Thursday, October 10, 2013

Affordable Care Act, a Profit Center, Public Private Partnership, or another Financial Scheme??

Do we need more Financial Schemes in this Country?  Isn't it a national security risk, if only Wall Street Insiders know who the sucker is in American Deal Making??


I'm just an Everyday Guy that has lost some money and watched more disposable income disappear in the modern American Age... The Financial Battleground.  A war for your wages, your income, your savings, and your retirement.


In the US Military we have Single Point of Contact who is responsible for particular expertise, operations, and coordination.  In the army I think that is called the SPO.  The SPO is responsible he gets both blame and accolades as he guides commanders and units through transitions.   

Do you think the USA has a SPO for Insurance, Financial Instruments, & Public Private partnerships??  I don't think you will get a returned phone call from the Federal Reserve, the US Treasury, the OCC, FSOC, the Executive Office, your congressman, FINRA, SEC, FTC, the US Media, the American Bar Association, ETC.   The CFPB is supposed to be the latest in a long line of agencies to protect us.  The list of federal agencies that protect us sort of looks like the 16 powerful big budget US Intelligence Agencies, ... except in the case of protecting individuals from commerce  they seem to lose most of their power when a new agency is added.  

https://en.wikipedia.org/wiki/Consumer_Financial_Protection_Bureau  

Dobb-Frank has provided us with yet another federal agency to follow behind the FTC and all the other agencies in protecting citizens from organized corruption and fraud.  But has that agency been given the Power, Authority, Budget, Resources, and Staffing to take a look at the Affordable Care Act (AKA Obama Care)??  

Today it has become even more clear all the risks American face in what is clearly another US Financial Scheme called the Affordable Care Act. 

1) Mandatory Program with Fees or Taxes in which personal data is surrendered and shared among various unknown agencies... enforced by the IRS.  
2) Appears there is no cost controls, policies are termed Insurance, policies exclude many features that would actually be needed for personal health, there is much lawyer language involved in the contract policies for which you will not be covered.  
3) We hear that all policies are doubling in costs, figure that co-pays and fees will also increase in some cases.  
4) All Insurance is a Financial Scheme. 
5) US Health Care is one of the most expensive in the world, no one ever talks about the costs, the executive compensations, the dividends or profits shared with investors, no one is addressing the inflation and overall yearly increases in costs.  It is sort of a spin zone. Or it is a "No Mans Land".  No one seems to be bringing the yearly cost growth to a National Discussion Level.  Capitalism Rules in the land of Insurance & Finance.   
6) The Affordable Care Act seems to be another mechanism for transferring Middle Class Wealth or Savings to Investors or Financial Managers.  The money is going to come from working Americans, I'm just not sure who the money is going to go to.  The health system will expand with more health facilities I'm sure.  But as a Public Private Partnership the wealth will be a transfer from the Federal Government to Investors and executives.
7) Bubbles, Financial Bubbles... Middle Class Savings Gone, Retiree Savings Gone, Home Equity Gone, Education Debt in process, Hurricane Damage losses to the US Wealth, US Wages Down, US GINI Coefficient Wage Gap increasing, Decapitalization of US Manufacturing, Offshore Incorporation, lower investment in US R & D, lower investment in US Job Training, No Real Leadership in Investing in the USA, ETC.   
8) I predict the Affordable Care act will create another Bubble, and transfer more wealth out of the poor and middle class.   
9) We have entered "A New Era of Financial Battles & Financial Profit taking characterized by the Rentier Class".  Executive Bonuses & Salary Increases are enough to keep the game going.  There are always ways to cut costs, cut wages, go off shore, to find new resources, and to invent new materials.  This is a kind of Social Darwinism in which corporations are sovereign, but don't really have to maintain or steward the US Economy or the US Consumer.  In the Affordable Care Act the taxpayer becomes more of a cog or "Profit Center" owned by the vast corporate system to be a monopolistic kind of bubble.

After all who can understand public private partnerships??  We have no National Security in the many areas of Economic, Financial, and Social Risk.  There is no Responsibility in Washington DC OR New York on Wall Street in this Era of Financial War... If there was then we would have a SPO and we would have National Discussions in the Mainstream Media about Financial, Economic, & Banking Literacy.    And as you have notice in federal budget discussion... the real budget data never sees the light of day.  In national budget discussions only the pieces of the budget which are getting cuts and increases are touched on at all.  Most Americans have never even seen the US Federal Budget Lines, the Trust Funds, the Revenue Streams, or the Budget Outlays.    

It is a Financial Battleground with National Security importance.  There is decapitalization in the US Economy, Capital Flight, Loss of Wealth, Loss of Average Wage Rate, Loss of Social Cohesion, and Institutional & Systemic Control Fraud.  None of this can be refuted.  No sane American would want to hide National Security Issues from the Voting Public or from Public Discourse.   

The point is the Affordable Care Act makes the federal budget & citizenry more risky as it was not designed to be simple or to address all the problems.  It is some kind of monster which might help 1% of the population while putting profits in the hands of an other 1%. Emergency rooms are still going to be filled with the uninsured who freely walk across the border and are not covered and seems doubtful they will pay into the program. Drugs are not covered. Inflation is not covered. Industry waste is not addressed. The spectrum of costs, wastes, fraud, and risk are ignored... and control has been ceded to Industry Executives.

I hate to even mention the possibility of more power going to technocrats in our government.  But we should start to broadcast and listen to the personalities that run our other agencies like the FTC, Department of Labor, SEC, FDIC, and FSOC.  Maybe if our agency heads felt more like they were on the National Stage and had more of a feeling of responsibility to the citizenry ... they would take a personal stand & develop their own personal networks to oppose the stupid political clucking out of congress.  The reason I fear technocrats is because of my perception of the EU and the Austerity imposed across Europe which is grinding all middle class people down to poverty.  

Conclusion:

But in the USA we have a chance if we recognize the changes to the global economy, transnational corporations, and the financial battle against taxpayers.  We just might be able to re-institutionalize the fight against fraud, control fraud, propaganda, the dumbing down of citizens & investors, and the loss of American Liberty, the American Dream, and American Privacy.  Maybe we should have US Celebrities that Fight Fraud, that work in our Federal Government, that expose complicated financial schemes which drain the Vitality of America!

12 comments:

Matt Franko said...

Mid,

I dont think it is necessarily a scam, if what it is trying to do is eliminate the health insurance industry's 'NVA' ie 'no value added'...

It is a state by state issue.

I am not buying that is is/was 'a gift to the insurance industry' ...

I dont see that.

Rather, I see it as a major threat to that industry...

Here is a major not-for-profit health care provider in my area and look at the numbers:

http://www.medstarhealth.org/body.cfm?id=11

"MedStar Health is a $4.4 billion not-for-profit, regional healthcare system with a network of 10 hospitals and 20 other health-related businesses across Maryland and the Washington, D.C., region. As the area's largest health system, it is one of the region's largest employers with almost 30,000 associates and 5,600 affiliated physicians,"

Do the math, 4.4b / 35,600 associates and physicians and you get $123k/year and then you have to take out certain overhead and direct costs from the gross so it doesnt look like at least on the surface this is a big rip-off...

In my state (MD), this provider can provide an offer to the state healthcare exchange for a monthly 'premium' to provide heathcare to currently uninsured citizens...

So they can figure out how much they need to charge a MD citizen to take care of their healthcare needs and put that offer on the exchange...

I still have some work to do on it but prior to Oct 1 the state administrators of the exchange were looking to get offers in the $281/mo rate...

They have screwed up the IT and it is not ready but that will be taken care of with time...

So what could happen is the Healthcare industry may be blown out by providers networking and bypassing the insurers.... Aetna has dropped out of the deal already here in MD...

So now all people need is the income to be able to pay the 281/person and we in MMT know where that can come from...

rsp,

Joe said...

The ACA, while definitely not perfect, is realistically the best that average people can hope for. Yes, the current state of affairs is that sad. Obamacare is as conservative of health reform that was possible and still be "reform", and even so, we get the constant "socialism", "government take over of healthcare", "the IRS is in charge of your healthcare", etc etc. Like Dean Baker said, there's not even a story anyone can tell that would give a remotely plausible path to single payer, (or Mosler's flavor of it). The paranoia and delusions of conservatives is just too deep. Other than insurance companies, wouldn't most of corporate america be in favor of single payer? Should lower their operating costs...

Tom Hickey said...

Conservatives are going to go ballistic over any "government" health care solution. Might as well just go for single payer and let their heads explode. The people will love it compared to what they have now, just like people love Medicare instead of their previous insurance plan, if they were lucky enough to have one.

The Just Gatekeeper said...

"But has that agency been given the Power, Authority, Budget, Resources, and Staffing to take a look at the Affordable Care Act (AKA Obama Care)??"

No, of course not! The CFPB has no purview over such things. Why would it? Health insurance has nothing to do with consumer finance. CFPB was created after ACA passed, anyway.

The Rombach Report said...

Matt - If you live in Maryland, does it concern you at all that personal data gathered in ACA exchange environment will be provided to law enforcement & audit activities?

http://www.weeklystandard.com/blogs/obamacare-marketplace-personal-data-can-be-used-law-enforcement-and-audit-activities_762237.html

Many waivers, exceptions and exemptions to ACA have been granted to special interests by the Obama administration. However, the one irks me the most is the IRS employees union which represents the people who will be enforcing ACA, who nevertheless want to opt out from it themselves. I guess all animals are equal, but some are more equal than others? ACA is not socialism, it is medical industrial complex fascism. The only real winners will be the health insurers and big pharma.

In a free market for health care there would be health savings accounts that would function like 401K accounts that would be portable from job to job and if you stayed healthy you could convert it to supplement retirement income. I don't see why private health insurance can't offer plans like term life insurance that locks in cost for defined coverage for 5, 10 or 20 years? I see it as partly a problem of supply and demand. Medical professionals like Doctors, nurses and medical technicians could be incentivized to donate their services to local clinics in exchange for a tax credit and patients should get a tax credit for any out of pocket health care expenses they incur.

Malmo's Ghost said...

Tom,

As a far left, non sectarian liberal myself (far to the left of most here, save you and a few others) I think conservatives are right to go ballistic over this 100% partisan (corporate Democratic), insurance industry drafted, 20,000 page bureaucratic monstrosity. This legislation will also never lead to a single payer system, which to my mind is the only system worth having.

Also it's not accurate to say rank and file voters from the left are equally not at ease with it either. Heck, not even the 15% who are uninsured seem to be enamored with it given their paltry numbers in signing up for the exchanges once they commenced with open enrollment. My guess is that when all is said and done, the ACA will not be recognized in its present form.

Tom Hickey said...

ACA is the MA Romney Plan drafted by Heritage Foundation. Why should conservatives hate it? It's a windfall for private insurance.

What led to the ACA was widespread public outcry that the existing insurance arrangement was very expensive and had all kinds of exclusions and loopholes allowing insurance cos to stiff clients.

There were two ways to deal with that, either a private plan that excluded pre-existing conditions, or else a government plan similar to Medicare. The no-brainer was the latter, but the Democrats didn't think it was politically viable so they went with the Heritage Foundation plan thinking that the GOP would be ecstatic that they caved.

Matt Franko said...

Ed,

I'm not on board with all of the "privacy" type issues.... it doesnt necessarily concern me... (not saying "my way is right...")

It just doesnt bother me... I'm not libertarian at all probably...

There are income issues related to qualifying for the subsidy for the premiums....

I dont see how anyone can say this is a benefit to the health insurance industry, I rather look at it as it may destroy that industry in its current form...

rsp,

Middleaged-Living-in-a-Land-of-Makebeleive said...

What great comments. I tend to believe that universal Medicare for all is the best idea. Medicare is well developed, has standardized procedures, is well known, and has cost controls and mechanisms for dealing with fraud, waste & abuse even if not evenly applied.

We lived with capitalism, so any business deal seems to have wide profit margins for executives & investors. Government contracts are known to have lax monitoring & enforcement against counterfeiting supply parts, fraud, and against tax evasion.

I feel most people don't realize we have social programs all over the US like in K-12 Education, Interstate building, congressional retirement & pensions, and Defense.

I feel there are things that should not be profit centers for Investors or capitalists. Health care, Food, Water, Energy, Emergency Services, Defense.

We can count on few things as truth:

1) Politicians & Media will not give us the truth about corporations.
2) The people with the Loudest voice are not correct any more of the time than anyone else.
3) Words like Capitalism & Socialism make many people overly sensitive to discussion.
4) No doubt I have a "Bias" myself - and I need to look deeper into Health Care.

Middleaged-Living-in-a-Land-of-Makebeleive said...

Matt;

Don't you mean you feel afraid that changes will come down in the future that will hurt the US Health Care System?? As it stands I don't see any cost controls at all in ACA. As I said looks like Insurance companies whether owned by the Federal Reserve or not can set their own premiums & coverage.

Seems like Insurance Companies are sharp shooters who can easily find a reason for not paying coverage on their policies.

Funny thing about Insurance companies I just heard that they don't keep reserves or assets to pay off the policies if policies are enforced. Not an expert, but it seems like Insurance is about collecting the money, talking about how they hedge the risk, then they invest in non-liquid or risky assets, and they manage the payouts with the strongest policies and strictest interpretations possible.

Insurance is a rough game played by tough people no doubt. I guess they have bullet proof windows at their offices in some cases??

Take AIG. Was that a Scam or were they conservatives, with a conservative business model, with adequate reserves behind them?

In order to be in business or form a government or run a family budget... you have to start with conservative accounting rules and conservative ethics, morals, and standards of practice. AIG was none of these things.

Middleaged-Living-in-a-Land-of-Makebeleive said...

Matt;

Regarding Medstar, looks like an interesting organization and probably a good example as it has many facilities. Of course we have to audit the organization to see where money goes to and where expenses or costs are going up every year.

Building on the Medstar Model we could make many suggestions on how the Federal Government could subsidize the operation to bring down cost of housing for doctors, building and office costs, paying off education loans for doctors over a period of 10 years, perhaps the government could repay the doctor for equipment purchased under certain rules to keep the budget tight and costs of services down.

But I'm an amateur and I might have a tendency to turn facilities that are simple and nice into facilities that look like old government buildings built on the cheap. This is the other side of the coin. But common sense comes over times and development. There might be some optimal hospital & clinic sizes (to consider when expanding and building new buildings) with smart features that provide smart health care at a minimum cost without shooting ourselves in the foot.

The military builds standard construction all the time, so this is already part of our government. We can grade military hospitals as very poor... but you have to do an audit to really see if it is a problem of recruitment, of personnel, of continuing education, of staffing or budgeting for staff or equipment...

In any case, we probably need much more transparency over the monsters that make up our health care system in order to even plan out an audit.

Recent news over the VA Computer System and records migration from Service records... seems to indicate that even when the news points out serious problems with health care records & systems integration that "No one does any thing to fix the problem" and so we see Kathleen Sebelius back pedaling in public about ACA repeating the same software/computer problems.

US Leadership is firmly committed to "Spinning" the truth to hide what is going on in your country & mine.

Matt Franko said...

Mid,

They didnt do a good job with the IT that is for sure and unfortunate see Tom's post above...

(imo, they should have brought in the defense establishment they know how to do mission critical govt IT... looks like thye brought in a bunch of HHS types who are out of their league....)

MedStar in NOT a health insurance scheme, it is a network of healthcare PROVIDERS...

The PROVIDERS are networking and cutting out the INSURERS here in Maryland...

The INSURERS are going out of business here in Maryland...

Independent physicians are moving to Virginia.... as they are not in netowrks so they cannot compete with the networks...

This should just be regulated and costs monitored by micro-economists to keep a lid on things... also, there is some "competition" between the provider networks here in Maryland which helps to keep each network cost conscious...

The only issue is where is the income going to come from for currently "uncovered" to pay the premiums? MMT has an answer for that...

rsp,