Sunday, August 09, 2009

The Penny Drops

“The Health Insurers Have Already Won” reads the Business Week title go here for article .
“Is Obama Punking Us?” reads the title of Frank Rich’s column in the NYT go here for article

Rich actually has an epiphany:
“The larger fear is that Obama might be just another corporatist, punking voters much as the Republicans do when they claim to be all for the common guy.”

All I can say, Frank is “Well… Duh!” it only took you 545 days to figure out what we knew and told you way back in February 2008. No grass grows under your toes, boy.

These are the latest in a growing stream of pundits experiencing the OMO (‘Oh, My Obama’ – formerly ‘Omigod’) syndrome, they’re waking up and saying ”Wha.. wha happened?”. The answer, of course, is: “Well, while you were stoned on your acid-infused Kool-Aid, somebody stole your country, guess who?”
So, here’s the skinny on the healthcare reform ‘debate’, as I see it.

First: it’s over, you won’t be getting any health care help.

There, you can stop reading now and get on with your life – in fact, don’t lose a minute because it looks very much like you’ll have to make some extra money to pay for the publically mandated payments to private companies for insurance that won’t insure you. Let me rephrase that: the likelihood is very high that by the end of the year Team Obama will have instituted a national government program that will require you to pay a private company for medical insurance (or pay a fine roughly equivalent to the insurance payments you would have made). Let’s repeat that: the US government is going to force you to pay insurance premiums to a private business. Think about that, is this what you meant when you asked for healthcare reform?

Ostensibly, there will be safeguards in place so that, 1.) You will not be denied coverage because of a pre-existing condition. And, 2.) You will actually be covered in case you come down with something.
…and if you believe that, I’ve got a friend in New Orleans with some great property deals… I can guarantee you that, by the time the bill goes to Obama’s desk for signing, there will be enough loopholes you could drive a truck through to ensure that no insurer is ever vexed with the problem of actually having to pay for anyone’s medical expenses.

Second: The debate is no longer about health care reform, it is about health insurance reform. This happened almost instantly – remember Max Baccus face turning purple as he shrieked “Single payer is off the table! Single payer is off the table!”. There is no health care reform in the offing. Obama has never had any intention whatsoever of providing universal health care. Yes, I know he said as much during the campaign – sit down and have a drink, take a deep breath – are you ready?


But anyone who was interested could have easily found out where Obama’s heart (or pocketbook) was.
From a Boston Globe article in 2007 go here for article:

“The bill originally called for a "Bipartisan Health Care Reform Commission" to implement a program reaching all 12.4 million Illinois residents. The legislation would have made it official state policy to ensure that all residents could access "quality healthcare at costs that are reasonable." Insurers feared that language would result in a government takeover of healthcare, even though the bill did not explicitly say that.

By the time the legislation passed the Senate, in May 2004, Obama had written three successful amendments, at least one of which made key changes favorable to insurers.
Most significant, universal healthcare became merely a policy goal instead of state policy - the proposed commission, renamed the Adequate Health Care Task Force, was charged only with studying how to expand healthcare access. In the same amendment, Obama also sought to give insurers a voice in how the task force developed its plan.

Lobbyists praised Obama for taking the insurance industry's concerns into consideration.
"Barack is a very reasonable person who clearly recognized the various roles involved in the healthcare system," said Phil Lackman, a lobbyist for insurance agents and brokers. Obama "understood our concern that we didn't want a predetermined outcome."

There is no reason for anyone to have had any illusions about who Obama was or what he was going to do.

There will be a lot of kabuki theatre going on over the next few months but it is just that – theatre.

The Bottom Line

For the insurance industry it’s all about the bottom line and I don’t blame them for that, it’s foolish in the extreme for us to assume that a profit-making business would do anything other than attempt to make a profit. What it comes down to is that we can’t have decent healthcare in the context of a profit-making model – it just doesn’t work and it never will.

The numbers themselves tell the tale: after you sweep away the bandit bookkeeping the insurance industry uses to hide their profits (very much like the bandit bookkeeping movie studios and record companies use to avoid paying artists any royalties) you find that the ‘overhead’ (read: actual profits) for private health insurance runs about 20-30%. The overhead (in this case actual administration costs) for Medicare runs at 2-3%. 20-30% vs 2-3%. Are there any questions?

The healthcare debate is over in terms of anything actually happening which might benefit Americans but it does serve a larger purpose: like pus coming out of a wound, it shows us the utter corruption that has enveloped our government. Even setting aside Obama as the sockpuppet-in-chief of the insurance industry, there was as much support for real healthcare reform in the Congress as there has ever been i.e., none. Let’s remember who torched HRC’s healthcare reform in the ‘90’s: Democrats.

For the record: it is not possible to have universal healthcare using the for-profit model; Not Possible. Universal healthcare will only and can only exist when it is a public service. Those are the facts, anyone who tells you anything else is lying to you.

The astonishing thing about this is that we already have a fully functioning, tried and tested universal healthcare system up and running: Medicare. And, like icing on the cake, Medicare actually serves the part of the populace most likely to need medical : those pesky oldsters. No less personage than Paul Krugman said recently that private insurance couldn’t even exist if Medicare weren’t there to skim off all the people with actual medical needs. All we have to do to provide basic healthcare to every American is to remove the age limit on Medicare. Does it have problems? Yes. Are they fixable? Again yes. But, out of the box, Medicare provides universal healthcare for all Americans and that’s exactly what we want, no more, no less.

But, apparently, we will do absolutely anything to avoid facing that fact. In itself, that is a pathetic commentary on our civic life.

We are seeing some signs of revolt: loudmouths at town meetings all over the country who are incensed at the monumental ripoff that is being perpetrated on us. I don’t even mind that they are incensed for all the wrong reasons as long as they, and we, can make this atrocious bill go down in flames.
I notice that many members of Congress are trying to find excuses to stay in Washington over the August break, not surprising as they are going to face a shitstorm of protest if and when they do go home. My congressman has made the mistake of scheduling a teleconference ‘townhall meeting’, heh, heh, heh! I can’t wait…

I urge everyone to write to their Senators and Representatives to let them know that this is a watershed issue. Let them know that single payer is the only acceptable path for healthcare reform. Not insurance reform, not ‘public’ option, only single payer. Suggest taking the age limit off Medicare as a starting point and fixing what needs fixing in five years or so. But please make sure they know that this one matters, let them know that if they do not come through with single payer healthcare reform you will not vote for them in the next election. Make it clear that, whatever other good works they may have done, whatever respect you hold for them; this is a deal breaker for you. Either come through for me on this one or expect me to vote for someone else next time.

No comments: