Hospitals Are Robbing Us Blind

Forget Obamacare. The real villains in the American health care system are greedy hospitals and the politicians who protect them.

Hospitals that don’t face competition from other nearby hospitals have huge power in their local markets.
Hospitals that don’t face competition from other nearby hospitals have huge power in their local markets.

By Reihan Salam

Five years ago this week, Barack Obama signed the Affordable Care Act into law, and we’ve been debating it ever since. Like many Americans, I oppose Obamacare, and I think we ought to repeal it and replace it. Over the past few months, however, I’ve come to the conclusion that the fight over Obamacare is a distraction from a much deeper problem, which is that America’s hospitals are robbing us blind.

I realize that this is an impolitic thing to say. What kind of lousy ingrate doesn’t love hospitals? Go to any big American city, including cities like Cleveland and Pittsburgh that have been devastated by deindustrialization and joblessness, and you’ll find a mammoth hospital complex in the center of town, buzzing with activity. Forget about big cities—there is a hospital in every congressional district in America, and local hospitals are often among the largest employers in the district. One of the reasons President Clinton’s 1993 health reform effort failed is that he never won over the hospital lobby. President Obama learned from the Clinton debacle; hospitals were among his most important allies. Republicans get in on the act too. Right now, for example, a number of GOP lawmakers are pushing a Medicare “reform” that guarantees higher payments to doctors and hospitals today in exchange for the promise of spending reductions a decade or two from now. Good luck with that.

You can hardly blame them though. The health sector employs more than a tenth of all U.S. workers, most of whom are working- and middle-class people who serve as human shields for those who profit most from America’s obscenely high medical prices and an epidemic of overtreatment. If you aim for the crooks responsible for bleeding us dry, you risk hitting the nurses, technicians, and orderlies they employ. This is why politicians are so quick to bash insurers while catering to the powerful hospital systems, which dictate terms to insurers and have mastered the art of gaming Medicare and Medicaid to their advantage. Whether you’re for Obamacare or against it, you can’t afford to ignore the fact that America’s hospitals have become predatory monopolies. We have to break them before they break us.

Read more at Salon.com

The GOP’s health crisis – Eugene Robinson, The Washington Post

Oh dear. The Republican Party’s worst nightmare is coming true. Obamacare is working.

The news that nearly 1.2 million people signed up last month for insurance through the Affordable Care Act exchanges is highly inconvenient for GOP candidates nationwide. It looks as if the party’s two-word strategy for the fall election — bash Obamacare — will need to be revised.

Wednesday’s status report on the health-insurance reforms was by far the best news for Democrats and the Obama administration since the program’s incompetent launch. January was the first month when new enrollments surpassed expectations, as the balky HealthCare.gov Web site began functioning more or less as intended.

Cumulatively, 3.3 million people had chosen insurance plans through the state and federal exchanges by the end of January. That is fewer than the administration had originally hoped but well above the predictions of critics who believed — or hoped — that the program would never succeed. The Congressional Budget Office projects that 6 million people will have chosen plans through Obamacare when the initial enrollment period ends March 31, down from a pre-launch estimate of 7 million. Not bad at all.

The numbers are even more encouraging when you look more closely. The proportion of young people — from 18 and 34 — who chose insurance plans through the exchanges increased slightly to 27 percent, compared with an average of 24 percent in previous months. This is important because premiums would have to rise if not enough young, healthy people enrolled.

Read more at The Washington Post

Eugene Robinson won the Pulitzer Prize in 2009 for Distinguished Commentary.

Kentucky governor sees health law as chance to heal an ailing state

Kentucky Gov. Steve Beshear is overseeing a promising rollout of the healthcare law. Defying bitter GOP opposition, he says it’s medicine the state needs.

FRANKFORT, Ky. — Relations between President Obama and Kentucky Gov. Steve Beshear have not always been friendly. When Obama paid his first presidential visit in May 2011, his fellow Democrat was somewhere else. Later, Beshear lashed out at the administration’s environmental regulators, telling them to “get off our backs.”

But leading one of the nation’s poorest, sickest states, Beshear has improbably overseen one of the most successful rollouts of Obama’s troubled healthcare overhaul and become, deep in his long public career, a hero to Democrats grasping to find a redeeming figure amid the political wreckage.

He’s an unlikely champion, not least because Kentucky’s two U.S. senators are both implacable opponents of the program.

“I knew if I was going to make a huge difference in the health status of Kentucky, it was going to take some kind of transformational tool to do that, and that’s what the Affordable Care Act is for me,” Beshear, white-haired and greyhound-lean, said as he sat behind a big maple desk in his office. “I think we’ve started something here,” he later added, “that a generation from now you’ll see a very different Kentucky than what you see today.”

For now, Kentuckians may feel understandably whiplashed.

While Beshear, serving his second and final term, has become one of the foremost proponents of Obamacare, the state’s senior senator, Republican leader Mitch McConnell, has been an even more visible foe. Facing a tough 2014 reelection fight, he calls the law “a disaster,” “a huge mistake” and “a monstrosity” that “needs to be pulled out root and branch.” The sentiment is seconded by Kentucky’s junior senator, Republican Rand Paul, who was elected in 2010 in a tea party fever born of seething opposition to the president and his healthcare plan.

Read more at the Los Angeles Times

Are All Those Insurance Company Cancellation Letters Too Good to Check?

Paul Waldman recounts yet another story of someone allegedly getting screwed by Obamacare. This time the victim is Deborah Cavallaro, profiled yesterday on the NBC Nightly News:

We learn in this story that her insurer is cancelling her current plan, which costs $293 a month, because it doesn’t comply with the new law. They’ve offered her a new plan at $484 a month. That sounds like it sucks!….But wait. Maybe she’s not a victim after all. How does the $484 plan her current insurer is offering compare to the other ones she could get? Did she or the reporter go to the California exchange and try to figure that out? Apparently, they didn’t. But I did.

It took less than 60 seconds. Let’s assume that Deborah has a high enough income that she isn’t eligible for subsidies. I put in that I was 45 years old and got nine different choices for a Bronze plan, which in all likelihood most closely resembles what Deborah has now. The average monthly cost was $258, or $35 a month less than what Deborah’s paying now for her bare-bones plan….She can get a Silver plan, with more generous coverage, for $316, only $23 more than she’s paying now. Congratulations, Deborah!

In a follow-up post, Waldman makes the right point about this:

I want to talk about the thing that spawns some of these phony Obamacare victim stories: the letters that insurers are sending to people in the individual market….There’s something fishy going on here, not just from the reporters, but from the insurance companies. It’s time somebody did a detailed investigation of these letters to find out just what they’re telling their customers.

Read more at Mother Jones

Web Sites and Grave Sites

Charles M. Blow

Republicans are apoplectic about Healthcare.gov, the official Web site for the Affordable Care Act.

They are trying desperately to change the subject from their disastrous government shutdown by ranting about the failures of a government Web site that cost a tiny fraction of what was lost as a result of the shutdown.

Republicans are pretending that they care about the problems encountered in signing up for a system that many of them are bent on destroying.

They are demanding an immediate fix to something they want to break.

They are trying to deflect public outrage away from their record-low approval ratings.

The only problem for Republicans is that a technical issue isn’t likely to have legs. Yes, it’s embarrassing. Yes, it’s frustrating. Yes, it’s an unforced error.

But it’s also fixable, and in the grand scheme of things, a malfunctioning Web site is more understandable and less consequential than a malfunctioning political party.

The Web site will be fixed. Can the same be said of the party that has planted its flag on the outskirts of reason? Can the same be said of the party being hijacked by hyperpartisans?

Read more at The New York Times

Shutdown Politics: Support for Democratic Takeover of House Spikes

John Nichols – The Nation

The numbers that matter in Washington are not the ones tossed around in discussions of debt ceilings or continuing resolutions.

The numbers that matter are found in the polls of public reaction to the ongoing government shutdown, and to the prospect that a bad circumstance could grow dramatically worse with the undermining of the “full faith and credit” of the federal government.

Those poll numbers explain why there has been at least some movement on the part of House Republicans—who engineered the shutdown as part of a scheme to derail implementation of the Affordable Care Act—to back down from their most hardline positions.

The latest data from NBC News and The Wall Street Journal is devastating for the GOP.

Fifty-three percent of Americans surveyed blame the GOP for the shutdown, while just 31 percent blame President Obama. Overall, approval ratings for the president are far better than those for the Republicans, and approval of the Affordable Care Act has spiked since the standoff began.

Read more at The Nation