Are we willing to sacrifice the solvency of the taxpaying public so that the elderly can eat freely at the “free” table of medical expenditures? In my mind, this figure alone highlights the insanity of a defined benefit for medical care– and knocks any thoughts around expansion of government “insurance” programs out of the water.

Its a paradoxical situation– government control of medical costs per visit (via the RVUs and billing through CPT based claims coding) has systematically swapped out thought-driven primary care for technology driven specialty care. As overall cost increases, government hits cost/ time units harder and harder, incenting physicians to dispense with talking to patients at all, while freely paying for diagnostics and expensive specialty procedures. We’re now at a point where the strong controls on primary care time have made that practice virtually unaffordable and the specialists are driving us faster and faster to bankruptcy.

Is this the system we should bolt all future health expenditures through? Seems the low administrative costs of this pass-through system have allowed the wolves to raid the henhouse. Were it not for taxpayers being forced to pay into the system, it would have been tossed on the scrapheap long before, with something better at managing overall spend (likely through enhanced access to primary care and increased controls on specialty medicine) in its place.

And I want 1 more thing. I want transparency. The way the government publishes information on money it spends ,receives and owes is a joke. No one in this country has any real knowledge of how much our country really owes. There are so many hidden and unpublished liabilities that if our country were a public company, someone would go to jail.

The accounting data of this country is public domain information. There is no reason why it can’t be published if not in real time on a government website, than at least quarterly. Money coming in . Money going out. Money that is owed to us and from us. It is currently being recorded somewhere , and someone has responsibility to collect it or pay it. So it can be published.

Then every quarter, our federal government can publish an Income Statement and Balance Sheet according to GAAP principles. It wont be perfect, but it will be a hell of a lot better than what we have today.

Without complete transparency, politicians will do what politicians always do. They find ways to play with our hard earned tax dollars and to put a lien on our current and future earnings, and that of our kids and grand kids just so they can get elected and re-elected. That’s just wrong.

So if Warren Buffett wants the Forbes 400 Rich to pay more taxes, great. Than Warren also needs to ask the two candidates he is supporting to do the same thing he would ask of any company he is investing in, show him accurate , up to the minute accounting data with transparent information supporting every number.

When that happens the government can take more of my money if they need it. My guess however is that when the citizens of this country see how much we really owe and where the money is being spent, and the short and long term implications of our politicians spending like addicts, they may start voting for those who respect the value of a dollar

This applies in general, but also specifically with regards to government health spending. How we can on one side be running huge unfunded liabilities while talking about expanding the same system with more coverage is absolutely beyond me.

In March 2006, the Red Cross, the international blood association AABB and America’s Blood Centers proposed replacing the lifetime ban with a one-year deferral after male-to-male sexual contact. New and improved tests, which can detect H.I.V.-positive donors within 10 to 21 days of infection, make the lifetime ban unnecessary, the blood groups told the F.D.A.

In a document posted Wednesday, the drug agency said it would change its policy if it received data proving that doing so would not pose a “significant and preventable” risk to blood recipients.

The agency said the H.I.V. tests now in use were highly accurate, but still could not detect the virus 100 percent of the time.

Think about the irony here…willing blood donors who pass the bar on other risky behaviors are prevented from donating (when supplies are at all time lows) because they engaged in an act of homosexual intercourse up to 30 years ago.

A major problem with our system today is that people feel like everything needs to be bulletproof. In fact, that will never be the case…nothing is 100% accurate. Walking across the street still carries a risk of being hit by a car. Until the medical establishment starts calculating risk and probabilities, we will continue to have this “blockbuster” approach to medicine instead of well-considered personalized approaches that provide the best chance of success for each individual.