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Guest Post: Real Danger Of “Obamacare”: Insurance Company Takeover Of Health Care

Tyler Durden's picture


Via Nomi Prins of,

Election rhetoric shuns the big picture in favor of the bigger platitude. Now that The Show is over, we are left with the equivalent of a Sunday morning hangover following a binge of promises and lies. We leave the theatre of political spectacle on steroids for the real world of unstable economy, a globally and publicly subsidized financial sector, and increased costs of living on everything from food to education to health-care; outpacing declining median incomes. The average cost for health insurance for a family is $15,745 per year vs. a median income of $50,502, or about half post-tax take-home pay.

“Obamacare” is the name commonly used for the Patient Protection and Affordable Care Act (PPACA) of 2010. The very moniker is indicative of how name-and-image-centric our world has become; Medicare was never called “Johnsoncare” when President Johnson signed it into law in 1965 and Johnson was not exactly a man of small-personality. At any rate, Obamacare or the PPACA ranks as one of the most misrepresented issues from the campaign, by both sides of the ever-slimming aisle.

The Tea-Party Conservative types get it embarrassingly wrong when they call it a “government takeover of health care.” Likewise, Progressive Obama-supporters are deluded in accepting it as the most sweeping healthcare reform since Medicare. (Side note: I wish the word ‘sweeping’ could be retired from politics until it actually means -sweeping.)

Here’s why. The PPACA does nothing to restructure the health insurance industry, anymore than the Dodd-Frank Act restructures the banking industry. This means everything else it attempts to do, positive or negative, will be vastly overshadowed by an industry accelerating to morph itself into a acquisition machine in order to circumvent anything that even smells like a restriction, including laws that exist and ones to come.

How? By doing the same thing energy and telecom companies did after they were deregulated in 1996, and that banks did after they were summarily deregulated (after moving that way for decades) in 1999. They are merging, consolidating, eliminating competitors, and controlling their domain. They are manufacturing power.

Investment bankers are roaming the world to exploit this hot new opportunity. That’s one reason insurance companies don’t even call themselves that anymore. Now, they are ‘managed health care’ companies. Call yourself a managed health care company, and you can buy everything from other insurance companies to hospitals to clinics to doctors. The more consolidation, the more fees bankers rake in, and the more premiums and medical reimbursements and health care procedures, each company can control.

The result of 1996 energy deregulation was a glut of crime-spawned bankruptcies like Enron. Likewise WorldCom led a pack of telecom degenerates in the production of tens of billions of dollars worth of accounting fraud. The final repeal of Glass-Steagall ignited a merge-fest of investment and commercial banks, their linkages ensuring that taxpayers, whose deposits have been protected since the New Deal, provide a safety-net upon which they can mint toxic assets loosely based on over-leveraged home mortgages, and engage in risky, speculative activity; big banks don’t go bankrupt when they fabricate values or lose big on stupid bets, they get federally subsidized in all sorts of ways.

You know who else is similarly too big to fail? The insurance industry. UnitedHealth Group, the nation’s largest health insurer covers 50% of the insurable population in over 30 states. Blue Cross-Blue Shield, covers 100 million people through a constellation of 38 sub-companies. They, and other insurance companies are growing in breadth. When companies consolidate, the result is less transparency, less competition, and more possibility for fraud and shady behavior. Every. Single. Time.

Obamacare and Accounting Fraud

By January 2014, the PPACA will require insurance companies to list their prices on competitive exchanges. In Obama-theory, this is supposed to reduce premiums via competition. But what if, say, only three companies control nearly all of the premiums? Consider the fact that it costs the same $3 to extract your money from a Chase, Bank of America or Citigroup ATM (if you don’t get it directly from the firm you bank at.) They constitute a monopoly that defies anti-trust inspection (thank you, Department of Justice.) What incentive would any of them have to charge less? None. That’s why they don’t.

Managed Health Care companies don’t just administer private, but government health insurance policies as well. The website says that under the PPACA, the life of the Medicare Trust Fund will be extended to 2024 as a result of reducing waste, fraud, abuse, and slowing cost growth. President Obama promised to reduce Medicare fraud 50% by 2012 according to the site – but if he did, he forgot to mention it during the campaign period. 

To supposedly combat price hikes, the PPACA calls for a new Rate Review program, wherein insurance companies must justify premium hikes of more than 10% to a state or federal review program. Given that banks aren’t supposed to hold more than 10% of the nation’s deposits in any one institution, and three do, this isn’t a comforting constraint.

While it is positive that the PPACA requires coverage of people with pre-existing conditions and prohibits lifetime caps, it can’t control what people pay for insurance, because it doesn’t limit actual premiums, which have risen 13% on average since the Act was passed.

The medical cost ratio limitation the PPACA instills; that 80% of premiums must be used for medical care in the case of individuals and small groups, and 85% in the case of large groups) to supposedly ensure companies operate on a more efficient premium in vs. premium out basis, is a joke. Its punch line is accounting manipulation.  Call everything a medical cost; even buying another company, and the ratio is meaningless.

WellPoint got the Joke

WellPoint got that joke immediately. The largest for-profit “managed health care” company in the Blue Cross and Blue Shield Association, it began trading publicly on December 1, 2004. Depending on the state, it operates under Blue Cross and Blue Shield, Blue Cross or Anthem. 

After the PPACA was passed, in March 2010, WellPoint allegedly reclassified certain administrative costs as medical care costs in order to meet the law’s new medical loss ratio requirements (which requires insurers spend at least 80% or 85% of premiums on health care services, depending on the type of plan, individual or group respectively.)

A month earlier, WellPoint announced its Anthem Blue Cross unit would raise insurance rates for some individual policies in California up to 39%. Federal and California regulators are still investigating this, but the premium hikes remained.

WellPoint is also one of Wall Street’s favorite “managed health care” companies; cause it keeps getting bigger through acquisitions that pay hefty fees to the bankers involved. On October 23rd, WellPoint got approval from Amerigroup’s shareholders to acquire Amerigroup, a Medicaid-focused health insurer, in a $4.9 billion cash deal. The deal makes WellPoint the nation’s largest Medicaid insurer, and provides it greater access to Medicaid patients who also qualify for Medicare.

It was the largest cash deal ever, and the largest premium paid for a company in the managed health care realm. As a result, Goldman Sachs (who advised Amerigroup) and Credit Suisse (who advised WellPoint) retained their top positions in the global healthcare deal advisory league table.

The value of Amerigroup, as a company, dropped 34% within two weeks of that agreement, in stark shades of what happened when Bank of America took over Merrill Lynch in the fall of 2008.

This summer, Amerigroup and Goldman Sachs faced a shareholder lawsuit filed by the city of Monroe Employees Retirement System and Louisiana Municipal Police Employees Retirement System. It alleged that Goldman advised Amerigroup to accept WellPoint’s offer quickly, rather than seek other bids, because the bank had structured a complex, and fee-heavy derivatives transaction on the back of the deal. The insurers resolved the suit by tweaking the deal parameters. All parties denied ‘any wrongdoing.’ But where there’s smoke in complex derivatives land, there is fire.

Other Mergers

After the Supreme Court upheld the PPACA, a spate of mergers rippled through the managed health care realm, to ostensibly cope with smaller profit margins and  ‘compliance costs.’  But really, it’s because each firm wants to corner as much as possible of the market, in as many states as it can, to garner more premiums and control more disbursements and prices at the upcoming insurance ‘exchanges.’

In late August, the third largest insurance company in the US, Aetna announced it was buying Coventry Health Care for $5.7 billion. Coventry provides Medicare and Medicaid services, thus the takeover expands Aetna’s Medicare and Medicaid business. Being part of Aetna enables Coventry to grab more consumers on more state-run health insurance exchanges, reducing competition in the process. The Department of Justice is examining anti-trust issues surrounding the deal, but it’s still expected to close in mid-2013.

On October 17th, UnitedHealth Group issued $2.5 billion of bonds as part of its $4.9 billion acquisition of Brazil’s Amil Participacoes. Bank of America Merrill Lynch, Goldman Sachs, J.P. Morgan Chase & Co., Morgan Stanley, UBS and Wells Fargo Securities were lead underwriters on the deal.

They are not buying international companies in order to increase accounting transparency. Like other multinationals, they are doing so to move profits around and circumvent restrictions and tax laws. They are using cash, or raising extra debt, to do so, rather than to reduce premiums or increase disbursements to medical professionals.

And if you’re keeping score – billion of dollars are flowing from insurance companies – NOT to reduce premiums to patients and NOT to reimburse doctors and NOT to enhance the quality of care, but to simply expand nationally and globally. Meanwhile, their CEOs are doing quite well from all that non-health care related movement.

Total compensation for the bulk of health care company CEOs rose by 14.7% in 2011 by 14.7%, or $11.1 million, to $87 million. Cigna’s CEO David Cordani made $19.1 million. UnitedHealth Group's CEO, Stephen J. Hemsley bagged $49 million in salary, stock options, and other compensation last year. The highest-paid CEO made 94 times the average compensation level of primary care physicians. And none of them had to pick up a single scalpel in the process.

Doctors as profit centers

Not just patients, but physicians have been bled steadily from the current state of insurance company controlled health care through diminishing insurance reimbursements, electronic medical records mandates whereby they spend as much time complying with Kafkaesque controls over their decisions on performing surgeries and providing care, and debt. New doctors are graduating with an average of $250,000 in debt, which, combined with diminishing disbursement and soaring costs, will keep many, underwater. Forever.

According to Dr. Michael H. Heggeness, President of the North American Spine Society, a group of 6500 global spinal and orthopedic surgeons (at which I delivered a speech last month), “The last people, that most of the population feels sorry for are doctors, yet they are in an economic crisis of their own. In 2002, 80% were in private practice, now 70% are in hospitals because they can’t afford to make a private practice work.”

Meanwhile the more hospitals are viewed as profit centers, the more their Chairmen will cut costs to maximize returns, and not care quality. They will seeks ways to sell underperforming assets, programs or services and reduce the number of nonessential employees, burdening those that remain. No doubt the private equity community will be getting more into this game, as insurance companies buy more hospitals, doctors, clinics, and perhaps drug companies, or vice versa, and ‘restructuring’ accelerates.

And if insurance companies can manage doctors directly, they can control not just costs, but treatment – our treatment. It’s not an imaginary government takeover anyone should fear; but a very real, here-and-now insurance company takeover, to which no one in Washington is paying attention.


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Tue, 11/13/2012 - 16:34 | 2977342 MillionDollarBogus_
MillionDollarBogus_'s picture

The presidential candidates both said they would force health insurance companies to take on folks with pre-existing medical conditions...


Tue, 11/13/2012 - 16:37 | 2977352 Lohn Jocke
Lohn Jocke's picture

We can make up the costs with cheaper drones.

Tue, 11/13/2012 - 16:38 | 2977363 francis_sawyer
francis_sawyer's picture

Especially if they start plinking sick people as target practice...

Tue, 11/13/2012 - 16:40 | 2977370 knukles
knukles's picture

The act has nothing to do with healthcare.
It is a milk the peasantry for federally mandated health insurance premiums in exchange for campaign contributions.

Called extortion

Tue, 11/13/2012 - 16:44 | 2977378 Michaelwiseguy
Michaelwiseguy's picture

There's nothing to worry about.

The complete and total economic collapse of the USA will take care of this problem.

Tue, 11/13/2012 - 16:55 | 2977439 ACP
ACP's picture

Unfortunately, it takes a helluva lot of effort to exterminate cockroaches, even after a collapse.

Tue, 11/13/2012 - 17:00 | 2977467 redpill
redpill's picture

This is how fascism works.  Regulate an industry so heavily that it essentially becomes indistinguishable from government.

Tue, 11/13/2012 - 17:25 | 2977574 TeamDepends
TeamDepends's picture

So now my insurance agent will have his hand up my bung?  Great, I already can't get him to stop yammering on about "full coverage"...

Tue, 11/13/2012 - 17:25 | 2977579 economics9698
economics9698's picture

I second that.

Tue, 11/13/2012 - 17:41 | 2977634 DaveyJones
DaveyJones's picture

it is exactly fascism but of course the regulation swings both ways. The "regulation"  is nothing more than the corrupt by-product of the criminal drug and insurance  (banking) companies influence. As knuckles said, It bears no resemblance to any other medical system and has little to do with health care. It definitely served the growing government interest but it just as much serves the non free market dominance of mega corps who want to exploit not cure the masses.    

that's the beauty of corruption.

Tue, 11/13/2012 - 17:45 | 2977658 redpill
redpill's picture

Well look, you don't keep public employee pension funds solvent by actually curing everyone, ya know?

Sorry Mrs. Johnson, we had a new kidney for you but Tim the male nurse accidentally dropped it in the almost-dead baby chute back by the "not rare" and "free" abortion room.  We'll still be billing your "insurance," of course.


Tue, 11/13/2012 - 17:56 | 2977679 DaveyJones
DaveyJones's picture

don't worry, at this point, nothing will keep public employee pension funds solvent

I think all this corruption is giving me a medical reaction.

crap, they win again

Tue, 11/13/2012 - 17:25 | 2977575 Radical Marijuana
Radical Marijuana's picture

Ah, an appropriate handle you have to make that comment here, Michaelwiseguy. I WISH that I did NOT believe that there is no doubt that you are right!  Just like the corruption of politics enabled USA banks to take over the economy, and pretty well destroy it, while making a killing do that, the same sort of corrupt funding of politics is driving the profit-from-diseases system to take over "medicine" to make more money. That will continue the trend that the main loci of the real death controls in the money/murder systems will become a medical industry, run to make more money.

The deeper problems are that our society is TOTALLY controlled by professional liars, and everything gets explained by immaculate hypocrites, using impossible ideals to actually defend making the opposite things happen. IN FACT, medicine is inside of militarism, because EVERYTHING operates inside of militarism, with the money system actually doing that more than anything else. Militarism is all about the ability to kill people and destroy things. Militarism is about using lies, backed by violence, to impose death controls, to maintain the established systems that benefit from that. America is the heart of the beast of runaway fascist plutocracy. Its "health care system" is now, by far, from an objective, statistical social fact perspective, the single greatest death control operation in the country. The murders done through medicine are now at least an order of magnitude greater than the murders done through the direct application of the armed forces.

The problem, of course, is that the various reactionary revolutionaries will insist that should not exist at all, whereas, the only realistic way to go foward would be to do that better, in the sense of using more information, with a higher consciousness, so that the death controls were both more efficiently and compassionately done. However, IN REALITY, since the majority of Americans have become brainwashed Zombie Sheeple, that were routinely getting fleeced more and more, for generation after generation, there are ACTUALLY conditions being set up to slaughter those sheeple off more than ever before, while those doing that will gain more wealth and power than ever before!

Here is another presentation, from November 2, 2012, about how the real FINANCIAL NUMBERS are headed towards a psychotic breakdown, because those NUMBERS ARE INSANE!

The Economy Is Going To Implode Pt.1 of 8

Although I do not agree with the Christian presumptions in the silly notions of "solutions" in that video, it does a good job of simplifying the REAL NUMBERS, and demonstrating that they are INSANE, and that the expectations that the future profit from disease systems will be able to continue are nearly ZERO.  Therefore, I am forced to agree with your "wiseguy" comment that the most probable future will be that "complete and total economic collapse of the USA will take care of this problem."

THE PROFIT FROM DISEASE SYSTEM IS NOW THE MOST EXPONENTIALLY GROWING MANIFESTATION OF ALL THE REST OUR SOCIAL INSANITIES! The deeper reasons for that are that our political economy is inside of our human ecology, and therefore, medicine is inside of the money/murder systems, BUT, our human ecology is dominated by the biggest social taboos, and the most astronishingly insane bullshit ideas, which make everything else a runaway growth of that MADNESS, driving itself through to psychotic collapses to chaos. It is quite impossible in America today to have a sane public debate of any important public issues. The entire establishment is due to the triumphant control of civilization through huge lies. For more than a Century, medicine has become more and more based on fraudulent science, with its fantastic special effects used to tell the same old stupid social stories.  Those who made the most money from their frauds have totally taken control of orthodox medicine in America, and "public health" policies are the result of the feedback of money made from fraud being reinvested through the funding of the political processes to achieve even more fraud.

Thus, all of the decisions made in the public health care fields have become psychopathic and sociopathic, and those are integrated into the overall combined money/murder systems. ALL OF THESE KINDS OF PROBLEMS ARE GOING TO BE "SOLVED" BY THE TOTALLY INSANE PSYCHOTIC COLLAPSE OF THE SYSTEMS THAT ARE GENERATING THOSE PROBLEMS ... I WISH that wiseguys like you were NOT right, and that learning about this was of some use, and that attempting to understand and communcate these problems had some practical point. However, actually, writing this comment, just like writing that article above, were wastes of time, that will NOT make any significant difference to what is still going to happen anyway!

Tue, 11/13/2012 - 18:52 | 2977667 Michaelwiseguy
Michaelwiseguy's picture

Wow Radical Marijuana. Another ZH commenter that can communicate in more than one complete sentence. And well thought out too.

Therefore, I am forced to agree with your "wiseguy" comment that the most probable future will be that "complete and total economic collapse of the USA will take care of this problem."

Thus, all of the decisions made in the public

health care fields have become psychopathic and sociopathic, and those are integrated into the overall combined money/murder systems. ALL OF THESE KINDS OF PROBLEMS ARE GOING TO BE "SOLVED" BY THE TOTALLY INSANE PSYCHOTIC COLLAPSE OF THE SYSTEMS THAT ARE GENERATING THOSE PROBLEMS ... I WISH that wiseguys like you were NOT right, and that learning about this was of some use, and that attempting to understand and communicate these problems had some practical point. However, actually, writing this comment, just like writing that article above, were wastes of time, that will NOT make any significant difference to what is still going to happen anyway!

I also think the economic collapse will solve the Geo Engineering Chemtrail problem for us.

Tue, 11/13/2012 - 23:17 | 2978640 Ident 7777 economy
Ident 7777 economy's picture




-1 CT (conspiracy theory) fail 


'Geo Engineering Chemtrail problem'.




(Man can't have taken a single science course IN HIS LIFE, ever looked at an UPPER AIR CHART or ever trained as a PILOT for an actual AIRCRAFT even as small as a Cessna 150!)






Tue, 11/13/2012 - 23:14 | 2978631 Ident 7777 economy
Ident 7777 economy's picture






What's a two-word term that means "Michaelwiseguy sock-puppet"?


Give up?




"Radical Marijuana"


Tue, 11/13/2012 - 17:17 | 2977541 toady
toady's picture


Nobody in Washington is paying attention?

The law was written for insurance companies by insurance companies, and now we're 'surprised'?

I'm not. Everyone who hates government run healthcare will be begging for it by the time this insurance company lobbied fiasco is done.

Wed, 11/14/2012 - 11:04 | 2979667 Kobe Beef
Kobe Beef's picture

Pay to play politics. I bet Pelosi and Obama hadn't even read the bill (much less wrote it), but just knew they'd been paid to pass and sign it.

Tue, 11/13/2012 - 18:05 | 2977716 Not Too Important
Not Too Important's picture

"It is a milk the peasantry for federally mandated health insurance premiums in exchange for campaign contributions."

Yes and no. The insurance companies are all broke. They don't have the investment return to pay claims. QE3, the purchasing of both Residential and Commercial MBS, is to purchase what little assets the insurance companies have left, as they are the primary private source of mortgage monies. Once the insurance companes are out of assets, now transferred to the Fed, they will be supported by forced premium purchasing (which SCOTUS calls a 'tax') enforced by the IRS (who just purchased many millions of hollow point bullets and sawed off shotguns).The American public might not stand for the Fed bailing out the insurance companies directly.

Yes, there will be plenty of campaign contributions all around. Paid for by minimum wage, part-time workers to support a health care machine that they will not enjoy the benefit of when they are older, and the GMO/Fuku cancers kick in and death panels are the law of the land. I mean really, if our lungs are full of plutonium, and the food is proven to give us cancer, at what point is expensive medical care not worth the investment?

Eventually all medical care will be directed to those paying for it (ie still paying taxes) and the rest (non-taxpayers) will be left to die. Comfortably, maybe, morphine is cheap now that we own the poppy fields, but left to die all the same.

Heck, the British hospitals even make a profit killing off their patients. That business model will make its' way here shortly.

The surest path out of a recession/depression is to kill off the 'useless eaters'. Works every time.

Wed, 11/14/2012 - 04:26 | 2979050 Parrotile
Parrotile's picture

Er, Euthanasia is ILLEGAL in the UK . . . . .

There is a vast difference between a "Not For Resuscitation" order and euthanasia. NFR orders are used when a Patient's prognosis is sufficiently poor that their quality of life post-resuscitation would be very bad indeed (i.e.  PVS or Persistent Vegetative State). It is also seen as good practice in most Western Countries where healthcare is restrained by resources - just as it is in the USA.

Incidentally if you want to point the finger at "State Euthanasia" look no further than Australia - in the Hospital where I work any Patient over 65 has "NFR explained to them, and there is a LOT of pressure on Patients and their relatives to agree to NFR orders, especially if the Patient has significant comorbidities (including hypertension, diabetes, chronic respiratory illnesses, and chronic renal illnesses)

Tue, 11/13/2012 - 17:05 | 2977488 ilovefreedom
ilovefreedom's picture

The medical consumption political equivalent of "THINK OF THE CHILDREN", but since children are relatively inexpensive to insure, people with diabetes and cancer will have to do. You aren't PRO-cancer, are you?!

Tue, 11/13/2012 - 17:06 | 2977496 FL_Conservative
FL_Conservative's picture

Just give people pussy and war and they'll forget about everything else.

Tue, 11/13/2012 - 17:42 | 2977649 DaveyJones
DaveyJones's picture

generals get both

Tue, 11/13/2012 - 20:33 | 2978154 Grinder74
Grinder74's picture

A 10% reduction in the population would work better.

Tue, 11/13/2012 - 16:36 | 2977349 buzzsaw99
buzzsaw99's picture

It was my understanding that someone else would be paying for all of this.

Tue, 11/13/2012 - 16:50 | 2977392 Vincent Vega
Vincent Vega's picture

I thought it was free!  Just like the phones. <sarc>

Wed, 11/14/2012 - 11:11 | 2979693 Kobe Beef
Kobe Beef's picture

It is free! Workers pay for it. Parasites don't. Just prole up, swipe yo' EBT, and the Party will take care of everything. Ignorance is Strength!

Tue, 11/13/2012 - 16:37 | 2977351 1100-TACTICAL-12
1100-TACTICAL-12's picture

Go figurure.. would'nt have thunk it in a million years, since the insureance companies wrote the motherfucker.

Tue, 11/13/2012 - 18:05 | 2977654 DaveyJones
DaveyJones's picture

and the drug companies. They make no sacrifice and we do not buy from the world market at much cheaper prices. Like Cheney and the oil boys, the now mayor of chicago had numerous "non-public" meetings with insurance and drug prior to presenting this bill knowing they had to appease them to ever get this off the ground proving that the whole playing board is already owned by these bastards. Whether its banking, bakken, babies or broccoli, nothing is going to get better without a dramatic move by the people. Seems to be the theme everywhere. And what do you know, the opponents are global. Was an innevitable chapter in world history. Sucks to be the generation living it.     

Tue, 11/13/2012 - 16:37 | 2977355 francis_sawyer
francis_sawyer's picture

The Real Danger of Obamacare is and always was that nobody in CONgress participates in the program...

Tue, 11/13/2012 - 16:40 | 2977359 Dr. Richard Head
Dr. Richard Head's picture

It's too bad Gov Kasich of Ohio is about to cave on ObamaCare.  I helped collect signatures to get a vote for adding an Amendment to the Ohio State Constitution that would prevent the Federal Government from forcing Ohio to implement ObamaCare.  The resolution passed by a majority of the Ohio voters in 2010.  Too bad fucktards in government ignore the people.  Surprise, surprise, surprise!

His excuse for ignoring the will of the people and giving up state authority? Federal funds being held over the state of Ohio's head.  That is exactly how those fucking Feds pushed a .08 drunk driving law on the people.  Federal funds withdrawal for all who did not comply. 

Holy fuck, Uncle Sam's got some big ass titties.

Tue, 11/13/2012 - 17:00 | 2977460 Skateboarder
Skateboarder's picture

Excuse the man-boobs, he's been going to town on the Flamin Hot Cheetos for the last few years.

Tue, 11/13/2012 - 17:26 | 2977587 WTFx10
WTFx10's picture

Organized crime (government) gets what it wants everytime. Extortion,bribes,or prison take your pick.

Tue, 11/13/2012 - 16:38 | 2977362 booboo
booboo's picture

Monitize everything, foreskins you say? yes we can, sell em to luggage makers, turn em in to wallets, rub em a few times and BOING, overnight bag. Next!

Tue, 11/13/2012 - 16:39 | 2977365 dick cheneys ghost
dick cheneys ghost's picture

ObummerCare=Corporate Welfare

Tue, 11/13/2012 - 17:29 | 2977602 machineh
machineh's picture

So if Nomi Prins is right, the health care 'market' is going to resemble the cellular 'market,' with a 'choice' between AT&T, Verizon, or a couple of minnows such as Sprint and T-mobile.

It's a feature, not a bug!

Tue, 11/13/2012 - 17:47 | 2977666 DaveyJones
DaveyJones's picture

name an industry where this isn't happening. The whole place is swirling down 

Wed, 11/14/2012 - 11:21 | 2979738 Kobe Beef
Kobe Beef's picture

As long as the Imperial Government remains the biggest gun in the room, and control of it alone is the difference between victor and victim, or profit and loss, then everyone will keep fighting, lobbying, buying, and lying to get their hands on it. To point it at their enemies and make them pay. If you don't, it gets pointed at you. Needless to say, this constant internecine law/warfare will doom this country. 

"Government is not reason, or eloquence. It is Force."

-George Washington

Down with the Imperial Government. States' Rights or Revolution.

-Kobe Beef

Tue, 11/13/2012 - 18:07 | 2977718 RobD
RobD's picture

As long as the use the T-mobile girl to do the commercials it's all good. Damn she is hot.

Tue, 11/13/2012 - 16:40 | 2977369 overhere2000
overhere2000's picture

We could call in a surge to fix this.

Tue, 11/13/2012 - 16:45 | 2977384 Titus Flavius C...
Titus Flavius Caesar Vespasianus Augustus's picture

We could just not insure smokers and fatties.


That's at least 2/3 of the frickin' problem.


It's going to take massive tax noncompliance or an invasion by space aliens to get Congress to stop writing checks the body politic can't cash.


But, I imagine the internet will be shut down via executive order and we'll all be chipped before we the American people realize they're in the ol' proverbial frying pan.


I'd like to see a chart of Justin Bieber's records sales plotted against our monthly deficits.   I suspect there's a link.





Tue, 11/13/2012 - 17:22 | 2977560 KCMLO
KCMLO's picture

But smokers cost insurance companies less because they don't circle the drain for 2 decades, they just die (younger).

Wed, 11/14/2012 - 04:35 | 2979054 Parrotile
Parrotile's picture

Not necessarily. Many develop chronic, costly to treat but not necessarily fatal lung and other diseases - microvascular problems along with heart disease, renal disease, poor circulation (leading to leg ulcers / recurrent cellulitis) - all inconvenient / unpleasant but all mostly treatable (at a cost of course!).  Treating smokers (who do NOT develop Lung ca) can be much more expensive (in the long term) than treating lung ca. sufferers!

Tue, 11/13/2012 - 17:49 | 2977669 DaveyJones
DaveyJones's picture

Monsanto, ConAg and the others could pick up the rest

Tue, 11/13/2012 - 16:59 | 2977374 Titus Flavius C...
Titus Flavius Caesar Vespasianus Augustus's picture

Essentially any legislation Congress can actually pass is backed by some lobby or other.


Big Oil, Big  Pharma, Big Insurance, Trial Lawyers, The AMA, The NRA, Israel Lobby, AARP - all put forward stuff that isn't generally in the average bear's interest.


Obamacare, however, depends on state cooperation, e.g. the exchanges, that many states simply haven't complied with.  There will likely be lots and lots more law suits going to, amongst other things, just how much power the feds have to order around the states.  The Roberts court said this is a taxing scheme - well, historically the feds couldn't hijack states to collect federal taxes - so how can they force them to set up exchanges?  Maybe a half-dumb question as I really don't understand how the Obamacare decision influences the previously limited pwoer the feds had to compel states.

It may be that we're simply, under Obama, in a post-Constitutional age.  In fact, people described as 'Constitutionalists' or '10thers' {people who believe there's a 10th amendment} are viewed as ignorant mouth breathers by the enlightened denizens of the Left.   For them, you see, progress should not be inhibited by something as dead, white and male as a 'Constitution' or outdated concepts like 'will and consent of the governed.'

Krugman, after all, admitted his fascination with Asimov's Foundation series - in particular, the idea that 'science' could design a perfect society.


It's so cute that he thinks economics is a science, isn't it?



But whatever - as I'm sure Pelosi would assure us - we have to let the insurance industry take over health care in order to find out what the insurance industry will do when they take over health care.



Tue, 11/13/2012 - 17:33 | 2977618 machineh
machineh's picture

If states don't set up health care exchanges (at gunpoint), the feds step in and do it for them.

Kinda like if your town disbands its police department, the county sheriff or the state police take over law enforcement.

CHOICE, bItCHeZ -- it's what's for dinner!

Tue, 11/13/2012 - 19:10 | 2977879 I am on to you
I am on to you's picture


Enjoy the flavour,all private insurance,has a Topping called corruption,shareholders gota eat!

Tue, 11/13/2012 - 19:11 | 2977882 I am on to you
I am on to you's picture


Enjoy the flavour,all private insurance,has a Topping called corruption,shareholders gota eat!

Tue, 11/13/2012 - 18:15 | 2977745 DaveyJones
DaveyJones's picture

well said  "Krugman, after all, admitted his fascination with Asimov's Foundation"

I often think of that book when I'm on this site 

Tue, 11/13/2012 - 16:41 | 2977375 aint no fortuna...
aint no fortunate son's picture

People don't understand how important true competition is in healthcare, but they're about to... tick tick tick

Tue, 11/13/2012 - 17:26 | 2977584 Bicycle Repairman
Bicycle Repairman's picture

One reason they don't understand it is they've never seen it.

Tue, 11/13/2012 - 16:45 | 2977381 q99x2
q99x2's picture

Hope it covers flights to Cuba and back.

Tue, 11/13/2012 - 16:45 | 2977383 Rainman
Rainman's picture

You are all sentenced to death, but before you leave all your fiat will be seized by these vermin. 

Tue, 11/13/2012 - 16:51 | 2977405 Yen Cross
Yen Cross's picture

 Your comment is more reality, than most people realize Rainman...  Having just witnessed the protocol for a "old" loved one.

Tue, 11/13/2012 - 17:14 | 2977526 centerline
centerline's picture

Too many promises have been made that cannot be kept.  System was build on perpetual growth (ponzi) and the price paid will be in lives at some point sooner rather than later.

Tue, 11/13/2012 - 17:40 | 2977644 Yen Cross
Yen Cross's picture

 • +1

Tue, 11/13/2012 - 18:17 | 2977752 DaveyJones
DaveyJones's picture

you just boiled everything down

Tue, 11/13/2012 - 16:46 | 2977385 NoTTD
NoTTD's picture

The true purpose of O-Care is to crash the private market, thus leaving only the single payor option.   Throughout the O-Care stat the"National Health Service" is referred to repeatedly, as though it already existed.   The government doesn't want to take over your life -but it will be forced to do so then.  For your own good. 

Tue, 11/13/2012 - 16:47 | 2977389 NoTTD
NoTTD's picture

Of course, Pelosi doesn't know that's in there.  She hasn't read it yet.

Tue, 11/13/2012 - 17:04 | 2977485 Titus Flavius C...
Titus Flavius Caesar Vespasianus Augustus's picture

Not sure that's how it would break down.


Actually the private market might end up much better off, with doctors cutting prices a bit and dealing with the far-easier-to-deal-with private companies.


My expectation, though, is that the middle class will largely lose access to private markets as premiums, inevitably, go up to cover the costs associated with the government-engendered loss of tens of millions of customers.


So what your saying might be basically true, but best believe rich folks will be getting the best private care and downloading into new bodies in 20 years while the rest of us fight over rats in the Hope Camps.


Tue, 11/13/2012 - 17:17 | 2977539 centerline
centerline's picture

Bingo.  The math does not add up any other way within the current scheme.

Tue, 11/13/2012 - 17:39 | 2977639 machineh
machineh's picture

'the middle class will largely lose access to private markets as premiums, inevitably, go up'

Exactly -- by design.

The rising uninsured population, priced out as employers drop health plans, creates the planned crisis needed for single payer to pass. 

Y'all dont get sick now, ya hear?

Tue, 11/13/2012 - 16:52 | 2977415 Spastica Rex
Spastica Rex's picture

Insurance companies just want to make a profit. I thought free enterprise was a good thing?

Tue, 11/13/2012 - 18:25 | 2977749 falak pema
falak pema's picture

not if its oligarchy controlled. In france all the healthcare is thru regulated government agencies funded by direct salaried  contributions. So the government negotiates with the doctors the tarrifs they get paid on the national schemes. Health insurance is also regulated industry by governement. There is private complementary insurance as plus. If you want to work outside the state scheme as private practionner you can and make more on the side. But those who perform within the government regulated scheme get paid fixed tarrifs negotiated industry wide. That way no surprises. Our health care is exploding because old age ills are very expensive and pharma bills thru big pharma monopolies cost more and more. Its not the doctors or insurance that is expensive in France nor the hospitals. 

French doctors overprescribe medecine and that creates the overspend. Pharma lobby and geriatric spike. 

The future will be for a mix of standard basic regulated services within affordable limits, plus private à la carte services. It cannot be 100% public or 100% private. Yes the rich and healthy pay for the poor and unhealthy to a certain extent. Thats solidarity of nation. 

Tue, 11/13/2012 - 19:26 | 2977929 Spastica Rex
Spastica Rex's picture

Thanks - I agree with what you've said.

I was joking. See my post below.

Tue, 11/13/2012 - 16:54 | 2977426 Catullus
Catullus's picture

Health insurance IS a put option on your health that expires every month. A company can underwrite all the promises it wants. On an aggregate level, the Fabians are going to continue to stuff more non-insurable risk via mandatory coverage that will drain these companies of cash and eventually make them go bankrupt. The government will then swoop in and claim it is "saving" the industry by bailing it out. Unlike the banking industry, the government is going to demand control as they bailout these companies. And that's how you have government takeover of the health insurance industry. Here's the great thing about these "insurance" companies, because underwriting is worthless now, theyve become nothing more than billing companies.

Still health insurance is not health care. It's a totally different balance sheet. The cash market will be key again. It'll be interesting to see if the Fabians will declare paying for health care in cash be made illegal.

Tue, 11/13/2012 - 16:59 | 2977456 Rainman
Rainman's picture

+1 for your Fabian insights

Tue, 11/13/2012 - 17:03 | 2977478 ilovefreedom
ilovefreedom's picture

I've been saying it from the beginning.

Aspects of PPACA sound good, like coverage of pre-existing conditions, extension of insurance until 26 for children on their parents insurance.

BUT, and this is a big but, estentially what it does is give the insurance/medical industry 30M new customers without so much as a discount.

Wait you say, they have to spend 80% on medical care and actual medical service, but the answer to that is to simply look at Hollywood Movie accounting.

Oops!! Forest gump still hasn't made a profit, Spider-man and Return of the Jedi either.

Creative accounting can do a lot for your tax liability and in the case of PPACA being federally mandated, your profit liability.

What a joke... we should be talking about the actual cost of medical care, instead we're talking about who deserves eligibility and who should pay for those inflated premiums.

Tue, 11/13/2012 - 17:16 | 2977535 Peterus
Peterus's picture

coverage of pre-existing conditions = don't ever get insured while young and healthy, pay nothing in untill you get sick, rised prices all around to compensate.

extension of insurance until 26 for children on their parents insurance = slightly higher rates to cover this distance, essentially a minor wealth transfer from people that are insured with children that are younger than 26, from insured people without children, or with older children.

Tue, 11/13/2012 - 17:06 | 2977481 Everybodys All ...
Everybodys All American's picture

Obamacare will create by market forces a single payer system because small businesses will not be able to afford the health care insurance costs. Once single payer is in place the insurance companies will be forced out of business much like the way coal companies are heading today. Prepare accordingly.

Tue, 11/13/2012 - 17:06 | 2977491 bankonzhongguo
bankonzhongguo's picture

Obamacare was written by the insurance industry.

It's always been a PRIVATE TAX.

Health insurance is NOT health care.

Jedi mind trick.

For everyone over the age of 50, check out the Liverpool Care Pathway for the Dying Patient.

That is your future.

Tue, 11/13/2012 - 17:17 | 2977543 Titus Flavius C...
Titus Flavius Caesar Vespasianus Augustus's picture

Well put.


The Roberts decision makes a lot of sense...


until you read the fucking thing.


Basically, we have the feds going beyond any enumerated power to merge with corporate interests in a particular field.


The question is - if they do it with health care, what's next?  What else could government do best?


Federal elections are probably frustratingly hard to steal given dispersal over 50 states plus assorted overseas jurisdictions.


I expect the Federal government will aggressively act to 'federalize' state elections for federal office.



Tue, 11/13/2012 - 17:44 | 2977656 machineh
machineh's picture

'... to 'federalize' state elections for federal office.'

Already done 99 years ago, my man:

The Senate was supposed to represent the states (no unfunded mandates, etc.), not the sheeple.

Federalism ended before we were even born.

Tue, 11/13/2012 - 19:09 | 2977877 Common_Cents22
Common_Cents22's picture

you only need to rig a few swing states in the electoral system to win.

Tue, 11/13/2012 - 17:56 | 2977693 James-Morrison
James-Morrison's picture

The ultimate way to retain premiums (and increase profits) is to let the patient die.  

This is not really new, what's new is now it is mandated by Big Brother. 

Wed, 11/14/2012 - 04:48 | 2979064 Parrotile
Parrotile's picture

You're immortal, then?? EVERYONE dies, and the Liverpool Pathway is a pretty good and pretty dignified "departure route" for the DYING Patient. In Aus. we'd LIKE to follow this pathway, but unless you live in a major centre of population, most smaller hospitals don't have the inpatient capacity for residential palliation, and the Palliative Care Centres here are always operating at max. capacity, often with inadequate outreach staffing to provied for dignified and comfortable palliation in the home (which after all is for most patients the "preferred option").


Tue, 11/13/2012 - 17:06 | 2977499 infinity8
infinity8's picture

Seriously, I fail to understand why doctors don't organize to cut the fat insurance man out of their business. I've read a lot about doctors just refusing to deal with insurance companies at all in their own private practice over the last few years but, wouldn't doctors and patients benefit if there were locally administered health savings accounts? I can see having insurance for major or catastrophic but it makes no sense for basic healthcare.

Tue, 11/13/2012 - 17:23 | 2977566 Ignatius J Reilly
Ignatius J Reilly's picture

let me explain how this really works.


Patient has something wrong.  Patient wants every f'in thing that is published on the internet available to them to fix problem REGARDLESS OF COST.  they pay their premiums.  The insurance company should pay for everything.


Doctor has to order a billion tests even though he or she knows what the problem is just because 1) they need to pay the bills 2) they do not want to be sued.


Insurance company pays bills willingly.  Why not?  They will just charge everyone more next year.


This spiral goes in only one direction.


Without insurance, Doctors would still be paid in chickens, eggs or whatever.  Everyone is complicit.

Tue, 11/13/2012 - 17:34 | 2977623 Spastica Rex
Spastica Rex's picture

Ask your doctor: is Cymbalta right for you?

They're breaking the windows of your soul.

Tue, 11/13/2012 - 17:37 | 2977632 infinity8
infinity8's picture

That's why I like health savings accounts. People set aside their own $ for medical care, as much or little as they want. That they can spend when and where they want. I think people would think harder about spending that money, bad doctors wouldn't be around too long, and doctors wouldn't have the overhead involved in jumping through the flaming hoops involved in filing and following up on claims. Some MD's might happily exchange chickens and eggs for treatment, some only cash. If they're smart enough to get through medical school, surely they can develop some basic business sense.

Tue, 11/13/2012 - 17:56 | 2977694 Ignatius J Reilly
Ignatius J Reilly's picture

I agree with you.  However, when I go to the hospital I lose my voice in the matter.  Ever go and see the bill 3 months later?  "Ice chips for $3.5 a cup WTF?!  Advil 2 pills $7.50.  did they even give me Advil?"

Tue, 11/13/2012 - 18:27 | 2977776 infinity8
infinity8's picture

I have seen the bills, thankfully mostly not mine. It's a fucking free-for-all because of insurance with hospitals trying to make it up with $50 aspirins. Again, I can see a place for insurance for hospital/catastrophic but for fuck's sake - premiums, deductibles, co-pays just keep going up and for someone like me who only goes to the doctor if I'm, like, gunshot it's so much money flushed down the toilet instead of saving up for the day my back does the final blow-out and I need (very expensive) work done. Everyone's been brainwashed into believing that health insurance and health care are the same thing.

Tue, 11/13/2012 - 19:12 | 2977883 Common_Cents22
Common_Cents22's picture

private cash/monthly retainer co-ops are springing up more often.  You still need a catastrophic major medical policy.   However, those policies will be banned as the bare bones minimums are jacked up by obamacare.

They thought of all the loopholes and are closing them all.

They even have the IRS as the collection agents named Vinny.

Tue, 11/13/2012 - 20:12 | 2978069 dapper_dan
dapper_dan's picture

Doctors can't run an insurance business. They aren't trained to run a financial company and set aside (nor it is allowed by regulation, I think...) reserves required for covering their insurees...  They can work out of the system, in cash fee-for-service or concierge practices, but they can't offer insurance products themselves, cutting out the financial companies/insurers. 

Also, Obamacare prohibits the sensible suggestion you have about having catastrophic insurance coverage.  It's specifically forbidden in their minimally-required health coverage statutes.  I've asked insurance execs about it and they say they could write those policies, they just aren't allowed to by law.  It's one way that Obamacare makes sure that the healthy are subsidizing the sick - a) make health insurance mandatory and b) establish a minimum set of health coverages per each policy (actually, a high bar) SO the healthy "pay for" a lot of health care they'll never need so that the sick/comorbid patient can get all the excess health care they need/desire.

Tue, 11/13/2012 - 21:18 | 2978295 infinity8
infinity8's picture

I'm saying doctors shouldn't run an insurance business. They should run a health care business. Hire a business manager to handle certain aspects if need be. Work outside the system, determine fees-for services - sometimes they may make less, sometimes more - like any other business. Change this fucked up system which has nothing to do with healthcare.

Tue, 11/13/2012 - 23:55 | 2978736 dapper_dan
dapper_dan's picture

Ok, yea I see your comment.  

The problem is that there are only so many rich people willing to pay fee for service and many markets are quite saturated already for concierge med.  I live in the Bay Area and the physicians with sterling reps who moved to concierge early are doing fine, but many are struggling and not making much money...  so many have gone concierge in last 5 years it's actually a buyer's market.

Other areas of the country I'm sure are not so saturated but less likely to have the wealthy clientele willing to pay.

There's an attitude about health care that people think its basically free.  They're more willing to pay $110 for a haircut than a doctor's visit for prolonged sinusitis with antibiotics (shouldn't health care be a basic right!  My God I have to pay for this shitty care!)

Tue, 11/13/2012 - 17:06 | 2977500 Peterus
Peterus's picture

"Meanwhile the more hospitals are viewed as profit centers, the more their Chairmen will cut costs to maximize returns, and not care quality." Meanwhile the more Samsung electric gadget factories, bakeries, pubs, printshops, landscaping companies are viewed as profit center, the more ...

All the meat in this article was - "unregulated greed makes insurance companies bad".  They are horrendous, but seriously the root cause to be greed and lack of regulation (made by never-greedy angel-people of the Government)? Anyway most measures proposed or run by socialists seem like surface band-aid. Like regulating greedy insurance company CEOs... this is obviosuly a half-measure. To really address the problem you need to replace these greedy humans with better stock that will behave more towards your ideals. Only real socialist project that "gets it" and does not pull punches - is public education.

Tue, 11/13/2012 - 17:08 | 2977510 Titus Flavius C...
Titus Flavius Caesar Vespasianus Augustus's picture

Smokers and fatties represent most of the preventable costs and if logic dicated legislative outcomes, they'd continue to pay far higher premiums even if they were already enjoying the fruits of their gluttony and addiction.


But because the Progressive Left is more passion than logic, fat, wheezing fucks will continue to drive up costs while directly and indirectly making it harder and harder to run or start a small business.


Which is why we need to start hunting and eating those muthafuckas.

Tue, 11/13/2012 - 17:10 | 2977514 The Proletariat
The Proletariat's picture

There is an easy way to fix insurance...make it illegal. 

Tue, 11/13/2012 - 18:26 | 2977552 TheObsoleteMan
TheObsoleteMan's picture

What Obama care is, is a marriage between insurance companies and the gubmint. Until now, they have only been "shacking up" {medicare, medicaid}. Now it is complete. This is crony capitalism at it's zenith. It won't stop until every sector of our economy is fashioned in this model.

Tue, 11/13/2012 - 17:25 | 2977577 rustymason
rustymason's picture

Thanks, Justice Roberts. Great job, you worthless bureaucrat.

Tue, 11/13/2012 - 17:48 | 2977668 machineh
machineh's picture

That guy needs a hammer and sickle tattooed on his sloped forehead.

Tue, 11/13/2012 - 17:25 | 2977578 jimod
jimod's picture

Insurance companies already control your healthcare.  If it's not in the "standard of care" be prepared to pay cash.

Try getting treated for chronic lyme disease for example.

Tue, 11/13/2012 - 17:30 | 2977604 Bicycle Repairman
Bicycle Repairman's picture

"Try getting treated for chronic lyme disease for example."

Try googling "Doxycycline, no prescription" and see what happens.

Tue, 11/13/2012 - 22:45 | 2978553 Bicycle Repairman
Bicycle Repairman's picture

"Try getting treated for chronic lyme disease for example."

Try googling "Doxycycline, no prescription" and see what happens.

Tue, 11/13/2012 - 17:40 | 2977640 ceilidh_trail
ceilidh_trail's picture

As a lifer in the healthcare industry, I can tell you that the biggest driver of costs is the federal .gov. Whatever they set via medicare/medicaid quickly is what all insurers also do. We the shmuck providers have to go along or we die. You would not believe the crap we have to do that adds NO VALUE WHATSOEVER. The biggest waste of money in one quick shot so far is electronic medical records. They dumped truckloads of stimulas money on us, and we blew it all at a handful of companies that produce buggy, crappy software that we HAVE to use... Just wait... not going to get better.

Tue, 11/13/2012 - 17:51 | 2977676 machineh
machineh's picture

But ... but ... Doctor Hillary told me that electronic medical records were the greatest invention since pneumatic tires!

I guess she only plays a doctor on TV.

Wed, 11/14/2012 - 05:05 | 2979074 Parrotile
Parrotile's picture

EMR - "Putting all your eggs in the one basket" mentality. Grerat when it works, not great when software / hardware / network problms mean you have to use the "Fallback" system (Paper!), and ALL the paper records then have to be retyped onto the "System" once it's back up . . . . . .

Tue, 11/13/2012 - 17:43 | 2977650 Jena
Jena's picture

As Obamacare gets implemented, the physicians who can are going to concierge practicies.  They retain those patients who are willing to pay an annual premium for the pleasure of same- or next-day appointments, email and phone access.  Some try to find other docs for the rest of the patients who don't want to pay the tab or can't afford it.  Either way, the doctor cuts 2/3 to 3/4 of his/her practice.  Generally, it is administered by MDVIP or a similar corporation.

And as Obamacare gets implemented, people with money will be looking for concierge phyicians.  It is going to be ugly out there when the available pool of doctors shrinks and suddenly the average patient realizes what this 'terrific' system actually means for them.  (Unlike Zhers who are ahead of that game.)

Will it make any difference in the quality of care delivered?  We'll have to wait and see but my guess?  Not a chance.  The system is overburdened.  The bed churning will only speed up.  And wait until those Medicare cuts kick in.  The Liverpool Protocol as mentioned above is nothing to mess with.  If you have someone you care about in the hospital, be sure you keep an eye on them.

Tue, 11/13/2012 - 20:16 | 2978080 Common_Cents22
Common_Cents22's picture

here's the problem with them.  You still need major medical policy.   Obamacare outlaws major medical by having minimum care/coverage stipulations.    Unless there are other loopholes, the co-ops will be screwed as well.   

Tue, 11/13/2012 - 21:58 | 2978413 Jena
Jena's picture

Your insurance cost doesn't go away.  You still get billed for each and every visit.  There appear to be some perks, like pretty labs or extra exams but other than that it's run like a regular office visit.  It just costs you more per year for the pleasure of belonging to an exclusive club in which you receive extra attention when you want it.

Tue, 11/13/2012 - 17:44 | 2977655 Tombstone
Tombstone's picture

Been 30 years trying to figure out the tax code.  Now you throw this Obummer-care crap at me.  Will I need to hire an Obamacare "expert" to help me navigate this stupidity?  No matter what anyone does, it will be unaffordable to be sick.

Tue, 11/13/2012 - 17:53 | 2977682 goatmug
goatmug's picture

Funny you say that it is unaffordable to the sick..... no, it will be unaffordable to the healthy.  The sick are accustomed to paying for higher premiums and paying because they cost more and use more services.....Obumma care flips that on its head and makes the healthy foot the bill for the sick, making the 70% that are healthy pay way more.  Nice ponzi scheme.

Tue, 11/13/2012 - 17:46 | 2977663 Yellowhoard
Yellowhoard's picture

America needs crappy fascicare.

Corporate campaign donors get rich and all of those expensive old people die early.

What's there not to like.

It's a brave new world.

Tue, 11/13/2012 - 17:51 | 2977674 goatmug
goatmug's picture

Excellent post!  A buddy of mine wrote this today and dovetails very nicely with what you are saying.  




Good stuff, I will probably put it on the Goatmug Blog with his permission it is so important to small business owners and individuals.



Tue, 11/13/2012 - 18:00 | 2977690 falak pema
falak pema's picture

In 1231, in the first written constitution of the medieval world, Liber Augustalis, established  for his Kingdom of Sicily, Holy Emperor Frederick II imposed that the hypothecary, or pharmacist, could NOT perform the function of medicinal doctor/physician, as it would create a conflict of interest situation. The man who diagnosed could not also sell the medicine he prescribed.

To protect the commercial interests of the patient. In today's world the Insurance lobby complements the big pharma lobby. 

If an absolutist king could understand THAT in the middle ages how can a president of a republic with more than 500 people in COngress allow such a thing to happen in the 21 st century?

Are these lobbies so much more powerful than the elected legislators of the USA so that the common people be less protected than those subjects of a king of the middle ages? 

Tue, 11/13/2012 - 18:00 | 2977705 illyia
illyia's picture

Medicare was never called “Johnsoncare” when President Johnson signed it into law in 1965 and Johnson was not exactly a man of small-personality.

But that was before MadMen took control of our minds and made everything a "catch-phrase" slogan in order to sell us on it. Today it would be LyndonCare or LBJ-Care or DemocracyCares. It would be sloganized, that is for sure.

Tue, 11/13/2012 - 18:45 | 2977821 TheObsoleteMan
TheObsoleteMan's picture

The difference is that people are wise to what the real intent of all the entitlements are. When I was a child, the nation was still only one generation removed from the Great Depression, and you would be hard pressed to find anyone who despised FDR {unless you came across my father's parents}. People of the 1950s and 60s were still under the spell of the gubmint, they really believed the feds were trying to do the right things for the people. Well, since then we have had scandal after scandal, and allot more is known today about the gubmint's so called benevolence.

Tue, 11/13/2012 - 18:48 | 2977827 AU5K
AU5K's picture

Ultimately what you will see is a single payer public system, and a private system, probably offshore and very profitable.  Need an operation?  6 month wait here, fly over to bahamas tomorrow.  This dual system is exactly what happened in the soviet union, only the top party and military were the elite.


Tue, 11/13/2012 - 19:34 | 2977950 Being Free
Being Free's picture

Patient Protection and Affordable Care Act

Thanks for the laugh.  It's been a tough day.


Tue, 11/13/2012 - 20:07 | 2978059 Michelle
Michelle's picture

I'm gonna fool 'em all, no doctors' visits, no trips to the ER, just a steady hand and a single bullet to the head and a final trip to the cemetery. Leave money to the kids, not to the docs. Sounds sick to be sure but the final two years of one's life is accompanied by the gushing sound of money flowing from my balance sheet to the life-saving machines that my family will be distraught having to turn off anyhow.

Tue, 11/13/2012 - 20:13 | 2978075 newworldorder
newworldorder's picture

I do not understand why this article is a suprise for a lot of us.  I am not oposed to corporate sutructures, BUT..... The Large Corporation has become the de facto mechanism for delivering almost everything to individuals in our society.  After government the modern corporation in America, has captured the high "high ground" in manufacture and services. Corporatism has come to define Americanism and Globalism.

Tue, 11/13/2012 - 20:17 | 2978086 Quantum Nucleonics
Quantum Nucleonics's picture

There is no love lost between the for profit healthcare companies and Obama and his socialist allies.  The healthcare comanies were offered a carrot to lead them into the slaughter house.  Short term, for profit health care will squeeze some cash from the new system.  But long term the Dear Leader's objective is to end up with a government run health care for all, aka single payer.  Once the state exchanges are set up, HHS can rachet up regulations to make for profit insurance a money loser.  The employer mandate is set up in such a way that companies can't help but dump their employees into the exchanges too and pay the "tax".  Once everyone is in the exchanges or Medicare or Medicad, HHS and the payment board (aka, the Death Panel) can use reimbursement rates and formulas to beat the health care and insurance industries into submission and/or bankruptcy.

If you're a health insurance shareholder, next quarter looks great... 2017 - not so much.

Tue, 11/13/2012 - 20:20 | 2978099 divide_by_zero
divide_by_zero's picture

The Tea-Party Conservative types get it embarrassingly wrong when they call it a “government takeover of health care.”

Actually if you consider the ultimate cronyism government=corporate, the Tea-Party has it exactly right, the author just jumped to the wrong conclusion.

Tue, 11/13/2012 - 20:34 | 2978157 Grinder74
Grinder74's picture


Tue, 11/13/2012 - 21:03 | 2978247 ebworthen
ebworthen's picture

No doubt the Insurance Industry Harpies and the Lawyer Warlocks are licking their lips over this new "health-care" legislation.

Just another way to bleed individual assets and parasitize the society.

Tue, 11/13/2012 - 21:23 | 2978297 dolph9
dolph9's picture

I'm a physician who is permanently giving up full time practice starting in January.  And to be honest it only has a little to do with Obamacare.

It would go beyond the scope of this discussion to talk about everything.  When it comes to Obamacare, though, it's a giveaway to insurance companies.

But you see, American sheep are too dumb for any of this.  They eat themselves to death and abuse their bodies to no end, and then when the private insurance companies raise their premiums, they yell "socialism!"  

And then when they turn 65 they yell "Get your hands off my Medicare!"

And then they think some procedure or drug is going to turn them into a 22 year old model or athlete overnight.

Tue, 11/13/2012 - 21:39 | 2978367 shuckster
shuckster's picture

Something tells me the yidz have something to gain from this Obamacare things

Wed, 11/14/2012 - 04:01 | 2979033 Lord Koos
Lord Koos's picture


Really smart guy

Tue, 11/13/2012 - 22:06 | 2978437 sharky2003
sharky2003's picture

I work in healthcare. A few months ago, I got a company wide email that was going on and on about the virtures of Obamacare. It also addressed upcoming funding cuts and argued that it won't really matter to us as we're going to cut costs by a similar amount using "lean methodology" staffing cuts. Joy!

I have a doctor friend still in fellowship. Between her and her doctor husband, she is anticipating 500k in debt by the time they are done in 2014. She is very worried about finding a job.

I have a friend who wants to be a nurse practitioner...she is also worried about whether or not it's worth it to take on 80k in debt and worried about the prospects of finding a job when she's done.

I myself am wondering if it's worth it to continue in my profession, in what will clearly be a understaffed, overworked, and underpaid environment. The stress of working ICU and having to be PERFECT (or risk killing someone + lawsuits) while fluffing your pillow and kissing your ass constantly with a smile (patient satisfaction scores now partially determine reimbursement) every second of every day is already bad enough, but add in those conditions's just not worth it.

Tue, 11/13/2012 - 23:18 | 2978641 ceilidh_trail
ceilidh_trail's picture

Sharkey- I am an ICU nurse as well. You nailed it. All of the phony baloney disneyesque stuff they push at us turns us from being professionals to just one more real time reality entertainment provider. Patient satisfaction rates- another fine gimmick brought to us by the .gov. Real empathy is not something that can be taught at an inservice. As I said above- lots of fed  pushes to make us waste a lot of $$$. Lots of people hired to manage "customer relations" programs. Real professional RNs do not need lectures on how to be kind. You either have it or you don't. Hospitals just need to be more selective of whom they hire.

Again on the EMR rant from above: We have lost a lot of staff to "the promised land" of working on making the crappy software work for us. My ICU alone has lost 8 FTEs to that crap. None have come back- hard to blame 'em- easier work and better hours and nobody dies.

Tue, 11/13/2012 - 23:06 | 2978608 Dungeness
Dungeness's picture

Two things I don't like about the Obamacare.

(1) Everyone will be required to take mandatory vaccinations and will have to have proof they are current, or else any type of medical care will be denied.

(2) Everyone will be required to have an electronic verichip inserted into their body to track medical and financial records, as well as monitor if medications have been taken or not, among other things.

If the economy implodes, or rather if/when the USD devalues significantly and loses world reserve currency status, will the government have any money or resources to implement any of this stuff?

Tue, 11/13/2012 - 23:20 | 2978653 ceilidh_trail
ceilidh_trail's picture

Bring on the implosion! Who the hell are they to tell us what we "must" do? Those a$$holes are supposed to work for us. This is still America- I hope.

Wed, 11/14/2012 - 00:27 | 2978802 jomama
jomama's picture

you have anything to link to back up your two points?

all i can find on the web are to the contrary.


Wed, 11/14/2012 - 04:02 | 2979036 Lord Koos
Lord Koos's picture

Bullshit -- where does it say that stuff...

Wed, 11/14/2012 - 02:53 | 2978994 Lord Koos
Lord Koos's picture

What part of your brain doesn't realize that insurance companies are already in this position?  They are the real "death panels".

Wed, 11/14/2012 - 03:34 | 2979016 Joe A
Joe A's picture

That happens now in Europe where the medical health insurance sector has been 'liberalized'. Under the banner 'free market is good for competition' meaning less premium and more service, just quite the opposite is happening. Premium goes up and you get less for it in return. For sure this 'liberalization' will lead to cartel forming and price fixing, gee, everything else in the financial sector. Who would have thought that?

Sat, 11/17/2012 - 22:08 | 2992721 Acridotheres
Acridotheres's picture

Overall, this is a general fair and well-informed post. However, I'd like to better contextualize a few statements you made.


"The more consolidation, the more fees bankers rake in, and the more premiums and medical reimbursements and health care procedures, each company can control."

--Sure, that may be true. However, condensation in the industry is also occurring to curb the out of control administrative expenses most of these companies have. You're going to start seeing condensation with small regional payers (<50,000 covered lives) because with ACA their hands are somewhat tied by the medical loss ratio. You do make a fair point that the MLR can be partially avoided by MCOs reclassifying expenses, but I would question whether the smaller regional MCOs have the internal expertise or resources to effectively do this (no doubt that large national MCOs have the resources and huge financial incentives to effectively manipulate their MLRs).

--Administrative expenses in the EU are roughly 6% of health expenditures, while in the US that number is about 4x as much. It's because we have a wildly fragmented payer system, rather than a single payer system. Of course there is going to be condensation of MCOs--there are hundreds of them, many with <50k covered lives (a "very small" health plan), and they can't effectively operate such small operations when larger payers like UHG have dominance in a given metropolitan statistical area (MSA). This is obvious, and has nothing implicitly to do with the financial industry's incentives to collect fees.


"You know who else is similarly too big to fail? The insurance industry. UnitedHealth Group, the nation’s largest health insurer covers 50% of the insurable population in over 30 states. Blue Cross-Blue Shield, covers 100 million people through a constellation of 38 sub-companies."

--Where are you getting that "covers over 30 states" number from? I do not believe this is accurate based on my knowledge of MSA and state-level number of covered lives by health plan. Also, are you talking about commercial, medicare, or medicaid lines of business (or all three)? Depending on what business line(s) you're referring to, that number can be completely miscontextualized.

--You're really stretching on the BCBS statement. BCBS plans operate independently and are very regional in nature--they don't have the buying power of 100 million members. They all develop their own individual formularies and coverage policies.

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