Category Archives: Healthcare

Why do we mandate that people with Covid antibodies get vaccinated?

We now know, from several studies, that those who previously had Covid-19 have natural immunity on par with vaccination.

Yet, nationwide, governments, health care employers, universities and others mandate that everyone be vaccinated even if they previously had Covid-19.

As a child, I had measles, mumps and chicken pox. Throughout life, this was recognized as having immunity. Indeed, I had a serology test in March confirming my immunity[1]. Because I previously had many of the childhood diseases before the availability of vaccines, I have routinely been exempted from vaccination requirements.

Why, then, do we require that persons who have proof of having had Covid-19 also be vaccinated?

Remember, I am a brain injured idiot with no relevant experience. I make observations and ask really stupid questions.

[1] Full disclosure: the serology test showed I had not had Rubella – the R in the MMR vaccination. Therefore, in early March, I received one shot of the MMR vaccine. The pharmacist remarked it is rare to give an MMR vaccine to someone at my age. I previously had measles, mumps, and chicken pox. As a child, I had only two vaccinations: smallpox and polio. The smallpox vaccination is no longer given as that disease is considered eradicated globally. Today’s kids are vaccinated against 14 to 17 different diseases. I am now in process of “catching up” – next up, the Hepatitis A/B vaccination, and then perhaps next fall or winter, pneumonia vaccination.

Insurance and ER use policy

ER access can be billed at $30 to $50 per minute, or more. They are extremely expensive points of care.

UnitedHealthcare’s new policy is “dangerous,” the American Hospital Association says. As many as 1 in 10 claims could be rejected.

Source: Insurance giant’s new ER policy called ‘dangerous’ by critics. It says as many as 1 in 10 claims could be rejected.

Thought does need to be given to which facility to use but this may tough for the public to know when it is appropriate and when not. Difficulty breathing, sudden onset extreme pain, uncontrolled bleeding, chest pains, likely bone fractures, etc, probably count as covered emergencies.

ER’s have access to diagnostic and treatment options not available outside the hospital but their availability is expensive. ERs are extremely expensive points of care. A few hours in the ER might be billed at $5,000 to $10,000.

Seems important: “Covid-19 death rates 10 times higher in countries where most adults are overweight”

The risk of death from Covid-19 is about 10 times higher in countries where more than half of the population is overweight, according to a report released Wednesday by the World Obesity Forum.

Source: Obesity report: Covid-19 death rates 10 times higher in countries where most adults are overweight – CNN

Their initial list of “Example” countries – Vietnam, Japan, Thailand, South Korea, etc also had low case counts per population. There may be other reasons for that – explanations previously included masks, efficient testing, efficient and comprehensive contact tracing, and so on.

Never the less, lower weight seems to be better for health.

The Pandemic Made Kids’ Eyesight Worse, Doctors Say – WSJ

Public health failed to consider overall health effects of their Orders.

Eye doctors say they are seeing more children—many of whom were in virtual school—with new and worsening prescriptions for myopia, or near-sightedness. Rates of myopia in children were already increasing globally before the pandemic, but some research suggests the past year has exacerbated the problem. Doctors also report more cases of digital eye strain in kids.

A leading theory behind rising myopia rates posits that when children look at screens or books for prolonged periods, the eye adjusts to accommodate a close focus, which may change and elongate the shape of the eye, leading to myopia. Likewise, decreased outdoor time may increase and worsen myopia, as people tend to look farther away when they’re outside. Natural light and physical activity outside may also play a role. (Adults don’t tend to experience significant worsening of myopia because eye growth generally stabilizes after childhood.)

Source: The Pandemic Made Kids’ Eyesight Worse, Doctors Say – WSJ

Public health is – surprise – more than just Covid-19. But they did not care.

Hospital at capacity, in part due to deferred procedures during the pandemic

The full capacity in the ICU is due to the ongoing spread of COVID-19, but also an increase in patients who put off medical treatment during the pandemic and are now showing up to the emergency room with neglected illnesses. In addition, the hospital is seeing heart attacks and major injuries that will likely increase through the summer.

Source: Bend hospital at capacity with trauma, COVID-19 patients | kgw.com

On a personal level, public health denied access to health care last spring, which for me turned out – ten weeks later when health care was available again – to be a broken foot and torn tendon. Left untreated, that caused caused other problems – I am now unable to walk more than a few hundred feet max due to a knee problem. I am scheduled for an MRI of the knee next week Monday (expect out of pocket costs of about $1,500).

Public health lost all sense of the public’s health. To the “experts”, public health meant one disease: Covid-19. All other ailments and diseases were ignored. And so here we are today – many now have on going health problems caused by the actions of public health, and overwhelmed hospitals. Public health must include a lot more than a single disease.

If experts mandated you wear sunscreen every day, even if inside, would you do it?

The continued suicide of expertise:

It turns out that if you want to protect your skin from the sun’s harsh UVA and UVB rays, you’ll need to put on sunblock every morning, according to medical experts, even if you’re staying completely inside.

….

‘If you can see where you are walking without the use of a flashlight, there is enough light to require the use of sunscreen,’”

….

Our phones, laptops, TVs and even LED light bulbs can emit blue light, aka high-energy visible light, which can impact the health of our skin as well.

Source: 18 best face sunscreens of 2021 | CNN Underscored

I thought only epidemiology was divorced from reality but dermatology is giving epidemiology world-class competition.

I thought the article was a parody of reporting (it’s CNN after all), but it is serious. What’s next? Experts advise you to wear a seat belt even when outside of your car?

Bike related head and brain injuries among adults remain high

“The fact is that bicycling leads to the highest number of ER visits for traumatic brain injury in the U.S.,” he said.

The threat to adults is especially dire.”With an increasing number of adults commuting to work in both urban and rural settings combined with escalating congestion in bike lanes, the potential for not just TBIs but multi-system trauma is the reality,” Glatter said. There’s the “potential for serious and life-threatening chest and abdominal injuries, including long bone, pelvic and rib fractures,” he added.

Source: Bike-linked head injuries plummet for kids, but not adults – UPI.com

The article goes on to note that many people have taken up cycling as adults, plus many are now riding e-bikes, where the injuries seem to be worse.

I suffered a fractured skull (5″ long) in a bike crash (due to a pot hole around a turn), and two knock out blows in separate crashes that broke my bike helmet and broke other bones. One of these two was a road way hazard and the other was on a large group ride were the group made a legal, free right hand turn, but the group was struck by a city bus turning from the opposite direction, throwing me off the roadway. (Two additional knock out blows occurred in falls.)

Under the advice of doctors, I no longer ride a bicycle.

I am not kidding when I write that I am a brain injured idiot.

Removing patent protections from vaccines not about delivering more doses

Turns out that advocating dropping patent protection is for public relations messaging:

It won’t speed the manufacture of vaccines. It enraged the developers who delivered lifesaving doses in record time. But President Joe Biden’s decision to support waiving intellectual property rights for coronavirus shots had a broader purpose: to broadcast his administration’s commitment to global leadership.

More than a month of internal debate led up to Biden’s decision this week to endorse international calls to strip patent protections for vaccines.

Source: Biden move to share vaccine designed to spread US influence | KATU

President Biden implies that taking the intellectual property of vaccine manufacturers is to promote himself. Others in his party suggest he should go further and establish price controls on drug products.

This is not going to end well.

EU leaders do not support the U.S. position and call it a “false debate” as eliminating patents will not deliver vaccines faster. In fact, the major restriction is that the U.S. government has banned the export of vaccines manufactured in the U.S., and in some cases, even the components used by companies to manufacture vaccines outside the U.S.

EU leaders are not pleased with Biden’s proposal at all and in diplomatic speak pretty much called it stupid.

Hospital system consolidation leads to higher prices

The arguments in favor of consolidation and vertical integration were that it would lower prices. Economists find the opposite – consolidation, mergers and acquisitions of other local providers has led to higher prices, sometimes much higher:

Peer-reviewed economic research failed to find significant cost savings. Quite the opposite occurred. Hospital mergers and physician-practice acquisitions led to immediate price increases averaging 10% or more above industry trends, with further price increases over time. Evidence on quality was inconclusive at best.T

o this day, the data are not friendly to megaproviders. One prominent study found that rising provider prices are the biggest contributor to rising health spending, especially in concentrated markets.

Source: Opinion: Here’s why local hospitals, not insurance companies, are to blame for exploding healthcare costs – MarketWatch

I live in a County with a monopoly hospital system. One provider runs 4 hospitals, plus various labs and clinics. There are no other hospitals. The hospital behaves as a monopolist – including balance billing. That is, accepting a negotiated discount payment from the patient, and then billing the entire remainder of the bill to the patient. In some situations (including one we are paying off over 18 months), the patient was billed for several times more than the negotiated accepted payment. The only difference between organized crime and hospitals is that organized crime is better organized.

The conventional wisdom is that competition cannot work in health care, since in an emergency, who can compare prices? The problem with that is that only about 2% of expenses go to the ER, and even when generously including Urgent Care clinics and same day “urgent” appointments, you get up to about 10-12%. Most of the large expense items are scheduled in advance – and are not spur of the moment.

The other proposed solution, as done in other countries, is the government runs health care and the government sets the pay scales of those in the industry.

Adopting Scandinavian social benefits and taxes in the U.S.

For something unrelated, I was researching some of the “social benefits” programs in Norway. This is my summary of what I came across – which may be sort of accurate or not.

What I found interesting is that this is nearly identical to what the Democrats have proposed for the U.S. (I am not a member of any political party.)

Some of the benefits already exist in the U.S. (Social security, for example) while others are new (“free college”).

Vacation

  • 25 days paid/year
  • 31 days/year at age 60+
  • Many jobs have negotiated more days of vacation

Education

  • University education is free, even for foreign students studying in Norway.
  • University graduate education is free up through PhD level.

Health care

  • Almost 100% coverage for health, dental, medical transport. Also includes coverage when traveling in the EU.

Maternity Leave

  • For mothers: 80% pay up to 59 weeks, or 100% pay up to 49 weeks.
  • For fathers: 15 weeks paid leave.
  • Either can then take up to one year unpaid leave beyond that.

Child Care

  • Heavily subsidized for children age 0-5 (nearly free)
  • Subsidized (but not free) for older children

Sick Leave and Disability

  • 100% pay up to 12 months, then 66%

Taxes

  • Standard and personal deductions (similar to US)
  • Then, 22% flat rate to US$22,000, then rises progressively to 33% at about $100k (that also includes costs of health care)
  • 8.2% social security
  • Property taxes
  • Value Added Tax (25% sales-like tax, and 15% VAT on food)
  • Capital gains tax flat 22%

A person making 55k / year will pay 24.7% in taxes or 32.9% including social security.

A person making about 100k and up will pay about 33% or 41.2% including social security.

Of course, on top of that, you pay 25% VAT (sales tax), property taxes and other taxes/fees.

In the U.S., social security tax is 12.4% but most workers only see 6.2% as the other half is, basically, taken out of income by the employer and used as the “employer’s contribution”.

The U.S. Federal tax scheme is progressive, without the large flat rate starting level. However, some states, like Oregon, have a largely flat rate 9 to 9.9% tax for most income and capital gains. Some cities also have additional income taxes. In worst cases, this can add 10-20% to the U.S. tax burden. It’s important when comparing taxes to try and identify all of the possible taxes: municipal income taxes, state income taxes, federal income taxes, state and federal capital gains taxes, sales taxes, property taxes, social security and Medicare taxes. This is why comparing one nation’s taxes to another is hard to do.

When all of the taxes are added together, it is apparent that taxes on Norway are very high. In Denmark, it is common for wage earners to pay 40% to 70% of their total income in taxes (those are not marginal tax rates but actual percent of income). The average Dane pays 45% of their entire income as income taxes.

There is a proposal to raise the U.S. capital gains tax to 39.4%, almost twice that of Norway. Economists say the maximum economic opportunity comes below 28%; after that, people change their behavior and the government gets less than expected and economic growth is harmed.

Another proposal would raise inheritance taxes for some to 61%. Since some states also have inheritance and/or estate taxes, these could raise the effective “death tax” to 70 to 80% of the estate value. Basically, the government would confiscate the majority of one’s wealth at death – this could make it difficult for some family businesses, including farms and ranches, to be continued into the next generation.

The Democrats have a tiny majority in the House and 50:50 in the Senate and some of them claim this gives them a mandate to restructure the U.S. into a high benefit/high tax scheme like those of Scandinavian countries.

Wealth Tax

  • In Norway, wealth of more than US$60,000, has a 0.7% (to city) and 0.15 (to state) or 0.85% of amount > $60k. That means for each dollar equivalent over US $60,000, you would pay 0.7% of that wealth to the government.
  • There are proposals in the U.S. for a wealth tax, albeit at far higher levels of wealth, for now.

Social Security Pension Program

  • 8.2% pay check contribution in Norway
  • Can retire at age 62 with 40 years work contributions. Can count work from age 13 onward.
  • Everyone eligible for retirement at age 67.
  • Pension based on “basic pension” + supplemental, based on years worked.

Scandinavian Social Benefits and Taxes Model

In the U.S., in 2021, the Democrats are proposing the U.S. adopt a Scandinavian social benefits and taxation model. Basically, a clone of the Scandinavian model.

Of the above, here are the proposed changes to the U.S., as best I can tell.

  • Vacation – no change
  • Health care – ACA subsidies extended, but not otherwise making fundamental changes. Some Democrats would like to implement a so-called “Medicare-for-All” concept (unrelated to Medicare except for the name) but this is unlikely to occur.
  • Education – free community college, and free tuition for families earning less than $125k, eliminating existing student loan debts
  • Maternity Leave – proposed family leave law
  • Child care – free pre-K school
  • Sick Leave and Disability – no change
  • Taxes – proposed 39.4% capital gains tax, proposed higher taxes for high income earners, discussion of 3% wealth tax on high wealth (various numbers of $10 and $50 million and higher)
  • Social Security – no changes

No guarantees on the accuracy of the above information. I was compiling this for some “back of the envelope” understanding – not necessarily accounting level accuracy. I thought this was interesting and chose to share it here on the blog.

UPDATE MAY 20, 2019

Child care tax credits ($300 per month per child) are likely to become permanent, to cut childhood poverty. That is the stated goal of proponents. Again, as noted in this post – the Biden Administration’s goal is for the U.S. to adopt Scandinavian-like social benefits programs and Scandinavian-like high taxes.