What Are We Missing?

Reading time – 3:20  .  .  .

The daily outrages and incessant infantile furies create a barrier to focusing on important but non-urgent issues. Indeed, this post is being written just 10 days after the weekend massacres in El Paso and Dayton. This is during the ongoing intransigence of Senate Majority Leader Mitch McConnell. On full display are his dual betrayals of, 1. refusing to bring legislation to the floor of the Senate for a vote to defend against foreign invasion of our democracy, and, 2. refusal to bring any gun safety legislation to a vote. Happening at the same time is the President’s lying and misleading about both issues. But his behavior is so consistent that it’s hardly worth a yawn. Still, he’s the president, so his narcissism-on-display does suck up our national focus.

We have to make time to shine a light on the important but non-urgent issues. These things beg for answers, so let’s look at one as a placeholder for all: our gargantuan healthcare complex and changes we don’t notice.

STAT, the daily briefing from The Boston Globe focusing on healthcare related issues, reported on August 12,

“A new report from UnitedHealth Group finds that hospital prices increasing at current rates could end up costing $250 billion over the next decade. The report says that prices set by hospitals for services  — and not physician salaries or how much hospital services get used — are what’s driving up patients’ spending. Between 2013 and 2017, for instance, hospital prices increased by 19% while the cost of physician services increased by half that amount.”

To put that into perspective, healthcare accounted for 17.9% of GDP in 2017 and inflated 3.9% that year to a total of $3.5 trillion, or $10,739 per person. We spend a crazy amount of money battling injury and disease and this report says the cost to do that is getting far worse.

The un-examined tidbit that seems like a throwaway in this report is that over that same 4-year period the cost of physician services increased by almost 10%. Did we receive 10% greater value? Why should we pay the extra 10%?

Silly question. We pay it because healthcare isn’t like deciding which car to buy or whether now is a good time to install an energy efficient furnace. There isn’t a marketplace of cost competitive choices for doctors and when you need healthcare you need it now, regardless of your ability to pay.

That’s compounded by most of us getting a major portion of the cost of our healthcare from a third party – an insurance company – so we may only see the co-pay and be ignorant of the true cost. The result is that doctors and hospitals can charge what they want. There will be some moderation of the cost as the insurance companies arm wrestle with doctor and hospital office managers over their invoices, but that’s pretty much it.

We are so accustomed to the price of healthcare going up, reflected in our insurance premiums that may right now be getting deducted from your paycheck, that we don’t even squawk any more. Millions are so accustomed to the ever-escalating cost system that they won’t even look at alternative ways to fund our healthcare or ameliorate its cost.

Extending our willful blindness about our pockets being picked begs an answer to how many other ways we’ve allowed ourselves to become numb, as others eat away at our financial well being. That stuff is bankrupting us, so the question begging for an answer is, “What are we missing?”

Bonus Section

In that same edition of STAT they report,

“President Trump announced late last month a plan to import drugs from Canada to help lower Americans’ prescription costs, and Canadians are not happy about it.”

Just think for a moment about the multiple crazies of this. First, most of those drugs are made in the U.S. and exported to Canada at substantially reduced cost, where they are sold for somewhat more sane prices to consumers. Trump wants to create a massive importation of those same drugs back into the U.S., thus effectively swatting at symptoms and refusing to deal with the root cause. And it’s worse than that.

The predictable Canadian backlash to this vacuum-headed idea is driven by shortages of drugs in Canada. Reports STAT,

“You are coming as Americans to poach our drug supply, and I don’t have any polite words for that,” said Amir Attaran, a professor at the University of Ottawa. Read more here.

This is just another of Donald Trump’s strategy-vacant ideas without any thought to consequence to others, especially to our strong ally and second biggest trading partner.


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Copyright 2023 by Jack Altschuler
Reproduction and sharing are encouraged, providing proper attribution is given.

Got It

Reading time – 3:39; Viewing time – 5:22  .  .  .

Question 1

In 2012 President Obama signed the Executive Order on Deferred Action for Childhood Arrivals – DACA. He did this both because it was the right way to treat these folks and because the Republican Congress was dedicated solely to opposing anything Obama endorsed, regardless of its inherent value. That meant that an Executive Order was the only way to get this – or really, anything – done.

Last September President Trump reversed Obama’s Executive Order with one of his own. His justification was the flimsy excuse that Congress should create a law about this. He gave them 6 months to get that done and, of course, nothing has been done by this Congress for over 9 months. Why would Trump do that?

Question 2

Kim Jong-un asked for a meeting with Trump and Trump leaped to agree. The “rocket man” taunt and the juvenile schoolyard brag that Trump’s button was bigger that Kim’s were gone, replaced by gracious statements about the murderous North Korean dictator. Then Trump sent a letter to Kim calling off the June 12 meeting because Kim had said a mean thing about Vice-President Pence. Why would Trump do that?

Question 3

Trump slapped significant tariffs on steel and aluminum imported from our best friends, Canada, Mexico and the countries of the European Union. He justified his actions with false claims about our balance of trade. The allies we are presently abusing in this way are in the process of establishing their own retaliatory tariffs on American products, especially our agricultural exports, and China is thrilled with us making ourselves an unreliable trading partner. Our economists and financial types have made clear that the trade war Trump has started will cause the net loss of tens of thousands of American jobs – maybe hundreds of thousands – and create higher prices for all of us. Why would Trump do that?


Trump has repeatedly demonstrated that his M.O. for negotiating is to take away something the other party has and wants. He figures that the other party will then bargain to get back what they had, giving Trump something he wants in the process, effectively at no cost. And all of that happens without Trump having any regard for the harm he does to others.

  1. Trump took away DACA and used that takeaway to bargain for his useless “beautiful wall.” He didn’t get the wall, but in the process of his manipulation he deported some and traumatized all 700,000 DACA people.
  2. Trump took away the North Korean summit so he’d look like he has the upper hand. What he got was a vague statement about de-nuclearization, so Trump said the meeting was now a go. Kim won’t eliminate his nuclear weapons, so Trump has fooled himself with his own stunt. And Kim will get exactly what he wants: international legitimacy and maybe sanctions relief. Foolishly, Trump will brag that only he could have done this. He might be right about that. But now millions will suffer and the world will continue to live in the shadow of Kim’s nuclear ambition. And all those bad things will happen even if Trump walks away from the summit. President Xi of China loves that.
  3. Trump slapped tariffs on our friends. Watch for Trump’s demand that they foot more of the cost of NATO as the key to terminating the tariffs. In the process he will have shredded decades, even centuries of built up goodwill, much to the pleasure of Vladimir Putin.

Trump’s negotiating strategy – got it.

Just keep in mind that Trump’s self-proclaimed genius for deal making led to six bankruptcies and a lot of very angry people. At the national and international level, abusing people is a really bad thing not likely to be forgotten by those angry people. That will have long term negative consequences for America.

Related to this, see the USA Today piece on Trump’s business relationships with top foreign leaders. And don’t miss the end of the ban on exclusions for preexisting conditions, coming soon to a medical insurance plan near you. What do you suppose Trump wants for his wealthy buddies in exchange for us keeping our insurance coverage?

As always, follow the money.

And Another Thing

Click me for the full story

The Center for Disease Control in Atlanta has issued a report, “Suicide Rising Across the US“. Two things jump out of the report:

  1. The primary tool for suicide is firearms. I’m guessing that easy accessibility and ease of use are key factors in that. Thanks so much, NRA sponsored legislators.
  2. The states with the highest rates of suicide are largely states Trump won. Correlation? Dunno, but it looks most curious. And lethal.


Ed. note: I don’t want your money (DON’T donate) or your signature on a petition. I want you to spread the word so that we make a critical difference. That’s the reason for these posts. To accomplish the goal requires reaching many thousands of people, so:


  1. Pass this along to three people, encouraging them to subscribe (IT’S A FREEBIE!).
  2. Engage in the Comments section below to help us all be better informed.


Copyright 2023 by Jack Altschuler
Reproduction and sharing are encouraged, providing proper attribution is given.

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