The difference between healthcare and health insurance explained (mostly for Republicans and Trump’s acolytes)

People like GA Republican Rep “Buddy” Carter and the rest of the GOP are either misleading Americans or out-and-out lying to them.

They either don’t know the difference or are intentionally obfuscating the difference between healthcare and health insurance *choices* by either unwittingly or knowingly talking about them as if they are one and the same, and that Americans are somehow being held back from making choices because of the Patient Protection and Affordable Care Act.

 

The only people who won’t have choices and who will be left behind by the GOP are people who aren’t covered by employer-subsidized health insurance and who aren’t poor enough to be covered by Medicaid. The so-called “free market” cannot solve this issue of access to healthcare in an affordable way for EVERY SINGLE AMERICAN.

It’s a Business – That’s the Problem

Health insurance as a business exists solely because healthcare has become too expensive to be a service one can pay for out-of-pocket.

Doctors stopped accepting chickens decades ago, and a 1.2trillion dollar industry – the insurance industry, that is, of which 55% is in the life/health side of the business – has absolutely nothing to gain and everything to lose as a business by actually insuring people who need healthcare.

Why does healthcare cost so much? Lots of reasons, I think, but mostly for two reasons.

Capitalism at its Worst

The first is because we’re all just greedy enough and selfish enough in capitalist America to actually put a price tag on healthcare and on life itself.

As every good capitalist would tend to agree, the more expensive something is, the better it must be (or at least many of us have convinced ourselves of that premise).

So, if healthcare costs a lot and some people are priced out of it, c’est la vie. That’s capitalism and free markets at work, right? (“Yeah! Tell those lazy poor people to get a job!”….and all of that dysfunctional and inhumane nonsense we hear all the time from libertarians and conservatives.)

The second reason healthcare is so expensive is one that many may not realize. It’s *how* it’s paid for in America.

30% of the cost of delivering healthcare in America is tied up in “administration.” That’s a euphemism for processing claims; claims that are paid by insurers whose profit motive is to take in billions in premiums and to not pay or to pay claims as slowly as possible.

Make no mistake about it. Private health insurance companies are the real death panels.

Compounding the problem of administrative overhead costs is that every health insurer has a different way to process claims. It’s why 1 in 4 people who work in healthcare work in administration.

In 2015 there were 859 health insurance companies in the the U.S. Even if all you count are the top 25, that’s still 25 ways a healthcare provider will have to know how to process claims if they want to be paid. That, or they turn away patients who have health insurance they don’t know how to process, or they outsource claims processing to a third party. Whatever decisions they make, it all adds up.

Single payer eliminates it all.

You Had 8 Years and Trumpcare is the Best You Can Do?

As for the embarrassment that is the GOP abomination presumably 8 years in the making, “choice” is among the many lies “Buddy” Carter and the rest of the GOP are trying to sell you on now.

I worked for a company that provided technology to insurance carriers. Not agents, the insurance companies themselves. I saw it from the inside. Here’s how the industry works in a nutshell.

Insurance companies come up with products – the plans they want to sell. They have to file the products with each state’s Department of Insurance where they wish to sell said product(s). Each state decides independently as to whether they allow said product to be sold to their citizens.

One of the many Protections in the Patient Protection and Affordable Care Act that insurers did NOT like (they only liked the mandate) was the elimination of junk insurance. It’s called that because that’s what it is.

Junk insurance were plans like the one I had to have a few years back when I was laid off, couldn’t afford COBRA coverage, and didn’t want to risk being “tagged” as uninsured by a future employer and their insurance company. I went to the open market in those pre-Obamacare days.

The plan I found and that I could afford was UnitedHealthOne Saver 70. It was $275.00 per month. It had a $12,500.00 deductible, paid only 70% after that was reached, and didn’t cover office visits or prescriptions.

That’s the kind of “choice” the GOP and insurance companies want back. A cheap plan that for all practical purposes guarantees the insurer will never have to pay benefits on because the insured will never go to the doctor because that’s another out-of-pocket expense, and they can’t afford the 12-grand anyway before benefits would kick in.

If Ryan and the GOP get their way with Trumpcare’s threat of a 30% buy-back-in penalty, junk insurance will fit the bill perfectly. It will make millions off of poorer Americans who will never file a claim but who will buy junk as a hedge against that future buy-back penalty.

Insurers Put Profits Over People. Period.

The insurers who are whining and crying and gnashing their teeth as they abandoned the Obamacare health insurance exchanges in some states didn’t abandon their health insurances business (although it must be understood that some insurance companies were so greedy they did stop selling health insurance because of the PPACA’s 80/20 rule).

The insurers who have left state exchanges did so because they couldn’t make enough money in those places and from people who were previously uninsured but who are now able to get healthcare for which the insurance company must pay.

Which brings us back to Rep Carter. He’s either an idiot or a liar or both.

I take that back. What he is is a Republican politician.

In my view, the sooner Americans come to their senses and stop voting for Republicans at every level of government, including the state and local levels, the better off we all will be, and the sooner we’re likely to move to a healthcare system that serves us better and which every American can benefit from regardless of their income.

 

Sources

INSURANCE INDUSTRY AT A GLANCE

The Reason Health Care Is So Expensive: Insurance Companies

Top Health Insurance Companies

Administrative costs are killing U.S. healthcare

Rate Review & the 80/20 Rule

 

Blogs I’ve written in the past on the topic of health insurance

More #PPACA Red Herrings: Renewals and Benefits

The ‘Protection’ in the Patient Protection and Affordable Care Act

Health insurance companies keep making the case for single payer

Weld and Johnson deserve each other, and libertarians deserve them both

Bill Weld tries to defend his ticket-topper and their candidacy in this interview on  The Takeaway.

He didn’t do either any favors.

weld

The takeaways for me are….

 

1) The tired, old lie that Democrats will “spend and borrow us into the poorhouse and hollow out the economy” when the facts are that Democrats have been cleaning up economic messes made by people like him – Republicans – since at least the original Gilded Age.

 

2) Debt. Another chicken-little exaggeration rooted in the childish notion that debt is bad, the government should stay out of the economy, and that the government should balance their checkbook the way people do. (Defenders of him and this idea should be forewarned not to expose their utter lack of understanding of economic and fiscal policies. In other words, save your libertarian tropes. I will not be kind to you.)

Anyway, he thinks the national debt could go to $50trillion under 2 terms of a Clinton presidency. He doesn’t even hint at how or why that would happen, but I’m sure he knows it’s another tried-and-true GOP misdirection that conservatives, libertarians, and people who think they’re Republicans lap up like a thirsty dog.

What he also conveniently fails to say is that presidents may propose budgets, but under Article I, Sections 7 & 8, the power to tax and spend rests with Congress. Gee. Which party has controlled the House ever since 1995 except for the 110th and 111th post-W-cluster-fuck and before the GOP gerrymandered state districts?

 

3) TPP. That’s right, boys and girls. The TPP. He says, like all good libertarians everywhere, that he favors “free trade.” Johnson is on record as saying he’d sign the TPP.

This is more evidence that the biggest corporatists on the political stage have always been and still are libertarians.

 

4) Aleppo. What would a conversation about this ticket be without a conversation about Aleppo?

Weld attempted to defend Johnson by saying “pop quizzes are not his (Johnson’s) long suit.” That’s so cavalier and so disconnected from the gravity of this atrocity that it stunned John Hockenberry into near complete silence.

Weld seemed to realize what a gaff of his own he made, and stammered toward an admission that, yes, “it’s been the news,” before babbling about his own experiences in foreign affairs, how Johnson has spent most of his time in Western states, and how Gary’s summiting of the world’s tallest peaks is evidence of Johnson’s international bona fides.

Listen for yourself to the whole interview for yourself. I assure you that I’m not creative enough to make this kind of shit up.

Only a libertarian could come up with bullshit like this, and only another libertarian would agree with it.

As I’ve said before. Libertarians sound good for the first 5 seconds. Johnson and Weld prove once again that that’s where it ends.

 

Add’l Reading

2016 presidential candidates on the Trans-Pacific Partnership trade deal, Ballotpedia.

The Constitution of the United States

Debt Vs. Deficit: Understanding the Differences, Investopedia

 

 

What Costco has to teach the 99-percenters who think they’re Republicans

It’s not complicated. Every retailer, restaurant, and corporation in America can do what Costco is doing, but they don’t.

Costco

Why is that?

I think it’s because the people who own and run these businesses refuse to look beyond next quarter’s financial statements. Their thought processes, their vision, and their values don’t include ways to share their wealth with their workers.

They are greedy, selfish, sons-of-bitches who want us to think that’s just how capitalism works.

That also seems to be how today’s conservatives who are outside the 1% think, too. What other explanation can there be for why they think they are Republicans?

Conservatives Don’t Seem to Understand Reality

Costco clearly has leaders, a board of directors, and shareholders who are visionary and courageous enough to implement ethical and moral business strategies that are profitable AND which include a more equitable distribution of those profits to workers in the form of livable wages.

Contrast that with the lies we’re told by Wall Street, by Big Business shills like the U.S. Chamber of Commerce, the National Restaurant Association and the National Federation of Independent Business, by libertarian mythologists like Heritage Foundation and Cato Institute, and by Republican politicians who keep claiming that trickle-down economics works, that we should abolish a minimum wage and leave compensation to market forces, and that government interference and over-reach are stifling business and our economy.

How is it that conservatives don’t get that all of that is, of course, complete and total bullshit?

How is it that conservatives who make less than $340,000.00 – what it takes to be in the 1% – insist on voting for Republicans and their failed policies which have ALWAYS been designed to benefit the rich and powerful first and foremost?

Liberals: Time to “Welcome Their Hatred”

We need leaders like Bernie Sanders who welcome the hatred of Wall Street and Big Money.

Compare Bernie

 

We need people like Lawrence Lessig as politicians who represent us and who are willing and eager to confront Big Money for their lies and their failures.

 

As individuals, we also must welcome the hatred of the rich and powerful. We need to find the courage to band together. We need to shine light on the fact that conservatism and Republican policy is to blame for where we are now as a nation and as a society.

More than anything, we liberals need to stop surrendering to the all-too-common liberal weakness of always wanting to find compromise.

No more compromises. It’s how we got to this sorry state of affairs. We let conservatives move the center further and further to the right by acquiescing to their demands and our own desire to avoid confrontation and conflict.

No more.

Liberals didn’t elect Reagan and two Bushes. Liberals didn’t cause banks to fail. Liberals didn’t demand that government shrink and corporations become less and less regulated. Liberals didn’t funnel all of the recovery and wealth to only the absolute richest among us.

We liberals need to continue to point out these and all the inconvenient truths that stem from conservatism (and its absurdly juvenile and greed-driven stepbrother, libetarianism).

Our fellow citizens who self-identify as conservatives need to hear from us whether they want to or not. They need to hear the truth; that they are also part of the ever-shrinking middle class and the ever-growing class of working poor.

They need to hear from us liberals that they are wrong – plain and dead wrong – for voting for ANY Republican anywhere and at any level of government.

They need to keep hearing it. Conservative (and much of libertarian) ideology that informs and drives Republican policies have unequivocally been proven to be dead wrong for everyone on every issue, and that includes economic issues. That is true, of course, for everyone except for the rich and powerful.

The Parties Are NOT The Same

It’s pretty simple and absolutely obvious. The GOP is the party of big business and the rich.

For those who are tempted to trot out the b.s. false equivalence that, “Both parties are the same,” save it. As far as I’m concerned, you’re second in line as the greatest obstacle to making real progress in this country. You give Republicans cover, and you need to stop it.

Number one on the list of obstacles are actually those Americans living in households with adjusted gross incomes of less than $340,000.00 per year who insist that they are Republicans and who vote for Republicans. I have news for them. They are not in the 1%. The conservatives in the 99% mean precisely nothing to Republicans except as useful fools who can be counted on to vote for them.

Organized Labor Is the Path to Prosperity

It’s absolutely stunning that conservatives aren’t banding together with the rest of us in the middle class in support of organized labor. History proves that stronger unions are the path to better and higher standards of living for everyone.

It bears repeating.

If you make less than 340-grand and think unions are somehow the problem and Republicans are the answer, then you not only don’t understand reality, you’re the biggest obstacle to prosperity we have right now in America.

So, how about it, conservatives?

How about you wake up and stop voting against yourselves and the rest of us?

You’ll thank yourself and, more importantly, so will future generations.

95 percent

——

Additional Reading:

Strengthen Unions

Wealth Inequality in America

Top 1 percent: How much do they earn?

Capital Eye Opener, March 8: The Fight Over Minimum Wage, and Rand’s Partisan Appeal

New Poll Shows Overwhelming Support for Major Minimum Wage Increase

Activists Around the US Fight to Raise the Minimum Wage

 

The Dirty Little Secret of #Libertarians? They’re Really #Corporatists.

First, the obvious. Not all libertarians are alike. The same, of course, is true for conservatives and liberals.

That said, I’ve had my fill of libertarians acting like they are the only ones who believe in a free society. That’s total bullshit, of course. I don’t know anyone who likes “state oppression,” do you? The debate needs to be – oh, eff that. I’m done debating strawman arguments like that.

from http://www.econlib.org/library/Enc/FreeMarket.html
Murray N. Rothbard, who died in 1995, was the S. J. Hall Distinguished Professor of Economics at the University of Nevada in Las Vegas. (Image and text from http://www.econlib.org/library/Enc/FreeMarket.html)

Where I really part company with libertarians is in their naive belief that markets operate in the way that Murray Rothbard describes them. They don’t. That “philosophy” requires a belief in something called, “Equal and simultaneous information.” It’s actually how the financial services industry is supposed to operate but doesn’t. And, why doesn’t it? Because of the lack of vigorously enforced and sensible laws and regulations.

What’s worse is when libertarians use phraseology like “state oppression.” They come off sounding like they have a tinfoil fear of the state.

Yes, of course, there are things about “the state” that libertarians and I want to change; from NDAA to NSA to KXL. Their incessant vilifying of “the state,” however, without including corporations and Big Money as the driving forces is, at best, disingenuous and, at worst, revealing of their libertarian naivety or outright corporatist obfuscation.

Remember this. WE ARE THE STATE.

Unlike government, corporate boards – and let’s not be naive about whatever paltry shares we as individuals may hold – are not elected by we ordinary citizens. We have no way of holding corporations accountable EXCEPT through the state regardless of the fantasy of the Invisible Hand libertarians may worship.

We do – or, rather, we’re supposed to, but too many of us don’t – elect those who are supposed to represent us in our government. We can control that.

Milton Friedman, the University of Chicago economist who, it's now known, was discoveed by the Buchanan Committee in 1946, to have arranged along with with George Stigler, an under-the-table deal with a Washington lobbying executive to pump out covert propaganda for the national real estate lobby in exchange for a hefty payout. (http://www.alternet.org/visions/true-history-libertarianism-america-phony-ideology-promote-corporate-agenda)
Milton Friedman, the University of Chicago economist who, it’s now known, was discovered by the Buchanan Committee in 1946, to have arranged along with with George Stigler, an under-the-table deal with a Washington lobbying executive to pump out covert propaganda for the national real estate lobby in exchange for a hefty payout. (http://www.alternet.org/visions/true-history-libertarianism-america-phony-ideology-promote-corporate-agenda)

For me and for as long as I’m able, I’m going to try to influence my fellow Americans to vote against libertarians (and conservatives) because of how their philosophies manifest into their policies; policies that put all but a few wealthy and powerful individuals in real peril because they stem from beliefs based on the fallacy perpetuated by people like Rothbard, the Kochs, the Cato Institute, the Heritage Foundation, and all the devotees of Milton Friedman.

Libertarians are probably not Statists, whatever they think that’s supposed to mean and whatever is meant by it when the “purists” accuse Rand Paul of it. He and his “mainstream” libertarians are, however, most certainly Corporatists in the mold of his fore-bearers.

And that, dear reader, is the dirty little secret of libertarianism as it’s being practiced today. It is a front for Corporatism, and it’s far more dangerous to our society, to our democracy, and to our planet than some misplaced and misinformed hand-wringing about “the state” somehow holding back “free markets.”

Call them out on it, and vote against every single one of them and their big brother proxies, the Republicans.

That is, of course, unless you prefer to be just another resource used by the rich and powerful to become more rich and powerful at your expense.

Main Street: Your recovery will come from the left, not the right. #GetMoneyOut #NeverForget915

The American public got played (again) for chumps back in 1999 when we weren’t in the streets protesting Slick Willy’s signature of the Gramm-Leach-Bliley Act.

It wasn’t the first time. It undoubtedly won’t be the last time, either, unless we’re willing stand up once and for all time against the failed ideology of conservatism.

So, what has GLBA wrought? The ’08 crash, for one thing.

Now there’s hope for us and for Main Street:

As it happens, a trial just ended in Sacramento in which a jury was convinced that “executives intended to make fraudulent loans.” Here’s the thing, though: It wasn’t the government that made the case against the financiers; it was the defendants.
“Finally, Wall Street gets put on trial: We can still hold the 0.1 percent responsible for tanking the economy”; Thomas Frank, Salon, Sept 7, 2014.

The real estate bubble that Wall Street executives knowingly manufactured while knowing they’d escape unscathed is finally coming to some justice.

It’s about time. Their crimes and the travesty they created turns 6 years old next week.

NeverForget915

Now, I know some of you still believe the libertarian fantasies of Invisible Hands and “free market” solutions. Wake up, please. Those are fantasies conjured up in the imagination of a sub-par Russian novelist and then perpetuated by the likes of big business propagandists like Milton Friedman and the Koch Brothers. It’s not the real world, and you have been duped.

I know lots of you like to mix in large doses of Wall Street hero-worship, too. You think people like Jamie Dimon, Dick Fuld, and  Lloyd Blankfein are people of admirable character with great and endless ambition who make for exemplary role models because of the wealth and power they have amassed.

Again, you have been duped. Open your eyes. They and people like them play you for a fool. They are the ones who drove the economy right off the cliff. They have never paid a dime of recompense and, with extremely rare exceptions, have not done a minute of time behind bars for their crimes. What’s worse is that they’re still in charge.

Finally, there’s this. I know you hate hearing it because you know it’s true. Reaganomics.

Too many of you insist on believing the lie that is trickle down economics. The economy has been slow to recovery because the government bailed out Wall Street instead of Main Street. The rich got paid off for their mistakes and then took their money offshore. Banks have been operating at a federal funds rate of effectively zero for how many years now, and still no money seems to be reaching anyone except the largest and most profitable corporations.

Do you not get it yet? The government didn’t do enough 6 years ago and it still hasn’t done enough to stimulate true growth and real prosperity at its source – the MIDDLE CLASS AND THE POOR WHO ACTUALLY DRIVE THE ECONOMY WITH OUR SPENDING!

Please look at the facts. Please stop telling yourself that less regulation is always better.

Please stop voting for people who think money is speech and corporations are people.
(Does it surprise anyone that the 18 Senators who voted today against an amendment to overturn Citizens United were all Republicans?)

Please stop ignoring the fact that all the gains in our rigged economy are going to the top, that none of it will ever trickle down to you, and that all the gains are privatized while all the losses are socialized because too many of YOU insist on voting against YOUR OWN economic self-interests.

Please stop voting for Clintons and Bushes and Ryans and Pauls and Romneys.
(Yes, Clintons, too, and any other corporatist Democrats. They are part of the problem, too, just not to the same degree as Republicans and their pesky little brothers and sisters in the libertarian and tea parties.)

I get it. It’s your choice. You’re free to vote for whomever you like. You’re also free to keep playing the role of the rich person’s chump.

Just know this. There’s a growing number of people who will keep revealing the truth while you believe the lies. We will keep working to get money out of politics while you continue to vote for Big Money, whether you realize it or admit it, or not.

We will keep doing this in the hope that you’ll one day come to your senses. We will keep doing it with the certainty that if you don’t come to your senses, well, at least there’s hope for your (and our) children and grandchildren. Remember this. It’s their eyes we’ll all have to look into someday.

One more thing you must know. It’s the only logical conclusion anyone can come to in light of the last 35 years or so, and that’s this. Conservatism is a failed ideology.

Whether its ISIS or Westboro; whether its bin Laden or McViegh; whether it’s Bibi or Cruz, conservatism in all its forms and flavors is a failed ideology.

In political and economic terms, it has failed everyone except for the very rich and the very powerful who wish to go on subjugating and oppressing workers and ordinary citizens.

No society has ever advanced by being conservative, or by looking inward or backward, or by concentrating more and more wealth and power into fewer and fewer hands. This is the very definition of conservatism today in America. Make no mistake about it. There is one and only one political party embracing the failed ideology of conservatism. One.

Main Street, your salvation is not going to come from ideologues who want to conserve the status quo of unequal power and unfair capital distribution. You must see by now that nothing is going to trickle down to you. There’s nothing for Big Money to gain by pressing politicians for policies that help you to thrive.

Remember this. It wasn’t liberals and progressive who drove you and your fellow business owners to the brink of extinction by bribing or threatening local zoning boards in order to get sweetheart tax deals for the likes of Walmart. It wasn’t liberals and progressives who put Main Street out of business by driving down prices for goods and services by moving manufacturing overseas and then importing cheaply made products back to store shelves. It wasn’t the poor or the disenfranchised or the liberals and progressives who, once they had forced you out of business, continued to pass tax reforms that further enriched the rich, tried to kill unions, and who caused your standard of living to stagnate and decline by ensuring that the only jobs left in your communities were the ones paying minimum wage.

These are not liberal and progressive ideals, but they are at the very core of conservative ideology and it’s evil offspring, Objectivism – a perverse euphemism for a degree of vile greed and selfishness to qualify as a psychosis.

Look, it’s time we all became progressives. It’s how society will progress.

More than that, it’s time we all took the fight directly to conservatives and libertarians using the facts and history they cannot deny and which proves, once and for all time, to Main Streets everywhere that, on election day and with extremely rare exceptions, a vote for a Republican or libertarian is a vote against yourself, our economy, our society, and our future.