Moneyed Politicians

Now we’re really in trouble… we’re talking “socialized medicine!”

By Jack E. Lohman

The reality is that — one way or another — we Americans, 100% of us, pay for 100% of all nationwide healthcare costs. Whether through increased employer costs that are passed on to the consumers at the cash registers, or through taxation. So, the big question is,

“why don’t we do this the right way from the beginning? Eliminate all unnecessary costs for industry profit and over-use and fraud, and just pay the damned bill and move on to fixing our real national issues???”

Yes, we hear all of these terrible things about Canada’s and Britain’s systems, but we hear it mostly from the for-profit insurance and private interests that also want to make their country’s system privatized and profitable like (God forbid) America’s!

The actual public — the peons and patients — love what they have because it gets the thing done — better, and at half the cost of America’s profit-making system, which is set to satisfy only the vultures.

Polls show that 80% of Canadians prefer their system to ours. Yes there are wait times for non-critical procedures, but not for urgent needs. And they could even eliminate the waits they have by increasing their spending from 10% to 12% of GDP (ours is 17.5%).

The most efficient is the V.A. Medical Center

Think Walter Reed and Bethesda Medical Center, government-run systems that have cared for (the well-respected) Dick Cheney and other government bigwigs. Not too shabby, I would say.

Yea, the V.A. system is currently overloaded because of the wars, but give them all of our private hospitals and physician clinics and they’d do a lot better than our privatized system. And incidentally, let them buy the failing Mt. Sinai here in Milwaukee and start the ball rolling.

Oh, but the right-wing ideologues would have kittens. “Government run??? You’ve got to be kidding!!!”

And clearly they’d have some good arguments. Government bureaucrats are sometimes worse than profit gougers. There’s just no in-between.

Or is there?

Let’s have the Federal Government (taxpayers) subcontract Universal Health Care to Halliburton or Boeing (okay, just kidding but you get the point) or another well-respected non-profit private entity. Expand the V.A. system to all Americans!

We taxpayers would be the only shareholders, and we’d establish a non-partisan board of directors (picked not by politicians but by a combination of health care professionals).

The only incentive will be executive wages, paid on a performance basis, which would be established by the board. With a $1 million CEO salary cap. And employee salaries. The doctors would be salaried (very well, I might add) with only one goal: good, solid, patient care.

And the estimated trillion-dollar-per-year savings?

We’ll find a place for it.

All of this may make sense but it is not accompanied by a campaign check. So making it happen will be difficult.

Medicare-for-all or single-payer are hopefuls, but both are still subject to over-billing and fraud. And politicians.

By Jack E. Lohman

Mainly political corruption. Because with this system the insurance industry is not needed, or at best, it plays a minimal role by providing “Gap” insurance to cover co-pays and deductibles. Thus they are willing to pay big money to the politicians who block it.

Guys like Sen. Max Baucus (D-MT) and Sen. Mitch McConnell (R-KY) are high on their list, but should be at the bottom of yours. They have their own gold-plated taxpayer-funded health care plan, even after their retirement. They are fixed for life.

Single-payer is a term we use, because the taxpayer is that payer. Medicare, Medicaid, and BadgerCare are all in that category, but importantly they only provide the administrative services. It all cases the medical services are provided by the same private hospitals and doctors we are currently using.

It makes a lot of sense, but that’s exactly why it is having problems attracting politician support.

Getting rid of the high profits to shareholders, high CEO salaries and benefits, sales commissions, excessive legal fees for defending denials and cherry-picking, and the cost of political bribes is key. Still remaining as problems is the fee-for-service system of compensating physicians, which encourages over-ordering, and the lack of a Certificate of Need which discourages overbuilding and the purchase of expensive MRI and other high-tech instrumentation.

Deductibles and co-pays are generally counter-productive

They keep patients away from the doctor and allow minor problems to escalate to more costly problems. People sometimes just can’t afford them, and even so, their cost of administration is often equal to the payment. Yes, unnecessary doctor visits may result without them, but few people relish sitting in a doctor’s waiting room unless they feel they need it.

Getting single-payer on the table

Not an easy thing when politicians are paid to keep it off the table. About eight healthcare activists attempted to get it discussed and were arrested for disturbing the peace at a Senate Finance meeting. Just allow a vote on it, was all they asked. Sen. Max Baucus, with his $5 million from the healthcare industry, wouldn’t have any such thing.

Rep. John Conyers had HR676, a Medicare-for-all system that would have cut $400 billion from our nation’s healthcare tab while providing health care to 100% of our citizens.

From the public’s standpoint …

… single-payer makes sense, because it gets employers out of the business of providing healthcare and it allows portability — giving people the opportunity to quit their job and start a new business on their own — without the fear of killing healthcare for their family.

But it doesn’t make sense for the politicians because it will kill campaign contributions.

From a cost standpoint, a Medicare-for-all makes sense for the taxpayers AND the business community… the non-insurance businesses, that is.

Our current system, filled with political corruption, high costs, excessive profits, denials, retroactive exclusions and fraud.

By Jack E. Lohman

The system is filled with the profit motive, even at the expense of the patient, and the politicians share the profits. So the political fix is not going to be easy, regardless of which of the two parties are in control, because they both take campaign bribes.

Hospitals have evolved from non-profit church-run institutions to corporations with CEOs and shareholders, too many of which give cash dollars to politicians so the rules are weakened to satisfy their profits. Cash dollars (campaign bribes) flowed before the state legislature nullified the Certificate of Need (CON).

The CON prevented hospitals from building wherever they wanted, and here in Milwaukee we saw new hospitals built near old hospitals “to compete.”

But they didn’t compete because they bought up the local physician clinics (their referral base) and are actually allowed to pay the doctors “productivity bonuses” for admitting patients and performing even more expensive MRIs and other tests and surgeries (whether needed or not).

Thanks but no thanks. We don’t need that type of competition, which drives costs up, not down.

Doctors, incidentally, should be paid very well, but not on the basis of how many tests or surgeries they perform or don’t perform (which is now the case). It’s what they call fee-for-service and applies to both private insurance and Medicare, though Medicare reimburses at a lower (though still profitable) rate. Indeed we have seen doctors who have maxed out their schedule refuse Medicare patients and hold out for non-Medicare patients.

Insurance companies are middlemen that simply profit from the system. More so from well people who need no medical services, and less so from people who really are sick and need care. Remember that only those requiring care increase our costs.

The insurance industry is virtually unregulated where it counts and have even cancelled insurance policies retroactively in what are called rescissions. One woman was refused breast cancer coverage because she failed to report the acne she had as a teenager, as just one ploy they use.

And denials of care are common, like the liver transplant for a 17-year-old girl in California. CIGNA finally approved it after months of public and media pressure, but the girl died the afternoon it was finally approved. Thanks CIGNA, for keeping your profits up front.

Fraud happens, mainly because virtually any outside billing system allows it. Bad guys obtain social security and insurance numbers, even after the patients die, and both private and Medicare are affected. Any time outside billing is allowed, inappropriate billing will occur, and in our case it is estimated at 10% of our total costs.

The Feds should reward outside contractors to pursue villains.

Sadly, we must rely on our politicians, who get a piece of the action in campaign bribes to keep the system broken.

But on healthcare reform, the insurance CEOs must love him!

By Jack E. Lohman

From Sensenbrenner’s web site ”I share the concerns of many Americans who believe that health care costs too much, insurance is unaffordable and the system needs to be reformed.  While some have advocated for the government to takeover and run the universal healthcare system, my opinion is that this would make the current situation worse and drastically reduce the quality of health care services in America.  Individual choice and free market competition – which currently do not exist – are steps in the right direction.  I support legislation to help the nation’s 47 million uninsured individuals obtain health coverage by creating a new tax credit for the purchase of private health insurance.  Health Savings Accounts also deserve the support of Congress as a way to increase access to affordable medical care.”

It’s probably best to treat this as honest ignorance, rather than a conflict of interest, which I tend more to believe.

But Sensenbrenner is correct on this!

ObamaCare is terrible and hopefully the (conservative) Supreme Court will disallow the mandates. That also destroys its funding, so it will likely die on the vine. If we are lucky.

For the Dems to pound their chest that even poor people now have coverage, when they have just passed a law mandating that these people spend part of their food money to buy a commercial product, is at best stupid and at worst corrupt.

As a former business owner, I would have loved that the government mandate that all Americans must buy my product. Now THAT would have been worth some campaign bribes.

My friend  James B. Rippy asks: “C’mon folks, we are going to force mandatory health insurance coverage on every citizen and yet we have court battles going on over the right to determine citizenship. Have we completely lost it?”

Yea, Rip, I think we have.

But look at the meat of the issue:

Sensenbrenner is calling for a “privatized free-market system.” He obviously is a very smart congressman, but he’s not a physician and clearly shouldn’t be. Though I’m quite sure he enjoys his own gold-plated taxpayer-paid healthcare plan that he denies others.

(And yea, he’s my congressman but I no longer vote for him.)

Simply, “competition” doesn’t work in health care, especially when the insurance company injects itself between physician and patient, or has congress ordering regulations in their favor. For a price, that is.

Or when hospitals employ their own physician/referral staff, and pay them bonuses for patient admissions and the ordering of expensive tests that are not needed.

Easily 80% of patients are not qualified to judge when and when not to see a physician. Especially if they are going to be hit with deductibles or co-payments or other penalties, or it negatively affects their health savings account.

Absolutely!!! Let’s start with eliminating workman’s comp and unemployment payments to the government! Then eliminate taxes on profit!

By Jack E. Lohman

Think about it. Employers pay these taxes and then add those costs to the price of their product, and we consumers reimburse them at the cash register. In a very regressive manner!

*OR* they move their manufacturing to countries with lower employee costs. Unless we give them tax subsidies that make the politicians look like heroes, which drives up campaign contributions!!!

Aren’t we lucky?

So if we cut these taxes, how do we make them up? How about taxing the top 1%? And convert this “capital gains” tax to an “income” tax (where it should be anyway) so they pay at 35% instead of 15%.

But wait, it is they who bribe our pol… sorry, fund the political campaigns!

This fact remains… our country would be better off if run by politicians who did not take cash bribes from special interests!

At what point in time will our corrupt congressional politicians recognize that their corruption is killing America? When they have totally drained us and our nation totally collapses? 

By Jack E. Lohman

So here we have it… American Airlines is going bankrupt because of high fuel costs, all when America’s biggest export is… get this… FUEL! All while we are gouging Americans at the gas pump, we are sending our own fuel out of the country.

Because … uh… that’s our “free market!” Fat Cats make more profits this way, which translates to more money for campaign bribes. No matter that when we import a replacement, we pay for additional transport costs.

And we argue about the Keystone XL pipeline between Canada and Texas. Forget that it may be hazardous to central U.S., it is profitable. And that translates to campaign cash. Even if — especially if — we export most of it once we refine it.

And now we have Wisconsin politicians set to give permission to new mining, all while out-of-state executives from mining company Gogebic Taconite are listed at giving $21,500 to Wisconsin politicians. It’s funny how that works.

Have these political jerks no shame?

Or better, does our electorate have no smarts? We MUST force a 100% turnover in November.

I have never seen our government spend so much time and money trying to avoid doing the right thing… but campaign cash does funny things to politicians.

By Jack E. Lohman

It would actually be better and cheaper to fix the problem and move on to fixing our state’s economy. Even if only for government employees and paid corporate opt-ins, improved and expanded BadgerCare makes solid financial sense and would be a feather in Gov. Walker’s cap.

Let’s call it what it is: BadgerCare is a non-profit insurance system, funded by the state, that buys services from the same private hospitals and physicians that we all use.

We need this instead of ObamaCare.

Universal BadgerCare makes sense!

Yea, it’s a bad thing to some… doing what has worked so well in other countries. Like Britain’s National Health Service or Canada’s Medicare-for-all or other socialized programs. Even with their wait times (which we would eliminate), their patient outcomes are better than ours.

One of the America’s best is the V.A. healthcare system (though over-burdened at the moment). Salaried physicians and non-profit hospitals (though paid by and owned by the government). Makes all the sense in the world, but “making sense” is not high on politicians lists. Even an optional V.A. buy-in for employers would make sense.

A challenge to the business community…

Today’s healthcare costs are spread into the community and affect the whole economy and business environment. Jobs, taxes, you name it. Our current healthcare system is costing us dearly, and its cost is absorbed by all.

But think about it… 20% of your current healthcare costs are going to the bottom line. Not your company’s bottom line, but to some insurance company’s. That’s not a wise investment, and it does not help you create jobs.

With us all investing in BadgerCare-for-all, we can correct that. Call Gov. Walker!

Though he’s pretty good on his own, he can’t be any worse than Obama or Romney.

By Jack E. Lohman

Rocky Anderson of the new Justice Party is an attorney and former mayor of Salt Lake City, and very well thought of. Hopefully he’ll get the 10,000 signatures he’ll need to get on the ballot in Wisconsin. One of his major issues is eliminating our corrupt political system, and he refuses all contributions over $100.

He’s also very much in favor of universal healthcare, but I expect that he knows that until we get politicians off the payroll of the insurance companies that’s DOA.

See him answer one-on-one questions HERE.

Part of me feels that if we let BadgerCare fail, the voters will finally oust all Wisconsin politicians, and in my mind nothing could be smarter. I’d sure support that.

By Jack E. Lohman

But the truth is that we have an opportunity to not only save BadgerCare, but make it our rock-solid healthcare system that even Republicans would be proud of. If done correctly it will not fail but instead become the best jobs attractor ever.

It’ll reduce state taxes and attract companies and employees to the state. What’s wrong with that???

Let’s call it BadgerCare Gold, and have it replace our current BadgerCare and Medicaid systems. All of these systems are just methods of payment, and having more than one common system just increases administrative costs and confusion.

But let’s make it better!!!

Reimbursement: Doctors and hospitals must be reimbursed fairly or the system will not work. Make sure that reimbursements are equal to or better than Medicare.

Coverage: Make it a minimum-coverage system with 80% system payment and 20% patient co-pay. Obviously some patients will not be able to pay even that and subsidies will be needed.

Public Option: Allow businesses and individuals to opt into the system at its lower costs. If they want to pay for Gap or “frills” insurance beyond basic care, so be it. Let those business deal with that in our free-market system.

Government Employees: Convert the existing state, county and local healthcare systems to the lower-cost BadgerCare Gold system. No better than nor worse than the private industry. Substantial tax dollars would be saved, maximum healthcare would be given, and we’d attract new businesses and jobs to the state. What’s not to like about that?

Free Market: Leave open the ability for businesses and individuals to opt out and provide their own coverage.

Offloading healthcare costs to employees may work for the short-term, but Wisconsinites need a solution that will not blow up on our businesses in the long-term! Business leaders must pressure our politicians to do the right thing.

Yes, but not while the politicians are on the payroll of the pharmaceutical and healthcare industries!

By Jack E. Lohman

So, for this we must first install honest politicians who are working for the public rather than private interests? You know, like, get rid of the payola? Egads!

Medicare Part D

The biggest political payback ever. A $780 billion dollar giveaway to the drug industry, and my Congressman (Jim Sensenbrenner) owned $5M in drug company stock when he voted for it.

Have they no shame? They don’t even try to hide their conflicts of interest any more.

Separate our hospital and doctor employment

This is a direct conflict of interest. There was a day when doctors oversaw the quality of hospitals; now they are employed by and beholden to them. And hospitals can adjust salaries and give “productivity bonuses” based on how many admissions they make or expensive tests they order (both whether needed or not).

Yes, the higher costs affect private insurers as well!

Separate our clinic/doctor and lab ownership

When doctors work for a clinic that owns their own testing lab, or they even own their own EKG machine, a conflict of interest and excessive ordering can easily result. All labs should be separate ownership, either owned by the hospitals or independent businessmen. Few of us would object to going to the hospital for needed tests.

Fee-for-service payment system

Aside from a healthcare system with salaried doctors, the fee-for-service seems the only option. Perhaps reducing reimbursements with increased volumes could discourage over-ordering, but the last two reforms (above) should do that on its own.

Privatize Medicare?

You mean, like, adding the extra 20% needed by the private insurance industry to offset its high CEO salary and benefit and retirement packages and brokerage commissions and shareholder profits and campaign bribes (er, political costs)?

No thanks. It is 95% private already and works just great as it is. It has its weaknesses, but they can be solved with political will. Unfortunately the politicians are being paid to NOT solve them.

Medicare Fraud?

And yes, fraud exists in Medicare as well in the private system. The best way to clean that up is to expand the whistle-blower protections so that employees effectively provide the oversight. And if government forces can’t root out the individual scam artists, give oversight to a private company. (Ouch!)

State Certificate of Need programs

Should be reinstated, but the same campaign bribes that were needed to get the law repealed, still exist. The CON prevented aggressive hospitals from overbuilding in areas they weren’t needed. But they could get by with it because they employed their own doctors to refer patients. But this conflict affects both public and private costs.

But fixing Medicare will not happen as long as our state and federal politicians are on the payroll of the industry vultures that want the system to remain broken.

That question from the Des Moines Register

By Jack E. Lohman

The simple answer is “The VA system works, and works well, and the last thing in the world the insurance industry wants is something that works well! And the industry helps fund the political campaigns, thus owning our politicians, so they win and you lose!”

And yea, a VA-for-all system *IS* socialized medicine, just like Britains. We should be so lucky.

Not even the conservatives could argue against this as a public option. Choice is what conservatives stand for, and if a citizen/patient “chooses” the VA system … and pays for it… how could they argue? And if we allow employers to opt into the system — at cost — how could they argue?

Well, if “they” is the conservative public, there will be no argument. But if “they” are the politicians that receive cash bribes from the insurance industry that would be sidelined in the process, you can be assured that there will be massive political opposition.

Unfortunately, health care has fallen into this black hole controlled by our corrupt political system.

Importantly, coming with a VA-for-all system would be the VA’s VistA patient database system that’s one of the best in the world. Doctors must be able to see how other doctors treated patients and their outcomes. Maximum security can be provided using two passwords.

As well, physicians at the VA are salaried and do not get paid on the basis of how many tests they perform or patients they admit, whether needed or not. But they are paid well. Though heavily burdened at the moment, because of troops coming home with medical cares, it is an excellent system. Ask the troops.

Do the math…

Pretend that we “privatize” the VA system, as I am sure is on Paul Ryan’s to-do list. And we add the high CEO salaries and benefits and shareholder profits and campaign contributions (yea, politicians get a piece of the action when privatized). The result will be at least a 20% increase over government costs. Make sense?

And interestingly, even with a VA-for-all system the U.S. would remain in the bottom third of taxed countries.

Source HERE and another excellent article VA offers lessons for U.S. health care

Thanks to Dr. Don McCanne for this link. And if you don’t get his daily email, you are missing a lot. Please sign up at his link.

Because it works, and should be expanded to everybody!

By Jack E. Lohman

This subject is surely getting old, but because it is still unsolved and our politicians are still being paid by the insurers to make sure it doesn’t get fixed and expanded, we cannot let these jerks win.

OF COURSE there are Republican fixes, and if Paul Ryan and his cronies would agree to first try them on federal and congressional employees including themselves, perhaps he’d get our ear. But he keeps using the “similar” word, which doesn’t cut it. I want Ryan to have Medicare too; not his gold-plated taxpayer-paid policy.

The problems with Medicare exist in the private sector as well… fraud and over-use being the biggies. The latest is all of the prescription drugs that are addictive and being freely sold, but as long as political money also remains addictive, don’t count on a fix. That our politicians are pocketing a piece of the action is unconscionable.

Fraud: Yes it must be eliminated in both Medicare and private insurance, and the best way is by adding protections for whistle-blower employees. But campaign cash from the offenders have kept such fixes off the table.

Over-use: Yes it must be eliminated in both Medicare and private insurance, but again, campaign cash from the offenders have kept it off the table. We pay doctors on a fee-for-service basis… every time they do an ECG they get paid. So whether you need it our not, they order an ECG. At least a few do (many doctors shun overuse). Solve it with either socialized medicine (salaried doctors) or increased oversight. (I could accept either one, but political cash is not on my side.)

Don’t throw away good stuff! Certain surgical procedures use 1 or 2 tools out of a surgical package. Rather than recycling the unused tools they are thrown away. Why? Because the hospital or clinic makes more money that way, while the costs are simply passed on to the patient (Medicare or private).

Negotiate drug prices: Thanks to campaign cash, congress has protected the pharmaceutical industry from having to bid on drugs. You know, the “free market” way. The VA gets a 50% discount on drugs, and so should Medicare. Better yet we should pull drug research from the industry, which manages to maximize its profits (in the range of 25%) thanks to its sweetheart relationship with our congressmen. It should be a public-private partnership between government and scientists at universities.

Better utilize nurses and pharmacists: Let them practice low-level medicine and dispense drugs for colds and minor ailments. Nurses can be housed at pharmacies, as they now are when giving flu shots. Keep patients away from the expensive emergency room.

Restore the Certificate of Need: Repealed thanks to massive campaign contributions from hospitals, this state law required legislative approval before hospitals could build needlessly in areas — not because they were needed but because they could drain market share (unfairly, not the free market way, especially when they employ their own physicians). Doubling hospital beds makes sense only when doubling population.

Prohibit hospitals from employing referring doctors: This is a direct conflict of interest, especially when the doctors are given “productivity bonuses” to increase patient admissions or the ordering of expensive testing, whether needed or not. I want my doctor overseeing hospital quality, not beholden to it.

Implement a national patient database: Secure with no names and double passwords if necessary, but listing all patient diseases with doctor treatments and outcomes. The VA VistA system is available for free and has already been funded by the taxpayers. Let’s do it!

Tort reform: Yea, let’s replace the 12-man jury of idiots with a three-judge panel of retired doctors, nurses and judges. Then we won’t need caps and people who are truly injured will still be treated fairly.

Great ideas…

… but none will take place as long as our politicians are allowed to take cash contributions from the health care interests that want the system to remain broken.

This is NOT an issue of finding the right answer, it IS an issue of finding politicians who are not being paid to keep the status quo and obstruct progress.

OF COURSE a single-payer Medicare-for-all system makes the most sense, but the insurance and healthcare industry gave $125 million in campaign dollars to make sure that didn’t happen. So what we have coming is a federal system that will mandate that 100% of citizens buy a policy from the insurance industry.

At their price!

And yes, Ryan’s plan sucks, but cut him some slack. Insurance was his biggest contributor! But that he’d sell out the country at such a small price is troublesome. Adding 20% to Medicare to offset private profits and CEO salaries is, uh, sort of stupid. Importantly, with public funding of campaigns Ryan would not likely favor trashing Medicare for his private contributors.