The American Bear

Sunshine/Lollipops

ObamaCare Clusterfuck

A new series by Lambert Strether at Corrente. Enjoy!

ObamaCare to cost fast food companies much less because people would rather pay the IRS fine than join

White House delays small business coverage, citing “operational challenges”

Low wage workers “screwed” (Salon’s word)

Insurers get to cherry pick 2014 renewals

The way out is single payer experiments by the states

CO pushes single payer citizen initiative

Is Joe Klein truly the most stupid member of the political class?

Its “Single Streamlined Application” is 26 pages long. To be fair, that includes the penalty for perjury

Yay for the entrenchment of the private insurance model as pretend-universal healthcare!

As Lambert says at the end of the 2nd linked piece:

Of course, with single payer these problems don’t arise. Lower Medicare eligibility age to zero and boom! You’re done. Well, over-simplifying, but the right idea. The political class, because they are owned and they suck, thinks people want choices in health insurance. They don’t. They want choices in health care. Doctors can do that. Abolish the health insurance companies, and all their complex rental extraction schemes, and make health care a right that’s paid for with a single payer, and all the “operational challenges” go away.

7th Circuit Enjoins Contraceptive Coverage Mandate | Jonathan Turley

Because Jesus:

In Grote v. Sebelius, (7th Cir., Jan. 30, 2013), a 2-1 decision by the U.S. 7th Circuit Court of Appeals granted an an injunction, pending appeal, where the defendants are enjoined from enforcing the contraception mandate against the Grote Family and Grote Industries. Grote Industries is a privately held, family‐run business headquartered in Madison, Indiana. Members of the Grote Family are Catholic and operate their business according to the “precepts of their faith, including the Catholic Church’s teachings regarding the moral wrongfulness of abortifacient drugs, contraception, and sterilization.”

Judge Ilana Rovner’s dissenting opinion is interesting, read on

ObamaCare working according to plan: Health insurance parasites screw more blood out of our stones | Lambert Strether

Times:

Health insurance companies across the country are seeking and winning double-digit increases in premiums for some customers, even though one of the biggest [putative] objectives of the Obama administration’s health care law was to stem the rapid rise in insurance costs for consumers.

Since ObamaCare was crafted by Liz Fowler, a WellPoint VP on secondment to Max Baucus’s office, you may be sure that this continued bailout of the value-less health insurance industry is quite deliberate and probably built into corporate planning years ago. Athough I envy the child-like faith of anyone who believes otherwise.

Particularly vulnerable to the high rates are small businesses and people who do not have employer-provided insurance and must buy it on their own.

In California, Aetna is proposing rate increases of as much as 22 percent, Anthem Blue Cross 26 percent and Blue Shield of California 20 percent for some of those policy holders, according to the insurers’ filings with the state for 2013. These rate requests are all the more striking after a 39 percent rise sought by Anthem Blue Cross in 2010 helped give impetus to the law, known as the Affordable Care Act, which was passed the same year and will not be fully in effect until 2014.

At which point costs will still not be controlled, but never mind that.

Under the health care law, regulators are now required to review any request for a rate increase of 10 percent or more; the requests are posted on a federal Web site healthcare.gov, along with regulators’ evaluations.

The review process not only reveals the sharp disparity in the rates themselves, it also demonstrates the striking difference between places like New York, one of the 37 states where legislatures have given regulators some authority to deny or roll back rates deemed excessive, and California, which is among the states that do not have that ability.

Great. So if you’re in CA, you get to see what’s happening to you without being able to do anything about it.

Critics, like Dave Jones, the California insurance commissioner and one of two health plan regulators in that state, said that without a federal provision giving all regulators the ability to deny excessive rate increases, some insurance companies can raise rates as much as they did before the law was enacted.

“This is business as usual,” Mr. Jones said. “It’s a huge loophole in the Affordable Care Act,” he said.

Why do you think it’s a loophole, Mr. Jones?

NOTE Murder by spreadsheet continues. Recall that health insurance companies add no value to any transaction in which they engage.

Throwing Supporters Under The Bus – It’s Easy If You’re A D.C. Insider | Steve Hynd

You really should click on over to AmericaBlog to read Gaius Publius on what the DC insiderers have decided is a great deal for everyone they care about: Obama’s fiscal cliff frame: “Let’s each kill one of our own”.

Politico discusses the Klein-described deal, and in the process, confirms that this is where the discussion is being had. Politico’s first sentence (my emphasis):

The script for a fiscal cliff deal was always supposed to be simple: Democrats would win on taxes. Republicans would win on entitlements.

It’s that simple. Politico is DC insider-central on this stuff, especially when they offer throw-away assumptions like the one above. The rest of the article details how small a deal Republicans are getting — the knife cut Obama delivers to Medicare may be mainly symbolic. Fair enough. On the taxes side, the compromise tax-cut agreement may also be symbolic. …

Again, the skeleton of the Obama-Boehner bargain is a mutually-agreed betrayal — “You kill one of yours, and I’ll kill one of mine.” It’s a mutual “Et tu, brute?” moment.

GP also reminds readers that  ”Obamacare is privatized medical care. It forces citizens to buy medical insurance from private insurers — like United Health Care, for example — instead of offering single payer government insurance, or even a public option to compete with private insurers.” So anyone from the DC insiderer set that tells you not to worry, the less affluent affected by any cuts to Medicare will get folded into the ACA, is advocating privatizing a public healthcare plan. Don’t be fooled by their three card monte spin, it’s just more of the same old.

Obamacare architect leaves White House for pharmaceutical industry job | Glenn Greenwald

When the legislation that became known as “Obamacare” was first drafted, the key legislator was the Democratic Chairman of the Senate Finance Committee, Max Baucus, whose committee took the lead in drafting the legislation. As Baucus himself repeatedly boasted, the architect of that legislation was Elizabeth Folwer, his chief health policy counsel; indeed, as Marcy Wheeler discovered, it was Fowler who actually drafted it. As Politico put it at the time: “If you drew an organizational chart of major players in the Senate health care negotiations, Fowler would be the chief operating officer.”

What was most amazing about all of that was that, before joining Baucus’ office as the point person for the health care bill, Fowler was the Vice President for Public Policy and External Affairs (i.e. informal lobbying) at WellPoint, the nation’s largest health insurance provider (before going to WellPoint, as well as after, Folwer had worked as Baucus’ top health care aide). And when that health care bill was drafted, the person whom Fowler replaced as chief health counsel in Baucus’ office, Michelle Easton, was lobbying for WellPoint as a principal at Tarplin, Downs, and Young.

Whatever one’s views on Obamacare were and are: the bill’s mandate that everyone purchase the products of the private health insurance industry, unaccompanied by any public alternative, was a huge gift to that industry; as Wheeler wrote at the time: “to the extent that Liz Fowler is the author of this document, we might as well consider WellPoint its author as well.”

[…] More amazingly still, when the Obama White House needed someone to oversee implementation of Obamacare after the bill passed, it chose … Liz Fowler. That the White House would put a former health insurance industry executive in charge of implementation of its new massive health care law was roundly condemned by good government groups as at least a violation of the “spirit” of governing ethics rules and even “gross”, but those objections were, of course, brushed aside by the White House. She then became Special Assistant to the President for Healthcare and Economic Policy at the National Economic Council.

Now, as Politico’s “Influence” column briefly noted on Tuesday, Fowler is once again passing through the deeply corrupting revolving door as she leaves the Obama administration to return to the loving and lucrative arms of the private health care industry:

“Elizabeth Fowler is leaving the White House for a senior-level position leading ‘global health policy’ at Johnson & Johnson’s government affairs and policy group.”

The pharmaceutical giant that just hired Fowler actively supported the passage of Obamacare through its membership in the Pharmaceutical Researchers and Manufacturers of America (PhRMA) lobby. Indeed, PhRMA was one of the most aggressive supporters - and most lavish beneficiaries - of the health care bill drafted by Fowler. Mother Jones’ James Ridgeway proclaimed “Big Pharma” the “big winner” in the health care bill. And now, Fowler will receive ample rewards from that same industry as she peddles her influence in government and exploits her experience with its inner workings to work on that industry’s behalf, all of which has been made perfectly legal by the same insular, Versailles-like Washington culture that so lavishly benefits from all of this.

But experience in the Netherlands and Switzerland, where insurance exchanges are part of health care reforms that have been ongoing for some time, provides two cautionary lessons. The first is that competitive insurance markets will not contain costs without reforms of the health care purchasing market. In theory, health insurers should negotiate with health care providers on price, volume, and quality of care. Innovative payment methods should result in the purchasing of efficient care. In the United States, there has been little discussion about strengthening the purchasing market, although the ACA intends to promote provider competition by requiring yearly publishing of standard charges for items and services. Experience from the Netherlands and Switzerland shows that such efforts are not enough. Purchasing-market reforms in those countries are a work in progress, but the results so far in terms of cost containment and quality improvement have been negligible. Implementing Insurance Exchanges — Lessons from Europe (via azspot)

(via azspot)

If Roberts had killed Obamacare, it would have rallied the DEMOCRATS. If Roberts had killed Obamacare, it would have meant facing Medicare for Everybody the next time the Dems (if ever) controlled enough Houses of Congress to give it to us. By saving the ACA, Roberts put off that day for a century or two. Medicare for Everybody is what Obama SHOULD have done. Instead, he sided with the health care insurance industry and kept them alive, nay, gave them fresh business and money, most of it from the government in the form of subsidies. The ACA is just about the worst ‘improvement’ of our health system that any person could imagine; but it IS an improvement. BartCop (via azspot)

(via azspot)

Perry ‘proudly’ refuses health care to 1.2 million low-income Texans

sinidentidades:

In a statement published Monday morning, Texas Governor Rick Perry (R) “proudly” declared that he will decline to implement key tenets of the Affordable Care Act — a move that will see his state forgo an estimated $164 billion dollars in federal aid and leave over 1.2 million low-income Texans, who would have finally been eligible for health care, helpless and uninsured.

“This is a fiscally stupid decision on the part of Rick Perry,” Texas Democratic Party spokesperson Rebecca Acuña told Raw Story. “Texas would be one of the states that gets the most money from the federal government and the Medicaid expansion would have provided health care to more than a million Texans. It’s… It’s very sad that Rick Perry is willing to play politics with the health of Texans, and that’s exactly what this decision is.”

With his announcement, Perry becomes the sixth governor to refuse implementing a key aspect of the Affordable Care Act: the Medicaid expansion and the state-based health care exchanges. Republican governors in Florida, South Carolina, Mississippi, Louisiana and Wisconsin have made similar decisions, but Texas is by far the biggest.

Perry would seem to be inviting a political free-for-all thanks to the relative size and power of the Texas hospital industry, which absorbed more than $4.6 billion in unpaid emergency medical costs in 2010. While not seeing it as a cure-all, Texas hospitals largely praised the Affordable Care Act for dramatically expanding health care options for poor people, who are ultimately paid for by others who carry their own insurance. Nearly 25 percent of Texans — 6.5 million people — do not have health insurance, including more than 1.2 million children, and the state’s health care system ranks last in the nation overall.

WATCH: Perry says Medicaid expansion like ‘adding 1,000 people to the Titanic’

(via basedlenin-deactivated20120831)

The Times resorts to crazily contorted wording to convince us the Affordable Care Act is the next logical step in the civilizing of the United States; that it bears some resemblance to universal health care as practiced in the rest of the developed world – an outrageous distortion of fact and history. Obamacare, like previous Republican healthcare schemes, is based on the principle that people should pay for their own bodily maintenance, and that ‘free riders’ must be forced into the private pool. It expands the healthcare compact only for those who are destitute, while turning everyone else into profit-centers for corporations. That’s not the direction universal healthcare advocates have been trying to go, all these years. It is, at best, a detour, and more likely an historic setback to the movement for a truly national health care policy. Glen Ford

How the owners of a society play with their property | William Blum

Something important to note:

The Supreme Court of the United States has just upheld the constitutionality of President Obama’s health care law, the Affordable Care Act. Liberals as well as many progressives are very pleased, regarding this as a victory for the left.

Under the new law, people can benefit in one way or another depending on the following factors:

Their age; whether their income is at or below 133 percent of the federal poverty level; whether their parents have a health plan; whether they use tobacco; what state they live in; whether they have a pre-existing medical condition; whether they qualify to buy health insurance through newly-created market places known as “exchanges”; and numerous other criteria … They can obtain medical insurance in a “competitive insurance market” (emphasis on the “competitive”); they can perhaps qualify for various other kinds of credits and tax relief if they meet certain criteria … The authors of the Act state that it will save thousands of dollars in drug costs for Medicare beneficiaries by closing a coverage gap called the “donut hole” … They tell us that “It keeps insurance companies honest by setting clear rules that rein in the worst insurance industry abuses.”

That’s a sample of how health care looks in the United States of America in the 21st century, with a complexity that will keep a small army of lawyers busy for years to come. Ninety miles away, in the Republic of Cuba, it looks a bit different. If you feel sick you go to a doctor. You’re automatically qualified to receive any medical care that’s available and thought to be suitable. The doctor treats you to the best of his or her ability. The insurance companies play no role. There are no insurance companies. You don’t pay anything. You go home.

The Affordable Care Act will undoubtedly serve as a disincentive to the movement for single-payer national health insurance, setting the movement back for years. The Affordable Care Act was undoubtedly designed for that purpose.

And lest you think Blum doth protest too much, let me draw your attention to this snippet from former Cigna Executive and whistleblower Wendell Potter:

I was still head of corporate communications and a member of the public policy team at Cigna when [former Aetna CEO, Ron] Williams began speaking out about the need for an individual mandate. Many in the industry, including my former CEO, Ed Hanway, were initially skeptical, so Williams set out to convince them he was right. He argued that if Democrats took control of both Congress and the White House, which was looking increasingly likely, they would set their sights on the insurance industry. They most certainly would attempt to ban many of the industry-wide practices that enabled insurers to be so profitable, such as refusing to sell coverage to people with preexisting conditions. If that were to happen, the best way to guarantee that insurers wouldn’t be saddled with just the sickest Americans would be to get the Democrats to agree to a requirement that everybody, including the youngest and healthiest among us, buy private coverage if they weren’t eligible for a public program like Medicare or Medicaid. The government would also have to agree to tax credits or subsidies to help low- and moderate income Americans pay their premiums.

Before long, the CEOs of the other big insurers were indeed on board. They came to realize that if Democrats would agree to an enforceable mandate and premium subsidies, their companies would be getting billions of dollars in new revenue every year — forever.

“Victory”.

(Source: theamericanbear)

How the owners of a society play with their property | William Blum

Something important to note:

The Supreme Court of the United States has just upheld the constitutionality of President Obama’s health care law, the Affordable Care Act. Liberals as well as many progressives are very pleased, regarding this as a victory for the left.

Under the new law, people can benefit in one way or another depending on the following factors:

Their age; whether their income is at or below 133 percent of the federal poverty level; whether their parents have a health plan; whether they use tobacco; what state they live in; whether they have a pre-existing medical condition; whether they qualify to buy health insurance through newly-created market places known as “exchanges”; and numerous other criteria … They can obtain medical insurance in a “competitive insurance market” (emphasis on the “competitive”); they can perhaps qualify for various other kinds of credits and tax relief if they meet certain criteria … The authors of the Act state that it will save thousands of dollars in drug costs for Medicare beneficiaries by closing a coverage gap called the “donut hole” … They tell us that “It keeps insurance companies honest by setting clear rules that rein in the worst insurance industry abuses.”

That’s a sample of how health care looks in the United States of America in the 21st century, with a complexity that will keep a small army of lawyers busy for years to come. Ninety miles away, in the Republic of Cuba, it looks a bit different. If you feel sick you go to a doctor. You’re automatically qualified to receive any medical care that’s available and thought to be suitable. The doctor treats you to the best of his or her ability. The insurance companies play no role. There are no insurance companies. You don’t pay anything. You go home.

The Affordable Care Act will undoubtedly serve as a disincentive to the movement for single-payer national health insurance, setting the movement back for years. The Affordable Care Act was undoubtedly designed for that purpose.

And lest you think Blum doth protest too much, let me draw your attention to this snippet from former Cigna Executive and whistleblower Wendell Potter:

I was still head of corporate communications and a member of the public policy team at Cigna when [former Aetna CEO, Ron] Williams began speaking out about the need for an individual mandate. Many in the industry, including my former CEO, Ed Hanway, were initially skeptical, so Williams set out to convince them he was right. He argued that if Democrats took control of both Congress and the White House, which was looking increasingly likely, they would set their sights on the insurance industry. They most certainly would attempt to ban many of the industry-wide practices that enabled insurers to be so profitable, such as refusing to sell coverage to people with preexisting conditions. If that were to happen, the best way to guarantee that insurers wouldn’t be saddled with just the sickest Americans would be to get the Democrats to agree to a requirement that everybody, including the youngest and healthiest among us, buy private coverage if they weren’t eligible for a public program like Medicare or Medicaid. The government would also have to agree to tax credits or subsidies to help low- and moderate income Americans pay their premiums.

Before long, the CEOs of the other big insurers were indeed on board. They came to realize that if Democrats would agree to an enforceable mandate and premium subsidies, their companies would be getting billions of dollars in new revenue every year — forever.

"Victory".

A Liberal form of healthcare? That would be socialized medicine. The kind of thing that much of Europe has. That Canada has. That Vermont is poised to implement on a statewide level. ObamaCare? It really is RomneyCare, just as RomneyCare really is ObamaCare. The smear cuts both ways. It’s a two-way mirror that each man attempts to hide behind, but which clearly reveals both of them in all of their center-right glory. Thus, the Florida decision was not a victory for Liberalism. Regardless of your actual opinion about the healthcare bill, in reality this decision is a reflection of center-right dominance in America. And that so many Liberals robustly celebrated when the ACA prevailed in court indicates at least two things: First, the partisan divide has become so deep that Americans loyal to this or that party or ideology will seemingly celebrate any victory, even those that do not actually reflect their values. Second is just how far to the right this nation has swung over the last quarter-century. So far to the right that, as we witnessed last week, a major policy initiative that used to be Republican is now Democrat. And most people simply accept that reality.

America’s Move to the Right (via azspot)

See also.

(via randomactsofchaos)