Archive for March 21st, 2011
Shaken: 10 Economic Disasters Which Threaten To Rip World Financial Markets To Shreds
2011 has already been the most memorable year in ages and we haven’t even reached April yet. Revolutions have swept the Middle East, an unprecedented earthquake and tsunami have hit Japan, civil war has erupted in Libya, the price of oil has been soaring and the entire globe is teetering on the brink of economic collapse. It seems like almost everything that can be shaken is being shaken. Unfortunately, it does not appear that things are going to settle down any time soon. The Japanese economy has been dealt a critical blow, the European sovereign debt crisis could flare up again at any moment and the U.S. economy could potentially plunge into another recession by the end of the year. The global economy and world financial markets were really struggling to recover even when things were relatively stable. If all of this global instability gets even worse it could literally rip world financial markets apart.
Yes, things really are that bad. The mainstream media has been really busy downplaying the economic impact of the disaster in Japan and the chaos in the Middle East, but the truth is that these events have huge implications for the global economy. Today our world is more interconnected than ever, so economic pain in one area of the planet is going to have a significant effect on other areas of the globe.
The following are 10 economic disasters which could potentially rip world financial markets to shreds….
#1 War In Libya
Do you think that the “international community” would be intervening in Libya if they did not have a lot of oil? If you actually believe that, you might want to review the last few decades of African history. Millions upon millions of Africans have been slaughtered by incredibly repressive regimes and the “international community” did next to nothing about it.
But Libya is different.
Libya is the largest producer of oil in Africa.
Apparently the revolution in Libya was not going the way it was supposed to, so the U.S. and Europe are stepping in.
Moammar Gadhafi is vowing that this will be a “long war”, but the truth is that his forces don’t stand a chance against NATO.
Initially we were told that NATO would just be setting up a “no fly zone”, but there have already been reports of Libyan tank columns being assaulted and there has even been an air strike on Moammar Gadhafi’s personal compound in Tripoli.
So since when did a “no fly zone” include an attempt to kill a foreign head of state?
Let there be no mistake – the moment that the first Tomahawk cruise missiles were launched the United States declared war on Libya.
Already the Arab League, India, China and Russia have all objected to how this operation is being carried out and they are alarmed about the reports of civilian casualties.
Tensions around the globe are rising once again, and that is not a good thing for the world economy.
On a side note, does anyone recall anyone in the Obama administration even stopping for a moment to consider whether or not they should consult the U.S. Congress before starting another war?
The U.S. Constitution specifically requires the approval of the Congress before we go to war.
But very few people seem to care too much about what the U.S. Constitution says these days.
In any event, the flow of oil out of Libya is likely to be reduced for an extended period of time now, and that is not going to be good for a deeply struggling global economy.
#2 Revolutions In The Middle East
Protests just seem to keep spreading to more countries in the Middle East. On Friday, five Syrian protesters were killed by government forces in the city of Daraa. Subsequently, over the weekend thousands of protesters reportedly stormed government buildings in that city and set them on fire.
Things in the region just seem to get wilder and wilder.
Even in countries where the revolutions are supposed to be “over” there is still a lot of chaos.
Have you seen what has been going on in Egypt lately?
The truth is that all of North Africa and nearly the entire Middle East is aflame with revolutionary fervor.
About the only place where revolution has not broken out is in Saudi Arabia. Of course it probably helps that the United States and Europe don’t really want a revolution in Saudi Arabia and the Saudis have a brutally effective secret police force.
In any event, as long as the chaos in the Middle East continues the price of oil is likely to remain very high, and that is not good news for the world economy.
#3 The Japanese Earthquake And Tsunami
Japan is the third largest economy in the world. When a major disaster happens in that nation it has global implications.
The tsunami that just hit Japan was absolutely unprecedented. Vast stretches of Japan have been more thoroughly destroyed than if they had been bombed by a foreign military power. It really was a nation changing event.
The Japanese economy is going to be crippled for an extended period of time. But it is not just Japan’s economy that has been deeply affected by this tragedy.
According to the Wall Street Journal, the recent disaster in Japan has caused supply chain disruptions all over the globe….
A shortage of Japanese-built electronic parts will force GM to close a plant in Zaragoza, Spain, on Monday and cancel shifts at a factory in Eisenach, Germany, on Monday and Tuesday, the company said Friday.
Not only that, GM has also suspended all “nonessential” spending globally as it evaluates the impact of this crisis.
The truth is that there are a whole host of industries that rely on parts from Japan. Supply chains all over the world are going to have to be changed as a result of this crisis. There are going to be some shortages of certain classes of products.
Japan is a nation that imports and exports tremendous quantities of goods. At least for a while both imports and exports will be significantly down, and that is not good news for a world economy that was already having a really hard time recovering from the recent economic downturn.
#4 The Japan Nuclear Crisis
Even if the worst case scenario does not play out, the reality is that the crisis at the Fukushima Dai-ichi nuclear plant is going to have a long lasting impact on the global economy.
Already, nuclear power projects all over the world are being rethought. The nuclear power industry was really starting to gain some momentum in many areas of the globe, but now that has totally changed.
But of much greater concern is the potential effect that all of this radiation will have on the Japanese people. Radiation from the disaster at the Fukushima Dai-ichi nuclear plant is now showing up in food and tap water in Japan as an article on the website of USA Today recently described….
The government halted shipments of spinach from one area and raw milk from another near the nuclear plant after tests found iodine exceeded safety limits. But the contamination spread to spinach in three other prefectures and to more vegetables — canola and chrysanthemum greens. Tokyo’s tap water, where iodine turned up Friday, now has cesium.
Hopefully the authorities in Japan will be able to get this situation under control before Tokyo is affected too much. The truth is that Tokyo is one of the most economically important cities on the planet.
But right now there is a lot of uncertainty surrounding Tokyo. For example, one very large German real estate fund says that their holdings in Tokyo are now “impossible to value” and they have suspended all customer withdrawals from the fund.
Once again, let us hope that a worst case scenario does not happen. But if we do get to the point where most of the population had to be evacuated from Tokyo for an extended period of time it would be absolutely devastating for the global economy.
#5 The Price Of Oil
Most people believe that the U.S. dollar is the currency of the world, but really it is oil. Without oil, the global economy that we have constructed simply could not function.
That is why it was so alarming when the price of oil went above $100 a barrel earlier this year for the first time since 2008. Virtually everyone agrees that if the price of oil stays high for an extended period of time it will have a highly negative impact on the world economy.
In particular, the U.S. economy is highly, highly dependent on cheap oil. This country is really spread out and we transport goods and services over vast distances. That is why the following facts are so alarming….
*The average price of a gallon of gasoline in the United States is now 75 cents higher than it was a year ago.
*In San Francisco, California, the average price of a gallon of gasoline is now $3.97.
*According to the Oil Price Information Service, U.S. drivers spent an average of $347 on gasoline during the month of February, which was 30 percent more than a year earlier.
*According to the U.S. Energy Department, the average U.S. household will spend approximately $700 more on gasoline in 2011 than it did during 2010.
#6 Food Inflation
Many people believe that the rapidly rising price of food has been a major factor in sparking the revolutions that we have seen in Africa and the Middle East. When people cannot feed themselves or their families they tend to lose it.
According to the United Nations, the global price of food hit a new all-time high earlier this year, and the UN is expecting the price of food to continue to go up throughout the rest of this year. Food supplies were already tight around the globe and this is certainly not going to help things.
The price of food has also been going up rapidly inside the United States. Last month the price of food in the United States rose at the fastest rate in 36 years.
American families are really starting to feel their budgets stretched. According to the U.S. Labor Department, the cost of living in the United States hit a brand new all-time record high in the month of February.
What this means is that U.S. families are going to have less discretionary income to spend at the stores and that is bad news for the world economy.
#7 The European Sovereign Debt Crisis
Several European governments have had their debt downgraded in the past several months. Portugal, Spain, Greece and Ireland are all in big time trouble. Several other European nations are not far behind them.
Right now Germany seems content to bail the “weak sisters” in Europe out, but if that changes at some point it is going to be an absolute nightmare for world financial markets.
#8 The Dying U.S. Dollar
Right now there is a lot of anxiety about the U.S. dollar. Prior to the tsunami, Japan was one of the primary purchasers of U.S. government debt. In fact, Japan was the second-largest foreign buyer of U.S. Treasuries last year.
But now as Japan rebuilds from this nightmare it is not going to have capital to invest overseas. Someone else is going to have to step in and buy up all of the debt that the Japanese were buying.
Not only that, but big bond funds such as PIMCO have announced that they are stepping away from U.S. Treasuries at least for now.
So if Japan is not buying U.S. Treasuries and bond funds such as PIMCO are not buying U.S. Treasuries, then who is going to be buying them?
The U.S. government needs to borrow trillions of dollars this year alone to roll over existing debt and to finance new debt. All of that borrowing has got to come from somewhere.
#9 The U.S. Housing Market
The U.S. housing market could potentially be on the verge of another major crisis. Just consider the following facts….
*In February, U.S. housing starts experienced their largest decline in 27 years.
*Deutsche Bank is projecting that 48 percent of all U.S. mortgages could have negative equity by the end of 2011.
*Two years ago, the average U.S. homeowner that was being foreclosed upon had not made a mortgage payment in 11 months. Today, the average U.S. homeowner that is being foreclosed upon has not made a mortgage payment in 17 months.
*In September 2008, 33 percent of Americans knew someone who had been foreclosed upon or who was facing the threat of foreclosure. Today that number has risen to 48 percent.
#10 The Derivatives Bubble
Most Americans do not even understand what derivatives are, but the truth is that they are one of the biggest threats to our financial system. Some experts estimate that the worldwide derivatives bubble is somewhere in the neighborhood of a quadrillion dollars. This bubble could burst at any time. Right now we are watching the greatest financial casino in the history of the globe spin around and around and around and everyone is hoping that at some point it doesn’t stop. Today, most money on Wall Street is not made by investing in good business ideas. Rather, most money on Wall Street is now made by making shrewd bets. Unfortunately, at some point the casino is going to come crashing down and the game will be over.
Most people simply do not realize how fragile the global economy is at this point.
The financial crash of 2008 was a devastating blow. The next wave of the economic crisis could be even worse.
So what will the rest of 2011 bring?
Well, nobody knows for sure, but a lot of experts are not optimistic.
David Rosenberg, the chief economist at Gluskin Sheff and Associates, is warning that the second half of the year could be very rough for the global economy….
Why The Foreclosure Mess Settlement Proposal Can't Fix The Damage: The Enormous Clouded Title Problem
Now there’s a huge fight over what to do about that, mostly focused on a 27-page proposal that was supposed to represent the consensus of the 50 state attorneys general, but apparently doesn’t. On top of that effort came a report of a “shock and awe” modification push from the federal government, but as Yves Smith at Naked Capitalism details, it’s neither good policy nor practical.
One feature of both the attorneys general’s proposal and the “shock and awe” maneuver is speed.
The attorneys general are in such a hurry to find a solution that they haven’t even investigated the banks: They’re just relying on consumer complaints to define the problem. Similarly, the shock-and-awe plan involves an impossible six month deadline. As Treasury Secretary Timothy Geitner explained to Congress: “All parties have a stake in bringing this to resolution as quickly as possible” and “It’s very important that we try to bring this to bed as quickly as we can.”
At least part of this desire for a fast fix is rooted in the belief that an agreement will help the housing market recover, which in turn will help straighten out the overall economy. That’s true to some extent: If millions of mortgages were successfully modified and unnecessary and servicer-driven foreclosures were halted, as the settlement proposes, that would be good for the economy and the real estate market.
The Enormous Clouded Title Problem
But the settlement doesn’t go nearly far enough to save the housing market. In fact, it can’t go far enough, because it can’t address one of the most confounding problems the banks have created: the millions of properties nationwide that now have “clouded” titles.
To put it plainly: Because of these bad titles, property owners can’t prove they own the properties they think they bought, and banks can’t prove the had the right to sell them.
Even though it’s impossible to know how many properties are affected, I have confidence in saying millions nationally for the following reasons:
- More than 1 million foreclosures have been completed since 2005; nearly 200,000 were completed in the third quarter of 2010 alone.
- Foreclosures involving securitized mortgages seem to be flawed as a rule, not the exception.
- Even when foreclosures may have been otherwise valid, the practices of foreclosure attorneys have clouded titles.
- The problems are ongoing. More flawed foreclosures are completed every day.
- The clouded title problem extends well beyond foreclosures. Both MERS, the electronic database that holds more than half the mortgages nationally, and possible securitization failures could have damaged the titles of the properties even though the borrowers are current on their mortgages.
The Solid Effects of Clouded Titles
You can’t sell real estate when you can’t establish that you own it — banks won’t loan money for purchasers to buy the property. That’s because the bank wants to be sure that if it forecloses, it will get good title to the property. (Yes, this issue practically oozes irony.) That’s why banks won’t approve a mortgage for a property if a title insurance company won’t insure its title. And title insurance companies won’t do that if they know the title is clouded.
A few months ago, the Massachusetts Supreme Judicial Court issued its Ibanez decision, which made it clear that the banks’ foreclosure practices — and indeed, the standard securitization deal — violated longstanding basic Massachusetts real estate law, and thus, many completed Massachusetts foreclosures were invalid. The foreclosing banks, which had either since sold the properties or still “owned” them, had no right to foreclose, and therefore had never owned those properties. So who owns them now? Well, the fact that it’s a question is the very definition of “clouded title.”

One agent called improperly foreclosed homes in Massachusetts “uninsurable.” Another explained that the problem underscored in the Ibanez case has been around for years, and that any title company would need to look at foreclosures dating at least until the late 1970s, when securitization became more common, to make sure no improper foreclosure had happened in all those years. And some properties, she noted, had been foreclosed on multiple times.
That agent did note that the problem was worst for properties improperly foreclosed on in recent years that were still bank-owned. Those properties were truly uninsurable. That’s because the bank couldn’t make a claim on the title insurance policy it had purchased when making the original loan, since it was the entity that clouded the title. Indeed, honoring that policy would be like letting a arsonist collect on fire insurance. Thus much of the current bank-owned inventory in Massachusetts is largely uninsurable and thus unsellable.
No settlement with the servicers is going to solve that problem. And it’s a national problem, not a Massachusetts one.
Where to Lay the Blame
When it comes to the clouded title problem, one group is wholly innocent: the borrowers — “deadbeat” or not. The title issues are the equivalent of unforced errors in tennis: the banks have done this to themselves.
By government I mean: regulators, particularly at the federal level; law enforcers at both the federal and state level; state legislatures and Congress to the extent they passed laws making the situation worse or failed to pass to pass laws that would have helped; and finally, Fannie Mae and Freddie Mac for their role in setting up MERS.
Even in that context, the largest share of the blame still must go to banks and their lawyers: But for them, the clouded title mess wouldn’t exist. Here’s how all of them created the crisis.
How Ownership Gets Confused
First, banks across the nation have used fraudulent documents to “prove” they have the right to foreclose. This is the classic robo-signing situation, and it, at least, would be solved if the attorneys general’s settlement proposal was adopted.
While the issue is clearest in judicial foreclosure states — where the documents are getting more scrutiny — the problem exists everywhere. In nonjudicial foreclosure states, the problem frequently surfaces first in federal bankruptcy courts when banks ask for permission to foreclose on debtors in bankruptcy. The problem also shows up in those states’ courts as homeowners try to fight the foreclosures.
For this title clouding problem, blame the mortgage servicers, who incidentally are also the big banks.
Second, as both the Ibanez and Kemp case from New Jersey illustrate, banks’ standard securitization procedures may have failed to properly assign the promised mortgages to the securitization trusts, which means those securities aren’t really mortgage-backed after all. It also means that the ownership of those mortgages (and in some states, title to the properties) remains with different banks that were part of the securitization processes — banks that may or may not still exist today.
The clouded titles that result from busted securitizations are a particular problem in those states where the lender who holds the mortgage holds legal title to the property until the mortgage is paid off. In those states, all the borrower has is the right to use and enjoy the property until the mortgage is paid off and she gets legal title. Importantly, busted securitizations cloud the titles of current and defaulted mortgages in those states equally.
For this problem, blame the securitizers, who include the big banks, Wall Street, and their big law firm attorneys.
Forgeries and the Illegal Practice of Law
Third, foreclosure attorneys have processed their filings in illegal ways. For example, in Pennsylvania, the attorneys have done foreclosures with papers no lawyer reviewed, bearing signatures forged with the firms’ named partners’ permission. Those foreclosures, which were done via the illegal practice of law, appear to be void — and there are many. Or consider that several Maryland firms have also had underlings forge lawyers’ names on foreclosure documents, including on more than 1,000 deeds. Or consider the practices of the now defunct David Stern foreclosure mill in Florida.
Remembering that the Lender Processing Services business model emphasizes speed over substance and LPS deploys lawyers for something like half the mortgages in default, it’s impossible that these problematic practices of foreclosure attorneys are limited to Pennsylvania, Maryland and Florida.
For this problem, blame both the foreclosing banks and their foreclosure lawyers. Blame the banks, because it was their relentless cost cutting that got us the current foreclosure business model. Blame the lawyers, because they knew what they were doing was illegal and let their greed get the better of them.
The Mess That Is MERS
Fourth, and perhaps most problematic, is the MERS debacle.
MERS mortgages have questionable validity. Whether or not the MERS model is legal seems now to depend on which judge is making the decision. Cases in different states, and even within the same state, are coming out differently. Where the MERS model is illegal, foreclosures done by MERS or by the people it assigns the mortgage to have clouded titles. Even where the MERS model is legal, the system’s incredibly sloppy record keeping could leave multiple banks believing they have the right to foreclose on a given property.
For the MERS problem, blame the following, in no particular order: Fannie Mae and Freddy Mac, who were instrumental in creating it; Covington and Burling, the law firm that blessed it; Moody’s, for blessing it as well; and the big banks who ran with the flawed system and made it what it is today.
Fixing the Problem
Because real estate law is state-based, fixing the clouded title problem will take legislation in all 50 states. But before legislators get busy drafting bills, a much more detailed investigation of the problem in each state needs to be done. How many properties are involved? How many different types of title problems? How many different players helped cause the problem, and how can they be made to pay for fixing it? What should be done about the innocent buyers of illegally foreclosed property? What should be done about the borrowers who were evicted by the wrong bank?
It’s a horrible mess. And it’s one that the rush to cut a deal with the banks is blowing right past.
Supreme Court Gives Fed 5 Days to Release Emergency Bank Loan Details; An Important Step in the Right Direction
In a rare victory for common sense, the Supreme Court has rejected appeals by banks and the Fed that disclosure of the emergency loans by the Fed to various banks in 2008 were “trade secretes”. The court gave the Fed 5 days to release the information.
Please consider Fed Must Release Loan Data as High Court Rejects Appeal
The Federal Reserve will disclose details of emergency loans it made to banks in 2008, after the U.S. Supreme Court rejected an industry appeal that aimed to shield the records from public view.
“The board will fully comply with the court’s decision and is preparing to make the information available,” said David Skidmore, a spokesman for the Fed.
The order marks the first time a court has forced the Fed to reveal the names of banks that borrowed from its oldest lending program, the 98-year-old discount window. The disclosures, together with details of six bailout programs released by the central bank in December under a congressional mandate, would give taxpayers insight into the Fed’s unprecedented $3.5 trillion effort to stem the 2008 financial panic.
“I can’t recall that the Fed was ever sued and forced to release information” in its 98-year history, said Allan H. Meltzer, the author of three books on the U.S central bank and a professor at Carnegie Mellon University in Pittsburgh.
Under the trial judge’s order, the Fed must reveal 231 pages of documents related to borrowers in April and May 2008, along with loan amounts. News Corp. (NWSA)’s Fox News is pressing a bid for 6,186 pages of similar information on loans made from August 2007 to November 2008.
The records were originally requested under FOIA, which allows citizens access to government papers, by the late Bloomberg News reporter Mark Pittman.
As a financial crisis developed in 2007, “The Federal Reserve forgot that it is the central bank for the people of the United States and not a private academy where decisions of great importance may be withheld from public scrutiny,” said Matthew Winkler, editor in chief of Bloomberg News. “The Fed must be accountable to Congress, especially in disclosing what it does with the people’s money.”
The Clearing House Association contended that Bloomberg is seeking an unprecedented disclosure that might dissuade banks from accepting emergency loans in the future.
Bloomberg initially requested similar information for aid recipients under three other Fed emergency programs. The central bank released details for those facilities and others in December, after Congress required disclosure through the Dodd- Frank law.
The New York-based Clearing House Association, which has processed payments among banks since 1853, includes Bank of America NA, Bank of New York Mellon, Citibank NA, Deutsche Bank Trust Co. Americas, HSBC Bank USA NA, JPMorgan Chase Bank NA, U.S. Bank NA and Wells Fargo Bank NA.
In trying to shield the documents from disclosure, the Clearing House invoked a FOIA exemption that covers trade secrets and commercial or financial information obtained from a person and privileged or confidential.”
The cases are Clearing House Association v. Bloomberg, 10- 543, and Clearing House Association v. Fox News Network, 10-660.
Information-Wise, a Big Yawn
The argument that information represents “trade secrets” is of course preposterous, as is the idea that “disclosure that might dissuade banks from accepting emergency loans in the future”. If banks need money to survive, they will take it.
We will know soon enough, but I expect the information to be a big yawn. We will see some loan amounts and names but everyone knows the names anyway. Perhaps there will be some excitement over loans to foreign banks.
Important Step in the Right Direction
Whatever excitement there is, will last all of a day. However, this was an important step in the right direction, that removes some unwarranted secrecy at the Fed.
The Fed hides behind a cloak of secrecy, doing what they want, when they want, with no disclosure, and no accountability to anyone.
Five Steps to Eliminate the Fed
The first step is a full disclosure of what happened. The second step is a full and complete audit. The third step is a plan to phase out the the Fed. The fourth step is Congressional approval of that plan. The fifth and final step is removal of the Fed itself.
This first step was a very small one actually, but every trip begins with a single step. It will take years to get rid of the Fed. I am hoping I live to see the day it happens.
Mike “Mish” Shedlock
http://globaleconomicanalysis.blogspot.com
Sickcare Will Bankrupt the Nation–And Soon
The costs of the U.S. “healthcare” system, a.k.a. sickcare, are rising at a rate that is three to five times faster than the growth of the GDP–when it’s growing at all. That guarantees sickcare will bankrupt the nation within a few years.
Forget the Pentagon and welfare: what will soon bankrupt the nation is our out-of-control malignant sickcare system, a.k.a. “healthcare.” The runaway costs of “healthcare” are undermining the nation’s economy on multiple levels.
The people actually providing the care know the system is broken. It’s not “fixable” via minor policy tweaks or limiting payments to one slice of providers; the problem is systemic.
The country is in a tizzy over public employee bargaining rights and compensation costs, but few ask this question: What is the biggest cause of public employees compensation soaring to unsustainability? Answer: The costs of providing healthcare, which are rising 6% every year across a flatlined economy, and up to 11% per year for public employees.
Here is a chart drawn from Public Pension and Healthcare Costs and Financial Common Sense (February 28, 2011) which depicts how fast-rising pensions and healthcare costs are completely disconnected from the underlying economy.
Public employee healthcare costs in some California cities have been rising an average of 11% per year in the decade since 2000.
Here is what happens to $1 in healthcare costs which increase 11% per year:
1 (2001)
1.11
1.23
1.37
1.52
1.69
1.87
2.08 (2008)
2.3
2.56
2.84
3.15 (2012)
3.5
3.88
4.31
4.78 (2016)
By 2012, these costs have more than tripled and by 2016 they will have jumped five-fold. Once again: does anyone seriously believe these trends are sustainable in an economy which isn’t even growing at all once we subtract Central State borrowing and spending?
For context on Central State borrowing (Federal deficits): Here are the deficits of the past three years, and the estimated shortfalls for fiscal years 2011 and 2012:
2008: $458 billion
2009: $1.4 trillion
2010: $1.3 trillion
2011: $1.5 trillion (est.)
2012: $1.6 trillion (est.)
total: $6.258 trillion in five years.
While healthcare costs are rising around the developed world due to the demographics of aging and more treatment options, the U.S. sickcare system costs twice as much as our competitors’ systems.
Medical Care Prices Are Rising Faster Than Overall Inflation (BusinessWeek)
The U.S. spent an estimated $2.4 trillion on health care in 2008, about 16.5% of gross domestic product and a 6% increase from a year earlier. Medical care prices are rising faster than overall inflation, and the burden on consumers continues to grow.
The source of the problem is the “fee for service” foundation of the system. There are no real limits on spending, despite various “reforms” which attempt to limit the runaway costs. Correspondent Quentin VT submitted this article from The New York Times on CEOs of publicly funded hospitals drawing millions of dollars a year in compensation: Immune to Cuts: Lofty Salaries at Hospitals.
I have covered these issues in depth for years:
Healthcare “Reform”: the State and Plutocracy Stripmine the Middle Class (Again) (November 9, 2009)
The Simulacra of Change, the Propaganda of Hope (January 20, 2010)
Is Fee-for-Service What Ails America’s Health Care System? (January 18, 2010)
Can Health Care Reform Possibly Control Costs? (April 10, 2011)
Sickcare is fundamentally a system of interlinked politically powerful cartels.
Insiders who refuse to speak on the record for fear of antagonizing the powers that be, exorbitant price increases, confidential agreements and a tug-of-war between warring tribes. Is this the Mafia we’re talking about?
From the point of view of investigative journalism, it could also describe America’s health care industry. Setting aside the politically attractive mantra of “improving access to healthcare,” from this point of view the industry is a highly profitable and politically powerful group of companies which operate in cartel-like fashion: that is, they use their clout to limit competition and establish highly profitable pricing.
These observers use the word “cartel” not in the sense of a formal organization like OPEC (the Organization of the Petroleum Exporting Countries) or the criminal activities of drug cartels, but in the informal sense of a small group of companies which dominate specific markets and thus wield significant political and pricing power within those markets.
Why should we care? Experts say that it is a sign of the medical industry’s enormous political power that the health reform bill overlooked some of the biggest cost drivers in American medicine.
And if costs don’t go down, then the affordability and sustainability of the U.S. healthcare system become questionable over the long-term. The U.S. already spends twice as much as other developed countries on healthcare as a percentage of GDP.
When asked to identify the source of America’s runaway health care costs — U.S. spending on health care has more than doubled as a share of GDP in the past 30 years — healthcare industries and trade groups excel at pointing to the next guy as the source. Doctors, hospitals, insurers, HMOs, pharmaceutical companies, malpractice lawsuits and the courts which award huge settlements, Federal regulatory agencies, Medicare–scapegoats abound, and so do rationalizations.
If no one industry is responsible, then perhaps we need to look at the entire system of self-serving industries which profit from guaranteed payments to private-sector corporations which involve special political dispensations such as exemptions from anti-trust laws, and a tolerance for ways of limiting competition and insuring highly profitable contracts.
If the healthcare reform bill doesn’t really address the cost drivers and the incentives built into the current system, then it’s difficult to see how costs can decline.
This system is based on regional networks of providers negotiating with insurers to exclude competitors and set exorbitant prices that are passed on as insurance premiums. While insurers complain about rising costs, they are exempt from antitrust laws and thus they have the power to consolidate smaller insurers within a region and then pass on price increases to consumers and businesses alike.
A recent report by Massachusetts Attorney General Martha Coakley uncovered multiple forms of anti-competitive behavior among providers, including huge price disparities that had no visible relation to any free-market factors. The report concluded that this and other forms of collusive behavior were “pervasive.”
Once upon a time in U.S. healthcare, it was the norm to post prices for procedures and care; this is no longer the norm.
Some local providers who post their prices openly, such as Keith Smith, an anesthesiologist with the Oklahoma Surgery Center, find that preferred provider organizations (PPOs) and insurance companies aren’t interested in contracting with his group, even though their prices are 70% less than those charged by local not-for-profit hospitals. To Smith, that is strong evidence that medical cartels are making deals with insurers to monopolize services in their region.
To cite another example of the distortions which end up costing the nation twice as much for health care (as a percentage of GDP) as competing developed countries such as Australia and Japan: Pittsburgh has almost as many MRI machines as the nation of Canada.
According to local media reports, Western Pennsylvania has about 140 MRI machines, while the 32 million residents of Canada share 151 MRI machines. And the machines are getting a lot of use: the number of CT and MRI scans (scans other than old-fashioned X rays) tripled from 85 to 234 per thousand insured people since 1999.
While proponents are quick to note that scans are cheaper than the alternative diagnostic procedures, one firm’s research found that a doctor who owns his own machine is four times as likely to order a scan as a doctor who doesn’t.
As if that wasn’t enough to highlight the self-serving nature of “fee for service” cartels, MRI scanner manufacturer General Electric waged a two-year lobbying campaign to roll back cuts in Medicare reimbursements for scans. While the effort proved unsuccessful due to the intense political pressure to reduce soaring Medicare costs, some critics claim that providers simply made up the reduced reimbursements by increasing the number of tests administered.
The only solution that actually addresses the systemic problem is to get rid of the entire fee-for-service structure and break up the cartels. Healthcare must be reconnected to diet, nutrition, fitness, lifestyle and community, and to education and emotional well-being.
The odds of any of this happening are essentially zero, and so we can safely predict that sickcare will bankrupt the nation (with a helping hand from the Pentagon) within a few years.











