Health Care Reform: Undoing Obama's Health Law Could Have Messy Ripple Effects

Single payer or Medicare for all destroys the health insurance industry.

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It actually doesn't.  

It would've been a two-tiered system: Basic coverage for everyone and boutique coverage for those willing to pay for it. So nobody had to worry about poor Big Insurance and Pharma -- There would have been work for all. Big Insurance and Pharma would just had to have made smarter gambles, with no taxpayer bailouts.

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Health Care Reform: Undoing Obama's Health Law Could Have Messy Ripple Effects

ACA originated in the rightwing think tank, the Heritage Foundation.

Obama and the DLC-controlled Democratic Party got the healthcare legislation through that the insurance industry and PhRma wanted.  

From Amy Goodman's interview with whistleblower Wendell Potter, former CIGNA executive:

AMY GOODMAN: But don’t the insurance companies like this legislation?

WENDELL POTTER: They do. And that’s why this will not be repealed. They like a lot about it. This legislation, we call it "healthcare reform," but it doesn’t really reform the system. There are a lot of good things in there that does make some of the practices of the insurance industry illegal, things that should have been made illegal a long time ago, so that—

AMY GOODMAN: Like?

WENDELL POTTER:—for that matter, there are good things here. But it doesn’t reform the system. It is built around our health insurance system, as the President said. And they want to keep it in place, because it also guarantees that they will have a lot of new members and billions of dollars in new revenue in the years to come.

AMY GOODMAN: How does it ensure that?

WENDELL POTTER: One of the—the core component of this—and it’s kind of ironic, but the one thing that the Republicans and conservatives are saying they want to repeal is the provision that we all have to buy coverage from private insurance companies.

AMY GOODMAN: Like we do for auto insurance.

WENDELL POTTER: Exactly, right. And they’re citing or they’re saying that that’s unconstitutional. That’s also all for show, because it is just an effort to try to, in a sense, turn people away from the idea of reform. It sounds complicated, but it’s part of the insurance companies’ strategy.

Read the entire interview here.
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Health Care Reform: Undoing Obama's Health Law Could Have Messy Ripple Effects

#3:

I can do nothing to fix the broken link.  I can provide the URL - http//www.guardian.co.uk/business/2011/dec/14/executive-pay-increase-america-ceos

Your belief that ACA will drive down these obscene CEO salaries is absent any reasoning.  The insurance industry has already figured out the way around medical loss ratio.  

On Countdown with Keith Olbermann, whistleblo­wer Wendell Potter talks with Lawrence O'Donnell about where the con game (medical loss ratio, the amount of money insurers must spend on health care) is in the legislatio­n, and how it will enable insurance companies to continue to price gauge and keep obscene profits instead of delivering affordable and quality medical care to policy-hol­ders.

Why put the insurance industry into the equation of Americans' medical treatment at all?  Insurance adds NOTHING to the medical model. The way that the insurance industry makes its profits is by taking a cut of money that can be spent on medical care.  And in reality the insurance industry profits like Wall Street and all other corporatio­ns that have crashed our economy have profited:  By denying claims and preventing treatment (Wall Street and corporatio­ns do it by offshoring manufactur­ing, outsourcin­g jobs, eliminatin­g jobs in spite of record profits for short term windfalls to shareholde­rs and bonuses for CEOs, etc.).  

The insurance industry is the 'Don Fanucci' (Godfather­, Part II) of medical care; the insurance industry is "wetting its beak", letting you get medical care (maybe, if you can afford the deductible­s, the co-pays, and if your illness is covered by your policy, but) only if you pay them a gratuity up front.

The controllin­g meme that has been operationa­l for the past 40 years, the sales pitch for privatizin­g government services and resources, is that "private industry can do it cheaper".  While Republican­s (Nixon) began it, Democrats joined in (Jimmy Carter).  But it's just not true that private industry does it cheaper.  Or even better.  

What the insurance industry has charged anywhere from 12-39 percent for, the US government (Medicare) does spectacula­rly well for 4 percent.
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Health Care Reform: Undoing Obama's Health Law Could Have Messy Ripple Effects

#2:

The real shame, the real tragedy for all of us is that Obama could have been a transcende­nt president, good for both business AND the People.  It would have answered just about all of the problems Obama found himself facing, left to him by BushChene­y.

The SinglePaye­rUniversal­Healthcare system wouldn't have put the insurance industry out of business.  It would've been a two-tiered system: Basic coverage for everyone and boutique coverage for those willing to pay for it. So nobody had to worry about poor Big Insurance and Pharma -- There would have been work for all. Big Insurance and Pharma would just had to have made smarter gambles, with no taxpayer bailouts.

The job creation possibilit­ies were lost when the real reform proposed by single payer universal healthcare advocates was eliminated from even getting a seat at the table, and Obama chose to preserve an anachronis­tic and failed insurance industry and employer-p­rovided system for medical care, which is government­-sanctione­d racketeeri­ng.

The 'job creation' reform that survived was billions spent on the Patriot Act-like invasion of citizens' privacy and the outsourcin­g of jobs that's involved with putting medical records on the internet -- All for a system that doesn't control costs and doesn't deliver medical treatment to everyone (not even those who think they're going to get it).  

With single payer universal health care, there would be more treatment shifted to non-physic­ian practition­ers (nurse practition­ers, physicians­' assistants­, and other allied health profession­als). Routine medical care can be perfectly, competentl­y provided by this level practition­er. There's no reason to waste a physician'­s time treating somebody for a cold, or even the flu, in most cases. 

If universal health coverage were to become an official reality, we'd need to expand training programs for both MDs and non-MD providers to insure there were enough to go around, and in the long run it would mean cheaper and more effective service, along with job creation.  As would a real stimulus bill (have been a job creator), and an alternativ­e energy policy with a Manhattan-­project style effort towards clean, green sustainabl­es.

These are all good things, but Obama and Democrats have chosen the dark side.  The corporate side.
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Health Care Reform: Undoing Obama's Health Law Could Have Messy Ripple Effects

With regard to exchanges, a failed idea.  They present a whole new layer of complications making them as the means to "providing competition" in order to make healthcare affordable a ridiculous folly.  To appreciate just how cynically corrupt Obama is (and the insincerity of his relying on exchanges in his 'signature' legislation), one has only to look at his administration of the early portion of ACA that's gone into effect -- Pre-existing condition coverage.  And then there's HAMP (http://www.huffingtonpost.com/2012/01/27/hamp-loan-modification-expands_n_1237169.html). 

I'm still blown away at the administration's inept handling of this provision in ACA legislation.  Just this past month, I met with 2 people with pre-existing conditions who can't get health insurance.  When informed of the Pre-ExistingConditionInsurancePlan, they knew nothing about it.  These are health care providers, mind you, who had just been denied insurance (ACA's regulations include no requirements of insurance companies to inform customers upon denial of the program).  Once they got in touch with PCIP, they were told they couldn't qualify until 6 months after they had been denied coverage by an insurer, which isn't true.  You just have to have gone 6 months without insurance.

Even EzraKlein, once a full-throated supporter of exchanges has changed his tune.  From Today:

But the CBO is in the right here: No matter how much sense competition makes in theory, no matter how obvious it is that it will drive down the price of healthcare, the fact is that it keeps failing when we put it into practice.


When I asked Sen. RonWyden to give me examples of programs that made him confident that competition could work, he mentioned the FederalEmployeeHealthBenefitsProgram (FEHBP) and the CaliforniaPublicEmployeesRetirementSystem (CalPERS). Rep. PaulRyan has also pointed towards the FEHBP as a model for his plans. The only problem? Neither system controls costs — a fact that poses difficulties for both conservative efforts to reform Medicare and Democratic efforts to reform health care:

The Medicare program includes MedicareAdvantage — a menu of competitive managed-care options meant to provide better service at a lower cost. That, too, has been a failure.

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Health Care Reform: Undoing Obama's Health Law Could Have Messy Ripple Effects

#1:

Insurance is typically, and will continue to be, tied to employment.  And in these times of economic uncertainty and chaos, one of the many problems with designing programs to use the employment system to expand health insurance coverage is that employment is not static. When insurance is tied to employment, turnover in employment results in turnover in insurance. However, recent evidence suggests that continuity in coverage and care are just as important as having coverage is in improving access to healthcare.  

Linking coverage to the workplace will not promote continuity in coverage for some population groups. Job losses are more common among younger, lower-income, and less educated workers. In addition, most new jobs are short-term; about 20% last less than three months, and about 50% last less than a year. This turnover raises the question of when and for whom an employer insurance buy-in is consistent with the policy goal of continuity. Employment turnover also raises states’ cost of administering employer coverage buy-in programs.

Then there's how employer-provided insurance drives down salaries:

ACA will create perverse incentives with respect to a number of important decisions affecting low- and moderate-income Americans, including: the ACA will deter low- and moderate-income taxpayers from accepting jobs with employers that offer “affordable” health insurance; the ACA will discourage many low- and moderate-income taxpayers from attempting to increase their household incomes; the ACA will penalize many low- and moderate-income taxpayers who choose to marry and will incentivize many low- and moderate-income taxpayers to divorce; the ACA will dissuade employers from hiring low- and moderate-income taxpayers and will encourage employers to reduce the salaries paid to some low- and moderate-income employees; the ACA will prompt employers to shift some low- and moderate-income employees from full-time positions to part-time positions; the ACA will tempt employers to implement a number of other costly strategies for circumventing the ACA’s employer mandates and penalties; the ACA will induce employers to stop offering “affordable” health insurance to at least some low- and moderate-income employees, and – if this occurs to a significant enough degree – the budgetary cost of the ACA may greatly exceed the official projections issued by the Congressional Budget Office.

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