tag:blogger.com,1999:blog-6519837413200053629.post5480622361434719632..comments2023-08-12T03:31:24.561-07:00Comments on postpostochlophobist: slave and free according to paul....Unknownnoreply@blogger.comBlogger16125tag:blogger.com,1999:blog-6519837413200053629.post-41231955295741746222011-05-19T20:26:47.128-07:002011-05-19T20:26:47.128-07:00cont'd
Medicare, at least the non-privatized ...cont'd<br /><br />Medicare, at least the non-privatized bits, and prior to Bush "reforms" required of health providers a hell of a lot less paperwork and admin expense than most for profit health insurance companies did. So perhaps I believe that we should "end" regulation by simply not having for profit health insurance companies at all. Have a gov't run single payer system, which will result in far less % of GDP spent on health care, with quality of care increasing for the aggregate of Americans, and allow non-profit health insurance groups who want something in addition to the single payer state run system.<br /><br />But as for this notion that health insurance companies would be more willing to insure marginal cases if they had more dynamic situations on the other end - I will never understand how you can have such faith in humanity here, but yet assert that you cannot hold other economic and political positions because it requires too much faith in humanity. Health insurance companies have made killer profits and still routinely denied care to any and every case they could get away with. Under our current ordo they have one goal - to make as much money for their shareholders as possible. Given that goal, why would they ever be motivated to pay out for a patient like Neal if they could find any means of getting out of it? Why would they not be motivated to set up contracts and administrative systems which result in as high a percentage as possible of claims they do not end up paying? There is a social phenomenon that must be spoken to here as well, which economists like Krugman have noted - with the advent of new trading technologies in the 70s, which made rapid trading possible between regions and different markets and thus increased the speed of economic transactions exponentially, there has been on the part of investors a demand for certain levels of profit margins, on a routine basis, than were ever expected before for a period as sustained as we have seen it (roughly a generation now). With the health care industry the current demand for both high profit margins and increasing profit margins demands, necessarily, that companies find creative means to deny claims. This has far more to do with the problem of people in America getting the health care they need than any regulation, including the many regulations the companies had custom written for them.Ochlophobist https://www.blogger.com/profile/13751003558600087713noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-80114218814053572172011-05-19T20:26:35.057-07:002011-05-19T20:26:35.057-07:00Gabriel,
Yesterday, Robert Zirkelbach, spokesman ...Gabriel,<br /><br />Yesterday, Robert Zirkelbach, spokesman for America's Health Insurance Plans (AHIP) took aim at the health care advocacy group Health Care for America Now (HCAN). HCAN took issue with AHIP's assertion that the average profit margin for health insurance firms is just 4.4 percent. Zirkelbach did not explain how he came up with that figure, but considering the fact that the big for-profit insurers had significantly higher margins than 4.4 percent last year (according to Yahoo! Finance), AHIP's calculations must have included the insurers that, at least in theory, don't make profits at all, like the so-called nonprofit Blue Cross and Blue Shield plans.<br /><br />In a memo to editors and reporters Thursday afternoon, HCAN took issue with the 4.4 percent figure and accused AHIP of trying to pull the wool over journalists' eyes.<br /><br />"AHIP's focus on profit margins is misleading and designed to protect their massive income by shifting attention away from their return on equity -- a key measure of profits as a percentage of the amount invested," HCAN's executive director, Ethan Rome, wrote.<br /><br />"That return is a phenomenal 16.1 percent as of today. By that measure, health insurers are ranked fourth highest of the 16 industries in the health care sector. The health insurance industry has a higher return for investors than cell phone companies, beer companies, mortgage companies, life insurance companies, TV broadcasters, drug store companies, or grocery stores."<br /><br />-- from here: http://www.michaelmoore.com/words/mike-friends-blog/insurance-industry-flack-screws-up<br /><br />I know I know, if Moore published it it must be wrong.Ochlophobist https://www.blogger.com/profile/13751003558600087713noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-22037748764468005842011-05-19T14:39:43.549-07:002011-05-19T14:39:43.549-07:00It took me a day to digest this, but let me see wh...It took me a day to digest this, but let me see what I can come up with here:<br /><br />First, to answer Lotar's point, I readily concede that there will be people who cannot (or will not) be insured in the private market, at least not for a price they are capable of paying. I would rather see government resources diverted to these cases than spread thin by trying to create something that looks like "universal healthcare." There's no need for that. I would object on one point: If insurance companies could be more dynamic about the deals they enter into with individuals/employers, they would be more willing to insure marginal cases for the simple fact that they have more in the bank to back their bet (and, really, all insurnace is a bet to some extent). Does that cover everyone? No. Does it cover the sickest? No. But it does extend the blanket of coverage without the additional administrative costs associated with regulatory oversight or silly penalities which do little more than raise prices for consumers.<br /><br />Second, I didn't mean to imply that the regulatory schema is a "failure" from the medical profession's standpoint (though in some instances it is). My definition of regulatory failure rests on whether or not the regulations result in an aggregate social welfare loss (which it does). The state-sanctioned monopolies are a boon for insurance companies; competition would be most unwelcome except, naturally, to those who are fit to compete. It would be a disaster, however, if the current regulatory schema was maintained <i>while</i> attempting to promote a freer market in health care services. At that point, you get none of the benefits of competition and all of the waste of regulation. No thanks.<br /><br />Third, I acknowledge the problems with the pharma industry, though I would posit that the issue is more complex. In the U.S. at least, pharma companies are incentivized only to pursue high-profit margin R&D. Why? Because their losses are so spectacular and the oversight process from the FDA is extremely burdensome. This doesn't justify in any way the behavior of pharma companies when it comes to denying the right for others to engage in R&D which, as you note, has the potential to save/improve lives. But that's a larger problem with I.P. law as a whole. I generally favor dialing-down copyright and I.P. protections, along with allowing for a fairly broad menu of defenses to litigation.<br /><br />As a final point, my argument is not for keeping the <i>status quo</i> or measuring off the <i>status quo</i> against other health care systems. I generally believe that the U.S. system can be improved, even radically so, through more recourse to the market. Maybe that's the "libertarian" in me, but so be it. I have seen very few instances where heavy-handed government involvement has produced concrete benefits for Americans in need of health care and the process of regulatory capture has given many health care industry stakeholders a free pass to profits without the benefits for consumers at large which are supposed to go with it.G Sanchezhttps://www.blogger.com/profile/11797757461858023882noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-35974350479192719172011-05-18T20:06:53.146-07:002011-05-18T20:06:53.146-07:00Even if a liberalized healthcare system would impr...Even if a liberalized healthcare system would improve care for the general population - which I doubt - it would be disastrous for the chronically ill. There is no free-market reason to cover someone for less than their guaranteed cost of medical care. Though, even under Obamacare, it would still be cheaper for an insurance company to drop someone on the new generation of chemotherapy and take the monthly fine (which is price at a 2000% markup, plus or minus - pharma really fucks you over when your life is on the line).Lotarhttps://www.blogger.com/profile/01796218033485037424noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-70782962313652979112011-05-17T13:38:31.982-07:002011-05-17T13:38:31.982-07:00cont'd
But in the end the reason I support a...cont'd <br /><br />But in the end the reason I support a single payer system over a libertarian free for all is that we have seen those places where single payer systems work rather effectively, and at far less cost than what Americans pay for health care today. The NHS faces many of the same problems that American hospitals face - increased rates of nosocomial infections, waiting lists, rationing, etc. But we have that in America today - the vast majority of Americans face those issues in some fashion during their lifetime. Britains, usually a quite bitchy lot when it comes to services, routinely rate the NHS quite high (just this month 66% of Britains stated that they believed the NHS provided the best health care in the world). Despite the rather mundane problems one finds in the NHS, in Britain folks who have medical problems rarely have to declare bankruptcy. There are drawbacks, sure. I had a dear friend, Mark, who died in England of a brain aneurysm. He died one week after the discovery aneurysm and was being treated for it. My mother, an RN who got most of the details she could as she had known Mark when he lived here in the States for a year, believes that had Mark been at a decent hospital in a large American city he would have survived. He would also have been bankrupt if uninsured or not sufficiently insured, but he would have survived. That sucks. But for your average 54 year old who has a heart attack, they are a hell of a lot better off in Britain than they are here. And there society is better off for their care, as high medical related bankruptcy rates are highly disruptive to local economies, even if they mean nothing to the Wall Streets of the world.Ochlophobist https://www.blogger.com/profile/13751003558600087713noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-23526325012027888362011-05-17T13:38:19.639-07:002011-05-17T13:38:19.639-07:00cont'd
As you know, my wife fights insurance...cont'd <br /><br />As you know, my wife fights insurance companies for a living. I realize that any story I tell of her work is only anecdotal, but with the work of Potter and others who are cataloging abuses of the health care industry, we can observe that the abuses my wife sees every day are routine, they are normal for the industry. You may like your insurance now, but in the event of certain medical problems you may find that you quickly hate it, as you or your wife may have to essentially work a part time job to get them to pay what they said they were going to pay. While some have to fight for care in a single payer system in the UK or Canada, I see no indication that the efforts to get needed care there are anywhere near as routine in the UK or Canada as they are hear. The health insurance companies' penchant and obvious motivation for fraud, not to mention their many decades of experience honing their skills at it, is not going to go away in the event there is some sort of near total deregulation of the health insurance industry. The big players are going to still have many means at their disposal to get the big contracts. They are still going to force health care providers to comply to demands (for instance, in many states insurance companies can require providers who are in contract with them to refuse to offer uninsured patients lower pricing scales than insured patients, thus these companies drive up health care costs overall). The idea that smaller, cheaper, better run health insurance companies will arise and clean up the industry in the event of deregulation requires a faith in humanity and in the processes of free market capital that I can't manage. When my auto/life/home insurance company, USAA, started offering policies to anyone and everyone, and not just military and the kids of military, even though they are a non-profit which is far higher rated in customer satisfaction than any of their competitors they still did not take a significant amount of marketshare or do much to change the modus operandi of other insurance companies. <br /><br />In the event of deregulation. If these new companies are public and they offer solid competition to the old large rich companies they will be bought out. The same will hold if they are private companies unless some private group thinks it is their calling to offer cheaper better insurance and not take the gobs of cash the big company is offering. Potter has clearly shown that the big insurance companies are in cahoots together, why will that change post de-regulation. It is in their interest to continue to deny paying for care as much as they possibly can.Ochlophobist https://www.blogger.com/profile/13751003558600087713noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-13362152490702072272011-05-17T13:37:54.579-07:002011-05-17T13:37:54.579-07:00cont'd
You state that you like your health i...cont'd <br /><br />You state that you like your health insurance. I am going to assume that you are insured through your employer. The type of institution that your employer happens to be is one of the last types of institutions where one can csn occasionally still get decent health insurance programs, outside of a state job. At my shop the Blue Cross Blue Shield PPO plan the company offers full time employees has been altered in the last 5 years such that employees now pay more than double what they did say 4 years ago for the plan, have a much higher deductible and co-pay, and are insured for less services/treatments/drugs/etc. My wife watches the insurance programs of large employers in our area and has seen the same phenomenon going on in many companies in our metro area. Whilst the increase in health care costs is what we usually hear reported on the news, the actual costs of health care for most Americans who get health care via their employer has shot up much more than the overall increase in health care costs as a raw figure - for the obvious reason that companies will use any excuse they can to pay less benefits, and have passed on considerably more of the cost to employees. My (then full time, now part time) company made record profits in the first quarter of this year, having laid off so many employees but still selling things. But they still have reduced salaries and benefits because they know that in the current Memphis job market nobody is going anywhere.Ochlophobist https://www.blogger.com/profile/13751003558600087713noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-66963189987441953892011-05-17T13:37:11.659-07:002011-05-17T13:37:11.659-07:00Gabriel,
I hope that I have never written anythin...Gabriel,<br /><br />I hope that I have never written anything which would lead someone to believe I support Obamacare. There are aspects of Obamacare which I support, but by and large I see it as further empowering a system which I believe to be highly ineffective and systemically unjust. The perversity of American liberalism is that it sees Obamacare as addressing the problem.<br /><br />Have you ever read any of Wendell Potter's exposes of the health insurance industry, or heard him speak? <br /><br />I've used this story before - I heard an interview with a guy doing a pharma start up which was basically coming up with new versions of old anti-biotics for which there were no current intellectual property rights issues. These drugs desperately needed to be updated. But the big pharma companies were not interested in that work because the profit margin was not going to be high enough. This company was going to be redoing drugs which in the end would be cheap because all that was involved was relatively slight alterations of old and cheap anti-biotics, but these alterations would potentially save thousands of lives because these new versions of old drugs would work against so called "super bugs" and have other applications which would be very important from a medical point of view. <br /><br />Then I took that Biotech class when I had time to kill last year and learned of how big pharma companies are buying the intellectual property rights to certain recombinant DNA technologies and other more advanced potential technologies with the sole intent of NOT using them in a clinical setting. I wrote a paper on recent Cerebral Palsy research and learned that Biotech firms owned by big Pharma companies have bought the rights to biotech intellectual property which many scientists believe will almost certainly one day provide a quick, easy, and cheap cure for CP in most CP patients with particular genetic patterns. But those companies are not working towards producing those cures. They are sitting on those intellectual properties and paying for research which would lead toward long term treatments of CP - treatments which would effectively end all symptoms of CP, but which would require the sufferer to receive the treatment for life. It is interesting to note that almost all the initial research for CP biotech was done with government funding. So your tax dollars basically found a potential cure for CP, as well as a potential long term effective treatment of CP, and then big pharma bought both, and is only pursuing the treatment instead of the cure because it stands to make a shitload more on the treatment than on the cure. It doesn't want a cure, as cures are bad for business.<br /><br />I don't see how deregulation will change anything in pharma in terms of providing greater care or greater efficiency. Pharma companies want to make their money on drugs which they can make a killing on, and they want a significant portion of the American populace to be sick at any given time. <br /><br />Coming back to health care - given Potter's utterly damning description of the health care industry (and talk about an insider's insider - I can't think of any other industry which has had a higher ranking and more intimately knowledgeable insider turn against the industry than what we see with Potter), I simply can't accept that it will in any way reform itself in the event of lessened regulation. Sure, there are aspects of current regulation which the companies hate (as you suggest with one year re-ups), but the majority of regulation for health insurance companies was written by lobbyists for the health insurance companies.Ochlophobist https://www.blogger.com/profile/13751003558600087713noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-54239443209223347102011-05-17T11:44:10.171-07:002011-05-17T11:44:10.171-07:00If I might offer my dissenting view for a moment…
...If I might offer my dissenting view for a moment…<br /><br />Without denying that there is a health care problem in the U.S. with respect to individuals who are under- or un-insured, coupled with runaway costs and a poor distribution of resources, I would suggest that the first step is to address the regulatory failures which, if they don’t give rise to these problems, at least exacerbate them.<br /><br />The health insurance industry in the U.S. abides as government-sanctioned monopolies in most states. The price for monopolization, however, are counter-productive regulations which compel these firms to avoid risks they might otherwise take and restrict their manner of coverage. For instance, most health insurance companies must, by law, allow its subscribers to opt-out of the insurance program once-a-year. That sounds great, right? Nobody wants to be “trapped” by an insurance company. The problem is that by limiting the ability of insurance companies to enter into long-term contracts with low-risk individuals, it undermines their ability to hedge their bets when they are considering insuring riskier parties. It also raises these companies’ administrative costs and prevents them from engaging in the sort of long-term planning other industries are free to undertake. This is just one example of a regulatory failure, but it’s a substantial one.<br /><br />Moreover, state health regulations time and again dissuade low-cost health care providers from entering the market to provide basic services (including preventative care). By not allowing real competition in the health care market, you set the stages for an environment where innovation is stifled, prices are (likely) inflated, and people are effectively forced to seek more expensive avenues of care (whether or not they can afford it). <br /><br />I don’t see, for the life of me, how adding new layers of regulation is going to solve a regulatory failure. Had the Obama Administration taken proactive measures to reduce regulatory burdens and see what the market could provide first, I’d be a lot less skeptical about the entire venture. I suspect that there would still be a problem with people receiving inadequate health care coverage/services, but once you see where the market failures exist (assuming that they do), you can take more meaningful steps to correct them (or at least assuage their impact). “Obamacare” won’t do that. Instead it will hand the reins over to the same folks who came up with the U.S. Postal Service. No thanks. I’d rather take my chances with the sort who thought-up FedEx and UPS.<br /><br />I’m not in the least bit surprised that the healthcare issue has been hijacked on all sides of the political divide by people who neither care nor understand where the problems lie. The vitriolic rhetoric of the Right is as nauseating as the moralizing of the Left. The problem is that neither side are offering a workable roadmap to meaningful regulatory reform which can leverage the benefits of the market to increase the health care supply before deciding to expend public money on programs which, any way you slice it, will be suboptimal (but “suboptimal” is far better than nothing). <br /><br />But on a personal note, I’m not thrilled about the coming health care plan because, well, I like my private plan. Yes, I suppose that’s a selfish reason to be opposed to “Obamacare,” but I don’t see the issue as an either/or. I should be able to keep my plan and many other people should be able to access affordable health care and insurance. We can get closer to that end goal if we think seriously about taking away state-mandated monopolies and letting the market—that great artifice the libertarians are always going on about and yet fail to fall back on if their own interests are compromised by it—carry some of the burden.G Sanchezhttps://www.blogger.com/profile/11797757461858023882noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-68269705057317590792011-05-16T08:38:51.667-07:002011-05-16T08:38:51.667-07:00I still find it hard to square this excellent post...I still find it hard to square this excellent post (plus TBM's comment, with which I am largely in agreement) with the comments section, in which words like "murder" and "liquidation" are so casually used. In an abstract way I suppose there is an equivalence between the modern executive and the tyrannical despot, but it doesn't quite work for me. Perhaps I lack the requisite Marxist phronema.<br /><br />On another note: Owen, perhaps in another post or comment you could address what you see as the problems of "Church Health Centers."Anthonyhttps://www.blogger.com/profile/14138565078105758659noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-65243552363160106402011-05-14T10:43:58.793-07:002011-05-14T10:43:58.793-07:00"The problem with our society today is that n..."The problem with our society today is that no one is trying to murder guys like Rand Paul."<br /><br />Were the working classes ever to rise from their slumber, I would like to see them go after capitalists first, say the execs of big pharma companies and pretty much anyone manager or higher at Goldman Sachs, etc. Those folks beg the world for liquidation. Of course, once you start knocking some of their kind off the others will offer more and more reforms, as Arturo suggests, which will only buy Capital more time. Sigh.Ochlophobist https://www.blogger.com/profile/13751003558600087713noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-61014438912644133522011-05-14T10:17:22.090-07:002011-05-14T10:17:22.090-07:00The other year we had $14k in medical bills with i...The other year we had $14k in medical bills with insurance. When we were looking at disability recently, we found out that medicare copays on my perscriptions would take most of the SSDI checks. The entire system is fucked.<br /><br />The problem with our society today is that no one is trying to murder guys like Rand Paul.Lotarhttps://www.blogger.com/profile/01796218033485037424noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-33000310664788445462011-05-14T04:41:22.654-07:002011-05-14T04:41:22.654-07:00I'm glad to see you have returned to your ramb...I'm glad to see you have returned to your rambling posts. I'm conflicted, I suppose. On the one hand, I really don't want to bourgeois state to provide anything. They're just going to fuck it up, or put profits before people, or something. Just look at the privatization of Iraq and the military. Government intervention without workers' control is just going to lead to all sorts of problems. I think the libertarians and the Tea Partiers know this instinctively, but they are just being manipulated by capital to do capital's bidding. The real tragedy is the Ron Paul is the only real major political voice who makes noises about dismantling the imperialist empire. I think it is just for show (maybe he might be an anti-imperialist, since the empire is expensive and some of the bourgeoisie are uncomfortable with it), but in the end, libertarians are just the tragic clowns of finance capital.<br /><br />The ironic thing about being "taxed enough already" is that while people complain about income tax, it is really sales tax and inflation that kill the working class and lower petit-bourgeoisie. I say get rid of all taxes for everyone but the capitalists and make them pay for it. Price controls would be nice too. But for that, you would need to have a mass workers' movement, general strikes, factory occupations, and so on. Not holding my breath.<br /><br />On the other hand, I am naturally authoritarian, and feel that if we have to coerce people into doing the right thing, so be it. Even if revolution is going to happen, there will no doubt be some form of authoritarianism taking the place of our current order of bread and circuses without the bread. The Hegelian side of me is fine with that.The bald Mexicannoreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-91492383869740540832011-05-13T21:42:05.543-07:002011-05-13T21:42:05.543-07:00Rand must not have any problem with talk of wage s...Rand must not have any problem with talk of wage slavery...MikeOnoreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-28438518334668505242011-05-13T19:51:27.153-07:002011-05-13T19:51:27.153-07:00I like how Sen. Bernie Sanders responded to Paul&#...I like how Sen. Bernie Sanders responded to Paul's statement by asking a Vermont doctor at the hearing if she thinks she's a slave and if she fears local police will beat down her door in the middle of the night to force her to see a patient. Of course she does not, further highlighting the absurdity of Paul's remarks.<br /><br />Perhaps it's time to move to Vermont now that they are on the verge of implementing universal health care. <br /><br />As recently as four months ago I would have said that Wisconsin is a humane place to live, thanks in part to BadgerCare health insurance, which was created by a Republican (!), Governor Tommy Thompson, in the 1990s. <br /><br />My family has been on BadgerCare for almost two years, after my husband lost his job that provided health insurance. The income guidelines are fairly generous. You don't have to be living in poverty to get BadgerCare like you do for Medicaid. Once one's income ventures too far up into the lower middle class range the parents no longer have access to it, but all children do, as long as their parents pay something of a premium, which can't exceed 5% of their income.<br /><br />Now that Walker is governor, he wants to lower the maximum income allowed for parents to remain on BadgerCare and boot many of us parents off the insurance by next summer. Given that my husband has two chronic diseases, I'm not looking forward to that possibility. Even if we do get to stay on BadgerCare it's possible Walker will horribly mangle it beyond recognition anyway, as the bill will give him the power to make any coverage changes he wants.<br /><br />At any rate, it's very unfortunate the words "single payer" get the conservatives and libertarians far more worked up than stories like yours of racking up tens of thousands in medical bills while uninsured.Anitahttps://www.blogger.com/profile/12385998114723349342noreply@blogger.comtag:blogger.com,1999:blog-6519837413200053629.post-16147982268864677402011-05-13T17:09:30.649-07:002011-05-13T17:09:30.649-07:00I suppose that when I exercise my RIGHT to habeas ...I suppose that when I exercise my RIGHT to habeas corpus, I'm enslaving a lawyer?<br /><br />(using Randy Paul logic)JLBhttps://www.blogger.com/profile/08189440422059549405noreply@blogger.com