Category Archives: South Korea

A Few Comments About Yesterday’s Post

After putting yesterday’s post to bed, I realized that there were some more things I wanted to say about COVID and the end of neoliberalism.

Recall that John McDonough had mentioned that the Orangutan’s war on trade and other economic policies, signaled the aging of the Neoliberal era. Well, over night, the baboon struck again when he asked the Supreme Court to overturn the ACA (Obamacare), which if it happens, will mean 20 million Americans will lose their health care during a global pandemic.

Their rationale — because it is unlawful. Really? From the most corrupt and unlawful Administration in US history. Could you try any harder to kill more Americans when the number of deaths has already passed 120,000?

In an Opinion piece in Wednesday’s New York Times, Charles Blow asked, “Can We Call Trump a Killer?” According to Blow, things are so bad, that the European Union is considering banning US citizens, and it is abysmal had Trump not intentionally neglected to protect American citizens.

In fact, several times since the pandemic began, he was quoted as saying the following about Corona, “Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away.”

Early on in the crisis, some have suggested that perhaps it is time to consider single payer health care. In fact, some have argued that single payer systems have coped with Corona better than for-profit systems.

Shortages of Personal Protection Equipment (PPE), ventilators, and the lack of enough ICU beds is proof that for-profit health systems cannot effectively handle a global pandemic. “Having a healthcare system that’s a public strategic asset rather than a business run for profit allows for a degree of coordination and optimal use of resources,” according to David Fisman, epidemiologist at the University of Toronto.

One country that has been able to deal effectively with Corona has been South Korea, and despite recent setbacks, the following data and chart from a tweet by @hancocktom, highlights what Korea did right.

South Korea has done more than just “flatten the curve” of new Covid-19 infections. It bought the curve down through: – Aggressive testing (20,000 tests daily, “drive through” testing)/isolation – School holiday extended – Government advice to stay inside – large events cancelled

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“Unhampered government intervention into the healthcare sector is an advantage when the virus is spreading fast across the country,” said Choi Jae-wook, professor of preventive medicine at Korea University in Seoul.

Denmark also has a single payer system, and like South Korea, offered drive-thru testing. Jorgen Kurtzhals, the head of the University of Copenhagen medical school, told the Washington Post that the strength of Denmark’s single-payer system is that it has “a lot of really highly educated and well-trained staff, and given some quite un-detailed instructions, they can actually develop plans for an extremely rapid response.”

“We don’t have to worry too much about whether this response or that response demands specific payments here and there,” said Kurtzhals… “We are aware that there will be huge expenditure within the system. But we’re not too concerned about it because we have a direct line of communication from the national government to the regional government to the hospital directors.”

One nation that has a single payer system and has had a bad experience with COVID is Italy. Presumptive Democratic nominee, Joe Biden, in a primary debate with Sen. Bernie Sanders in March, said that, “With all due respect for Medicare for All, you have a single-payer system in Italy,” said Biden. “It doesn’t work there.”

HuffPost healthcare reporter Jonathan Cohn said in a tweet, “[Single-payer] isn’t the reason Italy is having problems,”…”Italy’s problem is health system capacity. Independent of health system design.”

Another critic said the following:

This is the dumbest point. No, single payer does not solve the problem of pandemics. But it definitely solves the problem of thousands and thousands of people going bankrupt because there’s a pandemic. It solves the problem of people not seeking out care for fear of bankruptcy. 

— Jill Filipovic (@JillFilipovic) March 16, 2020

There is no panacea for dealing with such a deadly and fast moving virus. Within a few short months it spread from China to Western Europe, the US (first cases found in a Washington State nursing home), and then globally.

Instead of going piecemeal to find a solution, all nations should have pooled their resources and worked to find a vaccine as soon as possible. Estimate recently said the world will hit 2,000,000 cases in the near future.

Single payer won’t cure it, but will make it easier to manage so that all infected will have the use of ventilators and ICU beds if needed, and medical personnel won’t have to reuse PPE that should have been discarded after treating one patient.

No Socialists Here

Dear Insurance company execs, pharmaceutical company execs, employee benefits consultants and executives, Wall Street investors, and all other stakeholders in the current dysfunctional, broken, complex, complicated, and bloated mess called the US health care system.

You have heard many politicians, and journalists, not to mention your own peers, or even you yourselves label the push for Medicare for All as “Socialism.”

We even have the Administrator of CMS, Seema Verma, calling it, and the public option plan,  “radical and dangerous for the country” recently when she spoke to the Better Medicare Alliance’s Medicare Advantage Summit in Washington, D.C.

Her solution, and probably yours as well, is to keep selling Medicare Advantage plans, which only makes the current system worse.

So, to help you get over your fear and loathing of Socialism, and to prove to you that the only reason why the US is the only Western, industrial nation to not provide its citizens with universal health care is because you are making money off of other people’s health, or lack thereof.

You are doing so, because you are greedy. There I said it. Now I hope you will pay attention to the following graphic:

Do you see any socialist countries? Do you see any radical and dangerous regimes that are hostile to the interests of the US? Well, maybe Slovenia. After all, they did send us Melania and her illegal family.

But back to the case at hand. I defy any of you hotshots in the health care space to prove to me that all of these Capitalist, free-market countries are flaming Reds, or even a bit Pinko.

You can’t, because it is not true. You and those who call Medicare for All, Single Payer, or even the so-called “public option” radical, just don’t want the government to interfere with your looting the pockets of the American people for your financial gain.

And that is why we are the only country with an “X”, instead of a check mark below our name.

Universal Health Care Start Dates

The graphic below shows those countries that adopted universal health care and the dates they did so. It also shows the dates those countries ended universal health care. Notice a pattern? They never did. But we are the only country to not offer universal health care, and are resisting doing so because of a medical-industrial complex that is greedy, profit-driven, wedded to an outdated ideological philosophy of the role of government and social services, including health care, all so that Wall Street, insurance companies, pharmaceutical companies, device manufacturers, large hospital systems, and consultants and service providers to the industry can get their cut of the pie. And notice that none of them are Socialist.

Five and a half years

Yesterday marked five and a half years since I began the blog.

To date, it has been viewed in over 100+ countries and had over 33,600 views, as shown in the image here:

The areas in grey represent those countries that have not viewed my blog, and as you can see they are mostly in Africa and part of the Mideast, especially Iran (but you would expect that).

Of course, there are exceptions, such as Greenland and those islands to the east of Greenland. Oh, and there is one other island that has not had any views: Cuba. And one nation that has been in the news of late: North Korea.

Still, I am very happy and grateful for all the views, wherever they come from, but some have surprised even me. Take for instance, the Palestinian territories, China, Vietnam, and those in the northeast part of Africa. Even Saudi Arabia (do they know I am Jewish?)

Thank you all for the past five and a half years, and once again, I’d like to invite you to reach out to me whenever you want to discuss an article, or have something to add. I want to get to know my readers better.

Medical Travel for Americans is Alive and Well

Many of you have probably thought that going abroad for medical care after passage of ACA was a thing of the past, or that the idea that workers injured on the job would go abroad was a “stupid, ridiculous idea and a non-starter”, have forgotten that medical care in the US is the most expensive in the world.

But the simple, undeniable fact is that we spend too much on medical care and get very poor results and outcomes, while other countries spend far less and get better outcomes.

Why are we so stubborn? And why hasn’t the workers’ comp world realized that they are fighting an uphill battle to lower costs every time they come out with some new strategy or cost containment measure that never lives up to its promise industry-wide?

Sure, there are individual cases where these companies save money for a particular client, but overall, the cost of medical care for workers’ comp still rises, even if that rise is slow at times, or appears to have shrunk, only to rise once again the next year, as seen in the NCCI State of the Line reports.

An article yesterday in Salon.com said that traveling abroad for medical care simply makes more sense — even regular teeth cleaning is four times more expensive in the US than it is in Mexico.

One of the first procedures mentioned in the article involves a Minnesota couple who went out of the country for an in-vitro fertilization (IVF) procedure. On her fourth trip to the Czech Republic, it finally worked, and she got pregnant. The procedure in the US would have cost them between $12,000 and $15,000.

While IVF is not something that workers’ comp would cover, the fact remains that procedures cost far too much in the US, and in the case of IVF, only have a 29% success rate, according to a CNBC report cited in the article.

An estimated 1.7 million Americans traveled abroad for care in 2017, according the Josef Woodman, CEO of Patients Beyond Borders, and author of the same titled book. In my seven years of studying medical travel, Josef Woodman’s name has figured prominently in many articles and forums of discussion on the subject.

The article goes on to say that that is 10 times more than the 2008 estimate from Time magazine.

Some of the top destinations for medical care are: India, Israel (always go to a Jewish doctor first), Malaysia, Thailand, Taiwan, South Korea (unless that little twerp up north gets an itchy trigger finger), and Turkey.

However, there are other, more accessible destinations closer to home like Mexico, Costa Rica, Panama, etc.

Typical operations are orthopedic or spine surgery (are you listening work comp world?), reproductive operations, cardiovascular and eye surgery.

For example, a coronary artery bypass graft (CABG) in the US costs an estimated $92,000 (you could buy a couple of nice cars for that amount), whereas in India, the same operation would cost $9,800.

A total knee replacement (are you still listening ,workers’ compsters?) cost around $31,000 in the good ole US of A, but in Thailand, costs around $13,000. Tell me how you can save that much on a knee replacement using any of your so-called cost saving schemes?

These same operations in Costa Rica would cost 45 to 65% less than in the US, and would not require such long flights from most parts of the US. What are you waiting for? Save some money, I guarantee your insureds will love you for it.

Malaysia would be 60 to 80% less, but why go there when you can go to Costa Rica?

According to Woodman, medical tourism (travel) is a Band-Aid for the country’s dysfunctional health care system.

Woodman told Salon, “I don’t think you can penetrate this with philanthropy. It’s gonna be baby steps all the way. But in the meantime, medical tourism is a really important option.”

Woodman also said he did not like the term “medical tourism” because it is not a vacation. You may have noticed that I use the term “medical travel” instead. It is travel for medical purposes, and if there is tourism component to it, it is incidental to the reason for going in the first place.

Patients who cannot afford dental work, IVF or orthopedic surgery in the US, Woodman said, should consider travelling abroad. If their operation or treatment is expected to cost them $6,000 out of pocket, they will save money — even with the plane ticket.

Oh, by the way, that Minnesota couple spent, get this, only $235 for the IVF, not including flights. With such reasonable cost savings, it would be a no-brainer for workers’ comp to do the same.

But some people are stupid, ridiculous, and non-starters in my book.