John Livingston

No Margin—No Mission

There are many organizations and individuals sitting at the top of the medical industrial complex food chain who are cashing in on the political narrative that has driven our Covid-19 strategies. At the top of the list are pharmaceutical companies and health care provider networks who have created utility and demand for “Cost Free” Covid testing. Cameron Kaplan in the WSJ provided analysis of the cost shifting and supply and demand manipulations that have created turmoil in the medical marketplace. If we have learned anything over the past 10 years it is the fact that Medicaid Expansion and The Health Insurance Exchange in Idaho have done nothing to decrease the cost of health care delivery to patients, businesses, and individuals who see their health insurance premiums go up every year along with co-pays and deductibles and at the same time they see their taxes going up to offset the cost of government health care programs like Medicaid, Tricare, Federal Health Care Programs and even Medicare—there never really was a Medicare Trust.

Savvy businesspeople many in the health care industry themselves saw the opportunity to profit from Covid Testing Programs that were subsidized by taxpayers or required by law to be covered by insurance companies. In an article in early 2020 at the beginning of the pandemic I opined that the Public Health Experts would require more testing, generate more data, and initiate mitigation strategies that were wasteful and destructive to patients, the economy, and that they would dig their heals in when it was appropriate to change course.

Type 3 mitigation—isolating entire populations to “flatten the curve” failed to protect and identify the most vulnerable people in our country. Today we know what we also knew early in the pandemic that 75% of deaths occurred in patients over 70 years old and that of the remaining group 75% of those deaths occurred in immune compromised patients or those with preexisting co-morbid conditions. These vulnerable patients needed to be protected and monitored with tests, not an entire population of people. But then the people making money from testing programs wouldn’t be able to make a profit. What good was testing 30,000 elderly patients in New York State who were hospitalized, finding out they tested positive and then sending them back to nursing homes where they died and reinfected other elderly vulnerable patients? How about monitoring those nursing home patients and the health care workers that took care of them?

The so called “free tests” aren’t free. Your insurance company pays for them at a price anywhere between $30-$285 a test. If you aren’t insured, taxpayers pick up the tab and our politicians call that “free”. I wonder who picks up their tab? Providers are given unchecked power to set prices—there is no market place and as always in command economies the price point will always be above a normal equilibrium point where supply and demand meet. In future articles I will describe how this same system worked for vaccines, monoclonal antibody distribution, and even therapeutics like Remdesivir which has been shown to cause renal dysfunction in 20% of hospitalized patients—and it is still part of many treatment protocols because its’ use is subsidized by government reimbursements that are inappropriate and above market prices. As they say in the hospital business “no margin no mission”. And maybe that explains why low-cost therapeutics like hydroxychloroquine and Ivermectin are being targeted by Boards of Pharmacy and State Medical Boards as being inappropriate, even when their risk profile and efficacy when taken early on has proven to be many times better than Remdesivir.

The terms of the insurance transaction have been switched on the carriers in this one case. They are placed in a position of supplicant and the only way they can recover from these increased costs is to charge higher premiums, co-pays, and deductibles to their customers in future years.

Once again, the opportunity costs and unintended consequences of the “government experts” have been not well thought out. Private entrepreneurs and providers set up their pop-up tents in affluent areas where people have insurance, while testing is almost inaccessible in poorer neighborhoods. Mr. Kaplan in his article unfortunately goes back to government as the “final solution” either with price limits or with subsidies. How about just insisting on transparency and documenting the price shifting that goes on between those who pay for insurance and taxes, and those who get “free health care”. Guess what. If nothing else Obama Care has proven that “free” always costs more.

In the end the problem is simple. Testing and vaccinations are not a medical service. Regular testing was for a public health community benefit. Policy makers made testing and vaccinations “free” for individuals but left the customers of insurance companies to pick up the tab. How inefficient was this? And what was the promise of The Affordable Care Act? Access—Quality—Cost. Really!

Time to invest in my own “testing tent”. I think I will park it next door to a country club—not the Rescue Mission or the Food Bank. Remember what the Sisters say—”No margin no mission”What a shame. And those most at risk and the elderly? We could have and should have done better. All we had to do was listen to the doctors and nurses who were in the trenches day after day, instead of the “experts and middle managers” who still don’t have a clue.

One reply on “No Margin—No Mission”

Outrageous cost for “tests” that test nothing and lie most of the time because they can be manipulated. No one should be “tested” with these fake tests!
Vaccinations? There are no such thing for this so-called coronavirus disease! They do not protect the recipients from anything and they do not stop the spread to others. They are deadly and toxic experimental gene therapy injections or franken-injections made up by sorcerers (pharmakeia). All who take the injections or tests are fools of the Cult of Covid as are the face diaper wearers.

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