Tell your Senators what you think about the #GOP healthcare bill

Everyone can make a difference. Everyone can call SEIU hotline, 866-426-2631, like I just did. You put in your zipcode and the system connects you. I left a message for Senator Toomey. E


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.




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

Health insurance companies keep making the case for single payer

To PPACA Detractors:

The federal government doesn’t set insurance premiums. Insurance companies set premiums. State Departments of Insurance must review and approve each and every insurance product sold in their state. The only limitations put on insurance company premiums by the Patient Protection and Affordable Care Act is that insurance companies can no longer sell junk insurance or gouge older people and women.

Understand what's going on here. Inflation is at 1%.  "Cigna is now asking for a 46% average increase, up from 23%, and Humana is requesting a 44% increase, up from 29%, The Tennessean reported on Friday. Expect these numbers to rise even more as insurance companies exit even more states."
Understand what’s going on here. Inflation is at 1%.
“Cigna is now asking for a 46% average increase, up from 23%, and Humana is requesting a 44% increase, up from 29%, The Tennessean reported on Friday. Expect these numbers to rise even more as insurance companies exit even more states.”


When they announce premium increases, it’s because they are unhappy with the amount of money they are making. They want to make more.

No one should be buying their bullshit or crying crocodile tears for them.

A whole new market was opened up to them with no competition from a public option. Even more to the point, it’s now a legal requirement for Americans to buy one of their products, and yet they have the balls to rattle their sabres about abandoning the very exchange,, that was created to give everyone, but especially poor people, the means to buy their legally mandated products. And, for those who can’t afford their products, taxpayer subsidies – your money and mine – go to these private insurance companies as part of the premiums paid by their new customers.

Now they want more? Why? Simple. Because…….wait for it…….these new customers through the health insurance exchange actually use their product – health insurance – to get health care services.

We must be idiots.

Anyone who doesn’t see what the insurance companies are and what they are doing now as the perfect argument for single payer health care – not health insurance, health care – is simply refusing to acknowledge that the health insurance industry in toto is a zero-value-add cost driver and inhibitor to a healthier population.

The sooner we elect people who want to move this country to a single payer system that essentially kills the health insurance industry, the better off we all will be.

10 States With Lowest Uninsured Rates Post-ACA

While the uninsured rate has dropped to a record low of 13.4% nationwide, according to Gallup figures, rates differ dramatically across states. Here are the top 10 states with the best uninsured rates in the aftermath of health care reform implementation, according to Wallethub.


What’s one of the things all 10 states have in common?


They’ve all expanded Medicaid.


See how that works?


Medicaid is expanded (almost entirely with the feds picking up the tab), and poor people get health insurance.


Where’s the bad news?

See on Scoop.itDidYouCheckFirst

How Many Sharks Can the #GOP Jump Before the Party’s Over?

Boehner ObamaJosh Gerstein’s piece, “5 questions about John Boehner’s lawsuit against Barack Obama,” in Politico is a frank and candid examination of the pros and cons, both short- and long-term, to both sides in the GOP House lawsuit against the president.

At this point, I consider the lawsuit to be an idiotic and colossal waste of time and taxpayer money. We need to understand that Obama’s executive actions to delay enforcement of certain PPACA provisions are supported by precedent and are good for businesses.

Anyone else ready to admit to not recalling that in 2006 W unilaterally decided not to penalize seniors for missing a deadline to sign up for prescription drug coverage under Medicare? Would anyone go on record as wanting to sue him for that?

Here’s the more delicious bit of irony in all of this.

Businesses and the people who own and run them – the segment of America that the GOP is always claiming to be on the side of – would be the ones to suffer if the delayed Employer Shared Responsibility (ESR) rules were being enforced on the timelines originally written into the law.
(For a quick primer on the ESR, see

The only question left for me is how many times the GOP has to jump the shark before anyone except white senior citizens constitute what Gallup recently described as the GOP’s “strongest age group?”

Is it any wonder that when thinking of the future of the GOP I’m reminded of the days when Don Meredith would sing to us on Monday nights?