From stockpiling to living off the grid, more Colo. residents preparing for disasters

COLORADO SPRINGS, Colo. — Four families in Yoder are building a sand bunker and stockpiling ammunition and weapons.
A Black Forest resident has erected a geodesic dome on her 5-acre spread to grow vegetables, keeps horses for emergency transportation, in case she can't get gasoline for her car, and plans to acquire chickens and goats as food sources.
A husband and wife who have a cabin on 100 acres of secluded land in Park County have weaned their property from the electric grid, acquired a three-year food supply and taken other measures to become self-sufficient.
While there's little threat of the earthquake and tsumani that rocked Japan last month in landlocked Colorado, other epic crises on the home front are possible: A flood or fire. A terrorist attack. A nuclear weapons launch. World War III. Or an apocalyptic-type scenario.
An increasing number of people say they are getting ready.
"More people are getting into the survivalist mode. I've been in business 30 years, and I've never sold so many assault rifles as now. The last year was the best we've ever had," said Mel Bernstein, a Class III weapons dealer and owner of Dragon Man's shooting range east of Colorado Springs.
Israeli gas masks, helmets and sand bags also have been selling well, he said.
"People are putting stuff away in case something big happens," he said. "I think it's superstition, but it's been good for business."
Interest in the survivalist movement has been heightened, many say, by global turmoil.
The ongoing strife in the Middle East, the lingering possibility that the Obama administration will enact stricter gun laws and the sustained economic downturn, coupled with political unrest in Libya and Japan's nuclear catastrophe, have made people uneasy.
In addition, doomsday prophesies by Nostradamus and the Mayans pinpointing 2012 are distressing for some. There's also a group of Christians who say they've determined that the end of the world will begin on May 21.
"People are afraid, and they want to be able to protect their families," Bernstein said.
Y2K — the dawning of the third millennium — brought forth a fury of survivalist instincts, as many believed the nation's network of electric connections and computer systems would crash.
The terrorist attacks of Sept. 11, 2001, raised concern among even the complacent.
But this time in history feels more urgent, say those who identify themselves as "preppers" — people preparing to have all they need to sustain a catastrophe.
"There's a distinct possibility that some other country could wipe out our electronics and computers, and the U.S. infrastructure is not ready — it would take six months to rebuild a transformer," said Bob, a retired engineer who said he designed airplanes, power plants and aqueducts for the government.
He asked that his last name not be used because he shares a philosophy common among preppers: the desire for anonymity. Not everyone understands why they're doing what they're doing, Bob said, and there's the possibility of others looting their stockpiles.
"Preppers will give someone a pound of rice and a bowl of soup, but we'll defend ourselves against people who are going to take everything we have," he said. "We're doing this to make sure that we can live the way we've been living and we're not going to be out there scrounging or stealing food from others."
Bob, who owns the cabin in Park County, said he used to be, as he says, "at peace" with the American government, but now, he said he is distrustful.
"It's like the government and law enforcement are bullies. They won't take care of us.
The dollar will crash, and the average American only has enough groceries in their house for three to five days. When it all goes to heck, what's going to happen?" he said.
While they say they're not among those on the fringes, preppers are doing more than just having a few extra provisions on hand.
"I believe in preparing for the worst and hoping for the best," said a 69-year-old Black Forest resident who said she goes by the name Annie Oakley, a legendary 19th century American sharpshooter who performed in Buffalo Bill Cody's Wild West Show. She declined to provide her real name because, she said, she too is fearful of being misunderstood and robbed.
"I was never a doomsday person. But with the way our society, our economy, our water problems, our dependency on oil are going, getting back to the basics makes a lot of sense," she said.
She said she has spent about $16,000 so far on prepping. After watching futurists discuss the world's overpopulation, declining financial situation, decreasing fossil fuels supply and other problems on a television program about three months ago, she said she got busy.
She bought a geodesic dome to grow vegetables, a solar generator to help get off the grid and a torpedo bucket to draw water from her well if the electric pump isn't functioning. She also began storing nonperishable food.
Chickens, goats, composting, grain grinders and a full-blown solar or wind power system are next. She also plans to acquire weapons for protection.
"I'm looking at the worst-case scenario to defend my resources. The end goal is to have food and clean water, stay warm and be self-sufficient," she said. Before retirement, she worked in the low-income housing division of a city in Southern California.
"A lot of people — and it's just human nature — think 'Oh, it'll never happen.' Or, 'Someone will take care of us.' Look what happened during (Hurricane) Katrina. You're going to be on your own."
But preppers want to band together. Bob has amassed 22 families who are interested in storing food and other essentials on his spacious mountain compound and congregate there in an emergency.
"We're ready, and we're looking for other like-minded people. So we're connecting and networking with people who are into pooling their talents," he said.
The woman who goes by the name Annie Oakley also is hooking up with fellow preppers via the Internet and in her neighborhood.
"It's like a support group. You share ideas, and there's strength in numbers," she said.
"It's hard to envision life without all the conveniences. But we can survive if we're ready. It's like the Boy Scouts say: Be prepared."
Bernstein, too, has heard of small survivalist-type groups forming, including the Yoder families who are building a sand bunker and studied a simulated machine-gun bunker Bernstein has on display in a military museum on his property.
One man in the group visits Bernstein every week to buy 1,000 to 2,000 rounds of bullets, Bernstein said. The man declined to be interviewed.

Ten signs of an impending bust

Where will the next crash emerge from? I don't know, but I do know the past few years have challenged the efficient markets nostrum that you can never know a bubble until it bursts. Actually you can. So here are my Easter tips for bubble trouble, any combination of them will make the "recovery" we have had so far look like the best party anyone's had since Oliver Reed died.

1 Chinese real estate

Take a number, double it and add 42 per cent and you get the rough annual rise in Chinese property prices. It's chaotic and exhilarating and frightening. This one easily passes the duck test; it walks like a crash waiting to happen; it talks like a crash waiting to happen, and it quacks like a crash waiting to happen. Investors, or more accurately speculators, can still make plenty of money out of it because no one knows when it will go pop. But for policymakers, the important point is that it will in due course go pop, and the consequences will be grim. Unlike the West, which suffered its own failures of transparency, the state-sponsored Chinese banks have even less incentive or obligation to put their bad debts into the public domain, but they will feel pressure. True, many Chinese homes are bought for cash, but someone somewhere in the financial system or the household sector will suffer from the usual consequences – collapses in confidence, the construction sector and confidence in financial institutions. It will stall one of the few storing engines of economic growth and, perversely, make China more dependent on her exports – the last thing we all need.

2 Commodities

If Goldman Sachs says it's all over, that's good enough for me. This is not all bad news; it will mean that the Bank of England will see its inflation forecasts come right next year as the "baseline" effects feed through powerfully, as they did in 2009. Four months after telling clients to invest in their "CCCP basket" – crude oil, copper, cotton and platinum – GS now says that the 25 per cent gain since January is the last puff of steam, and "in the near term risk-reward no longer favours the basket". A collapse in commodity prices would do the "real economy" no harm, but again risks destabilising the financial sector. At any rate we might then find out just how important speculation has been in driving prices skywards. As Warren Buffett said, when the tide goes out you can see who's been swimming without their trunks.

3 Exchange traded funds

As I was saying about speculation... For quite a long time I, rather dozily, thought these were just a harmless diversion for naive domestic punters to attempt to make and usually lose money on markets they usually found it difficult to gain exposure to, including, predictably enough, commodities. As a proxy for the real index, and thus the real materials behind the index, they are a derivative, at which point the alarm bells ought to start ringing. Yes indeed, they are more than a little like the asset-backed securities that grew on the back of the U S mortgage market and caused all that trouble a couple of years ago. Yet again we have poorly understood "synthetic" financial instruments growing far beyond their underlying assets, only this time, one hopes, not perched perilously on the back of easy money by highly leveraged outfits hoping the taxpayer will bail them out if things get rough. Then again, can we be sure?

4 Emerging market bonds

This oddly enough, is because of inflation in the emerging markets , often forgotten as we fret about our own inexorable rise to a 5 per cent annual rise in prices. In India, China and Brazil, inflation is running rather higher than that, and they have been hiking rates and ordering the banks to restrict credit to get a grip on it. Sky-high interest rates imply plunging bond prices, sooner or later. Not that any of these nations apparently have much trouble funding themselves; but they might conceivably find economic life generally trickier if they don't get a grip on consumer price inflation (leaving aside the asset price inflation in other areas of their economies).

5 Emerging market equities

We in the West have to put our money somewhere, and the "search for yield", or at least capital gains, have pulled huge flows of capital into the trendy emerging markets. OK their economies and their companies are growing fast, but the general rule in such environments is that they have a lot of ups and downs on the way to world domination. Will western investors have the balls of steel not to run?

6 American sovereign debt

You heard the Standard and Poor's warning, and it meant it. With some $14trn of national debt, about $5trn of it owed to foreigners, a debt devaluation would destroy wealth globally on an epic scale. Far worse than a euro meltdown, bad as that will be.

7 American property

It isn't over, basically. Even now, US real estate values in the darkest corners of the property market where the worst sub-prime selling practices were perpetrated are still mounting, which means the still-large stock of "toxic assets" based on them held by banks, insurers, pension funds and governments are not going to come good soon. The worst may be over, but it isn't helping the US recover its mojo. Put it this way: if this is what happens after a couple of trillion dollars have been pumped into the economy via fiscal and monetary easing, what happens when the US starts to fix the deficit and raise interest rates on those unaffordable mortgages?

8 European banks

The IMF stated it quite bluntly: fully one-third of European banks, representing 25 per cent of the total assets of the system, are operating with inadequate capital. Any deviation for European sovereign bonds, either through the usual crisis-type dumping on to reluctant markets or through formal defaults, would trigger what economists euphemistically refer to as "negative feedback loops", with further losses and banks drawing further on national treasuries and pushing public debt still higher, as Ireland recently found. Even if the euro survives, it will be ugly.

9 Japanese sovereign debt

How do you fund a national debt running at 200 per cent of GDP? Answer: get yourself a crazily pessimistic hard saving workforce that uses domestic financial institutions like the Post Office Bank and who patriotically subscribe to government bonds with virtually nil return. Common sense and demographics tell us this cannot persist. The worldwide trend to higher rates might eventually push up the cost of debt servicing in Japan, or make foreign securities more enticing. No less destructive, though much slower, will be the ageing of the baby boomer generation that will become pensioners instead of savers. In a nation notoriously resistant to immigration, it is a poor prospect. Long before the US, Japanese debt was being disparaged by the debt rating agencies; further downgrades this year, uncharitable as it may seem at such a traumatic time, could trigger a panic.

10 Deflation

That is to say, not inflation, which is the usual worry for the West. You'll have noted by now that most of the risks I mention are to asset values. Or, to put things another way, the inflationary risk that was supposed to have shown up in consumer prices has not done so because it has all been channelled into new asset price bubbles of one sort or another – see the chart. It is tempting, and not entirely wrong, to attribute this to the massive programmes of monetary easing that have been undertaken by every major central bank in the world. You don't have to be a hard-line disciple of Milton Friedman to see that such an increase in the quantity of money chasing a finite or highly inelastic quantity of asset classes is bound to ramp their values. Indeed, this was freely admitted by the Bank of England among others at the time – it wanted to deflate gilts and to inflate the value of equities and corporate bonds, thus making them more attractive to investors and helping companies to raise cash and rebuild balance sheets. If and when it goes into reverse, it will mean a certain amount of asset price deflation; if this is not managed skilfully it might well trigger the debt-deflation nightmare we postponed with the globally co-ordinated fiscal and monetary boosts in 2009-10. We didn't escape the pain; we just delayed it.

Maybe you think some of this far fetched, but surely I get 10 out of 10 for pessimism, anyway.

Into The Economic Abyss

Over the past few years, mainstream analysts have shown a tenacious blind faith in the U.S. economy and the dollar that goes far beyond religion to the point of mindless cultism, so, when even they begin to question the future of American finance (as has been occurring more and more everyday), you know its time to worry. For those that have been following my work since 2007, the events of the past few months have not been a surprise at all, however, for those just waking up to the ongoing implosion of our fiscal infrastructure, the bubbling inflationary meltdown just over the horizon and the nightmare unfolding around our national debt is rather shocking. Living through a full spectrum catastrophe is, to say the least, confusing, especially when you have no idea where the whole thing began.

Until now, the mainstream media has provided nothing but economic fantasy for the masses. They have satiated the public with what amounts to financial toddler talk for helpless preschool minds averse to any research beyond their daily 15 minute sippy cup of New York Times, CNN, MSNBC or FOX cable news sound bites. I mean, have you ever actually stopped and read a Paul Krugman article more than once? Or listened carefully to an MSNBC economic piece? It’s like being violently accosted by a band of slobbering mental deficients with securitized ARM mortgages stuffed in their pants. Of course, fewer and fewer people are now buying what these hucksters are selling. With gasoline nearing $5 a gallon, grain prices doubling, and shelf prices beginning to skyrocket, it’s hard for even the most ignorant suburban schlep to remain oblivious to the problem anymore. We are no longer on the edge of the abyss; we have fallen into it head first…

I make this statement not for effect, not to startle people out of their apathy, not even to illustrate what “may” be coming around the bend in the near future. I make this statement as directly and sincerely as I know how; we have indeed crossed the line between economic weakness and economic catastrophe. For those of you who have been asking when the final stage of the economic collapse will begin, that time has arrived. Here is why…

Energy Inflation Overdrive

Here’s how to tell when inflation is about to run out of control in your country; wait for the politicians and bankers to begin making excuses for its consequences instead of pretending it doesn’t exist! Remember after the initial 2008 spike in oil prices when we talked about the prospect of “speculation” as the culprit? Remember also that I have pointed out for the past three years at Neithercorp Press that when the dollar eventually began to crumble, and the price of crude began to spike again, the government would try to blame speculators as the scapegoat hoping that Americans would assume the situation today was the same as it was in 2008?

http://neithercorp.us/npress/2010/12/oil-juggernaut-unleashed/

Well, guess what? The Obama Administration has just initiated the first volley of “speculation” propaganda talking points by tapping the Department Of Justice among others to “investigate” possible trader fraud and speculation in the price destabilization of oil:

http://www.bloomberg.com/news/2011-04-21/obama-says-u-s-team-to-study-whether-speculators-driving-up-pump-prices.html

Ah! So it’s those devious “traders” and “speculators” out there in the ether that are driving up the price of oil, and don’t worry folks, ole’ Barry is on the case! Little mention of OPEC’s general distaste for current U.S. activities in the Middle East. And certainly, no mention of the dollar’s continuous sharp decline over the past two months from the White House as being even remotely responsible for you being robbed at the gas pump. The dollar, despite intervention by G7 countries, continues to depreciate against the Japanese Yen, and has also slid to a 15 month low against the Euro:

http://www.rttnews.com/content/CurrencyMarket.aspx?Id=1597070&SimRec=2&Node=

At the publishing of this article, the Nymex crude index is at around $113 a barrel, while the Brent crude index stands at $124 a barrel. Gasoline prices across the country are averaging $3.50 to $4.00 a gallon. Now, some crazy individuals out there may question any overt concerns towards $120 or even $150-a-barrel crude. We survived it back in 2008, right? Why not today? However, this fuzzy logic depends greatly on a very unfortunate premise; that the economic atmosphere of today is the same as it was in 2008. Not even close…

The crude explosion in 2008 lasted for around six months, peaked at around $4 a gallon, and then ended with a deflationary-like plunge precisely because that price spike WAS (for the most part) caused by speculation. This time, expect no peak. Only an endless steady climb as the summer months progress. We have been calling for an increase in oil costs far exceeding the $150 a barrel achieved in 2008 and we stand by that prediction.

Negative aspects of energy inflation will take hold much faster than in 2008, primarily because our economic foundations are even weaker than they were three years ago. Today, we not only have a massive and unsustainable national debt, and a credit crisis still unresolved, but also a privately controlled Federal Reserve with no oversight running amok, printing non-stop since the derivatives bubble first popped. Not even the dollar’s fake reputation as a safe haven investment can stall the collapse now.

High energy costs hit every conceivable sector of the economy, from freight, to food, to vacations, to housing. People drive less when it costs them twice as much to do so, which means less shopping, fewer trips to Disney World, and second thoughts about moving to a new home in a new state. The cost of producing goods hits wholesale prices, which eventually hit retail prices when corporate chains are no longer able to absorb the increases. Your electric and heating bills take a bite right out of your tender behind. All of these factors will snap the thin thread our system is clinging to. America, as we know it, WILL NOT survive $5-$10 gas. Period.

To Default, Or Not To Default

Should the debt ceiling be raised? Should it be frozen in place? Frankly, in the short term, these questions are irrelevant. In either case, the taste and feel of the resulting chaos will be the same. Holding the debt ceiling in place will at least (in theory) stop the Federal Reserve’s printing bonanza. If the Treasury can’t continue borrowing from the Fed, then the Fed has no means to continue creating debt or fiat (my suspicion though is that they would find a way around this). A national default would result. The U.S. Treasury Bonds held by governments around the world would become essentially worthless, the dollar would lose its reserve status, plummet in value, and hyperinflation would result.

If the debt ceiling is raised yet again, the Fed will persist in its quantitative easing programs until the dollar is dust, or foreign central banks lose all interest or respect and begin a dollar/treasury dump, again resulting in hyperinflation or Stagflation. Today, news has hit the wire that officials in China are discussing a reduction of their large forex (Foreign Exchange) reserves to around $1 Trillion and diversifying away from the Greenback:

http://news.xinhuanet.com/english2010/china/2011-04/23/c_13842843.htm

To put this in perspective, China currently holds around $3 Trillion in various bonds and currencies, a large portion of them U.S. dollars. This means that China is now considering cutting its reserves by over two-thirds! Can you guess where the majority of those cuts are going to come from…? This is devastating news for the dollar!

It is perhaps not a coincidence that this news comes right after the S&P changed its debt rating outlook for the U.S. to negative. At the beginning of this year, the Obama Administration and the Treasury made it clear that rating agencies would be ignored when it came to their analysis of the American debt situation. Rather convenient since this was right before U.S. default became a stark reality in the face of budget battles and the falling dollar. Ironically, despite the government’s insistence that ratings agencies views no longer mattered, the White House still attempted to pressure the S&P to back down from its recent announcement:

http://www.foxnews.com/politics/2011/04/20/obama-officials-tried-convince-sp-issue-credit-warning/

Fitch has also warned that the U.S. “official” debt to GDP ratio is around 100%, an impossible position for any nation to maintain and still hold onto a AAA credit rating. As long as we continue to spend at the rate of a trillion dollars or more a year (not counting Fed stimulus spending which is mostly unknown), and the so called GOP leadership is willing to compromise cuts down to a pathetic pantywaist $38 billion, you can bet the ratings outlooks will grow much worse in the coming months. That said, if you see what I see; the endless stream of evidence asserting a deliberate destruction of the U.S. economic structure and the dollar as a pretense to remove it as the world reserve and replace it with a basket of currencies under the control of the IMF, then the government’s seeming fiscal madness and its complete inability to heed the wishes of the people it is supposedly tasked with defending makes perfect sense. To put it simply, they represent globalist interests, not our interests. Shocking….I know. But then again, I’m just a crazy kooky conspiracy theorist doom monger terrorist puppy killer….

But at least I’m not a liar…

Alternatives: Ours And Theirs

Nothing scares the hell out of me more that $1500 an ounce gold and nearly $50 an ounce silver. I mean, I’ve been predicting it since the credit collapse, and I’ve been begging people to buy precious metals for the better part of three years. Its one thing to know that such inflation is coming, but it’s another thing to witness it first hand. If you took my advice to buy silver back in November of 2010 at $25 to $27 an ounce, for instance, then your investment has just doubled. It’s barely been six months!

http://neithercorp.us/npress/2010/11/silver-still-the-investment-of-a-lifetime/

Despite incredible market manipulation, precious metals have fought back and are now on the path to historical highs. Even if you are a holder of PM’s, though, this is not good news for the country.

There are two reasons why international banks like JP Morgan have consistently manipulated the market value of gold and silver down (and been caught in the act). First, global bankers strive to remove all competition from any economic system, and this includes forms of currency. Gold and silver have long been competing forms of currency to fiat paper. Therefore, banker attacks on metals are a given. The less viable gold appears to be as an investment, the less people will take it seriously as an alternative to the dollar. You must be forced to believe that only dollars hold “tangible value”, otherwise, Americans would realize they don’t need the dollar (or any fiat currency) at all.

Second, commodities like gold and silver are traditionally prime indicators of inflation and dollar devaluation. Skyrocketing commodities mean poor monetary policy. Thus, manipulation of metals downwards helps to hide poor monetary policy. The doubling of silver in only six months despite this manipulation, along with the doubling of most other commodities in the past two years, is not just a sign of destructive inflation, it is a guarantee.

As the dollar heart attack nears a climax, many individuals as well as sovereign states are turning towards precious metals and alternative markets as a way to hedge against a Weimar-style fiscal fiasco. At the same time, globalists are introducing their own “solutions” into the mainstream. Joseph Stiglitz of Columbia University has come out against the dollar, calling for an end to its world reserve status as well as the implementation of a new “global system”:

http://www.bloomberg.com/news/2011-04-10/stiglitz-calls-for-new-global-reserve-currency-to-prevent-trade-imbalances.html

George Soros has done the same at his Bretton Woods II conference, which received almost no initial publicity despite four major journalists on the speaking list, including the editors of both Reuters and The Times, calling for the “global regulation of financial systems”, as well as the formation of a “New World Order”:

http://www.guardian.co.uk/politics/2008/nov/14/g20-summit-key-aims-imf

So, you have the American people pulling towards transparency and sovereignty, and you have the globalists pulling towards more secrecy, more unaccountability, and more centralization. Story as old as time, right? Perhaps the stakes are higher this go-around…

If global banks have their way, we are facing, at minimum:

Full Housing Collapse

Full Credit Collapse

Grid Failures

State And Municipal Defaults

National Default

Energy Crisis

Food Crisis

Civil Unrest

Increased Crime

Reduction Of Civil Liberties

Martial Law

How these incidents play out in the end is dependent upon the reactions of the citizenry. Placation will result in the complete loss of Constitutional freedoms. Rage could result in civil war. There are no easy answers. There are no magic bullets that remove all obstacles. This IS the reality we are facing in the near term, and there is little left to question. I am personally shifting away from economic analysis because I feel that the problems are so numerous and so evident that it makes little sense for me to point them out much longer. The elephant in the room has been noticed.
<!--[if !supportLineBreakNewLine]-->

<!--[endif]-->If ever there was a time for solutions and action, it is now. From my perspective, the best bet for short term protection against inflation and dollar collapse is for communities and hopefully states to begin decoupling from the diseased system entirely. This means localized markets, self sustained neighborhoods and towns, as well as sound money legislation and nullification bills at the state level. It means average Americans taking responsibility for their own food, energy, money, and defense. It means pursuing the exact opposite of what international bankers are suggesting; a global version of the Federal Reserve with prolonged fiat slavery.

Again, we have crossed the line. Every concrete economic signal and index I know of shows the avalanche is no longer building but in progress. Prepare now, or not at all.

A Good Poem For Trying Times Like These.............................

Invictus

by William Ernest Henley

Out of the night that covers me,
Black as the pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds and shall find me unafraid.

It matters not how strait the gate,
How charged with punishments the scroll,
I am the master of my fate:
I am the captain of my soul.

Now That's A Rant!!!!!!!

.

4.190475

 

But Not Sufficiently Sacred for Physicians to Work for Free

Paul Krugman today sneeringly asks

How did it become normal, or for that matter even acceptable, to refer to medical patients as ‘consumers’?  The relationship between patient and doctor used to be considered something special, almost sacred.  Now politicians and supposed reformers talk about the act of receiving care as if it were no different from a commercial transaction, like buying a car.

Krugman here taps into the antediluvian hostility toward bourgeois modes of providing for one’s self and one’s family.  This ancient prejudice holds that ‘mere’ commerce might be acceptable to govern the production and distribution of trifles such as candy and cars, but it’s too crass for goods and services that tradition or elites declare should be untainted by such sordid, competitive activities.
If consumer choice isn’t the ultimate driver of health-care supply, however, what – or who – will be its ultimate driver?  Health-care suppliers?  Congress?  Government bureaucrats?  Princeton dons?

Admittedly, the politically engineered wedge separating the receipt of health-care services from the responsibility for paying for these services creates problems.  But the best way to address these problems is to remove the wedge rather than to arrogantly suggest that some mysterious transcendent force will more reliably look after individuals’ health-care needs than will those individuals themselves as they operate in markets in which insurers and physicians must compete for consumer dollars.