Insurance Pawns, I

Here’s the column I was going to write today. It would use facts and data that have been reported for almost a decade to show, yet again, how the boosters of our current Unaffordable Care Act and the medical conglomerate it supports have become insurance pawns.

George Gobel was about six months older than my parents. He died at age 71 in 1991, shortly after undergoing heart surgery.

“Here’s the thing, Nancy Pelosi told George Stephanopoulis yesterday, “when we did the [Un]affordable Care Act, if everyone loved their care, if everyone loved it, which they didn’t, and their insurance, we would still have had to do it because the escalating cost of health care in our country were (sic) unsustainable to individuals, to families, to small business, to corporate America, and to the public sector…”


We “had three goals,” Rep. Pelosi continued. “One, to lower costs. The other, to expand benefits. And the third, to improve — increase access of many more people.”

Right.

Lower costs: In 2008, healthcare cost $7,889 per capita. In 2016 healthcare cost $10,345 per capita. In Rep. Pelosi’s world, jacking the costs by 31% is “lowering costs.”
In 2014, my own new plan cost 15% more (from $5,172 per year to $5,965) and covered less than my commercial, “substandard, predatory, and inadequate insurance.” In fact, my own individual premium was $2,502 at the beginning of the Obama Administration in 2009. Premiums soared to $7,239 on the Exchange in 2017.

Expand benefits: The Unaffordable Care Act added some coverage guarantees (you can buy insurance only during open enrollment) and premium guarantees (they will rise based on family structure, geography, the actuarial value of the benefit, age, and tobacco use).
Benefits don’t include bariatric (weight-loss) surgery, infertility treatment, alternative medicine including acupuncture, long-term care, foot care, eye exams, and more. And co-payments have skyrocketed. The co-payment for an asthma inhaler used to cost $7. Then it went to $30. Then $60. Now it’s $100, every month. Flexible spending account are limited to $2,500.

Increase access: 20.4 million people were forced at gunpoint to buy health insurance. My existing, commercial Blue Cross plan was dropped and I had to buy a new one on the Exchange.


For the record, the standard plan premiums on the Vermont Exchange were $6,880 for gold, up from $5,965 in 2014, $5,814 for silver, or $4,910 for bronze in 2016.

For the record, the standard plans on the Vermont Exchange had a $750 individual medical deductible for gold, a $2,000 individual medical deductible for silver, and a whopping $4,000 individual medical deductible for bronze in 2016, with additional deductibles for prescriptions and other services. The so-called standard “High Deductible” plans are worse.

Sen. Elizabeth Warren (D-MA) is beating the horse again. “20 million people are about to lose their health insurance as the GOP ‘destroys’ the [Un]affordable Care Act,” she says.

Right.

Remember the flat out lies about the Unaffordable Care Act?

Caduceus• Mr. Obama said, Like your plan, keep your plan.
• Mr. Obama said, Like your doctor, keep your doctor.
• Ms. Pelosi said, Premiums will decline.
• Mr. Obama said, Premiums will drop on average $2,500.
• Mr. Obama said, Deductibles will go down.
• Ms. Pelosi said, We have to pass the bill so that you can find out what is in it.
• Kathleen Sibelius said, The Exchange website will work.
• Jonathan Gruber said, The Exchange website was secure.
• Ms. Pelosi said, Emergency room visits would decline.
• Ms. Warren said, Obamacare is the best thing that ever happened to this country.

Mr. Obama and the Congress knew the public wouldn’t buy this gift to the insurance companies, so they forced mandates and regulations and false guarantees on us. The only real guarantee was to drive up the cost of health care.

We’re going to make people buy it, Mr. Obama decreed about the false promise of the Unaffordable Care Act, and if they don’t buy it, they’re going to get penalized.


I simply do not understand why so many people, from insurance pawns like Ms. Warren to my liberal friends who support her, don’t get how bad this thing is. The news, the statistics, the facts have shown over and over that Obamacare is accelerating the demise of a system that has failed us.

“Make America Great Again!” Presidential candidate Donald Trump, 2016.
“America never stopped being great.” Presidential candidate Hillary Clinton February 27, 2016.
“The average American is actually economically in a lot of economic desperation, insecure. We have parts of this country that are — really, desolate…” Democratic National Committee Chair Tom Perez, February 26, 2017.

Apparently the American protesters want their unaffordable premiums to climb more and more and more. American protesters want their unaffordable prescription drugs to cost more and more and more. American protesters want to their healthcare system to kill more patients than Iraq, the Maldives, Mexico, and 126 other countries. Apparently the American protesters want to buy the lies.

Those inconvenient truths, of course, don’t fit Ms. Warren and Ms. Pelosi’s story.


That’s the column I was going to write, until I realized the futility of using facts to counter the religious belief in Obamacare. I’ll just repeat a joke instead.

Squares Day…
True or false, George: experts say there are only seven or eight things in the world dumber than an ant.
George Gobel: Yes, and I think I voted for six of ’em.

The Legacy

Today is Barack Obama’s final day as President.

Politicians like Mr. Obama have get out front to talk about their legacy because they fear more than anything else that even their True Believers might hear the truth. On his last full day as President, here’s the truth. It is a Legacy of Failure.

The Legacy of Shame
• Aleppo. Benghazi. China. Iran. Iraq. Israel. NATO. Russia …
• Mr. Obama drew the line in the sand to Bashar al-Assad over his use of chemical weapons, then ran away. He spoke forcefully to Vladimir Putin, then ran away. He spoke harshly to Iraq in 2011, then ran away (that precipitated the rise of ISIS).
• Former NATO Supreme Allied Commander James Stavridis said Mr. Obama will someday look back on his Syria policy “with deep sorrow and some shame.”


The Legacy of Broken Dreams
• “We [don’t have] an energy policy in this country that makes sense,” Mr. Obama said in remarks on the American Jobs Act in 2011. There is still no coherent energy policy. Sadly, the coherent energy policy is to bankrupt any energy producer not on the “friends” list. FAIL.
• The cost of college has increased faster than the rate of inflation. FAIL.
• China devalued their currency to make their goods cheaper and our goods more expensive. The Obama China policy was never to challenge them. FAIL.
• Health care policies have failed to lower health costs. FAIL.
• In 2008, Mr. Obama claimed his investments in green energy would create 5 million new jobs. FAIL.

The Legacy of Bankruptcy
• In 2008, Mr. Obama said that adding $4 trillion to the national debt was “irresponsible” and “unpatriotic.”
• On Jan. 20, 2009, the debt held by the public was roughly $6.307 trillion. Intragovernmental Holdings added 4.32 trillion bringing the total national debt to $10.63 trillion on the day of Mr. Obama’s own inauguration. The national debt stands today at 19,961,179,000,000 (>||< close to TWENTY TRILLION DOLLARS) and counting.

The Legacy of Ill Health
• About 9.1% of people in the U.S., or around 28.6 million, were uninsured in 2015.
• “If you’ve got health insurance, we’re going to work with you to lower your premiums by $2500 per family per year.” The average family premium increased by $3,065 from $12,680 in 2008 to $18,142 this year, a 43% increase.
• U.S. health care spending grew 5.8% in 2015 alone, reaching $9,990 per person. Health spending accounted for 17.8% of the Gross Domestic Product. It is now $10,384 per person.

The Legacy of Joblessness
• 86,591,000 men and women, young and old, either don’t have, don’t want, or can’t do a job. The Obama administration does not count them as unemployed because they had not searched for work in the four weeks preceding the BLS survey.

The Legacy of Lies
• “We will pursue the housing plan I’m outlining today. And through this plan, we will help between 7 and 9 million families restructure or refinance their mortgages so they can afford-avoid foreclosure.” Uh huh.
• “If you like your health care plan, you’ll be able to keep your health care plan.” Okey dokey. (Obamacare alone is a legacy of deception unlike any previous government program.)
• “I cut spending by over a trillion dollars in 2011,” Mr. Obama said in 2012 on Meet the Press. Right. (Spending actually increased by $147 billion in that period.)
• “As president, I will work to solve this energy crisis once and for all.” How’d that work out for us?

The Legacy of Overreach
• The Environmental Protection Agency is the poster child for Administration overreach. The Supreme Court had to smack down the EPA over and over again including the EPA’s first limits on coal-fired power plant emissions, Sackett v. EPA, and more.
• EPA head Gina McCarthy was not concerned about the power plant emissions ruling. The regs went into effect “three years ago,” she said. “Most of [the plants] are already in compliance, investments have been made.”
• The EPA would send armed agents to incarcerate landowners for a spill similar to the Animas River in Colorado but now won’t pay $1.2 billion for the damages it itself caused.
• Now, the EPA has madly pushed through new regulations, not because they think they will work, but to create a mass that Mr. Trump’s EPA will have to correct, allowing the Far Green to decry a “rollback.”
• The EPA is not alone. In 2011, after Boeing had hired 1,000 new employees to work at its new factory in South Carolina, the Obama administration ordered the company to shut down the factory, because the factory was non-union.
• Armed SWAT agents raid the Gibson guitar factory, ordered the employees to leave, and seized guitars and other property from the factory, all without warrants or charges filed. It was later revealed that Gibson had not broken any laws.

The Legacy of Poverty
• In 2009, 42.9 million people had income below the poverty line. That was 14.3% of the U.S. population. The official poverty rate is now 14.5%. That means 45.3 million people in poverty, up by over 8 million since 2008.

The Legacy of Terror
• In December, Mr. Obama told us that “no foreign terrorist organization has successfully planned and executed an attack on our homeland.” Uh huh.
• He called the 2009 Christmas Day bomber an “isolated extremist.”
• The Fort Hood shooter who shouted “Allahu Akbar as he pulled the trigger” committed “workplace violence.”
• He called the 2013 Boston marathon bombing a “vicious attack” and directed the full resources of the government to Boston to find the source of that “terrorist act.”
No terrorist attacks?

The Legacy of Theft
• Mr. Obama stole General Motors from its stockholders — the government took a 60.8% ownership of the company and fired its CEO — then delivered ownership of the company to reward his voting block.

The Legacy of Wimps
• Even NBC’s Meet the Press questioned his manhood.


The Wrap Up
Mr. Obama brought a legacy of inadequacy and fear to America but he didn’t do it alone. There are still about 2,700,000 Executive branch civilians, 535 Congress critters, and about 65,000 people working for Congress in place and ready to keep on keeping on.

Mr. Trump has promised a clean sweep would start tomorrow but he has a lot to overcome.

 

Everything Is New Again!

I walk a couple of miles around South Puffin most mornings but yesterday was special.

“It’s a new year” and change was in the air. I expected transformation. I’d greet new people dressed in finery coming out of brand new homes. They would have handsome gardens and all their children would be above average.

It came as a surprise that I recognized every single house on my street. Every one.

Pundits insist on parsing “Make America Great Again” so it means something bad. In fact, on Face the Nation Sunday morning, the consensus was that the slogan specifically evokes racism and anti-feminism and classism and probably fascism.
Why is it so hard to look forward?
David Frum was so negative that he is the absolute embodiment of why I don’t read the Atlantic. He’s a “neoconservative” political commentator and senior editor at the Atlantic. A speech writer for Bush 43, he later wrote the first insider book about the Bush presidency. On Face the Nation, Mr. Frum called the current “crisis of democracy” something that hasn’t been seen since World War II. He was so virulently, consistently negative about Mr. Trump and a Trump presidency that even the Atlantic editor-in-chief Jeffrey Goldberg called him on his negativity.

The very people who wailed and gnashed their teeth over the Bush Administration are trotting out a similar litany again. Maybe one reason we need to make America great again is because these negative nellies are so afraid of change.

Here are some of the stories I’m hearing for 2017:

The president-elect doesn’t listen to anybody else.
Translation: “We need a president who will go along with the status quo.”
Reality: Mr. Trump tallied 1.4 million more votes than Ms. Clinton did in 49 states (only her huge disparity in California gave her a lead in the popular vote). He carried 32 states overall. She carried 18 and the D.C. He carried about 82% of all U.S. counties; she got the other 18%. That was a call for a significant shift. Voters deliberately chose a man who promised not to listen to the politicians.
The hope: Americans are already more hopeful that the country will be better in 2017 than it was in 2016 under Mr. Obama, according to a new AP-Times Square Alliance poll. People are looking forward to having more jobs and more money to spend.

The new administration has no substantive policies.
Translation: “We need to continue the Obama policies.”
Reality: The new mandate is to repair the damage done by years of political skulduggery on both sides of the aisle. More people than ever before fear and hate the federal government.
The hope: New policies will pare down every Federal department; reform the regulatory code; strengthen the U.S. military to discourage expansion by China, Russia, and terrorists; revamp all U.S. healthcare from the ground up and transform the VA; change the EPA from a fascist front to an environmental steward; establish school choice; create a working energy policy; do real science on climate matters; rewrite the 74,608-page federal tax code; and make us proud of our elected government.

The president-elect and most of the new administration have no political experience.
Translation: “We need a president who will go along with the expansion of big government.”
Reality: For more than a century, all “first world” countries have been rife with interest groups driving bigger government. The fundamental checks on such growth such as our allegiance to local control and a Constitution that limits the government’s role in economic life have been dissolved by Democrats and Republicans alike. Thank goodness that We the Overtaxed People finally elected someone with no political experience!
The hope: The classical liberal hopes that it may still be possible to stem the growth and return the “power to the people.”

The president-elect is morally outrageous!
Translation: “We need a president who is kind to women like Bill Clinton, or FDR, or LBJ, or Grover Cleveland, or James Buchanan.”
Reality: There’s no excuse for bad manners or illegal behavior but every recent election shows we not only accept it but approve of it from “good” politicians (the ones who confirm their supporters’ bias).
The hope: How about a resolution that we punish crimes and eliminate the Victorian prurience?

The president-elect is a rapacious businessman or a terrible financial manager. Or both!
Translation: “We need a president who knows nothing about business.”
Reality: We haven’t elected many politicians who have ever built anything whether it’s a house, a race car, a rocket ship, or a stent. Look where we are now.
The hope: This country was founded on citizen legislators and public servants. Maybe, just maybe, we can reinvigorate the idea of finding successful, capable people in other fields to “lend” their expertise to the government for a little while and then return to real life.

All the new appointments hate [science | women | foreign policy | the EPA | education | Obamacare].
Translation: “The new appointments will throw away all our hard-gains in newspaper science, affirmative action, and ‘free’ perpetual care.”
Reality: Newspaper science isn’t real. Fake trophies punish real accomplishment. And TANSTAAFL.
The hope: We can move the 46.3 million people in the labor force who were actually unemployed into productive jobs. We will value truth over political correctness and doublespeak. And we will task NASA to collect earthly data and return to the stars.

Plenty of people are trying to rewrite history right now but our best chance is to write a better story from today onward.

 

The Unaffordable Care Act, Part 739

USA Today found that “Many of next year’s premium rate increases on the Affordable Care Act exchanges threaten to surpass the high and wildly fluctuating rates that characterized the individual insurance market before the health law took effect.”

I told you so. My liberal friends hoped against hope that I was wrong. Deep down, you may have known this moment would come. I really did.

Politico reports that “Obamacare has turned into a financial sinkhole.

“UnitedHealth Group, the nation’s largest insurance company, is pulling out of the Obamacare business in North Carolina next year,” they found. “Blue Cross Blue Shield of North Carolina, which dominated the individual market with more than a half-million customers, reported that losses on its Obamacare business in 2014 and 2015 topped $400 million. The insurer said that figure includes government payments designed to shield insurers from big losses during the early years of Obamacare.”

The simple formula of the Unaffordable Care Act sugars out thusly:
1. Build network around a large dominant group.
2. Force everyone into the system.
3. Ration care.
4. Raise prices.

Sounds a lot like cable television, doesn’t it?

Wotta surprise.

Here’s another surprise. Hillary Clinton says she will “defend the Unaffordable Care Act, build on its successes, and go even further to reduce costs.”

Anybody want to tell her that jacking your premium by hundreds of dollars per month ain’t reducing costs? I don’t think she’ll listen to me.

 

Sale! Sale! Sale!

Americans lurve sales. We shop the grocery fliers. We bargain for our cars. We go to garage sales.

I bought milk on sale Saturday because it was “on sale” but it would be “regular price” today when I actually run out. I have to buy milk every few days, sale or not, but I try to time it to match the store cycles.

On the other hand, I’m in the market for a new-to-me pickup truck and a camera lens. I don’t need either of those today so I’ve been more picky waiting for the price I’m willing to pay.

Willing to pay is the key.

Ever tried to figure out what that new car actually cost the dealer? How about what the dealer paid for that “certified pre-owned”?

I found a car on sale recently. A dealer bought the car for $9,500 and spent about $400 for repairs and reconditioning. The car went on the lot for $13,990. That’s more than a 40% markup for some “floor” space on a gravel lot.
The eventual buyer “negotiated” the price down to $12,450 for that $9,500 car.

We trust used car dealers, don’t we?

The Interwebs have exploded with people discussing Mr. Sanders and his plans to tax the rich to fund free universal health care, free college, free birth control, free housing for the poor, and more. One poster wrote:

“Obamacare is a giant bloated horrible mess. Medicare is much the same. We can’t simply toss them in the trash, though, and tell everyone, ok now, go out there and shop for insurance same as you do shoes, good luck! Because unlike the kabillion shoe-sellers competing with each other for our business, there are only a couple health insurance companies colluding to eff us all up the ass. No matter what happens, they are guaranteed to raise their rates and make more money. Nothing and no one stops them, the way things are currently structured. Obamacare never even pretended to fix this.”

Mr. Obama lied.

The NYTimes reported that, Back when he was pushing the Unaffordable Care Act, President Obama lauded Grand Junction as a model of better, cheaper health care. “You’re getting better results while wasting less money,” he told the residents.
It turned out that Grand Junction’s Medicare billings were lower than average with no impact on health outcomes. “All we have to do,” he implied “is get the rest of the country acting more like Grand Junction, to get U.S. medical costs to drop.”

Grand Junction is one of the most expensive health care markets in the country for anyone on ObamaDon’tCare or any other private insurance despite its unusually low spending on Medicare. It turns out that Grand Junction has a small enough, healthy enough Medicare population that providers can cost shift to the private plans. Grand Junction has a big enough population with little enough competition that they can charge mostly what they want.

That works because a house call used to cost one chicken but today we have no idea how much your physician will charge for the half-dozen “procedures” that go on the bill for a simple checkup.

Have you ever asked your doc what an office visit costs?

And no one every notices that Emperor Obama’s plan has no clothes.

We need a sale!

Oh. Wait. Here’s a more personal example of costs and transparency.

SWMBO had a “screening mammogram” last fall. The bills included the actual boob crushing/digital picture taking, computer analysis, more computer analysis, and an assessment. The hospital billed $402. The physician who read the “film” charged $151. Medicare paid the hospital $104 and the doc $38, about a third of the billed cost.
No one at the hospital knew how much it would cost. No one could even tell us who would “read the film” so we could ask that price.
A south Florida provider advertises “cheap” mammograms for $799. The commercial doesn’t tell us if that includes just imaging, imaging and computer assessment, imaging and computer assessment and assessment, or something else.

We had no idea how much SWMBO’s procedure cost until Medicare sent us the make good on how much they paid. It’s intriguing that the total charge (not what we paid but the total charge) was less than the “cheap” one in Florida.

Medicare is like getting medicine on sale, right?

I’ve written about cost shifting before.

ObamaDon’tCare is like getting medicine on sale, right?

Rather than reducing costs, the Unaffordable Care Act has raised the annual cost of health care from $8,299 to $9,146 last year to a looming $10,000 per person this year. That makes it a $3.2 Trillion budget item. That’s THREE POINT TWO TRILLION DOLLARS.

Mr. Sanders’ failed-plan to expand health care coverage is pretty simple arithmetic. He wants to expand health care coverage by adding or increasing specific taxes (a 6.2% income-based health care tax plus a 2.2% income-based tax, plus new progressive income tax rates, plus capital gains and dividends taxes, plus estate tax). Total government spending is about $3.8 Trillion for the Feds and $6.2 Trillion for all U.S. Federal, state, and local governments. Mr. Sanders will double the Federal budget and push government spending overall to about $10 Trillion. That’s TEN TRILLION DOLLARS.

Mr. Sanders’ “let’s pretend we can do it by soaking the rich corporations” approach takes away the retirement of seniors and guarantees poverty for everyone else working for for a living.

We need a sale!

Many pundits believe all we need is some transparency. They’re wrong, too. Just knowing how much an office visit costs is only part of the solution.

The real answer is simpler. There isn’t enough money in the U.S. economy to pay for the current model of U.S. health care whether it is nationalized a la Mr. Sanders or market-based a la the national association of used car dealers.

Back in 2009, my treatise on fixing the U.S. health care system started from a simple premise: Health care in America is fundamentally broken. The numbers in that piece are still dead bang on. In 2018, I wrote then, “health care will cost $13,000/year for every man, woman, and child in America.” It’s 2016 now and we’re at $10 grand already.

The fix is a two-part piece, starting here.


This directory lists some of the earlier  No Puffin Perspective™ articles about the Patient Protection and Unaffordable Care Act signed into law by President Obama in 2010.