Category Archives: Insurance

To Our GOP Friends Who Don’t Seem To Have A Clue How Insurance Works

We might go for the Ryan budget bill in regard health insurance directly, but others have already noted that either (a) he doesn’t have a clue how insurance works, or (b) he’s trying to pull a fast one on the American public.  At any  rate, the phase I of the ACA repeal is essentially a gigantic giveaway to health insurance and pharmaceutical corporations, a tax boon to those in the upper 0.1% income bracket, and a dismantling of the Medicaid program. The contents of Phase II have been tipped.  It’s on the Speaker’s website, but requires a bit of unpacking:

“Administration actions, notably by HHS Secretary Price, to stabilize the health insurance market, increase choices, and lower costs…”

Translation: The content of health insurance policies, currently listed as “essential provisions” for all policies, is under a head on assault.

If a corporation is going to offer a comprehensive health insurance policy for sale to customers, it must include “ambulatory care for patients in a hospital or not,” “emergency services,” “hospitalization,” “pregnancy, maternity, and newborn care,” “mental health and substance abuse treatment,” “prescription drugs,” “rehabilitation,” “laboratory services,” “preventive and wellness care,” “pediatric care including vision and oral care,” and “birth control and breastfeeding coverage.”

Now, just guess what parts of this coverage the GOP finds objectionable?  If you guessed anything having to do with WOMEN give yourself the prize of the day.

Why, the guys grouse, do I have to have a policy covering maternity and neo-natal care, birth control prescriptions, and pediatric care?  It’s because of how insurance works.

Aside from the obvious part wherein it requires both men and women to create a ‘maternity situation,’ the whole idea of insurance is encapsulated in the word POOL.

“When you buy insurance, you join many others who pay money to an insurance company.  The insurance company uses the money collected to pay claims that are submitted by those who have purchased insurance.  The money is “pooled” and losses and expenses are shared.  An important aspect is the members of a pool share similar risk characteristics.” [HIW]

In the case of health insurance, the “shared characteristic” of note is that everyone who buys a policy is a human being, who at some point will need health care.  The more people (policies) in the pool the wider the risk can be shared. And, that’s the point of insurance — spreading the risk among as many policy holders as possible.

Creating ‘cafeteria’ policies might be profitable for the insurance corporations, but it doesn’t make health care affordable for most people.  If we carve out special coverage for maternity care and remove this from the larger pool (which includes men) all this serves to do is to increase costs for those remaining in a smaller pool.  Similarly, if prostate cancer screening and treatment is carved out from comprehensive coverage, this serves to increase costs as the overall pool is diminished.

Got it? If not, think of your auto insurance.  10 people buy GenZ Insurance, 9 of them never file a claim, 1 does. The costs related to the one claim are shared among those who bought into the pool and paid premiums to maintain their insurance.  We require all automobile owners in this state to have at least minimal insurance. In Nevada, this means you have to have a policy covering $15,000 for bodily injury or death in an accident for one person, $30,000 for bodily injury or death of two persons in an accident, and $10,000 to cover property damage. Thus, all Nevada drivers must have at least minimal participation in the auto insurance pool. Again, the larger the pool the greater sharing of risk, the entire point of having insurance.

Back to health insurance, if we thought Phase I is a disaster, Phase II should be even worse. Phase III is the ‘portability canard.”  Has it occurred to anyone in the GOP hierarchy that nothing that really prevents insurance corporations from selling their policies across state lines — IF they agree to accept the standards set by state insurance commissions for the protection of their consumers.  More on this later — if necessary.

 

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Filed under Economy, Health Care, health insurance, Insurance, Politics

Supreme Court Rules In Favor Of ACA: Heller Kicks The Gator Ade Bucket

Senator Dean Heller (R-NV), or as the Fine Wordsmith The Gleaner calls him, “The Senator By Appointment Only,”  wants us all to know that he is not pleased by the Supreme Court’s ruling on the Affordable Care Act and Patients’ Bill of Rights.

“Nevada families and businesses are already struggling in this current economic environment, and the President’s job-killing healthcare law is making a difficult situation worse. Congress spent more than a year debating healthcare legislation while Nevadans were losing their jobs and their homes. Obamacare made sweeping changes to Medicare, impacting thousands of Nevada’s seniors, and cut the program by a half trillion dollars.

“This law has now been affirmed as a colossal tax increase on the middle class, and its excessive regulations are stripping businesses of the certainty they need to hire at a time when Nevadans and the rest of the country are desperate for jobs. The President should work with Congress to find real solutions to healthcare reform so the excessive mandates and taxes in this law do not further add to our national debt or continue to stifle economic growth. This onerous law needs to be repealed and replaced with market-based reforms that will provide greater access, affordability, and economic certainty to our nation,” said Senator Dean Heller.

Let us parse:

Heller:Nevada families and businesses are already struggling in this current economic environment, and the President’s job-killing healthcare law is making a difficult situation worse.”

Coupling “job-killing” and “healthcare” is a Republican construction which doesn’t do anything more than seek to associate a change in health care statutes with something (anything) negative.  If unemployment in Nevada were at 2%, and the nation’s major problem was smog, then it would be easy to imagine that the ACA and Patients Bill of Right would be “pollution producing.”  That’s speculative, so let’s drill down a bit further.

Let’s go to that bastion of liberal thinking, Forbes, to see if the ACA/PBR is actually “job killing?”  The answer: No.  In fact, when we go to the Urban Institute’s Study the Massachusetts health care reform enacted under Governor Romney’s administration did NOT produce “job killing” results:

The graphic reduction is difficult to read, so click on the image for the full sized version in the Urban Institute’s original study.  What happens when we take a look at the right hand side of the chart?

While the U.S. was experiencing a decline in full time jobs during the Recession of 3.6%, Massachusetts saw a 2.8% drop.  While the U.S. witnessed a 0.8% increase in part time employment, Massachusetts saw a 0.9% increase.  Whether Governor Romney wants to admit it or not, the Massachusetts plan is the closest statutory comparison to the Affordable Care Act we have, and the numbers about “job losses” in Massachusetts don’t make the Republican point.

Neither do the national numbers: “Since the Affordable Care Act was signed into law, the economy has created 3.5 million private sector jobs, including 488,000 jobs in the health care industry. The unemployment rate is 8.3%, lower than it was in March 2010.”  [Hoyer] And this: “360,000 small businesses have taken advantage of tax credits that are making health insurance more affordable for 2 million workers.  As many as four million small businesses are eligible for these credits.” [Hoyer] And, again, this: “…over 2,800 employers are participating in the Early Retiree Reinsurance Program, which is helping provide coverage to 13 million early retirees who are not yet eligible for Medicare.”  [Hoyer]   Whether we look at national numbers or state numbers, or both — the health care reforms enacted in Massachusetts and in the United States are NOT job killing.

Heller:Congress spent more than a year debating healthcare legislation while Nevadans were losing their jobs and their homes.”

Yes, many things happened while foreclosure rates in Nevada were leading the nation,  and during this time what was the GOP agenda on financial reform and mortgage relief?

On October 12, 2010 Representative Eric Cantor (R-VA) laid out the GOP position on the foreclosure crisis: “Republican leader Eric Cantor chose to break his silence on the foreclosure crisis, with other Republicans quickly picking up the talking points.  And his position should come as no surprise.  Rep. Cantor came to the defense of the housing industry and laid blame squarely on the feet of the American homeowner.” [C2C]

Then, there was the infamous comment from current GOP standard bearer Governor Romney on home foreclosures: “Don’t try to stop the foreclosure process. Let it run its course and hit the bottom,” Romney said when asked what he would do to jump-start the floundering housing market.” [WashMonthly Oct 2011]

Thus, while Congress was debating, the President was signing, and then the Department of Health and Human Services was implementing the provisions of the Affordable Care Act and Patients Bill of Rights, the Republicans were blaming homeowners for the foreclosure debacles and the leader among the GOP presidential candidates was asserting that Nevadans who were in the foreclosure process should close their eyes and Think of the Free Market.  In other words, the Congress could have been debating the desirability of regulating Sea Horse Races, and the GOP wouldn’t have been much interested in legislating solutions to the housing crisis.

Heller:Obamacare made sweeping changes to Medicare, impacting thousands of Nevada’s seniors, and cut the program by a half trillion dollars.”  We won’t go into the part in which the Ryan Budgets in their various incarnations cut massive amounts from Medicare AND sought to turn the program into a voucher/coupon program.  Let’s just deal with the blatantly misleading statement about cuts to Medicare, and see what the professional fact checkers had to say:

“Under the act, Congress voted to reduce $500 billion in projected Medicare spending over the next 10 years, not in one substantial chunk. The reductions are aimed at eliminating parts of the Medicare program seen as ineffective or wasteful. For example, the plan phases out payments to the Medicare Advantage program, an optional program set up under the George W. Bush administration, where seniors could opt to enroll in a private insurance program and the federal government would subsidize a portion of their premium.”  [PolitiFact.com, 5/10/11] (emphasis added)

Under the Affordable Care Act the savings were reinvested in the Medicare program itself, not simply cut from the budget and the program privatized.  And note — some cuts were made to the taxpayer subsidies to insurance companies offering highly profitable optional insurance.  The cuts were in areas considered wasteful, and were NOT related to basic Medicare services.

Heller:This law has now been affirmed as a colossal tax increase on the middle class, and its excessive regulations are stripping businesses of the certainty they need to hire at a time when Nevadans and the rest of the country are desperate for jobs.”   This statement is straight out of the GOP Talking Point Random Generator.

Interesting how Republicans like Senator Heller become really engaged in the problems of the Middle Class when taxes or fees might be increased, but rarely (if ever) when said Middle Class is getting pounded by corporate raiders, union busters, private equity Giant Squids, and stagnating wages.   Be that as it may, if the middle class wants a colossal tax increase — it’s more likely to come from the Republicans.

There is, for example, the tax proposal set forth by Governor Romney, about which the Christian Science Monitor reported:

“In any case, not extending the 2009 tax cuts still in effect in 2012 means that Romney’s plan would, on average, raise taxes for households in the bottom two quintiles, relative to what they’re paying this year.  Mitt Romney’s tax plan would cut taxes, by about $180 billion in 2015 alone, relative to current tax policy. And, despite all arguments to the contrary, a disproportionate share of the savings would go to households with the highest incomes.”  (emphasis added)

Ezra Klein, Washington Post columnist, added this analysis of Governor Romney’s plan:

“Note that the Tax Policy Center could only conduct a partial analysis of Romney’s tax plan. That’s because Romney’s proposal itself is incomplete. He’s said that he wants to scrap various deductions in the tax code, particularly for high earners, in order to broaden the tax base. But he hasn’t offered any details about which deductions he’d scrap or how, so there wasn’t anything for the Tax Policy Center to analyze.

Based on the details Romney has provided so far, his plan would lower tax rates for the top quintile by 5.4 percent, saving the wealthiest an average of $16,134. (The top 1 percent of earners, meanwhile, would save an average of $149,997.) The lowest fifth of earners, by contrast, would see a small tax increase of 1.3 percent under Romney’s plan, owing the federal government an additional $143 extra on average.

Obama’s tax proposal, meanwhile, would keep tax rates roughly the same except for married couples making over $250,000 per year (or single earners making more than $200,000 per year). On average, under Obama’s plan, the top 1 percent would be paying about $87,173 more per year.”

Klein offers the following illustration:

There are many “ifs” involved in the Romney tax proposal, incomplete as it is, but there are some deductions which if eliminated would have a definitely negative impact on middle income level Americans:

“Most middle-class families would get little help. About 18 million working families would actually pay higher taxes because Romney would end the American Opportunity Tax Credit for college and cut tax credits for taxpayers with children and earned income.”  [OCCD]

In fine, if one would like to see a tax structure which bestows the greatest advantages on those who already have great advantages — Governor Romney and the Republicans are your kind of people.

There’s nothing quite like tossing in a phrase like Excessive Regulations to stir the hearts of the financial and insurance sectors, both of whom dislike being told, for example, that using premium payments for CEO compensation and advertising aren’t the best use of consumer dollars.   And, the phrase tickles those who think the EPA is merely a professional thorn in the side of the energy sector — Deep Water Horizon notwithstanding.  It’s often notable that when expounding on the “excessive regulations” in the ACA, very few — if indeed any — examples are offered.

Ah, the now hoary and hirsute talking point “uncertainty and hiring” comes back for yet another encore.   The “uncertainty” allegation is a one size fits all gob-lob at any legislation or legislative proposal which might cause corporations to THINK about what they’re doing.

We’ve been told that implementing the provisions of the Dodd Frank Act on financial regulation reform creates “uncertainty.”  In this instance there’s something to be said for a bit of uncertainty — no bank should believe that it “certainly” has the latitude to use depositors funds to play around in proprietary trades, or has blanket permission to bet against the interests of its own clients, or has leave to arbitrarily play with interest rate reporting because it wants to make its own books look better.

And for the umpteenth time — small business hiring won’t increase until small businesses (not to be confused with Washington, DC lobby shops and hedge funds) see the demand for their goods and services increase such that their current staffing levels are insufficient to meet customer needs.   The only thing that is Certain is that middle class income and middle class jobs need to advance in order to improve aggregate demand.  This has precious little to do with the desires of the Wall Street Wizards to play cowboy with depositors dollars.

Heller:The President should work with Congress to find real solutions to healthcare reform so the excessive mandates and taxes in this law do not further add to our national debt or continue to stifle economic growth.”

Now what could be adding to the national debt?

So, if we are really serious about reducing the federal deficit — then we get rid of the Bush Tax Cuts! And, we do something to get more “growth” into the economy.  Hardly the austerity prescription being touted by Senator Heller and his Republican cohorts.

Heller:This onerous law needs to be repealed and replaced with market-based reforms that will provide greater access, affordability, and economic certainty to our nation,” said Senator Dean Heller.”

Yes, the House will make another symbolic move at “repealing” the Affordable Care Act during the week of July 9th.  Meanwhile, what are “market based reforms?”

Representative Paul Ryan has suggested some “market based” reforms which mean that Medicare recipients will get a “coupon” or voucher toward paying their private health insurance premiums.   This is essentially a government subsidy for health insurance corporations to give them an “incentive” to offer health insurance for the elderly.  Meanwhile back in the real world — the reason we have Medicare in the first place was that insurance corporations do not want to offer plans for elderly people — they get sick, and old, and old and sick.

This might be a good time to remind ourselves that it’s not a “free market” when some corporations are being subsidized by the taxpayers to offer services and products they don’t otherwise want to sell.  For those keeping score, “market based solutions” is GOP-Speak for privatization.

Not to belabor the point much further, but the GOP response to the ACA ruling as evidenced by Senator Heller is simply to offer no solutions to demonstrated problems, and demonstrations about issues of primary interest to the upper 1% of the American income earning public.  It is a tale bedecked with focus group tested buzz words and talking points, which can mean almost anything to their devoted listeners, and almost nothing to anyone seeking solutions to real American problems.

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Filed under 2012 election, Bush Administration, conservatism, Economy, employment, family issues, Federal budget, financial regulation, Foreclosures, Health Care, health insurance, Heller, Insurance, Medicare, national debt, Nevada politics, Politics, privatization, Republicans, Taxation, unemployment

>Insurance Companies Face Loss of Anti-Trust Exemption

>It’s on the Twitter lines this morning: A brief announcement that at 11:30 (E) AM Senators Reid (D-NV) Leahy (D-VT) and Schumer (D-NY) will call for the repeal of the McCarran-Ferguson anti-trust exemption for insurance companies. ‘Bout time!
desertbeacon.blogspot.com

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Filed under Insurance, Reid

>Clips and Quotes: Bush won’t sign SCHIP bill – but it’s not his fault

>

How ironic? Nevada news outlets are replete with stories about the release of O.J. Simpson on bond, while a study released in conjunction with the Nevada Network Against Domestic Violence Statewide Conference reports that in 2005 Nevada had the most women murdered by men in the country; in 2004 Nevada ranked fifth. [KTVN]

Eight: The number of times Senate Republicans have blocked attempts to alter Bush Administration policy in Iraq with filibusters. [LAT] “Effort to shift course in Iraq fails in Senate” [NYT] Iraqi Prime Minister Nouri al-Maliki is citing other incidents in which Blackwater contractors have been involved in violence against Iraqi citizens. [McClatchy] The State Department was surprised with the vehemence of the Iraqi response, and remained “silent on the circumstances of Sunday’s shooting.” [McClatchy] Meanwhile, U.S. Embassy personnel are confined to the Green Zone. The Iraqis are firm in their insistence that the U.S. review policies that govern the use of military contractors. The Washington Post describes “When Rules Don’t Apply: Blackwater’s security force in Iraq given wide latitude by State Dept.” The Post provides links to its ongoing coverage of “Private Armies.” For more information: “Armed guards in Iraq occupy a legal limbo” [NYT]

Is anyone surprised? “The Carlyle Group, the District’s private-equity giant, announced that it is selling a 7.5 percent share of its general partnership to an investment group owned by the government of Abu Dhabi — one of a flurry of deals today involving Arab governments and U.S. and British financial assets.” [WaPo]

No surprise here either: “The nation’s biggest telecommunications companies, working closely with the White House, have mounted a secretive lobbying campaign to get Congress to quickly approve a measure wiping out all private lawsuits against them for assisting the U.S. intelligence community’s warrantless surveillance programs.” [Newsweek]

In a parody of logic, the President Bush announces that the Democratic plan to fund the State Children’s Health Insurance Program will “put poor children at risk” because he won’t sign it. [NYT] ”If they fail to do so, more than a million children could lose health coverage,” Bush said at a press conference. ”Health coverage for these children should not be held hostage while political ads are being made and new polls are being taken.” The new polls may show what the old polls have been saying: “Greenberg found that 60 percent of voters would be more likely to vote for the Democratic incumbent when he or she backs the SCHIP initiative and that 40 percent would be much more likely to do so, according to a memo obtained by The Hill.” [The Hill] Cuts to insurance corporation “Medicare Advantage” programs may alter the lobbying landscape on the re-authorization of the SCHIP program. [The Hill]

Florida homeowners won’t be pleased with two decisions from the state’s Supreme Court which ruled that insurance companies won’t be required to pay for damage beyond those covered in the policy.’ Previous rulings held that the companies must pay for hurricane damage even if flooding created part of the problem. [FTU]

Intolerance thy name is GOP? Representative Peter King (R-NY): “Unfortunately, we have too many mosques in this country. There’s too many people who are sympathetic to radical Islam. We should be looking at them more carefully. We should be finding out how we can infiltrate. We should be much more aggressive in law enforcement,” [USAT] The reporter for Politico tried to give King another chance to explain, but King barreled on: “Unfortunately, we have too many mosques in this country. There’s too many people who are sympathetic to radical Islam. We should be looking at them more carefully. We should be finding out how we can infiltrate. We should be much more aggressive in law enforcement.” When King replied to the controversy created by his remarks with the charge that they had been taken out of context, Politico released the video tape.

New Orleans’ labor shortage strains already struggling economy.” [NNS] “From April to June last year, the New Orleans metropolitan region had 60,000 job vacancies, up from 22,000 in the same period of 2005. Last year, 34 percent of businesses reported having trouble filling their jobs because there just weren’t enough people applying.”

In the continuing soap opera concerning ABC New’s use of discredited (phony) journalist Alex Debat: Debat had a contract with the Center for Strategic and Budgetary Assessments, a think tank administered by Pentagon defense analyst Andrew Krepinevich, and until last week was “related to” the Nixon Center. [Mother Jones] This certainly isn’t the first time the Pentagon has had media “relations” with questionable ties, witness the hiring of the Lincoln Group to inject stories into the media for Psy-Ops purposes.

Nevada News Round Up at Blue Sage Views

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Filed under Heath Insurance, Insurance, Nevada, New Orleans

>Coffee and the Papers

>This is going to be a bit more difficult to handle than the Grope Garage situation: “Jim Gibbons, the newly-elected Republican governor of Nevada, is facing a federal investigation for suspicions of criminal behavior while he was a member of Congress, according to a Wall Street Journal report today. The probe would make Gibbons, who left Congress last fall, the fourth member of the former House Intelligence Committee to come under such scrutiny. The FBI is investigating whether Gibbons improperly accepted gifts from intelligence contractor and longtime friend Warren Trepp and helped Trepp’s company, eTreppid, win contracts for secret government work, the paper said.” [ABC] See also: The Gleaner as well as Vote Gibbons Out Mr. Gibbons responds (denies) in the LVRJ. Gibbons says he’s “troubled” by the allegations. [RGJ] Now it’s not just a local story anymore — the Big Papers pile on — [WaPo] [NYT] More from TPM Muckraker. And, TPMM also reports that House Democrats are calling for U.S. Attorney Carol Lam, who brought the indictments against Duke Cunningham, to be retained in her position by the DoJ. [TPMM] Update: More from The Gleaner including a summary of the news about the Governor and his current legal issues with the Feds.
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Going Nuclear: Representative Shelley Berkley (D-NV01) called on the Energy Department to withdraw the $450,000 consulting contract given to a former executive of the nuclear waste project. [LVRJ] Former Yucca Mtn. director says the project is “in trouble.” [LVRJ] Senator Harry Reid (D-NV) introduced his legislation to streamline compensation for Test Site workers who suffer from work related illnesses related to radiation exposure. [LVRJ]
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“Mess O’ Potamia:” In addition to the $8.8 billion in Iraq funds lost by the U.S. occupation of that country, the GAO now estimates that another $10 billion “has been squandered” on contracting overcharges and unsupported expenses. That’s one out of every six dollars wasted on “repeated work delays, bloated expenses, and payments for shoddy work or work never done.” [AP]

Army Chief of Staff Gen. Peter Schoomaker estimates that the 17,500 combat troops in Iraq is the “tip of the iceberg” and that commanders have already requested another 2,500 trainers, and 5,000 – 6,000 logistical and support personnel. “Virtually all of the U.S.-based Army combat brigades are rated as unready to deploy, Army officials say, and to meet the immediate needs in Iraq and Afghanistan they are finding it necessary to transfer personnel and gear to those units now first in line to deploy.” [WaPo] (emphasis added)

The International Organization for Migration estimates that the “unrelenting violence and insecurity in Iraq” may cause as many as 1 million Iraqis to flee during 2007. [LAT]

Rep. Don Young (R-AK) thought he was quoting Pres. Abraham Lincoln — a little work with The Google and he could have discovered he was quoting right wing commentator J. Michael Waller. [WaPo]
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One hurricane too many: Senators Trent Lott (R-MS) and Patrick Leahy (D-VT) have introduced a bill to repeal the federal anti-trust exemption for insurance companies. “… “Federal oversight would provide confidence that the industry is not engaging in the most egregious forms of anti-competitive conduct – price-fixing, agreements not to pay and market allocations,” Leahy said. “Insurers may object to being subject to the same antitrust laws as everyone else, but if they are operating in an honest and appropriate way, they should have nothing to fear.” Lott, who lost his home in the hurricane and who’s part of a lawsuit that’s being settled with State Farm & Casualty Co., said, “After Hurricane Katrina we learned a lot of lessons.” He said he found out “to my absolute horror that the insurance industry is not covered by the antitrust laws.” The bill has the support of Nevada Senator Harry Reid. [McClatchy] Ironically, it was a Nevada Senator, Patrick McCarran, whose legislation (McCarran-Ferguson Act of 1945) that granted the exemption.
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Nevada state/local at Blue Sage Views

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Filed under Gibbons, Insurance, Iraq, Reid, Yucca Mountain