A Huge Bailout for Another Failing Industry ObamaCare as Corporatists United by CLARK NEWHALL, MD
In an eagerly anticipated opinion on the Patient Protection and Affordable Care Act, colloquially known as “Obamacare’, an unusual alignment of justices upheld the Act nearly entirely. The crucial part of the decision found the ‘odd bedfellows’ combination of Chief Justice Roberts joining the four ‘liberal’ justices to uphold the ‘individual mandate’, the section of the law requiring all Americans to buy health insurance from private health insurance companies. The alignment is especially strange given the lengths to which Justice Roberts had to go to support his convoluted reasoning. He accepted the argument that the individual mandate was unconstitutional as an exercise of the Commerce Clause becuase it required a commercial activity that had never hitherto existed, i.e. the purchase of health insurance by someone who had never purchased it. He accepted the argument that the individual mandate was unconstitutional as an exercise of the “Necessary and Reasonable” Clause. And he rejected the argument that the payment of a penalty to the IRS by those who refused to comply with the individual mandate (“refuseniks”) was a “tax” subject to a law that says you first have to pay the tax before you can sue for a refund. But then he turned about and found that the money that the IRS can take from a refusenik WAS a tax and NOT a penalty. Under that reasoning, the ‘individual mandate’ requiring everyone to buy health insurance from a private company becomes a ‘tax law’ and therefore constitutional. With this bizarre twisting of words, the Supreme Court has revealed the nature of 21st century American political thought. Those who make, interpret and enforce the laws no longer lie on the ‘left-right’ political continuum. Instead, they are in effect at ‘right angles’ to that continuum. The ideology that drives the Supreme Court, the political administration and the Congress is not Conservative or Liberal but can best be described as “Corporatist.” This is the ideology that affirms that “corporations are citizens, my friends.” it is the ideology that drove the Roberts Court to the odious Citizens United decision. it is the ideology behind a bailout for banks that are ‘too big to fail.’ And it is the ideology that allows Congress to pass a law like the ACA that is essentially written by a favored industry. The Corporatist ideology allows the Supreme Court to uphold the ACA despite the obvious and glaring consequence: forcing someone to buy health insurance is like forcing someone to buy a used Rambler — it’s a shoddy product at an inflated price, but you must pay a tax or swallow your anger and buy it from the smirking dealer down the street. Why does Corporatism favor Obamacare? Because Obamacare is nothing more than a huge bailout for another failing industry — the health insurance industry. No health insurer could continue to raise premiums at the rate of two to three times inflation, as they have done for at least a decade. No health insurer could continue to pay 200 million dollar plus bonuses to top executives, as they have done repeatedly. No health insurer could continue to restrict Americans’ access to decent health care, in effect creating slow and silent ‘death panels.’ No health insurer could do those things and survive. But with the Obamacare act now firmly in place, health insurers will see a HUGE multibillion dollar windfall in the form of 40 million or more new health insurance customers whose premiums are paid largely by government subsidies. That is the explanation for the numerous expansions and mergers you have seen in the health care industry in the past couple of years. You will see more of the same, and if you are a stock bettor, you would do well to buy stock in smaller health insurers, because they will be snapped up in a wave of consolidation that dwarfs anything yet seen in this country. As I write this, I note that health industry stocks have taken a big jump on Wall Street. What a surprise! Dr. Clark Newhall MD JD is Executive director of Health Justice. Please reply to cnewhall at cnewhall.com<http://greenhouse.economics.utah.edu/mailman/listinfo/marxism> ----------------- FDL Fact Sheet: The Truth About the Health Care Bill<http://firedoglake.com/fdl-fact-sheet-the-truth-about-the-health-care-bill/> The FDL health care team has been covering the health care debate in congress since it began in 2009. They have put together a fact sheet to help readers sort through the myths and facts of the health care bill: *Myth* Trut*h* *1. This is a universal health care bill.* * * *The bill is neither universal health care nor universal health insurance. * Per the CBO: - Total uninsured in 2019 with no bill: 54 million - Total uninsured in 2019 with Senate bill: 24 million (44%) *2.* *Insurance companies hate this bill * * * *This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009. * The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%. *3. The bill will significantly bring down insurance premiums for most Americans.* * * *The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised*. Annual premiums in 2016, status quo / with bill: Small group market, single: $7,800 / $7,800 Small group market, family: $19,3oo / $19,200 Large Group market, single: $7,400 / $7,300 Large group market, family: $21,100 / $21,300 Individual market, single: $5,500 / $5,800* Individual market, family: $13,100 / $15,200* *4. The bill will make health care affordable for middle class Americans. ***** *The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use.* A family of four making $66,370 will be forced to pay $8,628 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income — out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible. *5. This plan is similar to the Massachusetts plan, which makes health care affordable.** * *Many Massachusetts residents forgo health care because they can’t afford it.* A 2009 study by the state of Massachusetts found that: - 21% of residents forgo medical treatment because they can’t afford it, including 12% of children - 18% have health insurance but can’t afford to use it *6. This bill provide health care to 31 million people who are currently uninsured.* * * *This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies.* *7. You can keep the insurance you have if you like it.** *** *The excise tax will result in employers switching to plans with higher co-pays and fewer covered services.* Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now. *8. The “excise tax” will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages. * ** *There is insufficient evidence that employers pass savings from reduced benefits on to employees.* * * *9. This bill employs nearly every cost control idea available to bring down costs.* * * *This bill does not bring down costs and leaves out nearly every key cost control measure, including: * - Public Option ($25-$110 billion) - Medicare buy-in - Drug reimportation ($19 billion) - Medicare drug price negotiation ($300 billion) - Shorter pathway to generic biologics ($71 billion) *10. The bill will require big companies like WalMart to provide insurance for their employees* ** *The bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage.* *11. The bill “bends the cost curve” on health care.* * * *The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by * *$234 million in 2019*. “Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries. In 2009, health care costs were 17.3% of GDP. **Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP) Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP) *12. The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition.** * *Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012* Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012. *13. The bill prohibits dropping ****people **in individual plans **from coverage when they get sick*. *The bill does not empower a regulatory body to keep people from being dropped when they’re sick.* There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check. *14. The bill ensures consumers have access to an **effective internal and external appeals process to challenge new insurance plan decisions.** *** *The “internal appeals process” is in the hands of the insurance companies themselves, and the “external” one is up to each state. *Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal level. *15. This bill will stop insurance companies from hiking rates 30%-40% per year. * * * *This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country.* *16. When the bill passes, people will begin receiving benefits under this bill immediately* * * *Most provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014.** * Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months*,* and community health centers will start receiving* * money.* * *17. The bill creates a pathway for single payer. * * * *Bernie Sanders’ provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn’t create a pathway for single payer.* * ***Obama told Dennis Kucinich that the Ohio Representative’s amendment is similar to Bernie Sanders’ provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system. *18 The bill will end medical bankruptcy and provide all Americans with peace of mind.* * * *Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class. * - In 2009, 1.5 million Americans declared bankruptcy - Of those, 62% were medically related - Three-quarters of those had health insurance - The Obama bill leaves 24 million without insurance - The maximum yearly out-of-pocket limit for a family will be $11,900<http://stabenow.senate.gov/healthcare/Patient_protection_section.pdf>(PDF) on top of premiums - A family with serious medical problems that last for a few years could easily be financially crushed by medical costs* * *Cost of premiums goes up somewhat due to subsidies and mandates of better coverage. CBO assumes that cost of individual policies goes down 7-10%, and that people will buy more generous policies. *Documentation:* 1. March 11, Letter from Doug Elmendorf to Harry Reid (PDF<http://cbo.gov/ftpdocs/113xx/doc11307/Reid_Letter_HR3590.pdf> ) 2. The AHIP Plan in Context<http://wonkroom.thinkprogress.org/2008/12/03/ahip-context/>, Igor Volsky; The Max Baucus WellPoint/Liz Fowler Plan<http://emptywheel.firedoglake.com/2009/09/08/liz-fowlers-plan/>, Marcy Wheeler 3. CBO Score<http://www.cbo.gov/ftpdocs/107xx/doc10781/11-30-Premiums.pdf>, 11-30-2009 4. “Affordable” Health Care<http://emptywheel.firedoglake.com/2009/12/27/affordable-health-care/>, Marcy Wheeler 5. Gruber Doesn’t Reveal That 21% of Massachusetts Residents Can’t Afford Health Care<http://emptywheel.firedoglake.com/2010/01/08/gruber-doesnt-reveal-that-21-of-ma-residents-cant-afford-health-care>, Marcy Wheeler; Massachusetts Survey (PDF<http://www.mass.gov/Eeohhs2/docs/dhcfp/r/survey/08his_access.ppt> ) 6. Health Care on the Road to Neo-Feudalism<http://emptywheel.firedoglake.com/2009/12/15/health-care-on-the-road-to-neo-feudalism/>, Marcy Wheeler 7. CMS: Excise Tax on Insurance Will Make Your Insurane Coverage Worse and Cause Almost No Reduction in NHE<http://fdlaction.firedoglake.com/2009/12/11/cms-excise-tax-on-insurance-will-make-your-insurance-coverage-worse-and-cause-almost-no-reduction-in-nhe>, Jon Walker 8. Employer Health Costs Do Not Drive Wage Trends<http://seminal.firedoglake.com/diary/23487>, Lawrence Mishel 9. CBO Estimates Show Public Plan With Higher Savings Rate<http://www.nationaljournal.com/congressdaily/cda_20090925_6347.php>, Congress Daily; Drug Importation Amendment Likely This Week<http://www.politico.com/livepulse/1209/Drug_importation_amendment_likely_this_week_.html?showall>, Politico; Medicare Part D IAF<http://www.missouriprovote.org/Docs/MedicarePartD_IAF.pdf>; A Monopoloy on Biologics Will Drain Health Care Resources<http://www.thelancetstudent.com/2009/12/23/a-monopoly-on-biologics-will-drain-health-care-resources/>, Lancet Student 10. MaxTax Is a Plan to Use Our Taxes to Reward Wal-Mart for Keeping Its Workers in Poverty<http://emptywheel.firedoglake.com/2009/09/11/maxtax-is-a-plan-to-use-our-taxes-to-reward-wal-mart-for-keeping-its-workers-in-poverty/>, Marcy Wheeler 11. Estimated Financial Effects of the “Patient Protection and Affordable Care Act of 2009,” as Proposed by the Senate Majority Leader on November 18, 2009, CMS (PDF<http://www.politico.com/static/PPM110_091211_financial_impact.html> ) 12. ibid 13. ibid 14. ibid 15. Health insurance companies hang onto their antitrust exemption, Protect Consumer Justice.org<http://www.protectconsumerjustice.org/federal-antitrust-exemption-for-health-insurers-remains-under-senate-bill.html> 16. What passage of health care reform would mean for the average American<http://fdlaction.firedoglake.com/2010/03/08/how-to-get-a-state-single-payer-opt-out-as-part-of-reconciliation/>, DC Examiner 17. How to get a State Single Payer Opt-Out as Part of Reconciliation<http://fdlaction.firedoglake.com/2010/03/08/how-to-get-a-state-single-payer-opt-out-as-part-of-reconciliation/>, Jon Walker 18. Medical bills prompt more than 60 percent of U.S. bankruptcies<http://www.cnn.com/2009/HEALTH/06/05/bankruptcy.medical.bills/>, CNN.com; The Patient Protection and Affordable Care Act Section‐by‐Section Analysis (PDF<http://stabenow.senate.gov/healthcare/Patient_protection_section.pdf> ) [Non-text portions of this message have been removed] ------------------------------------ --------------------------------------------------------------------------- LAAMN: Los Angeles Alternative Media Network --------------------------------------------------------------------------- Unsubscribe: <mailto:[email protected]> --------------------------------------------------------------------------- Subscribe: <mailto:[email protected]> --------------------------------------------------------------------------- Digest: <mailto:[email protected]> --------------------------------------------------------------------------- Help: <mailto:[email protected]?subject=laamn> --------------------------------------------------------------------------- Post: <mailto:[email protected]> --------------------------------------------------------------------------- Archive1: <http://www.egroups.com/messages/laamn> --------------------------------------------------------------------------- Archive2: <http://www.mail-archive.com/[email protected]> --------------------------------------------------------------------------- Yahoo! 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