That's a good point. I think taxes in Australia are a little higher than in the US, but overall the net cost to an individual seems lower.

So to your point, my wife works as a radiologic technologist, and I've been able to get some details about how many procedures can be done in a day, etc.

The average insured family spends $10,000 to $15,000 on health insurance a year. Say the family has no health emergencies, except dad slips and falls on some ice, and needs to have his knee imaged via magnetic resonance (MRI). The cost of the MRI, $8,000 to $10,000, with ~$500 going to the doctor who inspects (reads) the images. The family typically has to pay the lesser of $500 per incident or 10% of the cost. So they have to cough up $500 in addition to the $10,000 they already paid. But they paid the $10,000 out over 12 months so while the $500 seems like a lot, the $833 per month didn't.

But... With a single MRI system, a knee can be scanned in approximately 30 minutes. Radiology departments typically offer this service from 7:00 AM to 7:00 PM. Then they can perform some where between 12 and 24 procedures a day. At $8,000 per knee, an MRI scanning knees all day would have a gross revenue of $192,000 per day!

High-end MRI machines cost between $500,000 and $1,200,000 each. The operator is paid about $25/hour, and the cost in electricity and servicing is probably less than $5000 per month.

So if you owned and operated a high-end MRI machine in one years time you could have the net revenue of:

$49,920,000 (gross) = $192,000/day x 52 weeks x 5 days/week
($138,000) (COB service/employment) = $5,000/month x 12 months + $25/hour x 12hrs x 52 weeks x 5 days/week
($50,000) = Real Estate
=================
$49,856,200

That's a lot of revenue. Now, I know I've left out benefits for the MRI technologist, cost of supplies like MRI dye, house keeping, and medical supplies. The estimate for the cost of real estate may be low too. There may even be more cost in operating the machine itself.

Even if it cost an additional $2,000,000 a year to operate an MRI machine, the system is net revenue generation for the operator whether that be a clinic or hospital.

It's not only competition between service providers but the regulations on how profitable insurance providers are.

Consider this, every State Insurance Board (SIB) sets these requirements on a policy before it can be sold:
* Minimum level of service for the policy type
* Policy Holder selection rules so that individuals are not excluded as prescribed by the Equal Protection clause of the 14th Amendment to the US Constitution
* Maximum policy price for the services offered
* Maximum profitability of the insurance provider (typical amounts are 7%)

If you are told what the maximum price you can sell a thing for, you are going to sell it for that price. Unless, your cost of doing business is too high (you don't make enough profit). If your cost of doing business is too low, you increase your costs to match the regulated expectations, and you're in the money because you're wasting it.

Under this model, insurance companies aren't interested in maximizing profit by being competitive with service providers. They could wind up making too much profit and be find by SIB for doing too good of job. They also aren't interested in optimizing throughput as this could decrease cost as well.

So maybe there's no room for competition, because it's already regulated out of the system.

I think you're on to something here. Paying $100 per week is a price point that has become acceptable based upon the available amount of funds in the system.

What if health service providers were required by law to provide you with services regardless of your ability to pay for the services? In that case the service provider may actually devise a price and payment model that both you and he can accept. This is the current model that is in place today. Both hospitals and drug companies have programs to provide service at a lower cost if you can't afford the "normal" price.

What if 80% of people seeking medical services had backing so that 100 times their ability to pay were available at any given moment. In a free market, the service provider is inclined to collect as much revenue per service per procedure. Thus the backer and the service provider agree upon a price for the service provider. Since the backer has much more available funds, the price per service is necessarily higher than if an individual could only pay 1% of what the backer is willing to pay. This is what health insurance companies today. It's called a Health Service Provider Network.

Consider if 95% of people seeking medical services had backing, so that 100 times their ability to pay were available at any given moment. The service provider will again increase prices, as the backer now has more available funds to work with, at least 15% more funds. This is exactly the model predicted in macro economics when available funds increase, but the number of items sold remains the same. There aren't any more sick people than before, just more have more money to spend.

When more and more people have more funds to spend, the only way to decrease the price point is by choice of the payer to not do business with the provider, unless the provider agrees to some other (hopefully lower) price. Insurance companies are for profit organizations, thus they are incented to increase revenue, but are limited by law on the maximum amount of profit they can accrue. They have very little reason to lower the payout amounts, because that would cause premiums to be lowered overall, or they would somehow have to increase the cost of doing business (which is also regulated). Insurance companies do not benefit from lowered health service costs, and neither do health service providers.

In the United States today, any person who arrives at a hospital cannot be denied services, regardless of their ability to pay. The Affordable Care Act (Obama Care) does not increase the availability of health services, but the availability of health insurance. When proponents say "We're providing access to Health Care," they mean, "We're providing access to Health Care Insurance."

The only way to reduce the cost of health services is to decrease the available money in the system. There are two ways to do this: Decrease the Number of Insured Individuals; or Mandate the Cost per Service in law. With the ACA in effect, the only remainder is government mandates for service price, which will either lead to reduced service or utopia.

I don't know about you but my bucket of ice cream has been getting smaller for the same price, not the same size for a lower price.

Anybody thought to wonder why the car was searched by the valet service instead of the the TSA itself?

The very reason is because the contents of your car has long been held protected under the 4th Amendment to the US Constitution {Jay-Z even wrote a song about it, 99 Problems :) }. Where as, common law has set, the yet non-SCOTUS challenged precedent, that private security firms may check your baggage with x-rays and magnetometers (otherwise referred to as non-unreasonable means) when you enter the secured portion of an air-port, to protect the persons and private assets operated there. In no situation, has it ever been shown that the Government of the United States may search the person or materials or vehicle of every individual, unless entering or exiting the country (which falls under export law, under which you would be considered a "smuggler"). Because doing so assumes that there is a reasonable belief that every single person is some how operating in a criminal manner. (BTW: This is also why the NSA search warrants, if challenged would be shown to be invalid.)

Look forward to big brother telling me when I can piss and shit.

Maybe we are missing the understood subject of the statement then it would be:

you.goForth().prosper();

My thoughts exactly. I've got a philosophy that I've taken is:

1) When you start a new career (programming or not), you're still the FNG whether you're 21 or 71.
        a) That means you'll probably have something to learn, even from your co-workers that are younger than you.
        b) You may have better life skills which you can contribute back to the your younger co-workers.
2) When you start a new career, you're still, still the FNG.
        a) Some employers will assume you want 20-50% more pay than the 24 year old entry-level person he hired too.
        b) Do you deserve 20-50% more pay to do the same job as someone much younger than you?
3) When you start a new career, the older you are, the younger your boss will be
        a) Can you take direction and criticism from someone who is the same age as your son or daughter?

Hiring managers take these types of things into consideration. When you're building a team, you have to find people that will work with each other. It takes a person with wisdom and grace to ignore the age of those around them. And that goes in both directions whether you're a crotchety-old-know-it-all or a young-disrespectful-punk.

Automat (http://en.wikipedia.org/wiki/Automat) FTW!

This is an interesting comment, that has been running around the community organization circuit lately. However, it doesn't hold to be true. Income after taxes have tripled since 1984 while expenditures as a function of income has decreased by 20%.

In 1984, people in the US spent 103.5% of their income on housing, food, entertainment, etc. In 2009 that number was down to 80.8%. (See: http://www.census.gov/compendia/statab/cats/income_expenditures_poverty_wealth/consumer_expenditures.html, http://www.census.gov/compendia/statab/2012/tables/12s0684.xls)

Most notably, we can see that housing increased its dominance over personal expenditure, and with the 20% decrease more income may be devoted to savings or discretionary spending.

I think one of the hardest parts to this change is the switch from large-scale manufacturing to small scale services. Factories with their large volume of employment allowed for the "Big Boss" to be abstracted away from Joe C. Worker. That meant, other than his shift supervisor, he really never saw either the customer or person running the show.

Now switch to the small scale, where employees have very close up and personal interactions with both the customer and the boss. Now as an employee you are expected to please both of these parties. This type of thing rubs up against the American Ethos, where everyman is his own boss and fully independent.

Working at the factory meant showing up for work, and joking around on break. Now, you have to show up for work, please the boss, please the customer, and rub elbows with the boss at break. Lost is that anonymity and independence.

Um, AC, you should check the record. Last I checked, Toni Harp is a Democrat, not typically a conservative.

I personally like this approach. I remember a case where a mother and daughter pair were ordered to be chained together. Just found the link: http://www.nytimes.com/1995/12/15/us/judge-orders-delinquent-girl-to-be-chained-to-her-mother.html

Turns out they had to be shackled for 30 days, else mom got 30 days in jail. Maybe this is a little better than punishing just one or the other.

I'm just waiting for the legislation requiring modification to the human genome, so that the thumb opposes the pinky finger, making it impossible for one to make "pew-pew" hand gestures. After all, this is the root cause of violence in American society, not the recent 4.5 year economic down turn, reduction in psychiatric services, or the continued marketing ploy dividing Americans into convenient niche groups.

My thoughts exactly. I guess it's not just dildos and electric razors that get airport security in a tizzy. Bur hey, if you can't cause millions of dollars in mayhem with a $3.99 item from WalMart, then you aren't worth your salt (or water if you catch me). My guess is that the average TSA agent hasn't even heard of Fight Club, 'cuze the Bush admin goal was to replace minimum wage security guards with professionals, i.e. people looking for a pension to retire on in 10 years, not the crowd who would go to see Fight Club.

The USPS has the facility for international money orders. (https://www.usps.com/shop/money-orders.htm) Handy when doing international business in small amounts. Otherwise, direct-wire transactions are available through most banks.