Hell no I’m not a happy camper…

April 6, 2012

Let’s understand the root problem in America…

By Jack E. Lohman

I’ve tried to blame our failed war on drugs on the pushers. It doesn’t work. I always come back to the core problem: politicians that are funded by private prison corporations and security guard unions, all of whom want to secure their financial and electoral futures, expand laws. They do not contract them. Look at this excellent 3min video, but also understand the numbers!

I’ve tried to blame our failed healthcare system on the insurers, for-profit hospitals, and doctors. That also doesn’t work! Yes they are all guilty of lobbying for their best interests, but the real culprit is the politician who is paid by the taxpayer to serve on its board of directors and lead this country through thick and thin, but instead has his hand out at every turn.

I’ve tried to blame our enemies in the middle east for causing all of these wars, and then I realize that it is Americans on their soil and not the other way around. And then I realize that the defense industry gives campaign cash to our trusted leaders and it has had the intended effect. No, I’m not a real happy camper.

Even the failed economy I originally blamed on happenstance, until it became obvious that campaign cash caused the politicians to steal from the poor to give to the rich. Tax breaks to the rich with fabricated claims that they create jobs, got a little sickening. We all know that employers would not survive without workers, so it is a necessary marriage. But CEOs fund the campaigns and the workers do not.

And remember this: High unemployment equals low wages, which equals high profits and CEO salaries, and more money for political bribes, all of which equals more profitable political ads flowing to mainstream media!

Isn’t our free-for-all market just great?

This story goes on in virtually every issue, but the Fat Cats get it and the 99% don’t. Or at least didn’t, but they have smartened up. But we sheeples must get off of the little fires that the politicians have built to divert us.

What is rather surprising to me is that our business leaders have not gotten wise yet. Or they have but are enjoying their temporary advantage. But in time a trashed country is not going to be good for them either.


Is ObamaCare on it’s way out?

April 2, 2012

Let’s hope so!

By Jack E. Lohman

Otherwise we will spend years trying to put lipstick on this pig, all while transferring huge public funds to the insurance executives and their politician co-conspirators.

ObamaCare is a terrible solution and would not have been passed without the $125 million in campaign bribes passing to our trusted and esteemed politicians. Money works, as was proven here when single-payer was kept off the table.

Let’s kill it and do it right.

Yes, some good things have happened with it, but what will we have after we are 100% into it? A garbage system that still rewards the insurance executives. And the politicians who get a piece of the booty.

There *IS* a better way but the politicians don’t want to go there… because their cash flow will stop.

Better options? Medicare-for-all or VA-for-all!

Medicare is not perfect, and our politicians want to keep it that way. Fixing it would remove some of the stigma that helps them pad their wallets and get re-elected.

Medicare’s biggest problem is that it pays physicians on a fee-for-service basis rather than on a straight salary. Thus “over-ordering” provides a financial incentive, which incidentally exists in the private system as well. The VA system solves that by paying salaries, but because of the wars it is simply overloaded.

If we want to fix healthcare we need simply to mandate that our congressmen and staff are limited to the same system they mandate for the elderly and poor. Got that Rep. Ryan?

A government-run system cannot give campaign bribes but a privatized system can.


Universal healthcare is a smart jobs and business model!

March 30, 2012

But let’s not accuse our politicians of being smart!

By Jack E. Lohman

Taiwan experts traveled the world looking for the best healthcare model to copy for their own country, and settled on (drum-roll please), America’s Medicare system. With 100% private doctors and hospitals, only with government payment rather than insurance company and employer payment.

And it works! With better health outcomes than ours (because they cover 100% of their citizens) they implemented it at a total cost of 7% of GDP. (Our costs are 17.5% of GDP with insurance company profits and administration!)

And they relieved employers from the cost of providing health care, and allowed 100% portability for employees wanting to change jobs or start new businesses. What’s not to like about that?

100% in, 0% out

Everybody is covered at less than half our costs, because they’ve eliminated the middleman. Instead of insurers taking 20% off the top and distributing the rest, a government’s private contractor distributes the money. Same medical services are paid for, except without the private mark-up for CEO salaries and retirement benefits, shareholder profits, actuarial and legal fees, marketing and broker commissions, and even political costs (campaign contributions) which are added to the bottom line and passed onto the consumers.

But get this…

100% of today’s inflated costs are passed onto consumers, if not through premiums then certainly when businesses add their healthcare costs to the price of their product and we reimburse them at the cash register.

And those costs (less the 20% of insurer waste) are also picked up by the taxpayers under a single-payer plan as well. Or however, but the same people paying today will also pay tomorrow…  one way or the other. The trick is selecting the best way to do it.

Today we are paying in the worst way possible by forcing employers to pay the bill and add their costs to the price of their product. OR, by taking their jobs to places like Taiwan, where their system does not penalize employers. And all of this so our politicians can give their insurer-friends 20% of the pie? Duh!!!


Has Santorum convinced us of RCV yet?

March 30, 2012

Ranked Choice Voting is good for voters but bad for our two-party conspiracy. 

By Jack E. Lohman

You’d think that our politicians would get smart. Australia loves it!

The reason for the Romney-Santorum-Gingrich mess is BECAUSE of the Democrats crossing over to vote for the least attractive of the three Republicans. And Santorum is eating it up.

Even here in Wisconsin, when we have our own primaries, it’s all a very costly game. And indeed we should implement it on the Walker recall. (So GAB, the ball is in your court.)

With Ranked Choice Voting (RCV) there could be a dozen politicians on the ballot in November but the most popular would win. You’d vote for your 1st, 2nd and 3rd choices, and if your 1st choice didn’t get 50%+1 votes, your vote would go to your second choice. And so forth.

But if you don’t want all of this “choice” crap, vote for only one person, as before. What’s not to like about that?

Too easy?

  • No games, and only ONE election!
  • No more manipulated and destructive primaries!
  • No more “throwing your vote away” on the lesser of two evils!
  • No more crossover voting to disadvantage a candidate!
  • Vote your heart!
  • Less cost to the state taxpayers!
  • Computerized or hand counts are easy!

No, the duopoly doesn’t like this because it might be a third-party win, and the cash flow would change. And so would their odds of winning.

And the special interests don’t like it because they’d lose control. Though it would slow but not stop them from funding (bribing) their favorite politician and receiving taxpayer-funded subsidies and favors in return; only public funding of campaigns would do that.

Eat your heart out. IF it is the right thing to do, it won’t happen!


OK, Rep. Ryan, we get it!

March 26, 2012

We know that the cut in entitlements goes to your contributor friends! A plus and a minus can equal a balance.

By Jack E. Lohman

I’ve got to give it to Paul Ryan (R-WI), he sure knows how to balance budgets. But cutting needed programs for seniors and the poor, so we can fund tax breaks for the rich, is not what we would have expected.

Yes Medicare needs fixing, but adding 20% markup for the privatizing that allows insurer profits to be shared with politicians is NOT what most of us had in mind. It is far cheaper to fold all healthcare into our national budget than to seek ways to keep the insurers in the loop.

Yes Social Security needs fixing, but adding 20% markup for its privatizing to allow banker profits to share with politicians is stupid and corrupt. That our politicians have been able to dip into the SSI fund to finance special-interest giveaways makes us madder than hell. At least those of us who understand the game.

THINK ABOUT IT!

Fix SSI by removing the income cap (for deductions) so the rich guys that fund your campaign pay on their entire income rather than just a portion. Don’t increase the age limit to 67, which will only force seniors to stay in the job market when we need those jobs for young adults.

Can you imagine how this country would function were it not being run by politicians looking for campaign bribes?

This is all a political game, and it may work!

To your disadvantage, that is. The politician’s trick is to propose very radical ideas, that won’t pass but gets the public prepared for the worst case scenario. And then settle somewhere in the middle. Not where originally proposed and not where the game began.

It’s called disrupting the status quo, with the bad guy wining in the end. Yea, I’d expect that of a Chicago politician, but I thought its borders stopped long before Ryan’s district.

And this guy is presidential material??? I don’t think so. ONLY a 100% turnover in November will save our nation.


So Obama wants to end oil company tax breaks?

March 19, 2012

Why? So Big Oil can raise prices to compensate???

By Jack E. Lohman

Better, eliminate the hoarding by speculators. Mandate that they take physical possession of the oil they buy.

Prohibit the export of US-drilled oil, which currently exceeds imports.

In short, don’t be stupid. The oil companies will simply increase their prices to maintain the profit levels necessary to maintain exorbitant salaries. And the speculators give neat campaign bribes, but you just ignore that!

How to keep the industry from killing itself (and America)? Create a “public option” oil company! It can mitigate CEO greed, and if you personally object, don’t buy their product but enjoy the results.

We have a no-win situation…

Thanks to our corrupt congressmen, who passed NAFTA and other laws that allow corporations to send jobs to other countries without penalty,  taxing corporations has a negative effect in our free-market free-for-all democracy. Mainly we encourage companies to manufacture product in countries that (a) have lower wages, (b) pay lower taxes, and (c) have fewer regulations.

Of course these astute outsourcers will eventually pay a heavy price. Can you imagine what would happen if Apple attempted to bring its manufacturing back to the US? Its Chinese manufacturer will likely send them the one-finger salute and create its own competing product after stealing their technology.

None of this would have occurred if our politicians were not on the take. Political bribes (campaign contributions) have destroyed our nation and the only fix is a 100% turnover in November.


If one is to be obsessed by anything…

March 16, 2012

… it IS the nation’s #1 problem… and to fight the little fires elsewhere makes zero sense.

By Jack E. Lohman

Because it diverts the people towards the little fires instead. Divide and concur is the strategy, and it is working.

Except that some new candidates finally get it and are pushing the message. Rocky Anderson says it best.

Truth is, I want my government to protect our citizenry from bad guys. Crooks who hurt people and rob banks ought to be thrown in jail. And the CEOs who run the banks they rob, ought to be in jail with them.

Unfortunately these bankers also own the politicians who write the laws (or don’t write laws) that allow the rip-off.

Wouldn’t it be nice if…

… we didn’t have to “save” BadgerCare?

The Fat Cats (at least most of them) don’t hate poor people who need medical attention. But they DO love the money that the state spends on these people and which otherwise could be diverted to their own bank accounts. Greed trumps compassion. Get used to it.

… we could get unbiased answers as to whether mining was either good for Wisconsin or bad for Wisconsin, and do what’s right?

Yea, we had one Republican senator who had a conscience, and so far Wisconsin’s bill has been stopped. The mining companies are either going to have to find his hot button — that is, send more campaign cash — or buy off a couple of Democrats. It’s nice to know where they stand, eh?

Alternatively we could hire real scientists who are not getting research money from either the mining industry or the tree huggers, and get an honest, unbiased answer that will force politicians to an up/down vote at their own peril. (Now, there’s a thought!)

… Congress was cleaner than the state legislature?

Don’t even think about it. The closer you get to the top the dirtier it gets. Our “change” president is the most embarrassing of all.


And the problem? Drum roll please…

March 13, 2012

… more political corruption!

By Jack E. Lohman

Why are we diverted by theoretical economists to little fires, instead of looking at this nation’s ACTUAL, #1 problem: the looters of our economy (bankers, oil speculators, hedge fund managers) paying off the politicians that pave their road to more wealth … at the expense of the many?

The answer, of course, is BECAUSE those politicians get a piece of the action… in campaign bribes, and they write the laws that permit it!!!

These same politicians also REFUSE to write laws to stop it and create jail time for the offenders…

It can get worse!

So here’s the good news: China has its problems too! China’s Billionaire People’s Congress Makes Capitol Hill Look Like Pauper

China ranks #78 on the international corruption index. Not to worry, though, the U.S. is #22!

The U.S. is NOT #1… it’s #22!!!

21 from the top!!!

Political corruption will bury us if we don’t force public funding of campaigns. I want these jokers working for the public rather than private interests, and the only way we’ll get there is with a 100% turnover in November.

Defense Industry Fraud?

I’m hearing (on TV, if you can believe the media) that over the last decade roughly $2 trillion of defense industry spending cannot be accounted for. It doesn’t surprise me.

I’d certainly start looking for dummy-companies… companies in name only where defense employees with sufficient authority have put them on the payroll (issued dummy contracts for dummy services) so the taxpayer money passed through can be laundered to their own personal wealth.

But no politician wants to touch it!!!

How do they get by with it?

As Rick Santorum says, by “giving one for the team!”  Even when you personally oppose things like funding the Bridge to Nowhere, which he voted for (and I am sure got paid well for it).

It’s called “Getting ready for a military takeover!”

NOBODY wants to talk about it, but I worry.

Here we have the government passing more and more laws to curb individual freedoms, even making it illegal (in 3 states already) to videotape a policeman committing a crime or abusing a citizen.

And more and more of the middle class are sinking to the lowest class, and the government is privatizing our armed services (Halliburton and Bechtal and you name it), and I wonder:

What’s next? A total rebellion, Egypt-style?


Time for mass political retirements!

March 2, 2012

Yea, these leakers have trashed our economy, and it’s time for them to go. We would expect that in Syria and elsewhere; let’s do as we say.

By Jack E. Lohman

With an acceptance rating of less than 10%, our congressional members must do what they are demanding of Syria’s Assad: they must step down from their leadership role and call for a new election in America.

100% of them; no exceptions!

There are many things wrong with the way politicians run our country, but they all hover around one core issue: political corruption.  Rocky Anderson hits the nail squarely on the head with his assessment. Whether he’s our next president or not, he’s got to be better than Obama and his Republican opponent.

Our core problem is our corrupt politicians

Whether you oppose the wars, oppose our nation’s drug policies, oppose our broken health care system, oppose the 1%, oppose the jobs’ export to other countries, look at your leadership. As long as they are getting cash dollars from the other side, you will remain on the outside looking in.

I do not like advocating for a change in government. But if we don’t do it voluntarily today, it will be forced on us by the American crazies with guns.

I do not believe for a moment that the US is beyond a military takeover. Here we are creating and training a private army, maybe even for the benefit of the politicians behind said funding. If you are part of the 90% that do not trust our current congress, how can you possibly trust them when the chips are down???

They have to go… NOW!


Gas at $5! So?

February 27, 2012

Why are we surprised? The oil industry still owns our politicians!

By Jack E. Lohman

Gas prices will go up to $5, because they CAN!

Get used to it. At least until late summer, when Obama gets tough just before the elections.

You’ll hear a lot about oil “speculators,” and he’s right. They are the number one problem. It’s not Iran. Our economy is rebounding and they want the cash in their pockets instead of yours. So they buy refinery-tank-fulls and hoard product until they have to back off.

And, much of the oil we refine in the U.S. and export to other countries. Oil is this nation’s biggest export, and our politicians want to keep it that way because they get a piece of the action.

It’s the free market, don’cha know.

Obama won’t do anything drastic because they help fund his elections. And the Republicans won’t do anything because also help fund their elections! (They could ban speculating/hoarding of vital product, but that would curtail campaign bribes.)

This is a game. Two people can play, the D’s and R’s.

There’s only one winner, but it’s never you. This is 100% a two-party game. They both know the problem, and they know the solution, but neither wants to go there because they are both on the take.

But you lose… and you should lose.

At least until you get smart enough to throw out both political parties. But to date the electorate has allowed the villains to divide and divert them. We’ve got to be smarter than this.

The fix?

Yea, there is one. First, throw all of the bastards out of office! None of them should stay! UNTIL they pass public funding of campaigns, and then we can start to move forward and re-anchor our families.

Step 1) A public-option OIL company. Let’s (the taxpayers) buy up the next failing oil company, or build one from scratch. Imagine the new jobs that would be created, with consumer rather than taxpayer money.

Step 2) A public-option bank! Let’s not bail out the next failing bank, let’s buy it! Of course, Bank of America would be gone in a heartbeat, but so would be our economic woes.

Step 3) A public-option car company! No more bailing out General Motors, they either run it right or lose it! And then we taxpayers will run it and set the CEO salaries ourselves. And the prices of our cars.

But wait, all of our political bastards get campaign bribes from these guys!

Say goodbye to that, too! With all of this public option stuff going around, political bribes will not be useful.

Remember this: “PUBLIC OPTION!” What’s not to like about that?

The free market will not just survive, but even hum with all of these newly competitive industries.


Three options for Health Care, Part 3

February 22, 2012

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.


Three options for Health Care, Part 2

February 21, 2012

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.


Three options for Health Care, Part 1

February 20, 2012

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.


Earth to Dems: Obama has to go!

February 17, 2012

For the sake of the country, he should be last on our list!

By Jack E. Lohman

The only thing worse than making a mistake is not correcting it when you can. And with the majority of the country unhappy with Barack Obama, we can undo it in 2012. That is, if the Dems are smart.

Russ Feingold took himself out, but we should draft a good progressive politician to primary the president. Hillary Clinton or Bernie Sanders come immediately to mind, but Dennis Kucinich or Alan Grayson would also surpass Obama’s popularity. If Obama really had compassion for this country he’d give someone else the steering wheel.

Failing that…

… my second choice would be a moderate Republican. Someone like Jeb Bush or Rudy Giuliani, who might be swayed by the right-wingers. It will NOT be Newt Gingrich or Mitt Romney.

Giuliani, incidentally, believes that Republicans should stay out of people’s bedrooms. Ouch! At the very least he will make decisions consistent with his heart. Maybe not totally progressive, but also not totally conservative.

The worst case scenario?

The presidency goes Republican? But no worse than we now have. I favor a good 3rd-party president.

More than anything…

… the House must convert to the Democrats and we must save the Senate. And the best way to do both is to demonstrate to the voters that we have but ONE cause for our poor economic system: cash dollars transferring from special interests who want in the taxpayer pockets! We need public funding of campaigns and we’ll find someone who agrees.

Disclosure: I am generally a pro-business Republican, but I cannot tolerate the far-right-wing nuts who stonewalled and blocked even the good stuff the Dems put forth.  Of course under those conditions Obama will fail. The far-right should be as embarrassed as the far-left.

And get this: Obama and the Dems could have set the senate rules to 51%, rather than allowing the filibuster. Had they wanted to, of course, which they didn’t.


Problem with health care is for-profit insurance

February 13, 2012

By Samuel Metz and Charlotte Maloney
The Register-Guard (Eugene, Ore.), Jan. 9, 2012

Modern mythology recounts James Carville giving candidate Bill Clinton memorable advice regarding his upcoming presidential campaign: “It’s the economy, stupid.” Those of us wrestling with health care reform might take similar advice: “It’s the financing, stupid.”

Why do politicians such as Sen. Ron Wyden, D-Ore., and Rep. Paul Ryan, R-Wis., obsess with untried models of health care reform? They propose a “premium support option” for Medicare that would also extend to small businesses. Insurance companies are expected to compete with traditional Medicare to provide comprehensive benefits at affordable prices. Beneficiaries unable to afford premiums will receive vouchers of limited sums to support their premiums; hence the name, “premium support.”

This plan presumes that private insurance companies will eagerly compete for market share by offering better benefits at lower prices to our seniors. This simply does not happen.

Our two congressmen may be confusing American insurance companies with those in Europe. European companies are forbidden to discriminate on the basis of health, must offer policies to any applicant, must supply comprehensive benefits in every policy, and cannot cancel a policy for any reason. They compete by offering better benefits at lower costs with better customer service.

In contrast, American insurance companies play by entirely different rules. They compete by refusing policies to sick applicants, shrinking benefits, dropping policy holders as soon as they get sick, and denying or delaying payment to providers. In short, they compete by providing less care to fewer people.

Our last experience with letting private insurance companies compete for seniors (Medicare Advantage) reconfirmed this: Private insurance companies skimmed off the healthiest seniors and provided them with no better benefits than traditional Medicare except they cost the government 15 percent more. Why should we expect private insurance to be more successful than Medicare with the Wyden-Ryan plan?

If we define a “successful” health care system as one that delivers better care to more people for less money than we do, examples abound around the world and within our own country. These systems come in all varieties — complete government control, minimal government control, private providers, group providers, fee-for-service physicians, salaried physicians, managed care, medical homes — you name the variation, and it’s been used successfully. The United States uses all of these, but our health care is in the pits.

The United States lacks the three common elements used in every successful health care system. And these elements are not delivery methods; they are financing methods:

* Everyone is included forever. No exclusion for any reason. No one is dropped or marginalized when they become old, sick, poor or unemployed.

* Little or no cost-sharing. No patient is discouraged from seeking health care. Instead of making a patient decide if they need medical care before seeing a physician, the physician decides after seeing the patient.

* Financing is provided by publicly accountable, transparent, not-for-profit agencies. Although some models permit profits from delivering health care, none allows profits from financing health care.

Successful systems can make almost any delivery method succeed, but only when financing fulfills these elements (unlike the Wyden-Paul proposal, which fails to address any of them). No delivery system has ever succeeded in their absence. Though pundits may obsess endlessly why these requirements are theoretically unnecessary, the reality is stark. Bad financing makes any delivery system fail.

America appears wedded to our traditional (and unsuccessful) private health insurance industry that fragments us into the healthy (who can purchase access to health care) and the sick (who can’t). And the fragmentation is not static. If you were previously healthy but become sick, your insurance company will do its best to exclude you from access on their dollar.

No other nation has provided universal cost-effective health care with this method. We haven’t either. There is no reason to think it will work in the future.

Wyden and Ryan neatly avoid tampering with our lethal dependence on financing health care with private insurance. This continues to place the health of the private insurance industry over the health of the people they serve.

Without a change in health care financing, reform is futile. In all recorded history and throughout the world today, we find no working models of a society providing universal cost-effective health care using our unique American system of private health insurance. It is possible Neanderthals achieved this goal with private insurance but left no written record. Doubtful.

We spin our wheels by focusing on our delivery system. It’s the financing, stupid.

Charlotte Maloney of Eugene is a retired occupational therapist and outgoing treasurer of Health Care for All-Oregon. Samuel Metz, M.D., of Portland (samuelmetz@samuelmetz.com) is a member of the Oregon Single Payer Coalition.

Originally on The Register-Guard


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