On Second Thought . . .

By Matt Wuerker from Politico -
click to enlarge.

Wouldn't it be nice if, after the plague has receded, we finally got honest-to-God national healthcare coverage in this country? Not the Band-Aid of Obamacare, but the real thing.

Don't take no for an answer.

Health Insurance Is Not a Product

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An excerpt from a piece by Egberto Willies in Daily Kos:

One of the biggest problems with health insurance is that we allow Republicans to treat it as if it is a consumer product.

It is not.

Republicans love to talk about leaving health insurance to market forces. Their ideological blindness and callousness leads them to believe that what is good for a capitalist market is always right for the individuals it purports to serve. The reality is that we have made the capital markets our religion, as opposed to treating it as a tool that can make life better for us all.

A company does not sell a product that is not profitable. The fiduciary responsibility of a business in a capitalist market is to its shareholders, not the customer. The client is nothing more than a means to transfer wealth to the shareholder and the executives running the business.

A company cannot make a profit on an unaffordable product. Prices must rise or costs of manufacturing the product must go down, or the product will cease to exist. That’s what is happening to health insurance under Obamacare. Some insurance companies raised their prices, while some just abandoned the health insurance 'product.' Because proper regulations were finally in place, they could not make the product less expensive. In other words, Obamacare did not allow health insurance companies to sell their customers a crappy insurance policy.

Republicans argue that it is a lack of choice that allows these businesses to charge exorbitant premiums. They claim it is overregulation that causes health insurance companies to have to provide services people don't necessarily want. They say that disallowing interstate health insurance purchase reduces competition and competitive pricing.

There is some truth in those statements—but that’s only because as long as health insurance is seen as a product, that abridgment of market forces is detrimental to the company's bottom line, and also to insurance pricing for Americans. . . .

Here is the reality: We do not decide when we get sick. When we get sick, we cannot just shop around for the hospital and doctor that will provide the best price to treat a disease we do not yet know we have. Sickness does not know our socioeconomic condition, so having a ‘choice’ to purchase a plan we can afford means we get wealth-based health care.

Health insurance is not a product. Selling it that way is immoral, un-American, and downright evil.

What I Say: Your Head Trucker, who has endured a great deal of poverty in his life, and watched his loved ones suffer and die with precious little help from the free-market system, believes in a much-expanded and much-improved Medicare for All - by which I mean, a single-payer system, which could be funded and provided by various means, but which would automatically cover every resident of the United States from cradle to grave without limitations, exclusions, or premium payments. Ideally, it should be free at the point of access, though I could support a sliding scale for nominal co-payments, based on income.  Anything less is inexcusable and immoral in this, the richest nation on the face of the earth.

All medically necessary care and services, including preventive exams and treatments, physical therapy, mental health services, prescription drugs, and appliances, as well as hospital and residential care, would be provided under a nationally determined list of allowable benefits to patients. Doctors, clinics, and hospitals could be either government employees or private providers who agree to accept the standard compensation for services. Patients would not be involved in the billing process at all.

The whole program would be funded either out of general taxation, or with the help of a nominal withholding tax on wages. But everyone young and old would be fully covered at all times, regardless of whether they were employed or not.  Private insurers would be forbidden from competing with Medicare on any benefits covered by the national program.

The ultra-rich - like snooty rich-kid pig Jason Chaffetz (R-Utah) - who can't bear to sit in ordinary waiting rooms with the commonality could use their gold-plated private doctors and hospitals, who could charge whatever the fat-cat market would bear - but they could not also receive any payments from Medicare.

Or maybe there's a better way than all that to cover everyone - I am no financier, but I do believe in the three principles upon which Britain's National Health Service was founded:

• That it meet the needs of everyone
• That it be free at the point of delivery
• That it be based on clinical need, not ability to pay

I see that the total expenditure from all sources on healthcare in the United States in 2015 was $3.2 trillion.  (For comparison, the total annual payroll in the United States, including government employees, was $5.9 trillion in 2014; and total federal spending in 2015 was $3.7 trillion.)  That's a lot of money, but I'll wager at least half of it is wasted on insurance middlemen and their bulging profits, not to mention mindless paperwork and the utterly needless drug advertisements that flood the airwaves and Internet night and day. All other developed countries spend much less per capita on healthcare than the U.S. does, and get better outcomes, too:

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And then there is the combined $2.1 trillion net profits of American corporations the year 2015, which benefit immensely from our skilled, educated workforce, high-class infrastructure, and natural resources - your Head Trucker thinks that instead of paying fantastic salaries and bonuses to the execs, the big companies should be doing some substantial good for the general public.

Chart from Statista.com; click to enlarge.

USA Today reported that just 28 big firms, or 6 percent of the total, made fifty percent of those profits in 2015.

I don't know for sure the best way to finance universal coverage, but what I do know is that there is plenty of money circulating around this old world, and the big-money boys in their gold-plated towers can always find a way to finance every whim and extravagance and obscene profit they want, and the public be damned - so they can sure can sure as hell figure out a way to finance Medicare for All if they are made to, and if they don't - may God reward them as He did Dives.

It's instructive to check out this comparison of various national healthcare systems from Wikipedia, with links to many other sources of information. Also enlightening is this comparison of U.S. and Canadian healthcare systems.

Physicians for a National Health Program has a proposal for a single-payer system that seems well thought out to your Head Trucker.

Healthcare? You'll Have to Ask Your Boss

A message from the good folks at Hobby Lobby, praise the Lord:



Yesterday, the Supreme Court heard oral arguments in the case of Sebelius v. Hobby Lobby Stores, Inc., which you should take a great interest in, no matter your age, race, orientation, or sex. Hobby Lobby (which takes in over $2 billion a year and employs 22,000 workers) is headquartered in Oklahoma City and owned by the family of founder David Green (net worth $5 billion), who has donated millions to the likes of Jerry Falwell and Oral Roberts.

Green and company are asking the Supreme Court, in effect, to declare that corporations - under the legal fiction of corporate personhood - are entitled to the free exercise of religion under the First Amendment, just like any natural person is. And that would mean that under Obamacare, Green or any other employer in America would not have to pay to cover your contraception expenses, or any other medical treatment that God doesn't approve of - according to their sacred, heartfelt beliefs.

Don't shrug this case off just because you're gay and never get even close to a vajayjay. Think about it, guys - some churches don't approve of vaccinations, psychological therapy, blood transfusions, or even of medical science in general (can you say faith healing?) - so if the Supremes buy Hobby Lobby's argument that they shouldn't have to pay for health insurance that covers anything they have a religious objection to, well, millions of people could be totally out of luck next time they need a doctor's care, or a medicine or procedure that offends somebody's notion of what God Almighty is all about.

This is part of the Republicans' war on women, but the implications extend much further, to men as well as children.  And the votes on the Court look to be evenly spread, with only Justice Kennedy between you and the blessings of theocracy. You really want the likes of Mitt Romney, Newt Gingrich, Rick Santorum, and Rick Perry deciding what your doctor can or can't do for you? Why is no one marching in the streets about this? Why are we even having this discussion in 2014? If you haven't paid attention to this case until now - better get up to speed, because it just might hit you right between the eyes, come the high court's ruling in June.

Scotusblog has numerous articles outlining and analyzing the issues. If you don't have time to read all that, at least watch what Rachel has to say about it - your health and maybe even your life depend on on what's going down at the Supreme Court.

Why Marriage Can't Wait

It could happen to you:




The good news is, yesterday the U.S. Department of Labor announced that henceforth it will consider same-sex married couples, no matter where they live, as spouses under the provisions of the Employee Retirement Income Security Act (ERISA) - which concerns private pension plans and health insurance coverage:

"This decision represents a historic step toward equality for all American families, and I have directed the department's agency heads to ensure that they are implementing the decision in a way that provides maximum protection for workers and their families," said Secretary of Labor Thomas E. Perez. "The department plans to issue additional guidance in the coming months as we continue to consult with the Department of Justice and other federal agencies to implement the decision."

"By providing greater clarity on how the Supreme Court's decision affects one of the laws we enforce, we are contributing to greater equality and greater protection for America's working families," said Assistant Secretary for Employee Benefits Security Phyllis C. Borzi.

EBSA protects the retirement, health and other workplace-related benefits of America's workers, retirees and their families. The agency oversees approximately 701,000 private sector retirement plans, 2.3 million health plans and other plans that provide benefits to more than 141 million Americans.

The Ugly Americans

Got no health insurance?  Then DIE, motherfucker.  That's the American way!

Obama's Last Stand

Seems like the President is finally taking the gloves off over healthcare reform, and it's about damn time if you ask me.  Kenneth T. Walsh reports in U.S. News and World Report:

President Obama has begun his last stand on healthcare. "Every idea has been put on the table," he said last week. "Every argument has been made. Everything to say about healthcare has been said, and just about everybody has said it. I believe the United States Congress owes the American people a final vote on healthcare reform."

Obama has taken a year to reach this point. He has long argued that without massive change, the public will face higher premiums, the government will amass more debt, and tens of millions of Americans won't have any health insurance at all. What is new, White House officials say, is the president's acknowledgment that he needs to get a bill passed now or nothing will be done anytime soon. He also has accepted the idea that there probably will be no Republican support so he will have to win passage with only Democratic votes. . . .

"The United States Congress owes the American people a final up or down vote on healthcare," he said. "It's time to make a decision. The time for talk is over. We need to see where people stand. And we need all of you to help us win that vote. So I need you to knock on doors. Talk to you neighbors. Pick up the phone. When you hear an argument by the water cooler and somebody is saying this or that about it, say, 'No, no, no, no--hold on a second.' And we need you to make your voices heard all the way in Washington, D.C."

He added: "They need to hear your voices because right now the Washington echo chamber is in full throttle. It is as deafening as it's ever been. And as we come to that final vote, that echo chamber is telling members of Congress, wait, think about the politics instead of thinking about doing the right thing."

And in a speech at Arcadia University in Pennsylvania, the President ripped the insurance companies for being the greedy bloodsucking bastards they are - those are my words, here are Obama's:

"Every year, insurance companies deny more people coverage because they have a preexisting condition. Every year, they drop more people's coverage when they're sick and need it most. Every year, they raise premiums higher and higher."

"These insurance companies have made a calculation," Obama said. "Listen to this, the other day, there was a conference call organized by Goldman Sachs; you know Goldman Sachs," he said to laughter.

He continued, "An insurance broker told Wall Street investors that insurance companies know they will lose customers if they keep raising premiums. But since there's so little competition in the insurance industry, they're okay with people being priced out of health insurance because they'll still make more by raising premiums on the customers they have. And they will keep doing this for as long as they can get away with it."

In his remarks, Obama cited the move last month by Anthem Blue Cross in California to raise rates by nearly 40 percent. He also mentioned his home state of Illinois where, he said, rates are going up by as much as 60 percent.

"So how much higher do premiums have to rise until we do something about it? How many more Americans have to lose their health insurance?" Obama said. "How many more businesses have to drop coverage? How many more years can the federal budget handle the crushing costs of Medicare and Medicaid? When is the right time for health insurance reform?"

I well recall when my best friend Tommy was dying of AIDS back twenty years ago, and how he had to argue, beg, and plead with the insurance company over the phone from his hospital bed to please approve this drug or that procedure, every single new thing the doctor ordered: the insurance company put him through flaming hell at his weakest, most vulnerable time.

And I could go on to talk about other friends and relatives, but the bottom line is this: it's simply immoral to be making a profit out of people's illness and injuries, period. And all that has to stop. Now.

Fired Up, Ready to Go - Against the Buzz Saw

At a Town Hall meeting on Friday in Elyria, Ohio, President Obama had this to say at the end of a gruesome week for healthcare reform:

So here's the good news: We've gotten pretty far down the road. But I've got to admit, we had a little bit of a buzz saw this week.

Now, I also know that part of the reason is, is that this process was so long and so drawn out -- this is just what happens in Congress. I mean, it's just an ugly process. You're running headlong into special interests, and armies of lobbyists, and partisan politics that's aimed at exploiting fears instead of getting things done. And then you've got ads that are scaring the bejesus out of everybody. (Laughter.) And the longer it takes, the uglier it looks. . . .

And I'm not going to walk away just because it's hard. We are going to keep on working to get this done -- with Democrats, I hope with Republicans -- anybody who's willing to step up. Because I'm not going to watch more people get crushed by costs or denied care they need by insurance company bureaucrats. I'm not going to have insurance companies click their heels and watch their stocks skyrocket because once again there's no control on what they do.

So long as I have some breath in me, so long as I have the privilege of serving as your President, I will not stop fighting for you.

Well, I'm glad to hear you testify, Mr. Fierce Advocate.  I hope you mean it this time.

House Passes Healthcare Bill

220 to 215.  Now I suppose the real showdown will be in the Senate.  Let's just hope that after all is said and done, we have a realistic public program that a working man or woman can afford - that will actually take care of people's needs and not simply feed the fat cat insurance and medical and drug interests.

And will same-sex partners be covered?  Had you thought about that? 

On my way to bed after staying up way too late.  Y'all have a good one, I'm outta here.

Why Your Medical Bills Bite

Ezra Klein in the WaPo reports on his illuminating talk with the CEO of a major health insurance company:

Halvorson handed me an astonishing packet of charts. The material was put together by the International Federation of Health Plans, which is pretty much what it sounds like: an association of insurance plans in different countries. But it showed something I've never seen before, at least not at this level of detail: prices. . . .

There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care. As Halvorson explained, and academics and consultancies have repeatedly confirmed, if you leave everything else the same -- the volume of procedures, the days we spend in the hospital, the number of surgeries we need -- but plug in the prices Canadians pay, our health-care spending falls by about 50 percent.

In other countries, governments set the rates that will be paid for different treatments and drugs, even when private insurers are doing the actual purchasing. In our country, the government doesn't set those rates for private insurers, which is why the prices paid by Medicare, as you'll see on some of these graphs, are much lower than those paid by private insurers.

One Closed Door after Another

Ordinary couples going about their business, living their lives, trying to take care of one another in sickness and in health . . . good luck if you live in the South - where you don't ride at the back of the bus, you can't even get on the damn bus.



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