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The New Bailout: Individual Health Insurance Mandates and Greater Personal Debt
Behind the escalating debate on the health care between Senators Hillary Clinton and Barack Obama on individual mandate -- she's for it, he's against it -- is a critical policy battle that not only cuts across health care reform but also the neo-liberal privatization dreams, the home mortgage crisis, and the recession that is no longer looming, it's here.
Sound far-fetched? Take a closer look, starting with the millions of Americans staring at the loss of their homes due to the sub-prime loan debacle. It's not a loan or a mortgage crisis for those families; it's a debt crisis being forced upon them by the banks, hedge funds, and insurers who are desperate to shift their own mammoth debt onto someone else.
Banking, other financial institutions, insurance and real estate which make up the finance sector, now account for about half of U.S. corporate profits. And, they are in trouble with more than $2.5 trillion in outstanding consumer credit, $800 billion of that in credit card debt, and another $10.1 trillion in domestic mortgage debt.
Being thrifty won't solve that problem. The financial planners have identified two lucrative pots of money. Trading carbon credits for industries and employers that want to brand themselves as green while continuing to pollute. And, making a killing in health care, currently 16 percent of our national economic pie and rapidly growing.
The banks are already into health care in a big way, serving as a repository for health savings accounts and other tax credit schemes so beloved by the Bush administration and the Republican presidential candidates. But the financiers would like more.
Enter the neo-liberal think tanks and policy wonks and plans they hawk to expand the reach of the market, especially the financial market, in health care. Central to that approach is shotgun insurance, forcing everyone not currently covered to buy health insurance policies.
Compelling people to buy insurance, however, is not the easiest sell. Big insurers and HMOs have a well deserved bad reputation for heartless denials of care - that's how they make money. And, it's pricey. Premiums the past decade have gone up 87 percent, not to mention the ever climbing bills for deductibles, co-pays, and a host of other transaction fees.
The finance industry is over the moon with this scheme.
For insurers, it means millions of new customers marched into their offices with the force of law. With no controls on costs, many consumers will just add on more debt. That's a boon for the credit card companies and other financial institutions, but a heavy new burden on many of the same people now losing their homes or struggling with other financial hardship.
Moreover, it doesn't work. The carrot is public subsidies for those least able to pay, but that approach has noticeable flaws, best evidenced in Massachusetts, the individual mandate pioneer and model.
As a result of the state's failure to control premium hikes, costs of the subsidized program are projected to double over the next three years to $1.35 billion, the Boston Globe reported February 6, and Massachusetts is debating whether to slash the health services offered through the subsidized plans or cut payments to doctors and hospitals.
To shroud the colossal problems and the real story of who actually makes out like bandits under this scheme, the proponents, including some liberal policy experts, have dressed it up with poll-tested rhetoric that mandatory insurance is "universal health care."
But "having" insurance is not the same as being able to use it. You're only being mandated to purchase the premiums; they're not mandating the insurance companies to make sure you get the care you need. Nor does "having" insurance protect you from financial ruin.
It accelerates the dismantling of group insurance plans with individuals forced to go it alone in the individual market, and institutionalizes risk and cost shifting on to the backs of individuals and families.
It distorts the role of government, which should be to protect people, not act as an insurance agent.
Finally, by expanding and entrenching the iron grip of the private insurance industry, it promotes the further privatization of health care, yet another crucial linchpin of the neo-liberal agenda.
Our health should not be a commodity, traded on the market like pork bellies or sold off to some hedge fund overseas to collect on medical bills we can not pay.
There's only one way to achieve genuine universal health care, the approach taken by every other industrialized country with a national health care or single payer system.
In the U.S. that would look a lot like an expanded and improved Medicare for all. With guaranteed health care, not mandated insurance profits, and insurance companies out of the way. Surely, Americans deserve no less.
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There are far too many mandate-driven programs out there already which merely serve to drive profit into the hands of those who prove, time and time again, that they deserve to earn none.
Tell you what: if you can get a $3 trillion budget for "a war," give $3 trillion more divided each and every American. What will you do with your $9,375.00? And the $9,375.00 that your spouse got, and the $9,375.00 also received by each and every one of your children?
Since that's an annual appropriation, let's just do that every single year from now on. If you get $3 trillion for bombers, we get $3 trillion for our bake-sales, or our schools, or what the heck, just to blow. Just like Washington does. The money that supports their "let them eat cake" lifestyle is coming from ... well, we do know where ... so, let's all get in on the gravy-train.
And if you recoil and think, "that's fiscally irresponsible!" ... well, isn't it fiscally-irresponsible already?
I think that anything less than a single payer health care plan is a waste of time and not worth the effort. If any of these lesser plans is passed it will just put off what really needs to be done. Sure cost may go down but they will rise again later and next time it will be harder to get anything done. This whole health care reform discussion can be summed up in one simple statement -
"The fight for the right to buy insurance".
No thanks, I've already got it, that's my biggest health care problem.
I think 'healthcare' is a racket. What if you're broke? Will they just kick you out of the Bambalance 'cause you can't pay? Where would they dump the body? They'd just have to go get it later...it's a racket. Healthcare is government-subsidized, and if they REALLY wanna provide health services to the public, send the auditors deep into the bowels of the hospitals, and come out with the books, and find out what REALLY goes on. If they can siphon a billion through the Church, what goes on at a hospital?
What, indeed...60 Minutes! Post!
It IS a racket, it's the number one growth area in jobs I think...why?
Because health costs KEEP SKYROCKETING that's why.
My insurance went up to $450.00!
I'm mad as hell but I can't do anything!
Can we just start a paralell but more efficient medical system? My sister works at the hospital, and she knows that the drugs prescribed are marked up hundreds of percent...which works when you get the bill after the fact whether the treatment was successful or not and after you haven't consented except with forms that are necessary to getting treated. Do you walk into a store to buy something and just say, "bill me later, no matter the markup?" No, it's unacceptable...we want value for our money, and a $50 copay for a five minute visit that accomplishes nothing is not good value. Alternative practitioners offer a much better value because they aren't being paid kickbacks for every prescription--it's just about wellness. And the insurance companies are like siblings to the pharma companies, working together to cover the symptoms but never actually curing anything while denying as many claims as possible. So if universal healthcare doesn't cover preventative and alternative care it won't work. As long as we let the established medical community and the insurers set the price and the availability, we will be screwed.
No, no, keep it up, I LIKE the idea of paying 19k per aspirin so some HMO stockholder can finance a personal war or whatever the hell goes on, there...spinner rims aren't cheap, you know...
Those channels dedicated to economics are scaring the holy living crap outta me!!! They are saying the reason for the economy "slow down" "wall street upset" is because WE failed to spend enough on our credit cards in Nov-Dec. What are they thinking? Two months of less spending has more to do with cost of living/gas/food/health care and losing the damn house than and damn credit cards not spending for two months. I am not very smart about the money and stocks but even I recognize it for the BS it is. I also do not see how printing more paper money which isn't backed up by anything but ink on the other side and sending me six hundred dollars will stimulate anything as I am like everyone else, I have to use it for bills and living expenses. I won't be able to afford to go on any spree and buy anything. Is 600-1200 plus a kid 300 bucks going to save a house? A car? The electric or gas being turned off? Food for a couple weeks? Maybe a doctor appointment I was skipping because the meds and co pay were out of hte budget? Reality says recession and it will hurt those of us who used to be middle class down to the poorist of the poor. 600 won't save me or you.
What can we expect from leaders who put through an economic breakthrough by giving me a tax "rebate" this summer only to take it back when I file next year, the fact that the democratic majority has yet to even try to push through a meaningful patients rights bill since they took congress shows what they will do in the future, and there is the 4th type of person to add to an earlier post, the one that has an HMO and a chronically ill child to bring through this mess. Like this denial of payment (read to me face to face by a rep): Although a final approval for the procedures was issued, the denial issued previous to that approval will take precedent since it was issued first. Same old stories (got alot more)but till you live it you can't imagine what is really happening, once Edwards backed out I gave up "hope".
Corporationists
Privatize and Profit
Scold the indentured slave for their reckless behavior and still them with your gambling debts- been working for nearly a Century.
time to pull the curtain back on these Wizards.
End the use and arrangements with the Private bankers hiding behind the facade of the agency euphamistically refered to as the "Federal Reserve". Demand an end to the illegal Personal income tax -labor is traded for wages - no profit their, end the IRS fraud.
Deamd health care is provided by the gov't or by NON PROFIT ORGANIZATION
Demand the Rights and Freedom outlined in our constitution are returned to US (WE THE PEOPLE) and never given to any brick and motar again
Time to kick the corp crap off our nations boots.....Start levying charges of Racketteerig , profiteering, spying, War Crimes ,Treason, Crimes against man and nature- You want to see a new list of priorities and business practices and philosophies coming from these Corp Fucks!
Hope you enjoyed your 'golden parachutes' they are going to cost you your freedom or your life.
"Take a closer look, starting with the millions of Americans staring at the loss of their homes due to the sub-prime loan debacle. It's not a loan or a mortgage crisis for those families; it's a debt crisis being forced upon them by the banks, hedge funds, and insurers who are desperate to shift their own mammoth debt onto someone else.
"
Really? I thought the only reason people can loose their home is because THEY DO NOT PAY THEIR BILLS. I yet to see a single banker, trader or loan officer take a gun and force anyone to take a loan. Where banks and some of the investor stupid in giving loans to the people who did not deserve them - yes. And banks so far have lost 90bln on that. But that does not mean that the homeowners got hurt because of that. On the contrary - it is homeowners who took banks for the ride by getting the loans they knew they can not repay. Good for them - if banks are that stupid why not take their money. But to cry that they were duped by the bank - please....
Yet we regularly bail out the banks? Kinda puts a new light on it.
excellent article. Bravo!!!!
There seems to be three kinds of Americans with regard to health insurance:
1. Those who have it, and can afford it's premiums without those costs causing sacrifices elsewhere in their budgets, and are happy with the level of health care (medical attention and services) coverage they receive (because if they were not happy, then they would make a change of some kind, right?)
2. Those who have it, but find it's cost to be excessive, and causes them to make sacrifices elsewhere in their budgets (or elect less comprehensive coverage than is satisfactory to their needs), and perhaps they find those high costs more urgently needed to make a mortgage payment (or in many cases, the high costs of health insurance premiums being one reason why they can't afford to even try and buy a home).
3. Those who don't have it.
And those who don't have health insurance, don't have it because they can't afford it; which places them in a position that the #2 type I listed above is trying to keep away from: #2 struggling with the exhorbitant costs of health insurance premiums, and maybe joining the ranks of #3 soon (or maybe failing to make a mortgage payment instead).
Types #2 and #3 obviously have a problem: The exhorbitant cost of health insurance premiums is causing them sacrifices in their life (maybe preventing home ownership), and in the extreme case of #3, causing them to go without health insurance.
QUESTION: How does legally mandating that #2 and #3 buy health insurance (which is a mandate to #2 that they not drop the coverage they have, and not join the ranks of #3)...
How does that help them in any way?
Truly, I'm at a loss to see how mandating buying coverage helps #2 or #3 in any way whatsoever.
Doesn't this "mandate" scheme simply CRIMINALIZE those who can't afford health insurance...
And threaten those who find it's cost so exhoritant that they may choose to go without it, threaten them with CRIMINALIZATION?
Very nice comment. I would ask another question - should #1 sacrifice the quaility of their insurance so #3 will have theirs?
I think the solution could be similar system to Russian (yes it is scary to think we borrow the idea on medical care from them, but if it works, why not)
Everyone in the country has a goverment profided medical care. It provides all coverage. However, the level of quality is very low. It is common for hospitals to use 30 years old equipment and the cheapest possible procedures ( even when they are not the best). No "quality of life" procedures are done. If you want a crown or a filling - you will get a metal one. If you need hip replacement - forget it. If you need antibiotic - take one of 6 available and good luck. No maplpractice complains allowed.
The service is bad enought that most of the private companies provide/offer a private insurances which provide services similar to US level.
By having this dual service level approach we will be able to extend health care (at the basic)level) to everyone, yet keep excelence in our healthcare for people who can afford it.
I don't know about health insurance in Russia, but if what you're describing is:
A system where People can avail themselves of a Government-provided and sponsored service (a service essential to People's lives), and in making that choice, they then deal with whatever attending inconveniences there are, that inevitably come with a Government program...
Or if they like (and can afford), they can elect to purchase this service from the private sector, and spare themselves whatever inconveniences are attending the Government-provided service...
Sort of like education in America, where People can elect to make use of a Government service, and send their child to Public schools (and accept all that goes with that choice)...
Or if they like (and can afford), they can elect to purchase this service from the private sector, and send their children to private (and perhaps better) schools...
If that's what's meant by "dual service", then sure, it sounds like a great thing.
I'd think it was a good idea that we require the Government to provide People with health insurance, like we require it to provide our children with an education...
I'd think health care was even more essential to People's lives, than education is.
How about the Scandinavian system: The BEST health care in the world, covers EVERYBODY including foreign visitors, and has at most a 20$office visit copay.
Or are the Scandinavians better people they we Americans?
When you include the US cost of health insurance, the Scandinavian taxes are about the SAME! But their system works for the people. Not the pigs with their quintuple bypass extravaganzas.
Rose Ann DeMoro is right. Both Clinton's and Obama's health care reforms are useless. That's because private insurers are left in play to broker the illusion of universal health care. Their plans are NOT universal. And as long as private insurers have a role, there will never be controls on costs. The elephant in the room -- rigged costs posing as what's coughed up in the vaunted free market -- is what caused this problem. When it comes to health care, republicans can take their free market and shove it. It doesn't work when profits from medical fate come first.
The only way this works is to eliminate healthcare for profit. Not only insurers, but hospitals and drugmakers as well.
let eleminate doctors as well...
Look at the most best health care system in the world: the Scandinavian system. The drugs companies are still for profit, and they have some of the best, but health care is free for all, with only token 20$ copays for office visits.
I believe the single payer plan would actually be cheaper to implement and run than the insurance plans.
Why do we need healthcare insurance people providing our healthcare? They are in the insurance money making business, not the healthcare business.
Until these leeches are removed from our healthcare system, it will remain broken.
Why did we need to pay the CEO of United Health Care $800 million when he retired?
Why do we have to fill out the same forms everytime we go to a new doctor or change insurance (meaning someone has to enter the same information into a different database)?
Why do we have to support the ad campaigns for Kaiser, UHC, Aetna, Met Life, etc, etc? It does not make the insurance any better.
Why are we the ONLY country in the world that pays retail for drugs? Everyone else pays wholesale?
BECAUSE WE ARE AMERICANS, AND THAT IS WHAT AMERICANS DO. (we are suckers for the med industry)
The USA pays twice per person what the other first world countries pay for health care that is 37th in the world!
That is a wrong statement as it includes people who are not insured. Compare people with insurance and you will see that we are #1
Rose Ann, I have heard you make this argument many, many times before. I certainly agree that single payer health care is the best system and frankly among the reasons for having gov't and taxes. What I would like to see from you and your policy people is the 'how to get from here to there'. I think you would have to agree that it would (will0 be monumental chaos to change from a system of Insurance company payments to single-papyer (pov't Medicare style) payments.
This maybe the scariest aspect that prevents people from getting on board. The great unknowns. For instance, what happens to all the employees of these insurance companies if they are no longer needed to: market the programs, process the claims, deny the coverage, answer the phone calls, authorize the treatments, etc. I'm not try to be facetious here, I'm sure these employees and their family's have great concerns for their futures if a change of this magnitude should happen.
I think that your organization is capable of creating a paradigm 9a game plan really) for such change. A step-by step process of how such a transition could occur that could put the minds of most Health Care consumers to rest so that they would no longer fear the idea of Single Payer Care but would embrace it.
Can you do something like this. This is really the missing link in this debate.
How to get from here to there? Well - if you are a Democrat you could support the candidacy of Kucinich or Edwards. Oh wait
As you mention in your post, we already have a model for a single-payer, guaranteed health care system " Medicare. Most doctors and hospitals are already familiar with Medicare, as are the more than 44 million Medicare beneficiaries. Transitioning to a Medicare-for-all system would require some benefit changes and new financing provisions, but would be far less chaotic than our current morass of insurers, each with different billing requirements, and the hodgepodge of public programs. It would also be far less complicated than the plans that Clinton and Obama put forward. Clinton"s plan would require some method to extract payment from any "outlaws" that couldn"t afford health insurance " things like garnishing wages and liens against homes. Both Clinton"s and Obama"s plans require monitoring employer compliance and collecting money from employers who don"t provide insurance, new laws and regulations that attempt to control an incorrigible insurance industry, administering purchasing pools with a variety of different private insurance plans, and patching up the safety net -- just to name a few of the most obvious things.
As for the employees who used to work for insurance companies, HR 676, the universal health CARE bill from Representatives Conyers and Kucinich (as opposed to Hillary"s sketch of a universal health INSURANCE plan) gives first priority in retraining and job placement to out-of-work health insurance employees. The bill also provides 2 years of unemployment benefits.
Just what Obama said: I'm for single payer, but it's just to hard to do.
Of course Hillary says: All you uninsured free loaders, get insured: It's the LAW!
And the rethugs say: got money?
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Posted February 8, 2008 | 11:43 AM (EST)