Thursday, June 28, 2012

Obamacare: Supreme Court Endorses Extracting Maximum Profit From Sick and Injured

It's official. It's constitutional for disease managers to extract the maximum profit from sick and injured people. Apparently, that's "change you can believe in."

It's a safe bet health insurers will now increase their staffing, in order to more effectively analyze patient claims, so they can see where to withhold payments and authorization, and thereby maximize profits. In exchange for issuing policies to the most unhealthy people, they will be allowed to jack up premiums on the elderly. Sweet.

For those keeping track, the favorability ratings of the health insurance industry are below those of the tobacco industry. A 2009 USA Today survey revealed that only 4 percent regarded the insurers as "honest and trustworthy." In fact, entrusting our health care to them is like entrusting our lungs to the tobacco industry.

Nothing in the Obama care bill spells out what benefits must be offered for insurance plans to qualify for the government-run health insurance exchanges that will be set up in 2014. But everyone must buy insurance, which will mean a swarm of cut rate policies designed to provide coverage without care, so private insurers can take money in without paying out. That's the name of the game in capitalist health care.

Absurdly redundant bureaucracies will continue to siphon off huge resources that could be better spent on needy patients. The U.S. currently wastes more than a trillion dollars a year on unnecessary middle-men in its grotesquely inefficient private insurance system. Administrative costs consume thirty-one percent of America's private health care spending. By comparison, administrative costs under Medicare are just 3 percent. But the government returns no equity to stockholders under Medicare, so it's by definition inefficient - at generating profit.

Obama quickly abandoned the popular and sensible single-payer system (basically, Medicare for all), in order to keep the Health Mafia Organizations in business, which they would not be if they had to compete against a more efficient government insurance plan. The public option was tossed out, along with a related "Medicare buy-in" that would have allowed people 55 and older to join the national health care system. Obama also made a secret bargain with pharmaceutical companies that the government would not "negotiate drug prices and demand additional rebates from drug manufacturers," this under pressure from lobbyists, and in opposition to 85 percent of the American public.

Americans can now be required to pay up to 9.5 percent of their income on insurance that will only cover an average of 70 percent of their medical expenses. Also, insurance companies are allowed to deny care with no court review of such decisions. Private insurers must cover people with pre-existing conditions, but they can charge people who don't meet their wellness guidelines double what they charge others. They can charge triple if they are older. Medicaid is to be expanded - with 16 million more people covered. But Medicaid is so underfunded that many doctors, paid such poor reimbursements, refuse to accept Medicaid patients. States are already stretched thin trying to pay for Medicaid, causing more cuts to services and less reimbursement to doctors.

Not surprisingly, Obamacare has devolved into another big giveaway to the private insurance companies and Big Pharma, in violation of the public will, and without the obvious measures to reduce gouging in the manner taken by other industrial countries. The new law will not make health care universal, or more cost-effective, efficient, and affordable for millions of middle-income Americans. Instead, it will guarantee hundreds of billions of dollars in windfall profits for pharmaceutical companies charging extortionate prices for drugs, because the government refuses to use collective bargaining power to negotiate costs with them.

Obama care features an individual mandate, high premiums, fines (actually a tax, says the Supreme Court) for those who don't buy the crappy product, and a lack of cost controls on insurers and providers. Obama's argument is that, in order to avoid "disruption," we need to take the current terribly wasteful privatized system and throw more money at it, rather than extend Medicare to everyone.

Obamacare actually worsens our health care crisis by further privatizing it. A large part of the increase in coverage under the law is based on an expansion of Medicaid, which is already vastly underfunded compared to the medical need it ostensibly addresses. Meanwhile, the number of uninsured Americans continues to grow, and soaring health-care costs (price gouging) destroys U.S. families and businesses. The most cost effective way of dealing with such a crisis would be to expand and improve Medicare, putting all Americans on the already established public insurance, instead of using hundreds of different health care companies that make profits from throwing sick people off their rolls. At least Medicare and Medicaid have been effective at improving the health of the population and lifting people out of poverty, while the same obviously cannot be said of private HMOs.

But Obama supports cuts to Medicare through the Independent Payment Advisory Board. The GOP openly advocates a voucher "Medicare" system; Obama favors slowly strangling the system with cuts, leaving seniors struggling to find doctors willing to take on their medical problems.

This is what "democratic choice" amounts to under government of rich capital, by rich capital, and for rich capital.

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