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The Fix for Obamacare? Single Payer

Creative Commons/Images_of_Money

Creative Commons/Images_of_Money

As President Obama’s approval ratings plummet and a parade of House subcommittees pile on over the failed rollout of the Affordable Care Act, 20/20 hindsight is finally kicking in for many who toed the White House line and supported this ill-conceived law.

The lone exceptions seem to be for-profit insurers and “free market” advocates – both of which, at the time of the law’s enactment and still today, have every reason to support it.

Obamacare, after all, represents the single-largest gift of customers the insurance companies have ever received, and they (and the “free market” boosters) know it. That’s why the industry is now scrambling to secure those customers – healthy ones only, please – by (oh so magnanimously) offering to help them enroll until the government’s website begins to function as advertised.

Despite the insurance industry’s embrace of the ACA, many have a hard time seeing how “free market” protections giveaways have any place in an industry which is supposedly devoted to keeping people healthy and returning to health those who are ill – and I’m one of them.

Let me put it more starkly: Health insurers exist purely to profit on the suffering – and more specifically, the fear of future suffering – of you and me. The health care industry (as distinct from insurers), meanwhile, exists to actually care for and heal people.

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IMHO

by Anthony Noel

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I’m not the first one to find it ironic that self-described free marketeers have no moral problem with insurance companies profiting on human suffering, despite the fact that a huge majority of those free-market boosters also claim to be good, God-fearing Christians. They are also many of the same people who, at town hall meetings prior to the passage of Obamacare, screamed, “Keep your government hands off my Medicare!,” though Medicare is a government program.

Such double-talk around health care – whether due to a genuine lack of knowledge or an insurance industry agenda designed to keep the profits rolling in – will not be ending anytime soon. There’s too much at $take. Insurers and their advertising agencies will continue to devote huge portions of the cash in which they already wallow to adequately frightening Americans over the prospect of what, in the end, is inevitable for each of us: Getting sick and dying.

That we as a nation not only allow such fear-mongering but have now codified it through the ACA’s requirement that people buy health insurance, rather than boldly wresting access to health care away from these insurance industry criminals and guaranteeing care to every American at no charge, is indicative not only of our nation’s devotion to the almighty dollar, but of the lip service so many pay the Almighty Him or Herself, as they profess their own humanism in church on any given Sunday.

Anthony Noel is a co-founder of the Guardian. His column appears when he gets around to writing it.

Responses (21)

  1. Steve Smiley says:

    Mr. Neol reminds me of the drunk waking with a wicked hangover (Obama care), reaching for a bottle of 151 proof rum since the govenment issue vodka did not obliterate the realty of economics. Is he aware that BCBS of NC is a mutual company owned by its policy holders/customers?

    Thinking is oh so difficult when one is drunk on ignorance, conceit, and youthful arrogance!

    Steve Smiley

    • Anthony Noel says:

      As long as we’re referring to each other indirectly, Mr. Smiley’s comment shows just how effectively “insurers” have convinced some that they are not the problem. The structure of “insurance providers” (i.e., organizations which convince you to bet them that you will become sick, and then look for reasons not to pay on the bet when you do) isn’t the issue. The issue is the need for these parasites at all.

      I do appreciate, however, Steve’s suggestion that I am “youthful” at 54!

  2. Ted Weil says:

    You recommend that medical care is to be provided for free,”That we as a nation not only allow such fear-mongering but have now codified it through the ACA’s requirement that people buy health insurance, rather than boldly wresting access to health care away from these insurance industry criminals and guaranteeing care to every American at no charge”.Do you have any suggestion on how the cost for these services are to be covered?
    Ted Weil

    • Anthony Noel says:

      Thanks for your comment, Ted, and I sure do: By following the example of every other industrialized nation in the world and taxing corporations at rates that cover a national health care plan. Since 1950, the tax burden in the United States has shifted from being primarily on corporations (and excise taxes on imported goods) to individuals. In that same period corporate profits have skyrocketed, and the poverty rate for individuals has reached its highest rate in history.

      Indeed, I’ll wager that funding Americans’ health care in this way would produce a net savings to business, compared to their current outlays for employee health insurance – since insurance companies and their profit motives would cease to be part of the equation. You’ll find an enlightening chart outlining the shift of taxation since 1950 here: http://www.huffingtonpost.com/2013/05/22/chart-shows-corp-taxes-grossly-unfair_n_3321737.html

      • Ted Weil says:

        If you will check the personal taxation in these countries you will find it is significantly higher than in the U.S. Part of these taxes go for paying for the health care provided to these individuals. I have no problem with taxation for medical care. A portion of Soc. Sec. benefits are taxed to help offset the cost of medicare. I feel that public health is as important as public education and should be financed by the public who receives the benefits.

        • Anthony Noel says:

          I agree, Ted, and was remiss in not including “the wealthy” alongside corporations re tax rates. Unfortunately, Americans in general do not understand the premise of taxation. Even the oft quoted “Taxation without representation is tyranny” is completely out of context. When one studies the full quote, it is clear that taxation is not the target: it is lack of representation, something from which the vast majority of Americans still suffer. Efforts to do the right thing are immediately quashed by morons like Grover Norquist and Ron Paul who call themselves “tax rebels” and “libertarians,” when in fact their work merely perpetuates the oppression of workers, the expansion of poverty, and the crumbling of infrastructure.

          Meanwhile, in Europe, public programs – which include everything from parental leave of up to a full year (with a guarantee that one’s job will be waiting for them when they return) to free education through college – are known by most citizens as “our beloved welfare state.” “Welfare” in this use refers to the well-being of the public and the infrastructure which serves it.

          In our country, however, “welfare” is a dirty word used to marginalize the poor and to argue against commonsense protections for our most at-risk residents. Only by returning to tax rates which were the hallmark of our system of progressive taxation when it was introduced early in the last century, and applying those revenues to the greater good, will America cease to be seen as a profit-first society and regain its long-lost reputation for putting people first.

  3. Sydney Moseley says:

    I would love to be wrong – but anyone truly at the bottom rung of the health care ladder really believed that anything good was coming out of a non-single payer system was at best naïve and at worst idiotic. Did you really think Americans would ever get over their greed and insensitivity? So many of us are doomed to early deaths because the elites, and even the merely affluent really need their tax breaks to be happy – and their happiness trumps our health. And guess what? It’s always been so, and will always be so. America in general, North Carolina in particular, and Greenville most specifically care so little for the disadvantaged that we can only be described as a horridly cruel society – not the first certainly and probably not the last but one that begs the question: What is it about “American Exceptionalism” that is really exceptional? I fear that it is, again, our greed and insensitivity.

  4. Candy Pearce says:

    I think Tony Noel is brilliant, an excellent writer, and often hilarious!

  5. Steve Smiley says:

    Adam Smith or Economics 101 demonstrates that corporations do NOT pay taxes, but only collect taxes from the people on behalf of the state!
    Either from employees via payroll taxes & reduced wages, and/or consumers through higher prices, and/or shareholders from reduced dividends/stock values. (That’s where your retirement/pension plan suffers.) Or all of the forgoing!

    Corporate tax rates, like the minimum wage, are means by which the lumpen prolatariate are deceived into believing that the welfare state serves their best interests, rather than the bureaucracy. What we/they never see is what might have been, absent the state Liviathan: the shops that never opened; the factories that were not built; the jobs that were not created; the inventions that never happened; the cures that went undiscovered, because the government crowded-out the commercial liberties of its citizens through the coersive police powers of the state!

    The good news is that the ongoing decline of the unsustainable European welfare state model, like the corrupting Canadian single payer health care system, and the disastrous UK national health care scheme, provide unimpeachable empirical evidence that government direction of the means of production/services (fascism), is rapidly losing support globally.

    These are not opinions but rather mathematics.

    May the Progressive Movement rest in peace!

    • Anthony Noel says:

      Steve, have you ever even been to Canada? Do you know anyone who lives there? The lies your libertarian friends are telling you are just that – lies, designed to scare you into believing the total fantasy (1) that free markets exist at all, and (2) unregulated markets will solve everything. Let me guess: you believe Ron Paul (a.k.a. John Birch) is God, Rand is the second coming, and, well, pretty much everything Ayn Rand wrote. Good luck with all that!

  6. Steve Smiley says:

    Don’t much like Rand Paul now, didn’t like or vote for Ron Paul then, and disliked Ayn Rand since Rose High School.

    As a matter of history, I lived in Buffalo NY for four years within walking distance of the Peace Bridge and commuted to Toronto weekly.

    I listened to and observed Canadian’s horror stories of rationing and mediocrity of health care services. As one older doctor explained to me, “bright young people don’t go to medical school in Canada anymore. Why would you want to work for the government, if you have talent”?

    More telling, a lady friend was an exec at Buffalo General Hospital (highly rated), and she regaled me with stories of Canadian refugees fleeing Canadian health care providers by crossing the US border and paying cash for US doctors/nurses/health care. The irony is that they provided very good profits to Buffalo General which in turn enabled it to provide huge amounts of charity care as well as research !

    All at the expense of the struggling Canadian economy.

    And yes, my insurance broker is thirty something, married to a Canadian MD on the faculty at UNC, living in Pittsboro, because “Canada sucks” for doctors”.

    I was not aware that John Birch (Society?) was still around, since the collapse of collectivism?

    The most “unregulated” market that I am aware of is for Pot, but the state(s) are starting to regulate & tax that too?

    I never suggested “unregulated markets will solve everything”, however, regulations have many obvious and many hidden costs.

    Markets require the rule of law, which are regulations!

    • Anthony Noel says:

      Maybe your Canadian ex-pat doctor friend should have actually studied the Hippocratic oath before swearing to it, in particular this bit: “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.” Or maybe she thought it was a “hypocritic” oath, so doing the opposite is okay?

      Again: Profiting on the suffering is wrong. Your claim that BC/BS is a non-profit refers only to its legal structure. I’m interested in reality, which last year, by the company’s own reporting, was this:

      “[S]ix [BC/BS NC executives] earned more than $1 million in salary, bonuses and other compensation during the year, according to the company’s annual report to the state Department of Insurance. Only two executives made seven figures in 2011 [the prior year].

      [Chief Executive Brad] Wilson earned a $1.6 million bonus to drive his annual compensation up to nearly $2.5 million – a 37 percent increase. The other five who topped $1 million saw raises between 41 and 68 percent:

      – Executive Vice President Maureen O’Connor had total compensation of more than $1.6 million, a 41 percent increase.
      – Chief Financial Officer Gerald Petkau earned almost $1.6 million, up 68 percent.
      – Chief Sales, Marketing and Communications Officer John Roos earned $1.2 million, up 46 percent.
      – Chief Operating Officer Alan Hughes earned more than $1.1 million, up 48 percent.
      – Chief Medical Officer Don Bradley earned almost $1.1 million, up 44 percent.

      The company’s premiums on individuals increased an average of 7.8 percent, and they went up 8.8 percent for small employers. Larger employers are usually able to negotiate with the insurer for better rates.”

      The above is from WRAL. But wait, there’s more:

      “Spokesman Lew Borman said salaries and premiums aren’t related. ‘Executive compensation is in line with comparable companies,’ he said, ‘and it’s not the reason for rising costs.'”

      “In line with comparable companies” – meaning all the OTHER parasitic insurers. Borman then had the chutzpah to add: “What drives premiums is medical costs, utilization, history, that sort of thing […] We have a state that has a lot of challenges in that area.”

      That BC/BS denies complicity in setting up those “challenges” – which it does through its price agreements with health care providers – and that otherwise intelligent folks like you, Steve, actually buy it, shows how effectively they run their racket.

  7. Ted Weil says:

    When, years ago, I was selling insurance, I would tell my prospective clients that insurance is the one commodity that you can’t buy when you need it. Public health falls under the rubric of “General Welfare”. It is for the society,as a whole, that it is promoted. Additionally, it should be run as a not for profit service in the same way our police and fire departments are operated. The cost for service under Medicare is far less expensive than through a for profit insurance company. The primary reason is the outcome goal,i.e., the former’s goal is health delivery and the latter’s is profit. The public as a whole benefits from the lower costs of Medicare, while only a very few gain from the profits of for profit insurance companies. The efficiency of Medicare would be even more so, if the legislative restriction of not being able to negotiate the price of drugs would be removed.

  8. Steve Smiley says:

    Ted proves the point! Medicare pays retail prices for Rx, while BCBS/Walmart pays a fraction of the price for the same pharmaceuticals, and passes on the savings to consumers. As a publicly administered entity, Medicare successfully hides it true costs from patients through a labyrinth of taxes, administration, and bureaucracy. If you believe that the state delivers health care as well as the private sector, then please go to ObamaCare’s web site!

    • Anthony Noel says:

      Medicare pays more for meds, Steve, because BigPharma-bought-and-sold congresspeople ensure the ridiculous legislative mandate that Ted cites remains in place. You know it, I know it, and your fabrications here to the contrary aren’t fooling anybody. Insurers, BigPharma and the congresspeople they own collude to keep the Medicare costs as high as possible – and they’re STILL far less than the bend-over-and-grab-your-ankles premiums charged by your beloved free marketeers. The rest of America is waking up, Steve. Here’s hoping you do, too.

  9. Steve Smiley says:

    So, in order of your comments, BCBS pays it’s top six managers, on average & in total, a fraction of the compensation paid to the starting five of the Charlotte Bobcats? If the Bobcats perform poorly, who suffers, much? If the premier mutually owned & operated health insurance non-profit (BCBS) in NC fails (as Medicare has become actuarially insolvent), most of the people of NC suffer.

    Compare the revenue/expenses of BCBS to its executive compensation is akin to comparing the convenient store inventory to the ‘give-penny-take-penny’ tray by the cash register! It is less than a rounding error in the financials and is only meaningful in assuring that competent leaders are recruited and retained.

    Yet, you seem to be among the 9% of the citizenry that approves of Congress’s performance, to the extent that you want to trust them with almost 1/5 of the economy. The institution of “bought-and-sold congress people” (your words) are to be granted near total powers of life & death over each individual citizen?

    You seem confused?

    PS-My Canadian emigre’s in Pittsboro left Canada because she can’t practice patient centered medicine in a system run by bean-counters!

    • Anthony Noel says:

      Just throw whatever you can at the wall and see if it sticks, Steve – oh, never mind, I see you already tried! And the wall *still* looks freshly painted.

      I’ve wasted too much time on you. Enjoy the rest of your day.

  10. Steve Smiley says:

    Aw Shucks!

    I guess this means we don’t get to move on from micro economics to macro economics or explore the welfare state as a remnant of feudalism & monarchy vice free markets and liberty as gifts originating in the Enlightenment?

    Not to worry! The empowering technology revolution is liberating individuals and making the nation state increasing less relevant and peace increasingly the norm!

  11. Steve Smiley says:

    Cool!

    Now, Edward Snowden, there’s a true Libertarian!

    General Electric Corporation? Creator of MSNBC? Brianchild of Jack Welch? Whose current CEO is POTUS economic guru?

    No thanks! GE’s dozen plus units ranging from banking, insurance, aircraft engines, light bulbs, washing machines to railroad locomotives would be more productive as several distinct company’s, but fear not, the markets will disassemble the house that Jack (Welch) built, and rebuild it into a more rational/profitable arrangement

    As you know, GE recently sold NBC/MSNBC to one of the leading global plutocratic families where that network can continue to act as ‘The Washington Generals’ opposition to the ‘Harlem Globe Trotters/Fox News’.

    Semper Fidelis

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