Why Medicare Is In Trouble

Listening to the Washington debate about Medicare (here, here, here, here, and here) one would think the program is in trouble because it's a government entitlement program that is handing out free health care to underserving freeloaders. And, if that is the problem, then the solution is to privatize the program (according to Rep. Paul Ryan, R-WI in the video below).

First, Medicare is not an entitlement program, it is a social insurance program that people pay into during their working years so they can have health insurance in retirement. The only sense it which it is an entitlement is that we are entitled to the care that we payed for with our payroll deductions. It is an insurance program because some people will need more care than others even though there have been relatively equal contributions.

Medicare, however, is in trouble because payed-out benefits exceed collections. This problem could be solved in two ways: increasing payroll deductions or decreasing payouts.

On the payout side, Medicare is in trouble partly because of private sector billing practices. The DHHS Inspector General released a report last December documenting Questionable Billing for Medicare Outpatient Therapy Services. The graphic above, from the report, shows the "high-utilization" counties, counties that supply up to eight times the level of services per beneficiary and thus services about eight times the level of payment for services.

Of these counties, Miami-Dade is the worst having "the highest average Medicare payments per beneficiary among the high-utilization counties and the highest total Medicare outpatient therapy payments in 2009." The higher payments are not going to produce better health for Medicare patients but are going to increased physician payments and higher executive salaries in the private health care sector.

Privatization will only make the problem of over-billing worse. And, strangely enough, all but one of the high-utilization counties is in a state with a Republican governor.

The World According to Americans

Here's a pretty self-explanatory graphic from the Mapping Stereotypes project (here for a detailed listing of stereotypes by country). It was presented in the first lecture of History 120: Europe and the Modern World, 1815-2010 to lots of nervous laughter from the class.

Arnold Palmer Turns 82

Yesterday, Arnold Palmer turned 82. In honor, the Golf Channel played the full 1960 Masters Tournament coverage (the first part starts above) which was Palmer's second (he also won the 1958 Masters). Looking over Palmer's record (here) produces an interesting list of great (Jack Nicklaus, Gary Player, Raymond Floyd, Johnny Miller) and probably forgotten (Dow Finsterwald, Doug Ford, Bob Goalby, Gay Brewer, Doug Sanders, Johnny Pott, Dai Rees, Billy Casper, Mason Rudolf, Gene Littler, Lionel Hebert, Gay Brewer, Gardner Dickinson, Deane Beman, Orville Moody, Gibby Gilbert, etc.) players that he beat.

From the "probably forgotten" list I have a story about Bob Goalby. I was walking in to the Thursday round of the Greater Milwaukee Open by the players entrance (the tournament stopped allowing entrance here a few years later) when a car pulled up along side me and the driver said "Get in". I hesitated, the driver looked familiar but I couldn't place him.

He said again, "Come on, get in," so I did.

Before we got to security at the players entrance, the drive said "Do you recognize me?" I said, "You look familiar, but..."

He said "I'm Bob Goalby" and I wish I could have said "Sure, you lost to Arnold Palmer in the 1959 Oklahoma City Open Invitational in 1959 by 2 strokes," but I didn't find that out until reading Palmer's record a few minutes ago!

In any event, "Thank you, Bob Goalby for a free pass into the GMO!" Bob was there to see his nephew, Jay Haas, play.

Back to the 1960 Masters, I had a flood of reactions to the coverage: (1) Palmer certainly was a physical specimen compared to the conditioning of most other players (Doug Sanders would say that "the heaviest thing he ever lifted was a skirt"), (2) the wristy putting styles are shocking by today's standards, (3) the caddies cleaned balls by rinsing them in their mouths (who knows what kinds of carcinogens they were putting on the greens then) and of course (4) it's amazing how far Plamer hit the ball with persimmon woods and balata balls.

In honor of Arnold's birthday and his achievements in golf (particularly introducing today's modern, power game), here's an analysis of Palmer's swing (above) by Wanye DeFrancesco with a very interesting comparison to Dustin Johnson swing and lots of discussion about the left wrist position.

In New Email to Constituents, Ron Johnson Defines Insanity

Today, I received a wonderful email and video from my US Senator, Ron Johnson, R-WI. After hearing president Obama's Job's speech the other night (here), my first thought was that Ron Johnson would set me straight on what to think about the president's oratory. And, today he did, invoking Albert Einstein to label the speech "insanity". From Johnson's email to me:

As Albert Einstein once said, "The definition of insanity is doing the same thing over and over again and expecting different results." On Thursday night, I was saddened to see President Obama's latest government stimulus program fits this definition to a tee.

Now these are really novel thoughts that didn't occur to me while listening to the President's speech so I decided to watch Senator Johnson's video (above) for more enlightenment. And, to my surprise, it wasn't your typical bag of gassy political euphemisms but a very specific set of points from Senator Johnson's "pro-growth" agenda.

Now, Senator Johnson does get off to a bad start talking about, in Paul Krugman's words, the confidence fairy (businesses won't do anything unless they are 100% confident about everything that will happen in the future, forever). Even though whining about "confidence" is just playing to right-wing dogma, it did help me understand why entrepreneurship is dead in the US. And, Senator Johnson did quickly move on to explain to me what he wanted to have confidence about.

He and other business leaders (Senator Johnson always points out that he ran a plastics business) have now been very clear about what they want:

1) A credible plan to limit spending and the size of government. Evidently, the huge amounts of money spent on foreign wars, the war on terror and other Bush administration expansions of the Federal government must come to an end immediately. Who can disagree with this proposal?

2) A Regulation Moratorium. We have also solved all the problems of lax regulatory oversight during the Bush administration that created the Subprime Mortgage Crisis so we can now be sure that the private sector will never do anything unethical like liar loans or robo-signing again. I'm relieved that our government has acted so quickly to create a responsible regulatory environment.

3) Tax reform. The tax cuts enacted by the Bush administration must definitely be reformed. US corporations pay one of the world's lowest effective tax rates (maybe Somalia has a lower effect business tax rate). Businesses exploit massive loopholes enacted by congressmen and senators who are in their pocket. Millionaires and billionaires pay less taxes as a percentage of their income than the workers who clean their toilets. Bravo, Senator Johnson. This has to change.

4) Federal Hiring Freeze. The large expansion of the Federal government related to the War on Terror and the military adventures of the Bush administration (TSA agents, CIA agents, military personnel, defense contractors, etc.) should definitely be rolled back.

5) Budgetary Reform. This is really pretty simple. Any budgetary item that returns any money whatsoever to individuals who make less than $250,000 per year (Medicare, Medicaid, CHIP, Social Security, Aid to Widows and Orphans, etc.) should immediately be eliminated. In fact, all forms of social welfare should immediately be returned to the private sector through a new Department of Corporate Welfare.

6) Create a Sunset Committee that will eliminate harmful laws and regulations. As a start, lets consider any legislation passed by the New Deal or the Great Society for immediate sunsetting. Some of these laws have been on the books for almost 100 years! For example, the Glass-Steagall Act separating commercial and investment banking was passed in 1932 and repealed in 1999. It's repeal had a great effect on increasing business confidence that banking deposits could be used to make risky bets on the subprime mortgage market.

Well, that was all very enlightening but I guess I'm still a little confused by the insanity argument and by allowing the private sector to keep doing the same thing over and over again and expecting different results. Maybe Senator Johnson's next email will help me think this through.

J. G. Wentworth Commercial Wins Golden Tweener Award

Congratulations to J. G. Wentworth on their unique, award-winning commercial that breaks almost all advertising fundamentals to use opera singers to communicate its message to an audience that has absolutely no interest in opera. In case you have trouble understanding the lyrics:

A:

If you have a limited intelligence

And you need cash now

Call J. G. Wentworth

877-CASH-COW

877-CASH-COW

(repeat with small variations on "limited intelligence")

B:

We've screwed thousands

And we'll screw you too

Give us your cash

And we'll know what to do

(repeat A)

IT'S YOUR MONEY AND WE NEED IT NOW!

Five Questions About Stack & Tilt

PGA pro John Dunigan's answer to Stack & Tilt detractors: (1) Is it a good idea to be able to predict your ball flight? (2) Is it better to hit the ball first? (3) Is it better to swing from in to out? (4) Is it better to keep your head still? (5) Is a full shoulder turn a good thing? Get it? No brainer!