SYNDICATED COLUMN: Saving Private Healthcare

Socialized Medicine Would Be Better Than Obamacare. In the Meantime, Let’s Waste Some Time on Some Lame, Doomed Reforms.

Anyone who has tried to sign up for Obamacare, as I have, knows that the launch of the Affordable Care Act has been — is — an unmitigated disaster.

Can it be fixed? Maybe.

But first, it’s important to digest the sheer ginormousness of this bastard cross between privatized grift — a wholesale transfer of wealth from individual patients to giant insurers subject to no oversight but their own absent consciences — and a spectacularly inept government bureaucracy run by careless, corrupt, connected buffoons.

More than 2 million people are getting booted from their existing health insurance because their current plans fall short of ACA standards.

Obama’s defenders say the cancelled coverage was “junk quality.” Which may be true. Still, it might have been nice to tell people about this provision, which the White House was well aware of, three years ago. When the president signed the law. As opposed to, you know, assuring us of the exact opposite.

Back in 2010, it turns out, the feds estimated that 50% to 75% of all current individual policies would have to be cancelled due to the ACA. So the current crisis is likely to expand in scope.

There’s no evidence that anyone has successfully purchased a plan. None. No one. Zero.

Six people managed to “sign up” on October 1st. Nationally.

As for the “signs-ups” — people who managed to register online or by phone, but couldn’t choose or sign up for an actual plan — it turns out that 90% of these people are so poor that they’ll get Medicaid. Only 10% might wind up buying the mandated private insurance plans. “When we first saw the numbers, everyone’s eyes kind of bugged out,” Matt Salo, head of the National Association of Medicaid Directors, told The Washington Post. “Of the people walking through the door, 90 percent are on Medicaid. We’re thinking, what planet is this happening on?”

Seriously?

The United States is not a rich country — well, it’s rich, but most United Statesers are poor. And anyway, who do you think is going to jam up the Intertubes to get healthcare first, 23-year-old “young invincibles” earning $10 an hour, or 53-year-old diabetics?

There may well be fewer Americans covered by insurance on New Year’s Day 2014 than on 2013 — due to Obamacare.

It’s been estimated that 45,000 Americans die each year because they’re uninsured. In other words, according to back-of-the-envelope arithmetic, 3,800 people will die because Obama and his underlings didn’t focus on the website launches until a couple of weeks before October 1st. Those are Katrina numbers. With more victims by the day.

I’m not counting those who will lose their existing plans without being able to replace them.

OK, it’s easy to complain (than to sign up for Obamacare, bapadumbum). What would I do differently?

Socialized medicine. Like in England. It works.

But an intelligent, pro-human solution is not in the cards. Not in bankster-owned America. Not now, anyway. Both the Democrats and Republicans are owned by the big corporate insurers that stand to make billions from the Affordable Care Act. Before the country, and eventually its political class, get real and get serious, we’ll have to waste a few years on attempts at reform.

If I were advising President Obama, here’s what I’d tell him to do:

Simplify the pricing structure. The current system’s complexity didn’t develop organically. It’s a feature. Deductibles and partial co-pays are hidden extra fees, like baggage fees charged by airlines. A plan that charges $7000 a year, but has a $3000 deductible, should be sold as a $10000 plan. Sticker shock is good. It encourages competition.

Price controls. Letting insurers charge whatever they want is ridiculous. The Department of Health and Human Services should set prices of everything from tests to drugs to visits to operations. They should squeeze the insurers to a reasonable, rock-bottom profit margin.

Eliminate sleazy out-of-network structures. Every plan should cover every doctor, every hospital, every drug. Americans shouldn’t have to live in a world where they can get a procedure at their in-plan hospital only to be told later — via a surprise bill — that the anesthesiologist, who works at the hospital, isn’t affiliated with it.

Suspend the stick, leave the carrot. The tax on Americans who can’t afford to buy for-profit insurance is unfair and cruel to working-class Americans — those who can least afford either the coverage or the fines.

Make it a national system. Rates vary wildly, not just between states, but even by county. We’re one nation. Let’s pool our resources as well as our risks. Under Obamacare as it stands, people who live in rural areas pay the highest rates — even though average salaries are lower away from big cities.

Whether these reforms fail in Congressional debate due to insurance company lobbyists or get enacted but don’t do enough to fix the system, they’ll get us closer to what we really need: a single-payer system. You know, like the rest of the First World has.

(Ted Rall’s website is tedrall.com. Go there to join the Ted Rall Subscription Service and receive all of Ted’s cartoons and columns by email.)

COPYRIGHT 2013 TED RALL

26 Comments.

  • It is always more difficult to “fix” a botched job than it is to do it right the first time. Since having lived under the German “socialized” system during the 1970’s I have always wondered why U.S. politicians pointed at the “failed” systems of Great Britain and Canada and lied to the American public about how bad those systems are. I haven’t found a single Canadian (and I have several Canadian friends) who would give up their system for what exists in the U.S. (I can’t speak for the Brits.) I also know that the system in Germany during the 1970’s was far superior to what exists in the United States. The point is, the U.S. Government is avoiding what is best for “The People”; but the question is: “Why?” I leave that to your own imagination.

  • alex_the_tired
    November 2, 2013 8:55 AM

    Putting aside the irony of a series of complaints by Ted (and the site’s regular cast) while the rall.com site is buggier than a hot sheets motel mattress …

    The crucial point is this: Obamacare was defective in utero.

    The majority of Americans will not be signing up for Obamacare. Many of those who do sign up are probably in worse health, collectively, than those who get their insurance through their employer. How can I say that? Because you have to be at a minimum level of health in order to drag your ass into work five days a week, 52 weeks a year. Thus, the pool is not risk-minimizing. Rather, it’s risk-concentrating.

    And it’s complicated. How many people, even if the damned thing ever starts working, are going to be able to fill out all the questions? There are millions of functional illiterates in this country, people who cannot comprehend and fill out such forms. Now imagine them trying to do this while sick. And what about the people who don’t have computers (again, millions of people).

    • Funny, the website seems to be working well for me. Can you delineate, either here or by emailing me, exactly what kind of problems you’re finding? I can’t fix them if I don’t know about them.

      • Ted, I’m *LOVING* your new website! I don’t see or hear any “bugs” at all. (On the other hand, I might be prejudiced.) 🙂

      • alex_the_tired
        November 2, 2013 9:19 PM

        Sorry, Ted. My bad. I meant the past few weeks (which is when the series of columns about your efforts to enroll in Obamacare started), not the last few days. The site has gotten much better after the initial week or so.

        Perhaps Sibelius can give your web designer a call?

      • She’d be lucky to have him.

      • When I read, “the website seems to be working well for me” I thought you’d finally gotten past your problems with healthcare.gov. Silly me.

        Your site seems to be working well enough. I haven’t noticed any fatal errors.

  • This is primarily addressed to Ted Rall, but others should feel free to respond as well. I’m curios to know others’ responses to what Van Jones has to say in this clip:

    https://www.youtube.com/watch?v=dLHb4Pb0Xwg

    • “curios” = “curious” !
      Ted, where’s that “EDIT” or “DELETE” button????? 😉

      • alex_the_tired
        November 4, 2013 4:14 PM

        Right. But it can’t just be “stand up for what you believe in.” That’s what the crazies do. There are people out there who genuinely think they’re right in asserting that whites and blacks should not marry each other. They “stand up for what they believe in” but what they believe in is wrong. That’s the big problem: no one’s told anymore (outside of Internet discussion forums) that they’re simply just wrong. It’s all this “I respect your opinion,” and “I hear what you’re saying.” Collectively, we no longer possess the capacity to realize that sometimes we reason badly and come to dumb conclusions, so we just cling to that bad conclusions. Look at the Obama supporters for an example.

    • alex_the_tired
      November 2, 2013 10:42 PM

      He made some excellent points, but I think he went past the most important point. We aren’t, as a political group, as a species, as whatever, making efficient, sensible, rational choices. We’re letting the special interest groups and the crazies run things.

      Here. Read this. Surprise. Gummint let big business dictate government recommendations for dietary guidelines. Anyone remember the 1970s commercials from Hostess trying to convince us all that a wholesome breakfast consisted of doughnuts? Here. Feast your eyes on it.

      So the supermarkets fill with cigarettes, alcohol, white flour, white rice, salt, refined sugar and processed foods. The meat counter consists of huge chunks of animals grown in conditions so unsanitary and disgusting that 99 out of 100 of us would probably not be able to complete a slaughterhouse tour. And who set the diet? The meat and dairy industries. Grain growers. Special interests.

      Hell, you can’t even learn about evolution in school. Why? Because a group of crazies who think a naked woman talking to a snake is perfectly reasonable refuse to accept the validity of the most rigorously evaluated and considered scientific concept of the past two hundred years. And rather than taking these people aside and telling them that, frankly, they need to stop acting like a bunch of children and grow up, we allow them to hijack every aspect of the system.

      That’s the point he missed, the point Walt Kelly reached decades ago: We have met the enemy, and he is us. And whether it’s Pogo on Earth Day or the unwashed masses texting away while the cops root through their bags, we have no one to blame but ourselves. We’ve let the goons and the idiots take over. If we all shouted them down, this would all start changing overnight.

      • @ alex_the_tired –
        I agree with what you’ve said and with the points in that article. Van Jones was addressing one specific theme: that the Progressives/Independents/Democrats have yielded too much power to the “bunny” which will never (NEVER) be caught. With this goal in mind, he didn’t miss the other point, because it wasn’t relative to his objective. The GOP’s opponents need to come to the realization that “compromise” only weakens their own strong points. The gist: Stand up for what you believe. I think he did a remarkably good job delivering that message.

  • Ted, we still have a pretty good public medical system here in Sweden, even though the right-wing government we’ve been subject to these last seven years is doing its best to destroy it (and our public school system as well) , but gradually, using the frog in the warm water method, so that nobody will notice. It’s certainly far more effective and less subject to being plundered than the one designed to bring still greater profits to the insurance companies which is in the process of being implemented in the US. But a good system which works would be even more of an anathema than a poor one that doesn’t to the Right, whose main mantra is that not a penny of my taxes can ever be used for something that benefits other people (military outlays, of course, excepted, as the benefit of being killed is one which the Right is most generous in extending to others)….

    Henri

  • A lot of good points being made here, and a lot of preaching to the choir. Still, much of what is being complained about and suggested will never come to be addressed until we can stop the flows of money going to our erected ofishals – making them shills for special interests. One of the things that needs to be done as soon as possible is to strike down Citizen’s United and other legislative vehicles that allow the unfettered flow of bribes and rewards to the shills.

  • Yes – it seems pretty wacko that the US cannot provide fair and balanced medical care for its citizens, while this is the norm for most of the developed nations. Yesterday I went to my doctor – Yes, I have a doctor – and received prescriptions for my ailments that allowed me to purchase (at a ridiculously low cost compared to the US) medications that will last me for a few months. There was no co-pay for the visit and examination – it was free. Socialized medicine works well here, and the benefits for young families for their children and maternity benefits make the US look barbarous in their treatment of the same situations. The insurance companies and medical firms are out of the equation here, while over in the US, they dominate a keep the costs sky-high. I look at the situation in the US, and I see children fighting over spare change thrown on the ground, people running in circles and legislators trying to corral cats. The insurance companies and corporations just laugh at all this ridiculous activity while the shovel the money into their accounts.

  • Okay, it appears that there has been a major malfunction with the website that needs to be addressed. Hello, Ted? Hello Webmaster?
    .
    I wanted to respond to alex_the_tired’s post of November 4, 2013 at 4:14 PM –
    but the “Reply” button has disappeared.
    .
    Here’s my intended post:
    Basically, I agree with what you’ve said, but if only the “crazies” stand up for what they believe in, they will overpower those of us who oppose their insanities and will win in the long run. Progressives must stand up for what they believe in, too! Here is an excellent example (copy & paste), which puts the lie to your assertion that “… no one’s told anymore (outside of Internet discussion forums) that they’re simply just wrong.”:

    http://www.youtube.com/watch?v=9owwg1LALxk

    The point of the Van Jones clip was that there should have been some conviction on the part of the opponents of the GOP, that would have countered any attempt at “compromise,” since that bunny will never be caught.

    • alex_the_tired
      November 6, 2013 7:49 AM

      I’m sure you can find multiple clips of people saying “you’re just wrong” in response to someone’s wacko assertion. I’m talking about the total, cumulative effect of a generation (two now) of people who have been socially conditioned to the whole “use your words” nonsense and the falsity of “respect the other person’s opinion” when that “opinion” is really nothing other than rote-memorized dogma.

      Read the New York Times. Did they ever call Bush a flat-out liar? Did they ever call ANY politician a liar? When the police arrested 600 bicyclists and pedestrians and 90% of the cases were dismissed when the unedited video tapes started coming into the evidentiary stream, did the New York Times write anything even remotely equivalent to the following: “The police lied.”

      No. They did not. The few sentences they devoted to the issue were the finest prose ever drafted in kneepads with a full mouth.

      Orson Scott Card’s bullshit also comes to mind. What the hell does he know about gay marriage? Does he even know any gay people? Well, his religion tells him that …

      I DON’T CARE WHAT HIS MYTHOLOGY SAYS. Period. Full stop. End of paragraph.

      But what do we get? We don’t get “Mr. Card, sorry, but leave the fantasy to the books. Let’s not use Mormonish, Catholicism, Judaism or any of the other religion-crutches as a basis for any public policy decisions. Why? Because, well, it’s stupid. The world isn’t six thousand years old, angels aren’t real, heaven doesn’t exist. Just knock it off. We don’t have the luxury of being stupid anymore.” What we get is a huge production about “separating the author as a person from the author’s work.”

      That’s the problem. Not that Van Jones is objecting and fighting the good fight with maybe 10 other pople. That all the rest are making his objections seem unreasonable.

      That Jones, Stewart, Carlin (the much-missed Carlin) and a few others actually oppose bullshit all the time isn’t enough. We, collectively, have changed as a culture, and not for the better. The five of six outliers pointing out the idiocy of airport searches and subway frisks are marginalized. They’re already at the absolute edge of the truth. They can’t get more truthful, it’s an absolute. But the people who start buying into random bag searches? They’re miles from how far from the truth they can be gulled.

      And sorry for the rant. I should have used my indoor voice.

      • It appears that you and I are in total agreement, based upon what you’ve said here. I guess I misinterpreted your previous post wherein you stated: “That’s the big problem: no one’s told anymore (outside of Internet discussion forums) that they’re simply just wrong”; and my purpose was to illustrate that there are those among us who will definitely call a liar a liar and an idiot an idiot. (BTW, you left out Colbert. 😉 )
        .
        I’ve never heard of Orson Scott Card before, so I looked up the Wikipedia article on him. Personally, I think he looks sort of gay in the picture on that site. That’s not to say there’s anything wrong with that. 😀

      • alex_the_tired
        November 6, 2013 11:42 AM

        So, I’m not the only one who thinks that OSC looks awfully, um, light in his magical underwear?

      • What does the religion of the author of a religion-free novel have to do with the ACA?

    • Is this still happening?

      • Ted, I experienced a problem similar to that mentioned above by derlehrer a couple of days ago, and considered posting you about it, but fortunately it suddenly decided to resolve itself, so I abstained. At the moment, everything is working just hunky-dory for me….

        Henri

      • Ted, it is still happening; but it’s random. For example, mhenriday’s post (below) does not have a “Reply” button; and the one I mentioned before (alex_the_tired on November 4, 2013 at 4:14 PM) doesn’t have one, either.

      • Ted, I see, in contrast to «derlehrer», a reply button under «alex_the_tired»’s post, but none under my own nor that of «derlehrer»’s second post on this issue – which is why I chose to reply to you instead, as one is displayed under yours….

        Henri

      • Ted, this is “selective censorship”! 😀
        None of the replies to your question has a “Reply” button (for me).
        [And when I wrote my previous post I referred to the one “below” which was below as I was writing, but actually (after posting) was “above”! This is stated merely to avoid confusion regarding which post I meant.]
        🙂

    • I don’t know about his underwear, and I really don’t want to know.
      .
      It’s just that there are certain characteristics/features that I have come to recognize over the 70+ years that I’ve been on this earth.
      .
      That, plus the possibility that his protestations might have another “raison d’être”!
      😉

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