’t spend much time studying public policy. Give that same man three health insurance plans that he can choose from, though, and chances are that he will spend time studying them. Finally, as noted above, the candidates are likely to be kidding themselves or the voters anyway. One could argue that in most of the presidential elections since 1968, the American people have tried to vote for smaller government, but in that time the federal budget has risen from $178 billion to $4 trillion. George Bush made one promise that every voter noticed in the 1988 campaign: “Read my lips, no new taxes.” Then he raised them. If we are the government, why do we get so many policies we don’t want?

People employ what economists call “rational ignorance.” That is, we all spend our time learning about things we can actually do something about, not political issues that we can’t really affect. That’s why most of us can’t name our representative in Congress. And why most of us have no clue about how much of the federal budget goes to Medicare, foreign aid, or any other program. As an Alabama businessman told a Washington Post pollster, “Politics doesn’t interest me. I don’t follow it. … Always had to make a living.” Ellen Goodman, a sensitive, good-government liberal columnist, complained about a friend who had spent months researching new cars, and of her own efforts study the sugar, fiber, fat, and price of various cereals. “Would my car-buying friend use the hours he spent comparing fuel-injection systems to compare national health plans?” Goodman asked. “Maybe not. Will the moments I spend studying cereals be devoted to studying the greenhouse effect on grain? Maybe not.” Certainly not —and why should they? Goodman and her friend will get the cars and the cereal they want, but what good would it do to study national health plans? After a great deal of research on medicine, economics, and bureaucracy, her friend may decide which health-care plan he prefers. He then turns to studying the presidential candidates, only to discover that they offer only vague indications of which health-care plan they would implement. But after diligent investigation, our well-informed voter chooses a candidate. Unfortunately, the voter doesn’t like that candidate’s stand on anything else — the package-deal problem — but he decides to vote on the issue of health care. He has a one-in-a-hundred-million chance of influencing the outcome of the presidential election, after which, if his candidate is successful, he faces a Congress with different ideas, and in any case, it turns out the candidate was dissembling in the first place. Instinctively realizing all this, most voters don’t spend much time studying public policy. Give that same man three health insurance plans that he can choose from, though, and chances are that he will spend time studying them. Finally, as noted above, the candidates are likely to be kidding themselves or the voters anyway. One could argue that in most of the presidential elections since 1968, the American people have tried to vote for smaller government, but in that time the federal budget has risen from $178 billion to $4 trillion.

A far better way to slow medical costs is to use Medicare and Medicaid’s bargaining power over drug companies and hospitals to get lower prices and to move from a fee-for-service system to a fee-for-healthy-outcomes system. And because Medicare has far lower administrative costs than private health insurers, we should make Medicare available to everyone.

We should remember why those programs were started: before the arrival of Medicare and Social Security, the private sector left most elderly bereft of support, the market for annuities essentially didn’t exist, and the elderly couldn’t get health insurance. Even today, the private sector doesn’t provide the kind of security that Social Security provides—including protection against market volatility and inflation. And the transactions costs of the Social Security Administration are markedly lower than those in the private sector. In addition, many of the people who receive government benefits without paying for them are our young, obviously unable to pay, say, for their own education. But spending on them is an investment in the country’s future. An

For some politics has become a battle ground that allows them to vent their frustrations, while at the same time hide behind the anonymity of the social media. For others it has become a weapon to overwhelm their opponents by the weight of the number of comments sent to the originator of the blog or article. Fair or not, this method of cyber warfare works and could possibly change the course of history. A continuance of this cyber activity is still not totally understood by most bloggers, but certainly can be threatening and intimidating. Recently we have witnessed where foreign countries become involved in the attempt to rig elections by altering the mind set of those receiving overwhelming amounts of mostly altered news. This is certainly presently true in France. In Pakistan a student was murdered by his fellow students, simply because he had a difference of opinion. Art has become a victim of this form of attack, being accused of being a financial drain on the country’s economy whereas it, in all of its forms, is a stabilizer of civilization. Helping and feeding those less fortunate then ourselves also stabilizes a good society. On the opposite side of this topic a destabilizing activity is war, which cost us much more, however it does get us to alter our focus. It is the threat of nuclear annihilation that really gets our attention and may even eventually offer job opportunities to the survivors. I feel certain that the opposing sides of these issues are already marshaling their forces and stand fast to their beliefs. You would think that funding for the arts should be non-political, however I have found it to be a hot button issue, whereas going to war is accepted by an overwhelming majority of people, even before we attempt peaceful diplomatic negotiations. Building a wall separating us from Mexico is a great idea that is embraced by many who still believe that Mexico will eventually pay for it, but our “Affordable Health Care” must be thrown out! What will give our people more bang for the buck? An improved health care Bill or a Beautiful Wall? I’ve heard that Medicare and Social Security are things we can no longer afford, but it’s the same people who still believe that we can afford a nuclear war. These are issues that we can and should address, however I’ll just get back to my books and deal with the pro or anti Castro activists, or neo-Nazis, or whoever else wants to make a political statement. My next book “Seawater One….” will have some sex in it…. Perhaps we can all agree that, that’s a good thing or perhaps not.

the lab’s essential public health functions could be compromised during the move and if the lab had fewer employees. The lab, now at a former Devon Energy Corp. field office building next to a cow pasture in Stillwater, has struggled to keep its top director and other key employees. Delays to get test results for basic public health surveillance for salmonella outbreaks and sexually transmitted infections have shaken the confidence of lab partners and local public health officials. As a new coronavirus emerges going into winter, the lab ranks last in the nation for COVID-19 variant testing. Many employees, who found out about the lab’s move from an October 2020 press conference, didn’t want to relocate to Stillwater. Those who did make the move in the first few months of 2021 found expensive lab equipment in their new workplace but not enough electrical outlets for them. The lab’s internet connection was slower than expected and not part of the ultra-fast fiber network used across town by Oklahoma State University. A fridge containing reagents, among the basic supplies for any lab, had to be thrown out after a power outage. Meanwhile, the Centers for Medicare and Medicaid Services finalized a correction plan after federal inspectors, prompted by an anonymous complaint, showed up unannounced at the lab in late September. “Although some aspects of the original report were not as favorable as we would have liked, the path of correction is clear and more than attainable,” Secretary of Health and Mental Health Kevin Corbett said Tuesday in a statement about the inspection. “We are well on our way to fully implementing our plan. (The Centers For Medicare and Medicaid Services) has confirmed we’ve met the requirements of being in compliance. We are looking forward to their follow-up visit.” In an earlier statement, the health department said the Stillwater lab now “has sufficient power outlets to perform testing with the new equipment, and has fiber connection that exceeds what is necessary to properly run genetic sequencing and other lab functions.” The department denied the lab had to throw out the reagents after a power outage.

private insurance and away from Medicare. The result would be “two-tier medicine,” a term that is as pejorative in Canada as “socialized medicine” is in the United States. Many fear that if Canada did move to two-tier medicine, the rich might get better care, with less waiting, than the poor. The rich getting better access to health care—that’s a fact of life that we take for granted in the United States. But in Canada, such a result would violate the powerful egalitarian impulse that is a crucial element of the national culture.

Now the Democrat Party has tilted so far left that it threatens to collapse any day. Just look at what remains of the party’s presidential hopefuls. Elizabeth Warren wants to arm the IRS (not literally but with more pencils) to punish the wealthiest people in the country. It doesn’t matter to her if they made their money by working hard, then creating jobs. She believes that the money belongs to the government. Of course, that didn’t stop her from making almost $500,000 a year from teaching one class at Harvard. It’s no wonder why college tuition is through the roof! Kamala Harris wants to get rid of all private health care and replace it with a single-payer government-issued model. The fact that the US government owes $122 trillion in unfunded liabilities such as Social Security and Medicare doesn’t even faze her. Just dump more debt on the pile, and let our children figure out how to pay for it.

The specific policy changes in the 1980s were profound in the aggregate, but beyond the nostalgic Reaganite Morning in America and freer-free-markets messaging, most of the changes were complicated and esoteric and seemed small, so they had a stealth quality. It didn’t feel quite like a paradigm shift because it was mainly carried out by means of a thousand wonky adjustments to government rules and laws, and obscure financial inventions, and big companies one by one changing how they operated and getting away with it—all of it with impacts that emerged gradually, over decades. Social Security and Medicare benefits were not cut, the EPA wasn’t abolished, labor unions weren’t banned. As it turned out, the 1980s were the ’30s but in reverse: instead of a fast-acting New Deal, a time-release Raw Deal.

Another example, one that touches more people, is the nursing home industry. Numerous studies have shown that living at home, in a house or an apartment, is better psychologically, more fulfilling, and cheaper than living in nursing homes.14 Yet these institutions prosper when federal programs that foster living in the community are cut. There are also funding disincentives that the U.S. Congress, through Medicare and Medicaid, has created to ensure the profit bonanza of nursing homes. According to the activist disability journal Mouth (1995), there are 1.9 million people with disabilities living in nursing homes at an annual cost of $40,784, although it would cost only $9,692 a year to provide personal assistance services so the same people could live at home. Sixty-three percent of this cost is taxpayer funded. In 1992, 77,618 people with developmental disabilities (DD) lived in state-owned facilities at an average annual cost of $82,228, even though it would cost $27,649 for the most expensive support services to live at home. There are 150,257 people with mental illness living in tax-funded asylums at an average annual cost of $58,569. Another 19,553 disabled veterans also live in institutions, costing the Veterans Administration a whopping $75,641 per person.15 It is illogical that a government would want to pay more for less. It is illogical until one studies the amount of money spent by the nursing home lobby. Nursing homes are a growth industry that many wealthy people, including politicians, have wisely invested in. The scam is simple: get taxpayers to fund billions of dollars to these institutions which a few investors divide up. The idea that nursing homes are compassionate institutions or necessary resting places has lost much of its appeal recently, but the barrier to defunding them is built on a paternalism that eschews human dignity. As we have seen with public housing programs in the United States, the tendency is to warehouse (surplus) people in concentrated sites. This too has been the history with elderly people and people with disabilities in nursing homes. These institutions then can serve as a mechanism of social control and, at the same time, make some people wealthy.

Extreme economic ignorance was displayed when various experts, including Ph. D. economists, forecast the cost of the original Medicare law. They did simple extrapolations of past costs. Well, the cost forecast was off by a factor of more than One Thousand Percent. The cost they projected was less than ten percent of the cost that happened. Once they put in place various new incentives, the behavior changed in response to the incentives, and the numbers became quite different from their projection. And medicine invented new and expensive remedies, as it was sure to do. How could a great group of experts make such a silly forecast? Answer: They oversimplified to get easy figures, like the rube rounding pi to 3.11. They chose not to consider effects of effects on effects. and so on.

if you believe in Medicare saving you,

The greatest of these unfunded obligations is the universal healthcare system for seniors implemented as part of Lyndon Johnson’s “Great Society” domestic programs of the 1960s. Medicare suffers from the same demographic challenges as Social Security. As of 2017, it costs the government over $590 billion per year, and these costs continue to spiral out of control. According to Walker, the fiscal strain of these two programs alone could bankrupt the United States of America.

The United States currently spends roughly 76 cents of every tax dollar it brings in on four items: Social Security, Medicare, Medicaid, and interest on the National Debt.*3 Absent any action on the part of Congress, however, the percentage of the government’s revenue required to pay for these four big-ticket items could balloon to 92 cents of every tax dollar by the year 2020.*4 As these four expenses grow and compound, they begin to crowd out all other government expenditures.

I used to buy everything,” Gloria said, “and then one day I found out that I could simply take what I wanted. It’s much better than buying. They run a little bus once a week to the mall and we get to shop around for an hour or two and then the bus brings us back here. It’s very pleasant.” “That’s stealing,” Lula said. “Not stealing,” Gloria said. “It’s shoplifting, and if you’re a senior or destitute, it falls into the RAM program. Redistribution of Available Merchandise. It supplements Social Security and Medicare. It’s an entitlement program.” “I never heard of that program,” Lula said, “but I know a lot of people who participate. Most of them are in jail.

We get paid much more to keep someone on dialysis than to keep them off of it. If we don’t achieve dialysis metrics—like avoiding dialysis catheters or providing a certain dose of dialysis—known to best result in long-term benefits, we are financially penalized. But create a fistula in a little old lady that usually requires interventions to make it work and keep it working and make her stay on the dialysis machine as long as it takes for the numbers to look right, then essentially get a bonus. If we see an in-center hemodialysis patient four times in a month, we stand to make 50 percent more money than if we only saw her once. And the nephrologist really only has to see the patient once each month—if a physician assistant sees the patient the other times, we still get paid. We would have to document a comprehensive medical history and examination over the better part of an hour with a patient returning to clinic twice to see the same money—and good luck trying to justify why that was clinically necessary to do. The second, third, and fourth in-center hemodialysis patient visits can be more like drive-bys—a simple documentation that we (or the physician assistant) “saw” the patient, with no notation of time required. Private insurance companies and the Medicare ESRD program pay top dollar for dialysis care, not clinic visits. It’s profitable to build another dialysis center, but we haven’t figured out how to build comprehensive outpatient palliative care services.

Medicare would not pay for more basic “life support,” such as someone to help Mr. St. Pierre to get up and dressed each day, to bathe him a few times a week, or to prepare his meals. These things were not health care, and Medicare and insurance guidelines make clear that only health care is covered.

If you are receiving Medicare and were receiving Social Security benefits when you suspended them, your Medicare payments can no longer be paid automatically and deducted from your Social Security payments. You will need to pay your Medicare premiums out of your own pocket. Don’t forget this, as failure to do so can mess up your benefit suspension.

Another possible solution would be to think about kidney exchange in a global way. There is virtually no kidney transplantation, and little or no access to dialysis, in places such as Nigeria, Bangladesh, and Vietnam, where kidney failure is a death sentence. Presumably, many kidney patients there have willing donors, but in a country such as Nigeria, for example, where fewer than 150 transplants occurred from 2000 to 2010, that willingness doesn’t do patients any good. But suppose we were to offer them access to American hospitals, at no cost? That may sound expensive, but it wouldn’t have to be—indeed, it could be self-financing. Remember that removing an American patient from dialysis saves Medicare a quarter of a million dollars. That’s more than enough to finance two kidney transplants, as well as postsurgical care and medicines. That money could pay for an exchange between an American patient-donor pair and, say, a Nigerian pair.