Category Archives: insurance reform

These? all in the last century

But we know better.

Why Medicare works and Obamacare might not

Picked this up at Andrew Sullivan’s site. More at the link.

Mike Konczal blames Obamacare’s technical problems on the law’s design. He contrasts Obamacare’s form of social insurance, which he labels “Category A,” with previous forms of social insurance, such as Medicare and Social Security, which he labels “Category B”

Anything else you want to ask me?

It’s been an unbloggy week, but I think I managed to say this on Monday:

(I’m staying out on my limb – I think Roberts votes for Obamacare. And if he does, so does Kennedy.)

Yup. That’s what I said. Gotta go. CNN’s calling.

(Whoops. My bad. Kennedy dissented.)

Governor Voldemort has a better idea because he knows all about health care.

My Gov don’t like him none of that Muslim-Keynan Obamacare stuff. He’s no fan of Medicare/Medicaid either (even though his criminal abuse of both made him and his co-conspirators millions). Nevertheless, we the people chose him to run things here in Florida, trusting, I assume, that he’d gotten ethically born-again.

He knows – made it clear on Day One – that Obamacare is not for Florida and so has refused to institute any of the legally mandated reforms. He has a better idea. States, he says:

. . . can do a better job . . . we should have 50 laboratories to see which is the best approach.

Yeah, that’ll work.

Here’s a little summary of his earlier career as head of Columbia/HCA (that’s Health Corporation of America):

On March 19, 1997, investigators from the FBI, the Internal Revenue Service and the Department of Health and Human Services served search warrants at Columbia/HCA facilities in El Paso and on dozens of doctors with suspected ties to the company.[21] The Columbia/HCA board of directors pressured Scott to resign as Chairman and CEO following the inquiry.[22]He was paid $9.88 million in a settlement. He also left owning 10 million shares of stock worth over $350 million.[23][24][25] In 1999, Columbia/HCA changed its name back to HCA, Inc.

I always like that getting rewarded with $10million dollars for screwing up your company part. It’s the new American way you know. Also, job creators.

In the settlements,  Columbia/HCA pled guilty and agreed to a $600+ million fine in the largest fraud settlement in US history. They admitted systematically overcharging the government . . . They also admitted fraudulently billing Medicare and other health programs by inflating the seriousness of diagnoses and to giving doctors partnerships in company hospitals as a kickback for the doctors referring patients to HCA. They filed false cost reports, fraudulently billing Medicare . . .  In addition, they gave doctors “loans” never intending to be repaid, free rent, free office furniture, and free drugs from hospital pharmacies.

That ‘overcharging the government’ part? That’s us, that’s taxpayer money he stole.

In late 2002, HCA agreed to pay the U.S. government $631 million, plus interest, and pay $17.5 million to state Medicaid agencies, in addition to $250 million paid up to that point to resolve outstanding Medicare expense claims.[26]In all, civil law suits cost HCA more than $2 billion to settle, by far the largest fraud settlement in US history.[27]


Take to the fainting couches! Obama criticized the Court!

(Apologies to someone – I grabbed this Daily Kos link from a blogfriend and have now lost track. So whoever put this up before me, thanks. Nice catch.)

Sen Mitch McConnell now:

“The president crossed a dangerous line this week,” read McConnell’s prepared remarks. “And anyone who cares about liberty needs to call him out on it. The independence of the court must be defended.” […]

So, some ‘reporters’ decided to visit the way back machine to see just where this ‘line’ not to be crossed falls.

Candidate Ronald Reagan then:

… campaigning in Birmingham, Ala., Thursday, Reagan blasted the court’s most recent abortion ruling as “an abuse of power as bad as the transgression of Watergate and the bribery on Capitol Hill.” …

Reagan administration then:

Attorney General William French Smith accused the federal courts of “constitutionally dubious and unwise intrusions upon the legislative domain,” and vowed to oppose such “subjective judicial policymaking.” […]

President George W. Bush then:

For the judiciary, resisting this temptation is particularly important, because it’s the only branch that is unelected and whose officers serve for life. Unfortunately, some judges give in to temptation and make law instead of interpreting. Such judicial lawlessness is a threat to our democracy—and it needs to stop.

And oh yeah, the good Senator had few words back then too (about the Schiavo case):

MCCONNELL: I don’t know. These are findings of fact that presumably the court, had it looked at it de novo from the beginning, which is what we granted the federal courts the authority to do, could have taken into account

[Between the lines – the Court overstepped ‘what we granted the federal courts the authority to do’?].

(there’s more at the link from lesser lights.)

George Washington did it. John Adams too.

Now that SCOTUS has finished hearing the challenges to Obamacare, we settle down to wait a few months for their opinion. (Elvis save us from the wrath of those who chant f-r-d-e-e-d-o-m-e-! at every loss if  the justices say, yeah, okay.)

The first US Supreme Court, 1790

Meanwhile, this is interesting. From friend Ed this morning:

. . . three laws, passed in 1790, 1792 and 1798 respectively . . . provide for mandates not unlike the one being considered by the Supreme Court this week . . .:

[In] 1790, the first Congress, which was packed with framers, required all ship owners to provide medical insurance for seamen; in 1798, Congress also required seamen to buy hospital insurance for themselves. In 1792, Congress enacted a law mandating that all able-bodied citizens obtain a firearm. This history negates any claim that forcing the purchase of insurance or other products is unprecedented or contrary to any possible intention of the framers.

PolitiFact dug deeper into Elhauge’s claims and found evidence that mandates were approved by Congressmen who had also signed the Constitution; refuting the assertion that the laws passed despite framers’ objections:

There was no roll call for the House and Senate bills requiring health care for seamen. But on the proposal mandating the purchase of a musket, firelock or rifle as part of the larger bill to establish a uniform militia, 10 of the 14 framers whose votes were recorded endorsed the measure.Not only did mandates pass muster with the Framers in Congress, they were signed into law by George Washington and John Adams.

No fat lady yet at SCOTUS. I say Obamacare makes it.

Long busy day, just now getting to my lonely laptop – and only for a moment before I crash – to say:

I think the ACA will be upheld by the Supreme Court, and I think it can be by a stronger majority than usual. I’m guessing 7-2. If Kennedy joins the liberals, I think Roberts might do the same, and encourage the other conservatives to join as well, and make the decision stronger, closer to unanimity, something he’s always desired for major decisions. If the bill is upheld, it’s an historic decision and Roberts will also want to put his name on it.

It wins. 7-2. And Roberts votes with the majority. Holdouts might be Alito and Thomas.

Hey . . . it’s months off. If I’m wrong, nobody will remember.

Ezra Klein reads Whatever Works – or – I guessed right

. . . . earlier today, I posted this:

I’ve just begun listening to today’s oral arguments in the Supreme Court – up first is the US Solicitor General. And he is just terrible. He is so so terrible. I haven’t heard a single legal argument from him yet, it’s all defensive. He’s halting and gets a bit off track. Yikes.

Shortly afterward, I posted this:

As they say “Now I’m  no lawyer”, but it just sounded like Breyer in his questioning was actually providing some of the reasoned argument one would expect from the SG.

And now I am looking at Ezra Klein’s Twitterfeed (he writes the Wonk Blog at The Washington Post) and look what he is saying.

Oh Clarence where art thou?

I’d forgotten about this. Justice Thomas doesn’t engage in oral argument. And indeed, he didn’t ask a single question in two days.

Are the liberal justices arguing the case for the United States instead of the Solicitor General?

As they say “Now I’m  no lawyer”,  but it just sounded like Breyer in his questioning was actually providing some of the reasoned argument one would expect from the SG.

UPDATE: Sotomayor is trying – very hard – to get the SG to articulate his actual argument. The man seems to be arguing the need for health insurance, instead of presenting the US’s legal argument for the mandate. He’s doing an awful job on the mandate.

UPDATE 2: I also wish he’d stop saying “In my opinion” and “I don’t think it’s fair to say blah blah”.

Oh no, oh please no . . .

. . . please let it get better.

I’ve just begun listening to today’s oral arguments in the Supreme Court – up first is the US Solicitor General. And he is just terrible. He is so so terrible. I haven’t heard a single legal argument from him yet, it’s all defensive. He’s halting and gets a bit off track. Yikes.

I hope it gets better. If it doesn’t, the Justices are going to walk all over him and it’s going to hurt the case.

Ready. Aim. Fire. USA! USA! USA!

How many ways can we cripple our own future . . . and how easily are we manipulated into cooperating in our own destruction, believing it to be salvation instead? Ahh . . .

A recent column by Ruth Marcus takes a look at that phenomenon with the antipathy towards the health care mandate, now headed to the Supreme Court.

Even I am surprised by the extent of the negative poll numbers. What doesn’t surprise me is that they are the result of misinformation. When the details of the health care law are polled, they do well. And when the financial benefits to taxpayers are explained . . . . well, the opposition should dissolve, but it doesn’t because the entrenched meme of government overreach has taken deep root.

The Obama administration’s brief defending the constitutionality of the health-care law come early on. “As a class,” the brief advises on Page 7, “the uninsured consumed $116 billion of health-care services in 2008.”

On the next page, the brief drives the point home: “In 2008, people without insurance did not pay for 63 percent of their health-care costs.”

And that $116 billion is of course paid for by those who do have insurance – in higher premiums and in taxes.

An individual mandate was essential to make the plan work. Without that larger pool of premium-payers, there is no feasible way to require insurance companies to cover all applicants and charge the same amount, regardless of their heath status.

. . . “People don’t understand how the mandate works at all and they don’t understand why it’s there,” Kaiser’s polling director, Mollyann Brodie, told me.

Brodie suspects that it’s too late to change minds. “This law as a whole has really become a symbolic issue to people and they really aren’t open to information,” she said.

The Court may very well uphold the mandate. And we should shudder at the consequences to us if the other provisions of the bill are left in place, and the funding mechanisms stripped out.

But Congress and its corporate overlords won’t give up. The flames must continue to be fed, the people must be kept agitated. The rational path must not be taken.

Fire. Aim. Ready. As usual.

LET ME I ADD: An earlier Post story (can’t locate link) reported that employer-sponsored health insurance premiums have risen faster than incomes in every state in the union – while consistenly delivering skimpier benefits. We can certainly look forward to more of this is the mandate is struck down.

A random thought

If the Courts uphold the ‘individual mandate’ in the new health care law . . .  Medicare for All could be more viable.

Big Pharma is our friend. The insurance dudes too.

A little something by artist Michael dal Cerro via A Paralell Universe. Says it all.  (from this post, “The Gilded Age on Steroids”)

We have the best health care system in the world dammit


Blue Shield of California seeks rate hikes of as much as 59% for individuals

“Another big California health insurer has stunned individual policyholders with huge rate increases — this time it’s Blue Shield of California seeking cumulative hikes of as much as 59% for tens of thousands of customers March 1. Blue Shield’s action comes less than a year after Anthem Blue Cross tried and failed to raise rates as much as 39% for about 700,000 California customers.

San Francisco-based Blue Shield said the increases were the result of fast-rising healthcare costs and other expenses resulting from new healthcare laws.

. . . Nearly 1 in 4 of the affected customers will see cumulative increases of more than 50% over five months. . . Michael Fraser, a Blue Shield policyholder from San Diego, learned recently that his monthly bill would climb 59%, to $431 from $271. “When I tell people, their jaws drop and their eyes bug out,” said Fraser “

We don’t need no stinkin’ reform

From the Washington Post today:

Anthem Blue Cross withdraws big CA rate hike

The Associated Press  Friday, April 30, 2010; 2:17 AM

 LOS ANGELES — Insurance giant Anthem Blue Cross, the company criticized by President Barack Obama when it proposed raising rates for Californians by as much as 39 percent, withdrew plans for the proposed hike Thursday.

Los Angeles-based Anthem made the decision after an independent audit determined the company’s justification for raising premiums was based on flawed data, state Insurance Commissioner Steve Poizner said.

The decision also came one day after Anthem’s parent, Wellpoint, Inc. of Indianapolis, announced its first-quarter profit soared by 51 percent.

Good morning

The Health Care ‘summit’ is over and we’re all still alive and breathing.  TV News has now begun to flail around for the next ‘story’. I did hear that George W. Bush gave a speech somewhere to someone recently;  speculation about what he said, what he will say next time and a flurry of questions he isn’t present to answer  – perhaps a candidate for the next story.

If not, there’s always the killer whale.

Because it’s altogether too much work to bother to report on the troops overseas, where it is the 140th day of the ninth year of the War in Afghanistan.

Going to miss the ‘summit’

Well, mostly going to miss it. Watching now, but have to head out to a meeting. May I say – and I’ve never noticed this before – Nancy Pelosi is a terrible speaker. She is not clear and she misspeaks.

Obama didn’t name a single congressional Republican in his opening remarks. Alexander named a half dozen Dems. Pelosi – so far – has not named a single GOP congress critter. Just sayin’.

And, as usual, I wish they would all leave the sad, sad stories outside the door. Bleh! We have heard these before.

UPDATE:  I missed a lot and when I got back, CSPAN had moved to the House and the Senate. The ‘summit’ is on CSPAN 3 which is a premium channel down my way. MSNBC has hockey. FOX is covering it maybe a little here and there. Which left me with the dreaded Wolf Blitzer and possibly the very worst panel in CNN history.

Donna Brasile. Candy Crowley. Mary Matelin. Gloria Borger. (David Gergen was there, but he’s pretty much turned into a place holder.) The only one missing was Bill Bennett.

They’re running very little live summit now – they have calculated, incorrectly, that they are far more interesting – especially when they guess about what’s being said because they can’t watch what’s being said when they are busy talking about what they think is being said. CNN has not figured out something that seems basic to me – the people who are watching the summit on CNN want to see the summit. Not Candy Crowley.

Health care now, health care forevah. Health care, eh?

We won't need heatlh care when we grow up. So it's okay!

Andrew Sullivan today (and David Leonhardt at the NY Times) get it about right.

Beneath The Anger, The Reality

David Leonhardt explains why the rage against a “leftist” Obama is baloney:

The current versions of health reform are the product of decades of debate between Republicans and Democrats. The bills are more conservative than Bill Clinton’s 1993 proposal. For that matter, they’re more conservative than Richard Nixon’s 1971 plan, which would have had the federal government provide insurance to people who didn’t get it through their job.

More conservative than Nixon or Clinton – and yet it’s a threat to the meaning of America. This is claptrap. Hooey. Hysteria. And wrong. If the Democrats give into this FNC/RNC campaign to smear Obama as something he is not, they will miss the only chance of real, imperfect but meaningful reform. They will have blinked after being psyched out.

Pass the Senate bill and then defend it loudly, strongly, proudly. And call the opponents’ bluff.

Stinkin’ liars

If health care fails to pass, it will mark the most remarkable victory of an industry lobbying effort in my life. The very saddest part of it will be that these people – who work against American interests – convinced Americans to go along.

Let’s never forget: corporations do not have any national allegiance. Corporations have no moral imperatives.

Shoot self in foot – repeatedly. It’s the American way.

These long excerpts are lifted directly from Eric Alterman’s CAP column this week. He addresses the crookedness of our privatized campaign financing system and the dreadful legislation it produces – while burying legislation in the public interest, but not the interest of those corporate sponsors of our congress. He says it better than I ever could:

While most in the media prefer to focus on personalities of these influential “consensus builders,” “moderates,” and “conservatives,” they would be wiser to obey that old Watergate adage and “follow the money.” For it is the manner in which we finance our elections—rather than the courage or cowardice of any given individual—that determines the shape of the legislation the “system” produces. . .

He gives us some examples:

Two of the top three donors to Olympia Snowe’s (R-ME) 2006 campaign, who voted against the legislation, were Aetna Inc. and New York Life Insurance. Overall, the insurance industry made the largest percentage of donations to her campaign. In June, Sam Stein wrote about Snowe’s relationship with the insurance industry when Democrats were still courting the senator to support reform.

The top two donors to Committee Chairman Max Baucus’s (D-MT) 2008 campaign were Schering-Plough and New York Life Insurance. The combined donations to Baucus’s campaign and his congressional leadership PAC from health professionals and the pharmaceutical and insurance industries totaled $2,488,139 from 2003 to 2008.

Baucus, Chuck Grassley (R-IA), Orrin Hatch (R-UT), and Ron Wyden (D-OR) all serve on the Senate Finance Committee and have all played vocal roles in the debate taking strong positions against the public option. These four senators and their political action committees have received a combined $201,403 from Blue Cross/Blue Shield since 2005. . . In July, Mike Ross (D-AR) led a bloc of seven Blue Dogs on the House Energy and Commerce Committee in a fight to weaken funding to a public health insurance bill.. . the [same] Blue Dogs had raised $1.1 million for their PAC, a majority of which came from health, insurance, and financial sectors. Bendavid singled out Mike Ross for his tough negotiating and his “moderate” positions on health care reform. Eggen reported that Ross alone raised over $1 million from the insurance and pharmaceutical industries in five terms in Congress.

He goes on taking special aim at  former Speaker Dennis Hastert and NY Sen. Chuck Schumer.

He wraps it up:

If Congress adopted a system of the public financing of elections—as is done in most democracies—they would receive better legislation at a miniscule fraction of the cost they now pay indirectly for their penny-wise, pound-foolish attitude toward election funding.

Read it and weep

Enough said? Just how batshit crazy are we anyway? Comes from here. With  hat tip to Andrew Sullivan.

Home for the holidays? Bah humbug.

I actually stayed up last night to hear the roll call on the 1:00 am vote on the Senate’s health care bill. (It passed with exactly 60 votes.)

And the second last speaker before the vote was GOP leader Mitch McConnell. And he, like the speakers before him, deplored – deplored I tell you – how the Dems were “sneaking this vote and doing it in the middle of the night.”

The 1:00 am time for the vote was expected by all news organizations and heavily covered in the days leading up to last night’s vote. And the Senate arguments have been on teevee – my teevee anyway – for almost a month. Sneaky.

Why 1:00 am? Reid could have held matters over till midday or afternoon today of course. But all the Dems wanted to wrap it up so they could hit the airports and be homeward bound this morning. The GOP, on the other hand, had absolutely no plans to go home at all and would have been absolutely thrilled to stay a few more days and prevent that sneaky, middle of the night stuff.

UPDATE: Hard as it is to believe, I got something wrong here. So I take back all that stuff about jumping on planes. Seems the actual floor vote is still scheduled for before Christmas, which probably means Christmas Eve. Although I have no idea why it has to stall like that. Did they not vote last night to move to a vote?

But the balance of what I said – about the feigned outrage at the ‘sneaky middle of the night vote’ – continues to be true.

Coming down to the wire

Nate Silver has written an important follow up to his earlier post  (referenced by me here) about health care reform – this one details what’s really out there, what each of the proposals means, what the arguments are – for and against – and why liberals should still support whatever emerges.

” . . .  So, we’ve talked a lot about what the bill is not. It’s not structural reform. What is it, then? At the end of the day, it’s a big bleeping social welfare program — the largest social welfare program to be implemented since the Great Society. And that’s really what it’s been all along: fundamental reform like single-payer or Wyden-Bennett was never really on the table. The bill comes very close, indeed, to establishing what might be thought of as a right to access to health care: once it’s been determined that people with pre-existing conditions cannot be denied health care coverage, and that working class people ought to receive assistance so that they can afford health care coverage, it will be very hard to remove those benefits. It’s the sort of opportunity that comes around rarely — and one that liberals will greatly regret if they turn down.

Jeeezzz, I want to feel better, not worse

Glenn Greenwald at Salon today, posts with excrutiating detail, the story of  Obama and health care reform. It’s long. It’s full of links to other long stories, but it’s an important read for progressives who really want to see something happen, and want to know why it feels like smoke and mirrors. (Greenwald says it is smoke and mirrors.)

Be forewarned though, if you’re living in any happy bubbles and don’t want them burst, stay away from this one.

Greenwald’s rage-meter can be a little high sometimes, so I always take him with a teeny dose of salt, but today? Well, today he’s got it all lined up and it’s not – ahem – to my liking.

Food for thought

Nate Silver at Five-thirty-eight, a statistican who made his name tracking the projections during the ’08 election (and being right more than anyone else) has a post this morning about health care and he says “Progressives would be batsh*t crazy to oppose the Senate bill”.

Well,  that’s a bold statement  from someone I respect and whom I’ve always perceived as progressive himself, so that makes his thoughts on this matter worth considering. He put up a graphic of his own making. I’m just putting it out there.


We’re winning again – in the race to the bottom that is . . . per the Organization for Economic Cooperation and Development, the US ranks near the bottom in life expectancy among wealthy nations despite spending more than double per person on health care than the industrialized world’s average.

Way to go!! We must be doing something right, yes?

From the story at MSNBC:

“Total U.S. spending on health care was $7,290 a person in 2007, nearly two-and-a-half times the OECD average of $2,984. The figures include spending by both individuals and governments.

“It suggests that the U.S. is not getting great value for its health spending, in terms of life expectancy,” Gaetan Lafortune, one of the report’s co-authors said.

He said the U.S. needs to look “closely at spending that has little or no value in terms of improved health.”

Clarity. Efficient use of words. Yum.

These days I often find Krugman a bit obtuse for me. He gets all wonky about economics, which is entirely understandable as that’s the most important thing out there even if you’re not a Nobel-winning economist from Princeton.

Today he writes about health care reform. And, as I’ve always appreciated whenever he’s ‘speaking civilian’, he is so very clear. Re Senate moderates who claim concern over fiscal responsibility, he has a delicious and succinct point:

” . . . if they’re really concerned with fiscal responsibility, they shouldn’t be worried about what would happen if health reform passes. They should, instead, be worried about what would happen if it doesn’t pass.

Further down, he says: “The path to cost control runs through universality.”

Like kryptonite to stupid*

I noticed this myself  when I watched the trailer (?) earlier today for the apparently actual upcoming tea-bagger documentary. (Really. There is one.)

A black guy named Nate appears a LOT in the trailer. I think it’s probably because he’s so handsome, not because he was the only black guy they could find. Here are three of his five appearances.

*An early blog title by an early blog hero: Oliver Wills.

Worthy of Jon Stewart

More and more these days, I find myself turning to Nicholas Kristoff in the New York Times for a dose of context and sanity. Because he hasn’t become a ‘celebrity journalist’, he holds onto his credentials as an actual journalist, who forms his opinions as a columnist by doing actual ‘reporting’.  (Archaic. I know.)

This morning, he brings us some predictions – from 1964, when Medicare was a-bornin’.

“Critics storm that health care reform is “a cruel hoax and a delusion.” Ads in 100 newspapers thunder that reform would mean “the beginning of socialized medicine.”

The Wall Street Journal’s editorial page predicts that the legislation will lead to “deteriorating service.” Business groups warn that Washington bureaucrats will invade “the privacy of the examination room,” that we are on the road to rationed care and that patients will lose the “freedom to choose their own doctor.”