But one central, over-riding fact in the debate over health care always gets lost — it was lost in the 1994 debate over “Hillarycare,” and it was never addressed in the debates in 2009 and last year that resulted in the Affordable Care Act reforms.
It’s this: The huge, multi-level crisis we’re facing in health care was, in fact, created by the private health insurance companies. The failure of the private “system” that has left millions of Americans without health-care coverage is a result of policies created — not in Congress, not in an Executive Branch regulatory office — but in the executive suites of private health-insurance corporations.
Over time, these failed private-industry policies have created a pool of 30 million-plus Americans. That’s more people than the population of Australia and roughly the populations of Canada and California.
It was deliberate policy decisions made by corporate insurance executives and enacted by private insurance bureaucrats that created the system in which Americans with pre-existing conditions are denied care — a policy based on corporate greed that is found in no other country.
It was policies of private insurance companies that capped lifetime coverage.
It is insurance company bureaucrats who — right now, today — operate real “death panels” that ration care.
These and the other inefficiencies and inadequacies that have driven the quality of health care in the United States down to 37th in the world could be resolved tomorrow — not by the government, not by laws — but by these private companies themselves.
All they would have to do is change their policies to cover everyone.
Period.
If, as Republicans say, only private industry can solve problems, then why haven’t private health plans put their heads together and come up with innovative, non-governmental strategies for covering everyone and keeping costs down while still preserving their profits?
Arguably, private insurance companies have had since they killed “Hillarycare” in September 1994 — 16 years — to solve this crisis. Instead, the crisis has gotten steadily worse.
The fact is, the private insurance corporations could resolve this crisis tomorrow, if they wanted to.
What’s stopping them? Why won’t private companies fix the crisis they created?
Obviously, resolving the crisis would cut into the $200 billion annual profits of these megacorps.
In 1994, these companies “invested” in Republicans in Congress in order to kill Hillarycare and protect their profits. What they learned then was that it was easier — and cheaper — to pay the Republican Party to do their dirty work and preserve the failed but profitable system than it was to come up with a solution that fulfilled their obligation as corporate citizens to provide health care to all Americans.
In 2009, the megacorps had a golden opportunity to institute a private-insurance alternative to the Democrats’ proposals.
Instead, they chose to invest millions in manufacturing rage among tea party mobs through their Republicans astroturfers at Freedomworks, Tea Party Express and the rest.
And yet, despite the millions they spent on lies, propaganda, disinformation and spin about health-care reform, they were unable to kill the Affordable Care Act in 2010.
In the 2010 midterms, the megacorps bought and paid for a new Republican majority in the House — and thanks to Citizens United, they were able to invest millions in GOP campaigns anonymously — in order to get another bite at the apple, another chance to roll back the clock and hobble the U.S. economy with their failed but profitable “system” once again.
All that said, one thing is puzzling. It’s unclear why the insurance megacorps oppose the individual mandate — a system that would deliver 30 million new customers to them overnight, a Republican pro-business concept produced by the GOP’s Heritage Institute “think” tank and implemented in Massachusetts by GOP 2012 presidential frontrunner Mitt Romney when he was governor.
One possible clue for what they really want can be found in statements from their mouthpieces in the Republican Party, particularly Rush Limbaugh and Sen. Minority Leader Mitch McConnell, who have said quite plainly that they want the government to fail. Why? Because a collapse of the American government regulatory regime would pave the way for complete and total corporate hegemony.
A more benign rationale is that, like the soulless executives who ran the “too big to fail” banks during the Bush era, insurance-company executives are blinded by their own greed, and just do not give a damn about the health and welfare of Americans who cannot afford to buy their products.
Under our regulatory capitalist system, when private companies fail to meet their obligations, it is the responsibility of the government to step in. That’s what happened here.
The bottom line is that, if the insurance megacorps and their tea party Republican lapdogs don’t like “Obamacare,” they only have themselves to blame for it.
Sadly, the Medical Loss Ratio will make things even worse in the long term. Well-intentioned, perhaps, but all it’s done is switch things to a different game. In the short-term it will probably reduce costs and it will improve the number of treatments people will receive.
Pre-HCR the insurers maximized shareholder return and executive salaries by refusing pre-existing conditions, applying annual and lifetime caps, recissions, etc.
With the MLR, they have to spend 80% of premiums (85% for group coverage of over 35 people) on medical expenses. Of course, they’re already trying to blur that a little by claiming that some of the admin side is really a medical expense.
The way MLR has changed the game is that they are limited to the percentage of the pie they can take. How to get more money for shareholders and execs? Make the pie bigger. A LOT bigger.
So they’ll happily take on people with pre-existing conditions. Remove annual and lifetime caps. Reduce or even eliminate co-pays. Actively encourage people to seek more treatment. Permit the prescription of expensive drugs and procedures they currently do not. Then they’ll show their books to the regulators and point out that they have to increase their premiums because their MLR has gone a lot higher than 80%.
Costs will go down in the short term because the insurers can fire all the clerical staff they currently employ to weed out people who would be expensive and to find ways to reciss those who become expensive. Long-term, expect costs to spiral out of control even faster than they have been.
The individual mandate would lower the costs a lot, but the only true solution is single payer.
Ya know I agree with this healthcare reform minus forcing people to buy it. We should preserve that choice for the individual, I think.
There is a lot of good than can come out of this, I know that I would buy into it but again…forcing someone to pay for something they don’t want ( and there are those people who just don’t want healthcare ) just doesn’t seem Progressive to me.
And, of course, the mandate was the Republicans’ idea. They were for it until Pres. Obama supported it, then they flip-flopped. Why? Because they have no real principles. They just want the president and the country to fail.
Nickka, are you talking about not wanting health care — like say, if you’re a Christian Scientist — or are you talking about not wanting health insurance? And if it’s the latter, to whom should we send the bill when the paramedics carry you in to the E.R.?
Uhm, hmm.
I believe I was referring to the not wanting to own health insurance or being forced to buy it. I like the idea of preserving choice, I feel that is Progressive.
And you don’t have to worry about me, I’m for buying it, as I said its my choice, like smoking or eat GMO food.
I’d worry more about undocumented workers that go to the hospital and have no way to pay the bill or just wont. Now, I’m Mexican and Italian by decent and a citizen of this country, I’ll have to side with the law. That is Progressive.
I say fingerprint anyone that doesn’t have proper documents proving their citizenship while at the E.R, take a photo of them for future visits and deliver said information to INS. Sounds Orwellian but I shouldn’t have to fit the bill for anyone, from anywhere in the world that hasn’t tried to become a citizen in the legal fashion.
The mandate is the part of the bill that requires everyone to have coverage. Similar to the way group plans work, the mandate requires everyone to buy coverage from private insurance corporations. As noted, the mandate was the conservatives’ solution.
The progressive approach would be to cut out the middle-man — the insurance companies — and create one giant risk pool, as Paul Allen said above, in a single payer system. Most industrial democracies in Europe have single payer systems. Canada has one. It would basically be lowering the eligibility age for Medicare from 65 to birth.
Right now, local governments pick up a total of $40 billion a year to cover costs of providing health care for the uninsured who show up at hospitals needing emergency and critical care. That’s the current “system” Republicans want to preserve by repealing “Obamacare.”
Nickka, have you tried the “being forced to buy it” argument with your car insurance? I’m sure if you explained it’s just not progressive to require you to insure your car, they’ll give you a pass.
Well car insurance is a lot different than health insurance. Car insurance is not mandatory either, it goes by the state and one can also choose not to drive. They have a choice to car pool, ride a bike or walk and etc..
Driving a motor vehicle is also a privilege,not a right, and that privilege can be taken away or modified based on certain conduct, including several issues surrounding drunk driving cases.
You have a right to own a car and you have a right to travel but driving is not at all a right.
I’d expect a grown woman to know this and not make snide comments because she thinks she knows it all. You don’t and no, you’re not funny.
And what does Democracy have to do with any of this? We’re not a Democracy, we have and use one to elect our Reps but we’re a Republic. Thats what our government is, its in the constitution….I don’t understand why my fellow Progresives are anti-republic and pro-direct democracy. Direct democracy is a joke. A myth and it has never worked out for the people.
I don’t see what any of this has to do with giving someone the right to make a choice for his or herself what they want. Its not like government is right about everything, guys. And if you really believe that government does, you need to seek mental help.
I trust government as far as I can throw it and thats not very far.
So, Nickka, what is the best way to provide coverage for the 30 million to 50 million uninsured Americans who can’t afford it now? Under the current Republican, corporate-backed “system,” these people have to wait until their cancer is inoperable or their pregnancy is in a crisis and then go to the emergency room. When they can’t pay the $250k to $1 mil hospital bill — all too often because they waited to long to seek treatment and died — it is paid by the residents of the city, county or state where the uninsured person lived.
There’s nothing easier than criticizing the proposed solutions. That’s all Republicans have done for the past two years. They even criticized and voted against their own solutions. But the days when people have the luxury of sitting around throwing monkey poo are over. It’s time for all the critics to switch gears and start advocating instead of constantly griping. Please explain the system you believe will provide health care for 30 million people — your neighbors and fellow Americans — whose choice is between spending $500 to $1,200 per month on health-insurance premiums or rent and groceries for themselves and their children.
That’s the “choice” under the current GOP/corporate “system.” What is your solution?
Nickka, I did a search and could find no states that don’t require some level of insurance in order to drive a car. If you have a specific example, please share it.
No, all states do not require car insurance but they do require financial responsibility to operate a vehicle on the roadway. While not all states require drivers to buy Liability insurance to show financial responsibility, 49 states (plus the District of Columbia) do. New Hampshire is the only state that does not have compulsory auto insurance liability laws.
Again Trish, you don’t have to own a car, you can get around many other ways. Driving is a privilege.
And Jon, when I say Republican I do not mean the GOP, c’mon use that head of yours. I mean ou system of Government is a Republic, one of the longest lasting governments of its type. I hope do death, that our Republic doesn’t fall.
Here are few options for having choice in our healthcare:
Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair.
?Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable.
Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care.
Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor’s visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us?
?Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility.
Revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.
Just a few options in making health care better. But I should say I don’t believe anyone is entitled to anything in this world except their right to life, liberty and the pursuit of happiness.
You have to go out and find all of that, it cannot just be given. Progress doesn’t come from institutions, progress comes from the individual.
Hi Nickka, Kim, Ray, Publis, Publius, Will. Very clever.
Have to say that what you are doing is extra creepy.
:)