The wealthy know how to get premium healthcare and now so can you. America is rapidly evolving into a two-tiered healthcare system where the wealthy are moving far away from the travesty that is Obamacare. Top-rated medical professionals cannot possibly be compensated in the socialistic confines of O’Care and, thus, are opting out—far out.

State and federal exchanges, as well as Medicare and especially Medicaid patients, will be out of luck and far off the radar of the finest healthcare professionals. Cutting-edge clinics and stand-alone operating facilities will operate on a concierge, cash-only basis. These facilities will be staffed by entrepreneurs committed to offering world-class healthcare to cash-paying clients. The government as well as the insurance industry will be persona non grata in this cash-oriented entrepreneurial system. States such as Florida, Texas, Wyoming and New Hampshire will be leaders in welcoming digital-age, cash-based facilities. Healthcare entrepreneurs will treat burdensome tax and regulatory purgatories (New York, California, Rhode Island, Illinois) as unsuitable for location.

Grand Rounds is one of many health care startups offering on-demand, concierge-like services once reserved for the ultra-rich to the middle class — similar to what tech outfits like Google, Amazon, Uber, and Lyft have done with personal shopping andtransportation. These budding health care companies offer basic access to medical advice, appointments, and other assistance. Some operate regionally, others nationally. Their services and prices vary substantially, but all aim to fill gaps in the existing health care system, in part by using the internet.

Often, they charge monthly or annual subscriptions — say $50 a month or $149 a year for primary care services — although physical exams, surgeries, and second opinions from specialists can cost more. At Grand Rounds, an online second opinion runs $7,500 and an appointment with a specialist is $200. But Sommers only paid $30 because he was covered through his son’s employee benefit package, which includes access to Grand Rounds.

Generally, these startups say, consumers pay them less than the tens of thousands of dollars a yearthat wealthy clients pay traditional concierge physicians for immediate access to high-end primary care. These startups profit by selling their services directly to consumers or to employers. Some of the firms accept insurance or payment through health savings accounts.

In Silicon Valley, employers are already piling concierge medical services atop their traditional health insurance offerings. For bigger companies, these services are a natural extension of the other perks — free dry cleaning, meals, housekeeping, shuttles — they provide to save employees time. “The market for these vendors is huge,” says Lynne Collins, vice president of human resources at the file-sharing service Hightail, based in Campbell, California, which offers Grand Rounds and Bay Area-based One Medical as benefits. For her company, adding these was a “no-brainer.”

Tailored Health Care

With the benefit of technology, the concierge firms say they offer a more tailored, streamlined health care experience than consumers can get otherwise. They also contend they provide better quality. Grand Rounds, for instance, chooses its doctors from a list of 520,000 physicians based on an algorithm, plugging in variables such as research and publication history, patient outcomes, and how other doctors rate them.

It’s all part of a shift toward personalized consumer-centered health care — a trend facilitated by the internet and growing digital access to medical information. Obamacare has helped by spurring the creation of online marketplaces for health care consumers and accelerating reliance on electronic medical records and data. In recent years, the government has released previously vaulted datasets on pricing and quality into the public domain, allowing tech companies to create tools that help consumers access better, sometimes cheaper, care.

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In a review of Nina Teicholz’s The Big Fat Surprise , Michael R. Eades, M.D. writes that it is perhaps the most important book on nutrition ever written. As Dr. Eades asks, how is it that we went from “a meat-eating, butter-slathering, lard-cooking society to the fat-fearful, heart attack prone, constantly dieting people of today?” Furthermore, we are in the midst of an obesity epidemic, and, even worse, in a diabetes epidemic that is going to spell disaster for our country physically as well as fiscally if it is not reversed. Read more here from Michael Eades about why he feels Nina Teicholz’s The Big Fat Surprise is a life changer.

Based on my own research on Paleolithic man and his diet, I knew that early man ate mainly meat. And the meat he ate wasn’t what we today consider the choice cuts. Not T-bones and tenderloins, but viscera, marrow, brain, and fat pads—all sources of saturated fat were doubtless his foods of choice. I also knew that prior to the early years of the 20th century, heart attacks were rare. So rare, in fact, that they were almost nonexistent. Doctors could go through their entire careers without seeing one.

What I didn’t know was that during this heart-disease-free period, folks in the United States were up to their elbows in animal foods and saturated fat. Same in Great Britain. In fact, people ate more meat then than they do now. But today cardiovascular disease is the leading cause of death. (Take a look at these two old papers (clickhere and here) Nina referenced to see the change.)

I had fallen victim to the myth that the agrarian pre 1900s America meant everyone ate grains and vegetables and a smattering of meat when they could get it. As Nina goes to great lengths to point out in The Big Fat Surprise, that ain’t how it was.

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“The inherent vice of capitalism is the unequal sharing of blessings; the inherent virtue of socialism is the equal sharing of miseries.” (Winston Churchill)

Does anyone for a moment think that the wealthy just throw his or her money into a deep, dark hole? Even if Mr. Wealth is not expanding his business and hiring more people, or is not contributing to Hollywood fundraisers for Mr. Obama, he is spending it on cars, boats, mansions, planes, and maybe even a charity or two. Along the way, there is an army of people—from the mechanics who maintain her Bombardier Global Express (Oprah) to the staff who maintain his vast collection of properties (Larry E.)—who benefit from Mr. Wealth’s consumerism, sanctimonious opinions aside. Every dollar George Soros or Sheldon Adelson spends trickles down in exactly the same fashion as does yours or mine. George and Sheldon just happen to have a lot more of them to trickle down.

Avik Roy, Forbes magazine opinion editor, asks, how would a thoughtful person address the problem of economic inequality? Does it not make sense to reward activities that promote economic growth? Reforming health care, mortgage finance and college tuition would lower the cost of living for many people. Slashing taxes on income and replacing with taxes on consumption and property would also go a long way in financing a safety net. Switzerland and Singapore, two countries with high costs of living, have had spectacular results with this approach. Read more of Mr. Roy’s views here on why French economist Thomas Piketty in Capital in the Twenty-First Century has a myopic view on income inequality.

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Rand Paul offers big ideas. Like getting rid of the Department of Education. Contrast that with the teleprompter reading/speeches and poll watching Obama administration that’s too timid to make change we can believe in.

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Jimmy Page honored.

The 25 highest-earning hedge fund managers in the United States took home a total of $21.15 billion in compensation in 2013, according to an annual ranking published on Tuesday by Institutional Investor’s Alpha magazine.

They earned that hefty sum in a year when most hedge fund managers fell short of the market’s returns. The multibillion-dollar payday is the highest since 2010, and it is 50 percent more than in 2012, according to the survey.

David A. Tepper, the 56-year-old founder of Appaloosa Management, maintained his spot atop the list, bringing in $3.5 billion last year, after earning $2.2 billion in 2012. Steven A. Cohen of SAC Capital Advisors ranked No. 2 after pocketing $2.4 billion, while John A. Paulson of Paulson & Company took home $2.3 billion, ranking No. 3.

The post His $3.5 Billion Haul appeared first on RichardCYoung.com.

James A. Dorn, senior fellow and vice president for monetary studies at Cato Institute, writes that French economist Thomas Piketty’s goal seems to be in penalizing the rich rather than in creating wealth and expanding opportunities for market exchange. In Capital in the Twenty-First Century, Piketty focuses on outcomes rather than on institutions, incentives, and process. As Mr. Dorn explains, Mr Piketty believes more in the power of government than in the power of markets. But history shows that individuals have a natural desire to improve themselves through economic freedom, not from the redistributive state. Read here from Mr. Dorn how economic freedom and limited government increase the choices available to everyone.

In his best-selling book Capital in the Twenty-First Century (Harvard University Press), French economist Thomas Piketty is concerned with equality of outcome, not equality under a rule of law safeguarding one’s unalienable rights to liberty and property.

He finds that inequality of income and wealth is increasing as the return on capital assets exceeds the growth of real GDP.  His policy for reducing inequality is to use the power of government to impose very high marginal tax rates on the incomes of the rich and near rich, and also impose an annual wealth tax.  His goal is “to put an end to such incomes.”

Piketty’s leveling schemes in the pursuit of “social justice” would undermine the primacy of property rights under the U.S. Constitution, adversely affect incentives to save and invest, stifle entrepreneurship, and slow economic growth. He seems more interested in penalizing the rich than in thinking of ways to create wealth by expanding opportunities for market exchange.

Underlying his approach to equality is the false idea that the rich get richer at the expense of the poor.  He ignores the reality that voluntary exchanges in the marketplace make parties to the trades better off—and wealth is created.

Pat Buchanan makes an interesting point here in which he suggests dumping the corporate tax with a 10% tax on imports. An easy sell to Americans might instead be a flat 10% tax on corporations, individuals and final sales. All Americans would contribute to the defense (not offense) of our country and the infrastructure we all use. The corporate tax rate would put America on the most competitive list. Finally at 10% sales tax is not going to prevent Americans from buying what they need. And food and prescription drugs might be good candidates for exception.The stock market would soar, new jobs would be plentiful with all the money corporate America would save, and April tax misery would be gone forever as only short forms would be required. All in all, fair, sensible and productive for all Americans.

News that Pfizer, the world’s largest pharmaceutical company, plans to buy Britain’s AstraZeneca for $106 billion, renounce its U.S. citizenship, and declare itself a British company, has jolted Congress.

Pfizer is being denounced as disloyal to the land of its birth, and politicians are devising ways to stop Pfizer from departing.

Yet Pfizer is not alone. Hedge fund managers are urging giant corporations like Walgreens to go nation-shopping for new residences abroad to evade the 35 percent U.S. corporate income tax.

Britain’s corporate income tax is 20 percent, and Pfizer stands to save over $1 billion a year by moving there.

In what are called “inversions,” dozens of U.S. companies have bought up foreign rivals, and then moved abroad to countries with lower tax rates, cutting revenue to the U.S. Treasury.

But Pfizer is far and away the biggest.

The real question, however, is not why companies are fleeing the USA, but why our politicians continue to drive them out of the country.

Consider. Here in America we do not tax charities, churches or colleges. Yet these institutions produce a fraction of the jobs that businesses produce.

If, as a nation, we are committed to “creating jobs,” does it make sense to impose the highest corporate tax rate in the Western world on our biggest and best job creators?

Is this not economic masochism?

A nationwide movement is underway to make fiscally conservative states even better positioned to lure business. Texas, as usual, is a leader, and South Carolina is charging forward. Here the WSJ brings you the good news. I like what I read. And I have long been championing a movement to strip the federal government of a broad array of responsibilities and turn these responsibilities over to the states. My broader plan involves putting the individual states in a powerful position to compete for business as well as new residents, such as retirees and families seeking school choice and family protection under, by example, Castle Doctrine protection. One of the initial federal agencies I would shutter is the Department of Education.

Michael Quinn Sullivan is a proud Lone Star son—on his desk he keeps a map that shows “Texas” and “Not Texas.” That helps explain why the conservative activist is leading a charge to use this year’s election to “trade up” Texas politicians, replacing the state’s already conservative majority with new Republicans, all raring to propel Texas to the front of the state-reform movement.

“Texas has things to be proud of,” says Mr. Sullivan, who runs Empower Texans, a political group that is playing big in the state’s primaries. “Then again, we’re like the least drunk guy at the bar. California is drooling on itself, Illinois is passed out in the corner. We look good simply because we can walk a straight line. We should be leading the way.”

The trade-up strategy is the defining feature of this year’s state races. The GOP emerged from its blowout 2010 midterm with extraordinary local power, and today boasts 23 states in which it controls both the governorship and entire state legislature (in some cases with supermajorities). Yet grass-roots activists have grown frustrated that many of the most solidly conservative parts of the country have sat out the state-reform push that has produced tax cuts, pension reform and education overhaul.

This midterm, conservatives are targeting the bottlenecks—going after lackluster Republicans in primaries, rallying around free-market gubernatorial candidates, and working to get final numbers for majorities or supermajorities in key states. One model here is Kansas, where a group of a dozen statehouse Senate Republicans balked at Gov. Sam Brownback’s aggressive tax reform. Conservative groups mobilized, and in the 2012 primaries nine of the 12 were defeated in primaries by more-conservative challengers.