Archive for the ‘Healthcare’

Kabuki and the Departure from Truth

May 07, 2017 By: El Jefe Category: Healthcare

After watching the cynical self-congratulatory beer bust in the WH rose garden on Thursday, I found myself not just angry or disappointed; I was enraged.  The arrogant, taunting, narcissistic, boasting Cheeto-skinned parasite currently infesting Our House, along with virtually every gerrymandered-in weirdo and screwball in DC made me want to throw my shoe through the screen.

That rage came alive on Friday morning when, on Facebook, one of my conservative friends expressed frustration with Republicans voting to strip him of his healthcare because of his pre-existing condition. Immediately, one of his more conservative friends responded about how wonderful the new bill was and that it would “help many”.   Enough was enough; I launched on him, pointing out that the bill was rushed through the House without representatives reading it, it wasn’t scored by the CBO, and that early readings by the media were pointing out its legion of flaws, including re-introducing lifetime and annual caps, restoring exclusion of pre-existing conditions, slashing of Medicaid, slashing healthcare for special needs kids, etc., etc.  His defense?  Lying.  Not just spinning, outright lying.

He argued that they caps are not part of the bill when they are.  He argued that health savings accounts would cover the shortfalls (which is laughable; when’s the last time you saw someone pay a $300,000 chemotherapy bill with an HSA?); he argued that this bill was an actual effort to improve healthcare when, in fact, it was just a disguised tax cut.  When challenged, he said, “Well, the bill’s not finished.”  Not finished?  They already voted for it in the House!  They went to the WH and celebrated!

In fact, this last statement was the only thing that he had said that was true…it wasn’t finished.  It still must go to the Senate where it most certainly won’t survive, at least in its current form.  The defense of this bill is built on lies.  It has to, because math is math.  You cut a trillion dollars out of healthcare, and millions will suffer, and no lie justifying it can change that.  You place caps on coverage, people will die.  You exclude pre-existing conditions, people will die.  It’s like gravity; those truths are just there.

So, what was this all about?  That’s easy – it’s Kabuki.  It’s a glittery show for the base voters of this crowd in DC who waste a lot of oxygen trying to meet there demands of erasing President Obama’s name from history regardless of damage to millions of Americans.  I believe that Trump and conservatives in the House realize that the chance of actually repealing the ACA is slim, therefore the shameful display in the rose garden.  With any luck, this will be the only celebration they hold cheering on the deaths of millions of Americans.

Shooting the Hostage – Or Not

April 13, 2017 By: El Jefe Category: Healthcare

Welp, no one can accuse this president of being consistent.  In fact, the only consistent trait Trump possesses is inconsistency.  His administration swerves from ditch to ditch worse than a drunk driver on a three day bender at the local watering hole, and this week’s swerving has been epic.  Yesterday, in an interview with Fox Noise Business, Trump reversed himself from putting tax reform cuts first to going back once again to urinate on people who need healthcare.  Then, in an interview with the WSJ, he declared that he’s going to “force” Chuck Schumer and Nancy Pelosi to negotiate by cutting off federal Obamacare subsidies, which will destroy the program for millions of poorer Americans.

Let’s get this straight – Trump who is already holding poor Americans hostage is now threatening to kill those hostages to force the Democrats to the table.  What a dumbass (sorry, Momma).  If the ACA fails on Trump’s watch destroying Trump’s voters’ health insurance, guess what happens in 2018 and 2020?  Yep, you guessed it, ol’ Dandy Don Meredith will be heard singing “Turn out the lights…” to the GOP.

The real tragedy here is that Trump and the Knuckle Draggers have painted themselves into a real corner here by chanting the “repeal and replace” mantra for 7 years.  All of Obamacare’s problems can be solved if only an adult stood up and stopped the nonsense.  For instance, Alaska solved its problem of skyrocketing premiums by diverting some tax revenues to supplement money being paid out by insurance companies to the sickest insured Alaskans.  The result?  This year’s premium increased dropped from 42% to 7%, and Obamacare continues to function.  The state is also setting up a reinsurance fund to stabilize its market.  Alaskan elected officials are considering introducing legislation to federalize the program.  How novel – working to actually fix a problem rather than burning it down.

Supporter No More

March 22, 2017 By: El Jefe Category: Healthcare

Kraig Moss, who lost his son to a heroin overdose, was a rabid supporter of Cheeto Jesus, attending 45 campaign rallies for him.  He believed the tripe CJ spewed promising to fix every problem, right every wrong.  He now is no longer a supporter after the new er, uh…(urp) president supports Cheetocare, which slashes addiction spending and kicks over 20 million Americans off of healthcare.

I wonder – What exactly did Moss see in CJ’s past behavior that convinced him he was anything more than a lying reality television star?

An Economics Lesson for Paul Ryan

March 13, 2017 By: El Jefe Category: Healthcare

Paul Ryan was on Face the Nation yesterday morning talking about the Republicans’ new anti healthcare bill they’re trying to sell to the American people.  Host John Dickerson tried numerous times to get Ryan to acknowledge that millions will lose their healthcare and that all major medical associations are opposing the measure.  Ryan engaged in his now familiar obfuscation with a big smile, repeating this most often used mantra of giving people “choice” and fostering “competition” in health care delivery.

Here’s the problem with the Republicans’ key economic assumption in their ideology.  Choice and competition come from a functioning free market.  You can call our healthcare delivery system in the US a lot of things, but “free market” is not one of them.  Here’s why:

Over 30 years ago, Michael Porter of the Harvard Business School developed a model to describe markets.  In his model, he describes 5 essential forces that control markets.  To be a fully functioning market, the power of buyers must be in parity with the power of the sellers.  At the same time, buyers must have alternatives from existing competitors, and those competitors must be continually under threat from new entrants into the market as well as new products or services that can substitute for the product already being sold.  An example: You want a car; you have numerous choices between new and used, expensive or thrifty.  You can buy online, you can buy from individuals, you can buy from numerous dealers.  You can check prices online, making the market relatively transparent.  As well, you can choose when you buy that car.  Or you can buy a motorcycle.  Or you can not buy a car and take Uber.  This market balance represents a relatively free market, subject to truth in advertising and financing laws.

Now, let’s look at our healthcare markets: Sellers (insurance companies and healthcare providers) dictate coverage and pricing.  The polices are intentionally complex and pricing is completely opaque.  In most Americans’ cases, EMPLOYERS pick which plan their employees can buy.  In this market, the sellers hold all the power and the buyers have only the choices that are dictated.  Additionally, the insurance markets are protected by state agencies, making it very difficult for alternatives to get into the market.  To make matters worse, when you’re sick, the LAST thing you have time or the inclination to do is price shop for healthcare.  Removing the market protections the ACA provides puts individual buyers at  the mercy of this cruel government protected market.  Republicans are trying to jam free market ideology into a market that is anything but free.  The cabal of insurance companies and healthcare delivery companies is impossible to to fight, especially by individuals.

So, with these clear market realities that make the Republican plan unfair and unworkable, what does that say about Paul Ryan’s argument for his plan?  There are two possible answers: 1) Ryan is stupid with no understanding of the realities of markets; or 2) He’s a lying sack of sh*t (sorry Momma) who is looking out for his base and the interests of his largest donors to the detriment of everyday Americans like you and me.

I’ll take Door Number Two, Alex.