Healthcare Insurance Quotes

America's health care system is neither healthy, caring, nor a system.

Everyone should have health insurance? I say everyone should have health care. I'm not selling insurance.

Pick a leader who is strong and confident, yet humble. Intelligent, but not sly. A leader who encourages diversity, not racism. One who understands the needs of the farmer, the teacher, the welder, the doctor, and the environmentalist -- not only the banker, the oil tycoon, the weapons developer, or the insurance and pharmaceutical lobbyist.

If there is one thing I'd learned about hospitals, it's that they aren't interested in healing you. They are interested in stabilizing you, and then everyone is supposed to move on. They go to stabilize some more people, and you go off to do whatever you do. Healing, if it happens at all, is done on your own, long after the hospital has submitted your final insurance paperwork.

Pick a leader who will not only bail out banks and airlines, but also families from losing their homes -- or jobs due to their companies moving to other countries. Pick a leader who will fund schools, not limit spending on education and allow libraries to close. Pick a leader who chooses diplomacy over war. An honest broker in foreign relations. A leader with integrity, one who says what they mean, keeps their word and does not lie to their people. Pick a leader who is strong and confident, yet humble. Intelligent, but not sly. A leader who encourages diversity, not racism. One who understands the needs of the farmer, the teacher, the doctor, and the environmentalist -- not only the banker, the oil tycoon, the weapons developer, or the insurance and pharmaceutical lobbyist.

What was to be a relatively innocuous federal government, operating from a defined enumeration of specific grants of power, has become an ever-present and unaccountable force. It is the nation’s largest creditor, debtor, lender, employer, consumer, contractor, grantor, property owner, tenant, insurer, health-care provider, and pension guarantor. Moreover, with aggrandized police powers, what it does not control directly it bans or mandates by regulation.

Seeing modern health care from the other side, I can say that it is clearly not set up for the patient. It is frequently a poor arrangement for doctors as well, but that does not mitigate how little the system accounts for the patient's best interest. Just when you are at your weakest and least able to make all the phone calls, traverse the maze of insurance, and plead for health-care referrals is that one time when you have to — your life may depend on it.

Admirable,” Astaroth had once said. “We could stand to learn a few things about ruthless manipulation and one-sided bargains from American healthcare insurers.

The thing they're trying to stop is 30-million people getting health insurance. That's the substance.

Fewer and fewer large and medium-sized companies offer their workers full health-care coverage—74 percent did in 1980, under 10 percent do today. As a result, health insurance premiums, co-payments, and deductibles are soaring.

This is the opposite of the free market.

It was the reason neither Florida nor any of her friends could afford health insurance—the industry had nothing to do with providing healthcare; it was designed to extract the maximum amount of money from each person.

The United States spends more than twice as much per capita on health care as other rich capitalist countries —around $9,400 compared to around $3,600—and for that money its citizens can expect lives that are three years shorter. The United States spends more per capita on health care than any other country in the world, but 39 countries have longer life expectancies. [...] Under the current US system, rich, insured patients visit doctors more than they need, running up costs, while poor patients cannot afford even simple, inexpensive treatments and die younger than they should. Doctors spend time that could be used to save lives or treat illness by providing unnecessary, meaningless care. What a tragic waste of physician care.

Let's run the experiment.

Good health shapes an expression of experiences.

Rand Paul...said national health insurance is slavery. He said, I'm a physician, and if there's national health insurance, the government is forcing me to take care of somebody who is ill. Why should I be a slave to the state? Here we're getting capitalist pathology in its most extreme, lunatic form. It is the opposite of solidarity, mutual support, mutual help.

You might also be wondering how the Obama administration thought they would get away with this disaster. I think their intention was simply to blame insurance companies when people started seeing their health insurance plans canceled. Liberals excel at vilifying the business sector, and the more they can demonize private-sector insurers, the more leverage they believe they will have for continuing to move toward the Holy Grail of the left that Ronald Reagan warned against in 1961—a single-payer, government-funded, socialized health-care system.

The insistence that healthcare finance must be obtuse, that we must be condemned to illness because of an untranslatable series of runes and glyphs accessible only to a specialized wonk class—that it just has to be hard and thus anything that isn’t hard isn’t a solution—is a kind of epistemic violence against us non-wonk humans.*4 It is a lack of ambition, disguised as pragmatism. So let’s start simple. Here’s single-payer in one sentence: we pool the money we already pay to insurance companies and use it to insure everyone, in full, with no cost-sharing.

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed. Similarly, there’s no billing code for putting a patient on a comprehensive exercise program designed to maintain her muscle mass and sense of balance while building her resistance to injury. But if she falls and breaks her hip, then her surgery and physical therapy will be covered. Nearly all the money flows to treatment rather than prevention—and when I say “prevention,” I mean prevention of human suffering.

Humans and machines might merge so completely that humans will not be able to survive at all if they are disconnected from the network. They will be connected starting in the womb, and if later in life you choose to disconnect, insurance agencies might refuse to insure you, employers might refuse to employ you, and healthcare services might refuse to take care of you. In the big battle between health and privacy, health is likely to win hands down.

Studies have showed that hospitals charge patients who are uninsured or self-pay 2.5 times more than they charge covered by health insurance (who are billed negotiated rates) and three times more than the amount allowed by Medicare.

New Rule: Republicans must stop pitting the American people against the government. Last week, we heard a speech from Republican leader Bobby Jindal--and he began it with the story that every immigrant tells about going to an American grocery store for the first time and being overwhelmed with the "endless variety on the shelves." And this was just a 7-Eleven--wait till he sees a Safeway. The thing is, that "endless variety"exists only because Americans pay taxes to a government, which maintains roads, irrigates fields, oversees the electrical grid, and everything else that enables the modern American supermarket to carry forty-seven varieties of frozen breakfast pastry.Of course, it's easy to tear government down--Ronald Reagan used to say the nine most terrifying words in the Englishlanguage were "I'm from the government and I'm here to help." But that was before "I'm Sarah Palin, now show me the launch codes."The stimulus package was attacked as typical "tax and spend"--like repairing bridges is left-wing stuff. "There the liberals go again, always wanting to get across the river." Folks, the people are the government--the first responders who put out fires--that's your government. The ranger who shoos pedophiles out of the park restroom, the postman who delivers your porn.How stupid is it when people say, "That's all we need: the federal government telling Detroit how to make cars or Wells Fargo how to run a bank. You want them to look like the post office?"You mean the place that takes a note that's in my hand in L.A. on Monday and gives it to my sister in New Jersey on Wednesday, for 44 cents? Let me be the first to say, I would be thrilled if America's health-care system was anywhere near as functional as the post office.Truth is, recent years have made me much more wary of government stepping aside and letting unregulated private enterprise run things it plainly is too greedy to trust with. Like Wall Street. Like rebuilding Iraq.Like the way Republicans always frame the health-care debate by saying, "Health-care decisions should be made by doctors and patients, not government bureaucrats," leaving out the fact that health-care decisions aren't made by doctors, patients, or bureaucrats; they're made by insurance companies. Which are a lot like hospital gowns--chances are your gas isn't covered.

To my thinking the greatest advance in recorded medical history is the thirty-minute walk before breakfast. Premiums for life insurance are usually paid for the benefit of someone else. If you want any life insurance for yourself you had better pay the daily premium of a thirty-minute walk.

No, I mean I'm sorry that you've inherited such a miserable, collapsing Old Country. A place where rich Bankers own everything, where you've got to be grateful for a part-time job with no benefits and no retirement plan, where the most health insurance you can afford is being careful and hoping you don't get sick, where --

Broken payment models. Because we rely on insurance companies to pay for care, the treatments offered are not necessarily the most effective or those supported by the most current evidence—they’re simply the treatments that insurance companies have agreed to reimburse. This is not evidence-based medicine, it’s reimbursement-based medicine.

I wonder what would happen if I tried the same reasoning on you. 'I have received your insurance premium invoice. My conclusion is this fee is not financially appropriate for you. It is my decision that you should be paid in bags of rocks deposited directly on your testicles. You may appeal this decision by screaming and hitting your head against a brick wall until you get tired, then read this letter again because I'm not fucking listening.

You cannot think of a better arrangement materially: in terms of healthcare, insurance, cars. You have more comforts and conveniences than any previous generation. But people are suffering immensely. In affluent societies almost every fifth person is on some kind of medication just to maintain mental balance. When you have to take a tablet every day to remain sane, this is not joyfulness. You are on the verge of breaking down because you have made a small aspect of your life the whole of your life.

Ozroth’s chest was tight, and his stomach was starting to feel sour, so he turned and stalked out of the kitchen. Lucifer, why did so many human emotions feel like physical illness? It was a wonder humans didn’t visit the doctor on an hourly basis. Then again, Glimmer Falls was located in America, and news of the horrors of the American medical system had reached even the demon plane. “Admirable,” Astaroth had once said. “We could stand to learn a few things about ruthless manipulation and one-sided bargains from American healthcare insurers.

Now consider free healthcare for illegals. This violates the basic idea of a social compact, which is a mutual bond among citizens who pledge that they are in this together. It violates the premise of the welfare state, in which citizens of a nation through the political process agree to pool some of their resources and insure themselves against certain risks. “Rights” are within that social compact. No group of people owes entitlements, whether subsidized healthcare or anything else, to anyone who is not a legitimate member of their community.

First, the very idea that there should be any serious kind of health insurance for Americans (beyond tiny elites) simply did not have much reality until World War II—and it was (again) the war that gave it reality. With wartime labor scarce, wage-price controls were enacted to keep bidding wars in check. Corporations, unable to offer more pay, tried to compete with benefits instead. The modern idea of widespread employer-provided health insurance developed as a strategy to attract wartime workers, and continued in many industries after the war, especially during the boom era.

By contrast, the American left and the Democratic Party operate on the principle that “free stuff” is truly free. The proposals of free healthcare, free education and free monthly checks all come with the tantalizing promise that someone else is going to pay. Not one Democratic candidate will stand up at a rally, point his finger toward the audience, and say, “The government is going to provide, and you are the ones who are going to pay for it.” This would bring an awkward, menacing silence. The reason for the cheering is the audience’s excitement over its realization that their bills and benefits will be footed by some other guy. This isn’t social insurance; it’s theft socialism.

...Ironically, three decades later President Barack Obama introduced a universal health insurance bill modeled closely after the Carter bill. Mondale´s former aide Richard Moe wrote that Obamacare ¨bore a striking resemblance to Carter´s proposal three decades before."The legislation pass Congress in 2009 with the support of Senator Kennedy, by then diagnosed with fatal brain cancer. In retrospect, Kennedy´s refusal to support Carter´s incremental, catastrophic national health insurance bill in 1978-79 condemned the country to wait three decades for meaningful healthcare reform. By any measure, this was a tragedy for the country. ¨The miss opportunity,¨ Eizenstat later wrote, ¨haunts me to this day.

In her book The Government-Citizen Disconnect, the political scientist Suzanne Mettler reports that 96 percent of American adults have relied on a major government program at some point in their lives. Rich, middle-class, and poor families depend on different kinds of programs, but the average rich and middle-class family draws on the same number of government benefits as the average poor family. Student loans look like they were issued from a bank, but the only reason banks hand out money to eighteen-year-olds with no jobs, no credit, and no collateral is because the federal government guarantees the loans and pays half their interest. Financial advisers at Edward Jones or Prudential can help you sign up for 529 college savings plans, but those plans' generous tax benefits will cost the federal government an estimated $28.5 billion between 2017 and 2026. For most Americans under the age of sixty-five, health insurance appears to come from their jobs, but supporting this arrangement is one of the single largest tax breaks issued by the federal government, one that exempts the cost of employer-sponsored health insurance from taxable incomes. In 2022, this benefit is estimated to have cost the government $316 billion for those under sixty-five. By 2032, its price tag is projected to exceed $6oo billion. Almost half of all Americans receive government-subsidized health benefits through their employers, and over a third are enrolled in government-subsidized retirement benefits. These participation rates, driven primarily by rich and middle-class Americans, far exceed those of even the largest programs directed at low income families, such as food stamps (14 percent of Americans) and the Earned Income Tax Credit (19 percent). Altogether, the United States spent $1.8 trillion on tax breaks in 2021. That amount exceeded total spending on law enforcement, education, housing, healthcare, diplomacy, and everything else that makes up our discretionary budget. Roughly half the benefits of the thirteen largest individual tax breaks accrue to the richest families, those with incomes that put them in the top 20 percent. The top I percent of income earners take home more than all middle-class families and double that of families in the bottom 20 percent. I can't tell you how many times someone has informed me that we should reduce military spending and redirect the savings to the poor. When this suggestion is made in a public venue, it always garners applause. I've met far fewer people who have suggested we boost aid to the poor by reducing tax breaks that mostly benefit the upper class, even though we spend over twice as much on them as on the military and national defense.

Templates for Protest Letters 1. TO TACKLE A SURPRISE OUT-OF-NETWORK BILL Dear Sir or Madam: The bills enclosed were for out-of-network services performed on __________ during my admission to __________ Medical Center, a hospital that is in my insurance network. I went to __________ Medical Center precisely because it was in my network. I was not informed of these providers’ out-of-network status and did not consent to being treated by any out-of-network providers. Since I did not give informed consent for treatment beyond the terms and network of my insurance policy, I suggest you contact my insurer to work out payment; I will pay only that portion of the bill that I would have paid for in-network services. Please stop this effort to collect a bill I do not owe for a service I was never informed would be out-of-network. If I get another notice, I will report this collection effort to the __________ State Department of Insurance and __________ State Department of Consumer Affairs. Sincerely, 2. TO OBTAIN MEDICAL RECORDS AND ITEMIZED BILLS Dear Sirs or Madam: I have now requested my medical records/itemized bill __________ times and have yet to receive the material. It is my right to receive these

Take Canada again: why does Canada have the health-care program it does? Up until the mid-1960s, Canada and the United States had the same capitalist health service: extremely inefficient, tons of bureaucracy, huge administrative costs, millions of people with no insurance coverage―exactly what would be amplified in the United States by Clinton's proposals for "managed competition" [put forward in 1993].21 But in 1962 in Saskatchewan, where the N.D.P. is pretty strong and the unions are pretty strong, they managed to put through a kind of rational health-care program of the sort that every industrialized country in the world has by now, except the United States and South Africa. Well, when Saskatchewan first put through that program, the doctors and the insurance companies and the business community were all screaming―but it worked so well that pretty soon all the other Provinces wanted the same thing too, and within a couple years guaranteed health care had spread over the entire country. And that happened largely because of the New Democratic Party in Canada, which does provide a kind of cover and a framework within which popular organizations like unions, and then later things like the feminist movement, have been able to get together and do things.

If you're involved in a motorcycle accident, this can result in devastating injuries, permanent disability or perhaps put you on on-going dependency on healthcare care. In that case, it's prudent to make use of Los Angeles motorcycle accident attorneys to assist safeguard your legal rights if you are a victim of a motorcycle accident. How a san diego car accident attorney Aids An experienced attorney will help you, if you're an injured motorcycle rider or your family members in case of a fatal motorcycle accident. Hence, a motorcycle accident attorney assists you secure complete and commensurate compensation because of this of accident damages. In the event you go it alone, an insurance coverage company may possibly take benefit and that's why you'll need to have a legal ally by your side till the case is settled to your satisfaction. If well represented after a motorcycle collision, you may get compensation for: Present and future lost income: If just after motor cycle injury you cannot perform and earn as just before, you deserve compensation for lost income. This also applies for a loved ones that has a lost a bread-winner following a fatal motorcycle crash. Existing and future healthcare costs, rehabilitation and therapy: these consist of any health-related fees incurred because of this of the accident. Loss of capability to take pleasure in life, pain and mental anguish: a motorcycle crash can lessen your good quality of life if you cannot stroll, run, see, hear, drive, or ride any longer. That is why specialists in motor cycle injury law practice will help with correct evaluation of your predicament and exercise a commensurate compensation. As a result, usually do not hesitate to speak to Los Angeles motorcycle accident attorneys in case you are involved in a motor cycle accident. The professionals will help you file a case within a timely fashion also as expedite evaluation and compensation. This could also work in your favor if all parties involved agree to an out-of-court settlement, in which case you incur fewer costs.

WHY DIVERSIFY? During the bull market of the 1990s, one of the most common criticisms of diversification was that it lowers your potential for high returns. After all, if you could identify the next Microsoft, wouldn’t it make sense for you to put all your eggs into that one basket? Well, sure. As the humorist Will Rogers once said, “Don’t gamble. Take all your savings and buy some good stock and hold it till it goes up, then sell it. If it don’t go up, don’t buy it.” However, as Rogers knew, 20/20 foresight is not a gift granted to most investors. No matter how confident we feel, there’s no way to find out whether a stock will go up until after we buy it. Therefore, the stock you think is “the next Microsoft” may well turn out to be the next MicroStrategy instead. (That former market star went from $3,130 per share in March 2000 to $15.10 at year-end 2002, an apocalyptic loss of 99.5%).1 Keeping your money spread across many stocks and industries is the only reliable insurance against the risk of being wrong. But diversification doesn’t just minimize your odds of being wrong. It also maximizes your chances of being right. Over long periods of time, a handful of stocks turn into “superstocks” that go up 10,000% or more. Money Magazine identified the 30 best-performing stocks over the 30 years ending in 2002—and, even with 20/20 hindsight, the list is startlingly unpredictable. Rather than lots of technology or health-care stocks, it includes Southwest Airlines, Worthington Steel, Dollar General discount stores, and snuff-tobacco maker UST Inc.2 If you think you would have been willing to bet big on any of those stocks back in 1972, you are kidding yourself. Think of it this way: In the huge market haystack, only a few needles ever go on to generate truly gigantic gains. The more of the haystack you own, the higher the odds go that you will end up finding at least one of those needles. By owning the entire haystack (ideally through an index fund that tracks the total U.S. stock market) you can be sure to find every needle, thus capturing the returns of all the superstocks. Especially if you are a defensive investor, why look for the needles when you can own the whole haystack?

Most of us feel basic healthcare is a basic need; we are taught that growing up. Children's story books will often carry a theme in them that if you have an injury, you go to the doctor. The stories do not say: if you have insurance and have an injury, then you go to the doctor; if you don't have insurance, try the county emergency room. But that's how it is right now.

Meanwhile, administrative costs are eating up 15–30 percent of all health-care spending in the United States. That’s twice the rate of most other advanced nations. This money goes mainly into collecting money: doctors collect from hospitals and insurers, hospitals collect from insurers, insurers collect from companies or from policyholders. At some hospitals, billing clerks outnumber physicians. A third of nursing hours are devoted to documenting tests and procedures so insurers have proof.

Therefore, the president added, “There is a moral component to this that we can’t leave behind. Having said that,” he continued, “if we don’t address costs, we will not get this done. If people think we’re simply gonna take everyone who’s not insured and load them up into a system … the federal government will be bankrupt. State governments will be bankrupt. I’m talking to you liberal bleeding hearts out there,” he added. “Don’t think that we can solve this problem without tackling costs. And that may make some in the progressive community uncomfortable but it’s gotta be dealt with.

Luntz used polls, focus groups, and “instant response dial sessions” to perfect the language of health-care attacks and then tested the lines on average Americans in St. Louis, Missouri. Out of these sessions, Luntz compiled a seminal twenty-eight-page confidential memo in April warning that there was no groundswell of public opposition to Obama’s health-care plan at that point; in fact, there was a groundswell of public support. By far the most effective approach to turning the public against the program, Luntz advised, was to label it a “government takeover.” He wrote, “Takeovers are like coups. They both lead to dictators and a loss of freedom.” “I did create the phrase ‘government takeover’ of health care. And I believe it,” Luntz maintained, noting too that “it gave the Republicans the weapon they needed to defeat Obama in 2010.” But most experts found the pitch patently misleading because the Obama administration was proposing that Americans buy private health insurance from for-profit companies, not the government. In fact, progressives were incensed that rather than backing a “public option” for those who preferred a government insurance program, the Obama plan included a government mandate that individuals purchase health-care coverage, a conservative idea hatched by the Heritage Foundation to stave off nationalized health care. Luntz’s phrase was so false that it was chosen as “the Lie of the Year” by the nonpartisan fact-checking group PolitiFact. Yet while a rear guard of administration officials tried lamely to correct the record, Luntz’s deceptive message stuck, agitating increasingly fearful and angry voters, many of whom flocked to Tea Party protests.

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inhabitants paid cripplingly high taxes. Which meant that we would, too. Oh brilliant! We’ll be even more skint by the end of the month than we are already… But for your Danish krone, I learned, you got a comprehensive welfare system, free healthcare, free education (including university tuition), subsidised childcare and unemployment insurance guaranteeing 80 per cent of your wages for two years.

Over the last few years, the changes the government had put in place were designed to ensure the public service failed, paving the way for full privatisation and an insurance-funded healthcare system similar to that in the US. The

Rush Limbaugh nailed it on his broadcast: “Obamacare is not about improved healthcare or cheaper insurance or better treatment or insuring the uninsured, and it never has been about that. It’s about statism. It’s about expanding the government. It’s about control over the population. It is about everything but healthcare.” Obamacare is just one part of the unwanted, unnecessary, unaffordable fundamental transformation of America hoisted upon us; its premise is unquestionable government control over a free people. Limbaugh’s message echoes that of early nineteenth-century minister William John Henry Boetcker: “You cannot strengthen the weak by weakening the strong. . . . You cannot build character and courage by taking away man’s initiative and independence. . . . You cannot help men permanently by doing for them what they could and should do for themselves.” Good leaders understand that the ills of our economy and our society won’t be solved by a bigger, more intrusive government. The answer to restoring America is to restore her values of freedom, hard work, and individual initiative. SWEET FREEDOM IN Action Today, get more informed about how big government is antithetical to America’s foundational principles. Work to elect leaders who promise (and then deliver!) to rein in government, repeal Obamacare, and return power to the people, who can make better decisions for themselves, their families, and their businesses than bureaucrats ever will.   DAY 92

You can have the best health insurance in the world, but it will not protect you from a contagious disease. What protects you from a contagious disease is if your whole population – rich and poor – can receive the healthcare they need.

Having free healthcare is easy, just eliminate the health insurance companies.

The rising cost of medical care has also been important; most employees receive health insurance as part of their overall compensation, and most research shows that increases in premiums ultimately come out of wages.16 Indeed, average wages have tended to do badly when health-care costs are rising most rapidly and to do better when health-care costs are rising more slowly.

I got fed up of my doctors saying ‘Your medical insurance does not cover the tests that you need’ during my journey through the USA healthcare system.

Anyone under the age of 65 that has private health insurance is not the true customer in American healthcare. Large and small group employers are.

Runaway costs are crushing the American medical system. Hispanics are the group least likely to have medical insurance, with 30.7 percent uninsured. Ten point eight percent of whites and 19.1 percent of blacks are without insurance. Illegal immigrants rarely have insurance, but hospitals cannot turn them away. In 1985, Congress passed the Emergency Medical Treatment and Active Labor Act, which requires hospitals to treat all emergency patients, without regard to legal status or ability to pay. Anyone who can stagger within 250 yards of a hospital—a distance established through litigation—is entitled to “emergency care,” which is defined so broadly that hospital emergency rooms have become free clinics. Emergency-room care is the most expensive kind. Childbirth is an emergency, and hospitals must keep mother and child until both can be discharged. If the mother is indigent the hospital pays for treatment, even if there are expensive complications. Any child born in the United States is considered a US citizen, so thousands of indigent illegal immigrants make a point of having “anchor babies” at public expense. The new American qualifies for all forms of welfare, and at age 21 can sponsor his parents for American citizenship. In 2006 in California, an estimated 100,000 illegal immigrant mothers had babies at public expense, and accounted for about one in five births. The costs were estimated at $400 million per year, and in the state as a whole, half of all Medi-Cal (state welfare) births were to illegal immigrant mothers. In 2003, 70 percent of the babies born in San Joaquin General Hospital in Stockton were anchor babies. In Los Angeles and other cities with heavy gang activity, hospitals must deal with “dump and run” patients—criminals wounded in shootouts who are rolled out of speeding cars by fellow gang members. Illegal-immigrant patients often show up without papers of any kind, and doctors have no idea whom they are treating. Mexican hospitals routinely turn away uninsured Mexicans, and if the US border is not far, may tell the ambulance driver to head for the nearest American hospital. “It’s a phenomenon we noticed some time ago, one that has expanded very rapidly,” said a federal law enforcement officer.

Hospitals cannot continue to hemorrhage. For the country as a whole, medical insurance premiums include a surcharge that pays for treating the uninsured. However, if the proportion of uninsured indigent patients exceeds a certain figure, a hospital has no choice but to close. In California alone, the heavy cost of free medicine for foreigners forced no fewer than 60 hospitals to shut down between 1993 and 2003; many others were on the verge of collapse. From 1994 to 2004, the number of hospital emergency rooms in the country as a whole dropped by more than 12 percent. In May 2010, Miami’s health care system was so strapped, it was considering closing two of its five public hospitals. This would mean laying off 4,487 employees and the loss of 581 acute-care beds. Experts explained that treating uninsured patients had stretched the system to the breaking point. Houston is a good example of a city whose hospitals are barely making ends meet. In the nation as a whole, about 15 percent of the population has no medical insurance, but Texas, with its large population of Hispanics, has the highest percentage at 24 percent. In Houston, the figure is 30 percent. The safety net cannot accommodate so many people who cannot pay. “Does this mean rationing?” asks Kenenth Mattox, chief of staff at Ben Taub General Hospital. “You bet it does.” There is such a crush at Houston’s emergency rooms that ambulances often wait for one or two hours before they can even unload patients. The record wait is six hours. Twenty percent of the time, hospitals end up sending patients to other hospitals, and some have died after being diverted. Politicians and businessmen pull strings so friends can cut in line. Americans who fall sick in Mexico do not get free treatment. The State Department warns that Mexican doctors routinely refuse to treat foreign patients unless paid in advance, and that they often charge Americans for services not rendered.

The IoT market grows rapidly and it’s acceleration will continue in all major areas like Industrial Internet of Things; Digital Enterprise; Internet of Healthcare; Internet of Energy; Internet of Education; Digitalisation of global Supply Chains. Security concerns add to the IoT complexity. Strategically, to assure the system’s reliability & data / knowledge engineering, it is important to insure data integrity, availability, traceability, and privacy. A complex problem of digital transformation globally. The Internet of Things cybersecurity, therefore, is not a matter of device self-defence. What is needed is a systemic approach. Identify underlying patterns. Secure elements of a chain: from security of a device that creates, captures your data.. to the data storage.. to the back-end storage.. Create/ join IoT ecosystems, driven by protection with external monitoring, detection and reaction systems. It is a challenge - to secure systems.

Look at the way that Obama greatly increased government control not only over healthcare—every hospital, every doctor, every health insurance company—but also over the financial sector—every bank, every investment house—and increasingly over the energy, automobile and education sectors as well.

in 2012, the three hundred largest cooperatives worldwide, covering agriculture, retail, insurance and healthcare, generated $2.2 trillion in revenue—equivalent to the world’s seventh largest economy.66 In the UK, the John Lewis Partnership, a leading retailer for almost a century, has over 90,000 permanent staff named as Partners in the business. In 2011, the company raised £50 million in capital by inviting employees and customers to purchase five-year bonds in return for an annual 4.5 percent dividend plus 2 percent in shop vouchers.

The imaginations of our nation's entrepreneurs, coupled with the constant discoveries of our scientists, can lead us to this future. But our twentieth-century policies, regulations, and market approaches cannot solve our twenty-first-century challenges. We are also hindered by our big, bureaucratic government and special interests that protect the past at the expense of progress. We must urgently rethink these failing systems and outdated regulations if we are to clear the way for a revolution in health science and technology. President Trump and congressional Republicans, therefore, must think much bigger and broader than changes in insurance financing to enact real reform that will save lives and save money. Instead, their number one priority should be to replace our current health bureaucracy with a flatter, more transparent, and more accountable health system that embraces innovation.

Every American should be able to expect certain standards, freedoms, benefits, and opportunities form a twenty-first-century health system. If they are willing to participate and be responsible, they will gain: •Improved health; •Longer lives with a much better quality of life; •A more convenient, understandable and personalized experience -- all at a lower cost; •Access to the best course of treatment for their particular illness and their unique characteristics; •A system that fosters and encourages innovation, competition, and better outcomes for patients; •A system that truly values the impact that medical innovation has on patients and their caregivers as well as on society as a whole; •A government that facilitates and accelerates extraordinary opportunities to improve health and health care; •Continuous but unobtrusive 24/7 monitoring of their general health, chronic conditions, and acute health problems; •Access to the most modern medical knowledge and breakthroughs, including the most advanced technologies, therapies and drugs, unimpeded by government-imposed price controls or rationing; •The chance to increase their personal knowledge by learning from a transparent system of information about their diagnosis, costs and alternative solutions; •A continuously improving, competitive, patient-focused medical world in which new therapies, new technologies, and new drugs are introduced as rapidly and safely as possible -- and not a day later; •Greater price and market competition, innovation and smarter health care spending; •A system of financing that includes insurance, government, charities, and self-funding that ensures access to health and health care for every American at the lowest possible cost without allowing financing and short-term budgetary considerations to distort and weaken the delivery of care; •Genuine insurance to facilitate access to dramatically better care, rather than the current system, which is myopically focused on monthly or annual payments; •A health system in which third parties and government bureaucrats do not impede the best course of treatment that doctors and their patients decide on; •A health system in which seniors, veterans, or others under government health programs receive the same quality of care as their children in private markt systems. Big reforms are required to transform today’s expensive, obsolete health bureaucracy into a system that conforms to these principles.

Cost-effectiveness analyses can be undertaken from a number of different perspectives. The choice of the study perspective is an important methodological decision because it determines which costs and effects to count and how to value them. The appropriate perspective depends on the objective of the study, the context, and the relevant decision makers. As indicated above, we recommend that analysts conduct Reference Case analyses from both the healthcare sector and societal perspectives (Recommendations 2–5). Other perspectives may, however, be relevant for specific decision makers. To illustrate, we briefly consider four perspectives potentially relevant to the analysis of health interventions: the payer perspective, the healthcare sector Reference Case perspective, the healthcare sector with time cost perspective, and the societal Reference Case perspective. Although we note two additional perspectives here, the remainder of this book will focus on the healthcare sector and societal Reference Case perspectives. The payer perspective includes the consequences that a specific payer considers relevant. This perspective will be more or less narrow depending on whether the payer is private or public. For a US private commercial payer (insurer), for example, costs might include reimbursement for medical care paid for by the insurer and consequences for patients covered by the insurer.

Health is a moral issue. It is about life and death first. Money comes second. Trump and the Republicans' vision for health care reform must be about more than repealing Obamacare. It must be about more than insurance. It must create a clear, positive path for twenty-first-century health and health care.

Perhaps less pernicious but still worrisome is reliance on “wellness” programs, which most medium to large employers in the United States have, despite the fact that, overall, they have not been validated to promote health outcomes. Typically, a wellness program combines step counting, weight and blood pressure readings, and cholesterol lab tests, as well as some incentive for employees to participate (such as a surcharge on an employee’s contribution to the cost of insurance). But wellness is poorly defined, and the cost effectiveness of such strategies has been seriously questioned.50 One way such programs could be improved, however, is through the use of virtual medical coaches, which could gather and make use of far more granular and deeper information about each individual.

The best health insurance we have is not something we can buy. It is how we take care of ourselves.

All one must do is remember basic math. If one system that administers medical payments require hundreds of duplicate services, equipment, software, & databases, and must make profits for passive investors, and must pay thousands of executives millions of dollars, then it is mathematically impossible for that system to be more efficient than one that must provide the same medical payments without those expenses and overhead. Not even an inordinate amount of waste and fraud in any single-payer system would likely match the legalized fraud of the private healthcare insurance system. It is simply basic math.

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.

Currently, the wealthy who have no pre-existing conditions can afford high-quality health care, while the poor and sick are relegated to hoping for and negotiating whatever health care safety net might exist in their area. This neoliberal form of capitalism structuring health care in the United States has led to those with the highest burden of sickness being simultaneously those with the least access to care.

I saw a documentary about prostitution in Holland a few years ago, that said over there health insurance actually pays for monthly visits to a prostitute for the disabled, because they feel that sex is part of a healthy life, so unmarried disabled men have a right to have sex, even if it's with a paid prostitute. Pretty bizarre, huh? Can you imagine a US health insurance company picking up the bill for your romp in the hay with a hooker?

In another cost control measure, it became mandatory in 2008 for employers to purchase medical insurance for low-income foreign workers, such as construction workers and maids.

No nation influenced American thinking more profoundly than Germany, W.E.B. DuBois, Charles Beard, Walter Weyl, Richard Ely, Richard Ely, Nicholas Murray Butler, and countless other founders of modern American liberalism were among the nine thousand Americans who studied in German universities during the nineteenth century. When the American Economic Association was formed, five of the six first officers had studied in Germany. At least twenty of its first twenty-six presidents had as well. In 1906 a professor at Yale polled the top 116 economists and social scientists in America; more than half had studied in Germany for at least a year. By their own testimony, these intellectuals felt "liberated" by the experience of studying in an intellectual environment predicated on the assumption that experts could mold society like clay. No European statesman loomed larger in the minds and hearts of American progressives than Otto von Bismarck. As inconvenient as it may be for those who have been taught "the continuity between Bismarck and Hitler", writes Eric Goldman, Bismarck's Germany was "a catalytic of American progressive thought". Bismarck's "top-down socialism", which delivered the eight-hour workday, healthcare, social insurance, and the like, was the gold standard for enlightened social policy. "Give the working-man the right to work as long as he is healthy; assure him care when he is sick; assure him maintenance when he is old", he famously told the Reichstag in 1862. Bismarck was the original "Third Way" figure who triangulated between both ends of the ideological spectrum. "A government must not waver once it has chosen its course. It must not look to the left or right but go forward", he proclaimed. Teddy Roosevelt's 1912 national Progressive Party platform conspicuously borrowed from the Prussian model. Twenty-five years earlier, the political scientist Woodrow Wilson wrote that Bismarck's welfare state was an "admirable system . . . the most studied and most nearly perfected" in the world.

The biggest problem that we now collectively face is that for many people, companies, nonprofit organizations, and governments, their incomes are low in relation to their expenses, and their debts and other liabilities (such as those for pensions, healthcare, and insurance) are very large relative to the value of their assets. It may not seem that way—in fact, it often seems the opposite—because there are many people, companies, nonprofit organizations, and governments that look rich even while they are in the process of going broke.

Netherlands, which has a restrictive immigration policy compared to the United States. Most European nations, including the Netherlands, after all, have universal health insurance coverage, which makes drug treatment and psychiatric treatment more available, and the Dutch government subsidizes more housing. Finally, the Netherlands’ big success was with heroin, which has effective pharmacological substitutes, methadone and Suboxone, not with meth, which lacks anything similar. But there may be fewer obstacles than appear. The Netherlands has a private health-care insurance system similar to that of the United States and covered the people who needed health care in ways similar to Medicaid and the Affordable Care Act, which significantly expanded access to drug treatment, including medically assisted treatment, in the United States.4 San Francisco subsidizes a significant quantity of housing, as we have seen. While California is larger than the Netherlands, the population of Amsterdam (872,000) is nearly identical to San Francisco’s (882,000).5 And while California’s population and geographic area are larger and more difficult to manage than those of the Netherlands, California also has significantly greater wealth and resources, constituting in 2019 the fifth-largest economy in the world.6 And the approach to breaking up open drug scenes, treating addiction, and providing psychiatric care is fundamentally the same whether in five European cities, Philadelphia, New York, or Phoenix.

However, as Rogers knew, 20/20 foresight is not a gift granted to most investors. No matter how confident we feel, there’s no way to find out whether a stock will go up until after we buy it. Therefore, the stock you think is “the next Microsoft” may well turn out to be the next MicroStrategy instead. (That former market star went from $3,130 per share in March 2000 to $15.10 at year-end 2002, an apocalyptic loss of 99.5%).1 Keeping your money spread across many stocks and industries is the only reliable insurance against the risk of being wrong. But diversification doesn’t just minimize your odds of being wrong. It also maximizes your chances of being right. Over long periods of time, a handful of stocks turn into “superstocks” that go up 10,000% or more. Money Magazine identified the 30 best-performing stocks over the 30 years ending in 2002—and, even with 20/20 hindsight, the list is startlingly unpredictable. Rather than lots of technology or health-care stocks, it includes Southwest Airlines, Worthington Steel, Dollar General discount stores, and snuff-tobacco maker UST Inc.2 If you think you would have been willing to bet big on any of those stocks back in 1972, you are kidding yourself.

This semi-privatization of Medicare was called Medicare Part C, or Medicare Advantage. Although it has the name “Medicare,” it’s not Medicare. It’s private, for-profit insurance, with almost all of the costs paid for with funds extracted from the government’s Medicare trust fund.

At the same time, she saw on the streets and subways of New York a depth of poverty unlike anything she'd ever witnessed in Europe, and realized that unemployment or even a poorly paid job in the US could lead to abject homelessness, hunger, and desperation. Compounding Partanen's anxiety was the fact that, while poverty was often visible, wealth frequently was not; she eventually realized that many of the people whom she thought of as her peers were not living on their earnings, but on inheritances or family support. Worst of all, it really did seem difficult to earn enough to own a home, send her kids to college, or have reliable health-care insurance. Paradoxically, as her insecurities added up, she found herself wanting to spend more money, rather than less. 'It was striking to me that I, who had grown up in a Nordic country and had not felt that before, got caught up in it quite quickly after moving to America. I felt like I should be consuming more,' Partanen said, 'You want to buy more things that will make you feel like you're making it, and like you are safe.

Since governments have the ability to both make and borrow money, why couldn’t the central bank lend money at an interest rate of about 0 percent to the central government to distribute as it likes to support the economy? Couldn’t it also lend to others at low rates and allow those debtors to never pay it back? Normally debtors have to pay back the original amount borrowed (principal) plus interest in installments over a period of time. But the central bank has the power to set the interest rate at 0 percent and keep rolling over the debt so that the debtor never has to pay it back. That would be the equivalent of giving the debtors the money, but it wouldn’t look that way because the debt would still be accounted for as an asset that the central bank owns, so the central bank could still say it is performing its normal lending functions. This is the exact thing that happened in the wake of the economic crisis caused by the COVID-19 pandemic. Many versions of this have happened many times in history. Who pays? It is bad for those outside the central bank who still hold the debts as assets—cash and bonds—who won’t get returns that would preserve their purchasing power. The biggest problem that we now collectively face is that for many people, companies, nonprofit organizations, and governments, their incomes are low in relation to their expenses, and their debts and other liabilities (such as those for pensions, healthcare, and insurance) are very large relative to the value of their assets.

Henrique Dubugras, the co-founder of Brex, told me he was most excited about companies focused on rebuilding insurance. Mario Schlosser, the co-founder of Oscar Health, pointed to the wealth of opportunities still left to revamp healthcare. Max Mullen, who co-founded Instacart, raved about the future of food; Max Levchin of Affirm and PayPal talked about the importance of “clean water, access to food, climate change, and improvement in education.” For Neha Narkhede of Confluent, it was “the consumerization of the enterprise,” meaning a bottom-up adoption of tools to make enterprise sales happen. Michelle Zatlyn, the co-founder of Cloudflare, was excited about the future of social networks. And on the life science and healthcare side, Arie Belldegrun of Kite Pharma was excited about cell therapy, while Nat Turner of Flatiron Health was keen on the application of data in “neurology, neurodegenerative disease, and cardiovascular diseases.” The most interesting response came from Tony Fadell, the co-founder of Nest. “I think it’s more important to look at the markets than spaces and industries,” he told me. Beyond Silicon Valley, big changes are happening in India, in Southeast Asia, and across Latin America. “These places are going through massive transitions, just like China has already. You need to pay attention to these new markets and see what unique problems you can solve for these markets. You always need to think in the context of the problems of the place you’re going after.

What American Healthcare Can Learn from Italy: Three Lessons It’s easy. First, learn to live like Italians. Eat their famous Mediterranean diet, drink alcohol regularly but in moderation, use feet instead of cars, stop packing pistols and dropping drugs. Second, flatten out the class structure. Shrink the gap between high and low incomes, raise pensions and minimum wages to subsistence level, fix the tax structure to favor the ninety-nine percent. And why not redistribute lifestyle too? Give working stiffs the same freedom to have kids (maternity leave), convalesce (sick leave), and relax (proper vacations) as the rich. Finally, give everybody access to health care. Not just insurance, but actual doctors, medications, and hospitals. As I write, the future of the Affordable Care Act is uncertain, but surely the country will not fall into the abyss that came before. Once they’ve had a taste of what it’s like not to be one heart attack away from bankruptcy, Americans won’t turn back the clock. Even what is lately being called Medicare for All, considered to be on the fringe left a decade ago and slammed as “socialized medicine,” is now supported by a majority of Americans, according to some polls. In practice, there’s little hope for Italian lessons one and two—the United States is making only baby steps toward improving its lifestyle, and its income inequality is worse every year. But the third lesson is more feasible. Like Italy, we can provide universal access to treatment and medications with minimal point-of-service payments and with prices kept down by government negotiation. Financial arrangements could be single-payer like Medicare or use private insurance companies as intermediaries like Switzerland, without copying the full Italian model of doctors on government salaries. Despite the death by a thousand cuts currently being inflicted on the Affordable Care Act, I am convinced that Americans will no longer stand for leaving vast numbers of the population uninsured, or denying medical coverage to people whose only sin is to be sick. The health care genie can’t be put back in the bottle.

Finding a person to declare your craziest, most profound insecurities to is not exactly a picnic. But the bureaucratic idiocy of America’s healthcare system turns what should be a chore into torture. If you’re a middle-class person in America, the dance goes like this: You call your insurance provider to find a meager list of therapists who take your insurance. Most of the people on the list are licensed clinical social workers or licensed mental health counselors. They can be wonderful and very helpful, but they often have less schooling and experience than, say, psychologists and PhDs. After digging deeper, you find that some of these therapists don’t take your insurance after all; others have full client lists. And even if they do have space in the day to treat someone, they might not be interested in treating you. According to one study, a low-income Black person had up to an 80 percent lower chance of receiving a callback for an appointment than a middle-class white person. And even though intellectually, therapists tell you that anger can be a helpful and legitimate emotion in processing trauma, God forbid you actually seem angry on the phone. Several mental health professionals have told me that therapists often avoid rageful clients because they seem threatening or scary. Therapists instead prefer to take on YAVIS—Young, Attractive, Verbal, Intelligent, and Successful clients. They love an amenable type, someone who is curious about their internal workings and eager to plumb them, someone who’s already read articles in The New Yorker about psychology to familiarize them with the language of metacognition and congruence. Good luck if you’re a regular-ass Joe who’d rather watch It’s Always Sunny in Philadelphia. But say you get lucky and find a licensed clinical psychologist with an open slot. The psychologist is white, of course (86 percent of psychologists in the United States are), which isn’t ideal if you are a person of color. But, fine, whatever: You just need to receive an official diagnosis for your insurance. You are certain you have complex PTSD, but he can’t diagnose you with that because it’s not in the Diagnostic and Statistical Manual of Mental Disorders. Your insurance only covers treatment for conditions listed in the DSM in order to assign a number of sessions to you. Most forms of insurance will pay for, say, only six months of therapy relating to anxiety, ten for depression, as if you should be better by then. Another consequence of C-PTSD not being in the DSM: This psychologist hasn’t been trained in treating it. He says he doesn’t believe that it’s a real diagnosis. He’d like to provide you with some questionnaires to see if you have something he can actually handle—bipolar disorder, maybe, or manic depression. This does not inspire confidence, so you leave. After some internet sleuthing, you find a woman of color who seems really cool. She’s specifically trained in the treatment of complex trauma. She has blurbs on her website that resonate with you—it seems as if she might truly understand you. But she doesn’t take insurance. (Psychologists are the least likely of any medical provider to take insurance—only about 45 percent of them do. And most of the time, the ones who don’t are the most qualified practitioners.) You can’t exactly blame her. You learn on the internet that insurance companies haven’t updated reimbursement rates for therapists in up to twenty years, despite rising rates for office rent and other administrative costs. If therapists were to rely on reimbursement rates from insurance alone, they’d wind up making about $50,000 a year on average, which is fine, but like, not great if you’re an actual doctor.

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This was clear less than thirty minutes into the speech, when—as I debunked the phony claim that the bill would insure undocumented immigrants—a relatively obscure five-term Republican congressman from South Carolina named Joe Wilson leaned forward in his seat, pointed in my direction, and shouted, his face flushed with fury, “You lie!” For the briefest second, a stunned silence fell over the chamber. I turned to look for the heckler (as did Speaker Pelosi and Joe Biden, Nancy aghast and Joe shaking his head). I was tempted to exit my perch, make my way down the aisle, and smack the guy in the head. Instead, I simply responded by saying “It’s not true” and then carried on with my speech as Democrats hurled boos in Wilson’s direction. As far as anyone could remember, nothing like that had ever happened before a joint session address—at least not in modern times. Congressional criticism was swift and bipartisan, and by the next morning Wilson had apologized publicly for the breach of decorum, calling Rahm and asking that his regrets get passed on to me as well. I downplayed the matter, telling a reporter that I appreciated the apology and was a big believer that we all make mistakes. And yet I couldn’t help noticing the news reports saying that online contributions to Wilson’s reelection campaign spiked sharply in the week following his outburst. Apparently, for a lot of Republican voters out there, he was a hero, speaking truth to power. It was an indication that the Tea Party and its media allies had accomplished more than just their goal of demonizing the healthcare bill. They had demonized me and, in doing so, had delivered a message to all Republican officeholders: When it came to opposing my administration, the old rules no longer applied. —

From the very start of the healthcare debate, policy wonks on the left had pushed us to modify the Massachusetts model by giving consumers the choice to buy coverage on the online “exchange,” not just from the likes of Aetna and Blue Cross Blue Shield but also from a newly formed insurer owned and operated by the government. Unsurprisingly, insurance companies had balked at the idea of a public option, arguing that they would not be able to compete against a government insurance plan that could operate without the pressures of making a profit. Of course, for public-option proponents, that was exactly the point: By highlighting the cost-effectiveness of government insurance and exposing the bloated waste and immorality of the private insurance market, they hoped the public option would pave the way for a single-payer system.

Still, there was no getting around the fact that we’d be asking House Democrats to swallow a version of healthcare reform they’d previously rejected out of hand—one with no public option, a Cadillac tax the unions opposed, and a cumbersome patchwork of fifty state exchanges instead of a single national marketplace through which people could buy their insurance. “You still feeling lucky?” Phil asked me with a grin. Actually, I wasn’t. But I was feeling confident in the Speaker of the House.

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Uninsured and underinsured Americans often get less testing and fewer services than they need. Poor Americans are less likely to get crucial recommended screenings for colin cancer and blood pressure. But well-insured Americans suffer often from too much treatment-particularly as they age-with tests and services meted out not for health but for money.

Here’s what I think in a nutshell,” Brian said with vehemence. “I think you are running what amounts to fraud with your health insurance coconspirators by taking advantage of this country’s laissez-faire healthcare situation to maximize your profits. In the process, you and your collections people are bankrupting me and hundreds of others.

Table Of Contents Introduction The Problem With Contracts The Smart Solution Distinctive Properties What You Need to Know What Is A Smart Contract? Blockchain and Smart Contracts Vitalik Buterin On Smart Contracts Digital and Real-World Applications How Smart Contracts Work Smart Contracts' Historical Background A definition of Smart Contracts The promise What Do All Smart Contracts Have in Common? Elements Of Smart Contracts Characteristics of Smart Contracts Capabilities of Smart Contracts Life Cycle Of A Smart Contract Why Are Smart Contracts Important? How Do Smart Contracts Work? What Does Smart Contract Code Look Like In Practice? The Structure of a Smart Contract Interaction with Traditional Text Agreements Are Smart Contracts Enforceable? Challenges With the Widespread Adoption of Smart Contracts Non-Technical Parties: How Can They Negotiate, Draft, and Adjudicate Smart Contracts? Smart Contracts and the Reliance on “Off-chain” Resources What is the "Final" Agreement Reached by the Parties? The Automated Nature of Smart Contracts Are Smart Contracts Reversible? Smart Contract Modification and Termination The Difficulties of Integrating Specified Ambiguity Into Smart Contracts Do Smart Contracts Really Guarantee Payment? Allocation of Risk for Attacks and Failures Governing Law and Location Best Practices for Smart Contracts Types Of Smart Contracts A Technical Example of a Smart Contract Smart Contract Use-Cases Smart Contracts in Action Smart Contracts and Blockchains In the Automobile Industry Smart Contracts and Blockchains in Finance Smart Contracts and Blockchains In Governments Smart Contracts And Blockchains In Business Management Smart Contracts and Blockchains in Initial Coin Offerings (ICOs) Smart Contracts and Blockchains In Rights Management (Tokens) Smart Contracts And Blockchains In NFTs - Gaming Technology Smart Contracts and Blockchains in the Legal Industry Smart contracts and Blockchains in Real Estate Smart Contracts and Blockchains in Corporate Structures - Building DAOs Smart Contracts and Blockchains in Emerging Technology Smart Contracts and Blockchains In Insurance Companies Smart Contracts and Blockchains in Finance Smart Contracts And Blockchains In Powering DEFI Smart Contracts  and Blockchains In Healthcare Smart Contracts and Blockchains In Other Industries What Smart Contracts Can Give You How Are Smart Contracts Created? Make Your Very Own Smart Contract! Are Smart Contracts Secure?

In the end, she said that I should pay no attention to how much money my insurance company was being forced to pay. After all, it’s not costing me anything.

When the National War Labor Board froze salaries during and after World War II, companies facing severe labor shortages discovered that they could attract workers by offering health insurance instead. To encourage the trend, the federal government ruled that money paid for employees’ health benefits would not be taxed.

All hospitals have a master price list—a chargemaster—and adjusting it to maximize income was the focus of Deloitte’s strategy. To squeeze more money from the purse, Deloitte advised hospitals to stop billing for items like gauze rolls, which insurers rarely or never reimbursed, and to boost charges for services like OR time, oxygen therapy, and prescription drugs.

As obesity rates climbed, medical equipment companies devised new operations using new products to help combat the condition, and bariatric surgery was a boom field. Companies, hospitals, and doctors’ groups lobbied successfully to have insurers pay for it all. Being overweight was rebranded as a disease.

The original purpose of health insurance was to mitigate financial disasters brought about by a serious illness, such as losing your home or your job, but it was never intended to make healthcare cheap or serve as a tool for cost control. Our expectations about what insurance should do have grown.

By the 1990s, the Blues, which offered insurance in all fifty states, were hemorrhaging money, having been left to cover the sickest patients. In 1994, after state directors rebelled, the Blues’ board relented and allowed member plans to become for-profit insurers. Their primary motivation was not to charge patients more, but to gain access to the stock market to raise some quick cash to erase deficits.

...the United States is the sickest of the rich. ... The United States spends more than twice as much per capita on health care as other capitalist countries on Level 4--around $9,400 compared to around $3,600--and for that money its citizens can expect lives that are three years shorter. the United States spends more per capita on health care than any other country in the world, but 39 countries have longer life expectancies. ...US citizens should be asking why they cannot achieve the same levels of health, for the same cost, as other capitalist countries that have similar resources. The answer is not difficult, by the way: it is the absence of the basic public health insurance that citizens of most other countries on Level 4 take for granted.

Another, related issue is that longevity itself, and healthspan in particular, doesn’t really fit into the business model of our current healthcare system. There are few insurance reimbursement codes for most of the largely preventive interventions that I believe are necessary to extend lifespan and healthspan. Health insurance companies won’t pay a doctor very much to tell a patient to change the way he eats, or to monitor his blood glucose levels in order to help prevent him from developing type 2 diabetes. Yet insurance will pay for this same patient’s (very expensive) insulin after he has been diagnosed.

To vanquish the ‘five giants’ of squalor, ignorance, want, idleness and disease, Beveridge’s plan was for everyone to contribute to a social insurance fund and in return receive the same entitlement to benefits such as healthcare or unemployment insurance.

An ounce of sauce covers a multitude of sins.” That might as well be the motto of the entire food industry. And the healthcare industry. And the medical industry. And the pharma industry. And the chemical industry. And the insurance industry. And government, which is its own industry. But the truth will set you free.

Estate-Planning Checklist (for each of you) • Up-to-date will • Healthcare proxy • Power of attorney • Living will • HIPAA form •  List of what you are bequeathing • Legacy requests •  Where your important documents are kept • What assets you have • Where your accounts are located • Account numbers, PINs, and passwords •  Names of trusted people who know where your car keys, house keys, and safe deposit box keys are kept • Important names and contact information: ○ Attorney/financial adviser/CPA ○ Insurance broker ○ Healthcare providers ○ Estate attorney ○ Bank name and branch office location ○ Safe deposit box location and number

insurance companies are terrible and yes, the two of us are just cogs in a vast healthcare industrial complex that puts profits over people every damn time.

During an interview with Diversity Inc.’s director of research and product development, she walked me through a typical presentation used to pitch the value of the company’s software to prospective clients. I learned that their products are especially valuable to those industries not allowed to collect ethno-racial data directly from individuals because of civil rights legislation that attempts to curb how these data are used to discriminate. But now those who work in finance, housing, and healthcare can use predictive software programs to ascertain information that they cannot request directly. The US Health Insurance Portability and Accountability Act (HIPAA) privacy rule, for example, strictly monitors the collection, storage, and communication of individuals’ “protected health information,” among other features of the law. This means that pharmaceutical companies, which market to different groups, need indirect methods to create customer profiles, because they cannot collect racial-ethnic data directly. This is where Diversity Inc. comes in. Its software programs target customers not only on the basis of race and ethnicity, but also on the basis of socioeconomic status, gender, and a growing list of other attributes. However, the company does not refer to “race” anywhere in their product descriptions. Everything is based on individuals’ names, we are told. “A person’s name is data,” according to the director of research and product development. She explains that her clients typically supply Diversity Inc. with a database of client names and her team builds knowledge around it. The process, she says, has a 96 percent accuracy rate, because so many last names are not shared across racial–ethnic groups – a phenomenon sociologists call “cultural segregation.”18

While Roosevelt ultimately lost the 1912 election, his party’s progressive ideals planted a seed that accessible and affordable medical care might be viewed as a right more than a privilege. It wasn’t long, however, before doctors and southern politicians vocally opposed any type of government involvement in healthcare, branding it as a form of bolshevism. After FDR imposed a nationwide wage freeze meant to stem inflation during World War II, many companies began offering private health insurance and pension benefits as a way to compete for the limited number of workers not deployed overseas. Once the war ended, this employer-based system continued, in no small part because labor unions liked the arrangement, since it enabled them to use the more generous benefit packages negotiated under collective bargaining agreements as a selling point to recruit new members. The downside was that it left those unions unmotivated to push for government-sponsored health programs that might help everybody else.

Taiwan30 has used its National Health Insurance powerful IT to provide near real-time information on expenditures and utilization to prevent unnecessary expenditure. There is also a panel review system of medical records to keep healthcare costs down, whilst maintaining the quality of healthcare.