Wednesday, June 24, 2009
Private Health Care Much More "Efficient"... Yet Can't Compete with Public Health Care? Surely You Must Be Joking.
When Private Insurers Claim They Can't Compete Against Public Health Care, They Just Make Themselves Look Silly
by Robert Creamer at HuffPO
You've got to give the private insurance companies credit for chutzpa. The argument that they have been making to Congress -- with straight faces -- that they "can't compete" against a public health insurance plan is preposterous. That's because it is internally inconsistent.
If it were true, then private health insurance firms must be inherently unable to provide health insurance as efficiently as the public sector. And if that were true, why would our nation allow itself to be held hostage by private insurance companies that unnecessarily siphon billions of dollars of wasted health care dollars from our collective pockets?
Every time the private insurance companies -- or their Republican apologists in Congress -- make the argument that "private insurance companies can't compete", they might as well dress up in clown suits and put on big red noses: they just look silly.
President Obama pointed out the absurdity of the argument in his news conference yesterday:
Just conceptually, the notion that all these insurance companies who say they're giving consumers the best possible deal, if they can't compete against a public plan as one option, with consumers making the decision what's the best deal, that defies logic.
The insurance executives are the first to tell us all about how much more efficient the private sector is at doing anything than the "government." Do they mean to tell us that the "best and the brightest" from private industry can't compete with a "bunch of government bureaucrats"?
There is, of course, considerable evidence that private insurance companies are generally more inefficient than public insurance plans. For instance, only 3% of every Medicare dollar goes to administrative costs, while from 13% to 17% -- and sometimes more -- goes to administering and marketing private plans.
Or there's the fact that "MedicareAdvantage" plans -- where private insurers are paid by Medicare to provide insurance for Medicare beneficiaries -- have required about a 20% subsidy above the cost of providing insurance through the regular Medicare system.
But the image of the poor little private insurance companies arrayed against the public colossus is ridiculous. One Republican went so far yesterday as to argue that the way a private insurance company would compete against a public plan was the way a rabbit competes with an alligator. The private insurance companies are not cuddly cute little bunnies. Many of them are giant multi-billion dollar companies that have massive provider networks, longstanding client bases and pay their CEOs tens of millions of dollars.
The real problem for private insurance companies is not that they can't compete with a public plan. It is that they can't compete and continue to do business they way they want to do business. And that, of course, is the point of a public option -- to change the behavior of the players in the health care market to assure that everyone has access to quality health care, and to stop the skyrocketing increase in health care costs.
The whole idea of insurance is to spread risk. Everyone pays into a common insurance pool, so when anyone gets sick they can count on getting the health care they need even if it costs far more than they could afford individually.
But left to their own devices, private insurance companies have an ever-present incentive to minimize their own risk of paying out for health care to their policyholders. That's why they try to select only customers who are well and get rid of those who are sick. That's why it's in their interest to spend millions on armies of people whose only job is to deny claims -- a task that has no value in the broader scheme of the health care system, but makes perfect sense from the standpoint of a private insurance company. That's why they don't want to take people with pre-existing conditions -- because they are more likely to get sick.
And, private insurers are not in business to provide health care coverage for every American, or to slow the growth of health care costs. They are in business to maximize return for their investors and the pay of their top management. So when left to their own devices, private insurers generate huge profits and pay their CEO's tens of millions of dollars.
The entry of a public insurance option into the health insurance marketplace would change the rules of the game. If consumers had a public option, who in their right mind would sign up with a company that would discontinue your policy if you got cancer or had a heart attack? Who would join a plan where they had to pay for bloated executive salaries -- or had to regularly do battle with an insurance bureaucrat in order to get a claim paid? Why do seniors like Medicare? They don't have to contend with these kinds of problems. They have secure, reliable health insurance.
So to compete, private insurance companies would be forced to change the way they do business. They would have to end all of those practices that American consumers have grown to hate, cut administrative costs -- maybe even cut CEO pay. Of course since the CEO of Cigna makes $26 million -- 65 times the salary of the President of the United States -- he could afford several million dollars in belt-tightening.
They could compete - but they would have to change the way they compete. That's what they are fighting tooth and nail to avoid - and that's also the whole point of health care reform: to change the incentives that determine how the players in the health insurance market do business day to day.
Of course there is another reason why all the concern about the competitiveness of private insurers is so absurd. The point of health insurance reform is not to benefit the private insurance companies. It is to provide everyone access to quality, affordable health care -- and to control exploding health care costs.
It's up to every one who cares about health care -- and the future of our economy -- to make sure Members of Congress remember what is really at stake in the health care debate. And it's not the health of the private health insurance industry.
Robert Creamer is a longtime political organizer and strategis,t and author of the recent book: Stand Up Straight: How Progressives Can Win, available on Amazon.com.
The Roadblock To Public Health Care? Democrats: Max Baucus, Ben Nelson, Kent Conrad, Mary Landrieu, Dianne Feinstein, Jeff Bingaman, Blanche Lincoln
Democratic Opponents of Public Health Care Option Called Out In Ad.
by Jason Linkins at HuffPo
So, the public option! The GOP hates it, based on some weird read of free-market philosophy that says even though it will be a terrible and inferior product, it will nevertheless be too beloved by consumers for alternatives to thrive. The media thinks it's some oddball idea, which they constantly confuse with the socialized style medicine in Britain and Canada, when they are bothering to discuss the merits of health care at all. But the general public? Well, they love the idea of a public health care option. So, lucky for them the Democratic representatives they elected in large numbers to considerable Congressional majorities are... well, filled with people who have been bought off by insurance companies.
In the Senate -- where filibuster-proof supermajorities have become necessary to do anything, anymore -- Max Baucus, Ben Nelson, Kent Conrad, Mary Landrieu, Dianne Feinstein, Jeff Bingaman, and Blanche Lincoln have thrown up roadblocks to the possibility of a public option. Why? Because of something they call "centrism!" Paul Krugman made note of this in a column on Monday:
The real risk is that health care reform will be undermined by "centrist" Democratic senators who either prevent the passage of a bill or insist on watering down key elements of reform. I use scare quotes around "centrist," by the way, because if the center means the position held by most Americans, the self-proclaimed centrists are in fact way out in right field.
But what Baucus, Conrad, Landrieu, Feinstein, Bingaman, and Lincoln have found out there in right field are millions and millions of dollars from insurance companies which they can use to get re-elected! And when they run for re-election, they can all talk about the pressing need for more health care, which is just adorable!
So, what are the vast majorities of people who support a public option to do, arrayed against an indifferent media and cash-soaked coterie of compromised lawmakers? Well, the Progressive Change Campaign Committee will be running a new ad, calling out these wayward Senators, and are offering the public the chance to get all interactive and whatnot, by offering public option supporters a chance to have their name in the advertisement.
Well, it can't hurt! (If it does hurt, sadly, many of you don't have health care coverage.) The ad, sans names, runs as below:
PREVIOUSLY, on the HUFFINGTON POST:
Public Strongly Supports Public Health Care Option
NYT Poll Indicates Even Republicans Back Public Option
Tuesday, June 23, 2009
The Culture Wars Are Over and the Idiots Have Won.
A veteran journalist's acidically funny, righteously angry lament about the glorification of ignorance in the United States.
In the midst of a career-long quest to separate the smart from the pap, Charles Pierce had a defining moment at the Creation Museum in Kentucky, where he observed a dinosaur. Wearing a saddle... But worse than this was when the proprietor exclaimed to a cheering crowd, “We are taking the dinosaurs back from the evolutionists!” He knew then and there it was time to try and salvage the Land of the Enlightened, buried somewhere in this new Home of the Uninformed.
With his razor-sharp wit and erudite reasoning, Pierce delivers a gut-wrenching, side-splitting lament about the glorification of ignorance in the United States, and how a country founded on intellectual curiosity has somehow deteriorated into a nation of simpletons more apt to vote for an American Idol contestant than a presidential candidate.
With Idiot America, Pierce's thunderous denunciation is also a secret call to action, as he hopes that somehow, being intelligent will stop being a stigma, and that pinheads will once again be pitied, not celebrated.A Q&A with Charles P. Pierce
Question: What inspired, or should I say drove, you to write Idiot America?
Charles P. Pierce: The germ of the idea came as I watched the extended coverage of the death of Terri Schiavo. I wondered how so many people could ally themselves with so much foolishness despite the fact that it was doing them no perceptible good, politically or otherwise. And it looked like the national media simply could not help itself but be swept along. This started me thinking and, when I read a clip in the New York Times about the Creation Museum, I pitched an idea to Mark Warren, my editor at Esquire, that said simply, “Dinosaurs with saddles.” What we determined the theme of the eventual piece—and of the book—would be was “The Consequences Of Believing Nonsense.”
Question: You visited the Creation Museum while writing Idiot America. Describe your experience there. What was your first thought when you saw a dinosaur with a saddle on its back?
Charles P. Pierce: My first thought was that it was hilarious. My second thought was that I was the only person in the place who thought it was, which made me both angry and a little melancholy. Outside of the fact that its “science” is a god-awful parodic stew of paleontology, geology, and epistemology, all of them wholly detached from the actual intellectual method of each of them. The most disappointing thing is that the completed museum is so dreadfully grim and earnest and boring. It even makes dragon myths servant to its fringe biblical interpretations. Who wants to live in a world where dragons are boring?
Question: Is there a specific turning point where, as a country, we moved away from prizing experience to trusting the gut over intellect?
Charles P. Pierce: I don't know if there's one point that you can point to and say, “This is when it happened.” The conflict between intellectual expertise and reflexive emotion—often characterized as “good old common sense,” when it is neither common nor sense—has been endemic to American culture and politics since the beginning. I do think that my profession, journalism, went off the tracks when it accepted as axiomatic the notion that “Perception is reality.” No. Perception is perception and reality is reality, and if the former doesn't conform to the latter, then it’s the journalist's job to hammer and hammer the reality until the perception conforms to it. That's how “intelligent design” gets treated as “science” simply because a lot of people believe in it.
Question: You delve into Ignatius Donnelly’s life story. In 1880, he published the book Atlantis: The Antediluvian World in an attempt to prove that the lost city existed. Yet, you characterize Donnelly as a lovable crank, and don’t take issue with him as you do with modern eccentrics, like Rush Limbaugh. What’s the difference between a harmless crank and a crank in Idiot America?
Charles P. Pierce: Cranks are noble because cranks are independent. Cranks do not care if their ideas succeed—they'd like them to do so—but cranks stand apart. Their value comes when, occasionally, their lonely dissents from the commonplace affect the culture, at which point either the culture moves to adopt them and their ideas come to influence the culture. The American crank is not someone with 600 radio stations spewing bilious canards to an audience of “dittoheads.” The concept of a “dittohead” is anathema to the American crank. He is a freethinker addressing an audience of them, whether that audience is made up of one person or a thousand. A charlatan is a crank who sells out.
Question: What is the most dangerous aspect of Idiot America?
Charles P. Pierce: The most dangerous aspect of Idiot America is that it encourages us to abandon our birthright to be informed citizens of a self-governing republic. America cannot function on automatic pilot, and, too often, we don't notice that it has been until the damage has already been done.
Question: Is there a voice or leader of Idiot America?
Charles P. Pierce: The leaders of Idiot America are those people who abandoned their obligations to the above. There are lots of people making an awful lot of money selling their ideas and their wares to Idiot America. Idiot America is an act of collective will, a product of lassitude and sloth.
Question: What is the difference between stupidity and glorifying ignorance?
Charles P. Pierce: Stupidity is as stupidity does, to quote a uniquely stupid movie. It has been with us always and always will be. But we moved into an era in which stupidity was celebrated if it managed to sell itself well, if it succeeded, if it made people money. That is “glorifying ignorance.” We moved into an era in which the reflexive instincts of the Gut were celebrated at the expense of reasoned, informed opinion. To this day, we have a political party—the Republicans—who, because it embraced a “movement of Conservatism” that celebrated anti-intellectualism is now incapable of conducting itself in any other way. That has profound political and cultural consequences, and the truly foul part about it was that so many people engaged in it knowing full well they were peddling poison.
Question: While writing Idiot America, what story or incident made you the most incensed?
Charles P. Pierce: Without question, it was talking to the people at Woodside Hospice, who shared with me what it was like to be inside the whirlwind stirred up by people who used the prolonged death of Terri Schiavo as a political and social volleyball to advance their own unpopular and reckless agenda. There are people—Sean Hannity comes to mind—who, if there is a just god in heaven, should be locked in a room for 20 minutes with Annie Santa Maria, the indomitable woman who works with the patients at the hospice. Only one of them would come out, and it wouldn't be him.
Question: With the election of President Obama, is Idiot America coming to an end? Or, will there always be a place for idiocy in America?
Charles P. Pierce: Look at the political opposition to President Obama. “Socialist!” “Fascist!” “Coming to get your guns.” Hysteria from the hucksters of Idiot America is still at high-tide. People are killing other people and specifically attributing their action to imaginary oppression stoked by radio talk-show stars and television pundits. That Glenn Beck has achieved the prominence he has makes me wonder if there is a just god in heaven.
Question: Are there any positive signs that we are moving away from Idiot America? If you could create a twelve step program to America back on track, what would be your first suggestion?
Charles P. Pierce: Remember that perception is not reality, that opinion, no matter how widely held, is not fact. An old and wise friend of mine said that the only question that any American citizen is required to answer is “Do you govern or are you governed?” It has to be answered in the former, and that answer has to be continuous. We have to get back to that.