Tag Archives: Obamacare

On this Friday 13th

There have been a few events going on, with all the hustle and bustle from America we are moving towards a possible point that this nation will be officially renamed, when that happens other domino stones will be pushed into a different direction. Yet there is still time, so we can ignore it for now. What was interesting for me, was a Facebook mail that has all the elements of becoming a flame, a wave of emotions, intentionally set in that way. Yet the part that was actually interesting were the facts that it had. Those facts were indeed interesting to look into, yet not by themselves. At this very moment I am digging to confirm certain numbers and see if they hold up.

 

Income 2013 Income 2014 Change

Aetna, Mark Bertolini

$30.7M $15M -50%
Centene, Michael Neidorf $14.5M $28.1M 93%
Cigna, David Cordani $13.5M $27.2M 101%
Humana, Bruce Broussard $8.8M $13.1M 48%
United Health, Stephen Hemsley $12.1M $66.1M 546%
Wellpoint Joseph Swedish $17M $8.1M -47%

These are health insurances and their CEO’s. This group of 6 have in their hands the health options of the bulk of Americans. Now, before we act in outrage, which we might still do, we see that two of them lost half their income, which in the worst situation, that person (Joseph Swedish) makes in 2 days the same I make in a year. In opposition, there is Stephen Hemsley, who makes in a day, the same I would make in 6 years. Now, we can make this about the imbalance, yet that is not what this is about.

Let’s not forget that these are manages health carers. In September 2016 we saw CNN report “A recent report by Kaiser/HRET Employer Health Benefits forecasts that the average family health care plan will cost $18,142, up 3.4% from 2015. That’s faster than wage growth in America“, and “Premiums on the Obamacare exchanges are expected to rise by double-digits this year“. Now, we need to tread carefully here, health care systems require more work and they need to look to what happens in the future, not just what happens now, So when we see Aetna report in 2016 a total revenue of 60 billion, yet an operating earnings of 2.7 billion, we see that there is a margin, yet not an overly exaggerated one. This is part of a system for 23.5 million members. In this on page 7 we see that the revenue is comprised of commercial and governmental premiums totalling 51.5 billion. Yet it goes further, when we see the growth that Aetna has had, the merger deal with Humana, which is interesting as it is set as a 37 billion merger, yet when we see the quarter of quarter growth of 3 years at least, does it make sense to see this as a mere 37 billion dollar merger when the operating revenue has been in excess of 58 billion for well over 3 years? In addition, Aetna reported an operating gain against costs of over 30%, so when we see the CNBC quote on November 10th 2016: “The Affordable Care Act was built on a flawed model that required getting as many people as possible into the insurance system, Bertolini said. And he said he thinks the Republican Party will make good on its promise to repeal it“, we wonder with their operating profits, a managed health care system no less, what are we not seeing? As stated, compared to the revenue, the profits are not outlandish, yet the entire Obamacare issue seems to give another view, one that clashes with the view that we see at Aetna. Now consider another quote, one we see on December 13th 2016, in bizjournals.com. Here we see: “As one of its arguments against the acquisition, the U.S. Justice Department says the deal would drive up prices on health insurance exchanges in 17 counties where Aetna (NYSE: AET) and Louisville-based Humana (NYSE: HUM) now compete“, you see where there is competition, prices are pushed down, so how come I suddenly see an increase in health insurance exchanges? The final part is one that strikes a sting on the violin of chaos too. Consider the quote: “Bertolini also testified that Molina Healthcare Inc., which has agreed to buy Medicare assets from Aetna and Humana for $117 million if the merger is approved“, now let’s be honest that $117 million is nothing to sneer at, yet what are these Medicare assets exactly? Where is the write-off? You see, two companies with a total revenue exceeding $100 billion annually over the last 3 years, in that light $117 million is close to no blip on the radar (0.11%). So why was it mentioned, why put Molina Healthcare Inc. in the picture? Well, like the other two players, they have had quarter on quarter growth for 3 years too, more important, even as their revenue is not as impressive of the two others, we see that annual on quarter, 2015 brought close to 50% growth, whilst 2016 is expected to surpass the 30% mark, those are operating revenue growths nearly unheard of in this day and age. And this is not the adult media sales, this is healthcare, so as we expect that there will always be growth, we need to see where the interests are of these players. Let’s not forget that the picture is changing. Humana Inc. is a for-profit American health insurance company, they clearly state this, so what will become of Aetna when that merger goes through? How will the picture change and how will that impact the members? They are both Managed health care, yet Aetna is not outspoken ‘for profit’, the numbers do bear this out to some degree. Yet in all this is not about the members or patients. This is about the shareholders and both have plenty, the question becomes what direction will Aetna take? Will we see a board of directors that find themselves in agreement with the senate under Emperor Tiberius Claudius Nero, when in 19 AD they proclaimed: ‘Puer Pauper‘ (fuck the poor), which by the way coincided with the expulsion of the Jews from Rome, life is full of irony at times. The reason to make mention of this is because Israel has a health care system not unlike the Netherlands. A compulsory plan where all Israeli citizens are entitled to basic health care as a fundamental right. There a person can sign up with one of four official health insurance organizations which are run as not-for-profit organizations, this is where we see the massive difference. ‘run-for-profit‘ comes at a price and that price is the additional dividends that the members must pay the shareholders. It is not that simple, but you get the idea. In all this the fact that this approach made Israel 4th in terms of efficiency and Israel was ranked 6th healthiest country in the world by Bloomberg rankings. These are numbers any government could be proud of. Neither the US nor the UK make that top 10, according to the article in Bloomberg, the UK doesn’t even make the Top20. So as we realise a few numbers and this all leads to a lot of questions, we can agree that there is nothing against ‘for-profit’, yet who remains in the US with the option to afford this? Perhaps that is why the link to Molina Healthcare Inc., just a small token proclaiming to remain ‘for the people‘, whilst relying on tax deductions and write offs to remain ‘for the shareholders‘. However, let’s face it, these two (Mark Bertolini and Bruce Broussard) are almost the lowest ones on the Health Care CEO list of incomes, still making per day about what I make per year. Yet even as their incomes drew the attention, it is the coverage, the operating profits and the for-profit sides in some of these Managed Health Care groups, whilst we see places like fortune.com inform its upcoming ‘victims’ that the costs will go up: “costs are expected to grow 6.5% through next year. While costs have finally reached a point of equilibrium after years of double-digit growth” as well as “36% of employers are even considering a defined contribution strategy where they would provide a set sum of money to each employee to pay for health care, and if a health care plan exceeds that sum, the employee is on the hook for the remainder of the cost“, so whatever increased quality of life the Americans did not get, there is information that well over 10% of the employers have adopted this strategy. Such plans, especially with the for-profit health care managers will see a shift in costs, from employer to employee. Fortune.com gives as reason: “There’s two primary factors that affect health care costs: how much is being consumed and the price for services and drugs. As it turns out, prices aren’t what’s primarily adding to the rising trend. It comes down to more people consuming more care“. I personally believe that the truth is somewhere in the middle lane. Both the needs of an aging population and the pharmaceutical patents driving up prices as pharmaceutical patents are chomping down on maximised profit per pill. In this Forbes reported two days ago that the pharmaceuticals are not happy. Here we see the quote “Much of Medicare is now run by private sector insurers like Humana or Aetna, who already bid on drugs to get lower prices (this is known as Medicare Advantage)“, Yet President elect Donald Trump stated: “I worry today that the pharmaceutical industry has a very false sense of relief or security because of a Trump administration and a Republican Congress. I think we should recognize that the drug pricing issue is a populist issue. Americans are rightfully angry. The fault is not, surely, on the pharmaceutical industry’s shoulders, but we bear that because we make the drugs. We innovate the drugs, and as a result of that, whether we like it or not, or we want to try to explain it or not, we have to deal with it.” As stated more than once in the past, I do believe in capitalism, yet at what point does capitalism become plain greed? When we look at the top 20 pharmaceuticals, they are hiding behind a 2% growth, yet these 20 companies which include Novartis, Pfizer and Johnson & Johnson were making 547 billion in 2014, whilst we see that 13 of them are turning a profit with one of them 127%, these are only the 2014 numbers, the profits have been steadily increasing, at the expense of those requiring medication, at the expense of a health care system that can afford less and less. In all this we see that places like Pfizer kept a gross profit of well above 38 billion and they weren’t even the best scoring one. Yet, the connection go on a lot further. You see, with Pfizer we see James C. Smith who is also on the public board of Thomson Reuters, Suzanne Nora Johnson is also on the board of American International Group, Inc. (insurances). James M. Kilts serves on the board of MetLife Inc. as well as Nielsen Holdings N.V. The list goes on. A group of board members already on a massive income, adding the incomes from other boards where they serve with incomes most people dare not dream of. What is more interesting is how we see an almost illuminati sized cloud of interaction with media, insurances and other interactions. All essential and profitable for Pfizer. When we look at Novartis that list of directors takes an even more interesting turn. Ann Fudge who also serves on the board of the US Council on Foreign Relations, with additional functions at Unilever as well as the Northrop Grumman Corporation. Pierre Landolt, Ph.D. who is also the chairman of the Swiss private bank Landolt & Cie SA, a Financial Institution in Brazil and a few other enterprises. Andreas von Planta, Ph.D, linked to HSBC, Moller Finance, and the regulation board of the Swiss stock exchange and finally Srikant Datar, Ph.D., who goes beyond mere Novartis, with additional board placement with ICF International Inc., Stryker Corp. and T-Mobile US. The pharmaceutical boards read like a weave of corporate interaction with links all over the Fortune 500. A conspiracy theorists wet dream.

For us it is not about who they are connected to, but how such links could be used to maximise profits. The idea that the Pharmaceutical industry has its representation, and on the other side we see an optional Novartis with its board member Ann Fudge who also serves on the board of the US Council on Foreign Relations, how is that for hedging your bets on both sides of the profit sandwich?

On this Friday 13th we see news in the Guardian mention of the NHS winter crisis, we have been seeing from all directions the Obamacare and how Obamacare Premiums are expected to Increase by ‘Double Digits‘ in 2017, one can only hope that the first digit is a ‘1’. With pharmaceuticals and insurances both on the maximisation of profit, the people in several places are pushed in a corner with no place to go see about any options.

Only the superstitious will think that the health care news will be better tomorrow, it is Friday 13th after all.

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A political minefield

If there is one place where politics have bungled the ball on near titanic proportions, than it would be healthcare. The UK with the NHS issues, Australia with Medicare, the Netherlands with Gezondsheidszorg and the less we say about Obamacare, the better it is for all of us. They all made massive errors which changed the game for any nation that needs to take care of healthcare.

The UK has had its own issues for some time, yet now we see a new event coming up. Let’s take a look at ‘Cancer diagnosis ‘within four weeks’ under new care plan‘ (at http://www.bbc.com/news/health-33574233). First off, it is a good article by Nick Triggle, he looks at it from a decent viewpoint, but is there an issue?

The first part is “The five-year plan will cost £400m a year but experts say earlier treatment will result in similar savings. They say the plan could help an extra 30,000 patients survive for 10 years“, so basically there is no additional cost, which sounds good, let’s face it, in the increasing pull of funds, breaking even over the next 5 years does sound awesome, the people get to live up to another decade, which is just a bonus.

My initial issue is with the quote “Harpal Kumar, chief executive of Cancer Research UK and chairman of NHS England’s task force, said the changes could help create a “world class” service over the coming years“, the term ‘world class‘ seems a little out of bounds and that also sets the tone, let me go on so that it will all make sense.

The second quote is “We have an opportunity to save many thousands of lives from cancer“, which in light of all this does not make sense, especially when we see “But Mr Kumar believes another 30,000 people a year could end up surviving that long once the changes have been put in place – a third of them simply through diagnosing the disease earlier

I admit that I am splitting hairs, because giving them an additional 10 years is not saving a life, it is prolonging it. Apart from that, is there an objection? You see, healthcare is about keeping people healthy (and saving lives whenever possible) so there is no real objection is there? Giving a person up to 10 years more is a noble goal, especially when 130,000 people die each year, letting them enjoy life a little longer is not wrong at all. So why am I looking at this article?

For that we need to look at the steps. These 7 steps is what brought the light in

  • The creation of a four-week target for diagnosis from GP referral. Currently patients are meant to see a specialist within two weeks of a GP referral but can then face weeks of waiting for tests, meaning a growing number of patients do not get their treatment started within 62 days as they should
  • An 80% increase in the number of tests being carried out, including increasing the ability of GPs to order tests directly – for many they have to go through a hospital specialist
  • Replacing more than 100 radiotherapy machines – half of England’s stock – with new, better models
  • Recruiting extra staff in areas such as specialist nurses and radiologists, with the latter needing to nearly double in number
  • Cancer patients to get online access to all their test results and a specialist nurse or other key worker to co-ordinate their care
  • A call for action on smoking and obesity – four in 10 cancers could be prevented through lifestyle improvements
  • All cancer survivors to be given a recovery package so they get the support they need to recover from their treatment and stay cancer-free

The first premise is shown in dots 3 and 4. Replacing 100 radio therapy machines with newer ones and recruiting extra staff (especially radiologists). The fact that the article implies that there are 200 radiotherapy machines is equally disturbing. You see, 280,000 diagnosed people implies 4 people a day and that is if every machine is properly managed, monitored and staffed. The issue is not complete and facts are missing.

For this we take a look at breast cancer. The site Jezebel had an interesting article linking to all this. ‘Can You Be Diagnosed With Breast Cancer In Just One Day?‘ (at http://jezebel.com/5865123/can-you-be-diagnosed-with-breast-cancer-in-just-one-day), where we read “I wrote to Dr. Karla Kerlikowske, professor of medicine and epidemiology/biostatistics at USCF’s Helen Diller Family Comprehensive Cancer Center. She explained: Mammograms can identify a site likely to be cancer, but it requires taking a sample of breast tissue and looking at it under a microscope to know a person has breast cancer. Rarely, less than 1% of the time a radiologist can look at a mammogram and based on the mammogram know a woman has breast cancer, even then it requires a tissue diagnosis for confirmation“. This seems to be a universal truth. In (as I see it) nearly all forms of cancer, confirmation is needed), which is part of the entire issue.

This does not change one essential truth “simply through diagnosing the disease earlier“, that is again a universal truth, so even for that mere fact this project should go on. The issue is not with the idea, or the plan or what we read, but by what we are not reading here.

Part 5 is the first real kicker, giving online to test results is a dangerous step, often cancer will hit the elderly, who do not comprehend the need for proper approach to common cyber sense and as such too many medical details will ends up in the open air, a place where medical details should not be allowed. Now, issue number 2 is one that can be handled, there is no reason why not to do this, yet we must acknowledge that specialists are there for a reason, as such, we can accept that GP’s could call for the test yet, here is also the danger that a GP will act under the ‘better be safe than sorry premise‘ which will now give the situation that 80% more tests are being made, yet it will also include the stronger increase of false alarm results, even under an issue of the best intentions. A mere consequence of people doing the best possible for the patient, an anticipated side effect of ‘world class cancer care‘. I do not object to these parts (or fight the approach here), but it calls into question the given budget already from this point on. So what is expected to be £400m a year, could end up being £520m a year. In addition to issue 4 where we see the need for specialist nurses and radiologists, there will also be the need for additional technicians and re-schooling of technicians and upgrading other peripheral devices. It is possible that these parts had been added to the cart of costs, yet the fact that they are not mentioned, the fact that some parts might not have been looked at yet makes the anticipated £400m a year incorrect and dangerous. The Labour party made a 12 billion IT fiasco, let’s not add to that, shall we?

You see, the cancer confirmation part is not always possible on the spot. So when we accept that ‘Most incisional and excisional biopsies are performed by surgeons‘, we see that additional costs and additional resources will be required. This means that there will be additional pressure on surgeons, was that factored in? You see, there is already a massive backlog. The Guardian reported on July 4th 2014 in the article ‘NHS patients waiting longer for routine operations under coalition‘ (at http://www.theguardian.com/society/2014/jul/04/nhs-patients-waiting-longer-for-routine-operations-under-coalition), that delays had been reported of up to 215 days.

So the entire ‘speed need’ in cancer diagnoses is going to take another matter of growth entirely.

So as I give you these facts and the thoughts around this, you might get a first idea what was wrong with the article by Nick Triggle. I am an ample Medici, but I never studied medicine and it took me roughly 17 seconds to get my question marks up, so why did Nick Triggle not voice these concerns?

The quote by Dr Maureen Baker, of the Royal College of GPs, who welcomed the plans was “The system is already overloaded and we must ensure that there is sufficient imaging and specialist capacity to cope with the increased number of referrals before promises are made to patients that cannot be delivered“. Yet her quote is equally incomplete. I would have expected the quote to be “The system is already overloaded and radiology is only one step in determining the path for a cancer patient. We must ensure that there is growth in several ways in several divisions of hospitals to cope with the increased number of referrals before promises are made to patients that cannot be delivered“, which would have been more correct and as lacking as the quote seems to be from my point of view, I personally would acknowledge that the BBC article could have been used to emphasize on how much work the NHS needs and how much more needs to be done.

None of that can be seen in the article.

It seems to be that the response from Lynda Thomas, chief executive at Macmillan Cancer Support is more on point. Even though it is ambitious, she states “This report has to be more than a set of recommendations on paper. It has to inspire action and lead to meaningful improvements for the lives of people with cancer“. I think that she is playing the game carefully as she wants to get whatever she can for people with cancer, yet the though in my mind is (based on the BBC article) that I would have phrased “This report has to be more than just a set of incomplete recommendations on paper“. That will lead to questions and that will lead to proper dimensioning of a massive problem. I agree that this needs to be done, but without the fact that the pressure for surgeons is already beyond believe (not just in the UK), not addressing this part will lead to another fiasco for NHS, which is what we need to avoid at all costs.

So we are facing a political minefield, one that Labour did not survive, I hope that the conservatives and especially the Rt Hon Jeremy Hunt MP takes more than just a few additional looks at it. And even though he might dread sitting down with a collection of ‘funny and entertaining people’ (like hospital administrators), he will do so and get a proper scope of what will be impacted, because spending another 2 billion only to learn that the term ‘similar savings‘ will never be an option is one he must be willing to accept having to deal with.

There is nothing against spending it on treatment and diagnoses of cancer patients, I just want to make certain that they do not end up becoming the group who ends up with the short straw, a draw they never got a choice in voted for.

 

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Growing the deficit?

I stumbled upon a small piece in the Guardian by Dean Baker (at http://www.theguardian.com/commentisfree/2013/feb/08/us-deficit-obama-grow) this morning. He wrote it in 2013, yet in light of several events this story still holds some visible issues, even though I completely disagree with it. It was however a nice piece to read. Dean Baker is the co-director of the Centre for Economic and Policy Research, which means that he has degrees in economy and I do not. So, why do I disagree?

This view comes through the following quotes. “First, the United States has large deficits because the collapse of the housing bubble sank the economy“. That in itself does not sound incorrect, yet when we look at the definition of ‘deficit’, we should accept this simple one: “The amount by which expenses exceed income or costs outstrip revenues“. So how is this housing bubble a US deficit problem? Houses are built through real-estate people, developers and such. So, there is a little truth in there. As these people made a huge loss, they would not be paying any taxation, which means the US is not getting money through taxation, which means that they get less money for their budget. So, in that regard we are all fine. The linked 2008 economic downfall was due to several idiots (or geniuses depending on your viewpoint) in Wall Street and Financial districts who were playing with all kinds of mortgage based hedge funds and in that way ‘lost’ about 8 trillion dollars, which comes down to devaluating 32 million houses from newly built to the instant value of $0. This comes down to the housing value of 27% of the US households became null and void with the instant snap of the fingers.

So, yes, we can agree that this impacts the deficit as taxation goes down, however should we consider that part of these events is because the US treasury failed completely? Consider that there was a recognised housing bubble at the time that Henry Paulson (who was at that time the big boss of the US treasury). The deficit grew to such an extent because the elements were not properly monitored. So in this view the quote “First, the United States has large deficits because the collapse of the housing bubble sank the economy” should be “The United States diminished its income as the US Treasury did not act preventive, proactive and in a timely fashion in regards to the housing bubble“.

The second quote we see by Dean Baker is “Second, if we had smaller deficits the main result would be slower growth and higher unemployment“. Well, that is one bubble we can pinch through. If taxable amounts increase deficit goes down, if expenditure goes down, then so does the deficit. Neither forces us into the view that this will result in higher unemployment rates, neither prove that there will be a slower growth.

This all depends on the application of the tools available. Yes, taxing extensively is a massive downturn, but is that the approach that should be taken? Am I against taxing the ultra-rich? That depends on the way taken. I do not think it is fair to just tax the rich, yet removing some of the tax shelters would be a very acceptable approach. Consider the following quote by the NY Times (at http://www.nytimes.com/2011/08/15/opinion/stop-coddling-the-super-rich.html)

In 2008, the aggregate income of the highest 400 had soared to $90.9 billion — a staggering $227.4 million on average — but the rate paid had fallen to 21.5 percent“. This is less than people making $36,251 – $87,850, they pay 25%. So, there is a massive imbalance here, which leads to the approach that a smaller deficit could be gotten by properly addressing a flawed tax system.

This is where we get to the news of January, (at http://www.theguardian.com/world/2014/jan/04/bill-de-blasio-new-york-mayor-inaugurated), where a quote is given that reads like an incorrect act. “But the most controversial element is to extract an extra $530m (£323m) in taxes from those earning more than $500,000 a year to pay for universal pre-kindergarten education and after-school programmes“, so New York wants to get a little more cash. I have mixed feelings, yet I do understand this move when the top 1% of the people in New York makes up for 39% of all income. Those objecting to this better understand that the tax increase amounts to an annual rise of $973 for those making a million a year, which is less than the price of a coffee a day. My issue is the fact that tax deductions allow for millionaires and billionaires to pay 4% less than those on an average income, which adds up to massive amounts of dollars. Dealing with these factors will not slow growth, it will not lead to a higher employment rate, it will however allow for a smaller deficit as the US grows its collected income from tax donations.

The third quote by Dean Baker was “Third, large projected long-term deficits are the result of a broken health care system, not reckless government ‘entitlement’ programs“. In my view it is both. I have a hard time speaking out against certain entitlements. Not because they exist, or should exist. The reason is that the 2008 crash left a massive population in an unfair position. A large group of people lost their house and homestead and these people had to be protected in some extended form. The fact that those who caused it walked away with amounts in that year would be beyond what the victims would earn in an entire lifetime is just obscene. Consider that in 2008, the year of the crash, Merrill Lynch handed out over 3 billion in bonuses (at http://www.forbes.com/2009/01/28/wall-street-bonuses-business-wall-street_0128_bonuses.html) and it happened just before they merged with the Bank of America. When we look at this all, we see entitlements, who largely impacted the US government due to what should be seen as high stakes poker games played by the commercial sector, which was loosely ignored by the US treasury. When we see the broken health care system, it seems that there is an issue there. We see the massive amounts of issues on all kinds of newscasts where we see that Obamacare will cost the people. Their premiums will double and in some cases triple. Now, on the side of the people there is outrage. I get that, but look at it from the other side. Does this mean that for decades, the people got medical care, whilst not getting properly charged for it? It is nice and easy to lash out at President Obama on this, but is this his fault? The actual costs, the investigations and as such the in-activities would play into the hand of President Obama. I might just casually ask whether the US treasury should have looked at this. Was this an area that had been ignored for way too long?

So in the end, Dean Baker makes one point that holds ground to some extent.

So why was I looking into this article 405 days (actually 4926 hours and 17 minutes) later? This is all due to an article that the NY Times published (at http://www.nytimes.com/2014/03/20/business/us-current-account-deficit-is-smallest-in-14-years.html). Let’s not get fooled here. This article is about trade deficit, not the US deficit or the US debt. The quote “Big gains in exports and overseas investment income narrowed the United States’ current-account deficit in the fourth quarter to the lowest level in 14 years“. So for one quarter they were only short a little north of 80 billion. It reads like when you have debt, flaunt it!

The valid question that you the reader might have is how the articles and the issues are linked. Well, they are not, but the issues of data behind them are. We are offered information by those who should give us clarity and information, yet, we have been ‘bamboozled’ for some time with an overly deep view in information, so the overview is gone for nearly all readers. When you want something to pass unseen, you just make sure that you give the people everything. It is something some researchers do. When the initial results lead to that one question, you just give them all 1247 result tables; there is a high chance that the certain question ends up not getting asked.

The last point to leave you with is the small issue that is playing thanks to some Ukrainian disagreements. How will these numbers impact when the acts of the EEC and the US will result in Russia closing the gas tap to Western Europe. As the Dutch NOS reported earlier this week, the Rotterdam Harbours are ready to switch and get their energy through the provision of liquid gas from the USA, the trade deficit will get smaller even still, yet the 20% hike the consumers in Europe face is something the people will only read about after the fact.

The US has a long way to go, with a national debt of well over 17,500 billion and a total debt of around 61,350 billion, being short by 80 billion seems like a pinch not worth mentioning, yet consider that the US is forecasting an total income of 3 trillion (before expenses), in 2013 the deficit ended up being $680 billion, which makes it unlikely that 2014 is a turning point for now, which means that the total deficit will grow for at least one more year. Then and only if severe cuts are found, it will still take up 70 years for the national debt to be gone, there is no way to predict how long the total debt of 61 trillion will take. So when you read all the upbeat articles on how there are three issues with the deficit remember, it will take 3 Generations (3G) to get rid of the national debt, the USA, now a 3G nation, how happy can anyone in the free world be for the foreseeable future?

 

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The reality that wasn’t one

Until we all realise that the edge of the abyss is on the Americans, we all need to realise that what will topple the Americans, will have a massive effect on us all. Partly because we are linked, partially because the events that are in effect there are also in effect in the Commonwealth and both are not willing to change their ways.

The issues all start with an article in the Guardian (at http://www.theguardian.com/world/2013/oct/19/barack-obama-address-shutdown-debt-ceiling).

The first quote is: “There’s been a lot of discussion lately of the politics of this shutdown. But the truth is, there were no winners in this.

Actually, there are. The banks! They are making a bundle and as things go, the US will be (pardon my French) the Bank’s Bitch for a long time to come. $17,000 Billion has that effect on them. The article by the LA Times, which I personally call laughable, can be found at http://touch.latimes.com/#section/-1/article/p2p-77819148/

The four points should be looked at.

1. The U.S. debt burden is starting to decline. That’s right – it’s going down, not up.

Really? $17,000 Billion remains that. The economy is not even close to being on par, and as long as the government is spending over a trillion a year more than they earn, the debt is not going anywhere. If we go from the T-Bill path, then the payable cost of T-bills (basically the discount value), for the entire amount would be $453 billion. This is of course not realistic; the number that is closer is based upon the annual deficit increase. These numbers were discussed in my blog ‘A new third World continent‘. So, when they do start to mature, an annual amount no less than $1,000 billion a year for no less ten 5 years would be needed. So, that debt burden is going nowhere, it will be there waiting for the people and it will come with additional bills.

2. China holds only a relatively small fraction of U.S. debt.

That is actually true, yet roughly 14% of $17,000 billion is still a massive amount, it just seems little. By the way, if they suddenly cash in, the chances of the US being able to pay it becomes smaller and smaller by the day. The debt ceiling is there and it would be instantly crossed.

3. The U.S. has had a national debt for almost its entire history.

Again that is also true for the most, yet in 2000 it was only 5 trillion (roughly), so in 13 years it grew by 12 trillion dollars, it grew from 5 to 9 trillion up to 2007 and the rest grew in the last 6 years.

4. Debt crises have marked American politics from the beginning.

Well, that is not entirely incorrect. The article starts with General George Washington. The guy who ran the American defence forces before Patton, roughly about 140 years before Patton. The debt remained under 1 trillion until the 80’s, so basically the US went through Independence Day 1 (1776, not the one with the aliens), WW1, WW2, the Cold War and the Vietnam war. All these elements involving massive amounts of politics, (except the Cold war, which was a contemporary event where Ivan Aleksandrovich Serov and Allen Dulles had a bit of fun, as well as their successors (boys will be boys).

The moral here is not about the marking of American politics, it is about Politics not doing what they were supposed to be doing. From my point of view, the right questions were not asked, hence the actions proceeded were of a game where open and clear communications were not in play (or this deficit would be a lot smaller).
There is plenty of blame to go around! Initial there was former President Clinton, even though the coffers actually had real cash in his era, the Silicon Valley crash started to leave its mark. It drove Gray Davis (former Governor of California) out of office and it was the beginning of a massive shift. After that the USA had former President Bush. He did a good job, but then 9/11 struck. The consequences had a major influence, it also changed the premise of many, instead of a true revamping of intelligence, 4 agencies were suddenly spending like there was no tomorrow. The military costs went up, which would really hurt the treasury coffers and lastly the financial crash of 2008 was one that had a long term consequence, especially as a building named America got prepped in the years 2003-2005, by the time the 2008 financial fire hit the house, there were no fire hydrants and there was no one able to actually fight that fire. The rest is the now and many are still reeling from those hits.

This takes us back to the article in the Guardian, where President Obama is quoted saying “First, we should sit down and pursue a balanced approach to a responsible budget, one that grows our economy faster and shrinks our long-term deficits further.

That is a simple answer, stop spending too much. I understand that spending $5 to make $50 is perfectly sensible, but America has become a nation of entitlements and costs, not profits. When you as a nation allow for tax evasion and keep on postponing putting a stop to these acrobatics (the Tax evasion rule is not expected to become active until 2014). So the US is in an extremely fragile situation. It is basically what you hear of Fox News (people like Glenn Beck, Bill O’Reilly and John Stossel), is that view wrong? Well the Nanny state is an overprotective government. I am all for protection. We should protect the weak, the sick and so on. But when you are broke, you cannot pay the beggar with coins you do not have, you cannot feed the hungry with food you cannot pay for. When your money runs out, it runs out. So until the government gets their horses back on track, entitlements will (not should) suffer. Perhaps doing something about Corporations and their tax evasion? For Example, Google paid the UK $12M in taxation, whilst their UK revenue was $3,000M. That is less than 1/2% in taxation. They avoided $2B in taxation in the US, according to the Bloomberg article (at http://www.bloomberg.com/news/2012-12-10/google-revenues-sheltered-in-no-tax-bermuda-soar-to-10-billion.html)

So how much taxation is NOT going into the US coffers? That list of corporations using tax havens is long and they are all prosperous. So, when entitlements fall away, look at those places on why support is gone.

The only part remaining is an article that came to view as I was reading up on a few parts. It is at http://www.rawstory.com/rs/2013/03/25/economics-professor-smacks-down-bill-oreilly-he-has-no-idea-what-a-nanny-state-is/

And the story is about Professor Richard Wolff having a go at Bill O’Reilly. It was on ‘Democracy Now‘ so the idea that this is about a democrat having a go at a Republican should be clear.

The first part was in regards to “a clip of O’Reilly talking about the latest round of European bailouts, which O’Reilly said is happening ‘because they’re all nanny states’ that do not have enough workers to support ‘entitlements’.

So what are the numbers? According to the site, http://apografi.yap.gov.gr/ where the Greek state currently employs 614,053 people, 15,000 jobs got axed in the first half of 2013. The Greek population is around 11 million; this gives us that just over 5.5% of the ENTIRE Greek population works for the state. There are reports that this used to be over 20% (in 2011), so how is that not a nanny state? According to the Oxford press it is stated as “a view that a government or its policies are overprotective or interfering unduly with personal choice.” when 1 in 5 works for the government, overprotective seems to be the case. The only part I do not agree with, in this case, with Mr O’Reilly is that Greece seems more and more the consequence of short sightedness and utter stupidity. In reflection, when a government asks Goldman Sachs to hide the size of their debt, I personally want to sail towards words like stupidity and irresponsibility.

Professor Wolff sees Germany and Sweden as Nanny States. That is not incorrect, however the next part “they’re the winners of the current situation. The unemployment rate in Germany is now below 5 percent.” is misrepresentation. First of all, when changes were needed (around 2009) Germany tightened the belt by A LOT! This is why it seems that they got off lighter, because they decided against borrowing (a lesson that the USA still has not learned). The second part is that Sweden has a different system. Yes, they do have a protective nanny state, but taxation is also higher. It is 57% at the highest tier; whereas the rich and playful in the US seem to pay only 29%. In addition, most Swedes are ‘proud’ (slightly overstated, I admit) to pay taxation. The more they pay, the higher their status. (Inwards they’ll sulk like nothing you’ll ever see).

So, Professor Wolff is missing his shares of facts too. In addition, Sweden had to deal with its own issues in 2003 as Ericsson dismissed thousands of people. They went from 85,200 staff members in 2001, to 51,600 in 2003. That is over 33000 in just 2 years. Try finding a job in IT in 2003. So as Sweden got itself back on its feet, they had moved themselves into a position to remain cautious. There is a good PDF file to read, it is called ‘Growth and renewal in the Swedish economy‘ It is by McKinsey and Company and worth reading. I wanted to add the link, but like Google’s ability to avoid taxation; they are getting better and better in avoiding clean links (just huge links full of Google statistics garbage). Although Sweden got through it all not too harmed, their current projections are not too good. Their deficit is likely to rise to 3% this year. One of the more noticeable incomes Sweden had was from Vattenfal and their nuclear power plant, the issues in the UK showed that Vattenfal has issues, some of their sites (outside of Sweden) were not panning out the way they were. www.vattenfall.com/en/file/Q2-report-2013_35251329.pdf has some interesting materials. So as they reported an operating profit of MINUS 25 billion (in Swedish kronor), they are still there, but that is an amount that hurts, and of course as they depreciated that much, it will affect the Swedish deficit. Let us not forget, they only have a population of 9.5 million and unlike Greece they are doing decently well. As for health care? The numbers from the OECD (Organisation for Economic Co-operation and Development) show us two interesting facts, percentage of government revenue spend on health gives us USA 18.5% (highest), whilst Sweden spend 13.6% (lowest), then look at the percentage of health costs paid by government which gives us USA with 45.1% (lowest) and Sweden with 81.4% (2nd highest). So, either the Swedes get a much better bang for their buck, or in comparison the American system is extremely flawed. There are ways to find out which, but compared to the UK, which is almost identical to Sweden in covered health costs, yet the slightly higher spending by the UK government leaves me with the thought that an overhaul of US healthcare was essential, but until I see the actual numbers on the new system, I will remain doubtful whether Obamacare would ever be a solution (but I refuse to judge until better numbers are known).

So in the end, the information by Professor Wolff reads less correct when you take another look at certain facts.

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