Re: [UC] Deductibles...Best coverage... more...

[Glenn moyer]

Thanks Rick.  I value discussing these extremely important issues with you.

Rather than allow pessimism or optimism, I know that you and I can talk about real policies and verifiable facts.  As I mentioned once before to you, our peace and well being comes from our meditation and the strengths of our connections to all creatures and the universe.  Ignoring reality and the positive thinking, we are brainwashed to believe in, leads to a false sense of optimism sometimes called delusion.  None of us needs that, despite the intense marketing.  They tell us to do the good addictions and stay distracted, and we will be happy happy until reality stands outside our door!

High deductibles.  I will tell you that for the individual and for the goals of public health; the absolutely most important health care dollars spent per year are the first $5000! I can't stress that enough!

It's an appropriate time to discuss this part of "out of pocket expenses" since today's news reveals that median incomes for Americans is 27,000 per year.  Let me emphasize, half of all Americans make 27,000 a year or much less.

Over the past few years, millions of new people, including me, have been forced into high deductible insurance.  Built into the ACA, as well as known industry/Wall St. goals, is to force all Americans into high deductible plans.  So what are the implications...?  Why is this an extremely important issue, that the media, the astroturf groups, and the democrats have completely avoided...?

Having come from the economic class that I refer to as the "throwaway class," I can assure you that middle class values and myths dismiss the constant struggle faced by the lower classes to, rob Peter to pay Paul.  Among the vast majority of the lower third, 100 million Americans, there is a daily struggle and set of choices around sacrificing some things because there is not enough money to make ends meet.  

The reason that the barriers of $5000 deductibles for an individual, and $12,000 for a family, is a taboo area for open discussion, is because these are immense barriers to care for the vast majority of people, who are supposedly being helped with the new access to partial health insurance!   What is important for people to consider is that the vast majority of the working poor, who will be receiving subsidized insurance, will not pass the massive barrier to accessing health care, until and unless, they have a catastrophe.  Because of these deductibles, preventable deaths will not be reduced, the emergency room crisis will not be reduced, the stress on safety net providers will not be reduced (even though they are going to receive massive funding cuts), and the daily suffering of some of the 100 million not getting care will continue unabated.  

And since millions and millions of people in the 2nd, 100 million Americans, have been forced into high deductible plans too, they have already begun skipping "out of pocket care" and increase many of those problems.

It has been an industry lie to claim that overall healthcare costs have gone up because the working poor are always running to the doctor.  In fact an important statistic came out about a year ago. Primary care visits have gone way down in the past couple of years, about 75%  of the previous rate! 

 Rick, this directly coincides with the movement of 10s of millions of people to high deductible plans in the midst of an economic collapse among the 99%.  This is not welfare queens getting boob jobs every other day.  This drop in tx visits are people from the lower income groups skipping the first $5000 of medical care; the screenings, early detection, or monitoring that is the most important part of routine care.  (The talking points keep stressing that some preventive care can no longer be uncovered, but they don't stress that deductibles apply.)  (Consider: If the movement of millions of middle class people to high deductible plans can measure them skipping care, what is the impact upon those making much less, who already can't make daily normal requirements?)  

I honestly believe when people consider these issues they can see the reality.  The high deductible plans being sealed with the new ACA will not change the extreme barriers for the vast majority of working poor!  Of course, some of the upper levels of working poor may gain some temporary advantages by accessing Obamacare, but a very small minority.  Like I said, if one evaluates access to care separately from access to partially subsidized insurance, people will understand why high deductibles are the very important issue, not the catastrophe insurance that comes into play when a major illness or accident occurs.    

We need to understand Obamacare as a type of partial catastrophe insurance, while we face the fact that millions more are quietly being moved into the health insecurity of high deductible policies, in which the most important medical access is "out of pocket." 

(It has been unfair to lump single payer activists in with the "let them die" republicans.  We aren't saying that it would not be a laudable goal to help many of the working poor even if the entire system isn't made reasonable.  What we are saying is that this "reform" is simply not going to deliver the help to these people, as we are being told.  We can ignore the idiocy and ultimate goals of the right wingers screaming about charity and welfare. And as we ask others to look at the real facts and policies, that nonsense should not interfere with real discussions and analysis.  That's what the cesspool called corporate cable news is there to do!)

Secondly, and I'll be brief, is the impossibility of reform in complex legislation written by Wall St.  Economists have noted the same reality with the financial industry.  It's just impossible to regulate these complexities, and the complex regulations are always pre-designed with a strategy to eventually gut their benefit or impact.  Whether the politicians will be directed to de-fund enforcement or if methods to circumvent a consumer protection are buried in the complexity or secret interpretation, it has been the same for corporate written legislation for decades.

This includes the prohibition on pre-existing conditions.  We don't know how, until it happens, but I suspect that the yearly cancellations and forced product choices will help them transfer the new severely ill to the government quickly.  Maybe it will be the priority of bill payments;  If deductibles and the insured's portion of hospital bills are not paid promptly, can the insurance company refuse further payments or drop the person?  I'm sure that some form of that is part of the ultimate scheme, even if it takes a couple of years. 

Instead of "curbing the worst abuses of the industry" as we've been told, we have some shifting and hiding of abuses, and we will not stop the inherent goal of the industry.  The goal of the industry is profit and abuse, not the public good or the well being of customers or society.  Just like the banks, we are taking a for profit system that is fundamentally flawed and trying to put a band aid on it.  Eventually, the same wound becomes open again for all to see.  If we hope that these corporate goals will be different this time and the outcomes will be different than other complex industry contracts, I believe we are engaging delusional or wishful thinking.

Thanks for the important discussion,

Glenn

PS:  Again, I wish I were wrong about all of this.  Unfortunately, I'm not.  

 

 

-----Original Message-----
From: "Richard D. Conrad"
Sent: Nov 4, 2013 5:21 PM
To: Glenn moyer
Cc: "William H. Magill" , "Mr. Craig Melidosian" , "univcity@list.purple.com"
Subject: Re: [UC] Best coverage... more...

Your thinking is honest, noble, basically fair, and extremely cogent Glenn - but I think spun in a pessimistic way - which while not fully unjustifiable, could be ignoring the ONLY known current way to get millions of people at least SOME better help - which I believe has most strongly influenced Pres. Obama and his supporters, including myself.  

On Nov 4, 2013, at 3:02 PM, Glenn moyer <glen...@earthlink.net> wrote:

Rick,

Ask yourself, who would the American people have supported if the well-intentioned democrats had allowed and championed a real health care policy debate? The people gave them a landslide victory and control of the house, senate, and executive branches.  The idiocy of the Sarah Palins would have been laughed at in the midst of an honest debate treating the majority of Americans like mature adults. 

 Real health care experts will always win against advocates of a profit based system, whenever a real and honest data driven policy debate takes place.  The evidence is not even close.  The blue dogs would have put their tails between their legs, but of course, that is not what happened.

That is why I point to the very "health care reform committee" that the well-intentioned democrats controlled and steadfastly defended.  They controlled the debate and they would not allow real health reform experts a seat at the table nor a forum to advocate for universal healthcare. That is crucially important.  It simply has nothing to do with Republicans, because the democrats completely controlled that corporate committee that unveiled Romneycare as Obamacare. .

 It's exactly the same unacceptable anti-democratic coup that we saw piloted here a decade ago, when UCD and the civic associations announced a hand picked steering committee to redesign Clark Park.  They lied about inviting all the stakeholders to the table, and offered a list of all the local corporations and universities as the entirety of "the community."  And when confronted about the closed, exclusive, secretive, corporate committee, they did not make amends and open the committee or allow transparency.  Instead they used ad hominem attacks against dissenters, just like Rahm Emanual called health reformers, "fucking retards."  The fake committee already had a pre-conceived plot and could not allow an honest public debate.  It's identical.

The well-intentioned democrats would never have needed to do anything except allow a real health reform policy debate to go in front of the American people.  The people were expecting the democrats to champion health reform. They gave the democrats the power and backing to do so, but the democrats would not even allow the debate when they had the power. When any entity uses deception to hide an antidemocratic exclusive process, and then refuses to open the process when caught, they actually lose their credibility at that point.  Expecting "good" results from such an unfair process is referred to in addiction literature as "wishful thinking."    

These fundamental concepts and processes of democracy aren't window dressing. They are absolutely required to allow for open and honest debate.  (By the way, I read a report about a year ago, documenting how many of the power brokers around the Bacchus committee had been rewarded with lucrative jobs in the health care industrial complex.)

If we support unfair processes and deceptions, we turn our backs on principles and descend into a culture no different than a street gang.  Loyalty to the leadership rather than to principles is the difference between gang processes and acceptable democratic processes. All we need do is watch the idiocy of Fox News and MSNBC to see gangland posturing!      

Please don't get me wrong, I and other single payer activists, really want Obamacare to live up to the promises of the democrats and benefit the American people!!! I sincerely hope you are right to support this plan of the Republican think tanks.  But when I go over the data in front of me, with all sincerity, I am quite certain it will not.

Sincerely,

Glenn  

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