Mystery Economic Theater 2015

[ewmayer]

Much-ballyhooed "squillionaire to donate almost all his ill-gotten gains to world peace and warm puppies!" story the past 24 hours:

Facebook CEO, wife pledge to donate nearly all of their company shares to charity | Ars Technica

But wait, there's more in the fine print!

UPDATE 10:56pm ET: A filing with the Securities and Exchange Commission, first reported by BuzzFeed, reveals that the Chan Zuckerberg Initiative is actually organized as a Delaware-based limited liability corporation (LLC), rather than a traditional non-profit.

So, a Bill-Gates-style "charity program" to privatize a public good (Gates is all about public-money-grifting charter schools and "educational standards" which mysteriously benefit "high-tech education initiatives" offered by companies like Microsoft) and make more money for one's company, then? Another benefit of the LLC setup: No limits on lobbying! Charity begins in the halls of congress, after all.

[ewmayer]

o Been a while since I postd anything on the ever-growing mess that is Obamacare - here a pair of recent Mish pieces:

Obamacare "Observations" and the Elusive Search for Improvements; Seniors Beware!

Obamacare in Action: 74% Say Insurance Costs Went Up, Record 36% Say "By a Lot"; Plan for Still More Hikes

And my sister recently e-mailed me this:

I just got notified that my obamacare bronze insurance cost is getting raised again Jan1 from 770 to 885/month (6K deductible per person except for the single preventative care visit which you still have a copay of 60 dollars on). What a bunch of crooks, fed up with this whole thing, that’s just for me and the 2 kids. [ewm: Her hubby is a Navy vet, so has coverage via that route.]

I had a really bad fall last weekend and severely injured my left thumb, seemed like it might be badly sprained or even broken in some places (still can’t use it to even hold a zipper and can’t bend it). Was afraid to go in to have it seen as I can’t afford a few thousand dollars worth of out of pocket bills. so I’m paying all that monthly premium and for what? Can’t even go see a doctor when I really need to go. I hate this healthcare situation, just getting worse and worse. My insurance was a little over $500 2 years ago, same crappy policy, that’s almost a 100% increase in 2 years, should be against the law, don’t see where the “affordability” of the equation is coming into play. if I didn’t have kids and weren’t on title for a house so they could take it from us, I would just do what you’re doing.

“What I’m doing” = uninsured and paying cash-for-service, most of which – ~$1000 in a normal ‘quiet’ year – is for Rxs, plus ~$200 for dental checkups and ~$100 for yearly doctor visit. Millions of us doing it that way here in the greatest country on Earth™.

(I told sis to look into a basic $10-at-the-local-pharmacy self-care thumb splint for the next several weeks, as it’s most likely a bad sprain, and a ligament tear, while likely needing surgery, wouldn’t be made significantly worse by self-treating via a splint for that time. Same kind of injury that has many NFL players walking around with heavily taped hands at this point in the season.)

But it feels good to know that as long as our exceptionally broken for-profit medical-industrial system keeps getting more fraud-riddled and wealth-extractive, the terrorists don't win, or something.


o Excellent essay by Barbara Ehrenreich on one particular strain of the toxic effects of the hollowing-out of the US economy, which for at least a full generation post-WW2, promised a broad sharing of wealth, as captured in the quoted snip by the NYT Paul Krugman - for once on the money here, sounding more like Robert Reich than his usual self:

"I grew up in an America where a man with a strong back — and better yet, a strong union — could reasonably expect to support a family on his own without a college degree."

As the piece notes, those kinds of jobs are long gone in 2015 America:

America to Working Class Whites: Drop Dead! | Barbara Ehrenreich, originally published at TomDispatch, reprinted here at NC.

Think you are immune due to a college degree in a 'desirable field'? Ehrenreich's closing summation provides a sobering cold-water treatment for that kind of complacency:

It’s easy for the liberal intelligentsia to feel righteous in their disgust for lower-class white racism, but the college-educated elite that produces the intelligentsia is in trouble, too, with diminishing prospects and an ever-slipperier slope for the young. Whole professions have fallen on hard times, from college teaching to journalism and the law. One of the worst mistakes this relative elite could make is to try to pump up its own pride by hating on those — of any color or ethnicity — who are falling even faster.

[LaurV]

Originally Posted by ewmayer

e, most of which – ~$1000 in a normal ‘quiet’ year – is for Rxs, plus ~$200 for

whooops! did anybody said something in the \(\LaTeX\) thread about those dollar signs?
(now we will see a little cat running from some biscuits...)

[ewmayer]

Originally Posted by LaurV

whooops! did anybody said something in the \(\LaTeX\) thread about those dollar signs?
(now we will see a little cat running from some biscuits...)

Ha! You think that's bad? You're gonna have kittens at this next dollar-sign-a-ganza:

I feel a great disturbance in the debt-spewing force that is the US government: Over the course of a full year, from 9/01/2014 to 9/01/2015, total US debt rose by a mere (in recent-historical terms) $402 Bln. In the 3 ensuing months, it jumped an additional $647 Bln, including a step-function move of +$340 Bln in just a single fiscal day, from Friday 10/30 to Monday 11/02. That was quite a naughty trick to play on Halloween! So who got the resulting monetary candy? Or better, since $340 Bln is around $1000 for each USian, where's my stack of 10 Halloween Bennies?

[xilman]

Originally Posted by ewmayer

“What I’m doing” = uninsured and paying cash-for-service, most of which – ~$1000 in a normal ‘quiet’ year – is for Rxs, plus ~$200 for dental checkups and ~$100 for yearly doctor visit. Millions of us doing it that way here in the greatest country on Earth™.

Here's a view from the right side of the pond.

Back in 94 I attended a conference in Boston (Mass, not Lincs) and chatted with Gene Spafford, universally known as Spaf in the security field. He was complaining to the group in general and me in particular about the US medical system, how he was paying $x per annum for health cover and that the National Health Service removed that obligation from me. I did a quick calculation based on how much tax I paid and on the then current exchange rate and announced: "So do I, to within 10% or so". The US people expressed surprise and asked me to explain my calculation, which I did.

My personal situation has changed in the last 20 years, in that I have paid essentially no income tax for the last three years. How the situation has changed for a typical employed citizen I don't know.

[fivemack]

I happen to have my Annual Tax Summary 2014-2015 lying on the kitchen table: I contributed £2868 to the health service, so about $4300, $350/month. According to https://www.gov.uk/government/statis...-and-after-tax I'm about a 91st-percentile earner.

(dollars. dollars are odd. if I edit the message to put backslashes before the dollar signs then the message appears with backslashes before the dollar signs and I have to reload the page to get it to look right again)

[Nick]

Originally Posted by xilman

Back in 94 I attended a conference in Boston (Mass, not Lincs) and chatted with Gene Spafford, universally known as Spaf in the security field...

Ahh, the good old days!
http://spaf.cerias.purdue.edu/tech-reps/933.pdf

[ewmayer]

Originally Posted by fivemack

I happen to have my Annual Tax Summary 2014-2015 lying on the kitchen table: I contributed £2868 to the health service, so about $4300, $350/month. According to https://www.gov.uk/government/statis...-and-after-tax I'm about a 91st-percentile earner.

(dollars. dollars are odd. if I edit the message to put backslashes before the dollar signs then the message appears with backslashes before the dollar signs and I have to reload the page to get it to look right again)

In modern crapified-health-insurance America, that is on the order of what an individual pays annually for a low-end policy which features deductibles of a similar order of magnitude, if not larger. And godforbid you actually have a nontrivial medical issue, in which case you get ensnared in the kinds of in-or-out-of-network and covered-not-covered-or-partially-covered traps detailed in my links above, where even a 'simple' ER admission plus a few X-rays and routine fix-up procedures can end up in one facing tens of thousands of dollars in 'so sorry - not covered!' bills. Plus the now-annual joy of 'being a smart health coverage consume' and navigating horribly complex choices and poorly designed websites, as opposed to simply being enrolled by virtue of being a living breathing resident of a country with an NHS. $5000 a year to 'just be covered' is an unattainable dream for an American.

Brits, please answer me this: Are there any scenarios in which you face financial ruin and impoverishment as a result of medical expenses? If so, how common are such scenarios? Because they are a leading source of personal bankruptcies and suicides here in the U.S.

[S485122]

Originally Posted by ewmayer

...
Brits, please answer me this: Are there any scenarios in which you face financial ruin and impoverishment as a result of medical expenses? If so, how common are such scenarios? Because they are a leading source of personal bankruptcies and suicides here in the U.S.

Not a Brit nor in the United Kingdom but in Belgium.

Health coverage is almost complete : there are just some experimental procedures to cure rare diseases that would not be covered or would go before a board to decide. But almost everything is covered including some doubtful procedures like leg lengthening...

This is not to say everything is perfect : people on welfare could have some problems covering their bills or having to think twice before going to the dentist. There is a maximum that one pays in a year for health bills, but that supposes that one has taxes to pay. Tax-exemptions do not benefit the poorest.

Jacob

[fivemack]

Originally Posted by ewmayer

In modern crapified-health-insurance America, that is on the order of what an individual pays annually for a low-end policy which features deductibles of a similar order of magnitude, if not larger. And godforbid you actually have a nontrivial medical issue, in which case you get ensnared in the kinds of in-or-out-of-network and covered-not-covered-or-partially-covered traps detailed in my links above, where even a 'simple' ER admission plus a few X-rays and routine fix-up procedures can end up in one facing tens of thousands of dollars in 'so sorry - not covered!' bills. Plus the now-annual joy of 'being a smart health coverage consume' and navigating horribly complex choices and poorly designed websites, as opposed to simply being enrolled by virtue of being a living breathing resident of a country with an NHS. $5000 a year to 'just be covered' is an unattainable dream for an American.

Brits, please answer me this: Are there any scenarios in which you face financial ruin and impoverishment as a result of medical expenses? If so, how common are such scenarios? Because they are a leading source of personal bankruptcies and suicides here in the U.S.

Financial ruin and impoverishment as a result of medical conditions is possible, particularly if you have the kind of mental health condition that precludes working, is hard to treat, causes you not to want to take the pills that treat it poorly and with side-effects, and also causes you not to be as good as the DWP requires at turning up to meetings and submitting documentation that proves you're still ill.

That $350 per month gets me treatment with no deductibles (except that prescriptions cost $12 for anything, unless you're ill enough to need more than 12 a year, in which case they cost $150 for any number).

I have turned up with the same condition to ERs in Boston and in Cambridge, UK; in Boston they dealt with it under local anaesthetic and charged $2500 which I eventually managed to recover through travel insurance, in Cambridge they dealt with it under general anaesthetic, kept me in overnight (doing the operation at 4am), and charged nothing.

[xilman]

Originally Posted by fivemack

Financial ruin and impoverishment as a result of medical conditions is possible, particularly if you have the kind of mental health condition that precludes working, is hard to treat, causes you not to want to take the pills that treat it poorly and with side-effects, and also causes you not to be as good as the DWP requires at turning up to meetings and submitting documentation that proves you're still ill.

There are other common conditions, such as various forms of dementia. Coming down with some variety or other of motor neurone disease is not good for one's financial status. Stephen Hawking is a very unusual case in that he was able to learn how to adapt to his condition and so support his family and his very expensive lifestyle.

It's the chronic conditions which generally tend to cause impoverishment in the UK.