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Finland’s Government Collapses Over Universal Healthcare Costs. March 2019 :Part 2

Part 2

Stanley Feld MD,FACP,MACE

https://blogs.scientificamerican.com/observations/finland-is-the-happiest-country-in-the-world-and-finns-arent-happy-about-it/

Bernie Sanders (I-VT) has been hanging his socialistic rhetoric on the success of Finland’s socialist society and especially Finland’s healthcare system which is supposed to be a free healthcare system for all. 

The New York Times published the article “Finland is a Capitalist Paradise” on December 2, 2019.

On March 3,2019, Finland’s government collapsed because the universal healthcare costs were unsustainable.                                                                                                                                                  

 President Donald Trump was correct when he said,

“Finland, of course, is one of those Nordic countries that we hear some Americans, including President Trump, describe as unsustainable and oppressive — “socialist nanny states.”

The New York Times ridiculed President Trump in December 2, 2019 for saying that Finland is a socialist nanny state.

https://legalinsurrection.com/2019/03/finland-government-collapses-over-universal-health-care-costs-bernie2020-hardest-hit/

https://freebeacon.com/politics/finnish-government-collapses-due-to-rising-cost-of-universal-health-care/

“Similar problems are bedeviling Sweden and Denmark, two other countries frequently held up as models to follow on health care. Finland’s crisis in particular comes as calls for universal health care have grown louder among Democrats in the United States.”

Americans have heard from few in the mainstream media about the collapse of Finland’s government or the reasons for that collapse.

Norway is excused from this discussion because Norway has become a very rich country from its North Sea oil income and its restrictive immigration policies. It is the citizen’s sugar daddy along with a 50% tax rate. 

The Kaiser Family Foundation found that 58 percent of Americans oppose “Medicare for all” if told it would eliminate private health insurance plans, and 60 percent oppose it if it requires higher taxes.

Reuters reported that soaring treatment costs and longer life spans have particularly affected the Nordic countries financial problems.

“Nordic countries, where comprehensive welfare is the cornerstone of the social model, have been among the most affected,” according to Reuters. “But reform has been controversial and, in Finland, plans to cut costs and boost efficiency have stalled for years.”

Just a few days before Finland’s government collapsed over its inability to foot the bill for its expansive socialist experiment, Sanders took to Twitter in an attempt to shame America.

https://pbs.twimg.com/profile_images/1097820307388334080/9ddg5F6v_bigger.png

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“In the United States it costs, on average, $12,000 to have a baby. In Finland it costs $60. We’ve got to end the disgrace of our profit-driven health care system and pass Medicare for all.”

Bernie Sanders is not being honest with the American people.

“With the collapse of Finland’s government over its inability to financially support its massive socialist agenda, Bernie will undoubtedly do the same thing he always does when socialism (or communism) fails: ignore, obfuscate, and deflect.”

 We only have to remember Vermont’s “Medicare for All” failure. 

Bernie Sanders and AOC should read Finland and Sweden’s newspapers to understand that the people are unhappy with free but unavailable medical care. The unhappiness of the citizens historically happens in every socialist state run healthcare system..

If Democrats are successful in getting “Medicare for All” into law, America will face the same dilemma in the future

“The social welfare and health care reform was one of our government’s most important objectives,” Sipilä said at a press briefing. “The snapshot of the situation that I got from the parliament obliged me to examine if there was a possibility of continuing the reform process. There wasn’t.”

“My conclusion was that my government had to hand in our note of resignation,” he added. “I take my responsibility.”

https://www.politico.eu/article/finlands-government-collapses-over-failed-health-care-reform/

Finland has a decentralized system of health and social welfare programs, where much of the administration is left to local municipalities. This arrangement has led to widespread geographic variation when it comes to quality and access to health care services.

The reform was meant to address these inequalities and reduce the growing cost of the country’s health care system, which has come under increasing stress from an ageing population. It included centralization of the administration at a regional level.”

Finland has been held up as a model welfare state. The distribution of the resulting high taxes is spent on the social issues the politicians think are most important and not what the citizens think are most important.

The government should not be telling the people what they need if a healthcare system is to succeed. The people should decide on what they need and be responsible for their own care. The government should protect the people from both government and corporate abuse in a free enterprise system.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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A New York Times Article Misleads Americans Part 1

Stanley Feld M.D.,FACP ,MACE

On 12/7/2019 the Times published an article by Anu Partanen and Trevor Corson

 entitled “Finland is a Capitalist Paradise.”

The media is the message. The article will resonate with many young couples trying to live a happy life in New York City.

The article also resonates with Bernie Sanders’ primary message.

Bernie: “Take a look at what Finland, the happiest country in the world, is doing. If Finland can provide everyone with health care, send everyone to college for free and provide affordable childcare, why can’t the US?”

The problem is the message is false.  

 “Two years ago, we were living in a pleasant neighborhood in Brooklyn. We were experienced professionals, enjoying a privileged life.

 We’d just had a baby. She was our first, and much wanted. We were United States citizens and our future as a family should have seemed bright. But we felt deeply insecure and anxious.”

There is no dispute with that statement. The college debt burden could be added to that feeling of insecurity.

“Our income was trickling in unreliably from temporary gigs as independent contractors. Our access to health insurance was a constant source of anxiety, as we scrambled year after year among private employer plans, exorbitant plans for freelancers, and complicated and expensive Obamacare plans.

Obamacare was supposed to solve the healthcare insurance problem for this young couple. Obamacare hasn’t solved the problem because of its faulty construction, its top-heavy government bureaucracy and its inefficient administration.

 “With a child, we’d soon face overwhelming day-care costs. Never mind the bankruptcy-sized bills for education ahead, whether for housing in a good public-school district or for private-school tuition. And then there’d be college. In other words, we suffered from the same stressors that are swamping more and more of Americans, even the relatively privileged.

“As we contemplated all this, one of us, Anu, was offered a job back in her hometown: Helsinki, Finland.”

As usual, the New York Times could not help taking a shot at President Trump’s philosophy when they said,

“Finland, of course, is one of those Nordic countries that we hear some Americans, including President Trump, describe as unsustainable and oppressive — “socialist nanny states.”

It turns out President Trump is right.

The couple moved to Finland from Brooklyn. The evidence they used to make their decision was all hearsay from friends and family living in the United States.

Their impression, after living in Helsinki for over a year, sounds like Utopia.

“We’ve now been living in Finland for more than a year. The difference between our lives here and in the States has been tremendous, but perhaps not in the way many Americans might imagine.” 

“What we’ve experienced is an increase in personal freedom. Our lives are just much more manageable. To be sure, our days are still full of challenges — raising a child, helping elderly parents, juggling the demands of daily logistics and work.”

The authors do not describe the meaning of personal freedom.

“But in Finland, we are automatically covered, no matter what, by taxpayer-funded universal health care that equals the United States’ in quality (despite the misleading claims you hear to the contrary), all without piles of confusing paperwork or haggling over huge bills.

This assertion has been disputed by many physicians and people living in Finland. https://www.ess.fi/uutiset/kotimaa/2015/07/30/terveyskeskuslaakarille-voi-paasta-nyt-tai-kuukauden-kuluttua—katso-oman-kuntasi-tilanne

https://legalinsurrection.com/2019/11/finlands-healthcare-system-still-flounders-bernie-and-warren-hardest-hit/

Is this true? What is really happening in Finland?

If you are not sick and do not need the Finnish healthcare system, you will feel very secure. However, if you need to use the healthcare system it is not so good.

Why the New York Times, along with Bernie Sanders and Elizabeth Warren, does not tell us the truth about Finland is obvious. The truth does not fit their agenda.

Finland has more doctors per capita than the UK but, at the level of primary care, a far higher proportion of these physicians are in private practice than is the case in Britain.

Seventeen percent (17%) of Finnish doctors work solely in the private sector. Most of these physicians are general practitioners. This is twice the percentage of physicians that were in the private sector twenty years ago.

An additional twenty percent of physicians work in both the private sector as well as the public sector. 

The bizarre thing is most employers in Finland pay for their workers to have private primary healthcare. Employers do not pay for their employees’ families. The families remain in the public sector.

The public sector is far from free. A visit to a family practitioner cost 16.10 euros. However, patients only pay for the first three visits and then it is free.

According to a Dr. Saarinen of Ula “the more experienced and “better” doctors end up in the private sector, leaving the “inexperienced” and “inefficient” doctors running the health centers.”

 Private practitioners are better paid and work under less pressure than public practitioners.

“A hospital consultation in the public sector costs patients about €38, and you pay for each night that you spend in hospital, up to a maximum of €679.”

The free healthcare service in Finland is not really free. Municipalities pay for the free service. The result is service in poorer areas of the country tend to have bad health service and limited access to medical care.

Private GPs usually set up practices in more affluent areas where they are more likely to get paid.

It looks like a grim socialized medical system. No wonder Finns deny the finding they are the happiest people in the world.

In Helsinki there are reports of huge queues at health centres (GP surgeries), waits for appointments of many weeks, and greater and greater demands with less and less funding. In south-eastern Finland it takes about a month to see a GP. Back in December 2013, it was reported that Finns were increasingly using private doctors in neighbouring Estonia to save time and money.”

Dr. Saarinen explains that the system essentially forces people to go private or rely on friends who are doctors.

Finland’s healthcare system has been a mess for at least two decades.

The couple writing this article are ignoring the facts. They said:

“Our child attends a fabulous, highly professional and ethnically diverse public day-care center that amazes us with its enrichment activities and professionalism. The price? About $300 a month — the maximum for public daycare, because in Finland day-care fees are subsidized for all families. 

And if we stay here, our daughter will be able to attend one of the world’s best K-12 education systems at no cost to us, regardless of the neighborhood we live in. The college would also be tuition-free. If we have another child, we will automatically get paid parental leave, funded largely through taxes, for nearly a year, which can be shared between parents. Annual paid vacations here of four, five or even six weeks are also the norm.”

Nothing is free!

The New York Times reported on a UN study proving Finland is the happiest country in the world. The problem is the Finns do not think the study is accurate. The Finns claim that the study was poorly designed and inaccurate.

https://blogs.scientificamerican.com/observations/finland-is-the-happiest-country-in-the-world-and-finns-arent-happy-about-it/

The New York Times has once again printed fake news story to influence readers to believe in the wisdom of “Medicare for All.”

Bernie Sanders, has long been touting Finland, Sweden, Denmark and Norway as the shining examples of socialism and socialized medicine.

Bernie says:

“Take a look at what Finland, the happiest country in the world, is doing. If Finland can provide everyone with health care, send everyone to college for free and provide affordable child care, why can’t the US?”

Carl Sandberg said, in “The Prairie Years”, “If you tell a lie enough times it becomes the truth.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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Healthcare Policy in The Post Truth Era

Healthcare Policy in The Post Truth Era

Stanley Feld M.D.,FACP, MACE

 The government has been deficient in trying to do anything to Repair the Healthcare System.

Unfortunately, John McCain’s vote blocked the repeal of Obamacare which froze any progress.  His reason was feeble and politically naïve.

John McCain wanted congress to work together and have bipartisan agreement on healthcare reform. The entire majority of the present House of Representatives has no desire to be bipartisan or help President Trump create or pass any bipartisan legislation.

Democrats in the house only want to impeach the president. They have no time for positive legislation to repair the healthcare system.

I believe the Trump administration has the right idea. 

President Trump and his administration have decided to make structural changes to the healthcare system by executive order until it can make big legislative changes. Their hope is they win a more cooperative Congress in 2020.

We are living in a Post-Truth era.

Post-truthpolitics(also called post-factual politics[1]and post-reality politics)[2]is a political culturein which debate is framed largely by appeals to emotion disconnected from the details of policy, and by the repeated assertion of talking pointsto which factual rebuttals are ignored.

Post-truthdiffers from traditional contesting and falsifyingof facts by relegating facts and expert opinions to be of secondary importance relative to appeal to emotion. While this has been described as a contemporary problem, some observers have described it as a long-standing part of political life that was less notable before the advent of the Internetand related social changes.”

https://en.wikipedia.org/wiki/Post-truth_politics

 The media is the message. Donald Trump threatens the Democratic Party, the bureaucracy and the traditional mainstream media.  He also threatens some of the Republicans.

He is a crude speaking person from Queens, New York. He has been called a brawler by some. He says he never starts a fight. He fights back. Many say he fights back in an unappealing way.

He says his goal is to drain the swamp. We have all gotten a glimpse of the inefficient and at times corrupt bureaucracy within our government. We can see the swamp’s depth only because of the Internet and the availability of alternate news opinions.

President Trump is working hard to streamline and increase the efficiency of the ever-expanding bureaucracy. He is a direct threat to their well-being. This is their justification for hating him.

The traditional mainstream media has promoted the Democrats’ agenda. They have helped obstruct President Trump’s agenda. The media has ignored or criticized the continual successes of President Trump.

It has either published disinformation or misinformation, ignored critical thinking on issues, or simply published non-truths.

President Trump has had no choice. Obamacare remained the law. It has been expensive and unsuccessful. It is impossible to know its yearly cost to the federal government. It is self-imploding and will disappear shortly.

Obamacare has just completed its open enrollment period for 2020. The enrollment period is supposed to end on December 15th. The Obama administration extended it to March 31 during some enrollment years. The Trump administration has extended the 2020 open enrollment period until December 31, 2019 this year.

85% of people who enrolled in Obamacare have a preexisting illness. The Obama administration has subsidized most of the premiums. It did not subsidize the deductibles. Obamacare participants still could not afford to pay the deductible. In essence, participants have no healthcare insurance because they could not afford to use it.

Open enrollment as of December 7, 2019, was awful.

2020 enrollment
http://acasignups.net/blogs/charles-gaba

There are only 6,134,477 who have enrolled in 2020 compared to 16.1 million enrollees in 2014. Medicaid was expanded by 9.3 million in 2014. With the Medicaid expansion, a total of 25 million people received insurance in 2014. 

Medicaid is a single party payor. It is inefficient. It has a problem getting physicians to participate because reimbursement does not cover most physician’s overhead.

President Obama decided to have the federal government pay over 90% of the state-run Medicaid programs for a few years.  The states, which signed up for the Medicaid expansion, did not have an increase in costs.

When states have to start paying more for the Medicaid expansion, they will have to raise taxes because by law they cannot have a budget deficit. At the moment most of those states have unauthorized budget deficits. Those deficits will become worse when they have to fund expanded Medicaid.

The mainstream media and Democratic congress continually publish the figure that Obamacare has decreased the uninsured by 20 million. However, eleven million were that result of the expanded Medicaid program.

2014

2014 graph

The numbers do not match. The government graphs are complex and confusing. However, they are very informative. The graphs tend to confuse us with estimates and actual enrollees.

 In 2016 the numbers decreased to 9.3 million with open enrollment extended to February 1, 2016

 2016

2016 enrollment

 Medicaid enrollment increased in 2016 to 15.3 million.  The Medicaid increase is included in the total number of previously uninsured, Obamacare provided healthcare insurance. Obamacare’s increase in previously uninsured is, in fact, an expansion of Medicaid.  The mainstream media use the number 20 million newly insured patients which is a misleading justification for fixing Obamacare. Some of Medicaid’s increase enrollment could represent the illegal immigrants who are now entitled to healthcare coverage.

2016 increase Medicaid

The net Medicaid increase since March 2010 in 2016 was 16.3 million. It looks like Obamacare’s goal was to increase Medicaid. The next step is to have “Medicaid/Medicare for All.”

2018 remained the same as in 2016, with many more dropouts because people realized Obamacare’s unaffordability. Since it was unaffordable, they realized they could not afford care event thought they paid their premium. Therefore, they dropped out and stopped paying their premiums.

2018 enrollment

2020 has been the expected disaster. Consumers needed relief from the Obamacare disaster. Obamacare has caused a further increase in dysfunction in an already dysfunctional healthcare system for people insured by Medicare, Medicaid and Private Healthcare insurance. 

Everyone is dissatisfied.

2020 enrollment

Only 6.1 million consumers have enrolled in Obamacare for 2020.

President Trump is hoping that after the 2020 election, he will have a friendlier Congress. Obamacare will be repealed. Congress will want to do something to help him repair the healthcare system. Meanwhile, he can only do some structural changes to lead us on the path toward an affordable healthcare system.

I predicted Obamacare would eventually fail when it was passed in 2010. Obamacare did not align stakeholders’ incentives!

Obamacare was destined to become unaffordable to consumers, the states and the federal government.

Bernie Sanders’ and Elizabeth Warren’s “Medicare for All” will suffer the same fate as Obamacare.

Most of all the taxpayers in the nation will suffer the most.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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