Skip to main content

Mon Jul 21, 2014 at 07:44 PM PDT

Israel is a fascist state

by Clever Handle

From today's Democracy Now!:

AMY GOODMAN: We go now to two guests. Rann Bar-On is an Israeli peace activist who participated in Saturday’s protest in Haifa. He is a lecturer in mathematics here in the United States at Duke University. He has been in Haifa visiting his parents for the last two weeks. And Max Blumenthal is with us, senior writer for, best-selling author. His recent book, Goliath: Life and Loathing in Greater Israel.

We welcome you both to Democracy Now! Let’s start in Haifa. I want to start by asking you, Rann Bar-On, what happened in this peace demonstration?

RANN BAR-ON: Hi, Amy. We were about three or four hundred left-wing activists demonstrating against the war, for peace between Arabs and Jews, refusing to be enemies. As we arrived, my partner and I saw well over a thousand activists from—militant activists from the right, surrounded by police and others, screaming, "Death to Arabs! Death to leftists!" As we were protesting, they moved towards us. The police allowed them to move towards us. The police allowed them to attack us, to throw stones at us. Later on, as we were trying to leave, the police took—the police did not attempt to allow us to leave. They took over an hour to evacuate us while we were under heavy attack by stones and other missiles. Many were injured. We’ve had over 30 injured. Two women are still in hospital. There were gangs roaming the streets, beating up anyone they thought was an Arab or member of our demonstration. The police were—

AMY GOODMAN: Rann Bar-On, can you explain why you went out into the streets to protest?

RANN BAR-ON: Absolutely. I believe that what Israel is doing in Gaza is a racist attack. It is not self-defense in any way. And it is a continuation of Israeli policy that has always discriminated against the Arab population. What happened to us at the protest is not new. This is something that is a trend that has been continuing for many years. There has been much incitement from the political class that has allowed even so-called moderate right-wingers to join cries saying, "Death to Arabs! Death to leftists!" and attacking activists and Arabs in the street.

Goodman continued by interviewing Max Blumenthal, who made the argument that Israel is becoming fascistic in his book Goliath: Life and Loathing in Greater Israel:
MAX BLUMENTHAL: Well, I guess I hate being vindicated for the facts that I produced in this book, that I described in this book, the facts on the ground inside Israeli society. And what we saw in Haifa, what I understand, is that these right-wingers who attacked Rann and other leftists, who are heavily demonized in Israeli society, incited against at the highest level by figures like the foreign minister, Avigdor Lieberman, that these right-wingers arrived in buses, that this was a very organized attack. It’s apparent to me that extreme right-wing elements have infiltrated the police, which have allowed them to attack leftists across Israel, to attack antiwar protesters. They’ve infiltrated them much in the way that Golden Dawn has done in Greece.

The right wing, the current inception of the street-level right wing, which kind of acts as the street muscle for Netanyahu’s governing coalition, particularly the right-wing elements represented by Naftali Bennett of the Jewish Home Party, they are not just settlers or religious nationalists. Many of them were army reservists, who came together as part of the orange cells that protested the withdrawal from the Gaza Strip in 2006. They formed a group called Im Tirtzu, which intimidates leftists and Palestinians on college campuses across Israel. And they are still a major part of the army, including the army officer corps. So the violence that we’re seeing in Gaza is not just related to a particular military strategy; it’s also influenced by the ideology that has captured the hearts and minds of these young men who have learned to demonize the other and see Palestinians and antiwar and human rights elements as absolutely subhuman. It’s playing out unofficially through a vigilante campaign in Israel, but in Gaza what we’re witnessing is the official revenge campaign orchestrated by Netanyahu and the military.

An article in the Jewish Daily Forward describes the same event:
hat all changed recently, on the evening of July 12, when a group of several dozen extreme-right activists, some of them wearing T-shirts with neo-Nazi designs, attacked a peaceful demonstration against the carnage in Gaza and the targeting of civilians on both sides — and for a cease-fire and peace. The right-wingers announced in advance that they would be coming to physically assault us in the protest. However, police paid no heed to the warnings, nor to the threats made on the scene when the protest began, nor to our requests that the very few police officers present would call for backup and try to physically separate the two demonstrations.

When the air raid sirens wailed in Tel Aviv that evening, we knew one thing for sure: The thugs in front of us were more dangerous than the rapidly approaching Hamas-fired rockets. While the Iron Dome intercepted the rockets, by the evening’s end one leftist activist was injured and hospitalized, an independent journalist had his video camera stolen and dozens of others were hit, pushed, thrown to the ground or had eggs thrown at them. Two local coffee shops were vandalized as the right-wingers suspected that demonstrators were hiding inside.

Now, I’ve been shot at, beaten, arrested and spent two years in prison for conscientious objection, but this brutal attack by dozens of bullies chanting, “Death to Arabs” and “Burn the leftists” — just two weeks after a young Palestinian boy was torched to death — was one of the most frightening experiences I’ve ever encountered.

One of the organizers of the mob, a local rapper dubbed “The Shadow,” later took to social media to express his pride in having given peace activists a lesson that nowhere can they protest in safety, not even in Tel Aviv, and mentioned how police on the scene showed their support for his actions. Not a single attacker was arrested, by the way, despite the fact that the attacks took place right in front of trained riot policemen. An official police representative later explained this by saying that “no one pressed charges.” Violent threats toward leftists by “The Shadow” and others continued on social networks and in the comment sections of media outlets in the days to come, creating a very real and physical fear among many activists.

Israel is a fascist state. And yet we give them a totally unbalanced amount of foreign aid (graph from

Why? Because game recognizes game.


I've been saying ever since it happened that it made no sense for Assad to use chemical weapons: he was winning, and all the attack did was risk more foreign aid for the rebels at best and direct intervention at worst. And doing it when there were already UN Inspectors in the country made it seem even more foolishly suicidal. Over at the London Review of Books, Hersh proves that my gut was right:

A US intelligence consultant told me that a few weeks before 21 August he saw a highly classified briefing prepared for Dempsey and the defense secretary, Chuck Hagel, which described ‘the acute anxiety’ of the Erdoğan administration about the rebels’ dwindling prospects. The analysis warned that the Turkish leadership had expressed ‘the need to do something that would precipitate a US military response’. By late summer, the Syrian army still had the advantage over the rebels, the former intelligence official said, and only American air power could turn the tide. In the autumn, the former intelligence official went on, the US intelligence analysts who kept working on the events of 21 August ‘sensed that Syria had not done the gas attack. But the 500 pound gorilla was, how did it happen? The immediate suspect was the Turks, because they had all the pieces to make it happen.’

As intercepts and other data related to the 21 August attacks were gathered, the intelligence community saw evidence to support its suspicions. ‘We now know it was a covert action planned by Erdoğan’s people to push Obama over the red line,’ the former intelligence official said. ‘They had to escalate to a gas attack in or near Damascus when the UN inspectors’ – who arrived in Damascus on 18 August to investigate the earlier use of gas – ‘were there. The deal was to do something spectacular. Our senior military officers have been told by the DIA and other intelligence assets that the sarin was supplied through Turkey – that it could only have gotten there with Turkish support. The Turks also provided the training in producing the sarin and handling it.’ Much of the support for that assessment came from the Turks themselves, via intercepted conversations in the immediate aftermath of the attack. ‘Principal evidence came from the Turkish post-attack joy and back-slapping in numerous intercepts. Operations are always so super-secret in the planning but that all flies out the window when it comes to crowing afterwards. There is no greater vulnerability than in the perpetrators claiming credit for success.’ Erdoğan’s problems in Syria would soon be over: ‘Off goes the gas and Obama will say red line and America is going to attack Syria, or at least that was the idea. But it did not work out that way.’

Given the recent leaks that showed Erdogan's plot to set up a false flag operation to justify a Turkish intervention, this shouldn't be surprising.

The report also details the "rat line" that was used to ship weapons to the rebels via recently "liberated" Libya. A key point on this line was a CIA outpost close to the American consulate in Bengazi. You can probably guess where this is going:

In January, the Senate Intelligence Committee released a report on the assault by a local militia in September 2012 on the American consulate and a nearby undercover CIA facility in Benghazi, which resulted in the death of the US ambassador, Christopher Stevens, and three others. The report’s criticism of the State Department for not providing adequate security at the consulate, and of the intelligence community for not alerting the US military to the presence of a CIA outpost in the area, received front-page coverage and revived animosities in Washington, with Republicans accusing Obama and Hillary Clinton of a cover-up. A highly classified annex to the report, not made public, described a secret agreement reached in early 2012 between the Obama and Erdoğan administrations. It pertained to the rat line. By the terms of the agreement, funding came from Turkey, as well as Saudi Arabia and Qatar; the CIA, with the support of MI6, was responsible for getting arms from Gaddafi’s arsenals into Syria. A number of front companies were set up in Libya, some under the cover of Australian entities. Retired American soldiers, who didn’t always know who was really employing them, were hired to manage procurement and shipping. The operation was run by David Petraeus, the CIA director who would soon resign when it became known he was having an affair with his biographer. (A spokesperson for Petraeus denied the operation ever took place.)
Thankfully, the Joint Chiefs of Staff were able to talk Obama out of war, according to Hersh. This should be a valuable lesson about repeating unverified claims made by the national-security state and spread through the compliant corporate media.

The man who said that electing him would cause the oceans to start to recede has been working overtime to help the extractive industry.

First, he greenwashed fracking, buying into the gas industry bullshit that it would end up emitting less C02. Under him, the EPA has suppressed negative evidence about fracking, from underestimating methane emissions to covering up water contamination in Dimock, PA and elsewhere.

Now, as other diaries have covered, he's poised to approve the Keystone XL pipeline. The State Department's environmental impact report that came out today was a travesty.

But an even bigger scandal isn't getting any coverage that I've seen. It comes at the nexus between surveillance and pollution, between spying and corporate dominance: the use of NSA spying to scuttle the Copenhagen Climate Change talks.

We've long known that Obama's goal at the talks was to keep a deal from being reached; that was reported on when the talks were still happening (and predictably ignored by those desperate to believe Obama cared about them). However, thanks to Laura Poitras and Edward Snowden, we now know how extensive and illegal those efforts were:

At the Copenhagen Climate Summit in 2009, the world's nations were supposed to reach an agreement that would protect future generations against catastrophic climate change. But not everyone was playing by the rules. A leaked document now reveals that the US employed the NSA, its signals intelligence agency, to intercept information about other countries' views on the climate negotiations before and during the summit. According to observers, the spying may have contributed to the Americans getting their way in the negotiations
I can already hear the gears grinding in some of the more robotic Obama supporter's heads: "Hey, wait a minute! Maybe he was using the NSA to get a BETTER deal!" First of all, I think we need to go visit the Wizard so he can do something about your debilitating naivety, tinman. Secondly, though, no, the evidence suggests the direct opposite:
Several officials from the COP15 office have told Information that they believe advance American knowledge of the Danish proposal may help explain US positioning in the months leading up to the summit. While many other countries formulated promises that were increasingly ambitious, the Obama administration never moderated its position that it would not accept any agreement resembling the Kyoto protocol. Also, the Americans only offered a 4-6 percent reduction in CO2 emissions as compared to 1990 levels, despite the fact that the UN recommendation for developed nations was 25-40 percent.

As one government official says: »They simply sat back, just as we had feared they would if they knew about our document. They made no constructive statements. Obviously, if they had known about our plans since the fall of 2009, it was in their interest to simply wait for our draft proposal to be brought to the table at the summit.«

Bill McKibben of calls the revelations: "insane and disgusting." He's not wrong.

Spying is not about protecting us. Spying is about power. And this President has made it clear through his actions, from banking to the environment to healthcare, that he will use power to protect and extend the interests of the wealthy.

Obama is not just a traitor to his own words, or his base. He is a traitor to every living thing on this planet.


The infrastructure that sends information from the is still not functioning properly. Insurers say that they need an error rate of 1% or lower (preferably much lower) in order to ensure good service; currently the error rate is stuck at 5%, according to Wonkblog. Earlier, I had predicted that this issue would prevent a surge of enrollements since I assumed that the Obama administration wouldn't want to throw millions of Americans into a Kafkaesque bureaucratic nightmare where they didn't know whether they were insured or not.

As you can probably tell by the fact that there are now 2.1 million enrollees, I was wrong. Mea culpa. I should have known Obama cares far more about optics and messaging than he does about reality.

Reality, though, always ends up rearing its head, as this article in the New York Times shows.

Paul D. Donahue and his wife, Angela, are among more than a million Americans who have signed up for health coverage through the federal insurance exchange. Mr. Donahue has a card in his wallet from his insurer to prove it. But when he tried to use it to get a flu shot and fill prescriptions this week, local pharmacies could not confirm his coverage, so he left without his medications.

Similar problems are occurring daily in doctors’ offices and drugstores around the country as consumers try to use insurance coverage that took effect on Jan. 1 under the Affordable Care Act.

The issues are widespread:
A spokeswoman for WellPoint, whose plans are being sold on exchanges in more than a dozen states and include Anthem Blue Cross, said the company was “experiencing an unprecedented level of questions from our members,” with one million calls to its customer service centers last Thursday and Friday alone. The centers typically receive a million calls in a month, said the spokeswoman, Kristin E. Binns.
And they are costing people real money:
In Los Angeles, Hilary Danailova, who is almost eight months pregnant, said she had to pay $630 for an ultrasound on Thursday after failing to get an ID card or any confirmation of coverage from her new insurer, Anthem Blue Cross. Ms. Danailova, 38, said she signed up just before Christmas and sent her first month’s premium of $410 by overnight mail on Jan. 3. She has repeatedly tried to reach Anthem to see whether the company has processed her payment.
Going back and fixing these errors will take more manpower, cost more money, and cause more harm than if the Obama administration had done the right thing and closed enrollment until the Exchanges actually worked. $630 is a lot of money, even if Danailova eventually gets her money back from Anthem (a big if, IMO, since insurers are Scrooge-like in their miserliness). What if she hadn't had that kind of money to spend out of pocket, and had to go without necessary prenatal care? What if she was visiting an oncologist instead of an obstetrician?

Public private partnerships like the ACA don't just suck because they allow corporations to socialize costs and privatize profits, they're also, in direct contradiction to neo-liberal orthodoxy, horrifically inefficient and stuffed to the gills with waste, graft, and incompetence. They bring together the worst aspects of both the state and the market.

Obama, whose plan to address income inequality is to set up Special Economic Zones, doesn't understand that. He's solidly indoctrinated in the same political ideology that brought us Thatcher and Reagan: neoliberalism, an ideology that remains hegemonic despite delivering us to the brink of economic oblivion in 2007, which we've remained teetering on the edge of ever since.


PNHP, from a story I saw linked over at Corrente Wire:

Insurers using high drug cost sharing to scare away patients with expensive chronic disorders

AIDS advocates say drug coverage in some marketplace plans is inadequate

The nation's new health-care law says insurers can't turn anyone away, even people who are already sick. But some companies, patient advocates say, have found a way to discourage the chronically ill from enrolling in their plans: offer drug coverage too skimpy for those with expensive conditions.

Some plans sold on the online insurance exchanges, for instance, don'™t cover key medications for HIV, or they require patients to pay as much as 50 percent of the cost per prescription in co-insurance - sometimes more than $1,000 a month.

The fear is that they are putting discriminatory plan designs into place to try to deter certain people from enrolling by not covering the medications they need, or putting policies in place that make them jump through hoops to get care," said John Peller, vice president of policy for the AIDS Foundation of Chicago.

As the details of the benefits offered by the new health-care plans become clear, patients with cancer, multiple sclerosis, rheumatoid arthritis and autoimmune diseases also are raising concerns, said Marc Boutin, executive vice president of the National Health Council, a coalition of advocacy groups for the chronically ill.

The easiest way [for insurers] to identify a core group of people that is going to cost you a lot of money is to look at the medicines they need and the easiest way to make your plan less appealing is to put limitations on these products,” Boutin said.

As I say in every one of these diaries about the ACA, it shouldn't shock us that insurers are making out like bandits because they wrote the law. We keep finding ways they've pre-gamed the system to preserve and expand their obscene profit margins, from narrow networks to paying out much less than they should.

Free markets, in my opinion, are never efficient. But they are especially disastrous when you're bargaining over a "commodity" that someone literally cannot live without: their health. Unless we eliminate the profit motive from the health system, we're never going to provide a truly equitable system.

According to a survey just released by Harvard's Institute of Politics, Millenials are getting increasingly fed up with the ACA status quo.

18-29 year olds believe the law will bring higher prices and lower care, whether you ask them about Obamacare or the ACA:

Whether you agree that they have a realistic view of the law (I would tend to think they're right), their perception that the Exchange plans aren't a good deal is going to affect their sign-up rate. That will have a major impact on premiums, going forward, unless a serious and convincing effort to sell the law is made for them.

Their negative view of the law has had a dramatic effect on the partisan identification of 18-24 year olds:

Thankfully, Republican support hasn't increased. This is an indication that they feel the Democratic party is to the right of them (a perception I again agree with). Their support for Congressional Republicans has plummeted:

This can probably be attributed to the government shutdown.

Now more bad news: black millennials report a much lower likelihood of voting from a year ago:

If I had to guess, I would say this probably has to do with the failure to do anything about the economy, which is hitting the black community especially hard (as always). The slight uptick in Hispanic likelihood to vote probably comes from the current focus on immigration reform.

The most surprising statistic is that 52% of 18-24 year olds would vote to recall Obama, if the United States, like more democratic countries, had that mechanism in it's constitution:

They still hate Romney, though.

I think this clearly indicates that the ACA is a major flop with Millenials, and is likely to hurt the party long term. I think we should follow Bernie Sander's lead and push for the Exchanges to be replaced with a single payer system. That would be a winning platform for 2014.


The press release

The American Health Security Act of 2013. The part about repealing Title 1 of the PPACA (which includes the mandate) is on page 17.

Obviously this can't pass a Republican House, but this is exactly the direction we should be moving in. I actually suggested this course of action (and was lambasted for it) recently in the comment sections here. I think it's pretty commonsensical. People don't like the mandate. They do like Medicare.

Making this the Democratic platform for 2014 is the best shot of winning in 2014. The neoliberal approach to health reform obviously isn't working; shouldn't we give the socialist option a try?


Reuters puts the count at 49.2 for the PSUV vs 42.7 for the MUD, the opposition party.

Venezuela Analysis reports an air of calm today, in contrast to the April elections which were much more tense. As I wrote in my last diary about Venezuela, their was a wave of violence directed at government supporters and community health clinics after Maduro's narrow victory.

MUD did retain the mayoralty of Caracas, Venezula's capital.


First, let's dispel some myths that are all too common in the English language media about Venezuela:

1) Nicholas Maduro stole the October elections.

The Venezuelan electoral system has been called the best in the world by Jimmy Carter. It's pretty much fraud-proof. Here's a writer at Forbes describing it:

Venezuela employs one of the most technologically advanced verifiable voting systems in the world, designed to protect voters from fraud and tampering and ensure the accuracy of the vote count. Accuracy and integrity are guaranteed from the minute voters walk into the polls to the point where a final tally is revealed.

The system Venezuela uses has some of the most advanced and voter-friendly security features in modern elections. Voters use a touch-sensitive electronic pad to make and confirm their choices. After confirmation, the electronic vote is encrypted and randomly stored in the machine’s memories. Voters audit their own vote by reviewing a printed receipt that they then place into a physical ballot box.

At the end of Election Day, each voting machine computes and prints an official tally, called a precinct count. It transmits an electronic copy of the precinct count to the servers in the National Electoral Council’s central facility, where overall totals are computed.

By mutual agreement between the contenders, 52.98% of the ballot boxes are chosen at random, opened, and their tallies compared with the corresponding precinct counts. This audit step ensures that no vote manipulation has occurred at the polling place. The extent of this audit, the widest in automatic elections, leaves little room for questioning.

An additional audit demanded by Henrique Capriles, that covered a full 100% of the ballots, turned up no signs of fraud. Furthermore, opposition auditors signed off on every step of the process, at each polling station.

Maduro's victory was close by Venezuelan standards, but in the United States, where you don't even need to win the popular vote to win the election, it was fairly average.

2) Maduro has lost popularity

Also untrue. While his popularity did suffer a hit immediately after the elections, it's climbed steadily since then. Today, it's even higher, thanks to his aggressive steps to control speculation in the economy (more on that in a second). Some polls put it as high as 55%.

3) The Venezuelan economy is in free fall

Again, false. Here's CEPR analyzing the macroeconomic fundamentals of Venezuela:

For more than a decade people opposed to the government of Venezuela – which today includes almost all major Western media outlets – have argued that the Venezuelan economy would implode.  Like communists in the 1930s rooting for the final crisis of capitalism, they generally saw Venezuela’s economic collapse as just around the corner.  How frustrating it has been for them to witness only two recessions:  one directly caused by the opposition’s oil strike (December 2002-May 2003) and one brought on by the world recession (2009 and the first half of 2010).  Despite these recessions, the whole decade’s economic performance – the government got control of the national oil company in 2003 – turned out quite well, with average annual growth of real income per person of 2.7 percent, poverty reduced by more than half, and large gains for the majority in employment, access to health care, pensions, and education.

Now Venezuela is facing economic problems that are warming the cockles of the haters’ hearts.  We see the bad news every day (Western reporting on Venezuela is almost exclusively bad news, as if by decree):  consumer prices up 49 percent over the last year; a black market where the dollar fetches seven times the official rate; shortages of consumer goods from milk to toilet paper; the economy slowing, Central Bank reserves falling.  Will those who cried wolf for so long finally see their dreams come true?

Not likely.  In the opposition and international media’s analysis, Venezuela is caught in an inflation-devaluation spiral, where rising prices domestically undermine confidence in the economy and currency, causing capital flight and driving up the black market price of the dollar. This adds to inflation, as does – in their theory – money creation by the government.  And the government’s price controls, nationalizations, and other interventions have caused more distortions and structural problems that will hasten the economy’s demise. Hyperinflation, rising foreign debt, and a balance of payments crisis will mark the end of this economic experiment, they hope and pray each day.

But how can a government with more than $90 billion in oil revenue end up with a balance of payments crisis?  Well, the answer is, it can’t, and won’t. In 2012 Venezuela had $93.6 billion in oil revenues, and total imports in the economy – which were at record high levels – were $59.3 billion.  The current account was in surplus to the tune of $11 billion, or 2.9 percent of GDP.  Interest payments on the public foreign debt, which is the most important measure of public indebtedness, were just $3.7 billion. This government is not going to run out of dollars. The Bank of America’s analysis of Venezuela last month recognized this, and decided as a result that Venezuelan government bonds were a good buy.

The central bank currently holds $21.7 billion in reserves, and opposition economists estimate that there is another $15bn held by other government agencies, for a total of $36.7 billion.  Normally, reserves that can cover three months of imports are considered sufficient; Venezuela has enough to cover at least 8 months and possibly more.  And it has the capacity to borrow more internationally.

So what's causing the sudden surge in inflation? Prices and shortages tend to increase around election times in Venezuela, which should let you know that the main cause is political. And the current crisis is no exception:
Specifically, the Venezuelan business elite has responded to the uncertainty surrounding the new government by taking money out of the country (capital flight) and deliberately creating chaos.

Currently the government earns Venezuela's dollars through oil exports and then distributes them to importers at a controlled rate in a system not very different from that applied during the "economic miracle" in South Korea which moved that country "from third world to first" (Korean capital controls were actually much more stringent than Venezuela's). This system of foreign exchange rationing should ensure that foreign currency is used to satisfy the needs of ordinary citizens and develop the country's productive capacity. The difficultly for Venezuela is that business-people are using the dollars that are allocated to them for the purchase of vital imports to engage in speculative activities on the black market, and to swell their foreign bank accounts. And of course, this means that essential goods are not imported.

At the beginning of the year, the government responded to misuse of the foreign exchange which it provides by partially reducing the levels of dollars it makes available, but this has had the effect of exacerbating shortages and driving up the black market value of the dollar. Prices have also shot up in the last months because Venezuelan businesses have made use of their oligopolistic control over distribution networks to massively increase prices,as part of a campaign to reduce the government's popularity in the run-up to the municipal elections in December.

Some businesses were marking goods up as much as 10 times import costs (private businesses receive US dollars from the government in a system called CADAVI; they don't pay the black market rate.) Maduro responded by sending the army to occupy offending stores and force them to sell their goods at a reasonable profit margin. While this was portrayed as looting in the private media there and here, it was extremely popular domestically. Counterpunch had a good rundown of the situation

With Chavez dead, it's likely the opposition will try and start trouble in the streets tomorrow, no matter the outcome of the elections. Despite media reports, all the violence after the October elections was directed against Chavez supporters and the poor majority in general. Political activists were murdered. Government health clinics were set on fire.

All of this instability is aided and abetted by our government. Unlike every other world leader, Obama has still not recognized Maduro's government. And it's hard not to speculate, though we have no proof currently, that just like in Chile in 1973 TPTB in this country have decided to "make the economy scream."


From Politico:

Even in states where Obamacare enrollment is booming, insurance companies are running into significant behind-the-scenes technical glitches that could threaten Jan. 1 health coverage.

Many of these 14 states and the District of Columbia have been eager to tout the success of their own exchanges compared with the bungled federal portal, but they now appear to be worrying about back-end problems similar to those afflicting
It’s a new twist in the unfolding saga of so-called 834 forms — industry jargon for the application files that insurers receive when someone signs up for coverage through an exchange.

Insurers in Kentucky and New York, for example, say they’ve received flawed 834 enrollment forms from their local exchanges, though the extent of the errors is unclear. Washington state has already had to correct thousands of 834s with faulty information about federal tax credits.

Several state exchanges waited until late last month to even start sending application data to insurers, meaning potential errors haven’t had much time to surface.
At the least, these issues run counter to the popular storyline: that states’ enrollment systems have vastly outperformed the Obama administration’s effort. At the worst, they could endanger coverage for thousands of people who think they’re already enrolled for the start of 2014.

This shouldn't be shocking, since they're all using the same back end infrastructure, but  we haven't had confirmation of this up until now. We don't know for sure what the error rate is (as with everything else related to the flubbed roll out officials are stonewalling) but we can assume that like with the federal website it's 10%

That extends the possibility that a significant number of people who think they have an Obamacare plan will get a dirty little surprise if they try and visit the doctor after January 1st to the entire country.

You can't blame Republican governors for this one.


As predicted, there was a reason they were trying to suppress the number:

An estimated 10 percent of all enrollments now being made on the federal Obamacare marketplace contain data errors that could delay people from actually getting health coverage, officials disclosed Friday.

And that error rate for enrollments submitted via and then sent to insurers before December was an estimated 25 percent, officials revealed.

The rate fell in the past week, officials said, because of repair efforts to's, particular the discovery and fix of one particular software problem that was causing an estimated 80 percent of data errors, officials said.

But both past and present error rates are much higher than 1 percent, the rate which insurers considered to be unacceptable when doing business outside the Obamacare exchanges. And they are raising serious questions about whether significant numbers of people will actually be without insurance Jan. 1 despite believing they have enrolled.

This is why you don't wait until the last minute to build the most complicated IT project in US history. This is why you test that system, end to end, before you launch it.

And we still don't know the error rate for Medicaid enrollment (see my last diary for info on that fuckup).

But hey, don't worry:


We already know that up to 1/3rd of all Exchange enrollments have corrupted data (ignoring Jay Carney's non-denial). It looks like Medicaid enrollments have similar issues. From Wonkblog:

Every week, usually on Tuesday, the Centers for Medicare & Medicaid Services sends state Medicaid departments something called a "flat file."
These files are sort of similar to the much-discussed 834 transmissions, which the exchange sends to an insurance plan when someone signs up. Except the flat files are for the Medicaid program, and lists people that the exchange thinks -- but hasn't officially determined -- will be eligible for the Medicaid program.

And, much like the those 834 transmissions, Medicaid officials say, these flat files are riddled with errors and incomplete information.

"They are really incomplete with lots of data cells missing," said Matt Salo, who runs the National Association of Medicaid Directors. "Sometimes the immigration status is missing, or their town is in a different state. A quick glance sometimes shows they're not Medicaid eligible because they earn too much, or they're already in the system."

The flat file was not initially meant to be an enrollment document. It was meant, instead, to give states a sense of enrollment volume, so they could beef up their staffing, if necessary. A separate account transfer function was supposed to be the actual enrollment vehicle.

That separate account transfer function, however, has not yet gotten off the ground. So the federal government told Medicaid directors Friday that it let states rely on a cleaned-up version of these flat files as an enrollment document.


First, a story from Kaiser Health News

Many doctors are disturbed they will be paid less -- often a lot less -- to care for the millions of patients projected to buy coverage through the health law’s new insurance marketplaces.

Some have complained to medical associations, including those in New York, California, Connecticut, Texas and Georgia, saying the discounted rates could lead to a two-tiered system in which fewer doctors participate, potentially making it harder for consumers to get the care they need.

I saw this story posted over at Corrente Wire. In the comments, Dromaius, who's been extremely informative on the whole issue of narrow networks and did this helpful survey of the dearth of specialists offered on plans in her state, chimes in with her 2 cents:
I've been saying this all along. Obamacare and its narrow networks have given insurance the power to run the show. It's extortion.

And I've been saying that it's not that those evil hospitals and providers aren't cooperating. It's that insurers are paying less in reimbursements, sometimes a whole lot less than they do with traditional plans. They frequently pay less than Medicare which is already reimbursed pretty low. And unlike Medicare/Medicaid, the reimbursements are NOT regulated.

In my state, the only way insurance companies would agree to participate on the Exchange is if they could offer narrow network plans. I believe that when insurance says they are "under pressure," they are lying.

The Kaiser article backs up her claim about lower reimbursement rates:
Physicians are uncomfortable discussing their rates because of antitrust laws, and insurers say the information is proprietary. But information cobbled together from interviews suggests that if the Medicare pays $90 for an office visit of a complex nature, and a commercial plan pays $100 or more, some exchange plans are offering $60 to $70. Doctors say the insurers have not always clearly spelled out the proposed rate reductions.
This should be surprising. We already know insurance companies are shifting costs onto consumers, per Olenick's spreadsheet of Exchange plan payouts, we shouldn't be surprised they're also shifting costs onto doctors.

Insurance costs are going to continue to rise in this country over the long term (assuming the economy improves). They're already way higher than any other industrialized nation. The reason is clear: the health industry (including not only insurance but also pharmaceutical and medical device companies) is extracting massive profits. The Affordable Care Act bargained away any chance of controlling this rentier behavior, and so it's only chance to control costs comes from shifting them onto us.

We shouldn't have let this happen. We shouldn't continue to let this happen. We need to remove profit from the field of human health; market forces, even if you believe in their efficacy, aren't going to come into play when one economic actor is bargaining for their life. People will pay anything to save their lives or the lives of their loved ones and so, if you allow the bandits-in-suits that make up the for-profit health complex take advantage of them, they will.

You can add a private note to this diary when hotlisting it:
Are you sure you want to remove this diary from your hotlist?
Are you sure you want to remove your recommendation? You can only recommend a diary once, so you will not be able to re-recommend it afterwards.


Subscribe or Donate to support Daily Kos.

Click here for the mobile view of the site