Tag Archives: health insurance

First Day.

The dust is settling on election 2020, at least for some of us. The Trump team is still in full-blown denial, and most of the rest of the Republican establishment is rolling right along with them. In the parking lot of a landscaping company in Pennsylvania, presidential lawyer and confidante Rudy Giuliani scoffed at the idea that the networks would project the winner of a presidential election … like they have for my entire life and probably longer. Rudy seems to think only the courts can decide elections, but to be fair, I think his mind might have been on the porn shop next door when he was saying that. Strange, strange man.

Unfortunately, Rudy isn’t the only one smoking crack these days. I found this in my daily briefing from the New York Times (The Morning, November 9):

Democrats are almost certainly fooling themselves if they conclude that America has turned into a left-leaning country that’s ready to get rid of private health insurance, defund the police, abolish immigration enforcement and vote out Republicans because they are filling the courts with anti-abortion judges. Many working-class voters — white, Hispanic, Black and Asian-American — disagree with progressive activists on several of those issues.

First off, the framing of some of these issues is straight out of the GOP election playbook, though I’ve heard conservative Democrats use some of the same language. “Get rid of private health insurance” is their way of saying “single payer” or “Medicare for all,” which in point of fact is a pretty popular policy proposal, and I believe none of the Democrats who supported M4A were defeated at the polls last Tuesday. Now, if the candidates tromped around their district saying only that they wanted to abolish private health insurance, the voters might have reacted differently – hard to say. (If they’ve had the same kind of experience I’ve had with private insurers, they might be tempted.) And “abolish immigration enforcement”? Seriously? That’s in the same category as Trump’s cries of how Democrats want “open borders.” No one on the Democratic debate stage said they want to abolish immigration enforcement.

Generally, though, the New York Times appears to be making the same mistake as these neoliberal Democrats in that they seem to think the electoral challenge they face is an ideological one. The fact is, many of the left’s core policies are pretty popular. The primary problem Democrats have is that they don’t know how to organize their base. Doug Jones, Democratic senator from Alabama and no liberal, complains that the party invests in candidates, not in voters, and that is in essence what AOC has been saying. The House leadership seems obsessed with preserving its own party-internal primacy; their entire electoral strategy is based on serving their big donors and not making a difference for their constituents. My guess is that they’re relieved that there likely will not be a Democratic senate, as that would put them on the spot to actually pass something that would have a good chance of becoming law.

Let’s face it, Democrats. If we keep making this same election post-mortem mistake, we will keep losing. Listen to the younger leaders in your party, for chrissake.

luv u,

jp

Check out our political opinion podcast, Strange Sound.

Say AAAHHH!

Here’s a little update on my health crisis from a couple of months ago: I’m still paying the price. Not physically, you understand – nothing noticeable in the way of lingering after-effects of my non-COVID illness. No, I mean I’m literally still paying the price of the hospital stay I experienced in April, the week after my birthday. I think I’ve gone over the numbers before on this blog, but let me just frame it in again so that there’s no mistake: the hospital fee – not the surgeon or anesthesiologist, just the hospital – added up to more than $50,000 for four days. The negotiated rate they charged was more like $37,500, but my portion of it was in excess of $5,000. Once again – I have employer provided health insurance … and the direct cost to me was over $5,000.

I am currently garnishing my own wages to cover this massive fee, adhering to a five month payment plan I agreed to with the hospital. Fortunately – and this is important – I am financially able to afford such an arrangement. But this is the best-case scenario in this cockeyed worker’s paradise known as employer-based health care. I have what has been termed a “Cadillac plan”, mostly because my employer pays 80% of my premiums. (Of course, I am also fortunate that I am not a woman and my employer doesn’t impose its religious convictions on my coverage or that of my wife, because apparently that’s a thing.) As I write this, I can imagine people all over Europe and the rest of the industrialized world scratching their heads over this concept of health care “luxury” – one that entails enormous contributions from the person stricken with disease or injury, regardless of their ability to pay.

I spoke about this issue in a couple of episodes of my podcast, Strange Sound, focusing on presumptive Democratic presidential nominee Joe Biden’s comments regarding the supposed popularity of employer-based plans. The fact that tens of millions of people have a thing does not mean that thing is popular. A lot of people have foot diseases, for instance. And in times like these, employer-provided health insurance is a lot like a foot disease … it plagues your every step. It’s just a goddamned ridiculous way to distribute health care services, though that very formulation erroneously suggests that that is the goal of our current system. The goal of our system is not to provide people with the medical care they need; the goal is for some people to make a lot of money. The only way you can honestly analyze our healthcare system is by beginning with that realization.

With the COVID-19 pandemic raging through our country, cases on the rise in forty states, we need to seriously reassess this system. And we need to do it quickly.

luv u,

jp

Check out our political opinion podcast, Strange Sound.

Cashectomy.

By rights, this should be an open letter to former Vice President Joseph Biden, a man who has nothing but good to say about employer-based health insurance. It actually dovetails fairly nicely with the first episode of my political podcast, Strange Sound, which was dedicated to that topic. As I mentioned therein, I am a subscriber to such a health plan – one of perhaps 170 million subscribers in the U.S., though that number has gone down by millions in recent weeks due to massive layoffs, furloughs, etc. I had cause to make considerable use of my coverage over the last month or so, and I am now experiencing the second wave of trauma that typically accompanies major illness in the United States: medical billing.

I’ll preface this with a brief “explanation of benefits”, as they say in the insurance game. I have what is known as a high deductible plan: health coverage that carries a $3,600 annual deductible, which means that I pay for the first $3,600 in medical charges, with some small exceptions, via a Health Savings Account. My employer kicks in about two-thirds of that. (They also cover about 80 to 85% of my premium costs, so as I said on Strange Sound, they are what makes the plan remotely affordable.) If I meet the deductible (i.e. incur $3,600 worth of medical charges), the insurance company starts picking up 90% of my medical costs; I pay a 10% co-pay until I reach another $3,600 hurdle, which is my “out of pocket maximum” of $7,200 per calendar year. After that, the insurance company is supposed to pay for everything.

Now there are various caveats having to do with out-of-network providers and the like, which I won’t get into here. Suffice to say that if I am fortunate enough to have a serious illness that doesn’t straddle two calendar years, the most my illnesses should cost me is about $4,400, allowing for my employer’s contribution. That may not seem like a lot of money to Joe Biden or Donald Trump, but in MY world, it’s close to a fortune. In fact, for most people, it’s a near-impossible hill to climb. If treatment for my illness started in December of one year and ended in, say, February of the next, I would be on the hook for at least twice that amount.

Part of the problem here has to do with how providers have structured costs around the private health insurance market. I’ve received a number of bills related to my hospitalization. The ambulance (a municipal ambulance, by the way) bill was $7,400. The hospitalization bill (minus charges from all of the medical personnel) came to $49,360. My portion of that last one is in excess of $5K, and I have yet to see a bill from my surgeon. Why does a four-day stay in a hospital (sans Doctors) plus some tests come to such a princely sum? It’s what the traffic will bear. You can see why rich people are fine with this system. It just doesn’t work for anyone else.

So, Joe Biden, what the fuck are you going to do about this broken system? And more broadly, Democratic party leadership, why are we patching this disaster with massive infusions of cash into COBRA plans when we could just be expanding Medicare/Medicaid to cover people who’ve lost their crappy employer coverage (and those who had none to begin with)?

You are going to need to be able to answer those questions if you want to win this year’s election … or at least minimally serve your constituents.

luv u,

jp

Check out our political opinion podcast, Strange Sound.

Issues and non-answers.

A little more off the top of my head. One of these weeks I’m going to take some pains over this posting, but… not this time.

Don’t worry, Kyoto. Canada’s pulling out of the Kyoto Protocol (can you say “tar sands”?) and Durban was a bust. What’s it going to take, people? We had massive tornadic storms this past year. We don’t have the luxury of another decade of inaction and ignorance.  

See you in health. One of the issues that comes up in our perennial presidential campaign is that of health insurance, mostly in the context of so-called “Obama Care”. What doesn’t get discussed so much is, well, the only possible positive solution to the current situation, which is bankrupting individuals, bleeding businesses dry, and threatening to drown the government in red ink. The only constituency the current health insurance system benefits is private health insurers. Seems like we, as a nation, sacrifice a great deal to preserve their profitability. That has got to end. We need a national health insurance system – basically universal Medicare with some enhancements – that covers everybody.

When GOP strategist Ed Gillespie was on the Daily Show the other day, he seemed to suggest that he didn’t have a problem with the notion of insurance exchanges or the idea that veterans, for instance, should have government coverage because they deserve the best. And yet his – and I think most Republicans’ – solution to the ongoing health crisis is to throw everyone into the private market. I can tell you from experience – that is not a good place to be unless you’re very young, very healthy, and can afford very steep premiums. And the employer based system isn’t working either, partly because it’s based on the pool of employees covered by the plan. If there are a lot of illnesses in a given year, that sends the premiums through the roof. The only way to control costs is to a) get everyone in the freaking country into the same pool, and b) cut the profit out of it entirely so that, as with Medicare, practically all of the money goes to patient care. 

Private, employer-based health insurance is an anachronism that should go the way of the typewriter. It was designed for an age of close to full employment, when companies needed to incentivize people to come to work for them. If the GOP wants to reduce “uncertainty” for their friends in business, they might consider making it possible for them to get out of the health insurance business altogether. The only reasonable way to do that is through a national health plan administered by the federal government.

War’s end. The Iraq war is coming to a close, at least with respect to American troops (though many contractors remain). Of course, there are those amongst us who consider withdrawal a mistake, such as Cheney, McCain, and nearly all of the GOP presidential candidates. I know – who cares what Cheney thinks, right? Has a man ever been more consistently wrong (or despised) than he? Still, I don’t think we should be too dismissive of their views. If Cheney, McCain, Lindsey Graham, Michelle Bachman, and other foreign policy super-geniuses want us to stay in Iraq, we should ship them over there. Good place for them. And they can stay as long as they want.

Of course, we could never really allow that to happen. I mean, haven’t the Iraqi people have suffered enough?

luv u,

jp

Weeks away.

Just a few hurried comments on the events of the day. (The events of the day are keeping me from the events of the day. Shall I say that a second time?)

Cain Mutiny. Presidential candidate Herman Cain has some more difficulties maintaining his myth of marital bliss, and this may be a game stopper for him. Naturally the death knell may come about over something that doesn’t matter a damn. Aside from his family, who the hell cares who he sleeps with, so long as it’s consensual and doesn’t involve minors, animals, etc.? Somehow this seems to bother people (and the mass media) more than the fact that the man has given zero thought to anything having to do with public affairs. He must be the first presidential candidate I’ve ever seen fail to give an opinion when someone asks him about something like the Libya intervention. He had to ask the interviewer what side Obama (i.e. the United States) was on. What the … ? Has the man been living in a pizza box? He is running for the G.O.P. nomination and apparently has no concept of what the pro-life and pro-choice positions actually mean.

Why the hell does this man want to be president? He smells to me like a cut-out for the Koch brothers, but what he says is that God encouraged him to run. Personally, I think God may have just been trying to order a pizza.

Deficit of Imagination. They’re sparring over the payroll tax cut – otherwise known as The Only Tax Cut That Needs To Be Paid For. With the Occupy movement receiving eviction notices from coast to coast, Congress is managing to turn the conversation back to debt with a good bit of help from the major news organizations. I heard Joe Scarborough sparring with Sherrod Brown about Medicare costs and showing “courage” by acknowledging that those costs were tantamount to a cancer on the body politic. His solution? Cut, cut, cut. Which is basically shift the burden onto the elderly, the ill, etc.

I didn’t hear Brown say this (he may have), but the courageous position to my mind would be to advocate expanding Medicare to cover everybody. The reason we have deficit Medicare spending projected for the next few decades is simple – we are subsidizing the profitability of private health insurers, who get to cover the least costly consumers while the government covers the most costly ones (i.e. the ones private insurers don’t want). The courageous thing to do would be to say, we can’t afford this model any longer.

I’m waiting to hear that from someone. Anyone?

luv u,

jp