Showing posts with label ACA. Show all posts
Showing posts with label ACA. Show all posts
Saturday, May 6, 2017
Health Insurance is harmful to our health....
Why the "health insurance' debate is killing us and bankrupting the country...
INSURANCE What does it really mean?
11-30-16
For more than 20 years, I've coached, cajolled, corrected and emphatically insisted that the news media and politicians quit conflating "health insurance" or "insurance coverage" with actual Health Care delivered successfully to patients. This is especially important for those who could not otherwise afford or locate any suitable care but it is even more important to the economy as a whole, and to our very survival as a nation and system of government. A nation whose health care access and outcomes is below that of many 3rd-world countries has no business setting any sort of example, or attempting to control the destinies of other nations.
The total collapse and de facto expropriation (by corporations, lobbyists and the governments they control) of our once-great health care system will puzzle historians for centuries to come. How could we have been so stupid? Why do we let these gangsters control and profit from the most basic charitable humanitarian and necessary services - Health Care. Physicians, Hospitals, Clinics, Public Health standards and services, etc.?
And most mystifying of all, why do we submit to monopolistic, profit-maximizing control over the quantity, variety, and quality of our vital services? It's an Economics-free Zone. No one here had heard of supply and demand, competitive pricing, or the Sovereignty of the Consumer. A real free market system means no patents or monopolies, no ability to coerce people to pay for what they don't want, or what they think is harmful to their health, etc., etc.
You can still practice (with its own certification process) "alternative medicine" in Montana (acupuncture, homeopathic and herbal medicine, etc.), but it's not "recognized" for Medicare or Medicaid reimbursements. Some treatments, which are popular and cost-effective, like Chiropractors, are included. And since most lower-paid workers now spend a third of their income on compulsory insurance (thanks to the Democrats), they have no resources left to obtain alternative medical services, but at least that's a convivial system where you can trade work, barter, or otherwise get by.
The Republicans didn't push for Romneycare precisely because it wouldn't work unless it forced the young and healthy to pay for the old and sick (something which Pres Obama has repeatedly used as a "justification" for this system - it is forced altruism, which we are told is good for us.). And Mitt said, repeatedly, that it was a system for Massachussetts liberals who were in favor of such programs. He knew it wouldn't work in most of the rest of the country, where the dominant elements are "fighting socialism" along with any other sort of benevolent government action, which they think is the road to totalitarian despotism. Now, why would they think a thing like that? Maybe they've been to Montana.
As for the despotism, they're certainly cool with that, and each party plays off the fears of "the other's guy's despotism" - whether it is the other major party, or foreign despots who use the terror instilled by American imperial violence to tighten their control over their own people. (c.f., Turkey). Maybe they can act out some of their James Bond or Matt Helm fantasies. In any case, their main mission in the legislatures and state bueaucracies is jobs, raises, more programs, more prisoners, more people on welfare and government health care schemes, all of it corporate and local-oligarchy friendly. If it's not a rip-off, they don't want to fund it. (Check your local School Board, for examples). In the end, they're all promoting failure on the side (in other words, hedging) in order to prove themselves correct (and thus blameless) in their analysis after the fact.
Republicans are more sensitive to people's "libertarian" desire to opt out of any federal program they don't like, and to find their own cost-effective solutions to whatever needs they might have. The two leading "architects" or proponents of the ACA - Sen Max Baucus, and now, Bill Clinton whose Democrat faction was still "building on" Hillarycare, c. 1993, have described it as "a train wreck" (Baucus, omitting who was driving the train - himself) and "the craziest thing I ever heard of", verifying my
estimation that we are now paying 4 times more than we need to, and still have rotten health care with co-pays and "insurance" deductibles we simply can't afford, so we still don't get the health care we need, or if we do, we are driven into bankruptcy.
It is indicative of the state of the news media that these meaningful statements by people who (perhaps belatedly) understood that a disaster had occurred, were immediately ridiculed or forgotten. The basic question as to whether or not we want to subsidize corporations with our health care dollars, rather than spend them on actual health care, has never been discussed, and those who tried to discuss it, like Green Senate candidate Margaret Flowers, were actually arrested at the order of our dear Sen. Max Baucus for attempting to present these facts at a hearing (at many hearings, for trying to deliver materials directly to the White House, etc., etc.) There is no excuse whatsoever for this discussion to continue in these terms. The "insurance model" has totally failed, and proven to cost 4 times more than it should, with some 2-3 million people employed, and somewhere north of half a $trillion wasted and thus removed from providing not only health care, but any other government service which we are now so often told "we cannot afford."
Tuesday, January 3, 2017
Time for real "Health Care Reform"
Daybook: Jan 3, 2017
Health Care Reform
I can't help but ask:
Just how far is this going to go? - Confusing for-profit "health insurance" with real public health care, financed by tax dollars and our own steadily-declining real incomes and wages?
And how long is the media, public and private, local and national, going to keep pushing this pleasant fiction that all we need is "insurance coverage" without any caveats, disclaimers, or sourcing?
When we say "It's all the media's fault" we weren't kidding. There's hardly a major issue out there which the media, individually and collectively, hasn't totally distorted and misled the public. Health care and climate change, along with foreign policy (the Russian "threat") are among the most catastrophic.
The real problems and real solutions are well-known by every well-educated specialist with knowledge of the field. It's beyond "misleading" or "corrupt" - it's a crime against democracy and self-government, as well as established principles of journalism and public access to accurate information.
Public media, especially, has failed us dreadfully, which is why I'm continually exposing its stupidity and corruption. Here, "public" means closer to the power centers - and thus subject to control by the political machines. And it is often much worse in distorting the reality, as well as the values and decisions which we as intelligent voting citizens need to apply in our collective decision-making and policies. Private corporations, networks, and newspaper chains are powerful, but they must provide a product which people want and will look at or buy. No so with our so-called "public media." And once a certain mind-set or political faction gets control, it's almost impossible to replace or correct them.
Since "health care reform" is now cast primarily as an issue in economics (and budgets/funding, from the perspective of Congress or state legislatures), why don't we simply hire some real economists - start a committee of them, chaired by someone like Ralph Nader or other dedicated public interest activist, and then listen to what they tell us? There are plenty of "conservative" or "free market" economists, as well as the tradtional advocates of the Welfare State and the Public Interest who understand that corporate fascism isn't good for us, or for our economic future.
The numbers don't lie - we pay more than twice as much, per capita, as any other "developed" country for our health care, and all the medical statistics - infant mortality, longevity, cancer and other disease rates, and most importantly, public satisfaction with the "insurance model", puts us somewhere near the bottom of our "peer nations."
"Insurance", in this instance, is a complete fiction. No one's health is being insured. If you have wealth or property, you need insurance to protect your assets from the medical bill collectors (who in America charge - and collect - at least 4 times more than high quality services in other countries would cost), and often the same margin even when compared with richer countries like Norway or Germany, where everyone's health care is covered, in a way each prefers, with medical philosphies and techniques they agree with.
While "Obamacare" was being developed (recycled Romneycare, after Republicans had totally rejected it as any sort of "answer"), none of the sustainable, public-health models were even considered. There were no representatives for a National Health Service like the UK, and not even the widely-accepted, popular Canadian "Single-Payer" system was allowed to be presented or considered. According to Sen Baucus, it was the insurance lobbyists who refused to "support" any such a system, and since they had already paid to play at Camp Baucus, who was he to refuse them?
There was a PBS series around 2008 which examined all the best public health care systems in the world, in hopes that our Congress and other authorities might learn from them. None of this information was applied to the problem. Americans are exceptional. Sen Baucus said (falsely) over and over again that "Americans like the present system, and if they want to keep their insurance (which few pay for out of their own pockets, and if they do, they know they're being swindled), they'll be able to do so." Even then, polls showed that at least 80% of those polled were very dissatisfied with our health care system, but all we were told was that "socialism had failed" and Canadians by the millions are coming South to enjoy the wonders of US "private enterprise" healthcare, free from "government takeovers" like Obamacare.
Yeh, right. A few hundred rich Canadians can jump the queue and negotiate real "market prices" with American doctors and hospitals, which the rest of us cannot do. Probably a third of Canadian health care professionals (trained, I'm sure, much better than our own medical schools do) come South for salaries which are the same ratio as other health care costs - 2-4 times higher than they could get at home. We do allow a lot of foreign-trained doctors to practice here (often out of necessity - we're turning out only a small fraction of the doctors we need, and they're all expecting a minimum of $200-400K/year in their first job.)
Both med schools and hospitals are "downsizing" in order to increase their monopoly power and profits. Even if a doctor or dentist wanted to charge fair and reasonable prices, chances are he or she wouldn't be allowed to practice, here.
Gov Romney himself said that the Massachusetts system he got passed (designed by the Heritage Foundation more or less under contract to the insurance industry) was devised for "progressive", liberal Massachusetts, as a lesson to them on how this model is totally unsustainable, subsidizing corporate profits and the "professional class" rather than patients or the public's health (statistically measured) as a whole.
As a Mormon, Romney (and most sane Republicans wanted to maximize the taxpayer's dollars, not in "proving that socialism doesn't work", but in actually delivering as much and as good health care services as they could, which is why everything has been standardized and corporatized. Obviously, no one would voluntarily participate in such a system, so it is illegal not to.
Such are the "libertarian" and Heritage values under which we live, but few who voted for Obama expected any outcome like this. We were continually promised "a robust public option" - meaning something like Medicare for anyone who wants it, financed out of tax dollars and sliding-scale fees. One of the problems with "Single-Payer" advocates, here, is that they insisted that "everyone is in, nobody out." So, if you don't like that "model" of health care and the corporate (or socialist) philosophies behind it, you don't have any alternatives.
As a First Principle, any sort of health care must be free and independent of political control and forced participation. That would seem to be self-evident - especially for those who call themselves "libertarians" or pro-liberty. But it is not.
What the Republicans and any other "reformers" need to look at is maximizing value in facilities and a focus on providing everyone with the best possible health care (which might be far inferior to what is deliverable as "the best", today). But it would be delivered health care, instead of all sorts of rackets to extract as much monopoly rent from everyone - patients, taxpayers, insurers, and even their own employees, without giving a damn about what sort of health care is actually delivered, or who is left out. (That is the present system, as exemplified by Mr Goodnow, the CEO of Benefis - created by the same "consultants" who designed Enron and other monumental failures - Arthur Andersen. After Enron, it was forced to dissolve, but last I heard, the same people, now based in Bermuda, are running our "Homeland Security" Gestapo.)
The days when any sick person could check into the ER, get some pain pills, and a taxi-ride home are long gone. Or have a serious operation and pay a small monthly charge to keep the account open, without killing the patient so that lawyers could collect from the estate, or else refusing any sort of real care for lack of "insurance."
Alternative medicine, midwives, herbalists, acupuncture, reflexology, etc have long been the standard for those who don't like corporate, for-profit medicine, and prefer a wholesome, natural approach to health and wellness. An enlightened public health care system would also cover such things, or at least not "regulate" them so that the prices are 10 times higher than they should be, as is the case with the aliopathic medicine we have, now.
Health Care Reform
I can't help but ask:
Just how far is this going to go? - Confusing for-profit "health insurance" with real public health care, financed by tax dollars and our own steadily-declining real incomes and wages?
And how long is the media, public and private, local and national, going to keep pushing this pleasant fiction that all we need is "insurance coverage" without any caveats, disclaimers, or sourcing?
When we say "It's all the media's fault" we weren't kidding. There's hardly a major issue out there which the media, individually and collectively, hasn't totally distorted and misled the public. Health care and climate change, along with foreign policy (the Russian "threat") are among the most catastrophic.
The real problems and real solutions are well-known by every well-educated specialist with knowledge of the field. It's beyond "misleading" or "corrupt" - it's a crime against democracy and self-government, as well as established principles of journalism and public access to accurate information.
Public media, especially, has failed us dreadfully, which is why I'm continually exposing its stupidity and corruption. Here, "public" means closer to the power centers - and thus subject to control by the political machines. And it is often much worse in distorting the reality, as well as the values and decisions which we as intelligent voting citizens need to apply in our collective decision-making and policies. Private corporations, networks, and newspaper chains are powerful, but they must provide a product which people want and will look at or buy. No so with our so-called "public media." And once a certain mind-set or political faction gets control, it's almost impossible to replace or correct them.
Since "health care reform" is now cast primarily as an issue in economics (and budgets/funding, from the perspective of Congress or state legislatures), why don't we simply hire some real economists - start a committee of them, chaired by someone like Ralph Nader or other dedicated public interest activist, and then listen to what they tell us? There are plenty of "conservative" or "free market" economists, as well as the tradtional advocates of the Welfare State and the Public Interest who understand that corporate fascism isn't good for us, or for our economic future.
The numbers don't lie - we pay more than twice as much, per capita, as any other "developed" country for our health care, and all the medical statistics - infant mortality, longevity, cancer and other disease rates, and most importantly, public satisfaction with the "insurance model", puts us somewhere near the bottom of our "peer nations."
"Insurance", in this instance, is a complete fiction. No one's health is being insured. If you have wealth or property, you need insurance to protect your assets from the medical bill collectors (who in America charge - and collect - at least 4 times more than high quality services in other countries would cost), and often the same margin even when compared with richer countries like Norway or Germany, where everyone's health care is covered, in a way each prefers, with medical philosphies and techniques they agree with.
While "Obamacare" was being developed (recycled Romneycare, after Republicans had totally rejected it as any sort of "answer"), none of the sustainable, public-health models were even considered. There were no representatives for a National Health Service like the UK, and not even the widely-accepted, popular Canadian "Single-Payer" system was allowed to be presented or considered. According to Sen Baucus, it was the insurance lobbyists who refused to "support" any such a system, and since they had already paid to play at Camp Baucus, who was he to refuse them?
There was a PBS series around 2008 which examined all the best public health care systems in the world, in hopes that our Congress and other authorities might learn from them. None of this information was applied to the problem. Americans are exceptional. Sen Baucus said (falsely) over and over again that "Americans like the present system, and if they want to keep their insurance (which few pay for out of their own pockets, and if they do, they know they're being swindled), they'll be able to do so." Even then, polls showed that at least 80% of those polled were very dissatisfied with our health care system, but all we were told was that "socialism had failed" and Canadians by the millions are coming South to enjoy the wonders of US "private enterprise" healthcare, free from "government takeovers" like Obamacare.
Yeh, right. A few hundred rich Canadians can jump the queue and negotiate real "market prices" with American doctors and hospitals, which the rest of us cannot do. Probably a third of Canadian health care professionals (trained, I'm sure, much better than our own medical schools do) come South for salaries which are the same ratio as other health care costs - 2-4 times higher than they could get at home. We do allow a lot of foreign-trained doctors to practice here (often out of necessity - we're turning out only a small fraction of the doctors we need, and they're all expecting a minimum of $200-400K/year in their first job.)
Both med schools and hospitals are "downsizing" in order to increase their monopoly power and profits. Even if a doctor or dentist wanted to charge fair and reasonable prices, chances are he or she wouldn't be allowed to practice, here.
Gov Romney himself said that the Massachusetts system he got passed (designed by the Heritage Foundation more or less under contract to the insurance industry) was devised for "progressive", liberal Massachusetts, as a lesson to them on how this model is totally unsustainable, subsidizing corporate profits and the "professional class" rather than patients or the public's health (statistically measured) as a whole.
As a Mormon, Romney (and most sane Republicans wanted to maximize the taxpayer's dollars, not in "proving that socialism doesn't work", but in actually delivering as much and as good health care services as they could, which is why everything has been standardized and corporatized. Obviously, no one would voluntarily participate in such a system, so it is illegal not to.
Such are the "libertarian" and Heritage values under which we live, but few who voted for Obama expected any outcome like this. We were continually promised "a robust public option" - meaning something like Medicare for anyone who wants it, financed out of tax dollars and sliding-scale fees. One of the problems with "Single-Payer" advocates, here, is that they insisted that "everyone is in, nobody out." So, if you don't like that "model" of health care and the corporate (or socialist) philosophies behind it, you don't have any alternatives.
As a First Principle, any sort of health care must be free and independent of political control and forced participation. That would seem to be self-evident - especially for those who call themselves "libertarians" or pro-liberty. But it is not.
What the Republicans and any other "reformers" need to look at is maximizing value in facilities and a focus on providing everyone with the best possible health care (which might be far inferior to what is deliverable as "the best", today). But it would be delivered health care, instead of all sorts of rackets to extract as much monopoly rent from everyone - patients, taxpayers, insurers, and even their own employees, without giving a damn about what sort of health care is actually delivered, or who is left out. (That is the present system, as exemplified by Mr Goodnow, the CEO of Benefis - created by the same "consultants" who designed Enron and other monumental failures - Arthur Andersen. After Enron, it was forced to dissolve, but last I heard, the same people, now based in Bermuda, are running our "Homeland Security" Gestapo.)
The days when any sick person could check into the ER, get some pain pills, and a taxi-ride home are long gone. Or have a serious operation and pay a small monthly charge to keep the account open, without killing the patient so that lawyers could collect from the estate, or else refusing any sort of real care for lack of "insurance."
Alternative medicine, midwives, herbalists, acupuncture, reflexology, etc have long been the standard for those who don't like corporate, for-profit medicine, and prefer a wholesome, natural approach to health and wellness. An enlightened public health care system would also cover such things, or at least not "regulate" them so that the prices are 10 times higher than they should be, as is the case with the aliopathic medicine we have, now.
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