Monday, March 20, 2017

Marcia Angell — Medicare for All should replace Obamacare

Paying for Medicare for All would require an increase in taxes — perhaps an earmarked progressive income tax for the purpose — but that increase would be offset by the elimination of premiums and out-of-pocket costs, and the slowing of inflation that stems from our market-based system. 
Angell buys into the false government as business or household analogy. Of course, a medical expert could not be expected to know the difference between an issuer of a sovereign currency like the USD and those who use the currency and must obtain it since they don't issue it.

The reality is the the federal government issues its currency and its cost of capital is zero, including interest payments if government chooses to include this even though it is not necessary operationally.

The only constraint is the availability of real resources. Public investment can augment real resources  through issuance at no cost of capital. As long as real resources are available for purchase in the currency they can be deployed. There is no affordability problem.

Issues might arise where government competes with the private sector for scarce resources. That would occur at full employment if government wishes to continue to expand services.

USA Today — Opinion
Medicare for All should replace Obamacare
Marcia Angell | corresponding member of the Faculty of Global Health and Social Medicine at Harvard Medical School and Faculty Associate in the Center for Bioethics, and former editor in chief of the New England Journal of Medicine
ht Lambert Strether at Naked Capitalism

16 comments:

Noah Way said...

I have Obamacare. It is extortion codified into law.

I am now submitting a claim for the FOURTH time.

The first time I filed several claims together and they ignored one. I resubmitted it (second time) in a separate mailing. They replied that my ID number was illegible or missing (yet they were able to identify me clearly enough to send me a reply and cash my premium payment).

I filed the claim again (third time) with the standard claim form filled out as instructed, a copy of the invoice for services, a copy of my ID card, and a copy of the receipt of payment. They replied "requesting" more information, specifically:

member HCID
member name
detail of service
provider tax ID
procedure codes
diagnosis codes
rendering provider name
billing provider NPI
total amount due
patient name

Infuriated beyond my normal state of seething rage I called Empire: "Wait time, 28 minutes and 34 seconds". I then called the provider - the billing dept. has a message saying "leave a message". Meanwhile the provider sent me another bill for services I paid for in January.

Empire has yet to reimburse me for out of pocket in-network payments that were required by various providers (who probably have one hell of a time collecting anything at all for their services) OR to respond to my request for reimbursement.

The cost of the office visit was $240.

Observations:

Obfuscation is a primary strategy for denial of coverage. The plan is to make you give up and forgo and "benefits" by wasting your time and energy and instilling a sense of absolute futility in your efforts.

The stress of dealing with this BS is really bad for one's health. I'd very likely be better off without insurance - just go to the ER and tell them to fuck off when they bill me.

Noah Way said...

On one of the visits - in network (but I had to pay in full, $250) - I sat in the waiting room and watched a guy with Medicare get checked in in 30 seconds flat. The guy after him had a $10 copay.

Meanwhile I'm out $250 and Empire (a perfect name) hasn't reimbursed me a penny.

Bob said...

Don't you have to take a vow of perpetual poverty to be allowed to utilize Medicare? Or file for bankruptcy?

Tom Hickey said...

The plan is to make you give up and forgo and "benefits" by wasting your time and energy and instilling a sense of absolute futility in your efforts.

This is how insurance works. And a lot of other things, too. It's a plan, like offering rebates that stores know from testing are unlikely to be submitted correctly or on time, or at least that's what they can claim.

Tom Hickey said...

Don't you have to take a vow of perpetual poverty to be allowed to utilize Medicare? Or file for bankruptcy?

You are thinking of Medicaid.

MRW said...

Noah, I don't know what state you live in but every state has an insurance ombudsman or a similarly named oversight group for insurance fraud. Includes all types of insurance. Call your State Attorney office in your state capital for starters to begin the process of finding out where to go.

If you have paid into your insurance, that is made the premiums on time, and they fail to honor your legitimate claims, that is considered fraud.

if you don’t get any satisfaction, write, don’t call, write your local Congressman’s office. Keep it to one page.

Listen carefully to what I’m going to tell you. My brother and I were investigating aspects of my father’s estate. Another family member had embezzled part of it and we needed blue-ribbon, court-approved copies father’s IRS business returns, not the gibberish of coded copies I got from the local IRS office. I tried for MONTHS and MONTHS to get them. I must have contacted 12 different IRS offices all over our half of the US trying to get help. Finally, my brother (an Executor) made an appointment with one IRS office three months out and traveled some distance for it, only to discover the IRS had no record of the appointment. He was out time and bucks, and we’d lost three months.

That’s when I hit the fucking roof. Through some kind of dumb luck, I got hold of a supervisor at that IRS location, and raised holy hell. When I’m pissed, I get quiet. I never swear in anger, not ever. But there’s no mistaking what’s in my voice. The female supervisor listened to me, then said, “Let me close the door.”

First she told me that she was going to send me a vault-protected copy of the codes I would need to interpret the docs I did have. Then, she said “The IRS is only afraid of Congress.” She said to write my Congressman and “use these five words” in describing the lack of response and inaction. I can’t remember them, I’m sorry, but one of them was “hardship.” I think another was “neglect.” The five words were dramatic adjectives or nouns to emphasize my distress. The point is to stress what the lack of action is doing to me. I’d have to dig the letter out of my computer mothballs to figure out what they were. This supervisor said that if I used these five words that a Congressman is honor-bound by law to contact the IRS and ORDER them to respond to me or be held in contempt of Congress! Who knew?!?

Anyway, I did what she said, and I named the IRS departments who refused to call me back.

Noah, what happened next was stupifying. My Congressman was back in DC. His local 24-year-old assistant got my letter and called me to say she was handling it. I was deluged with accommodating phone calls from all the IRS offices that had ignored me over the next four weeks: calls, follow-up calls, and follow-up on follow-up calls. Some left me their personal cell numbers. You wouldn’t believe the solicitation. Unreal! Seriously.

I later found out that insurance fraud comes under the same thing. Congress can shut down an insurance company in a state for unsavory practices. The insurance business is highly regulated.

So write your Congressman a letter stressing how in these economic times, paying your monthly premium is a hardship you manage in order to maintain medical coverage, but that you can’t afford to endure the insurance company’s failure to manage its back office management of bonafide claims. (Asking for that bullshit list you cite is a failure of their operations.)

Anyway, lay it on with a trowel. And demand your Congressman to help you.

MRW said...

Noah, do it at least for shits and grins. And let us know how it turns out. lol

Ryan Harris said...

I don't understand why there is a gag-order among politicians to avoid discussing expanding medicare.

Every person in the nation loves the idea.

Every politicians knows it is impossible politically.

Noah Way said...

Every politician makes it impossible. BO killed the public option "to save insurance jobs".

MRW said...

Noah, you going to take my advice?

GLH said...

Noah, I am sorry that you are being treated so badly. I have to admit that I voted for O the first time but when I saw how he lied about healthcare I decided that voting for all of these liars and crooks was a waste of time. The ACA was written by the assurance companies. Obama had secretly agreed when he went into office not to have a public option but went around the country for six months spouting lies about how he would have one. We can only hope that the republicans screw healthcare up so much that the next person has to go with medicare for all.

Penguin pop said...

Noah, thanks for sharing your very tragic story. It's always a bait and switch scheme with crazy politicians at the helm who don't have the interests of the people in mind, even the ones who claim to be "progressive" end up being like this as well. I don't personally have much hope in the short-term, but I'd fight like hell to get your situation rectified and worked out the way MRW described.

gene kalin said...

Obamacare does indeed work though when the S really hits the fan!

My wife and I were in a head on crash 1/1/17, and she's only home about 1 week. After being saved and transported from the crash. Then 74 days of hospitalization, one life saving and multiple orthopedic and other surgeries, and then inpatient rehab.

All covered - so far at least - and mostly out of region and state, as it was all a very serious emergency. Not once has anyone asked me for a penny in payment! No co-pay and no deductible. In fact I have received several checks FROM my insurance companies! God knows why, but I doubt that I'll be returning them. Time will tell and maybe one day someone will ask me to pay the $M back.

But this is Obamacare/catastrophic insurance working as it should.

Matt Franko said...

Noah,

All of those mfers should be thrown in fing jail imo.... no .... beaten first and then thrown in jail...

Noah Way said...

@Gene, hoping the best for you and your wife.

That sounds like your auto insurance policy, not ObummerCare.

gene kalin said...

Thanks Noah!

Auto pays $5K medical. The deceased other driver's policy will pay some. My auto insurer will be paying a bunch as we have under insurance through them. So far my wife's Obamacare policy has been paying the medical bills - as far as I know.