The health care reform process is getting extremely ugly.
href="http://www.latimes.com/news/nationworld/nation/healthcare/la-na-healthcare-insurers24-2009aug24,0,6925890.story">
href="http://www.latimes.com/news/nationworld/nation/healthcare/la-na-healthcare-insurers24-2009aug24,0,6925890.story">Healthcare
insurers get upper hand
Obama's overhaul fight is being won by the industry, experts say. The
end result may be a financial 'bonanza.'
LA Times
By Tom Hamburger and Kim Geiger
August 24, 2009
href="http://www.truthdig.com/report/item/20090823_this_isnt_reform_its_robbery/">This
Isn't Reform, It's Robbery
Truthdig
By Chris Hedges
Aug 23, 2009
Small world. Truthdig was started by, among others, Robert
Scheer. Robert Scheer used to work for the LA Times. He
href="http://en.wikipedia.org/wiki/Robert_Scheer#End_of_Times_relationship">alleges
that he was fired for writing about controversial topics (criticizing
President Bush). So he went off and started his own gig.
Then he publishes a controversial story, one day before the LA
Times publishes a similar story on the same topic. Still trying
to figure this out. Maybe it is OK for the liberal media to be
critical of a Democratic president, but not a Republican one.
From the LA Times:
Reporting from Washington - Lashed by liberals and
threatened with more government regulation, the insurance industry
nevertheless rallied its lobbying and grass-roots resources so
successfully in the early stages of the healthcare overhaul
deliberations that it is poised to reap a financial windfall.
The half-dozen leading overhaul proposals circulating in Congress would
require all citizens to have health insurance, which would guarantee
insurers tens of millions of new customers -- many of whom would get
government subsidies to help pay the companies' premiums.
"It's a bonanza," said Robert Laszewski, a health insurance
executive for 20 years who now tracks reform legislation as president
of the consulting firm Health Policy and Strategy Associates Inc.
[emphasis added]
From Truthdig:
The current health care debate in Congress has nothing to
do with death panels or public options or socialized medicine. The real
debate, the only one that counts, is how much money our blood-sucking
insurance, pharmaceutical and for-profit health services are going to
be able to siphon off from new health care legislation.
By the way, Hedges cites, via Harper's Index, the statistic: Chances
that an American bankrupted by medical bills has health insurance: 7 in
10. This may have come from the recent article in The American
Journal of Medicine:
href="http://www.amjmed.com/article/S0002-9343%2809%2900404-5/abstract">Medical
Bankruptcy in the United States, 2007: Results of a National Study.
The original article is behind a pay wall, but again, Google (or Yahoo)
the title, and you find that a full copy has been posted
href="http://www.samhsa.gov/Financing/post/Medical-Bankruptcy-in-the-United-States-2007-Results-of-a-National-Study.aspx">somewhere.
Using a conservative definition, 62.1% of all bankruptcies
in 2007 were medical; 92% of these medical debtors had medical debts
over $5000, or 10% of pretax family income. The rest met criteria for
medical bankruptcy because they had lost significant income due to
illness or mortgaged a home to pay medical bills. Most medical
debtors were well educated, owned homes, and had middle-class
occupations. Three quarters had health insurance. Using identical
definitions in 2001 and 2007, the share of bankruptcies attributable to
medical problems rose by 49.6%. In logistic regression analysis
controlling for demographic factors, the odds that a bankruptcy had a
medical cause was 2.38-fold higher in 2007 than in 2001. [emphasis
added]
One of the ugly things about the debate over health care finance
reform:
href="http://www.heritage.org/Research/HealthCare/wm2231.cfm">The
Fallacy of Health Care Reform as Economic Stimulus. This
dreck highly questionable article, posted on the
Heritage Foundation site, alleges that health care
reform won't be a boost to the economy. The ugly part of it is
that they may be correct. Not because reform could not boost the
economy, but because none of the proposals under serious consideration
could do so. Instead, they'd act as an additional drain on the
economy. As currently proposed, the changes (I'll stop calling
this a reform) would extract money from the pockets of poor and
middle-class persons, and put it in the coffers of the
super-rich. And from there, it would be invested in paper.
This would be very bad.
It does not have to be that way. Don't screw around with a bill
that runs thousands of pages. Write a one-page bill that gives
everyone Medicare, and be done with it. Anything else, and you
end up with a camel sausage designed by a committee.
Still trying to understand this. Obama could do better, I
think. But to understand, read
href="http://www.democracynow.org/blog/2009/8/25/who_is_obama_playing_ball_with">this,
on Democracy Now!
It looked like it was business as usual for President
Barack Obama on the first day of his Martha's Vineyard vacation, as he
spent five hours golfing with Robert Wolf, president of UBS Investment
Bank and chairman and CEO of UBS Group Americas. Wolf, an early
financial backer of Obama's presidential campaign, raised $250,000 for
him back in 2006, and in February was appointed by the president to the
White House's Economic Recovery Advisory Board. Economic recovery for
whom?
At first glance, it seems completely unrelated. Obama playing
golf with a high-stakes banker...what does this have to do with health
care?
The relevance comes from what it tells us about Obama's
psychology. This is speculative, so take it that way. Obama
is like Isaac Asimov. Asimov was a science fiction writer, who
famously was characterized as being able to write faster than most
people can read. He also was criticized for being unable to
portray a character that truly was evil. The thought was, that he
was such a gentle intellectual, that he simply could not even conceive
of an evil person, much less portray one.
Perhaps Obama is the same way. Despite all his experience, he
simply cannot understand that some people are just plain evil, or just
plain greedy. He seems to think that if you are nice enough to
everyone, they eventually will do the right thing.
Playing gold with a powerful banker, he may think, is fine.
Perhaps some of Obama's good qualities will be imparted to the
banker. He seems to not realize how hazardous it is to be around
these people. Likewise, he does not realize how thoroughly
corrupt some industries have become.
The articles I cited early in this post, seem to indicate that the
insurance companies are not serious about reform. They look at
the changes in the system as an opportunity to increase their
profits. This, obviously, makes the health care delivery system
less efficient. It cannot be a good thing.
We in the USA were shocked in 2008, when schools collapsed in China,
during an earthquake. Other buildings, near the schools, did not
collapse. It was alleged that shoddy construction was the
cause. Activists who tried to investigate were arrested and put
on trial for subversion. We may never know the truth.
What this illustrates, and the way it relates to the health care
situation, is this: The construction companies
href="http://www.msnbc.msn.com/id/24604692/">allegedly used
substandard materials.
"These buildings just weren't made for that powerful of a
quake. Some don't even meet the basic specifications," said Dai Jun, a
structural engineer and concrete specialist in Chengdu who was
surveying damage in the area.
That increased their profits. Now, I have nothing against profits
in general. But when lives are lost, and profits are excessive,
there is something wrong with the system.
Bill McCamley
pointed out, corruption can kill people.
I realize that there is a gray area here. It is easy to call someone
else's profit excessive. But when a top executive is making
href="http://deep.mastersfamily.org/2009-08-12/billionaire-insurance-ceos-102k-per-hour-salaries/">$100,000
per hour, using insurance premiums that people paid with the
expectation that a fair portion would go toward their medical expenses,
that is excessive. The Truthdig and LA Times
articles indicate that the situation may get worse, not better.
That is why I can't honestly call the proposed changes reforms.
From the Truthdig article:
The Democrats are collaborating with lobbyists for the
insurance industry, the pharmaceutical industry and for-profit health
care providers to craft the current health care reform legislation.
"Corporate and industry players are inside the tent this time," says
David Merritt, project director at Newt Gingrich's Center for Health
Transformation, "so there is a vacuum on the outside." And these
lobbyists have already killed a viable public option and made sure
nothing in the bills will impede their growing profits and capacity for
abuse.
"It will basically be a government law that says you have to buy their
defective product," says href="http://www.pnhp.org/news/2006/march/interview_with_dr_d.php">Dr.
David Himmelstein, a professor at Harvard Medical School and a
founder of Physicians for a National Health Plan. [link added]
Is it odd that someone from Newt Gingrich's Center for Health
Transformation would be opposed to the same thing that
href="http://kucinich.us/index.php?option=com_content&task=view&id=2806">Dennis
Kucinich opposes? Not really. Gingrich's group is all
about free market solutions. The current proposals have nothing
to do with free market principles, rhetoric notwithstanding.
Government protection of private profits is something that neither the
free-market types, nor the progressive types, can abide.
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I think you are mistaken about some things about this legislation the biggest of which is we still do not know whether or not a public option will come out of the senate. By definition if there was a public option we not not have to buy their broken product (not that the insurance companies couldn't make like bandits out of the deal, I will get to that later). Then afterwards the legislation would need to go to conference to address all of the differences between the House's proposal and the Senate's proposal. Therefore, we really don't have something to really nitpick at, and you should be suspicious of anything liberal or conservative that says otherwise.
Addressing your point of why we need to have a 1300 page bill instead of a single "medicare for all" is that our system is a hell of a lot more broken then that. As it stands the private insurance companies support Medicare under a process called cost sharing. If Medicare was the only payer hospitals would be bankrupt, as it stands many are going bankrupt and are running in the red. There is no way to instantly dump another 30million people into a system that already is at capacity. You need to target physicians who are retiring early due to cost of practice or are frustrated at malpractice lawsuits and also address physician distribution into rural areas. That discussion of how much a doctor's time should be worth is complicated (much less nurses salary, physician's assistant, physical therapists, etc...) and as it stands both sides are willing to compromise, just don't expect it in a single page.
The other component of the health care legislation deals with the empty product that you refer to. Health Insurance is a very abstract product and unlike say a meal or even a car you have an extremely hard time telling if it actually can do what is supposed to when you need it. You address the issues involving medical bankruptcy even of the insured and we are absolutely in agreement that is perhaps the biggest thing that needs to change. The legislation includes proposals to standardized policies, it doesn't say exactly what would be included in the most basic of insurance. But the status quo of insurance "nickel and dime'ing" someone to death with several dozen 1000$ dollar co-pays in a single year would change. There would also be an affect on denying claims. As it stands there is just too much money to be made by exploiting loopholes and bouncing the claim back to the patient. I will take a long worded senate bill over a long worded insurance policy any day. And remember, most people don't even get to pick their insurance they are overwhelming decided by business administrators who make maybe 1-3 policies available. No consumer forces are going to work there. The only way to fix these practices are mandates from above.
Perhaps too, that once insurance companies are getting a chunk of the public pocketbook there will be more pressure on their pay-structure, and tremendous scrutiny into whether or not they reimburse when they are supposed to. Just like we saw after the bailout journalists were grilling financial executive's for their "bonuses". As it stands we are complacent about the cost of our insurance but once it starts being called a tax instead of an employment benefit we are going to demand cost reform. Think of the health care crisis as having two sides the first is coverage (being dealt with now) and the second is cost which is being procrastinated. However, simply getting started on more government involvement in health care is a big deal and it will take a lot of small steps. This one is the first, and the next time this gets brought up the right wing groups will be just a little less vocal. Medicare certainly didn't come out in one legislative session. Yeah it sucks, it is like getting everyone on board a sinking ship and then trying to patch the holes. The alternative though is much worse...
Theodore
University of Colorado School of Medicine
You bring up a very good point WRT bankruptcy. We'll have a good idea of how things are going when someone inserts a late amendment sheltering medical debts from being discharged in bankruptcy.
The Obama administration's approach to fixing the insurance system in this country, as with its approach to re-regulating the financial sector, serve to illustrate just how broken our legislative process is. What we have is a shadowy oligarchy of moneyed interests and individuals, who write all the rules and call all the shots; and then, everyone else. The wealthy and powerful top 0.001% reap the benefits, and the rest of us pay the price. It seems like the system is more impenetrable and broken now than it's ever been, but, then, I'm not a historian, so I can't be sure. Not really sure, either, what it's going to take to change things. Second coming of Christ might do it. Until then, just wait til we really get going w/ genetic engineering, or other pharmaco-medical means of enhancement that will allow the super wealthy to design their own offspring. Maybe we'll become two or more distinct species. Kind of like "Brave New World", but with up-to-date technology, instead of just alcohol baths for the betas, gammas and deltas. In any case, I'm glad I'm a beta: the alphas have to work so hard, and the gammas and deltas are gritty.