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Mon Apr 21, 2014, 12:13 AM

For Any Democrat Who Is Tempted to Call the Health Insurance Industry Our Party’s BFF

Sorry in advance. This is not a "feel good" thread. This is not a human interest piece. This is not designed to make anyone feel warm and fuzzy. This is a word of warning. There is an industry that some may feel tempted to call out friend. However, this industry has spent the last two decades stabbing us in the back with very sharp knives over and over again----

In 1995, George W. Bush becomes governor thanks to Texas voters who mistake him for his dad. Texas is in the middle of an HMO crisis. Managed Care plans have seized control of health care from physicians. Patients and doctors are fed up, scared, and, in the worst cases, dying from lack of appropriate health care. The legislature passes the first Patient Protection Act to stop HMO abuses. It is overwhelmingly popular. Then Gov. George W. Bush waits until the legislature is out of session to veto the bill. It is his first controversial act as governor. The veto is so controversial that when the act is brought up again two years later, he allows it to go into law---grudgingly. During a debate with Al Gore in 2000, he brags that he is responsible for the passage of the Texas Patient Protection Act—a bald faced lie. Ceci Connelly, the health insurance industry’s date-for-money (the other word is so ugly) in the news media leads the Gore is a Liar Big Lie that year. She does not report on the Bush lie. Bush gets into office. Attorney General John Ashcroft is assigned the job of going to court to get the Texas Patient Protection Act---about which Bush bragged and lied in the debate—struck down in federal court. Bush has now managed to kill the Texas Patient Protection Act twice. The law is designed to protect patients from HMO abuses which deny them appropriate medical care. These abuses---denying coverage for drugs, denying referrals for specialists, tests and surgery, sometimes after the fact—are used by HMOs to reverse cherry pick---drive sick people off their plans since they are not allowed to refuse to sign up people with pre-existing conditions.

We all know that Enron’s fate depended upon the 2000 election. However, few realized that the health insurance industry was also in trouble. Huge trouble. The first time the White House and both Houses of Congress were under Democratic control, health care legislation would be passed. This was inevitable. Newt Gingrich had helped the industry dodge the bullet in the 1990s, but one day the Dems would have power. Connelly’s job was the delay that event. She served her corporate masters well. That is why she is in the private sector now.

Medicare was the big threat to private health insurers, because it was a model for single payer. Under Bush, they began their War on Medicare. Bush allowed private insurers to raid Medicare, giving them outrageous sums of money for taking care of cherry picked healthy seniors aka Medicare Advantage. He allowed Big Pharm to raid Medicare by coming up with Medicare Part D, the outrageous plan that forced Medicare to pay Big Pharm exactly what it wanted for its overpriced drugs. No bargaining allowed. Drug prices soared. Medicare spending rose. For the first time in decades, people began to speak disparagingly of Medicare.

In 2008, the unthinkable happened (for the health insurance industry). A Democratic grand slam. All they could do was bribe, bargain, threaten and wheedle Washington politicians into giving them a seat at the table. They could alter the Affordable Care Act, but they could not prevent it its passage. And so they said “Hey, come on. Give us a chance. We want this to work.”

Now, the health insurance industry is at a crossroads. It desperately wants to keep collecting premiums from healthy people—and shunting all the poor, sick and elderly people into government programs. That is their business model. They do not prevent disease. They never have. When people get sick enough, they lose their jobs, they can not pay their premiums, they go on disability and Medicare. If the ACA continues as written and is never changed, the private insurers will do fine---

Until some government bean counter notices that the federal government is doing most of the actual health care spending and the privates are collecting premiums but not paying out as much in expenditures. Until the bean counters notice that a lot of health insurance "expenditures" are actually meaningless internal Q&A--paper pushing. And, as health care spending grows and taxes grow and people demand tax relief, eventually the government will look at the private insurance company's profits and say "Do we really need this middle man here? We can collect premiums from healthy people and not pay out much in health care spending, too." And once that happens, the very next Democratic White House/ Congress combo will author ACA II---and the privates will be out.

What is a concerned health insurance industry executive to do? Play along with the administration in power, do whatever it takes to keep the GOP in charge of at least one House of Congress and try to get a friendlier party back in control of Health and Human Services in 2016.

Ok, you can start crying "Burn the heretic!" But please keep this in mind: Big oil likes the GOP but Big Oil will always have a buyer for its product no matter which administration is in power. Banking may prefer the GOP, but we will always need banks. The private health insurance industry---if you think about it, they are not essential to life as we know it on this planet. They have to work extra hard to keep their house of cards standing.

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Reply For Any Democrat Who Is Tempted to Call the Health Insurance Industry Our Party’s BFF (Original post)
McCamy Taylor Apr 2014 OP
Tarheel_Dem Apr 2014 #1
McCamy Taylor Apr 2014 #2
msongs Apr 2014 #3
bearssoapbox Apr 2014 #4
djean111 Apr 2014 #5
Doctor_J Apr 2014 #6
McCamy Taylor Apr 2014 #8
McCamy Taylor Apr 2014 #9
McCamy Taylor Apr 2014 #10
blkmusclmachine Apr 2014 #7

Response to McCamy Taylor (Original post)

Mon Apr 21, 2014, 12:34 AM

1. TLDR!




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Response to Tarheel_Dem (Reply #1)

Mon Apr 21, 2014, 12:43 AM

2. I had to look it up and OMG they have a short hand for "Too long, didn't read" now????

All my posts are super long. I was an English major in college and I type like a gazillion words a minute.

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Response to McCamy Taylor (Reply #2)

Mon Apr 21, 2014, 12:56 AM

3. TLDR = Iraq war resolution/AUMF. nt

their price for pol

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Response to McCamy Taylor (Reply #2)

Mon Apr 21, 2014, 04:28 AM

4. That was long????

Compared to some I've seen it's practically a post-it.

When it's interesting and well written, like yours, I don't notice the length of a post.

And I learned something.

I'll be checking out some of your other posts.

Thanks for posting this one.

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Response to McCamy Taylor (Original post)

Mon Apr 21, 2014, 05:50 AM

5. Spot on. Good read.

 

I really had not noticed anyone here at DU having any good thoughts about private insurance, though.
To me, they are just a fat evil cat crouched down and smiling at all the mice that have been delivered to it.
I am sure they are busily buying politicians who will work to get rid of Medicare and then work to get rid of the parts of the ACA that they do not like - I believe they LOVE the indentured servitude, but HATE accepting pre-existing conditions. I am sure that if the next prez is GOP, the ACA will be history, and I am worried that a Dem Third-Wayer prez will keep the ACA, but let the insurance industry gut it while keeping the indentured servitude part.

I do not mistake the insurance industry for a BFF, nor do I believe 99% of politicians are my BFF.

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Response to McCamy Taylor (Original post)

Mon Apr 21, 2014, 07:03 AM

6. while I appreciate the two hours you spent on this, the only word for it is

 

preposterous. Allow me to address one representative paragraph+

Until some government bean counter notices that the federal government is doing most of the actual health care spending and the privates are collecting premiums but not paying out as much in expenditures. Until the bean counters notice that a lot of health insurance "expenditures" are actually meaningless internal Q&A--paper pushing.


Not only does every bean counter already know this, so does everyone else in the country, unless his/her brain is Fox-saturated. Actually everyone in the rich world knows this - which is why we're the only ones who pay "insurance" companies to...do nothing.

And, as health care spending grows and taxes grow and people demand tax relief, eventually the government will look at the private insurance company's profits and say "Do we really need this middle man here?... The private health insurance industry---if you think about it, they are not essential to life as we know it on this planet.


No kidding. Or rather duh. This is not a matter of suddenly waking up to this fact. It is patently obvious and has been for 25 years

We can collect premiums from healthy people and not pay out much in health care spending, too." And once that happens, the very next Democratic White House/ Congress combo will author ACA II---and the privates will be out


There's the preposterous part. The ACA, which used to be called Romneycare, and before that Gingrinchcare, and was developed by the right-wing propaganda house the Heritage Foundation, is exactly the plan the Hillary was campaining on during the 2008 primary. What on God's green earth makes you think she'll sign off on real health care? That "the very next Dem Congress" will do what 60 Senators, 258 Reps, and a Dem president wouldn't do in 2009-2010?

You are completely missing the big picture here. The 500 billion dollar giveaway to Big Insurance that Obama signed into law was not an anomaly. He has show for 5-1/2 years that he is a corporatist through and through. While he and the rest of the DC dems may not be Big Insurance's best friends, they're really, really good friends.

Your post makes it sound like the fact that Big Insurance is a blood-sucking, murderous crime organization is unknown. Everyone knows it. Finding someone with the political will power to take them on and defeat them is the problem.

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Response to Doctor_J (Reply #6)

Mon Apr 21, 2014, 10:00 PM

8. The virulence of your post gladdens my heart. I mean that from the bottom of my heart.

The way some folks online hold the ACA up as if it is the Holy of Holies, I was beginning to fear that Good Democrats are now supposed to believe that the corporate financial wellbeing of Blue Cross and Prudential = the Well being of America. However, that may just be Astroturf talking.

The one below this was deleted because it was the same as this one. I think DU is having seizures. Nurse, where is that IV I asked for?

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Response to Doctor_J (Reply #6)


Response to Doctor_J (Reply #6)

Mon Apr 21, 2014, 10:14 PM

10. I'll try this again. Thanks. I'm glad to find lots of healthy skepticism

of the health insurance industry. (I don't know where my last response went.) If you want to hear what I really think about health insurers, send me a private tell and I will send you a free copy of the manuscript of "Damaged Care Redux" updated for the 21st century. They are up to all their old games from the 1990s and they have some new ones. Working for a health insurance company must be like working in a bureaucratic hell. The one that really gets me is the mindless Q&A that they can claim as a patient medical expenditure towards the 85% they have to spend on patient care. Every month, my nurse has to call for a pre-authorization for the same medication for the same patient---the drug is $4 on the Wal-Mart formulary. If the drug the patient can't get is a heart drug, they get scared and at the next enrollment period, the change insurances, so it works as reverse cherry picking, too.

Take away an insurers right to exclude for pre-existing conditions and things get ugly.

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Response to McCamy Taylor (Original post)

Mon Apr 21, 2014, 02:45 PM

7. Insurance is your "friend," until you actually NEED something...

 

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