Extortion of the Sick: How For-Profit Health Care Has Destroyed US Medical Care

by Nomad

In the past, an armed mugger would offer his victims a stark choice: "Your money or your life!"

That bleak option, in our times, has literally become the business model for the US health care system.

An Inescapable American Burden

Physician-turned-journalist Elisabeth Rosenthal, opens her new book, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back, with these lines:

In the past quarter century, the American medical system has stopped focusing on health or even science. Instead, it attends more or less single-mindedly to its own profits.
Everyone knows the healthcare system is in disarray. We’ve grown numb to huge bills. We regard high prices as an inescapable American burden.

Income Inequality and North Carolina Health Care: A Tale of Two Extremes

by Nomad

Without the Medicaid expansion, health care for the poor of North Carolina has become a real problem.  Of course, you'd never know it by the looks of salaries paid to CEOs of  non-profit healthcare organizations. 

To put it bluntly, If you are poor in North Carolina, don't even think about getting sick.

  

The Tarheel State is one of 20 states that rejected Obamacare's optional Medicaid expansion. Governor Patrick Lloyd "Pat" McCrory and a Republican-majority legislature left healthcare coverage as it stood, covering some 1.9 million residents, around only a fifth of the state's population. 

Surviving in the Gap
Not everybody was happy with the arrangement. Advocates of the expansion claimed that another 500,000 people might have been added to the rolls, including tens of thousands of childless nondisabled adults.  

USNews reported last October that there was a good reason for this dissatisfaction. The states' Medicaid program is broken.

Bureaucratically antiquated and growing faster than state revenues, it has gone over budget in three of the past four years, and its taxpayer cost and total enrollment have both doubled over the past decade. Last year, it cost North Carolina taxpayers $15 billion, nearly a third of the budget and more than twice what the state spent in 2003.

At the end of 2015, Gov. McCrory signed into law a bill to reform North Carolina's overgrown and out of control Medicaid program.

However, this reform will take, by the official estimate, around four years to become fully implemented. Supporters claim that it will reduce existing spending by 2%, saving hundreds of millions every year. 

How accurate that is is anybody's guess. But one thing is clear, until then, the uninsured poor in the state are going to have to live with things as they are. 

The Great Society, Medicare and the Summer of ‘65

The summer of 1965 was one of many critical moments of American history. The Great Society, President Johnson's ambitious policy to overhaul the country, became a reality. However, at the same moment, a new movement of a different kind was emerging. It was a kind of backlash that would take 15 years to mature into the conservative movement.

With Republican presumptive nominee Mitt Romney’s announcement of Wisconsin Representative Paul Ryan as his running mate, there’s bound to be a lot of talk about Ryan’s budget proposals, particularly the proposed reforms in Medicare and Medicaid. Democrats are no doubt pleased with Romney’s decision since any changes - no matter how necessary- to these social programs are bound to create some fear with some affected voters. 

Still, something has to be done. Everybody agrees on that, at least. Health care is the biggest driver of future budget deficits.

It is true that Ryan’s tweaking of his original plan should have removed some of this understandable anxiety and yet when it comes to something this complex, voters on both sides of the political spectrum are deeply suspicious of any tinkering. Even the ultra-right wing Tea Party movement is opposed to medicare cuts.
One source- correctly or incorrectly- captures the mood of the anxious voter.

Ryan’s plan has been rightly called “a thinly disguised assault on Medicare.” The House GOP knows they have no immediate hope of ending Medicare, but they’re telegraphing their long-term plans to cut all the cords holding up America’s social safety net. That should be a brutal wakeup call for all of us as we get a glimpse of how they would reshape America as a less kind, less gentle nation. They don’t plan to stop at Medicare; Social Security won’t be far behind.

It would be tempting for Democrats to scare the elderly voters with exaggerated fears about what Romney and Ryan might do. Even without the medicare fears, the less than charismatic Paul Ryan is certainly not going to be giving the Romney campaign anything close to a boost.

As I said, I will leave further discussion of that topic to others. 

Instead, I would like to take you back forty-seven years to a small town in Missouri where important events were happening.

The Health Care Reform Debate: Shame of a Superpower

by Nomad

It’s often asked how people can vote against their own best interests. As a social phenomena, this strange, pathetic quirk of democracy is being played out before our eyes in the healthcare debate. 

For a nation that once prided itself in being a leader among nations, with a system of governance to be admired and imitated, the whole thing has been one embarrassment after another.

First the good news.

According to provisions in the Affordable Care Act (ACA), better known as Obamacare, health insurers that covered large groups were required to spend at least 85 cents out of every dollar on medical care or “activities that improve health care quality.”

This provision became effective last year and its implementation is now producing real results. Insurers who spend more than allowed on expenses other than patient care will be required to compensate policy holders. Meaning, policyholders can expect to see a rebate check in the mail before August 1 2012. 

The Rise and Fall of Businessman Rick Scott 1/2

Businessman Rick Scott, 
the Face of 
Corporate Healthcare

by Nomad

The story of Rick Scott's career before entering politics is a fascinating one. How a person with such a background would even consider the public scrutiny of a campaign show something about the audacity of the man.

When businessman Rick Lynn Scott decided to throw himself into the Florida governor’s race, he had one significant problem to deal with. 

As a candidate with absolutely no prior political experience, his sole qualification for being the Sunshine State’s governor was his shady history in business. 

A Very Aggressive Corporation

Before he lost his empire, Rick Scott had much to be proud of. At the young age of 34, he co-founded what was to become the largest private for-profit health care company in the US, Columbia Hospital Corporation. 

According to his supporters, Columbia was a wonderful example of how the free market system could be applied to health care, an idea that conservatives have gushed about for decades. Columbia, like Bain Capital, became known for its aggressive business tactics and since its founding had embarked on one of the most aggressive and successful buying and takeover sprees ever seen.