Is Euroland on Verge of Disintegration?

Is Euroland on Verge of Disintegration?
Source: WilliamEngdahl.comf
F. William Engdahl
April 21, 2017

The decision last year by a majority of British voters to exit the European Union was more than a simple vote of the people. The Brexit campaign was promoted and financed by the most influential banks of the City of London and by the British Royal House. Far from the end of Britain, Brexit is far more likely to be the beginning of the end of the disastrous Euro single currency experiment .

Since the global financial crisis of 2008 little significant has been done by Brussels or the governments of the 19 member Eurozone countries to bring the largest banks of the Eurozone into a healthy stability. On the contrary, even venerable mega-banks like Germany’s Deutsche Bank are teetering on the brink.

In Italy the world’s oldest bank, Monte Paschi di Siena, is on state life-support. That is but the tip of an iceberg of Italian bank bad debts. Today in total Italy’s banks hold Italy’s banks hold €360 billion of bad loans or 20% of Italy’s GDP, which is double the total five years ago.

It gets worse. Italy is the fourth largest economy in the EU. Its economy is in dismal shape so bank bad loans grow. State debt is almost as high as that of Greece, at 135% of GDP. Now, since the 2013 Cyprus bank crisis, the EU has passed a stringent new bank “bail-in” law, largely under German pressure. It stipulates that in event of a new banking crisis, a taxpayer bailout is prohibited until bank bond-holders and, if necessary as in Cyprus, its bank depositors, first “bail-in” or take the loss. In Italy, most holders of bank bonds are ordinary Italian citizens, with some €200 billion worth, who were told bank bonds were a secure investment. No more.

German Austerity Medicine Killing Patient

A major problem is that the Eurozone economies have been forced to impose the wrong medicine to deal with the 2008 financial and economic crisis. The Eurozone crisis has been wrongly seen as states spending too wildly and labor costs rising too high. So, under again German pressure, the Eurozone countries in crisis such as Greece, have been forced to impose draconian austerity, slash pensions, cut wages. The result has been even worse economic recession and rising unemployment, rising bank bad loans. By 2015 Greece’s GDP had declined by more than 26%, Spain’s GDP by almost 6%, Portugal by 7%, and Italy’s GDP by almost 10% compared with 2008.

Austerity is never a solution to a state economic crisis. The example of the German economic crisis that erupted in 1931 in depression, unemployment and a banking crisis as a consequence of the severe austerity policies of Chancellor Heinrich Brüning ought to be clear enough to German authorities whose historical memory seems to have amnesia today.

Across the Eurozone more than 19 million workers are jobless. Greece, Italy, Portugal and Spain have a total of an unprecedented 11 million unemployed workers. In France and Italy unemployment is over 13% of the labor force. In Spain it is 20%, and in Greece a staggering 25%. This is all the state of economic affairs more than 8 years after the 2008 crisis. In short there has been no economic recovery in Euroland. Since 2009 the European Central Bank (ECB), the bank of the Euro, has made unprecedented moves to try to stabilize the banking crisis. They have only postponed not improved the situation.

Today as a result of ECB buying of mortgage bonds, corporate bonds, state bonds, and asset-backed securities, the ECB balance sheet is more than €1.5 trillion. The ECB, whose President is Italian Mario Draghi, has held interest rates in an unprecedented negative interest rates around -0.4% since June, 2014. The ECB has made clear that negative central bank interest rates will remain “for some time.” This is leading some to try to convince voters to go to a cashless society as India did last year with catastrophic consequences and as Sweden, not a Euro country, has largely done. If banks begin to charge their customers a fee for using customers’ deposits, an incredible thought for most, people would simply “take the money and run,” into gold or other safe assets, or cash.

The ECB negative interest rates are a sign of desperation to put it mildly. With interest rates on bonds across the Eurozone so low, many insurance companies are facing severe liquidity problems meeting their future obligations unless Eurozone interest rates return to more normal levels. Yet were the ECB to end its negative interest rate policy and its quantitative easing so-called, the debt crisis of many banks would explode from Greece to Italy to France to even Germany.

A Coming Currency War?

So, to put it gently, the Eurozone is a ticking debt time bomb ready to blow at the slightest new shock or crisis. We may well see that shock in the next two years, once Britain has completed its exit from the EU. Already the new Administration of Donald Trump in Washington has signaled a potential launch of currency war against the Euro. On January 31, US Trade Czar Peter Navarro accused Germany of using a “grossly undervalued euro to exploit” the US and Germany’s EU partners. Navarro went on to call Germany, the core of the Eurozone economies, a de facto “currency manipulator.” Navarro has stated, “While the euro freely floats in international currency markets, this system deflates the German currency from where it would be if the German Deutschmark were still in existence.”

Britain with the vast financial resources of the City of London, once free from the shackles of the EU membership, could well join with Washington in a full-scale covert currency war to bring down the Euro, something that would have devastating consequences for the Eurozone economies. Britain’s Pound is the third largest global payments currency after the dollar and the Euro. If Britain, free from the restraints of the EU can bring down the Euro, the Pound could become a major gainer–currency war with Britain on the side of Washington against the fragile Eurozone with their Italian, Greek, Spanish and other problems. Already British Prime Minister Theresa May is in discussions with the Trump Administration about forging a bilateral US-UK trade agreement and some in influential UK circles are talking of inviting the USA to become an associate member of the British Commonwealth. For the US dollar and Wall Street banks, wounding the rival to the dollar as central bank reserve currency is a very tempting thought. Now with Britain and the City of London soon to be free of EU restraints, the temptation might become reality.

All of this is because of the dysfunctional nature of the entire Eurozone project, a supranational currency with no democratic elected authorities to control abuses. The half-way dissolution of national sovereignty that the Maastricht Treaty introduced with the European Monetary System back in the 1990s, has left the EU with the worst combination in event of future crisis.

Read More At: WilliamEngdahl.com
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F. William Engdahl is strategic risk consultant and lecturer, he holds a degree in politics from Princeton University and is a best-selling author on oil and geopolitics, exclusively for the online magazine “New Eastern Outlook”

Book Review: UFOs For The 21st Century Mind by Richard Dolan

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TheBreakaway | BreakawayConciousness
Zy Marquiez
April 4, 2017

In UFOs & The National Security State: Chronology Of A Cover-up – Volume 1, Richard Dolan carried out his opening salvo into the field of UFOlogy.  Seeking a veritable encyclopedia  of verifiable UFO sightings and never finding one, Dolan wrote a book based upon all data he collated from all the previous research he had undertaken.  In essence, he wrote the book he was looking for in UFOlogy, but wasn’t available.

In UFO’s & The National Security State – Volume 2, Dolan further cemented himself as a genuine historian by buttressing his previous work with another landmark piece.  Like his other books, this book is sourced to the hilt, which is appreciated for those seeking to venture further into the abstruse.  Moreover, this book is also the book in which the term “Breakaway Civilization” was coined.  A notable point to be sure, because that idea has been used by others seeking truth within this field and others, and it’s helped shed light into darker areas in this field.  What’s more, the ‘encyclopedia’ that Dolan began in volume one continued.

Thence, in A.D. After Disclosure, Dolan and his author Bryce Zabel sought to examine how the day after “the Others” are announced might play out, and they carry out the examination in salient fashion.  This book features a very sober analysis to many of the probable scenarios that will play out in a post-disclosure worked.  Anyone seeking to understand the possibilities such a sobering day will bring should ruminate upon getting this book.

Now, in UFOs For The 21st Century Mind, Dolan wrote a book to grapple the mind of newer generations and readers, the unexposed minds, the interested minds that have long sought to dive into “the phenomenon” but didn’t know where to start.

Along this stream of thought, this book strikingly brings about a fresh new look at UFOs, with modern eyes, employing a much broader perspective and dataset than the average UFO book.  Dolan doesn’t simply stick to classic sightings, abductions and declassified documents, but goes beyond to ruminate upon the realm of consciousness, quantum entanglement and more.  This book really is an up-to-date assessment of the situation from a multiplicity of angles.

Dolan begins the book by examining what UFOs could be by guiding the reader closer to the subject thoughtful and yet trenchant manner.  This helps the reader familiarize themselves with the subject and come to realize that there are a variety of explanations for UFO phenomena, many of which do not get considered   at length, if at all.  Additionally, this is also crucial because many individuals still continue to experience the phenomena in a variety of ways, and yet there aren’t any official channels to seek help from.

In Dolan’s own words:

“Whether or not you consider UFOs to be nonsense or of great importance, people are seeing things that are affecting them deeply.  Because there are no institutional structures for them to report or discuss what they see, they often keep silent, and try to forget or only secretly cherish one of the most incredible experiences of their lives.”[1]

Dolan, however, doesn’t shy away from the fact that this is a very serious issue.  While ruminating deeply upon it, he ponders reasons both pro and con that will help bring lucidity to a situation often bathed in shadows.  In fact, implications in the fields of economy, politics, religion, culture and science are given a cursory overview early on, and then are covered at length later in the book.  Dolan doesn’t merely stop there, though.

Journeying back in time, Dolan goes on to explore this phenomenon all the way back into ancient times and attempts to separate the wheat from the chaff.  This is important because it shows UFOs aren’t merely a modern phenomena.   In addition, salient subjects such as pyramids, lost civilizations, and ancient images goes to show that there probably is more than meets the eye within this field.

Interestingly, we know that some pyramids contain astronomical data.  This is particularly interesting because when this information is taken in conjunction with much of the lore and myths that abound those structures, and the fact that there’s hundreds of pyramids around the globe, and the fact that many of the core of the myths echoes nigh carbon copy traditions,  it should bring one pause.  Granted, it’s not proof, but very suggestive evidence nonetheless.

What’s more, some ancient writings seem to have what could be descriptions of ancient technology, such as the passage from Ezekiel, from the Bible, which Josef Blumrich, former NASA employee, sought to debunk.

Ironically, in the book The Spaceships of Ezekiel:

“Blumrich presented technical specifications of the spacecraft that he argued, fit Ezekiel’s description perfectly.  Of course, we should remember that Ezekiel presumably was describing something well beyond his experience for his time 2,500 years ago.  If he did see a descending spacecraft, he would have lacked the language or technological understanding to describe it in any way other than he did.”[2]

Later in the book, Dolan brings the reader up to more modern times when he examines a distinct array of sightings  and issues from the time.  These include ghost rockets, the Airship mysteries, which are rather fascinating in fact, the Minot case, the Malmstrom case, airspace violations and more.  Subsequent to that that, Dolan grapples with the issue of pervasive secrecy which he ruminates upon at length, and all that that entailed.  Many of the classics – Kecksburg, Aztec, Roswell – are also given a cursory glance.

But it doesn’t stop there.  Other significant incidents of “High Strangeness” get examined, such as some famous sightings around the globe, encounters with these beings, abductions [i.e. Travis Walton & Betty & Barney Hill] and even some crash retrievals.  All of this coalesces to allow the reader to note that there’s more than ample evidence to show that the phenomena not only existed for many decades, but was taken extremely seriously by those in the upper echelons of society.

Dolan also makes sure to hone in on quite of few aspects of the early period within UFOlogy’s history.  Here he covers everything from the blatant cover that took place behind the scenes, FOIA requests, the penetration of UFO groups by intelligence agencies and even touches upon the need for more people to get involved in a more serious manner.

This call to arms isn’t to be taken lightly because, as Dolan intimates:

“…a proper study of UFOs is a revolutionary experience.  It shatters old belief systems and forces us to look at our world in a completely new way.  Everything is affected: history, politics, economics, science, religion, culture, and our ultimate vision of who and what we are as human beings.”[3]

This subject seeps into all aspects of life, which is why it should be taken seriously.  When all collated information Dolan has amassed is pondered at length and given a fair shot, it is impossible not see something is going on.  Deeper truths lie locked-up within the rabbit holes of the field.  Undoubtedly, whenever some of these truths arise they will change the face of the world over night.  Those that are researching this field will be ahead of the pack in understanding the phenomenon and much of the disinformation that will also come regarding it, in the future.  That is another point to consider why this book should be read.

This subject is too important to overlook, and if humanity is ever going to prepare itself to live in a post-disclosure era, it is important to know the history of this subject and its implications.  If you’ve never read a book on this subject in your life, make this your first one.  You will not regret it.  As someone whose read over three dozen books on the subject, nothing else comes close to be this comprehensive while also being sober and realistic. Simply stated, if you want a book that is accessible to lay person, but also stimulating enough to get your brain cells churning, get this book.

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Footnotes:

[1] Richard Dolan, UFOs For The 21st Century Mind, p. 9
[2] Ibid., p. 55.
[3] Ibid., p. 2.

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This article is free and open source. You are encouraged and have permission to republish this article under a Creative Commons license with attribution to Zy Marquiez and TheBreakaway.wordpress.com.
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About The Author:

Zy Marquiez is an avid book reviewer, researcher, an open-minded skeptic, yogi, humanitarian, and freelance writer who studies and mirrors regularly subjects like Consciousness, Education, Creativity, The Individual, Ancient History & Ancient Civilizations, Forbidden Archaeology, Big Pharma, Alternative Health, Space, Geoengineering, Social Engineering, Propaganda, and much more.

His own personal blog is BreakawayConsciousnessBlog.wordpress.com where his personal work is shared, while TheBreakaway.wordpress.com serves as a media portal which mirrors vital information usually ignored by mainstream press, but still highly crucial to our individual understanding of various facets of the world.

When the “Solutions” Become the Problems

TheDeepState2
Source: OfTwoMinds.com
Charles Hugh Smith
March 28, 2017

Those benefiting from these destructive “solutions” may think the system can go on forever, but it cannot go on when every “solution” becomes a self-reinforcing problem that amplifies all the other systemic problems.

We are living in an interesting but by no means unique dynamic in which the solutions to problems such as slow growth and inequality have become the problems. This is a dynamic I have often discussed in various contexts. In essence, a solution that was optimized for an earlier era and situation is repeatedly applied to the present–but the present is unlike the past, and the old solution is no longer optimized to current conditions.

The old solution isn’t just a less-than-optimal solution; it actively makes the problem worse.

As a result, the old solution becomes a new problem that only exacerbates the current difficulties. The status quo strategy is not to question the efficacy of the old solution–it is to apply the old solution in heavier and heavier doses, on the theory that if only we increase the dose, it will finally resolve the problem.

Take borrowing from the future, i.e. debt, as a prime example of this dynamic. Back when credit was scarce and expensive, unleashing a tsunami of cheap, abundant credit supercharged growth by enabling millions of people who previously had limited access to credit to suddenly borrow and spend enormous sums of cash.

This tsunami of new spending supercharged growth such that servicing the debt was easy, as incomes and wealth both expanded far beyond the cost of the new debt.

Fast-forward to today, and adding 50% of the nation’s GDP in new federal debt ($9 trillion) and trillions more in corporate and houshold debt in the past 8 years has yielded subpar growth–roughly 2% a year.

This poor response to massive floods of credit, borrowing and spending has flummoxed conventional economists, who incorrectly assumed old solutions would always work as they had in the past.

In a similar fashion, conventional economists expected fiscal stimulus to boost growth. Fiscal stimulus–one-time tax refunds, infrastructure spending, tax cuts and various forms of “helicopter money”–central banks creating money out of thin air for the government to spend or distribute–have all failed to generate the self-sustaining virtuous cycle of boosting the output of the engines of income/wealth creation.

As I noted in Fragmentation and the De-Optimization of Centralization (January 2, 2017), The 4th Industrial Revolution has de-optimized centralization. Centralized control, power and money are now the problem, not the solution.

In the past, centralizing control of industries, credit and production increased the productivity of the whole economy. But that was then, and this is now. In the current era, centralization only breeds corruption, moral hazard, revolving doors between state agencies and private industry, opaque, rigged markets, rentier cartel parasitism and state-cartel crony capitalism, in which the central state regulates industries like Big Pharma, defense weaponry, higher education and so on to benefit entrenched interests, elites and cartels.

Regulations have also slipped from being solutions to problems. Everyone weighing the costs and benefits agrees that building and zoning codes enacted at the turn of the 19th century and the beginning of the 20th century greatly reduced the health hazards posed by slums and unregulated industries. Everyone weighing the costs and benefits agrees that clean air and water regulations imposed in the early 1970s benefited the public and the nation, despite the higher costs for goods and services that industry passed down to the consumer.

Technological improvements and efficiencies offset much or all of these costs by the 1980s, and by the 1990s, technological gains were increasing the income and wealth of almost every participant in the economy.

Recently, these technological gains have become concentrated in the top 5% of wage-earners and the owners of the capital. There are several drivers for this, including proximity to cheap credit, tax evasion techniques available only to corporations and the wealthy, pay-to-play lobbying for tax breaks and regulatory barriers to competition, and so on–all the foul fruits of centralized power and the crony-capitalism it breeds.

But technology is also exacerbating the trend to a winner-take-all or winners-take-most asymmetry between the most profitable and productive and “everyone else.”

Regulations have now become burdens rather than low-cost means of improving the commons shared by all. Advocates for “tiny houses” and similar solutions to homelessness run into buzz-saws of regulations that prohibit such construction and zoning, and advocates of innovations from urban farming to crypto-currencies find regulations (often serving the interests of political donors rather than the public) are stifling innovations and efficiencies that would benefit the many rather than the few.

The regulatory agencies are prone to self-serving complexity that justified their budgets and power; as the regulations become more voluminous and arcane, “experts” in reading the runes and keeping up to date justify their big salaries and departmental budget.

The Lifecycle of Bureaucracy (December 2, 2010)

As I explain in my book Resistance, Revolution, Liberation: A Model for Positive Change, the state only knows how to expand; there is no mechanism, no institutional memory and no reward motivation to reduce the size of state power or revenues, or reduce the reach of the regulations and laws that empower the state to control virtually every aspect of life.

There are many other “solutions” that no longer solve their intended target problem but have become burdensome problems in themselves. One need only look at healthcare, higher education and weaponry acquisition programs to find hundreds of examples of perverse incentives and unintended consequences that are the direct result of anti-competitive, intentionally opaque, centralized regulations that are implicitly designed to benefit the few (wealthy political donors, lobbyists and entrenched interests) at the expense of the many who are shut out of the regulatory game.

Student loans are an excellent example of a “solution” becoming a problem itself, while the underlying problem–soaring costs for diminishing-return diplomas–rages on, enabled by the “solution”: force student debt-serfs to borrow another trillion dollars to fund sclerotic, self-serving bloated bureaucracies.

The Nearly Free University and the Emerging Economy: The Revolution in Higher Education.

Borrowing and spending $9 trillion did little but indenture future taxpayers to pay for for our massive malinvestment in diminishing-returns dead-ends.

Continue Reading More At: OfTwoMinds.com

The Divided Deep State is a Symptom, Not the Disease

TheDeepState2
Source: OfTwoMinds.com
Charles Hugh Smith
March 23, 2017

If we understand the profound political disunity fracturing the nation and its Imperial Project, we understand the Deep State must also fracture along the same fault lines.

I’ve been writing about the divided Deep State for a number of years, most recently in The Conflict within the Deep State Just Broke into Open Warfare. The topic appears to be one of widespread interest, as this essay drew over 300,000 views.

It’s impossible to understand the divided Deep State unless we situate it in the larger context of profound political disunity, a concept I learned from historian Michael Grant, whose slim but insightful volume The Fall of the Roman Empire I have been recommending since 2009.

As I noted in my 2009 book Survival+, this was a key feature of the Roman Empire in its final slide to collapse. The shared values and consensus which had held the Empire’s core together dissolved, leaving petty fiefdoms to war among themselves for what power and swag remained.

A funny thing happens when a nation allows itself to be ruled by Imperial kleptocrats: such rule is intrinsically destabilizing, as there is no longer any moral or political center to bind the nation together. The public sees the value system at the top is maximize my personal profit by whatever means are available, i.e. complicity, corruption, monopoly and rentier rackets, and they follow suit by pursuing whatever petty frauds and rackets are within reach: tax avoidance, cheating on entrance exams, gaming the disability system, lying on mortgage and job applications, and so on.

But the scope of the rentier rackets is so large, the bottom 95% cannot possibly keep up with the expanding wealth and income of the top .1% and their army of technocrats and enablers, so a rising sense of injustice widens the already yawning fissures in the body politic.

Meanwhile, diverting the national income into a few power centers is also destabilizing, as Central Planning and Market Manipulation (a.k.a. the Federal Reserve) are intrinsically unstable as price can no longer be discovered by unfettered markets. As a result, imbalances grow until some seemingly tiny incident or disruption triggers a cascading collapse, a.k.a. a phase shift or system re-set.

As the Power Elites squabble over the dwindling crumbs left by the various rentier rackets, there’s no one left to fight for the national interest because the entire Status Quo of self-interested fiefdoms and cartels has been co-opted and is now wedded to the Imperial Oligarchy as their guarantor of financial security.

The divided Deep State is a symptom of this larger systemic political disunity. I have characterized the divide as between the Wall Street-Neocon-Globalist Neoliberal camp–currently the dominant public face of the Deep State, the one desperately attempting to exploit the “Russia hacked our elections and is trying to destroy us” narrative–and a much less public, less organized “rogue Progressive” camp, largely based in the military services and fringes of the Deep State, that sees the dangers of a runaway expansionist Empire and the resulting decay of the nation’s moral/political center.

What few observers seem to understand is that concentrating power in centralized nodes is intrinsically unstable. Contrast a system in which power, control and wealth is extremely concentrated in a few nodes (the current U.S. Imperial Project) and a decentralized network of numerous dynamic nodes.

The disruption of any of the few centralized nodes quickly destabilizes the entire system because each centralized node is highly dependent on the others. This in effect what happened in the 2008-09 Financial Meltdown: the Wall Street node failed and that quickly imperiled the entire economy and thus the entire political order, up to and including the Global Imperial Project.

Historian Peter Turchin has proposed that the dynamics of profound political disunity (i.e. social, financial and political disintegration) can be quantified in a Political Stress Index, a concept he describes in his new book Ages of Discord.

If we understand the profound political disunity fracturing the nation and its Imperial Project, we understand the Deep State must also fracture along the same fault lines. There is no other possible output of a system of highly concentrated nodes of power, wealth and control and the competing rentier rackets of these dependent, increasingly fragile centralized nodes.

Of related interest:

Is the Deep State Fracturing into Disunity? (March 14, 2014)

Read More At: OfTwoMinds.com

 

A new kind of doctor’s office charges a monthly fee and doesn’t take insurance – and it could be the future of medicine

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Source: BusinessInsider.com
March 19, 2017

Dr. Bryan Hill spent his career working as a pediatrician, teaching at a university, and working at a hospital. But in March 2016, he decided he no longer wanted a boss.

He took some time off, then one day he got a call asking if he’d be up for doing a house call for a woman whose son was sick. He agreed, and by the end of that visit, he realized he wanted to treat patients without dealing with any of the insurance requirements.

Then he learned about a totally different way to run a doctor’s office. It’s called direct primary care, and it works like this: Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee that covers most of what the average patient needs, including visits and drugs at much lower prices.

That sounded good to him. In September, Hill opened his direct-primary-care pediatrics practice, Gold Standard Pediatrics, in South Carolina.

Hill is part of a small but fast-growing movement of pediatricians, family-medicine physicians, and internists who are opting for this different model. It’s happening at a time when high-deductible health plans are on the rise – a survey in September found that 51% of workers had a plan that required them to pay up to $1,000 out of pocket for healthcare until insurance picks up most of the rest.

That means consumers have a clearer picture of how much they’re spending on healthcare and are having to pay more. At the same time, primary-care doctors in the traditional system are feeling the pressure under the typical fee-for-service model in which doctors are incentivized to see more patients for less time to maximize profits.

Direct primary care has the potential to simplify basic doctor visits, allowing a doctor to focus solely on the patient. But there are also concerns about the effect that separating insurance from primary care could have on the rest of the healthcare system – that and doctors often have to accept lower pay in exchange for less stress.

How direct primary care works

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Courtesy Lauren Clark

Dustin and Lauren Clark, who operate Black Bag Family Healthcare.

For Brent Long and his family, paying for healthcare is now like paying a cellphone bill. Since they joined Black Bag Family Healthcare in Johnson City, Tennessee, about two years ago, the family has paid about $150 a month to belong to the practice.

Long joined around the time he was shifting his insurance to a high-deductible health plan. There were two reasons he decided to switch and start paying for all six members of his family to get direct primary care: the cost-effectiveness of not having to deal with copays or urgent-care visits, and the fact that it could easily fit his family’s busy lifestyle that doesn’t jibe with spending hours in waiting rooms.

Included in that monthly fee are basic checkups, same-day or next-day appointments, and – a big boon to patients – the ability to obtain medications and lab tests at or near wholesale prices.

Direct primary care also comes with near-constant access to a doctor – talking via FaceTime while the family is on vacation, or taking an emergency trip to the office to get stitches after a bad fall on a Saturday night. Because direct primary care doesn’t take insurance, there are no copays and no costs beyond the monthly fee.

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Skye Gould/Business Insider

When Blythe Fortin went in for a recent visit at sparkMD, a direct-primary-care practice in Boise, Idaho, Dr. Julie Gunther spent an hour chatting with her before getting to the results of her blood test, which showed elevated blood-sugar levels.

“She listened when I said I can manage with diet,” rather than starting her on medication, Fortin said.

Fortin, who pays $60 a month for sparkMD, had used a different kind of subscription healthcare called concierge medicine. It has some similarities to direct primary care but often costs thousands per month and still incorporates health insurance. She says she prefers direct primary care because the quality of care she has received is better than concierge medicine, and she likes that it’s available to a wider base of patients.

At the 17 direct-primary-care practices Business Insider spoke with, the percentage of members who still had insurance varied. At some practices, all but a handful had some form of insurance, while at others a little more than half didn’t have insurance.

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Courtesy of Dr. Julie Gunther

Dr. Julie Gunther of sparkMD with one of her newest patients.

To describe how coverage functions under direct primary care, doctors use the example of car insurance: You don’t use your car insurance for small transactions like oil changes, but it’s there for you if you get in a car accident. Likewise, health-insurance plans – especially those with high deductibles – can be there if you require healthcare beyond primary care.

For those who have insurance, the choice to pay for both makes financial sense, even if they can’t use it at their doctor’s office.

Fran Ciarlo has coverage through Medicare but decided to pay for sparkMD as well. One of the ways she’s seen an advantage is in prescriptions – like many direct-primary-care practices, sparkMD can provide prescriptions at wholesale prices, adding a 10% fee. On a recent visit, Ciarlo estimated she had saved at least $100 on prescriptions for standard steroids and antibiotics that in total cost her $6.

And for those with high health-insurance costs, it’s occasionally a choice between paying a monthly premium or the monthly membership fee for a direct-primary-care practice. For Rebekah Bennett, paying for direct primary care at sparkMD made more sense for her and her children than opting for insurance through the Affordable Care Act marketplace, since for roughly the same cost, if not less, her family could see their doctor without any copays.

The history of the direct-primary-care movement

Philip Eskew, who has tracked the movement through his website, Direct Primary Care Frontier, said direct primary care began at the end of the 1990s and early 2000s. Around that time, three doctors had the idea to go insurance-free, charging monthly fees instead and freeing up time to enjoy practicing medicine. This way, patients who might not have insurance could have a clear idea of how much going to the doctor would cost.

One of the three founded Qliance, a direct-primary-care system based in Washington state that got its start in 2007. The company was backed by Amazon CEO Jeff Bezos and Dell founder Michael Dell before the company leadership bought it to run it privately, without investor pressure. Qliance now has about 25,000 members visiting a handful of clinics around Puget Sound.

Cofounder Dr. Erika Bliss sees this movement growing in the future from its grass roots, rather than becoming big and national.

“It keeps the resolve and the drive toward independent primary care,” she said, which she described as a critical element. She says she envisions independent practices with maybe 10 to 20 providers at three to five locations being about as big as they’d get.

Getting off the ground

Dr. Matthew Abinante opened his practice in Huntington Beach, California, in September. Since then, he has had two people call his office to find out more about his practice. When he explained the system, he said, the callers thought it had to be a scam.

It’s one of the biggest hurdles doctors face when starting direct primary care – the “too good to be true” factor, the learning curve that comes with the understanding that “No, you won’t be using insurance here.” Even so, Abinante has signed up about 150 patients.

Going into direct primary care often means ditching the reliability of a salary. Because the practice relies on membership fees, the more patients who sign on, the more money that can be made. Practices cap their number of patients at anywhere from 300 to 1,000.

And it’s not exactly cheap to get started. Dr. Vance Lassey, who runs Holton Direct Care in Holton, Kansas, took out a loan to start his practice and spent time renovating a 750-square-foot space he rented from a friend at an industrial park. He picked up a lot of old equipment from a nearby nonprofit hospital and surplus stores. For his in-house pharmacy, Lassey took mismatched cabinets and refinished them so they matched.

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Courtesy Dr. Vance Lassey

Dr. Vance Lassey in front of the pharmacy cabinets he built from a mismatched set.

Keeping his costs low helped Lassey break even within four months of opening his practice. Still, he’s not earning as much as he used to when he worked at a hospital and had only five to 10 minutes with a patient – a lot less time than he gets to spend with his patients now.

“I am making a profit, I have more free time, and I can practice properly,” he said. “It’s worth it to me.”

Others, like Dr. M. Chad Williamson in Fort Payne, Alabama, went upscale – he offers his patients a 24-hour gym as part of his practice’s $60 monthly membership fee. Williamson, who opened his practice in August, a few months after finishing his residency, currently has 215 members. He wants to bring that up to between 600 and 1,000 people, ideally.

And it’s not just building the office space – direct-primary-care doctors are also responsible for building referral relationships with other doctors in the area.

What’s holding direct primary care back

While doctors and patients using direct primary care might praise the model – it was hard to get anybody to suggest a group, geographic or otherwise, that they thought wouldn’t benefit from direct primary care – not everyone is sold just yet.

Carolyn Long Engelhard, a public-health expert and professor at the University of Virginia School of Medicine, broke down the main concerns with direct primary care:

  • It might give the false impression that it’s a kind of insurance, so people might not opt to also get a real insurance plan. But if a patient were to have a health issue outside the scope of primary care, they wouldn’t be protected financially. All the providers Business Insider spoke with said they recommended patients have some form of insurance, and there were many instances where most patients in a practice had insurance or took part in a healthcare sharing plan, a program that functions like insurance in which an amount is sent monthly to people who have medical expenses in the plan.
  • Because doctors at direct-primary-care practices take on fewer patients than doctors at traditional primary-care practices, it might add to the caseloads of primary-care doctors. There is a shortage of these doctors in the US, partly because many choose to go into specialty medicine. Some doctors, on the other hand, say that they would have considered leaving medicine outright if they hadn’t had the option to do direct primary care. “There are doctor shortages already, so I say, ‘Compared to what?'” Dr. Chad Savage, who runs YourChoice Direct Care in Brighton, Michigan, told Business Insider.
  • Direct-primary-care physicians could become isolated from other doctors, and because the only person the direct-primary-care doctor has to answer to is the patient, there are fewer insurance regulations in place, potentially putting patients at risk. This is one of the reasons that getting hard data on how direct primary care compares with traditional practices is difficult. But between direct-primary-care networks and the referral relationships doctors build in their communities, there might not be so much isolation from the rest of the system. Dr. Deborah Moore of AmarilloMD in Amarillo, Texas, said she has more time now to do research than she did when she worked at a clinic. “I can do what I really need to be doing,” she said.

Engelhard worries about the direct-primary-care model becoming the norm. Generally, she said, “I do think it has a place in our healthcare system.” Instead, though, she’d like to see more adoption of the “patient-centered medical home,” a model in which primary care is more of a team effort.

Medical organizations have had mixed reactions to the movement as well. The American Academy of Family Physicians supports it, while the American College of Physicians, which represents internal-medicine doctors, has chosen not to take a stance on direct primary care.

There are also logistical hurdles that present challenges. For example, Eskew said that in the eyes of the Internal Revenue Service, having a health savings account is illegal if you’re a member of a direct-primary-care practice. The IRS views the monthly fees as insurance payments, making the person ineligible for an HSA, he said. Patients also can’t use the funds from an HSA, flexible savings account, or Medicare savings account to pay their monthly membership bills.

But politicians have shown support for the business model. Libertarians see direct primary care as a free-market solution to healthcare, and legislation at the state level has gained support from Democrats and Republicans alike. And direct primary care is on the radar of Department of Health and Human Services Secretary Tom Price, who while he was a member of Congress introduced a plan that would allow HSA funds to pay for direct primary care.

“Whoever is in power tries to take credit,” Eskew said. The ACA contains a paragraph about direct primary care that allows for the business model. It’s unclear what would happen to direct primary care under the American Health Care Act, the proposed bill to replace the ACA.

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Courtesy of Dr. J. Bryan Hill

Hill with a patient.

Where does direct primary care go from here?

As one of the first pediatricians to go into direct primary care, Hill has had the additional challenge of figuring out how the service works with children. Unlike many direct-primary-care physicians, he offers one-time visits to nonmembers. He said he also spends a lot of time listening to what parents want and sets his prices accordingly, offering discounts to families with three or more kids.

Doctors who are part of the movement tend to be the first in their area to have a direct-primary-care practice, and patients the first of their friends to use direct primary care. But all said they had positive experiences with the model.

“This is a niche, but a niche that makes sense,” Long said.

If direct primary care continues to gain traction, it could lead to new kinds of insurance plans – ones that don’t necessarily factor in primary care. Already, patients with high-deductible healthcare plans are using this. But direct-primary-care doctors also said they’d prefer to recommend catastrophic health insurance plans, which have deductibles as much as $10,000 or $30,000 and aren’t allowed under the ACA.

Even with the growth in the last few years, Bliss said the market is still slow, and a lot of unknowns would come with the AHCA should it become law. And it will be hard to get fully insured employers to use it in the same way self-insured employers and unions have picked it up.

Either way, those in direct primary care are optimistic about the movement’s future.

“In 10 years, we’re going to be an overnight success,” Eskew said jokingly.

Read More At: BusinessInsider.com

Here’s One For The 3-D Printing Scrapbook

Source: GizaDeathStar.com
Dr. Joseph P. Farrell Ph.D.
March 11, 2017

It has been a while since I’ve updated the 3d-printing scrapbook on this site, but not for want of stories about it. In fact, as we will discover this week, there is big news on this front, beginning with today’s story, which several readers here noticed and shared. Now, you may be wondering why I’ve put this story under the category of the “transhumanist scrapbook,” but we’ll get to that in a moment, for it has to do with today’s high octane speculation. 3-d printed structures have already been built in China, so what’s the fuss here? Here’s one version of this story that appeared at Zero Hedge:

This House Was 3D-Printed In Under 24 Hours At A Cost Of Just $10,000

OK… the “house” is not exactly a nice looking modern American middle class brick home with faux Tudor turrets and windows, but then again, those homes now cost as much as three-or-four modern overpriced automobiles that can be remote controlled and sent into trees if you or your family step out of line.   Ahhh… progress!

This cozy little place was only a little over $10,000, and that means, considerably less money than a new car, and unlike other structures made from “additive manufacturing,” this one was not printed elsewhere and assembled on the spot, but printed right on the spot.  With a little extra money, I’m sure a basement could have been dug out and a basement printed as well for those requiring shelter during tornado season in Russia (remember,  they get them too).

But just allow your mind to wander a bit, and speculate on all the implications: suppose they perfect all this and can print your modern American middle class brick home with faux Tudor turrets and windows… at a fraction of the cost (that is to say, for the price of just one – not several – of the modern over-priced automobiles that can be remote controlled and sent into trees if you or your family step out of line). What’s brought down the cost? Once again, it’s labor productivity that has been drastically reduced.  Now let your imagination really go: imagine printing roads with the process. Indeed, why have humans driving the equipment that digs the roadbeds at all? This can be done with automatically controlled vehicles. Another robot printer can print the frames for the concrete pouring, and another can then pour the concrete. Few, or no, humans needed. Cost of making or even repairing and maintaining the road? Drastically reduced. Why? Labor productivity has once again declined, dramatically.

Speculate further: if it is simple houses today, why not high-rises? As the article states, apartment buildings have already been constructed in China using parts printed by 3-d printing. But now imagine doing it on the spot – as with this little house – and today’s erection cranes give way to tomorrow’s 3-d printing modules, and high rises could conceivably go up not in a matter of weeks, but possibly just days. And again, at a fraction of the cost. Why? Once again, because of the decline of the costs of labor productivity.

And of course, there is the application of the same technology for space purposes; already NASA and other space agencies are looking at the process not only for printing spare parts in space for simple repairs, but looking much farther ahead to the possibilities of using the process to construct permanent human habitation and working spaces off-world. And the black projects world has a wonderful new technology to play with in their underground bases and tunnels, a boon not only to the elimination of labor productivity and maintenance costs, but, as human labor production requirements fall, so do the security risks as fewer people are “in the know.” As I’ve stated before, I strongly suspect that additive manufacturing comes out of the black world, since the process has been around for a long time(decades, if one really digs into it), and it probably much more advanced in that black projects world than is evident in the public one. (And here’s a thought to ponder, why in the past few years has 3-d printing been being “driven” into the public consciousness by stories such as these?)

So why belabor all of this? Because again traditional economic models of analysis will have to be drastically revised. Typically, housing is one area that has been looked at as an indicator of the economy’s health and the employment market. When houses are built, people are spending, and people are employed building them. But with the progress and advances in the additive manufacturing process and the low cost of building a house manufactured on the spot, more people who cannot now build or afford a home will be able to do so. Thus, a housing market can expand, without the hitherto typical expansion of employment. Hence, for those making such models and emphasizing the need to shift back to a production economy, a problem is posed: how does one increase production when labor productivity is falling due to technological progress? What does one do with the decrease of jobs once filled by humans?

As I’ve argued before, there must be a dramatic increase in human productivity.

See you on the flip side…

Read More At: GizaDeathStar.com
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About Joseph P. Farrell

Joseph P. Farrell has a doctorate in patristics from the University of Oxford, and pursues research in physics, alternative history and science, and “strange stuff”. His book The Giza DeathStar, for which the Giza Community is named, was published in the spring of 2002, and was his first venture into “alternative history and science”.

Catherine Austin Fitts – Covers Politics, Pedophelia, Food price, The Bond Bull Market, Factional Infighting, & More

Source: USAWatchDog.com
Greg Hunter
March 12, 2017

One of the big headwinds for Trump is the bond market and rising interest rates. Financial advisor Catherine Austin Fitts contends, “The long term bull market in bonds is at an end, and rates are going to rise and continue to rise as they should. Savers, pension funds and insurance companies are not getting a return on their capital. To me, this is a welcome. If you are holding a big bond portfolio, they are going to be down, but interest rates are going to rise and the party is over. We have a President who understands the cost of capital and is screaming that it is no longer zero. To a certain extent, you are watching all of Washington blame Trump for the end of the debt birth model. It’s not his fault. He’s just trying to get the culture to switch to reflect something to where the future is going.”

Fitts, who has managed hundreds of billions of dollars of assets as Assistant Secretary of Housing in the Bush Administration (41), says the stock market could blow up to a “Dow of 30,000 or crash down to 10,000.” Fitts tells all her clients to hedge for any scenario and “hold a core position in gold.”

Join Greg Hunter as he goes One-on-One with Catherine Austin Fitts, Publisher of The Solari Report.