Welcome to Healthcare Hell

[McCamy Taylor]

Welcome to Healthcare Hell, the new $849 billion dollar theme park being designed by Sen. Joseph Lieberman, the single most powerful man in a city where members of another party, the Democrats control two of the three bodies of government. Why Joe and not some Democratic Senator? Why not? This is a theme park we are talking about. People don’t want the same old same old---like Western European style affordable health care for all that delivers quality results. The American people crave the new, the unexpected.

No one expects Healthcare Hell. That is part of its charm. Here is a preview of some of its attractions. In honor of its architect, all the rides are named with words beginning in the letter L.

I. Limbo




Healthcare Hell is not scheduled to open its doors until at least 2014. But you get to buy your ticket now. Pardon me. Did I just write get ? I meant you have to buy your ticket now. The federal government is going to start collecting more in taxes immediately, so that its coffers will not be quite so bare when it comes time to start delivering big bags of money to the Health Insurance Companies.

http://abcnews.go.com/GMA/HealthCare/howard-dean-health-care-bill-bigger-bailout-insurance/story?id=9349392


While you wait in limbo, your undiagnosed diabetes, hypertension and hyperlipidemia will be clogging your coronary arteries, damaging your kidneys and stroking out your brain. If you are lucky, you will be ready for dialysis and a CABG right about the time you finally snag some insurance. If the health insurers are lucky, you will be dead before they have to cover you.

While you are doing your best to pretend that your exertional chest pain is indigestion, health insurance companies will be paying their executives enormous bonuses and making frivolous investments. Why? So they can argue to government regulators that they are close to bankruptcy and therefore they all need to raise premiums the exact same amount at the same time . Once you get out of Limbo in 2014, health insurance premiums will be much higher than they are now.

Impossible, you say? Because Sen. Leahy has introduced the Health Insurance Industry Antitrust Enforcement Act? Leahy’s name may begin with an L, but he is just a senior member of the party in power in Washington. His word carries no weight.

http://leahy.senate.gov/press/200909/091709a.html

But Sen. Ben Nelson (D-Neb.), who has received $536,846 from health insurance companies, has reportedly moved to block the amendment from inclusion in the Senate bill. He is one of 30 senators who have received at least $200,000 from the industry since 1989.

"This is yet another example in the health care reform debate where the health insurance industry is hoping its $17.5 million investment in the U.S. Senate pays off," says Bob Edgar, president of Common Cause, a Washington-based watchdog group. "If we want policies that are truly in the public's interest -- like this proposal to repeal legal protections for the health insurance industry -- we need to take the special interests out of the business of funding political campaigns."

http://onthehillblog.blogspot.com/2009/12/health-industry-hopes-influence.html

As long as health insurers are exempt from anti-trust rules, they will continue to fix prices to their hearts content. And, with the federal government footing the bill, there will be no limit to what they can charge.

Speaking of limits, the next attraction in our theme park is

II. Limits



Because good Americans follow the motto "Moderation in all things"...including their catastrophic illness.

The Senators, under the guidance of Joltin’ Joe and his Hartford Connecticut friends, have created a fun new attraction they call Annual Limits . As long as the monetary limits are not “unreasonable”, they are ok. What is “unreasonable”? The Obama administration gets to decide. That is the same Obama administration which has rolled over like a puppy for the health insurance industry.

http://www.google.com/hostednews/ap/article/ALeqM5iY4N1OnmEl-p6kEdB_ROs6toazbQD9CH9VBG0

You or I might think it reasonable to expect our insurance to pay for a bone marrow transplant for our daughter’s leukemia (which also begins with an L). After all, bone marrow transplantation is a recognized, effective treatment for many forms of the disease. However, the insurance companies (and their lobbyists) are likely to have different definitions of “reasonable.” To them, big ticket items like transplants are just plain not fair. Why should they be penalized because some kid decided to get Reye’s Syndrome and is now the color of Big Bird? Let him save his pennies if he wants a new liver.

Limits are also likely to apply to intensive care unit stays. Such as your premature infant’s Neonatal ICU stay. Here, the insurance companies will luck out, since no NICU will kick out a preemie for lack of funds. Or will they? Remember all that talk about “death panels”? In Texas, hospitals can pull the plug over family members’ objections---if the insurance has run out. The moral here: be sure to divide your ICU stays up like vacations, no more than two weeks a year. Or, maybe you can buy a second insurance policy, one that takes over when your primary plan bows out.

III. Lawyers

http://4.bp.blogspot.com/_utj_WiTT3tU/SUubBT2dXfI/AAAAAAAABB8/GVd2U-0hVlo/s400/Gustave+Dore+Mohammad+in+the+ninth+circle+of+Hell..jpg


Health insurers claim that they have gotten everything they wanted from the Senate. We all heard them crowing about it. That worries me, because one of the things that they wanted most from Health Care Reform was exemption from state insurance board rules and oversight.

The Senate bill contains a provision long sought by the health insurance industry lobby AHIP. It would allow for the sale of “nationwide plans.” Theses plan would not be required to follow the state laws regarding what medical treatments must be covered.
These nationwide health plans will, in effect, gut state health insurance regulations and create a race to the bottom. What will likely happen is what happened with the credit card industry: all the card companies moved to the two states with the absolute lowest regulations.
snip
I fear for the millions of Americans who will lose their current health insurance coverage because of this law. If you have a medical condition that your insurance company must cover by state law, but is not part of the new essential benefit package, you are in serious danger of losing that coverage. Unless your state opts out of the “nationwide plans,” there is a very high probability that your insurance company will “leave the state” and drop your coverage. That company will just move to another state and start selling a “new,” less regulated, nationwide plan in your state.

http://fdlaction.firedoglake.com/2009/11/19/at-the-request-of-ahip-senate-bill-guts-state-health-insurance-regulations/

Do you live in one of the progressive blue states? Did you work hard to elect leaders who would write mental health care parity into the law? Big fucking deal. Now, you get the same shitty coverage that the downtrodden masses of the worst of the red states get. And that is not all.

There is another potential problem with these so called nationwide plans. It is called “where the hell do I go if I want to sue my insurer?” Right now, you can sue in local court. Once insurance becomes “nationwide”, you will have to go to federal court. And we all know how congested the federal court system is.

Picture this scenario. Your child’s pediatrician says she needs that new heart by next week. Your insurance company says “Blow me.” You get a lawyer. And you get put on a docket somewhere and your case is heard next year on the anniversary of your child’s death.

Right now, with many Americans getting their health insurance from their employers, insurance companies are protected by the ERISA loophole. A law designed to protect pensions was interpreted by the courts to mean that if pre-tax dollars where used to pay your premiums, then you had to sue your health plan in federal court. And the insurer could only be held liable for the cost of the denied procedure not the harm that resulted from the denial of the procedure. For instance, if CIGNA refused to pay for an $800 CT scan and your husband died of a ruptured aneurysm, the federal court would make CIGNA pay you…$800.

Insurance companies just love this crazy loophole. It allows them to disregard the health of their members without fear of financial loss. They have fought like a pack of wild hyenas to keep Congress from closing it, since they absolutely positively do not want to be held liable for the death and disability that results from their medical decision making.

Under Health Care Reform, more folks will be purchasing their own insurance. That is a problem for the insurance companies, because suddenly they will be writing a lot of policies that will put them at financial risk if they deny necessary care. One of the intended side effects of "nationwide" policies is to stop this from happening. Expect insurance company lawyers to file federal suits the day after the first nationwide policies are written, in hopes of getting some judge somewhere to restrict your right to sue. Expect them to pay Congressmen outrageous sums to write "tort reform" laws that will "keep premiums down." Bonus points if they can argue that ERISA covers plans partially paid for out of federal dollars.

IV. Lines



Hey. It wouldn’t be an amusement park without lines. With all insurance policies written in places like Guam, plans will be free to offer extra crappy coverage with a bare minimum number of local providers. That means that you will likely have to wait months to see a specialist, even if there are plenty of specialists in your area, because your insurance company will have an exclusive contract with just one of them to cover all of its members in your city/county/state.

This was a favorite strategy of the HMOs in the 1990s, which made up for their inability to cherry pick healthy members by making it impossible for their sick members to get care. Have one dermatologist for the entire Houston Metropolitan area, and no one gets acne treatment. If the closest pediatric neurologist is two hours away, your child’s seizures may have to wait until you can get some time off work. If the only general surgeon in your town on your plan in booked up months in advance, you will have to learn to live with those gallstones. And if the one orthopedist is kept busy treating fractures, you can kiss goodbye your hopes of getting that bum knee replaced.

The federal government plans like Medicare and Medicaid will continue to have more or less open provider directories, which means that everyone who uses a lot of health care will eventually figure out that they are better off on a federal plan, not a private one. That will save the insurance companies even more money.

V. Luxury



Hey, but at least we are all gonna get free health care (that we pay for from our own taxes) right?

Au contraire. Even the Senate does not claim that it is going to cover everyone. Low to middle income Americans, being poor and therefore unholy in the sight of God, do not deserve the same health care that richer (i.e whiter) folks get.

A family of three with income of $27,465 (150 percent of the poverty line) would have to pay $1,250 for premiums, or over $400 more than under the House bill. Many families with incomes this low already struggle to pay the rent and utilities and put food on the table and could have difficulty paying this much for health coverage.

http://tpmdc.talkingpointsmemo.com/2009/11/cbpp-despite-insufficient-subsidies-health-care-bill-enormous-step-forward.php

Anyone who has ever tried to support a spouse and child in a major US city for less than $30k a year knows that thousand dollar bills do not grow on trees. With the fines set to max out at $750/year for no coverage, there will be a lot of lower income Americans who end up subsidizing the subsidies for their higher earning neighbors. Ironically, Congress plans to finance “universal health care” by collecting fines from folks too poor to purchase insurance.

VI. Lobbyists



With the White House regulating the massively profitable health insurance industry (instead of state boards), presidential candidates will have access to almost unlimited cash. Here is how it works. We, the tax payers, will hand over our hard earned money to the feds who will give it all to private insurance company CEOs who will avoid spending the money for health care. This will give insurers enormous reserves from which to bribe presidential candidates. If Congress wants some of the action, they can pretend to tinker with health care reform, too (the way that the current Congress is doing). This will be just like the bank bailout (in which money paid to the banks to loosen up credit is being horded for campaign contributions, instead) but it will happen over and over again.

VII. Losers

For an advance preview of this attraction, just look in a mirror.

[highplainsdem]

1. K & R

[madrchsod]

2. probably your best work to date

the truth with images that capture the true evil of those who profit off the misery of others. well done and if i had some money i`d give ya star.....

[TornadoTN]

3. This is a stunning masterpiece

Bravo for this. I'd like to repost this on my blog, citing you of course, so others may see it, if I may.

[McCamy Taylor]

18. Go for it.

[Vinnie From Indy]

4. A truly excellent post! Thank you!

I have been writing for days now that Big Insurance is NOT GOING TO PLAY FAIR!!! They have pages of strategies to effectively deny coverage without calling it that. Calling this bill an "incremental" improvement might be fair if your definition of "incremental" is the slow descent into health care HELL!

Bravo to you and cheers!

on edit: This is the post of the day! The structure, the art and the substance are all superb! Thanks again!

[WillYourVoteBCounted]

5. my sibling told me not to worry, I could always go to the ER

and they would treat me.

He forgot the part about how I'd be bankrupt.

But oh - he has health insurance, and he makes so much money he can
afford the $10,000 deductible!

Wait till they drop him next year after they had to spend so much
on his care this year, after a stent and cardiac rehab.

Uh huh.

[Lydia Leftcoast]

6. This bill is even worse than I thought

:-(

[bertman]

7. Words fail me, McCamy, but they certainly did not fail you. Masterful wordcraft. The imagery

is perfect.

Thank you so much for this.

Highest possible recommendation.

[EFerrari]

8. "Which way I fly is hell." PL 4.75

[Hannah Bell]

9. k/r

[Lugnut]

10. K&R and thank you. n/t

[slipslidingaway]

11. Excellent and thank you! n/t

[Mithreal]

12. K&R with sorrow

[regnaD kciN]

13. "No rational person could fail to support the Senate bill."

Thank you, Robert Gibbs.

[mojowork_n]

14. Don't forget the other "L" category:

...as in this painting,



With all that money being shuttled back and forth so seamlessly from the pockets of insurance industry execs to the pockets of politicians -- and being returned, again, over and over...

...some of the Lemmings leaping off cliffs may feel a surge of common humanity, a twinge of sympathy for the plight of others -- maybe even a quick rush of enthusiasm ("everybody's pulling oars in the same direction -- 'We're In This Together'"), in those last final moments of clarity/epiphany, as the tide sweeps all floaters out to sea.

[salib]

15. Well, now I understand why Obama says that the U.S. will be bankrupt without the bill

As seen in the original post:

"Healthcare Hell is not scheduled to open its doors until at least 2014. But you get to buy your ticket now. Pardon me. Did I just write get ? I meant you have to buy your ticket now. The federal government is going to start collecting more in taxes immediately, so that its coffers will not be quite so bare when it comes time to start delivering big bags of money to the Health Insurance Companies."

All that CEO/Bankster/DefenseContractor/Sociopath bailout money has to be paid for somehow. Well, it cannot possibly be through higher taxes on those same filthy rich a-hats. Instead, it is through the requirement to "buy-in" FOUR YEARS EARLIER than any benefits need be paid.

Let's see...hmmm...30 million people...20% of gross income...four years....

Yeah, that outta do it!

And we could even have more wars while we are at it!

[laughingliberal]

16. Brilliant work!

:applause:

[cornermouse]

17. k & r

[4_TN_TITANS]

19. Oh my... outstanding! k/r

[tomm2thumbs]

20. awe-inspiring work

the last chapter is succinct
truths often are

[SandWalker1984]

21. Massachusetts health care system is broke -- so why does Obama think it will work for nation?

I came across this story back in 2008. It was written by 2 Massachusetts doctors & goes into detail as to why their health plan with mandates is not working. Basically, this is the same concept the Senate wants to dump on all Americans.


The Gaping Holes in Massachuesetts' Health Care Plan
Mass Failure
By Dr. STEFFIE WOOLHANDLER
and Dr. DAVID HIMMELSTEIN

In 1966--just before Medicare and Medicaid were launched--47 million Americans were uninsured. By 1975, the United States had reached an all time low of 21 million without coverage. Now, according to the Census Bureau's latest figures, we're back where we started, with 47 million uninsured in 2006--up 2.2 million since 2005. But this time, most of the uninsured are neither poor nor elderly.

The middle class is being priced out of healthcare. Virtually all of this year's increase was among families with incomes above $50,000; in fact, two-thirds of the newly uncovered were in the above-$75,000 group. And full-time workers accounted for 56 percent of the increase, with their children making up much of the rest.

The new Census numbers are particularly disheartening for anyone hoping for a Massachusetts miracle. In the Commonwealth, 651,000 residents are uninsured, 65 percent more than the figure used by state leaders in planning for health reform. Their numbers came from a telephone survey done in English and Spanish. But that misses people who lack a land-line phone--43.9 percent of phoneless adults are uninsured, according to other studies.

It also skips over the 523,000 non-English speakers in Massachusetts whose native language isn't Spanish (e.g. Portuguese, Chinese, or Haitian-Creole), another group with a high uninsurance rate. In contrast, the Census Bureau goes door-to-door for its survey and has translators for almost every language. It gets a more complete picture.

In sum, Massachusetts health reform planners have been wishing away a quarter of a million uninsured people. Recent Patrick administration claims that health reform is succeeding are based on cooked books. According to the state's figures, almost half of the previously uninsured gained coverage under the health reform bill by July 1. But according to the Census Bureau, the new sign-ups amount to less than one-quarter of the uninsured. Moreover, it's likely that much of that gain has already been wiped out by shrinking job-based coverage--a longstanding and nationwide trend.

Why has progress been so meager? Because most of the promised new coverage is of the "buy it yourself" variety, with scant help offered to the struggling middle class. According to the Census Bureau, only 28 percent of Massachusetts uninsured have incomes low enough to qualify for free coverage. Thirty-four percent more can get partial subsidies--but the premiums and co-payments remain a barrier for many in this near-poor group.

And 244,000 of Massachusetts uninsured get zero assistance--just a stiff fine if they don't buy coverage. A couple in their late 50s faces a minimum premium of $8,638 annually, for a policy with no drug coverage at all and a $2,000 deductible per person before insurance even kicks in. Such skimpy yet costly coverage is, in many cases, worse than no coverage at all. Illness will still bring crippling medical bills--but the $8,638 annual premium will empty their bank accounts even before the bills start arriving. Little wonder that barely 2 percent of those required to buy such coverage have thus far signed up.

While the middle class sinks, the health reform law has buoyed our state's wealthiest health institutions. Hospitals like Massachusetts General are reporting record profits and enjoying rate increases tucked into the reform package. Blue Cross and other insurers that lobbied hard for the law stand to gain billions from the reform, which shrinks their contribution to the state's free care pool and will force hundreds of thousands to purchase their defective products. Meanwhile, new rules for the free care pool will drastically cut funding for the hundreds of thousands who remain uninsured, and for the safety-net hospitals and clinics that care for them. (Disclosure--we've practiced for the past 25 years at a public hospital that is currently undergoing massive budget cuts.)

Health reform built on private insurance isn't working and can't work; it costs too much and delivers too little. At present, bureaucracy consumes 31 percent of each healthcare dollar. The Connector--the new state agency created to broker coverage under the reform law--is adding another 4.5 percent to the already sky-high overhead charged by private insurers. Administrative costs at Blue Cross are nearly five times higher than Medicare's and 11 times those in Canada's single payer system. Single payer reform could save $7.7 billion annually on paperwork and insurance profits in Massachusetts, enough to cover all of the uninsured and to upgrade coverage for the rest of us.

Of course, single payer reform is anathema to the health insurance industry. But breaking their stranglehold on our health system and our politicians is the only way for health reform to get beyond square one.


Dr. Steffie Woolhandler and Dr. David Himmelstein co-founded Physicians for a National Health Program and are primary care doctors at Cambridge Hospital.

[rollingrock]

22. Obama would have to be Satan

if he is going to put his stamp of approval on this nightmarish, draconian legislation that makes what we have now almost look like paradise by comparison. and I don't think that's mere hyperbole because this bill is just plain evil.

[ProSense]

23. Actually, looks more like hyperbole hell. n/t

[rollingrock]

24. Can you refute/debate any of the OP's points?

or are you content with making snarky one-liners?

[ProSense]

25. You want me to refute

speculative BS?

Under Health Care Reform, more folks will be purchasing their own insurance. That is a problem for the insurance companies, because suddenly they will be writing a lot of policies that will put them at financial risk if they deny necessary care. One of the intended side effects of "nationwide" policies is to stop this from happening. Expect insurance company lawyers to file federal suits the day after the first nationwide policies are written, in hopes of getting some judge somewhere to restrict your right to sue. Expect them to pay Congressmen outrageous sums to write "tort reform" laws that will "keep premiums down." Bonus points if they can argue that ERISA covers plans partially paid for out of federal dollars.

Go ahead, entertain ludicrous.

[rollingrock]

26. It's a perfectly reasonable prediction to make

considering the insurance industry's draconian behavior during this process and in the past.

or do you simply expect the insurance industry sharks to all of the sudden start behaving like Mother Theresa or like choir boys once this magical bill is passed? well, good luck with that.

[McCamy Taylor]

29. Glad to see that some things are constant, like your 100% enthusiastic support of

anything that Obama does. If he turns on the Senate Health Care Bill next week, I suspect you will be among the first to start the denunciations of the bill.

My own personal philosophy is question authority--even in my own party. I have watched and waited for Obama to deliver on his promises. I am still watching and waiting. Of course, since I distrust politicians, I had a feeling he might not deliver, so I can not say that I am shocked. Just disappointed.

[hfojvt]

27. Why did you start with taxes?

That business you wrote there is crap. "You get to start paying now". Well, that's only true if YOU are a doctor or somebody else making over $500,000 a year, isn't it? But hey, thanks for advancing the Republican anti-tax talking point.

The rest of it sounds like some kind of worst-case speculation. My child with Reye's syndrome, my premature baby. I am not sure how I am supposed to have those, unless they are part of the Health Care Reform to provide a single guy like me with sick children.

I happen to think that limits make sense. My own pockets are not that deep, although I can understand why a doctor would want a blank check from the taxpayers. You did say that you are a doctor, didn't you? Some doctors do favor the emergency walletectomy in many cases.

So after the first two, I am not impressed.

[McCamy Taylor]

28. "Limits make sense"? I hope you never get involved in a bad car wreck

and need neurosurgery, orthopedic surgery, an extended ICU stay and then months of rehabilitation, because you will exceed "limits". And a car wreck can happen to anyone, even those with so called "superior" genes who are absolutely certain that their children will not be afflicted by disease.

As to why I started with "Limbo", it is the first stop before you get to real Hell. It was a purely artistic decision. I could have started with the Lobbyists and then worked my way up from the 9th (lowest) circle.