Who is Helped and Who is Hurt by Obama Care: The Blood in the Water

Among the health insurance contract aspects, a few things were fixed by Obama Care (at least fifty years late; what took the Democrats so damn long?) but many more were not fixed. For example, insurance companies can still deny payment for unusual and novel treatments even if doctor requested and doctor approved. If the new or unusual treatment is not in the Government mandated health insurance package, you don’t get coverage for it whether it is approved by doctors and scientists or not. The new health insurance policy management system will be quite inflexible, slow moving, bureaucratic, and financially conservative due in part to the overall economic context.

Also, insurance companies can still deny payments and rescind policies if they declare fraud. Unlike before when whatever the insurance company said was automatically worshipped as gospel and dutifully obeyed by every governmental and judicial official, the companies may now have to "prove" fraud at a hearing IF the consumer actively contests the fraud. But with huge staffs of extremely high paid attorneys, the insurance companies will be able to prevail in most hearings when they decide to kick someone off the policy they don’t want to pay on by declaring fraud.

The concept of fraud, which is still alive and well with Obama Care, is vague and wide ranging enough to allow for a lot of successful attacks on consumers by the insurance companies. (And no, there is nothing you can do to eliminate the chance that your insurance company will falsely declare something you filed was fraudulent. Along with the huge staffs of highly paid shark type attorneys, they have plenty of legal tricks up their sleeve with which they can successfully accuse anyone of fraud.)

As I have said before, all these new laws do is rearrange the deck chairs on the Titanic. The system will eventually go to the bottom of the briny blue, but in the meantime, some people will enjoy a better position on the deck than they have now. In particular, here are some who will be helped:

--Higher income people who know how to "do health insurance" and have a big enough and dependable enough income to back up those skills and make all the right payments at all the right times will be helped by Obama Care.

--Those who have been hammered by the “donut hole” (that big gap in Medicare Part D prescription coverage) will be better off in about ten years when it is finally gone (assuming no repeal).

--Those who simply can not get health insurance under the status quo but have enough resources to pay for premiums, deductibles, co pays, uncovered items, prescription drugs, dental care, and vision care in full and on time year after year after year. These would be fairly rich people by definition and it is no surprise that the right of center Democrats are strongly behind them.

Here are some of the groups of people who are harmed:

--Those who are ignorant about the many complexities and consumer traps of private, for profit health insurance. Such people will still be subject to disasters caused by such things as lapsed coverage due to missing premium payments, for example, interrupted health care, incomplete health care, and inadequate health care.

--Lower income people in general, especially those between 133% and 250% of the federal poverty line. Those with less than 133% will get Medicaid, but actually getting quality treatment with Medicaid (especially in a quasi depression when states are completely broke) will be at best a very dicey proposition.

--Some people who would have declared one or more bankruptcies pre Obama Care will now never have to declare bankruptcy. But lower income people (mostly among those with incomes less than 500% of poverty) have been often avoiding medical bankruptcy by not attempting the impossible (for them) task of feeding the private health system beast year after year, but now they will be induced to feed that ever growing beast, and numerous bankruptcies among them will inevitably follow. In other words, medical bankruptcy is moving down the income scale. Going forward, the people filing medical bankruptcy will be lower income and will perhaps have a smaller gap between assets and liabilities than the prior group of bankrupts. But this is obviously a key way in which Obama Care does nothing but rearrange those Titanic deck chairs.

--Those who become unemployed due to a bankruptcy filing. Many professions and employers become very negatively disposed to employees who have filed bankruptcy in the US and they start looking for pretenses to get rid of such employees.

--There will be a good number of people who get so totally carried away by "their responsibilities" under Obama Care that they will end up homeless when they would never have been homeless under the status quo. These people will ironically end up in much worse health than they would have been with no Obama Care since homelessness is usually devastating to a person's health.

--Medicare Advantage enrollees, since that program has been heavily cut. My understanding is that many will simply drop out of that program in the wake of the big cuts to it.

--Existing Medicaid beneficiaries, since the demand for service among the big influx of new Medicaid people will be much in excess of new resources for the program. The number of people on Medicaid is supposed to increase by roughly 50%.

--Small businesses, especially those with roughly 50-250 employees, which operate with their heads just above the waterline financially speaking.

--Employees of those small businesses who are fired so that those small businesses can offset the new health insurance mandate they must take on, or so that the small business can reduce it's workforce below 50 employees and thus escape the new regulations that target small businesses.

--People who harbor a lot of resentment about being denied health care freedom. Different people come at this from different perspectives but end up in the same place: very much in opposition to the Obama Care “mandate”. Generally speaking, everyone but especially right of center people very much resent being told by the government to buy a particular product. (This is of course unprecedented not only in the US but world wide.) Rather then being told what they must do, people want the freedom to buy it, to buy something different, or to buy nothing.

Progressive people are more often most resentful of being indirectly blamed for the mess when a health system is a governmental responsibility that the government should discharge with ordinary public and progressive financing methodologies, and/or they are very resentful of having to help pay the massive salaries, massive perks, and massive profits of private health insurance companies.

--In my wide angle view, probably the most outrageous thing of all about Obama Care is that it is a slap in the face of basically the entire rest of the planet on the issue, which has decided that health care is ultimately a societal and governmental responsibility rather than an individual responsibility.

Coming next is a complete exposé focusing on this last aspect.

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The Republican Proposals Versus Obama Care

GUEST COMMENT
Mookie March 22nd, 2010 1:35 pm
What Republican plans? The absolutely only thing Republicans harped on was tort reform. Yeh, let's let the existing poor health care system in the United States continue to kill 200,000 a year through malpractice and unclean medical care.

No one who thinks Republicans are worth a frack is worth listening to.

UNITY PROGRESS
Laugh out loud, I don't agree with Republicans very often and I suppose I am playing the novelty of the moment for all it's worth, but I do agree with them regarding how bad Obama Care is. I mean, it may never happen again so I have to enjoy the novelty of it now.

Seriously though, if you want specifics, the Republicans' allowance of interstate health insurance purchasing and their proposal for allowance of a very low cost but limited insurance policy, useful for full out health/financial catastrophes only, are economically well grounded proposals within the context of the current bad system and would slightly (or marginally if you prefer) improve it.

Although a few Republican ideas were included in the thousands of pages of new laws, I do not believe the two I just mentioned, which were among their best, were included. If I were a Republican economist (laugh out loud at the thought) I would know enough to be able to tell you definitively whether or not it is generally true that the best or at least the biggest Republican ideas were not included while the lesser and not so good ones were included. But I do suspect this is true.

Moreover, the mandate is so extremely regressive that the mere absence of it in the Republican proposals means that they are much more progressive than Obama Care (or much less regressive, to put it more accurately).

So of course I stand by my rankings. Technically the Republican proposals are more progressive than Obama Care despite the fact they are still overall quite regressive by world standards and doomed to eventual total failure as is Obama Care. And then we don’t know whether the Republicans would actually vote for them or whether they are just for public relations.

The truth is neither the Republican plans nor Obama Care are really worth even discussing if your objective is a truly good working system. No serious person in most other countries of the world who had any say in system design would take either very seriously. On my ranking scale, the Chinese system is much better than the Republican modifications of the US status quo while the distance between the Republican proposals and Obama Care is less than that.

The issue of Republican proposals versus Obama Care is only a side issue by world standards and amounts to just a matter of deciding which would be better among two very bad health systems. But for the record, the Republican system would be a little better than Obama Care if both economics and health care are taken into account. If ONLY health care is taken into account without regard to costs and economics, I suppose Obama Care is better than Republican proposals. But only in Wonderland can you support one health system over another while totally ignoring costs and economics, especially in the current context of labor market collapse.

The above was in response to this article.

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Obama Care: A new low in Health Care Systems; A Very bad System Gets Even Worse

Just to make sure everyone who visits here understands exactly where this Site is coming from, here, based on tried and true economics and health care theory, is a rank order of health care systems from best to worst:

1. Single Payer with insurance companies eliminated for everything except for luxury types of care intended for rich people. (For example, United Kingdom, Sweden, and Canada.)

2. Modified or indirect Single Payer with people required to sign up with a heavily regulated but technically private insurance company. The company "selling" the insurance at the bequest of the government is strictly not allowed to make a profit on the insurance package that the government requires people to buy: they get reasonable costs only. Moreover, low income people pay only token amounts or nothing (beyond anything they already pay in other taxation) since the subsidies are huge and are much larger relative to income than proposed American subsidies for people to buy grossly expensive private US policies. (Examples of countries that most closely represent this system would be Switzerland and The Netherlands.)

3. The (mainland) Chinese Plan (a work in progress): heavy subsidies of community based health providers and other various interventions, provisions, and system organization plans to keep health care prices low enough for most people in diverse situations to afford. Note that at least for most people in China, for profit health care insurance is a totally foreign concept. Due to not being tied down to the concept of for-profit insurance (which fails for health care) the Chinese in effect get a big head start in their quest to design a good system for their country with its gigantic population.

4. Various Republican plans existing in 2009 and 2010 to modify and slightly improve the status quo.

5. The U.S. status quo as of March 21, 2010 (outside Massachusetts which already had drunk the kool-aid). There were actually progressive features in the status quo, backdoor as they were. Most notably, you had a small ( much smaller than claimed by the Democrats, however) subsidy of poor people lacking insurance by those with it, brought about by the 1986 Act which mandates that those without insurance be treated in emergency rooms of hospitals. Technically this backdoor progressive subsidy will apparently continue on, although now the amount will be even smaller than before.

6. Obama Care.

Yes it’s true; Obama Care is virtually the worst possible system and represents a new low in humanities’ efforts in the area. It not only maintains but reinforces and gives new official backing to all of the bad elements of the existing system and also makes things worse in many ways, for example, by subsidizing items that are drowning not only the health care system but the economy as a whole, particularly health insurance. When you subsidize something you raise the cost of it. It has been downright amusing to see Democrats claim that health insurance prices will be restrained or even go down going forward when roughly 15 million new people (a good number of them sicker than dogs) suddenly buy the product. (Do Democrats never take any economics courses?)

In other words, the Democrats’ new system digs the hole deeper cost wise and sooner or later health care wise as well. And now the hole is deeper still because now the new authoritarianism in the US system is unprecedented among such systems.

The Americans' refusal to follow the rest of the world into a single payer approach (and to end their unhealthy obsession with for-profit health insurance) has caused them to end up very, very deep in the health care hole indeed. They now have:

--By far the most expensive system

--By far the most unfair system

--By far the most dysfunctional system (many get care they don't really need and many more don't get care they really do need.)

--By far the most authoritarian and regressive system: the system with the least freedom, the most needless bureaucracy, and the most regressivity.

The last one is added into the toxic mix by Obama Care. How ironic is it that the country that supposedly has the most people obsessed with freedom from authoritarian, heavy handed government now has the most authoritarian health care system among advanced countries? Very ironic indeed.

Laugh out loud. They always say truth is stranger than fiction. Indeed, I couldn’t with a straight face have written a fiction book about how the Americans would make their health system even worse after having an election driven by fear of massive unemployment. I would have laughed myself out of the room at the thought of writing such a work of fiction (but it would now be fact, so laugh out loud.)

And I told you the Americans will never get health care right. I guess hell will freeze over before they get it right. The same would appear to be true about unemployment (despite the motivations of voters in the most recent presidential election): hell will freeze over before the Americans take real action to get unemployment down now and keep unemployment in check in the future.

READING LIST
The Health Care Hindenberg has Landed

The Hindenberg has landed indeed (a very sharp analogy). I can't wait until it blows up. And I have a folder ready for downloading 2010, 2012, and 2014 concession speeches of Democrats who voted for this and then lose their re-election. This folder will hopefully include Obama's 2012 concession speech.

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Unity Progress is Reborn Bigger and Better

We are making the following changes:

1. Postings will no longer necessarily be tied to articles appearing at Common Dreams. Going forward, some postings will be tied to articles at Common Dreams, some will be tied to articles elsewhere, and some will not be tied to any article at all. When we say "tied to," specifically we mean that the posting is in direct response to the article and that article is linked to at the conclusion of the posting. In other words, the article linked to has motivated the posting here.

2. Whether or not a posting is tied to an article at Common Dreams or elsewhere, there will be going forward intra post links from time to time. If the text color suddenly changes from gold to green, you have come upon one of these. These intra post links are used by me and other writers to direct readers to a good source of supporting and/or of additional information about the subject being covered at that moment.

3. On the right sidebar we recently installed crucial article reading lists. These are all-important, totally on point articles that we rank a nine or ten (usually a ten) on a scale of one to ten. These lists will be added to and will eventually grow to the point where separate pages will have to be made for them. We hope some people will use these lists as Internet surfing time savers.

Separately, from now on we will also from time to time append a reading list of one or more articles at the end of postings. These links will be to articles rated between 7 and 10 on the scale. Those ranked 9 or 10 will simultaneously be added to the most crucial lists that are currently in the sidebar.

4. Even though we disagree with "tea baggers" and other off the deep end conservatives most of the time, we agree with them whole heartedly that Obama Care unnecessarily and unconstitutionally restricts health care freedom. We also agree with them that Obama Care fails to control costs more than trivially and will be economically counter productive to one extent or another. Therefore, we will from time to time link to anti Obama Care and anti Romney Care articles at right of center and conservative sites.

5. While resources for producing Unity Progress remain limited, we expect to soon get approval to slightly but significantly increase the planned production time for articles produced for this site. We are doing so mainly because opposition to Obama Care is even stronger than we thought it would be, so an increase is needed to correlate with that.

6. Readers have been installed that show the titles of the most recent 85 postings. There are five readers that each have 17 posts in them, placed in order from newest to least new from highest to lowest on the home page. These are not simply links that you can click on to pull up the item. No, this is much better than that: you can actually read the item right in the reader after you have clicked on it. A Massachusetts based software / internet company provides this extremely valuable resource.

7. "Pages" have been installed. These are particularly important resources collected on a single, stand-alone, but updatable posting that you click a link to get to. The links to pages are near the top of the right sidebar under the header “Health Disaster Monitor”. (Google Blogger uses the term "pages" but this is really a misnomer since only the posting is unique while everything else is the same as it is on the main, multi-post page.)

The “pages” currently are:

--Health System News
--Physicians for a National Health Program Press Releases
--Health System Disaster Blogs
--Single Payer Explained
--Penalties and Enforcement

The first four are mostly links to the latest news, commentary, and research on the health front. The Penalties and Enforcement page will be custom designed by Unity Progress and will be a vital and unique consumer aid for those facing the authoritarian ravages of Obama Care. Here the penalties and the enforcement will be objectively and in detail explained. Commentary and context about the penalties and enforcement will continue to appear in various postings on the main page.

8. The new Unity Progress satellite site (or page) called NDP Canada is launched. The NDP items that were on the main page have been farmed out to here in the never ending fight to prevent the main page from becoming overloaded (which causes it to take too long to load).

9. The new Avoidance, Repeal, State Opposition, and Lawsuits Site (or page) is launched. This will keep you up to date on the many and varied ways Obama Care is being opposed, thwarted, and hopefully eventually nullified. Obviously, the motivation for this page is the unexpectedly strong opposition to Obama Care. Although I still disagree with them on most things, I have a new found respect for conservatives due to their clear and strong rejection of Obama Care and due to their active plans for opposing it. The status quo is horrible, but it is better than Obama Care. Many Americans don't seem to understand that no matter how bad things are, they can always get worse.

Note that the main topics of this site remain the same regardless of these changes, improvements, and expansions. The focus remains on:

--The health care system disaster in the U.S.
--The labor market disaster in the U.S.
--The economic disaster in general in the U.S.
--Haiti (will remain a sub focus, but time limitations will not permit continual coverage of Haiti)

The main ultimate mission of the site remains the same as well: to unify Americans into a new and instantly popular political party that will be center-left but be so with American characteristics. The ultimate goal must be to restore maximum freedom by reestablishing lost economic freedom and by establishing economic fairness in the first place in America. Economic freedom and economic fairness are by no means contrary objectives as many on the right in America falsely believe.

I hope you will agree that Unity Progress has now been reborn as bigger and even better than before and I thank you for visiting.



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Comments are very much appreciated. Comments are moderated but all comments will be approved except for those that do not belong on Unity-Progress. For example, comments that contain any commercial advertising and ones that contain objectionable hatred will not be approved. Many comments that appear will receive a return comment by Unity-Progress.

The email address for Unity-Progress is
unity.progress.mail at gmail.

Use this address for all communications, including requests for link exchange if you have a good economics or political site.