[Postscript] I should have perhaps advised readers new to political intrigue (prior to diving into this piece) that deception in politics is of high quality and multileveled. Of course politicians lie all the time! They cannot serve two masters, the public and the financiers, at once. Beyond that, behind the scenes, there are no “parties” and all the sniping at each other that goes on in public is checked at the door when they work in private. Obamacare was decades in the making. It was put in place to stay in place permanently, a financial straightjacket, a massive new corporate subsidy just like Medicare D. The idea that Trump represents something new and different is hogwash, and the notion that he has the power, let alone the desire, to make changes to a long-running and achieved goal like Obamacare is just a political stage play. The purpose of this stagecraft is to convince people that Obamacare is something worth keeping. After all, if Republicans hate it … it must be good, right? We are witnessing mere reverse psychology.
There are rumblings now, and have been since the “election” of Trump to the presidency, that changes are going to be made to “Obamacare.” I seriously doubt it. That bill, also known as “ACA,” or the Affordable Care Act, put us in an economic straight jacket. It gives insurance companies power over us that they will never relinquish voluntarily. If anything, Congress and Mr, Trump are now engaged in a ritual known as the Kabuki Dance, or a staged presentation where all the players know the final outcome.
There might be insignificant changes to surface features of Obamacare, done to placate reactionary right wingers who constitute the bulk of the Republican Party. But there will be no substantial changes, and this will satisfy the clueless do-gooders who imagine that the bill actually improved our health care system. We call them “Democrats.”
I am going to use a hypothetical here to give some substance to my use of the words “economic straight jacket.” This varies depending on our age. Let’s say, for example, that you are self-employed, age 40, have a spouse and two children and want to protect yourself from health catastrophe. You are given only one way now, and that is to purchase a health insurance policy. There is no public option, so it has to be from a private company. There are many choices, but oddly, the prices and coverages among them do not vary. They are, in effect, a monopoly.
You are stunned at the cost of a policy, $1,200 per month. You are also feeling the economic straight jacket because the insurance companies, acting through government, can now track you down and penalize you if you fail to buy a policy. You cannot escape unless you join the underground economy, not an option for most. So you buy a policy from Humana/Cigna/Aetna/WellPoint/BSBC … all different tentacles of the same octopus. You will now be paying $14,400 per year, and will receive in return mere access to the health care system. Not health care … access.
There is more. Health insurers introduced us to the concept of “moral hazard,” which means that we might overuse the health care system if access is made too easy. To prevent this, they have burdened us with deductibles, co-pays, “coinsurance” and policy exclusions (things they don’t cover). Each policy now carries a “max out-of-pocket,” or costs we must bear in addition to premiums, now set at $14,300 for a family (without regard to exclusions).
Here is the real “moral hazard:” Health insurers introduced deductibles, co-pays, etc., because, they say, they don’t want us abusing the system. Truth is more basic. They introduce these features because they don’t want us using the health care system. They know that if, in addition to onerous monthly premiums, we still have to fork out out-of-pocket costs to see a doctor, we won’t do it. We are already financially stressed. It’s a perfect system for them, virtually eliminating exposure to financial peril.
So now in this hypothetical situation our poor self-employed schmuck is faced with $14,400 in premiums and $14,300 max out-of-pocket, or in theory $$28,700 in health care costs before an insurance company even has to fork out $1!
Who designed such a crazy system? The health insurance industry, through OBama, of course.
We are able to avoid this situation by buying better policies. I did extensive research back around the time of implementation of Obamacare, running a set of normal health care costs through the various offerings here in Colorado. What I found was that the better the policy, the higher the yearly out-of-pocket cost for consumers. This is basic and bonehead math … higher premiums to protect us from deductible and co-pays are a losing proposition. What I found was that everyone should buy the most basic nuts and bolts policy and minimize premiums, as the max out-of-pocket was the same for ALL policies, whether bronze or platinum. (These choices, bronze, silver, gold, platinum, are cruel and ironic, as they describe the benefits to the insurance company, and not the policy holder.)
That, folks, is “Obamacare.” He didn’t dream it up. He merely enabled it. A committee of health insurance bureaucrats, headed by a WellPoint executive named Liz Fowler, wrote the bill. Fowler pretended to work for Senator Max Baucus during the Kabuki Dance known as the “debate,” and the pretended to work for the White House during implementation. She was the industry front person in charge.
Obamacare was imposed on us by health insurers, but only after they had caused so much suffering and premature death during the “preexisting condition” regime that we fantasized they might fix the problem that they caused.
It is a sweet, sweet deal for the insurance cartel. Since that cartel, along with others, owns the congress, I foresee no changes, no loosening of our straight jacket. Just more Kabuki Dancing. We are stuck, and I do mean stuck, with OBamacare.
Piece of Mindful 
Greetings: I suggest that this began in the 80’s with the advent of DRGs, HMOs and managed health care under Reagan. I worked in a hospital business office back then and had to deal with all those new rules and regulations I think this is when medicine started transitioning from caring for people to big business. As always, the bottom line was/is $$$$ and power.
I don’t buy everything you’ve written on various subjects, but you’ve challenged me to examine the evidence and think for myself, and I like that. Critical thinking seems to be a lost art. Thank you!
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“You are given only one way now, and that is to purchase a health insurance policy.
There is no public option, so it has to be from a private company. ”
Could have added , if you desire to not participate , you will be breaking the law and will be fined ,
these thieves will never give up the mandate or give us single payer .
Would a single issue independent pres. candidate have a chance of election ?
Would you vote for Bernie if that was the case ?
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Sorry , lost my mind and thought we live in democracy , I think
I would vote for Jesse Ventura or the Rock if he promised to remove the
insurance parasites from my life . But not Bernie , another Devil’s bargain .
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When enough people refuse to vote for the next liar promising a health care system that works for people, threatening the very existence of “our (fake) democracy,” will the insurance monopolies, drug companies and hospital companies consider substantive improvements to the system. Individual persons, en masse, must be willing to risk their grand illusion of representative government in order to be considered anything above slave status by TPTB. Like most “Catch 22s today, we must kill it to save the few scraps left worth saving.
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They will never, ever give up the mandate. That was the whole point.
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Heritage Foundation (corporate headquarters) is the origin of the mandate. Asymetrical bipartisanship is always a death sentence for the masses. https://www.forbes.com/sites/theapothecary/2011/10/20/how-a-conservative-think-tank-invented-the-individual-mandate/#5a7345e61877
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Thanks for the insight. The loss of personal freedom under Obamacare is astounding in historical terms … perhaps nothing since the Federal Reserve and imposition of the Income tax match it in importance.
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Insurance companies will never relinquish voluntarily? Really Mark? They’re leaving by droves.
A new report by Edmund Haislmaier, a senior research fellow for the Center for Health Policy Studies at The Heritage Foundation, shows ACA has in fact limited consumers’ health insurance options by driving numerous insurers out of the Obamacare marketplace. According to Haislmaier, there are now only 287 “exchange-participating insurers,” down from 307 in 2015 and significantly less than the 395 insurers Haislmaier says were in operation in the 50 states and Washington, DC in 2013, only one year prior to the opening of the ACA health insurance marketplace.
Haislmaier also says 22 states and Washington, DC, representing 45 percent of all states, now have fewer health insurance providers offering plans than they did just one year ago. Only 10 states have managed to increase the number of insurers in their health insurance marketplaces.
Among the 45 exchange insurer departures, 31 were “voluntary exits,” and 21 of those resulted from insurers pulling completely out of all ACA exchanges-Justin Haskins
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This was in Spam, do not know why. Big insurers are driving smaller ones out … not hard to grasp. It is down to a few, and they will not let go. They have us by the gonads. They wrote Obamacare. There are no political parties. Behind the scenes they are all one.
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You are not far from real “socialism”, where there will be just one bank, which happens to be/own the only insurance “company”. All owned by the state.
Such had been the state of affairs in the country I grew up.
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I better name is neo-feudalism
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Just substitute “subject of the King” for “citizen of the State” 😉
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By the way, you forgot to use quotation marks.
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You’re missing one part of it. The insurance companies as the boogie-men is also part of the kabuki dance. They are given effective monopolies, yes, but their margins are still low. The REAL beneficiaries of our corrupt system are the medical PROVIDERS. Pharmaceutical companies, hospitals, and, yes, DOCTORS. All these entities charge vastly higher prices in the U.S. than in any other rich country in the world. Average drug prices are five times higher in the U.S. than anywhere else. Average costs of a doctor’s visit are at least double in the U.S. vs. the UK, Switzerland, France, Japan, etc. And U.S. doctors are notorious for running up the bill with unnecessary tests, etc. The real point of Obamacare isn’t to enrich insurance companies. It’s to enable medical price gouging of the people for the benefit of the entire grotesque health care industry.
It’s appealing to blame faceless insurance companies. But the people ripping you off have faces. And they often wear lab coats. We don’t want to believe this. We want to trust our doctors. But they are totally complicit in a corrupt system that causes hundreds of thousands of unnecessary deaths per year (due to medical error) and hundreds of thousands of personal bankruptcies due to medical price gouging. The doctors know what’s up. But they’re not talking. Instead, they say we should feel sorry for them because their jobs involve too much paperwork nowadays! They don’t much like to comment on adverse drug reactions either, although they are perfectly aware of the devastation.
Everyone is in on it but the patient. That’s the genius of it. Have a friend or relative who is a doctor or nurse or pharmaceutical sales rep? Hard to hate them, right? But they are living off of your excessive medical bills. That’s why the abusive system is stable. It’s like how defense contractors make a piece of the fighter plane in every single state. It helps Congress see that they have to vote yes on all defense appropriations bills. For “jobs.”
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The real reason is probably the desire to fleece the disorganized masses. If people have less money ,they are less powerful. Most doctors are just sheeple that obey the medical establishment (or people behind the establishment). If you go against the system you will become a crank. The sins of the medical establishment go beyond insurance. They destroy health in the first place, and this is probably their greatest sin.
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Great, great nick. All my sympathies to that piece of land. CATALONIA IS NOT SPAIN. VISCA BARCA!!
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