The failure of the Federal con game

Wizbangblog:

The world’s largest entity in terms of gross revenue had a bad month in April. The IRScollected only $245 billion dollars in April 2010 compared with collections of $266 billion in April 2009. This was only part of the reason the U S government ran up an $82 billion dollar deficit in April of this year because the government spent $327 billion dollars in that month versus $287 billion in April of last year. For 43 of the past 56 years there has been a budget surplus in April owing to the fact that tax collections occur then.

Of course, none of this is news to voters in Virginia, New Jersey, Massachusetts, and Utah and, as of last night, West Virginia. In all of these states the “surprise” losers were either irreparably tainted by an Obama/Pelosi/Reid connection or ossified incumbents that finally felt the wrath of an electorate that has had enough of giving at the office, giving at home, giving at the store ad infinitum, ad nauseum and giving everywhere else the government has extended its insatiable desire for taxes. Add to that anger a state immigration law in Arizona that a majority of Americans broadly support but is wildly unpopular in the establishment media, academia and other elitist strongholds and you get one of those rare moments in U S history when events converge to create a wave.

We are witnessing a worldwide repudiation of big government and Keynesian economics. In the Unites States the evidence of this is found in the results of the several state elections I mentioned above, most if not all of which were plebiscites on national policy issues. However, this skepticism is becoming an international issue. In Europe the response is much starker, verging on panic. Last weekend, before the big Euro Bailout, European bank stocks and sovereign credits (government issued loans and bonds) were almost falling off the cliff. Monday morning brought news of the bailout and things looked rosy….for about a day. Today brought news of abject panic buying of gold in Europe.[…]

The reason why there is such a loud repudiation of the Obama/Pelosi/Reid agenda is that many fly over country citizens know that what is known as the European contagion can happen here also. As I have mentioned before, in the midst of these financial crises of the past three years there is an enormous confidence game going on. When that confidence is lost (as appears to be happening in Europe) the result is not something that can be contained by a press conference or a new stimulus plan.

Read the whole thing. See also Bank of England: US faces similar problems as Greece.

Physicians ‘going Galt’

Hot Air has a thread up on a 63-year old dermatologist (a low-burnout specialty, mind you) in Scottsdale, AZ, who announced on his office door that he would retire before BHOzoCare went into full effect. There’s an interesting, lively discussion in the threads that suggests he’s just the tip of the iceberg.

In case you think a dermatologist mostly deals with teen acne anyhow, think again:

The man is in Arizona, skin cancer capital of the US and home to lots and lots of elderly people; he’s been in practice since the 70s; he’s talking about Medicare patients.[…] One Arizona retirement community can provide (or could previously provide) enough Medicare customers to keep several dermatologists in business.

The phenomenon of physicians refusing to accept new Medicare patients is not new. Now, apparently, another phenomenon begins: ‘cash-only practices’, where health care providers do not accept insurance of any kind but only ‘cash on the barrel’. If you can get a refund from the insurance company yourself, more power to you; if not, it’s your problem.

Also, get this nugget from the comments:

If the 63-year-old deciding to retire doesn’t bother you, maybe a 47-year-old deciding to will? My sister-in-law is 47, and is overworked in her practice under the current system. She hates to think of giving up the work she trained for so many years to do, and has spent nearly two decades becoming a respected professional in.

But there is a strong probability that she will do just that if Obamacare isn’t repealed. The rewards would no longer outweigh the expense and aggravation. Her good friend and partner (in a multi-physician practice) is also looking at the same thing. If they quit the practice, it will almost certainly have to break up, and its partners reevaluate their professional arrangements and even life choices.

My brother and sister-in-law aren’t sure what they’ll do. He’s an electrical engineer, and the two of them would be employable overseas, which is something they’ve been seriously considering. They hate to uproot the kids, but what matters is opportunity and a promising future.

What they will not decide is that Lynne will remain in practice in the US, under the worse conditions that are inevitable with Obamacare. It’s not even just workload and pay. As the Arizona doctor’s comments make clear, it’s loss of professional discretion while still being stuck with all the liability, and higher penalties. It just won’t be worth it. A very large number of those who have the option of dropping out will.

In the past, professionals would seek to immigrate to the USA in search of oppostunities. Now we have some seeking to emigrate to do so. The world is standing on its head.

And here is a cold shower for those of us who thought that NPs (nurse practitioners) are always a ‘good enough’ replacement for MDs:

I went to the doctor for what I thought was just a chest cold. Certainly that’s all that the signs pointed to. The nurse did a quick check and made a few notes. My doctor, an amazing woman, spent time with me and asked several dozen questions while giving me an increasingly serious set of tests.

Finally , she called for her nurse and told her to get a wheelchair, and get me straight to the (attached) hospital. The nurse looked as confused as I was. The doctor made a call to the emergency room and off I went for a battery of tests and treatments I was sure were a waste of time.

Sometimes the body can’t recognize an infection, gives up fighting an infection, or simply doesn’t know how to do so. You’ve probably heard of similar things, though often described incorrectly with such terms as “walking pneumonia”, etc

Hours later in the ICU, oxygen on high and a mix of powerful IV antibiotics and steroids pumping into my arms, I found out how close I had come to dieing. I still have some scarring and reduced lung function, and take medication to this day.

My doctor saved my life, the nurse would have given me a z pack and sent me home. That is why you use a GP. They can find that 1 out of 100 case. Sure, a nurse might get 99 right, but what if it’s your turn to be the outlier? Maybe your son, or daughter? Will you still feel that doctors aren’t really neccesary?

I, through experience, disagree.

Also from the comments, an interesting link on hidden (de facto) rationing in 0bamacare

NEJM survey: Physicians on 0bamacare

The New England Journal of Medicine has a survey of physicians’ opinions on 0bamacare. Some highlights (emphases mine):

Physician Support of Health Reform in General
62.7% of physicians feel that health reform is needed but should be implemented in a more targeted, gradual way, as opposed to the sweeping overhaul that is in legislation.
28.7% of physicians are in favor of a public option.
3.6% of physicians prefer the “status quo” and feel that the U.S. health care system is best “as is.
Health Reform and Primary Care Physicians
46.3% of primary care physicians (family medicine and internal medicine) feel that the passing of health reform will either force them out of medicine or make them want to leave medicine.
Health Reform, Public Option, and Practice Revenue/Physician Income
41% of physicians feel that income and practice revenue will “decline or worsen dramatically” with a public option.
30% feel income will “decline or worsen somewhat” with a public option. [That adds up to 71% (!) who feel it will decline.]
9% feel income will “improve somewhat” with a public option, and 0.8% feel income will “improve dramatically” with a public option.
Health Reform, Public Option, and Physician Supply
72% of physicians feel that a public option would have a negative impact on physician supply, with 45% feeling it will “decline or worsen dramatically” and 27% predicting it will “decline or worsen somewhat.
24% of physicians think they will try to retire early if a public option is implemented.
21% of physicians would try to leave medicine if a public option is implemented, even if not near retirement age at the time. [Can you spell: “g-o-i-n-g    G-a-l-t”?]
Health Reform and Recommending Medicine to Others as a Career
36% of physicians would not recommend medicine as a career, regardless of health reform.
27% would recommend medicine as a career but not if health reform passes.
25% of physicians would recommend medicine as a career regardless of health reform.
12% would not recommend medicine as a career now but feel that they would recommend it as a career if health reform passes

Conquest’s Third Law states that “the behavior of any bureaucratic organization can best be understood by assuming that it is controlled by a secret cabal of its enemies.” It is pretty much the only way the 0bama-Peelousy flogging of a dead horse can be rationalized, as its passing will be disastrous not just for the United States but for their own party. Pretty much the best way to guarantee a landslide GOP victory in November is to ram this monstrosity down Middle America’s throats “so they can read what’s in it”.

Then again, “Vision of the anointed” hubris may itself be an adequate explanation.

UPDATE: “Turn” on C2 points me to an “AP flying pig moment”: AP fact-checks the claim that 0bamacare will reduce insurance premiums and finds it wanting.