Guest Post: Why Would We Let Them Rig The Game?

Tyler Durden's picture

Submitted by Dylan Ratigan

Why is health insurance the only business that has an exemption from the Sherman Anti-Trust Act other than Major League Baseball? If the delivery of taxpayer trillions by our politicians to the banks to support their fraudulently paid bonuses hasn't shown you what our current government's values are, check this link out.

Through the governmental negligence that we as voters allowed, a health care system was created in which a single health care company controls at least 30 percent of the insurance market in 95% of the country, including states like the following:

Maine, where Wellpoint controls 71% of the market.

North Dakota, where Blue Cross controls 90% of the market.

Arkansas, where Blue Cross Blue Shield controls 75% of the market.

Alabama, where Blue Cross Blue Shield controls 83% of the market.

This monopoly, combined with the misaligned incentives that trap people in employer-based health care, is causing the skyrocketing health care costs that are hurtling our nation towards bankruptcy.

I don't know what's worse: that most Republicans seem to be against ending this unfair legal protection for an entrenched industry that is ruining our country with their non-competitive practices, or that most Democrats seem to be threatening this arrangement only as a bargaining chip to push for a meaningless public option that wouldn't be accessible to almost 85% of the population?

Instead of improving our country, through creating and enforcing free and fair markets, our politicians are currently engaging in backroom deals, most of which protect the very companies who profit the most from these disastrous outdated systems -- industries like health insurance and big Pharma.

While we clearly have the ability as a group of 305 million to update the system that is American Health Care and move our country into the 21st century in the process, it's becoming clear that we may not have the leaders to do it.

Instead of seeking answers to the problem of paying for and providing medicine, we are doing the exact opposite. Taxpayers' money is being played with by politicians who are desperately trying to protect the competition-stifling, false security of the monopolistic employer-based health care system and its outdated, over-charging, under-delivering ways. Given the least consideration are those affected the most -- the patients and the doctors who care for them.

This country's founders built an ingenious system of checks and balances for a reason: to ensure that no special interest or group could use government power to commandeer the creative and economic wealth of our nation to their own ends. How much longer must we live in a country where the citizens are subservient to the banks, health insurance companies and any other special interest able to control our government at the expense of our the most basic principles of fairness, our future as a nation and, as a result, our freedom?

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phaesed's picture

Goddamn... well, we all knew the revolution wouldn't be televised.


Amazing to watch this country moves towards what may be the beginning of a civil war.

Anonymous's picture

Respectfully, you're wrong: There will be no civil war.

The rest of the world realizes that Americans of today are a lesser people than their fathers and grandfathers: They are fat, lazy, and pathetic.

They won't protest—a few will bitch and moan for a while, but ultimately all Americans will acquiesce like the trained "non-judgmental" sheep that they are.

They deserve the small-motion collapse that is happening. Hell, they made it happen.

Village Idiot's picture

As one poster put it, "just in case you aren't kidding, go fuck yourself." 

If you haven't already pulled your head out of your fat ass, my fellow American, time to do so. We have work to do!

See, that is a much more empowering statement. 


Anonymous's picture

"Amazing to watch this country moves towards what may be the beginning of a civil war."

-Not amazing to watch this at all as an immigrant, came here to make life better, little did I knew....
But I can tell one thing, people are very nice and educated, but are cowards from inside. The policies are definately worng and society is very scared to raise voice against any wrong doing and very scared to punish the wrongdoers, they are very instered in watching someone innocent executed in Texas for no mistake. I don't feel good here but I am trapped...can't go back and can't breath here amongst bunch of cowards.

Anonymous's picture

A civil war is the only solution. I'm ready, are you?

Anonymous's picture

Let's attempt to split the country peacefully first.
Then I am with you. Heart and soul. Blood if need be.

sysin3's picture

Just being snarky, but this is surprising why ?

It's the golden rule ..... he who has the gold makes the rules.

The rest of us are consigned to suck hind tit.

Anonymous's picture

Sorry no tit for you. Too many pigs, not enough tits. Someone goes hungry.

suteibu's picture

The rest of us are consigned to suck hind tit...on the boar hog.



crzyhun's picture

NOOOOO, most conservatives want don't want the status quo, Mons. Rat.

We want open state competition among the insurance comp., portability, and more well run HSA's, to start with.

We want fraud and waste out of Medicare and Medicaid.

We want the gov't to be 'governor' of all the options as they are in regards to Medicare.

We want bloat gone, drones nailed, patronage cut 99%.

We want innovation with market solutions pointing to those uninsurables and pre-existing conditions.

The issue is people and they are hard to change. People run corp, small business and banks. Only in some ideal far away unrealistic place are there no 'special interests'. We all have them. Some are reasonable and some are not.

ghostfaceinvestah's picture

Depends on how you define "conservative". 

Ron Paul has mentioned the points you listed - let's get competition into the system.

I live in an urban area, where i have a choice of hospitals and doctors.  Why can't I get a quote for a simple doctor's visit?  Or a fixed price bid?  Or at least some kind of price list?

Before we add another player to the oligopoly, let's try competition first.

Sure, some people question: "you would go to the lowest bidder?"  NO, I don't take my car to the lowest bidder, I don't take my child for childcare to the lowest bidder, i don't get my haircut from the lowest bidder.

But I DO use the information available to make informed choices on the cost/quality tradeoff.

Give me price information and an online rating system for doctors (e.g. Yelp) and me and millions like me will "reform" healthcare.

Anal_yst's picture



The fact that Doctors and health-care providers bill AFTER the fact with usually zero discussion of cost before hand is mind boggling, although not nearly as ridiculous as 99% of people just going along with it like mindless zombies.

Hephasteus's picture

My uncle is a certified public accountant, many people my family are. I felt really sorry for my cousin not passing his test the first time. He got a bit of pressure on him. LOL

Anyway I had the great experience of driving him around to various doctors for eye surgery paid with cash. After being dishonorably discharged for refusing to violate the constitution from the navy, leaving arthur anderson for refusing to bend accounting rules this was one cranky old man that doctors just didn't want to have to negoiate with.

"What you mean you don't know what it costs? You doctors have lost COMPLETE CONTROL OF YOUR PROFESSION!!"

Nurses standing around smiling. Me swapping stories about doing the lens physics for somene who was writing an application for a lense salesman who makes 2 million a year and has offices all over the country that are just phones in buildings. Discussing hospitals buying $900 bucks for the little metal poles to hang the IV bags on. It was a good day.

long-shorty's picture

The doctors do this because it doesn't matter how much they bill, unless the patient has no insurance, they are getting paid whatever rate their local insurance monopoly/oligopoly decides to pay them (well, if they beg and file the claim three times, except for the 15% of the time when they still don't get paid), and because of the system that the government has established that assigns a value to documentation and procedures, but not to thinking or to making good decisions.

The profession of medicine, and primary care medicine in particular, is, like everyone who took a hit from the current economic crisis (which is everyone), a victim of bad government policy. The government has established a health care delivery system with large financial incentives for PC docs to see a lot of patients poorly and consult a lot of specialists. And then the specialists get paid the most when they do tests and procedures.

And primary care salaries keep going down every year in real terms, which means you get people with MCAT scores of 17 from some osteopathic school rather than people with MCATs of 33 as the gatekeeper making the most diagnoses and controlling expense.

The system is FUCKED. Getting at good policy here is incredibly complex and against many entrenched special interests, so it isn't going to happen. We need a health care system that pays primary care providers generously when they provide good care and poorly when they don't. Not one that rewards ineptitude and greed.

- former top decile board certfied Internal Medicine doc who scored 40 on his MCATs, and left medicine to manage my own hedge fund (where even in my first year with microscopic AUM, I earned more than I could make as a primary care doc, with much less stress, and that was during the financial crisis).

long-shorty's picture

if it wasn't clear from that, giving everyone a chance to have Medicare is not going to solve anything. it's a social program, not an answer to why we spend so much and don't get the best results for that expenditure.

Rusty_Shackleford's picture

Great posts. I too have known the vast, soul crushing Sisyphean ordeal and existential void that is primary care medicine. I hear you dude.


2 quotes I always try to remember regarding government "programs".


Government is force. Every government program, law, or regulation is a demand that someone do what he doesn't want to do, refrain from doing what he does want to do, or pay for something he doesn't want to pay for. And those demands are backed up by police with guns. - Harry Browne


Government is not reason, it is not eloquence, it is force; like fire, a troublesome servant and a fearful master. - George Washington

handsfree's picture

Congress has long ago given up all moral authority on this issue. But, go figure. When you lay down with whores, expect to wake up with STD's.

Goldman and Bank of Amerika run the markets along with Geithner, and beagle boy Ben. There is no free markets, only welfare capitalism and socialism for capitalism.

good articles; good articles 4 slow news day ..http://www.. hat tip: finance news & opinion updated daily

Miles Kendig's picture

I gotta ask...  You know the Oaktown.  CR?

Assetman's picture

Depends on how you define "conservative". 

Democrats & Republicans = conservative

Revolutionists = liberal

Assetman = smart aleck


TumblingDice's picture

That sounds more like a "capitalist" POV to me.

ghostfaceinvestah's picture

Right, or "libertarian" maybe.  That is my point on the use of the term "conservative"; it has been co-opted by people who are anything but.

Notwithstanding political affiliation, there are plenty of economic studies that show markets are less efficient when there are informational asymmetries.  How can any market work without even a priori price disclosure?

Even though I have health insurance and thus have seemingly little incentive to price shop, I would do it on principal alone, besides the fact that it would improve the market in the long run and thus reduce my health costs.

Better yet, put me in a high deductible plan where the deductible can be paid with pre-tax dollars, and damn right I will shop like a motherf*cker.

TumblingDice's picture

But the government doesn't trust you to make the right decision, giving you less reason to trust the government. As this process continues there becomes only one reason to trust the government, and that is because you have to. Thats where many folks are right now. Not efficient at all.

The government doesn't have to spend a dime to fix this problem, but it won't because you can't buy trust and spending money is the only thing it knows how to do.

Anonymous's picture

IMHO, the words "conservative" and "liberal" have become worthless, at least in the USA. I know people who work at firms which subsist primarily on government contracts, but call themselves "conservative", and even listen to Fox News, at work. They don't see the irony. As for "liberals", consider DailyKos. Is the primary goal of "liberals" merely to get "liberals" elected, and then, nobody knows? We probably need about a dozen new terms. For example, "Ronpauls" could include Ron Paul, Alan Grayson and, sometimes, Tyler Durden and the delectable but dangerous Marla Singer. Or, maybe, just abandon labels completely.

defender's picture

"the delectable but dangerous Marla Singer"

Nicely said.

Anonymous's picture

Remove the job-health care connection by giving the tax break to the individual, not the corporation. That way when you switch jobs, you don't have to switch health care providers.

Sell "pre-existing condition" insurance that would guarantee you access to reasonably priced health care insurance if you develop a condition.

Remove/reduce the state regulations, so it's possible to move to a different state without having to switch health care companies.

Encourage high deductible policies - there's nothing like a little out of pocket expenses to get people to stop going to doctor every time they get the sniffles.

Tort reform! I've been losing the hearing in one of my ears for years. My doctor sent me to the specialist who orders a CAT Scan test for the one in a million chance that a tumor is causing the problem. That was strictly a CYA move that cost over a $1000.

Miles Kendig's picture

We want fraud and waste out of Medicare and Medicaid.

Ya.  Right.  How many convictions for fraud were there and the total aggregate of said fraud from Jan 01- Jan 09?

That is why a conservative controlled government passed Part D?

So called liberal or conservative.  Just two sides of the same blood sucking, prostituting coin.

Cognitive Dissonance's picture

When the people decide to lead, the leaders will eventually follow.

Veteran's picture

Viva la revolucíon

Edna R. Rider's picture

Anecdote:  I run a smallish company.  We use Aetna for health insurance.  By coincidence our policy renews this month.  The new proposal is on my desk.  The premiums are INCREASING by 11.3% over last year.  I bought ($28) some AET as a hedge (sold $29, when learning the "public" option that other solvent countries have (Canada) had been voted down).  Barack n roll.

Enkidu's picture

Edna - I live half in Canada/ half in UK and love the health systems in those countries because it does not matter what your status is. If you are divorced or unemployed or poor - everyone is treated the same. However, my question is why can't the Obama Administration just keep bringing Medicare forward so that it starts at 60 then 55... etc.? Isn't Medicare just like the systems already used in Canada/UK?

shargash's picture

Medicare is more similar to Canada. The VA hospital system is more similar to the UK.

We can't have everyone treated the same in the US. That would be Marxist or something.

Anonymous's picture

"However, my question is why can't the Obama Administration just keep bringing Medicare forward so that it starts at 60 then 55... etc.?"

How can the government pay for full and complete health care for 310 million people when there is $50 trillion of cumulative debt across the entire US economy?

Miles Kendig's picture

Simply because a fair portion of that debt is earmarked not for actual services or expenditure, but for those that hold the crossroads of commerce.

Enkidu's picture

Health costs rise as people get older for obvious reasons - so America has already covered the worst part of the curve. The younger part of the curve will be less expensive.

With regard to the payment, the US could halt or half their military adventures (US military spending is more than the next 10 countries put together), stop the rape of the Treasury by the financial services industry, end subsidies to the housing sector (as in Canada), etc.. It would seem that there is absolutely no limit to the amount of fiat that can be produced. I would sooner be confident in finding health services than I would in being handed cash for a car!

defender's picture

This will never work.  Even with the high minimum age the three largest expenditures for the US govt are Social Security, Medicare/Medicade, and defence.  If it costs just as much to make thousands of tanks and airplanes for the sole purpose of being blown up in some distant land as it does to care for people over 65, how much is it going to cost to care for the rest? 

Two things need to happen:

1. Schools need to let more doctors in/graduate.  This is keeping an artificially high cost to all doctor visits.

2.  There needs to be more clinics.  This means decent places where you aren't just another number that they are squeezing for cash.  If the hospitals have to compete, then they will lower prices.

Anonymous's picture

You should check out healthcare downunder. Public and private options. Going bankrupt through catastrophic illness is unheard of. Reading this piece I now understand why USA healthcare is 'rip your tits off' expensive. If only the average American Joe knew that your public system is more expensive per eligible person than the sum of all the healthcare per capita in every other Western country.....

Rusty_Shackleford's picture

Don't be so quick to accept the "epidemic of medical bankruptcies" meme.


The classifications used to determine a medical bankruptcy were odd. Only 28.3 percent of the sample cited self-reported illness or injury as a cause of bankruptcy.  However, H & W managed to almost double that figure (to 54.5 percent) by counting the following as "illnesses":

  • 1. A birth or addition of a new family member
  • 2. A death in a family
  • 3. A drug or alcohol addiction
  • 4. Uncontrolled gambling
  • 5. Loss of at least 2 weeks of work-related income due to illness or injury by anyone in the household
  • 6. Out-of-pocket medical bills of $1,000 in the two years before filing by anyone in the household
  • 7. Mortgaging a home to pay medical bills.

In a 2005 article in the Northwestern University Law Review, Prof. Todd J. Zywicki called the $1,000 threshold for contributing medical debt "indefensible." That's an understatement.  By H & W criteria, a bankruptcy with $50,000 in student loans and $1,001 in unpaid medical bills would be classified as a "medical bankruptcy."

Anonymous's picture

For a while D.R. had me going, especially the phrase "governmental negligence"........but he immediately veered to the left as expected and his argument lost it's flavor.

Unwinding decades of bad government must be done extremely carefully, and my hopes are not high for it's successful outcome. When the foxes are guarding the henhouse bad things generally happen.

I am a Man I am Forty's picture

Not sure what you mean, didn't notice him veering in any direction.

Unwinding decades of bad government should happen at warp speed with a bill less than a page long.



Miles Kendig's picture

Unwinding decades of bad government will never be accomplished carefully.  Such unwinding almost always happen rapidly as a great vacuum equalizing.

The time is rapidly approaching when most everyone will know who has the power, the monster or those that created and loosed the monster upon us.  Dylan Ratigan is a product of some simply enfeebled attempt to say something is being allowed to be said when next to nothing real is being said & done.  Just more expenditure of O2 rather than true pressure releasing by the monster creators.  Soon, the choice will be out of their hands as well.

AN0NYM0US's picture

This was originally published at HuffPo - amazing that the comment thread there is void of partisanship - Mr. Ratigan has tapped into a populist sentiment that resides in people of all political stripes. His message transcends party lines  and I suspect that void of any missteps or serious scandal he will hit prime time in the near future, not to mention a real shot at political office should he be interested. 

Miles Kendig's picture

That is the whole concept.  Push the Unity '08 concept into '12 after the trillions were obtained, the concept of deferential justice cemented, south & southwest Asia bagged and the populace engrossed in how it will satisfy the gatekeepers of finance for the public & private notes.

Too bad the monster won't be satisfied with this and will demand ever more that it's creators or its host cannot satisfy.

Daedal's picture

Dylan, I miss you and Jeff Macke.

kosherenchiladas's picture

Is this that slut from "Fast Money?" What a tool... Although, he makes good points. For a dick.

Anonymous's picture

I wouldn't call him a dick just yet. I'll just call him Major_Shill. We see his transformation from CNBC to MSNBC he's now a real good guy, not. Now the Obama admin has Major_Shill in their pocket.


Anonymous's picture

Maybe if our leaders (i.e. legislative branch) was more concered with creating a better country for its citizens instead of how their votes will affect their reelection chances (especially as relates to donations from special interest groups), we might actually see something positive happen...

D.O.D.'s picture

Corporate Feudalism, that's what it is, whether the founding fathers, and whatever societies they may or may not have been a part of, had Corporate Feudalism in mind is debatable.

The question is, why are people still holding the hand that insists on holding them/us down? (Dylan, that's to you as much as anyone else.)

Hephasteus's picture

Corporate feudalism and illusory slavery versus real brutal slavery was the goal.