Why Obamacare is not achieving its name

This segment on WAMC's Roundtable offers a good explanation of why the “Affordable Care Act” has done little to make health care more affordable. Lots of people in the industry have made out like bandits in recent years. Spoiler alert: those who actually treat patients – doctors and nurses – are not among them.



Journalist Steven Brill, author of  America's Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System, points out that “not-for-profit” hospitals have higher profit margins than the for-profit ones.

Brill offers a great anecdote of him presenting an explanation of benefits letter to the CEO of his health insurance company and the CEO being unable to explain what it means. This is not what happens in any kind of rational industry.

Until we decide to implement Medicare for All, which removes the profit-motive for those who are nothing but money changers, our sick care system will be a mess.

How hideously inefficient is our health care system?

How hideously inefficient is our health care system? 

As this graphic from the Wall Street Journal illustrates, over 22% of the taxes you pay goes to health care. 

And most Americans are required to find money on top of this to pay for private insurance (now mandatory, a historic first, under Obamacare) as well as treatment. 

At least if we had Medicare for All, our tax money would be spent in a far more rational and efficient way.

The Tea Party alternative to Obamacare

"When I give food to the poor, I'm called a saint. When I ask why they are poor, I'm called a communist." -Archbishop Dom Helder Camara.

My criticism of the Affordable Care Act is on the record but the 'Tea Party' narrative about ending Obamacare might be a little more compelling if this weren't their alternative.

Millionaires lead GOP crusade against health insurance for working people

I never voted for Barack Obama and my criticisms of the Affordable Care Act ("Obamacare") are on the record, but GOP attempts to hold the economy hostage to defund it and ram through other parts of their fringe agenda are despicable.

The Republican strategy is essentially this: get a bunch of guys with taxpayer-subsidized health insurance, most of whom are millionaires. Anoint them to be your spokesperson on why people who have to work for a living shouldn't necessarily have access to health insurance.

Let me know how that works out politically.

Majority oppose Obamacare... but not in the way you probably think

A CNN poll reports that 54% of Americans oppose Obamacare. But the dynamic is not as simplistic as the “tea party” or Obama partisans would have you believe. 

It reports only 35% of Americans think Obamacare is ‘too liberal.'

Nearly 1/3 of all opposition to Obamacare is by those who, like myself, think it is ‘not liberal enough.’

This reality probably isn't something you've ever heard in the mainstream media's narrative.

Democrats brag about how little they’ve moved the bar

The Health and Human Services secretary just bragged to the Democratic convention that under ObamneyCare, private health insurance companies are now required to spend at least half of every dollar you pay in premiums on actual health care or else they send you a refund check. “This is what change looks like,” she intoned.

So an insurance company can still spend as much as 50 cents of every dollar you are now compelled by law to give them on themselves and their stockholders and we’re supposed to believe that this is some sort of revolutionary advancement?

That the Democrats feel the need to brag about setting the bar so ridiculously low really only highlights the need of a real progressive political option.

Far right think tanks pushed individual mandate

I read an interesting column today about the Affordable Care Act (referred to by critics as Obamacare). It pointed out that the individual mandate, the heart of Obamacare, was once endorsed by the right-wing think tanks [sic] The American Enterprise Institute and The Heritage Foundation as a way of pre-empting Medicare for All (single payer).

This inconvenient fact illustrates several truths:

1) If far right think tanks endorsed it, then it's a pretty safe bet that the individual mandate is NOT a bridge toward single payer, as Obamacare apologists claim;

2) Democrats are now as far to the right as conservatives used to be;

3) Republicans are now further to the right than Attila the Hun;

4) Serious progressives should have nothing to do with either of them.

But given that ACA apologists seem intent upon 'forgetting' that Obamacare is virtually identical to the plan implemented by his Republican rival, I suspect rationalization and self-deceit will prevent them from realizing #4.

Obamacare: like solving hunger by mandating everyone eat three meals a day

Today, the US Supreme Court upheld the Affordable Care Act (ACA), often called by critics ‘Obamacare.’

The simplistic dichotomy peddled by the mainstream media is that if you oppose Republicans/The Tea Party, you support Obamacare. If you oppose Democrats/Pres. Obama, you oppose Obamacare. Everything’s neat, simple and tidy. Anything that varies from that easy narrative is pretty much ignored. Frankly, MSM journalists should have read some of the discussions my friends and I participated in today. A progressive hating on the ACA, a libertarian praising it... the nuance would make their heads explode.

So here I am a progressive who is disappointed that the ACA is still the law of the land.

Obamacare is akin to solving the problem of hunger by mandating everyone eat three meals a day.

In its decision, the Supreme Court has ruled that health insurance (ACA has nothing to do with health care) is the only private commodity that all Americans are required by law to purchase as a condition of citizenship, as a condition of being.

The health insurance industry is surely sending a huge thank you to the corporate Supreme Court, for this greatly expanded and government-mandated (under penalty of fines) pool of buyers for their racket.

This is a huge step backwards for real health care reform. Liberals, who know in their brains that Medicare for All (single payer) is the real solution to the problem of access to affordable health care, will be neutered for at least the next 20 years. They think Obamacare is just fine. People who think the situation is just fine don’t agitate for something better, especially when it’s completely different.

The ACA also pre-empts further efforts real reform because it gives the private health insurance industry even more of an incentive to preserve the status quo at any cost.

This is what passes for ‘choice’ in America. Mitt Romney and the Republicans are running against a health insurance scheme he inspired. Obama and Democrats are defending a health insurance scheme their hated opponent inspired. This pathetic state of affairs illustrates so perfectly why America needs real multipartyism.

No more taxpayer funded health insurance for state legislators

The Adirondack Daily Enterprise ran a piece how some of the region's town and village boards are stopping board members from getting taxpayer-funded health benefits because they are only part-time elected officials.

As an excuse against ethics regulations relating to disclosure, state legislators in Albany claim that, despite their very hefty salaries, they are part-timers as well...

Health insurance providers?

I was listening with interest to an NPR interview with Rep. Paul Ryan, who has become a media darling for his role as de facto spokesman for the Congressional Republicans on budget issues. In passing, he made a gross misrepresentation of reality.

A brief memo to Ryan: health insurance companies are NOT "providers" of health care services. They are money changers. They do not cure an ailment. They do not heal a wound. They are not providers of health care.

Flexible spending accounts: the only health care ‘reform’ we can hope for?

Bob, over at Planet Albany blog, is providing coverage of the New York Conservative 'Party' conference in Colonie, a suburb of Albany. He makes reference to former lieutenant govenror Betsy McCaughey, who made a national name for herself opposing health care reform under Bill Clinton and who is, not surprisingly, dead set against so-called Obamacare.

She said that there are indeed alternatives to Obamacare, blah blah blah... I’ll believe that when the House passes something concrete. Until then, it’s just empty talk. Besides, we know that if the Republicans actually ever passed a health care bill, it would be at least as bad, if not worse, than the Democrats’ awful plan. It would take us further away from the Medicare for All that would be cheaper, more comprehensive and more efficient than the totally dysfunctional system we have now.

It’s clear that neither the Republicans nor the Democrats are interested in real health care reform. They merely tweak around the edges, arguing about exactly how to give more power to health insurance bureaucrats and how to expand profits for the private insurance money changers.

Since both corporate parties are only interested in making the tiniest changes possible so they can claim the mantle of 'reform,' here’s one: flexible spending account (FSA) reform.

FSA is where you can put aside a small part of your paycheck tax free to use on medical expenses. But there are several problems with the way FSA is structured.

First, flexible spending accounts are actually quite inflexible. You must decide before the year even starts how much per paycheck to put aside. Once decided, it can not change under any circumstance (except, I believe, the birth of a child or death of a spouse). This is fine if you have access to a crystal ball or are related to a time traveler.

For example, I put aside $260 a year ($10 per biweekly paycheck). That’s plenty to cover an ordinary year’s medical expenses for me: a physical, an eye appointment and glasses or contacts, contact lens solution.

But if I get injured during the year or get diagnosed with an illness or condition or something else happens that I CAN’T PREDICT, what’s left of that $260 is going to disappear in a heartbeat and I will be out of luck. You should be able to increase your FSA contribution during the year to account for unexpected changes in your health condition.

Another major problem with FSA is that it’s use it or lose it. If you don’t use all of the money in your account by the end of the year, it disappears into the pocket of, surprirse surprise, the insurance company. Essentially, this is a system that fines you for being healthy and encourages you to be wasteful.

This can be remedied in one of two ways. Either the balance remaining in your FSA should be refunded to you on Jan. 1 (and thus it becomes taxable) or it should be rolled over so it can be used in the next year. Your money shouldn’t disappear into the insurance racket’s coffers.

What’s worse is that recent inexplicable changes make it so you are unable to use FSA money on legitimate medical expenses like such as aspirin and cough medicine. As of Jan. 1, 2011, you can only use FSA for prescription medications.

Again, this is only tweaking around the edges of our dysfunctional health care system, which critics say can be more accurately described as 'sick care.' But since we can’t expect any more from the RepubliCrats, maybe they’ll take up these changes.

Most US medical bankruptcies are by people with health insurance

A blog post on Naked Capitalism cites numbers from publications like Reader’s Digest and The Washington Post which note that the overwhelming majority of Americans driven into debt and bankruptcy due to medical bills have insurance.

Americans celebrate 45 years of 'socialized medicine'

Single payer health insurance in America is 45 years old today.

Government-provided, national health insurance for all senior citizens was signed into law on this date in 1965.

We've had four and a half decades of Medicare for some. It's about time for Medicare for all.

News and observations

News item: Study: Insurance companies hold billions in fast food stock (CNN)

Observation: This is a bit like mining companies taking out life insurance on their employees

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News item: Canadian Prime Minister Stephen Harper's hard right turn (Maclean's)

Observation: It's too bad that America's noxious mix of religion and politics (which inevitably corrupts both) has drifted northward.

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Comment [verbatim]: "Since we seem to be the worlds policeman. The US should be paid for it. If we are going to be in the Pursian Gulf , Pursia needs to pay the US (I think they can afford it." (seen on an NCPR blog entry)

Observation: "There's nothing scarier than ignorance in action." -Tom Smothers

Further observation: "The argument against democracy is to spend 5 minutes with the average voter." -My old high school friend Dan

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Article: The Return of Christian Terrorism:Threats of right-wing violence have doubled in the past year. What is behind the latest upsurge in the movement to create a Christian theocratic state? (Alternet)

Observation: Probably the arrival of a president who, though religious, doesn't shove his religion down people's throats at every waking instant. This is seen by Christian theocrats as "secularism."

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Article: How the FCC Can Protect the Internet from Pro-Corporate Judges and Greedy Telecoms (Alternet)

Observation: If you don't want your internet provider to routinely block your favorite website (whether TheDailyShow.com, GlennBeck.com or anything in between), you should support net neutrality.

Rep. Murphy will pay for the vote he hasn't cast yet on the bill that's nowhere close to being finalized

A look at today's letters to the editor in The Post-Star (unavailable online except to people willing to pay extra for their pdf version) gives a good hint about why it's so hard to be an elected official today. There were several letters excoriating local Congressman Scott Murphy for supporting the health insurance bill that recently passed Congress, all from the right. That's to be expected.

It was a poor bill, one that did a little good and a lot of bad. And much like the Wall St. bailout, the health insurance bill DID represent socialism, just not in the way that the Tea Party types mean. The bill was a giant giveaway to health insurance conglomerates, which is why I refer to it as the health insurance bill not the health care bill. It is also why that industry supported the bill. The health insurance bill represents corporatism, which is corporate socialism. Maybe the Tea Party types will realize that the fundamental problem crippling our democracy isn't progressives supporting gay marriage but a government run on behalf of corporations and a Supreme Court validating this perverse notion... though I'm not holding my breath.

Criticisms of Murphy's vote on the health insurance bill are legitimate, if a bit misguided. But what's really infuriating is that at least three of the letters criticized Murphy for votes HE HADN'T EVEN TAKEN YET. They criticized him for the climate bill. They criticized him for cap and trade. They criticized him for citizenship for illegal immigrants. I don't believe he's taken firm positions on these issues and he absolutely hasn't voted one way or the other on them.

Fury and paranoia at living under a corporate Democratic administration (who replaced the corporate Republican administration) has made some people so unhinged that they'll attack a politician for things he hasn't done or even talked about doing yet. It shows how debased, how completely insane our political culture has become.

Exhibit A on why we need real multipartyism

Apparently, the US Senate health "reform" fraud retains the provision fining people $750 for not being able to afford or choosing to not buy health insurance while rejecting the provision creating a public option that might actually make insurance affordable for a lot more people. This proves yet again that a) it's not just the GOP who is sticking to the little guy and b) why I don't belong to either of the corporate parties. An honest, pragmatic analysis can only conclude that neither is a vehicle for progressive ideas.

Update: This bill is a bit like mandating all Americans eat prime rib and organic vegetables twice a day as a "plan" for eradicate hunger.

Further update: Both The Progressive offers a critique of the Democratic 'reform' fraud. So does the group Physicians for a National Health Program. While left-wing opposition to the bill is usually pooh-poohed with phrases like 'the perfect is the enemy of the good' or most inanely 'If both extremes hate it, it must be good,' the critiques are a little more substantive. Like me, PNHP most objects to the atrocious mandate that individuals be forced to buy an overpriced, inadequate insurance policy or else face a hefty fine, a provision no doubt adored by the private insurance lobby.

Sick of/from lobbying

Facts of the week: "The bill for lobbyists [on the 'health care' issue before Congress], television ads and political donations [sic] has topped $375 million --- or enough to pay the entire insurance tab for about 30,000 families a year,' reports CNN Money. Meanwhile TIME reports there are now 2.3 drug industry lobbyists for every member of Congress." -The Progressive

The public nothing

I am starting to agree with the objections of those who rage at the thought of paying so that someone who needs it can receive health care. I will use that logic to see if I, as a non-driver, can get a rebate on my taxes that subsidize the interstates.

The health insurance debate

I wish people would stop referring to the current debate as having to do with "health care reform." To the questionable extent that it constitutes "reform," the bill winding its way through Congress is about private health INSURANCE. It has little to with how health CARE is delivered.