April 21, 2019

The Culture of Entitlement in Medicine II: Your Invoice is Rejected

billI previously wrote about the culture of entitlement in medicine back in 2017. This is to be expected in an industry in which half of all gross revenue is tax revenue. That’s not to say doctors, nurses, etc. are bad people. Quite the contrary. But it’s human nature to overestimate the value of one’s own services – who doesn’t think he or she is underpaid?

The market provides discipline for this childish impulse. In a vibrant free market, we find out precisely what the goods or services we offer are worth to other people, because each customer decides precisely how much money they are willing to pay for our products, not to mention whether to buy them at all. Government regulations and subsidies have largely removed these market forces from the medical industry.

In addition to skyrocketing prices, this has fostered a culture of entitlement among medical providers. They feel entitled to an arbitrary amount of compensation for their goods or services, regardless of whether their customers are willing or able to pay.

This is reflected in their invoices. Rather than bill you for the amount both parties previously agreed to for a given service, as is customary in every other industry, they send you a bill for what they believe they “should” be paid and then represent the difference between that arbitrary amount and their contracted reimbursement (usually established via your health insurance provider) as an “adjustment.”

This passive-aggressive tactic attempts to portray  medical providers both as victims of “greedy” insurance companies (and moochers like you) and as altruists who have foregone most of what they believe owed to them out of the goodness of their hearts. It is important we disabuse them of these delusions.

I suggest we consumers, who not only pay for our own medical care but for the care of millions of strangers, process medical bills the way invoices are processed in any other industry. If you receive a bill priced any way other than what you and your provider have previously agreed to, simply reject the invoice with an explanation and invite the provider to resubmit. Repeat the process until you are billed accurately. Feel free to use the example below as a template:

Dear Accounts Receivable Manager,

Your invoice #XXXXX (copy enclosed) has been rejected for the following reasons:

*Pricing Errors

Your invoice contains five procedure codes for which you have a contracted rate with us through our health insurance provider. It is clear you are aware of this contract as you would not even agree to an appointment until eligibility with our health insurance provider was confirmed.

However, the billed charges on your invoice exceed the amount you agreed to in that contract. For example, your contract stipulates a charge of $38.14 for CPT code 99214. You have billed $175.00 for this service and then represented the difference as an “Adjustment” down to our contracted rate.

It is standard business practice for any going concern to bill its customers at the price(s) the customer agreed to pay via purchase order or contract, not the price the vendor wishes it could get paid.

In no other industry do vendors enter a contract to provide goods or services at one price and then bill for a higher one, representing the difference as an adjustment, as if the vendor were doing the client a favor. Rather, they bill for the agreed upon price and thank the customer for the business.

Please resubmit your invoice within 30 days with billed amounts matching our contracted rate for each service. We will waive the invoice rejection fee on this occasion as a courtesy. If you have any questions, please do not hesitate to contact me. Thank you.

Best regards,

Tom Mullen

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Words and Phrases to Avoid on April 15

income taxWe hear a lot about words and phrases we should or shouldn’t use these days, politics having crept into virtually every area of our lives. At the risk of promoting even more “political correctness,” here are some terms that can legitimately be considered “microaggressions” when used in the presence of net taxpayers on April 15:

fair share

not paying their fair share

common good

common sense (when used as an adjective)

public goods

the public interest

public servant

public spirit

public education

social contract

general will

will of the people

national conversation

“our” seniors

“our” roads

“our” schools

“our” infrastructure

“our” veterans

rebuild the military

support the troops

thank the troops

freedom isn’t free

keeping us safe

fighting for our freedom

national interest

the poor

the rich

the children

the troops

working Americans

work of the American people

sustainable

green energy

Green New Deal

(the old) New Deal

green anything

income inequality

the gender gap

the wealth gap

healthcare is a right

Medicare for all

single payer

These are just a few things to avoid saying on this somber day for freedom. If you find yourself about to parrot any of these talking points, then at least for today, please say the following instead:

TAXATION IS THEFT.

To all those who grant this humble request, THANK YOU FOR YOUR SERVICE!

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Conservatism is More Harmful to Liberty Than Progressive Liberalism

Publication1Following the horrors of the Wilson and FDR presidencies, conservatives made nice with classical liberals and later libertarians as the only way to maintain any relevancy. This was a rather odd fellowship, conservatism being a fundamentally authoritarian philosophy. And because people seem unable to think in terms of anything outside the conservative-liberal spectrum, this has caused many people genuinely interested in a freer society to conflate authoritarian, conservative positions with classical liberal or libertarian ones. Examples:

  • Conflating conservative “pro-business” mercantilism/crony capitalism with free markets
  • Worshiping the enormous standing army rather than being suspicious of and reluctant to pay for it, as any liberty-minded person should be
  • Ditto for the ubiquitous domestic standing army, the police
  • Blaming corporations acting in their best interests in a corrupted business environment, rather than the government that created that environment and made it a business necessity to exploit it, lest their competitors do so first (Amazon, Walmart, etc.). This is how Tucker Carlson finds himself agreeing with Bernie Sanders

The foundation of conservatism, the reason it seeks to “conserve” what is already established by any forceful means necessary, individual rights be damned, is its belief that man’s nature is so fallen, dark, or inherently violent that it must be kept at bay. Thomas Hobbes, Edmund Burke and Russell Kirk all agreed that the primary purpose of government was to override men’s natural inclinations by force. For all of them, any freedom man has in society is a privilege granted by the government, not an inalienable right carried into society which the government is charged to defend.

In American history, Hamilton was a true conservative, seeking to conserve mercantilism and empire, the status quo of his day, albeit under American control. Lincoln was a true conservative, seeking to preserve the status quo of the union despite the expressed wishes of the states attempting to leave it peacefully. Today, Trump and the majority of the Republican Party are the true conservatives, pursuing an explicitly Hamiltonian platform, even borrowing Hamilton’s “national greatness” slogan.

Ironically, what attracts well-meaning people to the conservative brand is the libertarian-sounding rhetoric it often employs, despite libertarian ideas being fundamentally antithetical to conservatism. Once they’ve adopted that brand, and seeing that virtually no conservative politicians ever propose anything resembling a move towards laissez faire markets, a less powerful police state or a more peaceful foreign policy, they resort to suggesting the people who run for office under the conservative or Republican banners are not “true conservatives,” or in the case of the Republican Party, are “RINOs” (Republicans In Name Only).

When pressed to name some “true conservatives” or “true Republicans,” the only answer one will ever get is Hamiltonian Calvin Coolidge, a conservative who genuinely seemed to hold some classical liberal positions, along with some conservative ones. We’re supposed to believe that in all American history, Coolidge and a few Republicans today like Rand Paul, Justin Amash and Thomas Massie are the true conservatives and/or true Republicans, and virtually everyone else were the “RINOs.”

That should sound ludicrous to any dispassionate observer. Why wouldn’t Coolidge, Paul, Massie and Amash be the RINOs, i.e., the ones who don’t think or act like 99% of the Republican Party throughout its history?

For these reasons, I believe there is a good argument that conservatism is more harmful to the cause of liberty than progressive liberalism. At least proponents of the latter come right out and tell us they’re going to trample our personal and economic liberty “for our own good.” Anyone seeking freedom knows not to vote for them. Not so the conservatives, who occasionally talk like Jefferson but always govern like FDR and Catherine the Great had a love child who won a U.S. election.

The conservative movement’s success in absorbing people with libertarian impulses keeps American politics from breaking out of a narrow range of positions, all statist to the core. This ultimately makes us poorer and less free than we would be if those interested in free markets, peaceful trade and a non-interventionist foreign policy would let go of their emotional attachment to the conservative label and let the Republican Party take its place on the junk heap with its predecessors, the Whig and Federalist parties.

A new movement and party, devoid of authoritarian conservative baggage, may attract a lot of people who currently hold their nose and vote Democrat, but don’t necessarily like the awful far left any more than libertarians do. In other words, what is needed is a radical change in the political landscape, meaning conservatism has to go.

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Here Comes Another Recession Wrongly Blamed on Capitalism

recession-comingThe stock markets sold off on Friday, and financial media headlines were dominated by an inverted yield curve, a key recession indicator for the past several decades. Was the selloff just a pullback as equity prices consolidate before heading for new highs? Or is this the top of a dead cat bounce after the December market meltdown?

Economic indicators are somewhat mixed. Unemployment remains low at 3.8 percent, although it is always important to consider what kinds of jobs people are doing, what they are producing, and why. Unemployment is always low just before a bubble pops, as monetary inflation leads to unsustainable expansion.

Meanwhile, February saw a nearly subterranean jobs report, and December’s much-ballyhooed number was revised downward from 312,000 jobs to just 227,000. Holiday retail sales, reported as “heating up” during December, ended up declining by 1.2 percent, the biggest drop since 2009.

That a recession is coming is a certainty. The question is when. And whether it hits in 2019 or 2020, you can bet it will take center stage in the political arena, with Democratic presidential hopefuls climbing over each other to blame President Trump and the Republicans. The GOP will find it hard to fight back after taking full ownership of the tail end of this ten-year, inflation-fueled bubble.

As ridiculous as we free-market types always find it, a recession during a Republican presidential administration is always characterized by our opponents as an indictment of capitalism, even though the business cycle is driven much more by monetary policy than anything presidents of either party do. And the Federal Reserve is not a capitalist institution. It’s an economic central planner Karl Marx considered a vital part of moving society towards communism.

Read the rest at Foundation for Economic Freedom…

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Cut Wasteful Spending on the Obsolete Conventional Military


A15332A0-C600-4068-9614-088791DE7B75What possible reason could there be to increase spending on the mostly obsolete conventional military?

The days of wars ending with one country marching into the capital of another are over, other than when DC invades some destitute, virtually defenseless Third World backwater.

No nuclear power is going to surrender without firing its nukes. No conventional navy is going to survive the first week of a war against a country with a modern missile system.

Generals in the Pentagon live in a dreamworld where they’re all Patton marching into Palermo. Let them fantasize on their own dime.

All of this military spending is a complete waste of taxpayer dollars. The 21st-century US military is just a wealth transfer program for a few rich elites and a jobs program for about a million people who would otherwise have to do something productive.

It keeps the latter in a childlike state where they don’t have to face the uncertainty of the real world, where you can be let go even if you’re doing a good job.

It also has the secondary effect of making single payer health care programs in other countries look more viable than they really are, as those countries can stay marginally solvent by not wasting a trillion dollars a year on military spending.

The federal government has to be cut drastically in size and scope, starting with the most economically-damaging spending, military spending, or we’re in for a shocking dose of reality in terms of lower standards of living.

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Amazon’s NYC Pullout Shows Economy Is Rigged, Just Not the Way Most People Think

cuomoandbezos4Amazon announced Thursday it will not build a new headquarters in New York City, citing the backlash from union leaders and some lawmakers over the nearly $3 billion in government incentives included in a deal to bring the company to NYC. Those leaders treat Amazon’s decision as a victory. For Governor Andrew Cuomo and NYC Mayor Bill De Blasio, it’s a defeat, as they led the effort to lure the company to New York.

No matter how it’s spun, the facts don’t change. This decision represents billions in lost tax revenues for the city and state, over and above the $3 billion in incentives. Amazon won’t be employing an estimated 25,000 additional New Yorkers. And many millions more in business with local vendors will not occur.

To opponents of the deal, a principle has been defended: Giant corporations like Amazon shouldn’t be offered tax “subsidies” to come in and “exploit” local workers and the community. But this theory raises several questions.

Read the rest at Foundation for Economic Education…

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Just like modern “progressives,” the big government Federalists meant well

mobocracyIt’s true Federalists like Madison (at the time) and Hamilton proposed a much stronger federal government than the 1788 constitutional convention authorized, but many people wrongly argue they were motivated by purely tyrannical intentions. On the contrary, their main motivation was the belief a stronger central government would protect the individual from the democratic mobocracies they believed the states were already becoming.

While there is certainly an argument their concerns were exaggerated at the time, one need look no further than NY, CA, MA or any number of “blue states” (and many red ones, too) for proof their concerns were valid. 

The flaw in their thinking was that a more powerful central government would ever protect individual rights from government power. Everything they wanted and more has come in through the back door over the past 231 years. Hamilton’s central bank and Madison’s federal government veto over state laws (but by SCOTUS, instead of Congress, as Madison proposed) are just two examples. We can see their strong central government turned out precisely the opposite of what they intended.

Power corrupts, absolute power corrupts absolutely, and absolute power over hundreds of millions of people, concentrated in one city, is absolutely terrifying.

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

I, Interest Rate

interestIt is often said, “Don’t kill the messenger,” but that is precisely what everyone seems to want to do in my case. I’m not sure why because the news I bring is neither good nor bad. It is simply the truth; and it is a very sad day when telling the truth can foster such ill will. There are some who go so far as to declare my very existence wicked simply for providing information people use to engage in a specific type of voluntary exchange that, although of immense benefit to society, has somehow acquired an unsavory reputation.

As you may have surmised, I am the rate of interest, the price difference between present goods and future goods. Now, many economists mistakenly identify me merely as the price of borrowing money over time, but that is only one of the many messages I carry. I also represent the price spread in the various stages of production, where capitalists purchase present goods in the form of factors of production in the hopes of selling what is produced by those factors for a higher price than what they spent. I am also this difference in price.

Nobody but me can gather the information I gather, for my message is determined by billions of individual transactions occurring simultaneously all over the economy. I consider the individual supply and demand schedules of hundreds of millions, sometimes billions of individual consumers and producers, along with the uncertainty involved in every time transaction, to determine the current price levels for transactions that involve time at any given moment.

In the case of individual borrowers, the uncertainty I mentioned includes that borrower’s previous behavior, which is generally called a “credit rating.”

While it is only one of the many prices I make available to the market, an inordinate amount of attention is paid to the price of borrowing money. That is likely for two reasons. One, as I said, is that most people erroneously believe it is the only information I impart. Two, people seem to be borrowing a lot more than they did previously in history for reasons I will explain shortly. As a result, it is regarding the price of borrowing money where I am most slandered and abused.

Because this price of borrowing is above zero, there are some who consider my existence alone as evil. They say I’m a party to a crime they call “usury,” which is a very strange concept. When everyone is acting honestly, money is a scarce commodity, so any loan by Person A to Person B requires a sacrifice on the part of A. Person A must forego consumption in the present in order to lend to B.

It is no different than if A were saving for a new car or some other expensive item for himself. He must forego eating out as much, or buying new clothes, or going on vacation this year in order to put aside money to buy the expensive item next year.

By loaning money to B, A is allowing B to skip this sacrifice and purchase the expensive item now. It seems a very peculiar notion that A should forego spending his own money on himself only to let B use it for free when needed. How did this obligation to serve B free of charge come about? Aren’t all men created equal?

Read the rest at Foundation for Economic Education…

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Should Social Security Be Means Tested?

383px-Ponzi1920Ken Langone told CNBC on Wednesday Congress “has to have the courage” to make Social Security means tested, arguing a billionaire like him shouldn’t be getting $4,000 a month (he and his wife) from the government when entitlements are 71% of spending.

In a way, means testing would be a good thing, as it would finally cure the delusion that Social Security is anything other than a welfare program, although I’m not sure the public wouldn’t make peace with that rather quickly, rather than consider turning off the spigot.

What it wouldn’t do, unless the benefit cutoff threshold were very low, is make a difference in the program’s basic insolvency. The problem with Social Security isn’t just that it’s welfare, but that it’s welfare for everyone – “Everybody plunders everybody,” as Frederic Bastiat would say. There are currently 62 million currently receiving checks. For 60% of them, Social Security makes up half or more of all their income. Millions more have come to depend upon the benefits, even if they make up a smaller percentage.

It might make people feel good to know millionaires and billionaires will no longer receive Social Security checks, but it won’t make much of a fiscal difference. There aren’t enough of them to significantly lower the payouts. To affect Social Security’s bottom line, people who would miss the money are going to have to take a hit.

There are only two ways out: default or bankruptcy. Either way, it’s going to be ugly. Social Security really is an evil mess that can’t but end badly. Ditto for Medicare, times ten.

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.

Democracy Goes Out the Window During “Government Shutdowns”

Important_government_shutdown_notice_for_the_Stature_of_LibertyEveryone loves democracy, until the vote doesn’t go their way. Then, there are protests, marches, recounts, and other forms of whining from everyone who doesn’t like the results. We saw that after Donald Trump’s election and after the 2018 midterms, when Democrats tried to keep recounting the votes in some races until they got the result they wanted.

Now, we’re seeing it with the impending “government shutdown.” I use quotation marks because two things are true. First, this time around, about 75% of the government is already funded through September 2019. Second, even when none of the government is funded, it doesn’t really shut down.

But it should.

Somehow, the strange notion has taken hold that when Congress votes not to pass a new bill, it “isn’t getting anything done.” Not true. If Congress takes a vote and the bill is voted down, Congress has done its job every bit as much as if the bill had passed. In most cases, it does us all more good voting bills down than passing them. Regardless, Congress is representing the people no less by voting “no .” There is no immutable law of nature that says new bills must be constantly passed. The system is actually set up to make new legislation difficult, not easy.

If you’re going to insist on the superstition that Congress does “the will of the people,” then at least be consistent. If Congress votes a bill down, that is as much the will of the people as passing one.

This Friday, Congress may very well fail to pass a bill to fund the remaining 25% of the government. If they don’t vote to appropriate those funds, then no money should be spent on any part of the government for which funds aren’t appropriated. Those aren’t my rules. It’s right there in the government’s own rule book, in black and white: “No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law.”

By the way, spare me the “republic-not-a-democracy” comment blizzard. I know it better than you do. The form of government is a republic, but there is a lot of democracy baked in – more all the time, unfortunately, thanks to the Supreme Court’s rampage over what’s actually written into the Constitution. But even without their tyrannical creativity, the republic is built on a series of majority votes. That’s “democracy,” even if the government is not “a democracy.”

Regardless, the rules say majorities in both houses of Congress and the president have to approve any spending. When that doesn’t happen, those of us who want the government to shut down are supposed to get our way. After all, Congress represents us, too, whether we like it or not. That’s one of the key rationalizations for taxing us (“no taxation without representation”).

I won’t hold my breath waiting for the evangelists of democracy to follow the tenets of their own religion. Those seeking your money in the name of their deities rarely do.

Tom Mullen is the author of Where Do Conservatives and Liberals Come From? And What Ever Happened to Life, Liberty and the Pursuit of Happiness? Part One and A Return to Common Sense: Reawakening Liberty in the Inhabitants of America.