Democrats Need to Talk Straight About Health Care

October 16, 2019

By Karen

Though I no longer have a dog in this fight because this month I finally got to enroll in Medicare, my hair still ignites when I hear the Democratic presidential candidates misleading us — whether in ignorance or intentionally, I don’t know — about how to reform health care.

If you’re confused about Medicare for All (a.k.a. “universal coverage”), let me explain the jargon…

Insurance – The crux of the problem. Candidates say “insurance” and “health care” interchangeably, but they’re totally different. Insurance is a piece of paper. Health care is visiting a doctor. The company who sold you the paper may not pay for your doctor’s visit.

Private Insurance – Candidates say this to mean insurance individuals buy for themselves AND insurance that employers provide for workers. Again, two completely different things. When dissing Medicare for All, candidates say, “People don’t want to lose private insurance they love.”

NOBODY loves true private (individual) insurance. It’s expensive because insurers cherry-pick and jack premiums based on age and health. It often has a high deductible, it can be canceled without warning when you get sick, and it can pay little to nothing on claims.

Employer-provided insurance is controlled solely by employers, who can change it, cancel it, or shift its cost onto workers. If you quit or get laid off or fired, you lose that insurance.

To control costs, both types of private insurance may lock you into “provider networks.” You see the doctors the insurer wants you to see, or go elsewhere and pay most or all of those medical bills yourself.

Affordable Care Act (ACA) a.k.a. Obamacare –Obama and Biden managed to pass this in 2010 over Republicans’ dead bodies for people who can’t get employer-provided insurance. It has an online marketplace a.k.a. “the exchange,” where you can buy insurance. Because the ACA didn’t go live until 2014, insurers spent four years royally screwing people (like me) who already had individual insurance by raising premiums astronomically.

ACA insurers on the exchange offer no discounts (see “Subsidies” below). Policies available on the exchange depend on which insurers do business in your area. It’s totally up to the insurers. There may several, one, or none.

Subsidies – Insurance premiums under the ACA are cheaper for people with low incomes because the federal government shovels billions of dollars in subsidies to insurers to make up the difference and keep them profitable.

Public option – Today, the ACA offers insurance only through insurance companies. The proposed “public option” is insurance provided by the government. The easiest way to have that option is to let people under age 65 enroll in Medicare.

Single-payer system – This would create a central federal billing and payment hub (think Medicare) that doctors would bill for providing health care for all Americans (universal coverage). There would be no paperwork for patients and it would have no co-pays, no deductibles, and no surprise bills. England, France, Canada, all of Scandinavia, and many other countries do health care this way because it’s more efficient and cheaper.

Medicare for All – The universal, single-payer system that eliminates insurance and pays for all Americans to receive health care from birth to death.

Here’s where some of the Democratic candidates stood in last night’s debate…

Joe Biden wants to keep the ACA and add the public option. Problem: insurance companies continue getting billions in federal subsidies that could otherwise pay for actual health care.

Pete Buttigieg wants “Medicare for All Who Want It.” He says people should keep private insurance if they like, which is bullshit if it’s employer-provided. He wants to keep subsidies to control costs, still shoveling taxpayer money to insurers to keep their profits up instead of paying for actual health care.

Amy Klobuchar wants to reduce premiums. She thinks punishing Big Pharma will do that. Insurance and drugs are separate industries; they have nothing to do with each other. The only overlap is when your insurance doesn’t cover your drugs and you have to pay full price.

This morning on Morning Joe, Klobuchar complained about Medicare for All kicking “149 million people off of their private insurance.” She’s another one confused about employer-provided insurance that workers have no control over.

Elizabeth Warren wants Medicare for All, but must be unsure of the numbers because she won’t say how she’d pay for it.

The ONLY candidate who fully understands the problem and how to fix it — because he “wrote the damn bill” — is Bernie Sanders. Under his plan…

No American will need health insurance. Instead, we’ll channel what we now spend on premiums, co-pays, deductibles AND surprise health care bills into one system.

A single, centralized billing and payment system will drastically cut administrative overhead and expense for the entire health care industry. This federal system will also have clout to negotiate lower rates for health care services.

You can go to any doctor. Networks won’t exist.

Not a penny from taxpayers will be wasted on subsidies to boost insurance company profits.

I believe, with Bernie, that not only will we all come out ahead financially, but no one will have to go bankrupt from disease or illness.

Check out this publication from the White House from March 2018 called The Profitability of Health Insurance Companies. It says insurance companies have done just dandy since the ACA took effect (emphasis mine)…

“As government policy amplified eligibility and per-enrollee spending, the stock prices of health insurance companies rose by 172 percent from January 2014 to 2018 resulting in improved profitability and outperforming the S&P 500 by 106 percentage points.”

And its conclusion says…

“Despite an initial rough patch in the ACA marketplaces, the ACA Medicaid coverage expansion and subsidies to insurers have resulted in a large increase in health insurer profits. Health insurers’ stock prices more than doubled the impressive gain in the S&P 500 since the law’s main provisions took effect on January 1, 2014. Much of insurers’ increased profitability has resulted from increased Medicaid enrollment and increased payments per enrollee in Medicaid expansion states where the federal government pays nearly all the costs. While insurers initially incurred losses in the ACA marketplaces as they adjusted to new regulations and a relatively unhealthy risk pool, insurers are now profiting on the individual market as well, with higher premiums that are largely covered by federal premium subsidies.

Bottom line: Any candidate, Democratic or Republican, who talks about subsidies, or even insurance, is for squandering our taxes to keep the biggest obstacle to health care — insurance companies — profitable.


Trump’s Revealing Behavior on Health Care

March 27, 2017

By Karen

Last week’s health care debacle highlighted Donald Trump as the quintessential man-baby. Now I think I know why Ivanka’s got an office in the West Wing. SOMEBODY’S got to change the diapers.

During the campaign, Trump claimed he would repeal and replace the Affordable Care Act on “Day One.” It would be easy. He had “something terrific” and cheaper in mind to cover everybody, and we’d all be very, very happy.

The fool didn’t realize he was describing the single-payer system Bernie Sanders advocates, also known as HR 676.

So why did Trump’s terrific idea never get mentioned last week? He offered NOTHING but vague, untrue promises, and even proclaimed at one point his amazement at how complicated health care is.

He was useless while Paul Ryan crafted an ACA replacement bill, and the result was disastrous. Had it passed and voters realized how deeply it shafted them, making health insurance drastically more expensive and doing nothing to improve medical care, they’d have descended en masse on Washington with torches and pitchforks, demanding heads.

Trump seemed oblivious to potential voter outrage that would surely sink him, if Russia doesn’t first.

Fortunately, congressional Republicans themselves balked. Some were repulsed by the bill’s inherent cruelty in stripping people of what coverage they now have, but others opposed the bill because it wasn’t backward-thinking and punishing enough.

While not having a clue as to what the bill meant, Trump spent a few days stamping his feet and demanding everyone vote for it because that’s what he wanted. If they didn’t, he’d do something mean to them. That’s his “art” of making deals.

Trump’s ignorance rendered him incapable of negotiating compromise on any point in the bill, and he changed no minds.

When his sheer bullying didn’t work, Trump dodged the humiliation of seeing the bill get crushed by having Ryan pull it before the vote and shelve it indefinitely.

With his now-expected spite, Trump immediately dismissed health care reform, saying he’ll let the ACA “explode.”

So much for his campaign promises to make his supporters’ lives better.

Instead of pouting, he could now try to correct the ACA’s deficiencies. Or, even better, he could roll out “Medicare for All,” the single-payer system he touted as a candidate. It’s already up and running, and redirecting the billions insurance companies now pocket as profit could finance its expansion.

Instead, Trump is letting insurers continue to be leeches, sucking subsidies from the government while charging people too much for high-deductible health insurance that pays for precious little medical care.

Trump’s an overgrown baby, grabbing at whatever shiny toy Steve Bannon dangles before him. Last week it was health care. This week, he’s on a tear to resurrect the coal industry by rolling back water protection and reviving air pollution because he thinks coal mines are neat.

Like any infant who hasn’t learned the concept of consequences, he’s making coal miners’ environment even deadlier while doing nothing to improve access to health care, and he thinks he’s doing them a favor.


Bill Clinton’s 100 Percent Correct on Obamacare

October 6, 2016

By Karen

Bill Clinton’s catching hell for calling a certain aspect of the Affordable Care Act — NOT the whole program, mind you — “the craziest thing in the world.” And this is what he said (quotes taken from CNN)…

“But there is a group of people — mostly small business owners and employees — who make just a little too much money to qualify for Medicaid expansion or for the tax incentives who can’t get affordable health insurance premiums in a lot of places. And the reason is they’re not in big pools,” Clinton said. “So they have no bargaining power.”

“So you’ve got this crazy system where all of a sudden 25 million more people have health care and then the people who are out there busting it, sometimes 60 hours a week, wind up with their premiums doubled and their coverage cut in half. It’s the craziest thing in the world,” Clinton said.

I’m EXACTLY who he’s talking about. I’m a sole proprietor with individual health insurance, and I earn a little too much to qualify for any subsidy from the ACA.

In the past two years, my premium has gone up 52%. I’m still three years short of qualifying for Medicare, so I just dug into savings and paid off my mortgage because I fully expect my health insurance premium to become so crushing, I won’t be able to continue paying both.

Trump, of course, is cherry-picking Clinton’s statements as agreement with Republicans. That’s because Trump doesn’t have a clue what he’s talking about. All Trump’s said is he’d replace Obamacare with “something terrific.”

But Bill Clinton is spot-on about the ACA’s biggest weakness. I thank him for bringing it into the conversation.

Hillary favors adding a “public option,” but as long as greedy private insurers continue to gorge themselves at this trough, raising premiums AND collecting government subsidies, Americans will continue being screwed while having unaffordable access to healthcare.

The ONLY solution is a single-payer system — Medicare for all — with EVERYONE (including employers if they keep offering coverage to employees) paying into one central, not-for-profit pot. Done right, it would eliminate copays and deductibles. These are the additional costs that become deal-breakers when piled onto already-high premiums.

We’d ALL come out ahead in the long run.


Once Again, Eric Cantor Disgraces Virginia

July 13, 2012

By Karen

Rep. Eric Cantor proudly led this week’s Republican charge — for the freaking 33rd time — to repeal Obama’s Affordable Care Act. I’m ashamed to say my Virginia taxes pay this rat-bastard’s salary while he and his cronies waste time on the clock making “symbolic” gestures.

I’ve got a “symbolic gesture” for Cantor.

Cantor’s bill passed in the House 244-185 so it can go to the Senate and get stomped to death — again.

Cantor keeps babbling about “patient-centered care,” yet never explains HOW he’d get there because he knows there’s only one way left — and he can’t say it.

But I’d like to see one politician from either party stand up and admit, “The ACA isn’t really about healthcare. It’s mostly about insurance.”

Anybody who’s ever wrestled their insurer over coverage knows —having insurance in no way ensures getting healthcare. And it virtually guarantees you will NOT get “affordable” healthcare.

Republicans, with their pathological refusal to face facts, keep calling the ACA a “government takeover.” Yet people won’t be fighting the government over medical bills. They’ll be fighting WellPoint, Aetna, Humana, Cigna, Unitedhealth…

With the ACA, Obama either screwed us royally, or he sees it long term as the best hope to ultimately achieve single-payer — Medicare for all.

Insurers will be giddy with power once they have 30 million new customers to screw and kill, and they’ll be cooking the books like mad to skirt the “85% must go toward healthcare” provision to keep profits growing.

Unfortunately, it’s us little guys who will be driven into bankruptcy and/or die while insurers squeeze every last nickel from the system in ways that would make the Mafia blush.

Finally, insurers will ruin enough lives so Americans of all parties will scream with one voice to end the corruption, forcing Congress to DO something for a change.

And the solution will be Medicare for all because it’s the only option left. And it WORKS in every industrialized society where people aren’t as stupid as we are, resulting in longer life spans and reduced infant mortality for less cost.

Republicans go about healthcare reform like a bunch of pathetic Civil War re-enactors, thinking if they keep refighting the same old battle, they’ll change the winner. They insist the U.S. has “the best healthcare system in the world” like the myopic souls who believed “one Southern gentleman can lick 10 Yankees.”

Representatives of both parties must first wean themselves from insurers whose billions in profits don’t go to healthcare — but help to buy off politicians. (Check out Cantor’s record on that.)

As long as Washington is on the take (while enjoying dandy healthcare benefits at our expense), we’ll never see meaningful reform.


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