RE-POST from 1-18-11 Correntewire:
So the interest in repealing Obamacare means some strident Republicans claim it is too unfair to corporations and want to eliminate the pathetically limited protections it offers the citizenry.
It is chock full of citizen pitfalls and corporate aggrandizements but that is not enough for the corporate overlords who want the last molecule of profit-making they can on the backs of American citizens or the Republican kabuki artists who wail just to wail because that is how they play the game.
The tepid media response from those who now pass as "progressives" (since real progressives have been disenfranchised long ago by the Obama administration and the corporate media) is Obamacare must be defended. Tepid, because it is hard to get passionate about a Trojan Horse law that aids and abets the profit-making of the insurance industry vendors. That blocked a universal health care system that would have been the tide that raised all citizens' boats in these dark times. That would have cost us all a hell of a lot less, 6% out of our payroll taxes, wasn’t it? That would have saved us and our families the upcoming economic and physical slings and arrows -- expensive and possibly critical (as in gratuitous suffering and death) ambushes -- those realists among us are having nightmares about.
But the disinformation campaigns of both parties aided by a craven corporate media worked their evil magic on a citizenry that got played, played, played. That turned on each other and lost the benefit of universal health care that most every other industrialized nation enjoys, while paying a lot less for it. Listening to Keith Olbermann and Howard Dean last night express impatience with the “repealers” rang hollow for me when it was the Obama administration and a Congress on both sides of the aisle that aided and abetted the collective screwing of the citizenry in terms of affordable health care. Along with the lemming mentality of the obtuse tea partiers on one side and the public option pragmatists on the other.
In July of last year Dr. John Geymanin pnhp (Physicians for a National Health Program) did a concise assessment of the Orwellian-named “Patient Protection and Affordable Care Act of 2010” (PPACA). The healthcare legislation investment will be $1 trillion over the next 10 years, ensuring the health of the health insurance industry far more than average Americans.
Here are first the profound negatives and then a few positives according to Geyman's analysis:
On the negative side of the ledger, however, these are some of the reasons that the PPACA will fall so far short of needed health care reform that it is not much better than nothing:
• Surging health care costs will not be contained as cost-sharing increases for patients and their families.
• Uncontrolled costs of health care and insurance will make them unaffordable for a large and growing part of the population.
• At least 23 million Americans will still be uninsured in 2019, with tens of millions more underinsured.
• Quality of care for the U. S. population is not likely to improve.
• Insurance “reforms” are so incomplete that the industry can easily continue to game the system.
• New layers of waste and bureaucracy, without added value, will further fragment the system.
• With its lack of price controls, the PPACA will prove to be a bonanza for corporate stakeholders in the medical-industrial complex.
• Perverse incentives within a minimally-regulated market-based system will still lead to overtreatment with inappropriate and unnecessary care even as millions of Americans forego necessary care because of cost.
• The “reformed” system is not sustainable and will require more fundamental reform sooner than later to rein in the excesses of the market.
Geyman examines why the reform effort got so offtrack:
• The issues and policy options were framed as the political process was hijacked by the very interests that are largely responsible for today’s cost, access and quality problems in health care. As examples, the drug industry lobbied successfully to avoid any price controls of drugs, as the VA does so well; the insurance industry avoided real rate controls over their premiums and ended up with other loopholes to game the new system; and all of the corporate stakeholders will gain subsidized new markets without significant regulation of the market.
• The quest for bipartisanship was futile as reform got run over in the middle of the road. The big questions cannot be answered in the political center, such as whether health care should be a right or a privilege, or whether health care resources should be allocated based on ability to pay or medical need.
• Market failure was not recognized as the wellspring of our system problems. When it was agreed to “build on the strengths of the present system” instead of more fundamental reform, corporate stakeholders and their lobbyists found willing legislators to craft centrist “remedies” which could be sold to the public as reform. But the various incremental tweaks of our existing system, such as employer and individual mandates, have failed over the last 20 or 30 years to remedy cost, access and quality problems.
In the absence of real health care reform, we can now expect these kinds of unfavorable outcomes in coming years:
• soaring costs without effective price controls throughout the system.
• managed care fails to control costs or improve quality.
• persistent financial and other access barriers for many millions of Americans.
• growing backlash by physicians and consumers.
• gaming of private plans and adverse selection in public plans.
• consolidation among hospitals sustaining high prices.
• increased cost-sharing for employees as employers cut back benefits.
• continued high levels of inappropriate and unnecessary care.
• added bureaucracy and waste in an even more fragmented and dysfunctional system.
Geyman gives the devils their due on the postiive side of the ledger. Good as far as they go, but way too few, limited and/or belated:
• Will extend health insurance to 32 million more people by 2019.
• Provides subsidies to help many lower-income Americans afford health insurance.
• Starting in 2014, expands Medicaid to cover 16 million more lower-income people.
• Provides new funding for community health centers that could enable them to double their current capacity.
• Eliminates cost-sharing for many preventive services.
• Phases out the “doughnut hole” coverage gap for the Medicare prescription drug benefit.
• Will create a new national insurance plan for long-term services: Community Living Assistance Services and Supports (CLASS) program.
• Will establish a nonprofit Patient-Centered Outcomes Research Institute to assess the relative outcomes, effectiveness and appropriateness of different treatments.
• Initiates some limited reforms of the insurance industry, such as prohibiting exclusions based on pre-existing conditions and banning of annual and lifetime limits.
• Contains some provisions to improve reimbursement for primary care physicians and expand the primary care workforce.
Thank God for these, but again, the negatives vastly outweigh the positives.
Geyman points out that most industrialized nations have learned many years ago that free-marketing health insurance programs perpetuate overwhelming health care burdens for a population. These more pro-citizen nations (as opposed to our present anti-empathy US government) at the same time spend a lot less on health care than we do in spite of this protective and regulating role of government. Why would a working government be regarded as evil when it exercises its capacity to ensure sustainable and better quality of care for ALL citizens. When it puts people over profits -- over gratuitously massive profit-making? When did most of our citizenry get so mean-spirited they lost all sensibility of a “common good”? Why are so many so short-sighted they confuse any government action with "bad" government action? They -- we -- got played, played, played by corporate overlords, pimped politicians, and a corporate-owned media.
Geyman writes:
There is a fix in plain sight for our problems — single-payer financing coupled with a private delivery system. The private insurance industry has outlived its usefulness, and is only being kept alive by government subsidies, whether by overpayments of private Medicare plans or this latest provision in the PPACA to pay out nearly half of a trillion dollars in subsidized premiums for their inadequate coverage.
When will we have the political will to face up to our real problems in health care and show that the democratic process can still work?
When will the political will happen, indeed, Doctor. Code name for the intelligent citizens who fathom the universal health care answer in America is “Rumplestiltskin”. You know, like that fairy tale character. The media, Obama, both legacy parties refuse to utter our name and undemocratically crush our political will. Including the so-called progressive media now "tching, tching" the present repealers, pretending that Obamacare ever seriously cared. I hope future generations get it and are not as obtuse as the majority in this one was.
The good news for Obama and those stupid enough to think that support for Obama is a substantial support for any of us is that he will get his corporate payoffs, as will also those back-stabbing Congresspeople on both sides of the aisle, for the elections of 2012.
Oh goody. More kabuki and betrayal. More ebbing tides for the citizenry.
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Geyman's article at pnhp from “Hijacked: The Road to Single Payer in the Aftermath of Stolen Health Care Reform,” 2010, with permission of the publisher Common Courage Press. http://commoncouragepress.com/index.cfm?action=book&bookid=402
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Another handful of nails in the coffin of a once-great nation.....
;-(
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;-(
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I see you are still doing your best to get Republicans elected, Libby.
Do you really think doing that will help with your liberal agenda?
Do you honestly think having a Supreme Court...and the federal judiciary...moved further to the right will help?
Libby, with all the respect in the world...what are you doing--and why are you doing it?
Do you really think doing that will help with your liberal agenda?
Do you honestly think having a Supreme Court...and the federal judiciary...moved further to the right will help?
Libby, with all the respect in the world...what are you doing--and why are you doing it?
The Patient Protection and Affordable Care Act of 2010, with its many pie-in-the-sky provisions that theoretically kick in somewhere far down the line, like expanding Medicaid to cover 16 million more people by 2014, health insurance extended to 32 million people by 2019, and so on. Will any of those provisions ever really perform as described? Nobody knows, but Obama/Axelrod kicked the can down the road exactly far enough to claim a "victory," and that's all they ever meant to do.
Thanks for posting this excellent overview, libbyliberalnyc!
Thanks for posting this excellent overview, libbyliberalnyc!
Obamacare is a nightmare waiting to happen. Obama didn't care how much it might it hurt us as a country, he just wanted a political victory and said as much to Kucinich as a reason to support it since there was no actual reason to support it.
Delusional Obama supporters ran around jacking their weenies off hailing it as landmark reform that will make everything fine again. As I said before, some people care about right and wrong and some people care about political power.
One thing no Obama supporter will admit is that O-man is more devoted to protecting greed than any Republican because Obama believes as a leftist he can do wrong. This law is absolute proof of that. He will go down as a monumental failure in history.
Delusional Obama supporters ran around jacking their weenies off hailing it as landmark reform that will make everything fine again. As I said before, some people care about right and wrong and some people care about political power.
One thing no Obama supporter will admit is that O-man is more devoted to protecting greed than any Republican because Obama believes as a leftist he can do wrong. This law is absolute proof of that. He will go down as a monumental failure in history.
Good work.
Any one who believes this bullshit is a moron. Ge the accurate information from people who know about the issue at
thepeoplesview.net.
thepeoplesview.net.
There's a lot of spin here that doesn't hold up. But I agree with you that the system "will require more fundamental reform." This is just a first step. But I bet you would have railed against Social Security as that law stood 16 months after it was enacted as well.
The all or nothing argument is a canard. You will not get it all--universal health care coverage--in the foreseeable future. Would you then throw the progress made out because this this law is significantly imperfect? Do you really want health insurance companies to be able to deny you coverage or drop you for any reason again? And of the 23 million still to be lacking coverage, I don't have your math on that, but we are all clear that undocumented workers are not covered under the law. If that number is 11 million, who are the other 12? People who choose to pay a penalty rather than sign up under mandated coverage? People living in the underground economy?
The law includes some weak or exploratory measure toward cost controls that could be strengthened with time. They have to be, I agree. But the law represents some basic steps in the right direction.
The all or nothing argument is a canard. You will not get it all--universal health care coverage--in the foreseeable future. Would you then throw the progress made out because this this law is significantly imperfect? Do you really want health insurance companies to be able to deny you coverage or drop you for any reason again? And of the 23 million still to be lacking coverage, I don't have your math on that, but we are all clear that undocumented workers are not covered under the law. If that number is 11 million, who are the other 12? People who choose to pay a penalty rather than sign up under mandated coverage? People living in the underground economy?
The law includes some weak or exploratory measure toward cost controls that could be strengthened with time. They have to be, I agree. But the law represents some basic steps in the right direction.
sky, today on my way to work an Asian man was playing some very poignant sounding violin-like instrument for the subway waiters. i knew I knew the song but it was such a different rendition and realized he was playing it as a gentle dirge. It was "God Bless America" and it was at such a haunting and sad pace it brought tears to my eyes. it is hard enough how harsh things are now but the realization that they will get worse before they get better and people don't seem to have cultivated much moral imagination in terms of embracing the nature of the problems and the nature of solutions to them is really confounding. thanks for commenting!
frank, I was thinking about Obama's spinning and spinning and spinning (talking and talking and talking the talk with so little to show) and all I can say to the Team Dem campers still left in the pack, just cuz there are piles and piles of verbal horseshit coming from the Obama/Axelrod cabal, doesn't mean you guys are ever getting a pony! (trojan horses? ... youbetcha, a whole herd of those!)
libby
frank, I was thinking about Obama's spinning and spinning and spinning (talking and talking and talking the talk with so little to show) and all I can say to the Team Dem campers still left in the pack, just cuz there are piles and piles of verbal horseshit coming from the Obama/Axelrod cabal, doesn't mean you guys are ever getting a pony! (trojan horses? ... youbetcha, a whole herd of those!)
libby
Admire Your courage in the face of obamabots.
To me it's simple: I've never voted for a war criminal, and I'm not gonna' start now (even if the idiot denier "thinks" differently: " . . . You really have to suck it up and start supporting Obama. He is NOT a war criminal…and quite frankly, neither is George W. Bush."
Frank Apisa
FEBRUARY 13, 2012 06:18 PM.).
-R-
To me it's simple: I've never voted for a war criminal, and I'm not gonna' start now (even if the idiot denier "thinks" differently: " . . . You really have to suck it up and start supporting Obama. He is NOT a war criminal…and quite frankly, neither is George W. Bush."
Frank Apisa
FEBRUARY 13, 2012 06:18 PM.).
-R-
thanks, jacob! I think you are so right and Dr. Geyman's positive list is even more generous than whatever reality will unfold in the future. the costs are so prohibitive that nice sounding programs will not be seriously accessible to many. how great it sounds that they can't turn you down "technically" for having a pre-existing condition, but chances are you can't possibly begin to pay since no holds barred on premiums for plans that could really do something for your health challenge.
Harry, I match your anger and disgust. I could not believe Obama sold out the single payer universal people so immediately and then said he was inviting everyone to the table. Yeah, everyone meaning the corporate fat cats for the health industry, not even the doctors and nurses particularly who really get the scope of corruption and manipulation. Like Issa's panel of no women! No citizen patients or doctors or nurses, in fact at one point people like Dr. Flowers were dragged off and arrested for trying to speak out at Maxie Boy Baucus's hearing he felt so oppressed by having people of integrity interfere with the lobby-love-in. The corporate press was not impressed with the people of conscience. No biggie. And the public option bullshit that the obama water carriers leapt on, totally shelving universal health care for America for another generation or two or never, incrementalism crap. someone wrote a great article back then, I wish I could remember the exact words, but to the effect that you can't get across a huge deep chasm of corruption in front of you with tiny steps. You fall in!!!! You jump over the damn thing to the other side. The psychopathic personality corporations do not function out of empathy and practicality for the "customers". they are only vendors as nader says, supposedly, but they are making all the rules for the people and the government. Jumping over the illegitimate power brokers is what whe needed to do and would have with a real leader. That is what reform is about. Not tweaking a broken and gamed system. Obama is the American Judas but apparently Axelrod/Rasputin is dressing him up in a Christ-like wardrobe one more time. glen ford of black agenda report really has Obama's number imho!
libby
Harry, I match your anger and disgust. I could not believe Obama sold out the single payer universal people so immediately and then said he was inviting everyone to the table. Yeah, everyone meaning the corporate fat cats for the health industry, not even the doctors and nurses particularly who really get the scope of corruption and manipulation. Like Issa's panel of no women! No citizen patients or doctors or nurses, in fact at one point people like Dr. Flowers were dragged off and arrested for trying to speak out at Maxie Boy Baucus's hearing he felt so oppressed by having people of integrity interfere with the lobby-love-in. The corporate press was not impressed with the people of conscience. No biggie. And the public option bullshit that the obama water carriers leapt on, totally shelving universal health care for America for another generation or two or never, incrementalism crap. someone wrote a great article back then, I wish I could remember the exact words, but to the effect that you can't get across a huge deep chasm of corruption in front of you with tiny steps. You fall in!!!! You jump over the damn thing to the other side. The psychopathic personality corporations do not function out of empathy and practicality for the "customers". they are only vendors as nader says, supposedly, but they are making all the rules for the people and the government. Jumping over the illegitimate power brokers is what whe needed to do and would have with a real leader. That is what reform is about. Not tweaking a broken and gamed system. Obama is the American Judas but apparently Axelrod/Rasputin is dressing him up in a Christ-like wardrobe one more time. glen ford of black agenda report really has Obama's number imho!
libby
baltimore, thanks for your powerful points! Yes, scope of health care is based on income in general, collective terms. Also based on income personally and specifically since it is linked up to employer chosen plans which single payer would have taken care of. with joblessness where it is at and going, it doesn't take a genius to see what compounding tragedy, double jeopardy, is happening to our citizens. Also, with the stress and despair, the psychological and physical symptoms of those you mention above, are manifesting like crazy, too. All the more reason to extend support to the citizenry, not to bring on fresh hells for them. We are citizens of a government without pity nor long range intelligence, for that matter. thanks for commenting! libby
Excellent summary of Obamacare, Obama's corporate welfare bill for insurance and drug companies
steve, i only have a minute or two to respond right now, but I can't believe you are implying the pnhp docs are "spinning", Geyman in particular.
Also that you are using the Rovian playbook on me, accusing me who is fighting for safety nets in this country for our struggling citizens as someone who would have been an obstructionist for social security. Attack someone for doing the opposite of where their heart is. Maybe I should say if you and frank were the dominating voices back in Revolutionary Days we would still be a colony of England.
And also can't believe you are bringing up social security issue to me when Obama and Simpson and Bowles and the faux-bipartisan hit squad are working on dismantling it.
Finally, I hope I am reading it wrong that you are NOT fretting that people in the "underground" American economy or lack thereof should not have health care accessible to them. I mean, I know we live in a narcissistic culture sometimes from stress all the more narcissistic, people being so very protective of what they have and then feeling they can't afford humanitarianism through the collective tax dollars, but come on. Better that the money for health care goes into the pockets of the corporate extortionists, (who is that guy who runs one insurance company who makes $90,000 an hour), and not provide for any of the lowest economic 99%ers? God forbid an immigrant child or a homeless person is provided emergency health care? Even though with universal health care the costs for providing that humanitarian social service wouldn't dent what the profiteers are taking in obscene profitmaking for themselves. Yeah, health care and immigration and what else will remain genuinely unfixed in this country and the victims always blamed and/or disenfranchised. Again, I went off on the tangent. I don't think you were going there. Forgive me but I did. anyway, thanks for commenting. libby
Also that you are using the Rovian playbook on me, accusing me who is fighting for safety nets in this country for our struggling citizens as someone who would have been an obstructionist for social security. Attack someone for doing the opposite of where their heart is. Maybe I should say if you and frank were the dominating voices back in Revolutionary Days we would still be a colony of England.
And also can't believe you are bringing up social security issue to me when Obama and Simpson and Bowles and the faux-bipartisan hit squad are working on dismantling it.
Finally, I hope I am reading it wrong that you are NOT fretting that people in the "underground" American economy or lack thereof should not have health care accessible to them. I mean, I know we live in a narcissistic culture sometimes from stress all the more narcissistic, people being so very protective of what they have and then feeling they can't afford humanitarianism through the collective tax dollars, but come on. Better that the money for health care goes into the pockets of the corporate extortionists, (who is that guy who runs one insurance company who makes $90,000 an hour), and not provide for any of the lowest economic 99%ers? God forbid an immigrant child or a homeless person is provided emergency health care? Even though with universal health care the costs for providing that humanitarian social service wouldn't dent what the profiteers are taking in obscene profitmaking for themselves. Yeah, health care and immigration and what else will remain genuinely unfixed in this country and the victims always blamed and/or disenfranchised. Again, I went off on the tangent. I don't think you were going there. Forgive me but I did. anyway, thanks for commenting. libby
ObamaScare, served up by F*X News and other apologists, is determined to keep the troughs of green swill full for the pigs lapping and sopping with matchless zeal. For all of its warts, it is a step in controlling unwieldy costs and designs for furthering corporate greed.
A solution is not even on the map. But where are those so enlightened to put forth their solutions? This is the real thing, the process of asking the hard questions, engendering real concern that will be addressed in the proper context -- with the content that
works for the masses. Only then will things move.
A solution is not even on the map. But where are those so enlightened to put forth their solutions? This is the real thing, the process of asking the hard questions, engendering real concern that will be addressed in the proper context -- with the content that
works for the masses. Only then will things move.
As long as we continue to support an employer-based system, we're all screwed.
Membership in the "reality-based community" keeps shrinking all the time. It's all true and no onc cares. I tire of making the same points over and over again--that two dozen other nations have solved the problem we are told can't be solved; that no other advanced (suposedly, time to use quotation marks on that term) nation makes no attempt to control soaring, privately-set health care costs.
Libby, if yours is the liberal view, what are the NY radicals saying nowadays? Have you considered changing your name?
I know that it's your birthday, joe, but do you have to follow the apisa way. As for "radical," the question should be addressed to the good doctor above. He blogged ""Radicals" for obama."
Just for the record markinjapan and others, I am happy we got whatever we did, and what we didn't get I lay at the stinky feet of our elected Congress and the healthcare lobby. Sure, I desperately wanted a single-payor system too. I think it's too soon to say that it will all fade away before it is fully enacted. Probably will though, if we get a repube president.
OK, Joe, whatever.
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