What's Not So

Is It Healthcare Reform—or Life Support for Insurance Companies?

The private health insurance industry is in trouble and needs a major ongoing transfusion of cash from government to survive.  This essential truth has been deliberately buried under the constant blizzard of lies about healthcare.  

 

Health insurance companies face a serious problem.  Expensive new medical treatments introduced over the years have impaired their once viable business model.  After thriving for many years, the health insurance business as we know it is fast becoming unsustainable.  Rising costs are driving up insurance prices, causing an ominous downward spiral of declining enrollment.

Don't unplug Granny to plug in healthcos

Now that we've all had a good laugh at them, it's time to note that those oldsters railing to Congress to “keep government away from my Medicare” may be misguided, but they actually have a legitimate point. The phony 'reform' being foisted on us by the healthcos will need $1 trillion to pay new subsidies to insurance companies. The 'reform' plan says it will secure half of that by making huge "savings" in Medicare, which can only be done by making drastic cuts in benefits - so the demand to "keep government away from my Medicare" is not so crazy after all. And those weird wingnut ads showing that 'reform' will kill old people are actually correct, if not in the way they claim. Big Medicare benefit cuts imposed by 'reform' will likely in fact cause numbers of retirees to die for lack of care.

Forget the public option. It's one of the biggest bait-and-switch scams in the history of the world.  Go to www.pnhp.org, search for "bait and switch", and read both articles by Kip Sullivan. The whole 'healthcare reform' scheme is corrupt from start to finish - it's life support for the healthcos being passed off as 'reform', so the "public option" has already been eviscerated so as not to threaten them.

DEMAND single payer Medicare For All, HR 676. Rep. Anthony Weiner a week ago extracted a committment from Waxman and Pelosi allowing him to put it on the floor of the full House for debate and vote. See the 2-minute video of this historic exchange here http://www.youtube.com/watch?v=H0fA2DfwFn4 Amazing that there has been almost no coverage of this on anywhere. Send free faxes to your Washington representatives tosupport HR 676 from http://www.1payer.net

 

Does "healthcare reform" signal the end of democracy in America?

"Democracy,” someone said, “is the last stage of government before oligarchy.”

The so-called healthcare reform being rammed through Congress by and for the healthcos confirms that we have made the transition to oligarchy. Single payer is “off the table”, even though it’s wanted by most voters and physicians, many state legislatures including those of Maine, New Hampshire and Illinois, the U.S. Conference of Mayors (by unanimous vote), the Maine Medical Association, Obama’s long-time personal physician, many civic, labor and religious groups, etc., etc.

Single payer Medicare for All is uniquely American, efficient and ethical, costs less than our present system, and covers everyone. The 27 pages of Medicare For All HR 676 define it. In contrast, the corrupt bills now being pushed through Congress are over 1000 pages long, mandate forced purchase of insurance, pay tax-payer funded subsidies directly to insurance companies, will add more than $1 trillion to the national healthcare bill over the next ten years, and STILL will leave millions with no coverage.

But this phony “reform” will add revenues and profits for the healthcos, so they want it and therefore it’s what we will get. By suppressing even discussion of single payer, the healthcos have diverted debate to fantasies of a “public option”, perhaps the biggest bait-and-switch scam in the history of the world: http://www.pnhp.org/blog/2009/07/20/bait-and-switch-how-the-%E2%80%9Cpublic-option%E2%80%9D-was-sold/

Rally for single payer in DC on Thursday. Here's how: http://www.democrats.com/node/19877

 

The Healthco Lobby Rolls On

A conference on healthcare will be held in Boston on February 26:

"The Transforming Healthcare Summit 2009: Impact & Opportunity in the Obama Plan"

This is clearly part of a well-oiled effort by the healthco lobby to steamroller acceptance of the “Obama Plan”, which will increase subsidies, taxes, mandates, intrusion into our personal lives, industry regulation, and the total national cost of healthcare.

Bill Moyers Drubs Pols on Healthcare

Politicians, including Obama, Clinton and McCain, get the drubbing they deserve in this excellent piece by Bill Moyers on our broken healthcare "industry".  Watch it here:

http://www.pbs.org/moyers/journal/05092008/watch.html

It remains mysterious why Obama in particular doesn't grab hold of this issue and respond to voter demands for Single Payer HR 676.  What is he thinking? 

The bad news on the Massachusetts plan is starting to come out: it has cut the ranks of the ininsured by only 50%, leaving many uninsured, and it is a fiscal disaster. 

It's what you get when you respond to the cry for universal coverage with mandates, subsidies, government intrusion into private lives, higher taxes and increased government regulation of the industry, with higher total costs and more hassles for employers, all just to keep the insurance companies in the picture.

Anything resembling the Massachusetts plan will be political poison come autumn---and that is what both Clinton and Obama are proposing. 

Obama On Healthcare: Still Getting It Wrong

Indiana will hold its primary on May 6.  The KPC Media Group, a collection of dailies and weeklies in NE Indiana, interviewed Obama.  Here's their Q&A on healthcare:

KPC: Health care is an important issue for most voters. More and more physicians are turning to national health insurance as a solution to our health insurance coverage gaps. According to a survey reported last month by Indiana University, of more than 2,000 doctors surveyed, 59 percent said they support legislation to establish a national health insurance program such as “Medicare for all” to insure all Americans. Why do you think your plan which continues our current patchwork of both public and private insurance is better than expanding Medicare into a “Medicare for all” universal health insurance plan?

Obama: I have said in the past if I were designing a system from scratch I would probably prefer a single-payer system. I think the administrative advantages are significant and by having patients in a single system they are much more likely to benefit from preventive care because the person providing the care has an incentive (to keep people in the system well). There are significant advantages.

The problem is we are not starting from scratch. A sizable percentage of the population gets health insurance from their employers and I think we are going to have to see changed attitudes before we would see a single payer system. I also think there is some advantage to the marketplace being involved and increased competition. So I have said if you are in an employer based plan currently, then we will work with your employer to lower premiums. If you don’t have health insurance then you can buy into a plan that is similar to the plan I have as a member of Congress, and there won’t be exclusions for preexisting conditions. If you can’t afford the plan, then we will subsidize you.

There will be tight regulations on insurers to make sure that we are reimbursing for preventive services, that we are emphasizing the management of the care of the chronically ill more effectively and that we are investing in information technology to reduce bureaucracy, reduce error and improve quality. If we do all those things, we can save as much as $100 - $150 billion per year that we can then use to subsidize those currently without care. These principles have to be applied to Medicare and Medicaid, as well...

This is the most effective way to provide the help people need immediately, and I think this is something we can accomplish within my first term as president of the United States of America.

Interesting that KPC quotes the very significant recent poll showing a clear majority of doctors (at last!) favoring single payer. Too bad KPC does not also cite one of the polls showing that a clear majority of citizens (not just doctors) also favors single payer, and has for some time.

Barack responds with his standard answer: "if I were designing a system from scratch I would probably prefer a single-payer system." ["Probably?" He came out strongly for single payer in 2003.  What's happened since?]   He then as usual goes on to say in essence that the reason we can't have it is that we already have something else. The illogic of this is staggering.  Can you imagine saying that about passing the Civil Rights Act in 1964, or granting suffrage to women before it was done? 

Too bad KPC let him off the hook so easily, instead of boring in with followup questions. When he says "I think we are going to have to see changed attitudes before we would see a single payer system," he implies he is referring to the attitudes of citizens, but that can't be right: the polls show they want single payer.  Can't be the doctors either, as the poll cited by KPC shows. 

So exactly whose "attitudes" is he talking about?  The insurance companies?  Never.  They will never favor letting go of their $950 billion per year revenue stream.

The only "attitudes" that need to change are those of politicians, like himself, who are either already bought by the insurance companies or who fear their wrath.  Joe Biden was at least honest about this: he does not advocate single payer for fear of being "eaten alive by Harry and Louise."

KPC also lets him get away with the standard red herrings about "the marketplace" and "competition," and therefore, among other things, to gloss over the incredible inefficiency of the private insurance based system, which will be even worse when more heavily "regulated", as he proposes. But what's most wrong here is the very idea that healthcare is suitable for "the marketplace".   If it were, it would not need the subsidies and mandates he proposes to add: additional patches to the present patchwork.

When even a free market champion like Friedrich Hayek accepted that collective action, not "the free market" is likely to be the best solution for healthcare, why does KPC let anyone advocate otherwise without at least questioning that advocacy?

Both sad and puzzling about the healthcare position taken by both Hillary and Barack is how damaging it is likely to be to their party's prospects in the general election. As fragile as a house of cards, it will be swiftly demolished by attacks from both left and right, and will serve only to distract from serious Republican vulnerabilities.   

The HillBar Healthcare Plan Could Cost the Dems the Election

"The HillBar Heatlhcare Plan Revealed" showed that the complexity, cost and government intrusion common to the health plans of both Hillary and Barack leave them wide open to attack from both the left and the right, making it unlikely that either will ever be passed.  And it seems to me that both Barack and Hillary are missing an opportunity to differentiate themselves by changing course and coming out for HR 676, a move that would boost their prospects by putting themselves on the side of the angels vis-a-vis healthcare and opening up an easily won debate.

But until I saw Miles Mogulescu's entry yesterday on Huffington Post, I failed to notice a more portentous implication of the crazy quilt "HillBar" plan: it gravely threatens Democratic election prospects in November. As pointed out by Miles, McCain can tear into the mandates of the supposedly "politically safe" HillBar plan like a buzz saw:

So here's what John McCain will say to a candidate running on a mandate plan: "The Democrats want to punish the middle class with a backdoor tax. If you're an uninsured family and make over $40,000 a year so you aren't poor enough for subsidies but can't afford insurance, the Democrats will fine you or garnishee thousands of dollars of your wages since the average policy for a family of 4 is $12,000." That should be enough to scare off millions of middle class families from voting for a Democrat.

The economics of middle class families will dominate this election, and the HillBar plan hands McCain a club he will use for bashing the Democrats on middle class economics, drowning out other critical economic questions where his positions are untenable. He can easily--and correctly--expose the complexities and the economic idiocies of the HillBar plan. It could cost the Dems the election.

Take a look at the excellent postby Miles, and also the earlier posts he links to. 

U.S. Health Care Gets Boost From Charity

For once, the media turns its spotlight on something real.  This "60 Minutes" segment shows the sad state of U.S. healthcare: for many, it's at a third world standard.  Every time you hear abour those "long waiting lines" in Canada, send people to this:

http://www.cbsnews.com/stories/2008/02/28/60minutes/main3889496.shtml

http://www.ramusa.org/

How To Reach RAM:
Remote Area Medical Foundation
1834 Beech Street
Knoxville, TN 37920
865-579-1530

Shout Out for Single-Payer Healthcare

Many people have no health insurance coverage. Unpayable medical bills cause about half of personal bankruptcies. Of these, three quarters befall people who actually have insurance at the outset of their illness, only to find themselves overwhelmed by costs not covered due to treatment denials, high co-pays, coverage limits, or ex-post-facto cancellation of their policies. All this, and our total health care bill is still twice what Canada pays per capita, 2.5 times what Great Britain pays, and they both cover everyone fully.  Even if you don’t like Michael Moore, be sure to see “Sicko”.  Don’t miss the DVD extras on the moral dimension to the healthcare question. Also, see the film “John Q”, with Denzel Washington.

House Resolution 676, the single-payer ‘Medicare for All’ bill now before Congress, would deliver universal healthcare for everyone for the same total cost we pay now, and with more choice of providers, not less, as is often falsely claimed. As with Medicare, private providers would be paid from tax collections, which cuts out the insurance companies. HR 676 somewhat resembles the Canadian system, with twice the funding.     

Obama and Clinton agree that single-payer is the best system, but both say it’s “politically impossible”. It is absent from their healthcare plans.  Both keep the insurance companies involved, actually adding subsidies from US taxpayers to the premium payments flowing to the insurance companies.

Why?  That’s not what voters want.  When polled, most voters say they prefer universal, single-payer health insurance, like that of HR 676.  But the insurance companies strongly oppose any move to single payer. Going to single payer would shut off the torrent of cash flowing in to them, so the insurance companies divert a fraction of that cash flow to buy the votes needed to block it—contrary to the wishes and the interests of the very premium payers who supply the cash. A truly vicious circle: we pay to be denied what we want.

For every member of Congress there are four healthcare lobbyists, who spray cash freely to anyone willing to go against the interests of their constituents and oppose HR 676. The media don’t expose this. Even C-Span and NPR rarely report on single-payer healthcare—many voters don’t even know what ‘single payer’ means. The insurance companies are left free to misrepresent it, and how they pay to block it is left unexposed.

At present, US employers and individuals pay $950 billion premium dollars per year to insurance companies, who pass on payments to treatment providers—doctors and hospitals—after slicing off a big chunk for their own expenses and profits.  Big expenses.  Big profits.  Lots of cash for lobbyists.

Think about it: in return for the 31% of total healthcare receipts they cost, what value do the insurance companies deliver? Answer: None.  Instead, they subject patients to the worries and sometimes the tragedies of treatment denials, and harass treatment providers with forms to fill out and phone calls to make for treatment and payment approvals.  The net: they add negative value, and cost much more than Medicare.

A tax-supported single-payer system would be much simpler and far more efficient. It would save the 1/3 of healthcare costs now attributable to the insurance companies. Those costs, worse than wasted, can instead be used to cover everyone who today lacks coverage. Imagine the Canadian system—with twice the funding! The ‘waiting lines’ that opponents of single-payer so love to cite would be gone.

Retaining insurance companies, as the plans of Obama and Clinton both do, dooms ‘universal healthcare’ to becoming a crazy quilt of complexity, higher costs, subsidies, mandates, government intrusion, higher taxes, and incomplete coverage, wide open to justifiable political attacks from both the left and the right.

But what if Barack or Hillary were now to defy the insurance companies and come out for HR 676, as Kucinich did?  He or she could not be ignored, as he was.  They could offer what voters want, be morally and fiscally responsible, and champion a healthcare system for everyone that would actually work.

Whatever the candidates do, we voters must demand HR 676 from Congress.  For more on HR 676, see: http://www.pnhp.org .  Contact your Representative in Congress and press for it. To confirm who your Representative is, see: http://www.govtrack.us/congress/findyourreps.xpd .

Shout out for single-payer healthcare. Even more than campaign funds, every elected official needs votes.  Thank them if they support HR 676; let them know you will oppose them if they do not get behind it.

The Great Brain Robbery

Joseph Stiglitz and Linda Bilmes have generated a buzz with their new book “The Three Trillion Dollar War: The True Cost of the Iraq Conflict,” where they argue that the all-up cost for the war in Iraq is 60 times greater than the original Bush forecast of $50 billion.  A cost of $10,000 for each man, woman and child in America, rather than Bush’s $167. The huge $3 trillion total they calculate has scary implications for the U.S. economy, driving us to—what? Nobody knows.

Meanwhile, what about healthcare?  It’s hard to believe, but in both its dollar costs and its human toll on Americans, the healthcare mess is even worse than the war. And all the current presidential candidates deliberately avoid the core of the healthcare problem: the corrosive behavior of the healthcare lobby. Why do we tolerate that behavior? Where are our brains?

Spiraling U.S. healthcare costs now total over $2 trillion per year, 16% of GDP, more than $7,000 per person. Our total public and private per capita healthcare costs are two or more times higher than those of any other industrialized country, who all manage to provide universal healthcare for everyone even though they spend much less than we do.  And they achieve much better health outcomes than we do—we rank 37th worldwide.

Private health insurance companies play a big role in U.S. healthcare. They collect insurance premium payments of $950 billion per year, and they want to keep doing so. Of that sum, about 2/3 pays for healthcare actually delivered by providers like physicians and hospitals, and the other 1/3 is what it costs us to keep the healthcos in the system: the slice of premium payments they retain for their own expenses and profits, plus the administrative cost burden they impose on doctors and hospitals for billing and insurance-related functions. For more, see http://www.pnhp.org.

Keeping the healthcos in the system ends up costing us $350 billion per year, over $1,000 for every person in the U.S. More than the current cost of the war in Iraq. And costs for Iraq are expected to decrease, while healthcare costs keep rising.

Now for the key question.  Consider carefully:

In exchange for the 1/3 of premiums they cost, what value do the health insurance companies deliver to their policy holders?

Answer:  None.

Actually, the “value” they deliver is negative. A healthco’s expenses for sales and marketing and big executive salaries deliver no value to its policy holder/patient, nor do the profits made for its shareholders, but at least all that is neutral. Also neutral is the extra cost the providers incur for coping with the hassles imposed on them by the healthcos. But the healthco’s administrative activities arguably deliver negative value.  All that accepting, refusing and rescinding policy applications and approving or denying treatments is certainly expensive, but it delivers only uncertainty and sometimes anguish, even death, to policyholders. At best, they deliver zero value for the 1/3 of premiums they cost.

And that cost could all be saved by going to a single payer healthcare system. 

Many experts looking at all this have concluded that the smart thing to do is to switch to tax-supported single payer insurance, greatly improving healthcare results, reining in skyrocketing healthcare costs, and saving $350 billion a year—enough to cover the 46 million currently uninsured in America.  But they turn pessimistic when they look at the political landscape, and see the power of the healthco lobby.  Naturally, the healthcos want to hang on to that revenue flow of $950 billion per year, so they use their considerable financial clout to oppose any move to single payer. They are now waxing enthusiastic about CDHC, Consumer Driven Health Care, which preserves the health insurance industry by pasting onto the present badly broken system band-aids like tax-sheltered Health Savings Accounts and mandated major medical insurance. Under CDHC, the overall revenues taken in by the healthcos increase significantly.

In their books on our healthcare system, observers Dr. Arnold Relman and Timothy Jost painstakingly dissect CDHC, showing precisely why it won’t solve the problems of the current system.  But each then sadly concludes that, because it’s what the healthcos want, CDHC will probably have to play itself out over some ten years before we voters finally give up on it, overcome the powerful healthco lobby, and install what will work: a single payer system like that of HR 676.  If we had any brains, we’d move to single payer now, not ten years from now.

Just how much of our money would we be letting the healthcos waste over the next ten years?  At least $1,000 per person for ten years, or $10,000 for every man woman and child in the U.S.  $3 trillion in total, the same total that Stiglitz and Bilmes calculate as the all-up cost for the war in Iraq. Sums this large threaten the stability of the U.S. economy.

And then there is the human toll— keeping the healthcos in the system is worse than just wasting money, it actually does real harm to many people. It kills some of them. Our broken healthcare system causes 18,000 deaths per year—far exceeding the 4000 deaths we have incurred so far in Iraq.

Remember—that $3 trillion over ten years, all wasted or worse, is for the 1/3 of premium payments the health insurance companies cost us, not the 2/3 spent for actual healthcare. And since the healthcos deliver no value to us in return, we are effectively letting them steal $3 trillion from us. Why are we doing this?  Where are our brains? Why don’t we even know what’s going on?

It’s because the healthco lobby doesn’t want us to know about it, and the media collaborates with a veil of silence. Think of it as a very quiet $3 trillion robbery.  The Great Brain Robbery.   Because first the healthco lobby had to steal our brains, so we wouldn’t notice what’s happening.