Completely Overlooked in Health Care Bill: Supply

The Wall Street Journal has an article today on something that should have been obvious to all when creating the health care bill, but was completely ignored by the Democrats: supply.

At the current rate of medical school completion, the US could be 150K doctors short in the next 15 years. The government plays a great role in medical education because Medicare funds most of the costs associated with medical residencies.

Common sense would say that the government, in concert with expanding the amount of those who will want access to health care, would greatly increase Medicare funding for residencies, so that medical schools could expand and more doctors could be trained to meet the demand of 30 million new medical consumers. Not only was Medicare funding for medical residents not raised, Medicare was cut by $500 billion in an accounting move to make the bill seem less of a boondoggle.

As a result, there will be a huge shortage of doctors and a looming supply problem in medical care that will require a huge fix in the years to come.

Something Never Discussed During the Health Care Debate: Supply

The House passed the Senate Health Care plan, as well as a series of Reconciliation measures designed to force those without health insurance to buy it (or face a penalty), as well as taxing upper income taxpayers to subsidize insurance for those who make under $88,000/year.

Regardless of whether you agree with this or not, and I clearly do not, there is one question that no one seems to be asking. Let's assume there are 45 million or so people in the U.S. who do not consume health care because they do not have insurance. This bill will insure almost all of them, so assume there will be at least 40 million new health care consumers in the U.S. in five years. Even with the influx of money that could be spent from the insurance premiums and payments by insurers to health care providers, who will be treating these patients?

As far as I can tell from cursory glances at the legislation and more in-depth study of the news reports on it, there is nothing in the legislation to support the creation of new medical schools. How will you increase the consumer base of medical care in the U.S. by 20% or more without any increase in the number of medical doctors, nurses, and other health care workers? How will the system handle all the new demand for services? Doctors are incredibly overworked as it is.

Money can build hospitals and buy equipment, but medical schools are the only way to tilt the balance of supply and demand. If the supply cannot keep up with the new artificially-inflated demand, the supply is going to get more expensive no matter what the government does. If the government was serious about cutting the costs of health care, it would provide incentives to universities to create medical schools and hospitals to create residency programs. After a few years with larger classes of new doctors, there would be more supply to meet the new demand for services, and costs would stabilize or go down.

That is how you solve a health care problem. Forcing millions more people into a health care system that operates at or near capacity on a regular basis is not going to solve any problem. Giving people insurance that they cannot use because the system is flooded with patients who cannot be seen is a disaster waiting to happen.

Just What the IRS Does Not Need, More Power

Under Obamacare, what will happen to your tax refund if you refuse to get health insurance?

The IRS may keep it and apply it to any penalty that the government decides to impose on those without health insurance. The IRS will be able to confiscate it under the House Health Care proposal. Of course, those who lack health insurance and are paying the penalty are likely not paying the penalty because they choose not to have coverage; they likely cannot afford it. Taking their tax refund is a horrible way to help people who need that money. After all, they overpaid the government in the first place!

Since the IRS will be given new powers of confiscation, they need $10 billion from the government over 10 years to separate tax refunds from hard-working people who need it. Oh, and another 17,000 employees to deal with all the new responsibility Obamacare would give them.

This scenario is likely just going to be compounded with all the new orders given to existing branches of government. Each department is going to need money above and beyond what the health care bill costs in order to implement it, as well as tens of thousands of employees, all at above market wages and union representation. So while the Democrats say health care is only going to cost so much, they clearly either ignore or discount the true cost of implementing this disgrace of a bill.

Anthem Under Fire For Lack of Common Sense

Anthem Blue Cross insurance has been under fire lately. The White House wants Anthem to explains its premium increases, and has been hit by a jury in California for refusing to pay for a liver transplant.

Ephram Nehme was approved by Anthem for a liver transplant in California, but his doctor told him to go to Indiana for a shorter wait. He did so, and Anthem refused to cover the transplant in Indiana, citing its contract with Nehme that stated all transplants had to take place in California. Nehme paid for the surgery himself, then sued Anthem and received the cost of his transplant and attorneys' fees.

While Anthem could be seen as proper for sticking to its contract language, contract language such as this is why people hate insurance companies, and why Democrats think people will support their reforms. Consumers don't understand contract language like this, and don't understand why an insurance company can approve transplants in one state but not another. It was not as if Nehme wanted to have his transplant done in Zimbabwe, he wanted it done in Indiana, another state in which Anthem sells insurance! Anthem could clearly determine whether a provider in Indiana meets its standards for payment. So while Anthem will say that Nehme, and others with Anthem insurance in California, can't leave California for transplants, consumers will only get angry with insurance companies, and become putty for the Democrats.

Insurance companies need to pick and choose their battles with consumers. Hiding behind contract language is going to get Obama's Single Payer System, and insurance companies (as well as Americans) will be the big losers there.

Collective Bargaining Agreements and the NBA

I like sports, a lot. All sports, from football to cricket. I was in New York City this past weekend on a rainy Saturday taking a nap while watching the Six Nations Rugby Championship on BBC America.

However, if you follow sports, the constant conflicts between the team owners and the player unions are always in the news. The NHL lost a season to a labor dispute in the early 2000's, and the NFL and NBA are potentially facing lockouts or strikes after the 2010 or 2011 seasons. The disagreements between the two groups is all about the Collective Bargaining Agreement, or the rules pertaining to signing players and offering contracts in each league.

The Collective Bargaining Agreements themselves are quite interesting reads for an attorney, or a sports geek. It is interesting to see the things negotiated on behalf of the players.

For instance, if you ever found yourself thinking how players deal with getting traded mid-season, the Collective Bargaining Agreement (CBA) in the NBA answers this. Players get hotel accommodation for up to 45 days, rent reimbursement of up to $4500/month for three months, and all reasonable moving expenses paid. Not a bad deal. Do NBA players have to pay for their own meals on the road? Not at all. They get $102/day meal money in 2005 dollars, adjusted for inflation using the CPI. That buys a lot of room service.

The NBA CBA also covers the completely mundane as well. The NBA Players Association also has the right to inspect any facility used by the NBA to conduct practices or games and can get a grievance heard within 24 hours. If players get the right to be given tickets, senior players have to be given better seat locations. Players with more than three years in the NBA have the right to buy two tickets to every game. And also, each NBA team agrees not to hold any player responsible for an injury in a fight to another player.

Also, if you're an NBA played demoted to the NBDL (see Thabeet, Hasheem), you are entitled to fly first class and not have a roommate in a hotel room, and you still get your $102+/day per diem. Not a bad deal at all, especially when considering all the other players will be jealous and angry with you for not having to suffer as they do.

All and all, for sports geeks interested with the rules of what perks players get, what sort of accommodation they are entitled to, and just the minutiae that needs to be negotiated for there not to be a lockout or a strike. It's not just about player contract size or length, it's how much meal money or how many tickets each player gets as well.

Sean David Moron vs. the SEC

The Securities and Exchange Commission is going after Sean David Morton, for allegedly collecting $6 million in money from investors in his "psychic" investment fund. Morton claimed his "psychic" powers could be used to substantial profit in the foreign currency trading markets. Morton collected $6 million from investors, but allegedly only placed $3+ million in trading accounts and used the rest of it for his "non-profit" and personal purposes.

The SEC has accused Morton of violating many sections of the Securities Act and Exchange Act, including Rule 10b-5. In the complaint, the SEC points out many false statements by Morton and numerous stories of Morton (allegedly) lying to induce investors to hand over money to him. Morton also allegedly failed to complete any SEC requirement in relation to registering his investment companies, and a statement he made to Coast to Coast AM appears to show that Morton did not think he was responsible for registering.

The SEC generally does not go after people it does not have an air-tight case against, with the notable exception of Mark Cuban. Additionally, Morton does not have the best litigation track record, particularly when you consider he calls himself "Americas' Psychic". UFOWatchdog.com exposed Morton repeatedly, pointing out every contradiction and fallacy that Morton stated about himself. Morton eventually sued the author of UFOWatchdog.com for defamation, but was found to have violated the Anti-SLAPP statute in California and ordered to pay legal fees of approximately $16K.

Morton also apparently sued the SEC in 2009 while the SEC was investigating him, claiming that the SEC was going after him solely to take taxpayer-paid trips to Disneyland and In-N-Out Burger. While noble goals of the SEC if they were true, the lawsuit was dismissed in December 2009.

Of course, Morton's psychic powers in dealing with the legal system and the SEC are comparable to his past predictions. Click the link to see some of the "psychic visions" of Morton, and you'll see that his only success is suckering people out of money. Hopefully the SEC puts Morton into a position where he cannot play PT Barnum anymore.

Leveling the Playing Field in Debt Collection Lawsuits

This past Wednesday I spent two hours being trained on how to assist pro se defendants who are being sued for allegedly not paying consumer debt. It was an interesting and enlightening session that gives an idea of the odds pro se defendants are up against in small claims and district courts.

The Volunteer Lawyers Project of the Boston Bar Association is doing great work in attempting to educate pro se defendants in consumer debt cases, and is attempting to soon be able to act as attorneys-for-a-day to these pro se defendants so that they need not have to go through it alone.

While uneven levels of representation exist in the judicial system, few levels of relative representation are as unequal as debt collectors vs pro se defendants. If a pro se defendant misses a hearing date, a default judgment is almost always entered for the debt collector, whereas if the attorney for the debt collector does not appear, the judge will get another attorney to appear for the debt collector and will allow the prosecution of the case to continue despite the appearing attorney's lack of information.

The Boston Globe Spotlight Series did a series of articles on the inequality rampant in Small Claims Court against defendants, particularly pro se defendants. Judges were complicit in the inequality, going much harder on pro se defendants than they ever did on debt collector attorneys. The Spotlight series highlighted that debt collectors got continuances when none should have been granted, that debt collectors lied on complaints and many other abuses. The SJC, starting in October 2009, required Small Claims Courts to, among other things, have Clerk-Magistrates review settlement arrangements and required debt collectors to provide some evidence of debt to obtain a judgment. These requirements are unremarkable and were already encompassed in the previous rules, but had to be specified because of the abuses of the debt collectors.

Despite what the SJC has enacted, the need for pro se assistance is still great and the playing field between pro se defendant and debt collectors is still unequal. Hopefully I am able to provide some assistance to those are in need. While many of the pro se defendants may owe the amounts being sued over, they still are entitled to have court procedures followed and to be treated with respect. The Volunteer Lawyers Project is starting to turn the tide against debt collectors having the run of District and Small Claims Courts.

Tax Dodgers Are Blind

You need to be a bit creative to honestly deny the ability of the US Government to impose an income tax, considering it was implemented during the Civil War and enacted as an amendment to the Constitution. Tax deniers claim that the 16th Amendment was improperly enacted by some of the states, so it never really was legal. They claim it violates freedom of speech (by requiring you to report income) and taking of property without due process, among other spurious arguments.

Joseph Stack was not so much a tax denier as much as a tax protester, but his suicide letter made many references to the idea that the income tax was unconstitutional.

However, Peter Pappas, a Florida tax attorney and author of The Tax Lawyer's Blog, has gone through Stack's suicide letter and refuted every inaccuracy stated. Among his points:

Stack:

We carefully studied the law (with the help of some of the “best”, high-paid, experienced tax lawyers in the business), and then began to do exactly what the “big boys” were doing (except that we weren’t steeling (sic) from our congregation or lying to the government about our massive profits in the name of God).

Pappas:

Again, Stack is upset that he couldn’t get away with what he alleges the Catholic Church got away with: Namely, tax fraud.

All in all, Pappas makes Stack's IRS diatribe look incredibly foolish and makes Stack look like a selfish person who just did not follow tax laws very well. While Stack's letter makes him on the surface to be harassed by the IRS, Pappas shows that most of what Stack said is pure smoke, and he was a rebel without a clue.

Need $50K? Flip Off a Cop

Getting arrested for flipping the middle finger at a police officer is apparently quite the profitable endeavor.

David Hackbart did such a thing at another motorist, and then a police officer in Pittsburgh. After flipping off the motorist, the police officer warned Hackbart not to do it. Hackbart then had the reasonable response of flipping the police officer off for telling him not to flip the motorist off. The police officer then arrested Hackbart for disorderly conduct, despite the act of flipping someone off being protected First Amendment speech and not obscene. In other words, even in the catch-all unconstitutionalness of most disorderly conduct statutes, flipping the bird is not included.

So Hackbart did the normal American thing; he sued the Pittsburgh Police under 42 U.S.C. 1983, citing violations of his First, Fourth and Fourteenth Amendment rights. Hackbart won at summary judgment against the police officer, with the judge finding that Hackbart was clearly pulled over because he flipped off the police officer in a retaliatory measure. Pittsburgh, realizing it was facing a substantial judgment, then settled the case for $50,000 and agreeing to inform police officers on the need not to pull motorists over for flipping them off.

So if you're driving in Pittsburgh, use your middle finger at will, and maybe you can be $50,000 richer.

Thanks to On Point News for the article and scanning the briefs.

Great Video of North Korea

(I just like this photo very much)

CNN had a link to a story done by an internet media outfit called VBS.TV. It is a 14 part series on VBS.TV's trip into North Korea, including what they saw while they were there, the trouble they had getting in, and the surrealness of it all.

Particularly interesting are the visits to the Arirang Mass Games, where the reporter is one of 15 spectators with 100K Koreans participating, and the reporters' trip to the DMZ from both sides of the North-South Divide. The Southern side is much stricter with rules (like no pointing at anyone in the North) and checkpoints, and the Northern side uses the opportunity to taunt the South. Very interesting also is the extent to which the North Koreans go to try and give the impression of abundance to the reporters.

I've always been intrigued about North Korea. It is such an unknown place, where time seems to have forgotten all about it. Watching the video, it's staggering to see how much in the past the DPRK is. In the largest library in North Korea, the DPRK Guide is talking with pride about the library having Mariah Carey and the Beatles on a cassette tape.

Of course, when you consider what North Korea looks like to the universe after dark (the picture, obviously), it is easy to see how it could be so backwards.

If you have an hour to kill and are as intrigued about North Korea as I am, I suggest watching the 14 part series from VBS.TV.

Parts 1-3 are on CNN's website in this story. Click on the video.

Part 4 starts here on the VBS.TV website.