If you're a person who has been following the health care jungle, Columbia Journalism Review, and particularly, the work of Trudy Lieberman, has in the last few years, stood out as being an oasis of sanity in a sea of mediocrity and worse.
Trudy has been bringing important information that others have been missing, intentionally or otherwise. This latest, an interview with Oregon Senator Ron Wyden, on the lack of affordability and access in the health bill, is a must read.
"So far, few pols—or journalists, for that matter—have dwelled on the point that insurance is likely to remain unaffordable for millions, even with help from the feds. Campaign Desk sat down with Wyden, one of the few politicians willing to talk about this thorny issue.
Trudy Lieberman: Why has the affordability issue been so hidden?"
"Trudy Lieberman: Why has the affordability issue been so hidden?
Ron Wyden: Because of the Washington spin. The Washington press sees this in terms of what the CBO, some office, or agency says, with the razzamatazz math. There’s a big Washington D.C. establishment bias for these kinds of stories. Will the CBO come in at $940 billion? No, here’s a news alert; it will come in at $890 billion. It’s all about the horserace and a lot of the rest is about personalities.
TL: Why hasn’t affordability caught on with the press?
RW: It doesn’t fit their idea of news. Their idea is liberals for and conservatives against. It’s the clash on Capitol Hill over the public option. The public hasn’t been informed."
Ron and Trudy, I know you can't just come out and say it, but you try. So let me. I think we all know that its becoming increasingly obvious that this is a very well coordinated campaign of deception, And the fact that Democrats have been cheerleaders for these lies, calculated to make people not look at the proposals unaffordability and corrupt encouragement of lack of accountability and responsibility represents a betrayal of democracy and all of the people who voted for them as alleged progressives, or even more pragmatically as the lesser of two evils. They really are going too far, far too far this time - for us to be silent as plans are essentially being laid to destoy a whole nation's future security,. In this atmosphere, silence or appeasement of the "preventcare™ beast is complicity.
What's the solution? Single Payer health care. The solution that the public loves but that the healthcare and insurance industry apologists disinformation campaign targets with its most dishonest and often quite revealing smears. Why? Because it works, its been shown to work in nation after nation, because it can be implemented in months instead of costing so much it needs to be put off until after the election (its something to be PROUD OF rather than to HIDE) If tried, it will become immensely popular.
Because its better and cheaper, because it alone increases quality, achieves 100% access ends healthcare bankruptcies, reverses job losses because of healthcare, stimulates the economy better than any bailouts or wars, and cuts costs.
The media has orchestrated a de-facto media quarantine on stories about single payer, precisely BECAUSE its the only solution that could REALLY work to cut costs, and waning to maintain this as an issue and keep people dependent the government has been an equal partner in deception.
What's the original purpose of this optional uniquely public interest-driven plan? Its obvious, THIS NATION CAN'T AFFORD THE INSURANCE INDUSTRY MONKEY ON OUR BACKS ANY MORE.
We can't afford it because its based on ripping us off. And public option is designed to fail because of Americans lack of math literacy and lack of understanding about a particular aspect of insurance that truly drives home the insanity of mixing profit with something people literally cannot live without, health care. The utter insanity of doing that.
Any economics student knows about adverse selection. When healthcare is so expensive that many can't afford it, the healthy will try to not buy it. People who are sick, often can't afford it either, but they are more likely to buy because to do otherwise means often to suffer horribly with an untreated illness, or often die. Governments in the 21st century take responsibility in this situation and MAKE THE SITUATION WORK. Responsible governments that is. Except the United States. The only way a public option could really work is to make it cover everybody rich and poor automatically, and take it out of taxes. But, the back story goes, those masters of us all, the insurance industry pulled on the politicians leash and said NO. (In reality, they've been in on this together from the beginning..)
So, to make a long story short, the publicoption as its now constrained is clearly designed to fail spectacularly. Its a lie.
Why does a President who once lectured at one of the leading economics schools in the world opine that a plan that is limited to a pre-selected group of people, people who are self employed and uninsured (and affluent, but thats also being hidden) are also far more likely to be sick - EXACTLY like the money-losing high risk pools- how can he say with a straight face that they can be self supporting or even (this is really an ugly lie) save money?
Repeat it often enough, and people will believe? Maybe. But its a lie.
Public option is of course the old idea, the "high risk pool". "What is a Risk Pool" (naschip.org).
High risk pools are the band aid solution to the mortal wound of corporations profiting by giving us no choice but to pay their price to be admitted to a healthcare system where a room costs typically over a thousand dollars a day (compare that to under $20 a day, the government set rate for a shared room in a Japanese hospital), High risk ools for the uninsurables among the rich in a sense also buy off the most politically and economically powerful among the sick. by offering them health insurance where its okay to be sick, at a price about twice that of what individual insurance costs normally. (which is to say that its far too expensive for most sick people) High risk pools are limited to small groups, like the documented uninsurables, and their cost is subsidized because they still lose a lot of money. They are a creation of insurance companies who don't want the public outrage to rise too high all at once (when people are sick, they are in no shape to fight) They want to preserve and prolong the profiteering on those who cannot choose. In this managed care era. insurance is all about the illusion of coverage, but all too often it sells empty hope. Coverage that leaves people naked when they start needing the insurance they've been paying for is worse than the honesty of knowing they are on their own. Its criminal when companies do this, but for the government to try to play the same name is unspeakably vile.
Just like HMOs who try to pay less and less as they become more and more powerful the government is trying its hand at tyranny of the weak and powerless by presenting false hope and built in delays leading to planned -in failure as reform or as anything more than a failure. Its time to do what they have been avoiding, do what we know works. What even Obama admitted is best.
Isn't our money good enough for him?
The carrion birds of a feather flock together. Insurance companies and now government make hope programs' business models depend on pricing away or dumping old or sick people for their profitability or self-sustainability.
The US government doesn't want the responsibility of doing what governments do elsewhere, so they have a vested interest in playing along with the con. But every for years or so the bad actors all have to make a dramatic TV performance about caring, and this is it. But its a trap.
In order for the trap to work they all need the enticing but pre-poisoned "public option" as bait. They also need to keep Americans ignorant of the ways the rest of the world has been solving this problem, and the longer they delay us, the more drastic our solution will eventually have to be, Right now, single payer would be affordable because the government would be able to save enough simply by directly paying providers, only effecting directly around 450000 people, the employees of HEALTH insurance companies. around one sixth OF ONE PERCENT of our work force. Compared to the jobs that would be added, those changes are minimal. And the people cast off of our backs.. wouldn't have to worry about finding health insurance, NONE OF US WOULD.
But I'm getting off the subject. Public option has another purpose, one thats just as important to their real goal of preventing change and preventing real affordability, wasting our time. The wizards of mass deception need to keep people occupied with tiring and divisive minutiae so they wont discuss single payer or get together, left and right to discuss how they might actually solve the problem satisfactorily.
So, a fake "debate" that deceives real people who might otherwise be educating for change becomes a circular death spiral in which more and more is said about less and less. So "public option" trap fills the hours, days and weeks, then months and years with a designed to fail fluff. Meanwhile 101,000 Americans die each year from preventable causes due to health care they need being unaffordable, and another 300,000 die from medical mistakes that often are brought about by the race to the bottom as quality and provider TIME is traded for less money spent, in a futile attempt to keep healthcare within budgetary targets driven by Washington's inability to say no to its benefactors. Many other develped countries (many now have standrds of living substantially better than our own) pay las little as a quarter what we do for drugs. An MRI scanning that costs $1000 in 1989 now costs $3000 in the US while in Japan the government-set cost of this highly useful diagnostic tool fell from $200 in 1989 to $98 now. (The reason, matter of factly discussed there, forbidden to even mention here, is that the machines to do the scanning have fallen tenfold in price in the last two decades)
Public option, a meaningless word to mask a desperate need. A way to WASTE A NATION's precious time. Waste the whole nations time and lead us around in circles. The insurance companies, dreamed the whole thing up, of course, but they can't say that, They skillfully tell us what we want to hear, that healthcare didn't pass the point of nonaffordability almost a decade ago, that somehow, if we can just be more efficient (somehow, that always means the sickest and poorest pay enough more, so they cant get care)
To make it work, of course, insurers need to say that they don't want a "public option" and that somehow a public plan with a sicker risk pool than the nation as a whole would have an "unfair advantage" or be profitable. They ever have a few defectors, who share confidences, true facts, with us, to lend the whole con an air of authenticity. Like Brer Rabbit and the Briar Patch.. "don't throw us in THAT briar patch" But who knows the briar patch or risk pools better than health insurers? Nobody. They want it because its designed to fail us.
In this atmosphere, Ron Wyden is doing the best he can to expose the hypocrisy by making it deny its own stated purpose. Clearly, the liars underestimated the desperate need of this nation for REAL, not cosmetic change, and they continue to underestimate the costs on many levels to us all of these corrupt criminals first stealing their votes with an obviously empty promise, and then betraying them.
Ron Wyden, thank you for trying to hold them to their phony promises. Thank you for trying to call their bluff.
"RW: The House public option would cover six million people and the Senate three to four million—roughly one out of eight people. (out of of those who need it) United Healthcare has seventy million policyholders. Why haven’t the American people been told that under ten million would be eligible? How can six million people hold United Healthcare accountable? You never see the press writing how virtually nobody would be eligible.
TL: What should the press be talking about?
RW: The typical consumer is getting clobbered right now. They want to know what’s in it for me—how does it affect me?
TL: How will they be affected?
RW: For the typical consumer, very little. On day one, the typical person is not going to have choice or a public plan. For the typical person nothing is going to change.
TL: Are people in for a big surprise if Congress passes a bill?
RW: I think people will be flabbergasted by the idea that the typical person is going to be virtually defenseless against the insurance companies."
Wyden goes on to detail how the whole situation is killing people, and how the Washington community seems to be ignoring that they cannot just continue their business as usual, as they seem to be planning, that people need immediate, substantial relief, and that we can't do it without real cost control. Reducing people's access to care wont help, thats the wrong approach to cutting costs. What we need is a plan that has some teeth for reducing costs, not care. He doesn't say it, but clearly, single payer is the only way to reach that goal for what seems to have been laid out as the finite financial target. It could actually achieve the goal of a national healthcare plan for less than we spend now. In this national emergency situation, keeping the insurance tax and the 30-50% overhead associated with it is absolutely crazy. Its as if the insurance industry, drug industry and some corrupt legislators got together to create a poisoned bait, winning the election by placing the nation in a lesser of two evils situation with no real choices, a HIGHLY sophisticated, impossible to escape, absolutely devastating trap for the whole, woefully naive nation and the few honest legislators who want, against all odds, for this to actually, somehow work. Wyden descrbes it as a "vise".
"TL: Does the potential affordability problem mean people will take the penalty rather than buy required coverage that they might not be able to afford?
RW: I think they will have no choice. We’re walking people into a no man’s land. They will have no coverage, pay a penalty, and put off health care concerns. It’s a prescription for people not getting the health care that they should get. People would rather pay $750 penalty in 2016 or $350 in 2015 than buy coverage. It’s way cheaper, and they’re going to say to themselves I’m looking at the odds of getting sick. They have rent to pay and other things. When they get sick, they can go to the Exchange and buy a policy. If they do that (and drop the policy when they don’t need it) that makes it harder to have a big risk pool to spread the costs and risks.
TL: How does real cost containment square with affordability?
RW: If you don’t have cost containment, you can’t get affordability. Lack of cost containment flows from an unwillingness to make the special interests hold the costs down. If you don’t have real cost containment and just tell the special interests we’re going to guarantee markets and subsidies, you’re in a vise. The [comprehensive] benefits are not there.
TL: Will people still be underinsured when illness strikes?
RW: Nobody has guaranteed all Americans good quality, affordable health care. There’s no question that, under the bill, underinsurance will remain a very substantial problem. Bankruptcies will still continue. People will be paying nineteen percent of their income out-of-pocket on health care—even people with subsidies. This is going to take a toll when you’re falling farther and farther behind every year. I’m very, very concerned with the issue of underinsurance.
TL: Can this problem be fixed legislatively?
RW: I’d like to improve the baseline plan, but we’re in a vise. Unless we have good cost containment, it’s very hard to fluff up the benefit package without blowing up the deficit. That’s the vise that has been created."