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For More Sticker Shock, Look Beyond the Pump

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With the early arrival of spring, car owners have another reason to be up in arms over the cost of filling their gas tanks. Projections of $5.00 per gallon by summer are being bandied about across the country, and people are so angered by reckless Wall Street manipulators and oil company greed that they can hardly see straight. While it feels like we are once again being held hostage by Big Oil, there are some simple things that can be done to lessen the load of fuel prices on our wallets.

NYC's Mayor Bloomberg tried a few years ago to encourage carpooling, but his proposal fell flat. Now, it may be worth a second look. If not carpools, then using public transportation should be encouraged. Maybe reducing fares a few days a week for trains and buses would prompt more people to use them? The nation's mayors and governors also need to address this issue and develop solutions to reduce fuel consumption, in both the public and private sectors. Otherwise, this burden on our already stretched budgets will continue causing people to make serious cutbacks in daily necessities, with even food for the family table facing the threat of downsizing.

Meanwhile, the push continues unabated from special interests and the oil industry to approve the tar sands oil-transporting Keystone XL pipeline and increase drilling at numerous other sites, including in the Gulf of Mexico. They are even demanding we ravage the pristine Arctic in pursuit of their "black gold." Domestic oil production has already increased 15% over the past 3 years, with little concern for our collective health or our environment. Yet still, Big Oil wants more. This issue has not gone completely unnoticed in Washington, as Senator Robert Menendez (D-NJ) has introduced the Repeal Big Oil Subsidy Act (S.2204).

It is a no-brainer that subsidies to oil giants such as BP and Exxon, which continue to post record profits, must end. The top five oil companies posted profits of $137 billion last year, alone. This bill would end Big Oil subsidies and use the money for new, clean, renewable energy sources that would create new jobs. America would become more energy independent and our air, water and land would become cleaner by reducing harmful pollution. What is our energy policy, anyway? The hysteria over oil prices is not just because it will cost more to fill up the tank, but because every single item we touch in our daily lives is shipped from somewhere, and the ever-increasing cost of oil inflates those prices as well. Is our president looking at those costs, too? One wonders.

Unfortunately, the bad news for our pocketbooks does not end there. Just about now, statements from health insurers are beginning to hit our mailboxes with a thud for health services delivered this year. Co-pays for specialists can now reach $50 per visit, with $30 for a visit to a primary care doctor, both more than double from last year, with additional increased premiums. If you need physical therapy following an accident or illness, you will be hit with higher co-pays of $30 or $50 or even $75 per session, coupled with a reduced number of covered visits and less time with the therapist. Many insurers only pay $5.00 to the therapist, of a $55 total, while the patient is stuck with a $50 co-pay. Indeed, the fix is in as the insurers reduce needed services and jack up costs across the board, causing patients to make the hard decision to avoid seeking medical care at all, leading to longer and more complicated illnesses that result in more and more costs -- a vicious cycle. To fight some of these outrageous costs burdening patients, the New York State Physical Therapy Association is promoting a bill in Albany to have the specialist designation removed from physical therapy, which would reduce co-pays to their struggling and aged patients. How could any patient working on recovery afford two or three physical therapy sessions a week with such co-pays? It is madness. Of course, the insurers will most certainly fight back so they can continue sticking it to their customers.

Last year, on-the-job health plans for a family of four rose 9%, with a corresponding 8% increase for single workers. Even with generous tax write-offs for corporations to supply health benefits, more and more are dropping employee coverage, or shifting more of the costs to their workers with reduced benefits. Between 2007 and 2010, family healthcare coverage for employees fell from 63.6% to 53.5%. Why are corporations in the business of providing healthcare in the first place? Meanwhile, according to Ira Stoll in his excellent article "Health Insurance Company Stocks Soar Under Obama" in the Riverdale Review on February 16th, profits at those rapacious insurers are on the rise, with United Health Care seeing an increase of 65%, Aetna 33% and Humana 76% in just the past two years.

And if this wasn't outrageous enough, a stunning March 9th editorial in the New York Daily News told the story of an ill person going to a New York hospital for emergency brain surgery and discovering after the fact that even though the hospital was in network, the neurosurgeon wasn't, and therefore only $8,300 of a $40,000 bill would be covered by the insurer, with the patient being expected to pick up the rest of the bill. According to the article, in 2011 alone, 2,000 complaints reached the Department of Financial Services in NY about such practices. Among those complaints, I'm sure, was the fact that out of network doctors can charge 50 to 135 times what Medicare would pay.

If this is being highlighted in New York, it is clear it is a nationwide practice as well. Who, during an emergency, has the clarity of mind to question their health team about who is or isn't in network? One sensible solution offered by the editorial was for legislatures to cap an individual patient's responsibility for the cost of emergency care, and for non-emergency care patients to be informed if their doctors are out-of-network. Patients have the right to be informed up front and to not be thrown into bankruptcy during a medical crisis.

Seniors are also feeling the pinch, with those in Medicare Advantage Plans (an HMO with benefits comparable to traditional Medicare) paying $4,700 out of pocket this year for prescription drugs until that infamous "donut hole" is closed and the insurers start picking up the tab. In addition, there are $2,800 in deductibles to be paid for doctor's services in some Advantage plans. With Social Security recipients receiving on average about $14,000 per year -- well below the poverty level -- these exorbitant costs are an invisible crisis of epic proportions.

The Affordable Care Act and its mandate is currently in the Supreme Court, with a decision due at any time. Even if it is instituted, the bill still won't fully kick in until 2014, when those subsidies for coverage start to appear in the federal budget. Of course, none of this is to occur, conveniently, until after the election. Ultimately, thirty-three million Americans are projected to be brought into this insurance program. It would be a good move for our government to take a look at restraining rising insurance costs on behalf of all hardworking taxpayers now, for the ACA only addresses this uninsured population. So the rest of the country who are insured are being hung out to dry, forced to sink or swim on their own.

With healthcare costs spiraling out of control, perhaps it is time we revisit the concept of cost controls practiced during World War II? Of course, this is a pie in the sky suggestion in this political climate. At the very least, costs for prescription drugs should be negotiated with Big Pharma, working out an arrangement similar to that with the VA system to effectively bring down costs for the public. The ACA, it must be acknowledged, has created several very good reforms that are commendable, and will cover millions, but few would disagree that much more is needed. The system of delivery and how we pay for it remains essentially the same, and there in lies the conundrum. It is that portion of our health care system that fails, with too many expensive moving parts. For now, however, this is what we have, but the process of envisioning and working for a different, better kind of healthcare reform must continue.

Clearly, healthcare as it currently exists is unsustainable, and the costs still leave 50 million uninsured, with 45,000 dying yearly because they can't afford healthcare at all. What kind of nation are we? As the unrestrained healthcare costs continue to rise, more will stop carrying insurance altogether. Meanwhile, the GOP has introduced their budget calling for a draconian cut to Medicare of $165 billion. Those vouchers will not be far behind to purchase healthcare from private insurers. This would speed the dismantling of one of our great safety nets and could be the death knell for Medicare if it is allowed to go forward. The GOP's budget across the board will stick it to the people and deliver more tax cuts for the wealthy. Even those on food stamps are in Paul Ryan's sights, with the program being decimated under his budget. Perhaps digging for food scraps in dumpsters is seen as alright in certain circles.

Many of these healthcare woes wouldn't even exist if 100 years ago in 1912, AFL President Samuel Gompers had taken the high road for National Health Insurance, which was on the table for the fledgling union, instead of workman's compensation. According to Jill Quadrango's excellent book One Nation, Uninsured, Gompers "...denounced compulsory health insurance as a menace to the rights, welfare and liberty of American workers," opting for workman's compensation instead. We continue to pay for that rotten decision and his lack of leadership. The president at the time, progressive Republican Teddy Roosevelt, would have supported the nation moving to a single-payer system.

Hardworking Americans are under siege on all fronts these days, especially in our on-fire pocketbooks. Something has got to give. Wake up, Washington! Occupiers should start to occupy the health insurance industry, along with the offices of Big Oil. A massive, cross-country occupation, with doctors and other healthcare personnel joining in, would make the point to the insurers that the public is sick and tired of the gross, despicable, inhumane behavior of an industry that holds our lives and wellbeing in its clutches. As for the oil industry, why not just park your car for a couple of days and use public transportation if you can, or carpool with friends? That message would also resonate loud and clear, if it is nationwide and coordinated. Hit them in the one place they understand -- their wallet -- and watch their stock prices plummet.

- with Jonathan Stone

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