It ain't broke. Let's fix it.

Sometimes you have to ask "are people actually this stupid?" And then, of course, the obvious answer comes back - "yes. Yes, they are."

Paul Ryan's plan to scrap Medicare has proven to be just massively unpopular with the average American (especially among those who don't watch Fox "News," or who actually use Medicare themselves). So now, of course, they need to get the focus back to Medicare "reform."

One of the chief problems with Medicare, from the industry's view, is that the government can just set prices and the industry has to go along with it (as opposed to raising prices just because they can). That is, in fact, the primary complaint in most anti-Medicare rants (at least the ones that don't devolve into "death panels"): "the game is rigged against private insurers!"

So, somebody went out and found themselves a "Democratic" Senator from Oregon, Ron Wyden, and convinced him to co-sponsor a new plan to "reform" Medicare (where "reform" is defined as "gut and destroy").

Let's see how quickly you can spot the landmines built into this plan:

Under the proposal, known as premium support, Medicare would subsidize premiums charged by private insurers that care for beneficiaries under contract with the government.

Congress would establish an insurance exchange for Medicare beneficiaries. Private plans would compete with the traditional Medicare program and would have to provide benefits of the same or greater value. The federal contribution in each region would be based on the cost of the second-cheapest option, whether that was a private plan or traditional Medicare.

In addition, the growth of Medicare would be capped. In general, spending would not be allowed to increase more than the growth of the economy, plus one percentage point — a slower rate of increase than Medicare has historically experienced.

To stay under the limit, Congress could cut payments to providers and suppliers responsible for the overspending and could increase Medicare premiums for high-income beneficiaries, the lawmakers said.

You got that? The problem is that Medicare is usually the cheapest plan around. So, first off, you make it so that it has to be, by law, the second cheapest plan around. That's step one.

Then, you force the government to funnel some of the Medicare money to the private insurers (a business that is traditionally astonishingly lucrative for the people who run it), leaving less money available for the Medicare program itself.

Then, you put spending caps on Medicare and increase some of the Medicare premiums, making the program less flexible, less able to respond to market pressures, and (just by the way) less popular among the people whose premiums just went up.

And those are just the obvious problems: this plan basically says "well, the game is rigged toward the government. The only way to fix that is to rig it in the other direction."

Now, just for fun, let's put our tinfoil hats on for just a second. Can you see any way that this system could be manipulated by the healthcare industry? Is there, maybe, a simple backdoor that somebody could sneak through to kill off Medicare entirely? (You know, pretty much what Big Pharma and the GOP have been trying to do for decades?)

Try this idea on for size. A couple of the health insurance companies (not working together! Oh, no!) set up some brand-new private insurance plans to "compete" with Medicare. And one of them is obviously cheaper than the rest.

(Can these plans lose money in the long run? Of course they can! In order to be a growth industry, you don't just look at short-term losses - you have to figure out long-term gains!)

And if you advertise that new plan like mad, people will change over to it. Meaning that there are, by definition, less people in Medicare. And less money coming in.

Remember, all the big insurance companies are already getting Medicare money directly from government subsidies under the new plan. And the government is still paying for the remaining Medicare patients.

So the money is still going out under the current plan, and damned little is coming in. And the industry can just quietly poke Congress in the ribs and say "Look! We can do it just as cheaply. And save the government money in the process. What do you think we should do about this? Oh, and would you like more Cabernet?"

But that's just paranoia, right there. Right? There's no way that could ever happen.

Is there?

Banking On The Widow's Mite

Get ready to chew gravel in the parking lot in sheer fury: an investigation of several large national insurance corporations has been launched by NY Attorney General Andrew Cuomo for what, in my opinion, amounts to the most cynical sort of war profiteering I can imagine. Eight insurers are suspected of managing the insurance payouts to military widows in such a way that the insurers continue to make a profit on benefits that belong to the deceased serviceman's family.


According to CNN,

The attorney general's office said it appears some insurers tell families of fallen military personnel that policy payouts will be placed in an interest-bearing account. But the bulk of the interest benefits the insurers, and the cash is not placed in banks insured by the Federal Deposit Insurance Corporation (FDIC), Cuomo's office said.

His office said insurers place cash in their corporate accounts, reportedly earning up to 4.8 percent interest while paying families as little as 0.5 percent interest.

 Eight insurance companies have been subpoenaed, including Prudential and MetLife. Prudential's practices are offered as an example of the way this scam feature works: the beneficiary receives what appears to be a checkbook from JP Morgan Chase to access their benefits; however, according to Cuomo's office,

"Instead, Prudential must send money to JPMorgan Chase before the checks can clear," the attorney general's office said. "Prudential beneficiaries are also not informed that, under a 2008 law, they have one year to place the death benefits in a Roth IRA and earn tax-free investment gains for the rest of their lives. Thus, real financial harm is suffered by Prudential's lack of disclosure."

 So, to break it down, they keep the death benefit and earn corporate interest on it, pay a lower interest rate to the beneficiary (who believes the money is earning a "competitive interest rate"), pocket the difference, and control the gate through which the money flows (possibly slowing that flow if it benefits the corporation?). Scummy. Slime. Bags.


Both the Veteran's Administration and Secretary of Defense Robert Gates' office are looking into the investigation. And, of course, we're taking all this with a grain of gravel, since Cuomo is running for the governor's office in New York.

Add-On:

He lied -- no he didn't

As though on cue, the South Carolina courts have upheld a $10 million dollar award to Jerome Mitchell who purchased health insurance from Fortis in 2001 when he was 18. A year later, when trying to donate blood, he was told he had HIV. Fortis decided he had lied on the application where it asked if he'd been diagnosed with immune deficiency and rescinded his policy.

As we know, although some won't admit it, Insurance companies pay bonuses to their death panels who reject claims and rescind policies, but I'm sure whatever they paid was a drop in the bucket in comparison. The court didn't mince words in upholding Mitchell's claim and upheld $10 million in punitive damages plus the amount he had spent on staying alive.

"We find ample support in the record that Fortis' conduct was reprehensible ... Fortis demonstrated an indifference to Mitchell's life and a reckless disregard to his health and safety"

and Mitchell was fortunate enough to be young enough to survive long enough to be vindicated. His life expectancy without very expensive treatment would have been 4 years, according to his suit. Older patients often die before they can get their day in court or before the inevitable appeals process winds down. The death panels love it when that happens. I think it happens rather frequently.

Do we need a public option to tame this kind of swashbuckling? Not necessarily, but we need something and we needed it a long time ago. Remember that that ten million isn't going to come out of the executive salaries, the multi-million dollar non-executive board members' salaries or anyplace but the hides of the insured.

Enough is Enough

Years ago my mother was convinced that Medicare would turn the USA into a communist country. Now, at 91, she uses it gratefully. My recently deceased father-in-law was the same; swore Medicare would make us all communists, but then swore by it when it helped extend his life to 90.

I, on the other hand, spent one year with minimal health care. Fortunately, I was able to change jobs in 1984 to obtain adequate health insurance for my family. I had a disabled daughter and flimsy medical coverage that paid for little of her care at the Children’s Hospital of Philadelphia. Luckily, I was able to find a job with a good private health care plan. Millions, however, are unable to obtain any health care and are sick or dying as a result. They would be well served to have a national health program as an option.

Where are the outcries about deaths caused by a society unwilling to see that everyone has health care? Where is the outrage about the needless suffering of so many fellow Americans?

Why aren’t the radicals out there screaming “murder” when a young uninsured woman dies of cancer? Or when a middle aged uninsured man dies of kidney disease? Where is the hype to stop “murdering” so many of our uninsured citizens? The private sector insurance business has failed these people miserably while some private insurance executives have rolled big time in the money we pay as premiums. It is time to try something different.

We spend more on health care now than any nation in the world, yet rank 37th out of 191 countries in health care according to the World Health Organization. Canadians outlive Americans by two years, despite all of the American criticisms about socialized medicine. True, we are better service providers and insurers for certain specialty diseases than any other country. But then, aren’t we smart enough to overhaul the system so it is accessible to all, yet retain our excellent specialty care? Aren’t we obligated to do just that if we are, as we claim, the most moral country on Earth?

The time is now to act outrageously indignant that any American anywhere would shout out against giving another American a fair chance at life saving health care. I am fed up with ignorant people rudely interrupting health care town hall meetings geared to helping tweak the President’s health care plan. Those of us in favor of the plan, including myself, are screaming back: “Haters, move out of the way. We want good health care now for all Americans. We will not be stopped by your ignorance.”