You scratch my back, I'll scratch yours

Did you ever own a fully restored classic car?  No?  Me either....they were always waaay above my pay grade.  But I have known people who did, and they all told me their restoration was a gradual, evolutionary process that took years before their cars were trophy winners.

First they disassembled everything to see what needed to be done.  Then they rebuilt the engine and transmission while the body was being repaired and repainted.  Finally everything was put back together, with new re-chromed wheels and appropriately sized tires.  With a new convertible top and upholstery, it was ready to meet the show judges.

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Stay with me here....Now that a replacement for ObamaCare has fizzled it looks like we're stuck with the old ACA, and that's a problem.  By all accounts it's failing fast.  There are too few insurance companies to choose from in many areas, premiums are rising, and deductibles are so high many people can't afford to actually use the insurance they're paying for.  So instead of just walking away from it and watching it wither, and killing people (literally) in the process, why don't reasonable people work together to FIX IT?

Just like with a classic car, first you see what needs to be fixed.  Then piece-by-piece you clean it up and keep what you can, buy new, better parts as needed, and finally reassemble it to become something that actually works.  It's an evolutionary process, not an overnight quick fix.

They say there isn't enough competition between insurance companies, so why not allow them to compete across state lines?  The GOP campaigned on that idea, and if it can bring down premiums, why would the Democrats object?  (They've always said insurance companies were their archenemies, right?  Here's their big chance to spank 'em!)  Except for the health insurance company CEO with a mega-bonus at stake, why would anyone object to companies competing for your business?  Am I missing something?

They say the pharmaceutical companies are screwing us blind, which is another reason insurance costs are so high.  The Democrats on the Left and now the Tea Party on the Right have always wanted to come down hard on them, so why can't they bury the hatchet long enough to give Big Pharma an ultimatum?  "Get your prices here in America in line with the international market, or we'll free up consumers to legally buy their prescriptions overseas.  No more official government cover."

Line-by-line, read the ACA, keep it if it's working, and change it if it isn't.  Have an ongoing amendment process that keeps constantly striving to improve it.  The old system (pre-ObamaCare) was slowing failing us, so it was just a matter of time before something new had to be tried.

They say if everyone walks away from a negotiation just a little miffed, it was probably a fair deal.  Forget the concept of "all or none".  It's time for some give and take.  Americans seem pretty fed up with the extremists after their sorry debacle last week, so this might be a good time for moderates to get something done.

We have us one helluva mess.  Something has to change. 

S

Wha...what? Flying pigs?...Icicles in Hell?...

Stubborn as hell and it never forgets.

Do you understand what's happening with this on again / off again healthcare bill about to come to a vote in Congress?  I think I have it figured out.  Here's my take:

The Red State congressional parasites have promised their constituents a Trillion Dollar tax cut, cause, you know, their folks need more $$$.  The first step to doing that is to trash ObamaCare.

The Blue State congressional parasites have promised their constituents more healthcare benefits with ideally even bigger subsidies.  They don't care what it costs because their constituents by-and-large won't be the ones paying for it.

Right now ALL House of Representatives Democrats (the Blues) will vote "no" because it cuts too deep, and many Republican Tea Party-types (the Reds) will vote "no" because it doesn't cut deeply enough.  Talk about strange bedfellows!  The bill is expected to fail.  But if by some miracle it passes, what then?

Then it's on to the Senate, where it's even less likely to pass, for the same reasons mentioned above.  The Republicans want their tax cut, dammit!  There are yachts that need buying!  They don't care who they have to whack to get it.  The Democrats just want their blank check.  Stalemate.

So what if the few moderate Democrats along with the few moderate Republicans sat down together and agreed to strengthen the good points of the ACA, aka ObamaCare, toss out the parts of the ACA that smell, and try to keep the expenses fairly neutral....no blank check for the Dems, and no 1% welfare check for the GOP?  The fringes of both parties could just go to their respective corners and throw their little tantrums.

And to get President Trump to sign it, they can call it "DonnieJohnCare".  He'll love it!  He'll think it's FANTASTIC, just TERRIFIC!  What do ya think?

S

Healthcare in America....where are we headed?

Yesterday a friend of mine, who is in the healthcare field, asked on her Facebook page what should be done regarding the "repeal / replace" controversy now raging.  She and her other healthcare professional friends agreed some form of coverage for everyone is absolutely necessary, while her more "conservative" friends said "no way". 

First, a personal disclaimer.  I'm covered by Medicare, which has worked great for me, and my wife, who is now once again a full-time college student, has a group plan offered through her university.  And after her college days, as a last resort, she is a disabled veteran and has VA care available to her.  In short, I have nothing personally to gain or lose in this debate.

The argument I heard from the conservative "Tea Party-types" was that they resented being told they MUST buy insurance, and would be perfectly happy if it would just go back like it was pre-ACA / Obamacare.  My strong suspicion is that they have secure (for now) jobs and enjoy employer-provided insurance, or are older and are covered by Medicare.  Both see ACA as just a giant wealth transfer from them, the relatively affluent, to the poor.  There's no upside to them if there is a replacement plan.  They would prefer repeal, period.

Those in the healthcare field almost universally say they see the desperation every day on the faces of people who can't afford insurance or the ER medical care they've been billed for and are absolutely begging for their charges to be forgiven by the hospitals and doctors.

My observation is this:  The Tea Party-types know in general terms that poor people can't afford healthcare for themselves or their families, but they don't actually know any of them.  They just can't relate.  I can.  During my 40+ year career in homebuilding I saw on a daily basis plumbers, electricians, painters, roofers, etc who I'm certain didn't have health insurance.  

They may work 40 hours one week, and just 30 the next.  If the economy tanks, they may have no work for weeks at a time.  They're always on the brink of desperation.  They work hard....they certainly aren't slackers. They don't get a yearly two-week paid vacation, or have a 401K, or health insurance.  That's just the nature of the construction industry.  Are we just gonna kick people like them to the curb?

In the old days you worked 40 years for your company and retired with a gold watch.  Today if you have seniority, which probably came with yearly pay raises for decades, you're now at the TOP of the pink-slip list.  You're good as gone, to be replaced by a 25-year-old with a MBA who will work for 40% less than you're making.  And if you're 58 and find yourself with more and more ailments, and you're suddenly unemployed, how are you going to afford health insurance?  Who wants to insure you?

I know plenty of people who are / have been in that very position.  A secure job today is no guarantee of a secure job tomorrow.  Remember that!

"Oh", the Tea Party-types say, "they won't be able to deny you because of a pre-existing condition."  Isn't this a classic example of having your cake and eating it too?  They abhor the ACA, yet want to cherry pick the parts they want to keep....without paying for it.   Sorry, but life doesn't work like that.  "You'll still get a [smaller] subsidy" they say.  Again, they're UNEMPLOYED!  They have no income!  A [smaller] subsidy is worthless to them....it's like being promised a BIG piece of NO pie.

I laugh incredulously when they say they'll expand Health Savings Accounts that people can use to pay for their health insurance and deductibles. They just don't get it!  Lower income people don't have the luxury of putting a few hundred dollars a month into a HSA.  They're living hand-to-mouth as it is.  It's like Marie Antoinette telling her hungry French subjects "Let them eat cake."

The Tea Party-types ask how fair is it for them to pay into an insurance scheme that benefits someone else?  So let me ask, why should residents in West Texas pay higher homeowner insurance rates to make up for their fellow-Texans who have suffered hurricane damage on the Gulf Coast?  Why should I pay for an interstate highway in Ohio when I've never even been to Ohio?  Why should I pay school taxes now that my youngest daughter is 35 years old?  Because it's for the public good, that's why. 

If we average the cost of healthcare across all age groups around the country, the young will indeed pay more now than they could have before the ACA, but they'll make it up later in life when they'll need healthcare and get a sweet price break.  That's how a "risk pool" (insurance) works, and there's nothing more free-market than insurance.  

Yes, I hear those who point out that insurance is optional, but not buying in means no benefits.  Are they going to be the gatekeeper at the hospital door that turns away the hysterical mother with no insurance cradling her deathly ill child?  And if the mandate stays that requires hospitals to care for anyone who walks in, whether they can pay or not, how much longer will it be before marginally funded hospitals start closing? 

I don't know how this will ultimately play out, but times have changed, and we must change, too.  We need to find a way to provide healthcare for all our citizens.  They can't give healthcare away, I understand, but anointing some to enjoy the American "good life" while condemning others to always being on the outside looking in is not what America should be about.  America should not have a caste system.

Not everyone can have an enviable IQ, be well educated, have a secure, high-paying job with benefits, and just skip merrily through life.  If they could, who would be left to change our oil, or build our houses, or maintain our sewer systems?  *any volunteers?* 

It won't be easy, and it won't be cheap, but we will be a stronger, more internationally competitive country if we're healthy and working smart.  We MUST find a way to care for our own. 

S

I'm tired of being the bug. I wanna be the windshield!

A modern day "Tale of Two Cities"....the number of "health insurance co-ops" set up to enroll people in the ACA program, aka Obamacare, is declining by two more due to financial underperformance, leaving only 15 of the original 23 still in business.  Meanwhile four of the giant health insurers are merging to become even more "giant-er".  

As the photo headline above says, Aetna is buying Humana, and Anthem (Blue Cross) is buying Cigna.  The combined Aetna-Humana will insure 33 million people, and Anthem-Cigna will insure 53 million people.  The current top insurer, UnitedHealthcare, insures 49 million people. (FYI, those three insurers will have a combined revenue of $448 BILLION per year.)

From what I have read (and if anyone inside the medical/insurance field has other information I'd like to hear it), far-and-away the BIG winners in the Obamacare health care reform movement are the health insurers.  Early on the Democrats who pushed for Obamacare enlisted the health insurers support, promising them millions of predominantly young, mostly healthy, new clients....in other words, lots of new income, with little additional expense.  CHA-CHING!

Here's what it comes down to:  the health insurers are making money hand-over-fist, with numbers few of us can even imagine.  They have to invest their profits somewhere (they don't pay it all out in dividends), and they have found that there is no place more profitable to put their cash than in....themselves!

“When big [companies] like this join forces rather than compete, it’s always a worry in terms of choice,” said Betsy Imholz, special projects director for Consumer Reports. “History has generally taught us when there’s greater concentration of health insurers, premiums are higher. Companies say there are greater efficiencies, but I’ve never seen that passed along to consumers.”

“We really do need the regulators to be watching out for consumers in this because there’s not too much consumers can do” about it, she said. 

What?  Regulators watching out for consumers?  ROFLMAO!  Maybe in the old days, but now regulators are controlled by the politicians who appoint them, and the politicians are controlled by the companies (via their campaign contributions/PAC's) being regulated.  The fox is in charge of the hen house!

I thought capitalism was all about free markets, and competition?  No?  This all sounds rigged to me.

So, let's all go to the polls next year and vote to re-elect the same bunch of politicians that we have right now.  I mean, they're doing such a great job looking out for our interests, why shouldn't we?

S