Health Insurance: Keep It Simple (conoutofconsumer)

Obama's Celebration of Obamacare: Based on a true story

2022-04-04T08:39:00.007-07:00

President Obama's ability to spin, with the cooperation of those afraid that any criticism of Obama represented racism during his term of office, and the now entrenched Democrat submersion of facts into the world of narrative means that at best what we're hearing is similar to those media that claim to be BASED ON A TRUE STORY, regardless of how little that media has in common with the original facts.

And so weirdly Obama and Obamacare are being paraded before us as a "victory," April 5, not the anniversary of Obamacare, but closer to today's anniversary of Martin Luther King Jr.'s assassination. And so the narrative begins.

Likely ignored in the narrative will be the fact that Obama was voted the liar of year, technically as telling the lie of the year, for his junk promise of if you like your health insurance you'll be able to keep it. (2013)

Also omitted will likely be the scandalous passage of the Affordable Care Act and Jonathan Gruber, an "architect" of Obamacare explaining that “Lack of transparency is a huge political advantage,” Gruber said. “And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass.”

We can anticipate that erased from the narrative will be the fact that the tradeoff for the faux achievement of covering those with pre-existing conditions was Obama's cave to the insurance lobby (AHIP, 2008) that an unholy alliance with the insurance industry would be formed and the US federal government would force people to purchase the consumer product of health insurance in exchange for the willingness of the insurance industry's agreement to offer insurance policies to those with pre-existing conditions.

Obama happily complied with insurance lobby demands and the Supreme Court upheld that nasty little partnership when it painfully twisted the reality of the individual mandate penalty by simply changing the narrative and saying it was a tax so that the provision could be upheld.

Uncovered by the based on true events, narrator Obama will likely ignore the consumer burden of the no-end-in-sight cost of prescription drugs.

Uncovered by the based on true events, narrator Obama will likely ignore the fact that enrollment in Obamacare health plans, NOT including enrollment in expanded Medicaid programs, has always been anemic never nearing the alleged 49 million uninsured (which number was adjusted downward by the Obama government in 2015).

Uncovered by the based on true events, the narrator Obama will likely ignore the fact that out-of-pocket expenses for consumers have also ballooned (aside from those eligible for government supported Obamacare and Medicaid) with everyone else paying more for deductibles, coinsurance, copays and premiums.

Obama is a great narrative composer and has misled the American public through his half-truth storytelling and narrative concoctions with a brazen confidence that his Dem pals will follow in lockstep and that the American public will remain "stupid." Worthy of his Netflix deal, Obama did plenty wrong and has decided to "fix it" through storytelling and narrative with the cooperation of his cronies and fans.

The Democrats have honored the dishonest legacy of Obama's style and its apparent success in fooling the American people with many less skilled storytellers, including our current President. Republicans have also enabled the stories and naturally, have many of their own, but without the widespread media support, censorship and manipulation.

We all like a good story, but we've become a nation of narrative rather than information, the good, the bad and the ugly that true information must leave room for in order for us to have enough self-respect to stop being stupid. Half-truths are lies.

So let's not say Obamacare "improved " things unless we understand that Obamacare caused a lot of damage in addition to creating a dangerous alliance between government and insurance salespeople and lobbyists.

Let's not say how great Obamacare is for the population of Obamacare signups without acknowledging the devastating cost increases to the hundreds of millions of our population who are not part of the measly 13.8 million enrolled this year in Obamacare.

Let's not self-congratulate that 2022's 13.8 million is the highest number of enrollees on Obamacare plans without noting that it was only because of the expanded thresholds designed to make more people eligible for government payouts under Obamacare health plans.

If you miss Obama, whether it's his scolding schoolteacher tone, his preacher tone or his politician tone, then have at it. If you're looking for some fresh from the garden good old-fashioned storytelling, have at it. If you're thinking of progress (as in moving forward, not simply trading one thing for another), likely you'll have to pass on the Obama entertainment and do some fact-searching.

Progressive Socialists and How to spot them: The Blurt Factor

2022-02-19T11:18:00.016-08:00

It might be time to reject the hard-core progressive socialists as bad for mental health. Progressive socialists, extreme liberal, leftists, all terms used to describe the extreme "leftists," follow their beliefs and gods as a religion and employ tactics used by history's fanatics, intolerance, illegalization, marginalization and cancellation, which is nothing more than the modern word for shunning, excluding dissenters.

In the US it seems that about 30 to 35 percent of today's Democrats are part of this extreme group and ultimately may be people everyone else chooses to avoid because their endless criticism, intolerance, labeling and black/white thoughts amount to little more than bullying and abuse with the known negative impacts on mental health.

What does this have to do with health insurance? It's important to note that most psychologists and social workers and assorted individuals providing therapy identify as democrats but are not supposed to self-disclose in order to protect themselves and the people they counsel. That's been the case for a long time, but with this new breed of liberal, it's not merely a so-what moment if you are unlucky enough to deal with an extremist liberal because the absolute rejection of any view but their own may jeopardize your mental health or your progress. Politics has destroyed relationships, ended friendships and infiltrated schools and even counseling services.

The outspoken progressive socialists are lecturers and scolders, not teachers or tolerant listeners. They silence, demean and illegalize views that are not their own and for many present a clear and present danger to ourselves and our well-being. They present their opinions as fact, their ideas with piles of debatable statistics, their hunches as truth and leave no room for dissent.

The danger of today's progressive socialists is they believe they have the moral high ground and are willing to publicly advocate for their opinions and berate, demean and marginalize all others as wrong.

I am an old-time liberal and I fully reject what's being peddled by Democrats today. After years of the strange allegations that I deny climate change if I don't agree with the AOC's Green New Deal, that I must be an anti-vaxxer if I don't believe that the COVID vaccine should be mandated, that I must be a racist Nazi if I disagree in limiting Supreme Court justice selection only to a black woman, that I must be a racist if I vote for any Republican, I can honestly say that I now totally reject this group as they reject "others" like me.

With the big push today that "counseling" is the answer to everything, and the long-time disclosure that most therapists identify as liberals, it's critical that parents and individuals seeking counseling recognize that the brazen openness with which these progressives spout their views may very well influence your provider choice, especially if you do not identify as a progressive socialist.

This is an important criterion to include in your consideration of therapist choice along with education, specialty, availability, if you hope to achieve the goals for which you turned to counseling to begin with.

The good news is that the extreme leftists are easy to spot because of what I call the blurt factor. Certain that they are the moral high ground and correct, most often they can't resist revealing their views. This is good news because it doesn't take long to identify them and you don't have to suffer their abuse, putdowns and false allegations before saying, "Goodbye."

Here I offer some of the observable signs I've witnessed to spot liberal extremists or democratic socialists that often emerge as part of their blurt factor that can help others avoid them and their intolerance.

First, if the individual has a sense of humor, that humor often focuses on Donald Trump or has a made-up accent reserved for representing the uneducated "everyone else: besides them.

Second, if you express an opinion on anything that differs from their view you will be met with silence or a request for examples. The second play, the request for examples is a loser's game because if you muster up examples, do their research for them, those examples will be dismissed as a one-off or as a conspiracy theory.

Third, they pepper their conversations with words that are designed to make you defensive by painting everyone different from them with the same brush as racists, climate deniers, anti-vaxxers, whatever name-calling term they're partial to. This play is designed to turn everyone who believes differently from them into apologists, "I'm not a …."

Fourth, they will dismiss your objections to their black/white views. For instance, if you bring up their party's anti-Semitism, they'll distinguish that as either some mentally ill person who happens to vote Democrat, or more dangerously in the case of persons of power like Representatives AOC who this week lied and accused Israel of putting children in cages, they'll recite that they're anti-Israel, not anti-Jew. They'll then tick off every extremist "other" who's done anything in the Republican Party or who identifies as Republican and assume that that is representative of all "others."

Fifth, they will steer you to their world view regardless of what topic you're discussing. If you're discussing shopping, it better be Target and not Walmart. If you're talking food it had better be about vegetarian options and not about steak restaurants.

Sixth, when all else fails, they will argue that their choice is better than the alternative, usually invoking Trump again.

If you are not an extremist, likely you'll feel uncomfortable, insulted and marginalized by their approach, a pretty "normal" reaction to endless bullying. This article is about the good news with these endless moral judges, you can spot them because they simply won't be able to contain themselves and will employ their disapproval strategies in whatever context you deal with them and you can decide whether you will take it or leave it.

The Biden Scapegoating Strategy Fail

2022-01-26T06:31:00.003-08:00

If you listen to business stockholder meeting reports and commentary, one of the factors in deciding whether to keep or sell a stock that is suffering is whether the company is blaming everyone and everything but themselves for poor performance. Sure, COVID, sure, supply chain, sure, global this or that, but ultimately a strong company like a strong leader must have a plan for a successful company in spite of challenges. This is where Biden's successful superficial campaigning became a downright fail for his presidency. Biden risked everything on demonizing President Trump and his "followers" as racist anti-vaxxers and promising his administration would eradicate the incorrectly identified "threat."

Primed for scapegoating, democrats followed the lead…All anti-vaxxers are Trump supporters who are racist extremists looking to destroy you, the golden opposite presumably of tolerant well-meaning utopian visionaries. If you still believe any of these lies, just look at the progressive scapegoating cycle.

So, the first problem for people is the mischaracterization of the "cause" of a problem that slows down at best and with legislation can completely annihilate the ability to solve a problem. For heaven's sake, this strategy is a repeat of the Obama Administration's despicable, deceptive, damaging reasoning concerning the health crisis in the US. They glommed onto the crisis as a health INSURANCE crisis and therefore decided that forcing people to have health insurance was the obvious solution. And so, the 47 million "uninsured" were to blame for the health crisis in the US.

Same with Biden, by identifying the unvaxed as the problem, the solution was simple, forcing people to get vaccinated was the obvious solution. No longer was COVID the threat, but those who didn't take whatever prescribed number of vaccines were the threat, the unvaxed. To this day the Internet pushes this view, weeding out any critique of the vaccine and the process used for its approval to justifying mandates, to invoking Trump and his followers as the anti-vaxers.

Just like with Obamacare that ignored people WITH insurance who were still going bankrupt, were still being denied coverage, were still unable to afford needed medical services and treatments for disease and accident, Biden has basically ignored that the vaccinated not only still can get but can still transmit COVID.

I don't object to people cutting people out of their lives who they've defined as dangerous to their welfare, that's their choice. For many thinking people who are not pro mandate, hanging with those who blame the unvaxed for everything from COVID to supply chain are very dangerous, so it's a divorce made in heaven, I'm worried about you and pity you and your views and vice versa.

With Obamacare, the false identification of the cause, "the uninsured," took on a life of its own as the stakeholders of insurance company, government, lobbyists and providers carved out benefits for their own interests and powers and financial benefits by supposedly addressing the "cause." Similarly, the false identification of the cause, the unvaxed, took on a life of its own as the stakeholders of insurance company, government, lobbyists, providers and big pharma carved out benefits for their own interests and power by supposedly addressing the "cause."

But scapegoating in both instances went further. For Obamacare critics, they were pegged as anti-health simply because they pointed out the myriad of shortcoming in a law founded on falsehood. For Biden, critics must be anti-vax, anti-health, racist Trump supporters who threaten their lives by having hesitancy about the COVID vaccines.

For those with a memory, the Obamacare strategy, which scapegoated the phony number of the allegedly 47 million uninsured (a number that was adjusted downwards by the government itself under Obama) as the reason for unaffordable and therefore inaccessible healthcare that prevented improved American citizen health became the false reasoning that brought us Obamacare, a partnership between government and insurance companies to fulfill their own agenda…Tally up the number of those who had any kind of insurance while saving both government and insurance companies money by addressing the finite costs of checkups (a finite cost that is not an insurance interest which is supposed to exchange the payment of premiums by consumers for the "promise" that IF, a contingency, something goes wrong with your health you will have coverage that provides you both access and coverage for addressing that illness or injury) at the expense of improving insurance coverage for real disease, injury and pharma needs.

Using the same successful though shameful Obamacare scapegoat playbook, Biden decided to do the same with COVID…Identify the unvaccinated as the problem and create a partnership with business, insurers, big pharma to get those unvaxed vaccinated by any means necessary ignoring the inadequacy of the vaccines regarding COVID and its variants. Unfortunately, shifting "the problem" from COVID-19 to "the unvaxed" is merely a scapegoating strategy.

Under Obamacare while you may be one of the around 11 million who have profited from your "free" health insurance under an Obama plan that has cost the rest of us double-digit increases in our out-of-pocket health insurance expenses, including premiums, copays, coinsurance and deductible costs, even you must know that we still have millions of uninsured, we still have medical bills causing millions of bankruptcies, we still have unaffordable medical services and pharma treatments, we still have people using ERs for non-emergency medical care.

Similarly with Biden, we still have COVID running its course. Whether you believe that the vaccines have changed everything or that natural immunity, virus life cycle, or any other strategy is what moved us from the deadlier COVID-19 to the variants we have today, pretty much everyone must acknowledge that there remain millions of people who are not vaccinated from citizens to illegal immigrants to those effectively "exempted" from vaccination requirements who are NOT the reason for variants, who are NOT even responsible for the spread of variants.

Like Obamacare's scam playbook that identified the "uninsured" as the problem rather than the cost and failed promises of the super-expensive health insurance and medical treatments in our society, the Biden scam playbook continues to harp on the "unvaxed," rather than COVID as the problem. They do this in typical scapegoating fashion, ignoring, denying or quashing any information that does not support their theory which sadly has the same result as all scapegoating, it delays or prevents real solutions to real problems.

So what does scapegoating miss? First, like under Obamacare, many people CHOSE not to purchase the consumer product of health insurance because it didn't work…it didn't prevent bankruptcy or inaccessibility to needed medical services and care because the product was flawed. This is the ignoring of the underinsured, the term used for people who do not have enough insurance to protect them from health and financial ruin in the event they become sick. While Obamacare mandates the purchase of the flawed product, it doesn't change this truth, the product is flawed. Oftentimes the very good citizens who have paid for health insurance find themselves in a deep health and financial crisis in the event of illness, when they need that product to do what it's supposed to do.

Same with the vaccine mandates, it's about the product. Many people CHOSE not to get the vaccine because they don't trust the product. Ignoring its newness, ignoring side effects, and deliberately quashing any doubts about its effectiveness have only worsened this problem. Vaccine mandates have not stopped COVID and as we play around with more and more "boosters," that is a fact. We're told that hospitalizations are reduced by having more people vaccinated, that's what we're told, believe it or not.

We don't know a lot. Many people have CHOSEN vaccines in the past but are not sure about the COVID vaccine, so it's not an anti-vax problem it's an early adopter problem. Just like with Obamacare, many people chose not to purchase health insurance because of the inadequacy of the PRODUCT, many people CHOSE and CHOOSE to avoid the vaccine because of the inadequacy of the PRODUCT. Mandates don't change this, they worsen the problem.

Similarly, denying the validity of criticism to sustain scapegoating is destructive. Have you read about the nocebo effect asserting that up to two-thirds of those who suffer side effects of the vaccine are imagining them? Yeah, everyone who disagrees with you is nuts, that's scapegoating not science.

Instituting mandates and denying problems with the product in terms of solving a real problem whether it's inadequate insurance or the spread of COVID is only a temporary fix. Government flexes its power and forces people to follow their flawed reasoning through mandates. With Obamacare from year one, there are problems with the flawed law. If you're unfamiliar with it, Obamacare has tiers of plans using the metal descriptors of bronze, silver, gold.

Purchasing any of these plans would satisfy the Obamacare mandate.

But people aren't stupid forever, and we immediately saw that the younger, healthier individuals opted for the cheapest plan they could get to remain within the law. This led to insurance companies complaining that they were actually getting people who needed to use their health insurance for the more expensive plans and that was costing them money.

Instead of adjusting its approach based on knowledge and reality, the government tried a few strategies and dug its heels in. One strategy was to make the bronze plans less of a "good deal" than the more expensive plans in terms of coverage and cost, the next was to raise the amount of premium assistance and cost-sharing available under more expensive plans as opposed to the cheaper plan, and then there was the change in the law regarding short-term insurance plans, disqualifying many of them for eligibility for satisfying the mandate. The proof is in the pudding…Obamacare today boasts the same anemic enrollment it has for its many years, insured people still face health treatment inaccessibility and bankruptcy when they NEED insurance, etc.

Still trying to accommodate their partners, the insurance companies, we see Biden EXPANDING those eligible for Obamacare plans and even trying to make illegal immigrants eligible as new "customers" for the insurance companies, still never addressing the costs of obtaining needed medical services and care that have bankrupted even those with insurance as they face disease or accident injuries or needs for medication.

Sadly, it's the same with COVID. Instead of acknowledging side effects, ineffectiveness of vaccines, lack of knowledge about long-term effects, the Biden Administration has dug its heels in insisting it is the unvaccinated have prevented the end of COVID. As we're told more and more Americans are "vaccinated," yet still we have COVID, the government has merely dug its heels in, expanding the definition of the "unvaccinated," to include those who haven't had second shots, boosters and anything else they can require. This maintains their false claim…it's the unvaccinated's fault and if we all just keep taking vaccines, COVID will be gone. Not even the pseudo scientists should be listening to this.

As stated, people aren't stupid forever and everything from second vaccine to booster uptake is not nearly as good as first-jab numbers. Of course, instead of addressing the real issues with the vaccine an suspending mandates until there is improved data, Fauci and his ilk have gone full-force pro booster. That's right, make the mandate worse.

Lying is the essential hallmark of scapegoating: One of the sure signs of scapegoating is the number of lies necessary to maintain the scapegoat's status as the "problem." Obamacare utilized these lies immediately, including inflating Obamacare numbers by including those who opted into expanded Medicaid (essentially free insurance paid for by the federal government) as part of the "enrollees" in Obamacare which are plans only for the employed who meet certain guidelines. Myriads of other lies surfaced all explaining the continued failures of Obamacare.

Biden's Administration is doing the same. We read of the almost 100 percent effectiveness of vaccines…whoops, not so much. We were told that the boosters would keep us in our super-powerful immune status…whoops not true. We were told that masks work…whoops, not true, only certain masks seem to have efficacy. We were told that all side effects are "minor," hmm, decide for yourself. We were also told that side effects weren't being reported as per law by OSHA because they didn't want to discourage anyone from getting the vaccine…Outrageous and thankfully the Supreme Court finally followed law and said, "No," to the OSHA mandates.

Biden said he was disappointed and encouraged companies to defy the Court and institute their own mandates. Whoops, sort of sounds like encouraging people to knock down statues and burn stores and protest violently against the "racism" they see with a government nod of approval. We're told that the unvaxed workers are the problem, not the unvaxed illegals, members of government or other effectively "exempted" groups.

So be clear, your fear does not legitimize your scapegoating nor does excusing your fearful scapegoating as justification for your bad behavior whether it's deeming the scapegoated as "less than," "undeserving of," or any other irrational solution to your irrational description of the problem as the unvaxed rather than COVID. Scapegoating is always an irrational you problem not a "them" problem.

Live by the Camp, Die by the camp: Rasmussen Poll

2022-01-22T14:08:00.003-08:00

All right, enough, or maybe just the start of something new. All over the news a Rasmussen poll alleges that almost half of Democrats polled support imprisoning the unvaccinated and taking their children away from them. While reality has little to do with the Democrats who trust government to legislate away anything they don't like, we need to address a reality check. Let's all live in their world for a dystopian moment.

The CDC has changed fully vaccinated to mean those who have received a jab in the past six months. Yea Pfizer and its cohorts for selling that. Maybe instead of stimulus checks we all should have been issued shares of Pfizer just like the 39 members of Congress who coincidentally invested in the company in 2018. After all, we are all customers forever, whether the government continues to "pay" for the shots or as more likely will happen it becomes an Obamacare type "coverage" that we all pay for with increased insurance premiums that "cover" the cost of the as-of-now twice yearly jab.

Good enough. Now the recordkeepers must step up their game. We must have a flagging system that directly reports to law enforcement any lapse in "fully vaccinated" status and those individuals must be unceremoniously grabbed and placed in prison camps. No "I thought I was good for a week," no, "I meant to do it," no, "I got sick from my last jab," no, "I've had COVID." No I have religious concerns. NO. Off to the camps you go.

OK, now we must have government seize individuals' property likely using a method like the current RICO statutes that allow for property seizure from lawbreakers. Bye-bye homes, money, jobs as we imprison the not fully vaccinated. Even if you get out of a camp after taking a jab, such seizures would not be voided any more than they are for anyone prosecuted by the government who gets out of prison.

Oh, but there's more. Unvaccinated being placed in camps now oversteps the phony reasoning used thus far by government that the penalty for firing unvaccinated individuals is a job-based penalty and that's why in addition to not requiring checking out, fingerprinting and jabbing all the illegals, those individuals are not subject to the vaccine mandate. However, under the new rules, it's a violation of law to be unvaccinated that would jeopardize your freedom, property and parental rights, not a job-based discrimination.

Time for some new signs at the border, "fingerprinted, vaccinated or imprisoned, your choice." Naturally, the Democrats would immediately carve out an exception for the illegals like every other amnesty program granted that erases all illegal marks against their names (or at least the names they provide in 'good faith.')

Then there would be the difficult issue of health insurance, deny that to those belligerent unvaccinated. But remember the last piece of idiocy from the Democrats, Obamacare that made it unlawful for insurance plans to deny or charge more for coverage for individuals with pre-existing conditions (unless it is tobacco use or age.) So, now we've got another problem, like other choices people make that amount to pre-existing conditions whether it's having children, being obese, binge-drinking, drugging (with anything besides tobacco), being unvaccinated today is not a legitimate reason for denial of health insurance without breaking current law (which of course does not bother Democrats in the least). We'd cull at least some of these non-thinkers from the population if we did an end-run around the pseudo-pre-existing protection provided by Obamacare.

As for those groups currently functionally exempt as not affected by the federal law, yep, Congress is there, the big, kind government that these idiotic Democrats need to nanny them, in April of 2021, Nancy Pelosi said she couldn't find out who was or wasn't vaccinated in the House because it's a matter of privacy. You know, the privacy these new socialists don't worry about for others.

Let's keep going, in defiance of the Supreme Court, Joe Biden still wants businesses to enforce a mandate. Again, it's just law, not meaningful unless the Dems are trotting it out or rewriting it to protect themselves.

So, now the government class will not only be protected from mandates without job jeopardy but they'll be "camp" proof if it's discovered that they are unvaccinated. Of course, this is much harder to do now that we know that even the vaccinated can get and spread COVID.

In this great new COVID-protected world of fantasy, those who are vaccinated can parade around freely (along with illegals, Congress, postal workers) while the rest of the world is either in camps or confined to their homes (if they still have them).

A public health crisis as a permanent excuse to force people to take a vaccine, you can bet it won't stop with COVID, but before we even get to other vaccines like the flu shot, let's remember that drug use disorders are also a public health crisis…Get rid of the ridiculous overblown number of "therapists" and make room in the camps, get over your drug use or see above on how we now handle a public health crisis.

Instead of defunding the police, we'll have new branches of enforcement, hotlines reporting those posing a public health risk, vaccine vigilantes "reporting" on suspected vaccinated status. By the way, chronic illnesses like diabetes, obesity, high blood pressure and heart disease are not only public health issues but are considered high-risk factors for COVID…Make more room in the camps.

There's a few hard truths…Being around people you can catch something and all the caution in the world will not protect you. For instance, there is a new TB outbreak (see WHO 10/14/2021) including identification of the disease in certain restaurant workers. Or if you purchase a food item or beverage where an employee has that disease, you too must go get a jab. The current COVID vaccines are not amulets regarding self-protection or protection of others.

So let's get the new "normal" body of law together for COVID and make sure it makes sense…ALL individuals without exception are subject to the camps if they are not fully vaccinated (in the past six months) and their children will be seized. Be tough, be consistent and instead of using the infrastructure bill to repair roads, start building those camps.

Biden's 2022 Press Conference: Yep, he was awake

2022-01-20T09:34:00.000-08:00

Two things stood out to me about President Biden's speech of 1/19/2022, first that he held himself together for a couple of hours and second, I stayed awake listening to him. Biden was also cautious and used language indicating "it's not your fault, but…" when denying any criticism of his administration, a change in tone that was actually welcome, though simply made him easier to listen to.

But Biden remains tone deaf. Perhaps in an effort to change the worn out Democratic chants that they're all racist or Nazis, a trope that today only persuades the most virulent leftists, Biden tried to initiate a new catchphrase, "What do they stand for?"

The question illustrates the problem: Disagreeing doesn't mean you don't stand for anything, it means you disagree. Resurrecting his clearest ideas about how Obama was thwarted by those who disagreed with him during his presidency and either forgetting or deliberately skipping over the Democrat political vicious attempts to thwart, discount and vilify President Trump with tactics beyond disagreement ranging from impeachment efforts, racism claims, Russia claims when Trump was President, Biden belligerently or genuinely wondered what Republicans stand for making him seem at best tone deaf and at worst mentally incompetent.

Nevertheless, Biden steered his answers towards his talking points and regarding health in the US used the fake narrative that brought us Obamacare in 2010 that apparently he hoped most listeners have long forgotten, touting the success of that law, an assessment that requires a pretty low bar in terms of truth.

But bringing up Obamacare and its newly expanded eligibility guidelines (enacted in order to somehow again try to boost anemic Obamacare plan participation), is a great example of a no-change in strategy for Democrats.

Hey, it was a successful cheat of the American people back in 2010 that to this day enjoys a durability that shows a lack of vision or plan for addressing the real, concrete devastation brought by that Act's partnership with insurance companies in providing the cheap seats of finite costs of preventive care in exchange for the sacrifice of affordable, needed medical services.

Balk if you like, but the increased out of pocket costs for consumers of higher premiums, higher deductibles, higher copays, higher coinsurance are real and verifiable over the law's decade of experience.

So, let's revisit reality. Obamacare was based on the crisis of the "47 million" uninsured, a number that years later was lowered by the government and a number that somehow has never been nearly reached during any of the more than a decade of experience of no more than 10 to 11 million people in any year enrolled in Obamacare plans (distinguished from Medicaid plans).

And of those 10 to 11 million people who "gained" coverage, even that lukewarm number never addressed whether those Obamacare plan enrollees had formerly had insurance that was no longer available because of Obamacare, thus representing a number of people who had switched insurance plans rather than "gained" insurance. Further, each year because Obamacare plans prepay premiums that number is adjusted downward as individuals fail for months to pay their share of premiums.

And so with the COVID numbers. The minute COVID as diagnosis was incentivized with government money and the minute COVID as diagnosis was used for Democrats to justify "emergency" powers that bypassed traditional protections from overreaching government was the minute the "accuracy" of the numbers should have been called into question.

As with Obamacare, with COVID, the government agenda in inflating numbers ignores the government's agenda in keeping those numbers high and hurts people. And so, by using the permanent pandemic label, Democrats are seeking to avoid legitimate process for everything from traditional election ballot rules to the freedom to travel, to the right to decide what we are willing to put into our bodies and instead want to make permanent those TEMPORARY EMERGENCY powers.

Same approach different decade. Since Obamacare, employer health insurance costs have soared in price for employees for plans that also boast higher out of pocket costs in addition to premiums, deductibles, copays, coinsurance while never making a significant dent in the '47 million' uninsured. This is Obamacare and whether we're used to this new "normal" of crappy coverage or not, that's what Obamacare does.

Obamacare also did not cover prescription drugs and here again, a little more discernment when it comes to those unfamiliar with Bernie Sanders' plan or the Medicare negotiating prices plan that could save us a lot of grief when you need expensive medication. These plans again go to low-hanging fruit, lowering prices for some common prescriptions like insulin, while excluding coverage for meaningful cancer drugs that can cost half a million or more a year. Sanders' plan specifically covers this low-hanging fruit, basic preventive, basic care and leaves expensive care for real disease as eligible for "private" insurance contracts for coverage…the government simply ignores the problem.

And lest we forget the individual mandate of Obamacare, that sketchy penalty imposed on individuals who dared not to purchase health insurance that the Supreme Court skirted addressing by categorizing the mandate penalty as a tax, Biden resurrected the democrat strong-arming used with the COVID vaccine mandates. Same strategy, different decade.

Biden touted the millions of Americans vaccinated ignoring that many were threatened with loss of job if they didn't comply with the vaccine mandate and ignoring the tens of millions of individuals who are NOT required to be vaccinated from those not covered by executive order (yep, Congress and their staff, postal workers, and all illegal immigrants). Just like Obamacare, buy health insurance that government dictates or else.

Biden also touted the No Surprises Act of 2022 as a means of preventing balance billing, the amount billed to patients by providers not covered in network by their insurance. Big problem, tiny step in the right direction. It's important that under the act you have to sign away your right to the protection if you are offered treatment by someone out of network. If you don't sign away that right, you can be refused treatment. This is more of the same since emergency services have already been covered by Obamacare since 2010 and as we've already witnessed, previously, the requirement meant you would be stabilized and then moved elsewhere for other services that were non-emergency in nature. This remains the same…If you don't sign away your rights and consent to balance billing, you can be refused treatment and must find someone in your network. The issue is a long-standing one and has seen many different strategies used by both providers and insurers to make sure consumers are left holding the bag.

Back to the same strategy, different decade. So, the democrats are harkening back to the good old days of the Obamacare scam. Obamacare also tried to make it obvious that it was a person's "civic duty" to purchase health insurance to prevent increased costs for all. Of course, the premise has and continues to fail. Tens of millions of people remain uninsured. People still use ERs for everyday medical care. Medical bills still bankrupt millions of Americans. People are still uninsured or underinsured. People are still drowning from the real costs of illness. Yet, as if it was 2010, Joe Biden brought up the good-old-days when people simply "didn't understand" that Obamacare protected individuals from being denied coverage for pre-existing conditions and once they did they were all onboard. Sorry, not true and certainly not true for intelligent people.

Pre-existing condition denials of coverage were an issue as insurers used their calculations to determine that those pre-existing conditions raised insurance company cost risks and therefore justified addressing those increased risk of costs. Most often this took the form of exorbitant premiums based on pre-existing conditions, and sometimes, it resulted in denial. Sounds great, right? What Obamacare did was remove pre-existing conditions as a criterion for increased premiums for everyone EXCEPT two groups, those who use tobacco and increased premiums based on age. This is important when it comes to the surcharges being tossed around for those who opt-out of a COVID vaccine.

Not being vaccinated should technically qualify as a pre-existing condition for which no premium surcharge is permitted under Obamacare since it is neither tobacco nor age related. So what gives? Insurance company/government partnership.

For Obamacare, political goals of claiming such-and-such number of newly insured was balanced with the mandate and penalty protecting insurance company profits. With COVID, the same, the increasingly tenuous validity that vaccines reduce COVID risk for everyone justifying "mandates" to force individuals to have the vaccine and the government's desire to keep the number of COVID cases up while arguing that the vaccines only have led to less serious variants…Biden bragging rights that mandates work, look at the millions vaccinated.

The reality is that Obamacare partnered with insurance lobbyists and companies to protect insurance company profits. Only after the government complied with insurance company profit concerns by MANDATING the purchase of their product would insurers address "covering" those with pre-existing conditions for no increased premiums. Same with the vaccine as insurers start to penalize those who opt out of the vaccine.

But the insurance companies don't stop with penalizing, they inch back towards charging more for pre-existing conditions by chagrining everyone more in terms of out of pocket expenses in the form of higher premiums, higher copays, higher coinsurance, higher deductibles. These higher out of pocket costs most definitely more greatly impact those who need medical care. We can anticipate the same with COVID. First those who aren't vaccinated will be penalized, though obviously a choice, a pre-existing condition much like obesity, drug addiction or pregnancy for that matter which therefore should be protected by Obamacare rules. Then we'll see even higher deductibles, copays, coinsurance and premium amounts as insurers claim they have to "cover" COVID costs. Same strategy, different decade.

So there was never a removal of the pre-existing conditions calculations, Obamacare merely chose to ALLOW premium extortion from tobacco users and those who are older and gave everyone else from drug users to the obese, to the alcoholics, conditions also arguably based on "choice," a free pass on increased premiums based on their unhealthy choices or natural condition. And then Obamacare "spread" that risk, so that employees were screened for health conditions and this overall screening was used to determine insurance costs for each employer plan, so if there were x number of people with high blood pressure, the plan offered by that employer would reflect that population risk. That's what we can expect from companies who dare to follow the Supreme Court and do not mandate vaccines, their annual plans will charge more than other companies where the vaccine mandate is in place. A back-door way to force support for the government and insurance company mandate agenda.

With COVID, don't think for a second the insurance companies aren't exploiting their new opportunities. We've already seen insurance companies charging more to the unvaccinated despite the science of new variants emerging. It's just another barrier to jobs, to benefits, to access and shouldn't surprise anyone. Insurance companies are enriched by covering less and charging more and COVID and their Obamacare era partnership with government is just another chapter in the same story.

Ultimately, yesterday afternoon, Biden's strategy was predictable and was delivered calmly as he droned on plugging in his talking points for every issue addressed. COVID strategy working, his staff are all wonderful, they're doing great. Hopelessly Biden confirmed we can hope for no better as he outlined his plans for next year to campaign for other Democrats, to engage more with the public and to seek more advice from academia and think tanks. Pretty sure no one would have suggested those top three goals for Biden's next steps based on the first year of experience with him.

COVID Crises and "Science"

2021-12-12T14:50:00.000-08:00

While a narrow majority still support the "handling of COVID," by President Biden, it's becoming clear that soft science is replacing hard "science" as the dominant consideration in what has been going on with COVID. Unfortunately a soft science approach to a hard science challenge requires that stakeholders have a common goal unsullied by self-interest, politics and money.

There are hard sciences such as math, biology, physics and chemistry and there are soft sciences, psychology, sociology, political science.

The real crisis of COVID was about the apparent worldwide surfacing and spread of a virus. Unfortunately, most of the COVID crises have arisen from the soft sciences and unfortunately, with increased time the soft sciences have overtaken the hard science that addresses COVID.

It started with the designation of a worldwide widespread virus that qualified as a pandemic and was identified as COVID-19, hard science. The first step taken by governments was to capitalize their own power and ability to achieve population compliance by playing on the soft science human response of fear that resulted from that designation of a pandemic.

Instead of addressing the hard science math rigor of defining the number of cases that qualified as a pandemic AND the definition of the numbers that would indicate something less than a pandemic, the pandemic label persists. Instead of examining the definition of pandemic, the numbers used to identify a pandemic and other factors such as severity and deaths also used to define the term, we've all given into the perpetual crisis of a "pandemic" that has manipulated our fear reaction into a continued acceptance of government overreach, sloppy data gathering and inadequate solutions to a pandemic.

Without a number below which a pandemic is over, each variant of COVID is enough to trigger a pandemic fear response justifying breaching civil liberties, bypassing government rules and laws and yes, even overlooking the scientific method.

Any hard scientist should demand that pandemic be identified by numbers, severity and risk to life. Soft science fear of disease is not good enough for the perpetual POWERS of questionable government authorities, perpetual invasions of individuals' privacy, perpetual waiving of previous scientific methods and protocols.

Fear is not a hard science, but a reaction in the realm of the soft-science world to a real or perceived threat. So why are we keeping the fear up? Unfortunately it's a combination of seeking continued compliance with whatever whacky thing is advised,(whacky meaning an insufficiently supported approach to "handling" COVID and its variants,)and the second more dangerous goal of maintaining and making permanent the "temporary" emergency powers granted to government under the public health emergency powers, the "temporary" suspension and relaxation of scientific rigor granted to get some vaccine available for the population, the "temporary" subsidies provided based on a COVID diagnosis.

But back to pandemic, that pesky requirement for the persistence of all these new benefits to politicians looking for a compliant population as they reach into that population's wallets, their livelihoods, their very ability to go out among others as government plays on those original fears, the billionaire pharma companies that have found endless support for speedy approvals that bypass scientific rigor of drugs and more drugs based on the "emergency" of a pandemic, the funding provided to any number of COVID related hardships that depends on the continued pandemic labeling of COVID, even to death, where without testing, if a physician "believes" a diagnosis is justified, those COVID funds keep coming.

Yep, for many, COVID has incentivized maximizing the diagnosis of cases, the continued threat of variants, the continued management of a fearful population even though hard science has taken a virtual backseat to continued progress.

Before COVID we had Emergency use authorization for drugs which is distinct from FDA approval. That emergency use is supposed to have a closing date. Of course, like the numbers that will indicate the end of a "pandemic," the government omitted a closing date for the "emergency," bypassing FDA approval processes.

Even as the Pfizer drug got a real "approval," that approval was rushed. The FDA gave it a priority review meaning both time and energy prioritized delving into the vaccine and its research. Whether you believe it was a great job or not, you can't argue that the priority review could not fudge one of the most important procedures necessary for review, time. There has not yet been a sufficient period of time for analysis and with Pfizer's request to keep its research material secret until at least 2076, that information is a long time coming.

Scientifically should every COVID variant be counted as a case of PANDEMIC? There is no evidence this should be so based on severity and deaths from the omicron variant. The omicron variant is simply a puffing tool used to maintain fear and that suits our COVID policy that depends on fear for compliance just fine.

And how about those who were becoming less afraid or for a variety of reasons or who were concerned about taking the vaccine? That's where mandates came in. Instead of giving people CHOICE on what would be put into their bodies, their livelihoods, their ability to engage with others, suddenly depended on being vaccinated.

We now separated people into the vaxed and unvaxed. Even as those vaccinated were still capable of getting and transmitting COVID, we assigned an "other" status to the unvaxed. OK, but there was more, because remember, this is a soft science fear-dependent approach to compliance. It's only SOME of the unvaxed that put others in jeopardy.

The executive mandate from Biden doesn't cover the judiciary, the post office, members of Congress and their staff. They are the PERMISSIBLE unvaxed. The mandate doesn't cover millions of illegal immigrants. They too are the authorized unvaxed. As for those who have religious, medical or just common sense reservations about the new vaccines, THEY are the threat.

It should be pretty obvious this is not a hard science distinction, but a soft science distinction of politics and sociology and mob behavior. Hard science would never allow such a result. A virus doesn't exclude postal workers, Congress people and staff, the judiciary and illegal immigrants.

Then there's side effects. From Facebook to OSHA the occurrence of side effects has been downplayed and in some cases deliberately unreported. Still, many reports of serious vaccine side effects leaked through and were dismissed as so few as to not matter (unless you're one of the unlucky ones).

How did we get there? The government determined that the risk was not nearly as important as the benefit and while many agreed and opted into vaccines, the government decided that it would decide for everyone else by punishing those non-excused classes of unvaxed.

Again, in the soft science world of mob behavior, bullying, fear mongering and marginalizing groups of people, the vaccinated had a new enemy, those who CHOSE not to have the COVID vaccine and weren't members of the groups mentioned above.

And now there are boosters being implemented, one, two, two and a pill, any number of recommendations to address the hard science of waning efficacy of the original vaccines. The answer here is simple from the world of soft science leaders, if one vaccine is good, more vaccine is better.

This soft science answer absolutely ignores everything hard science tells us. Anything we put into our bodies from aspirin to vitamins has DOSAGE requirements and limits. Anything we put into our bodies from Tylenol to supplements lists side effects. Yet these two hard science requirements also seem to be being largely ignored as the CRISIS class beneficiaries push for more and more.

Using the imaginary status of ongoing "emergency" and "pandemic," because neither term is defined but is instead used to maintain fear, we get exposed to "interviews," like the one between Rob Finnerty and Dr. Ashish Jha, dean of Brown University School of Public Health when he spoke on Newsmax on 12/10/2021. https://www.newsmax.com/us/jha-booster-vaccinations-covid/2021/12/10/id/1048133/

The host, Rob Finnerty asked: Just a basic question, how much vaccine can the human body take in a very tight period of time? Because to me that seems like a lot.

Dr. Jha answered: I get it. Look, we give kids basically like up to a dozen shots in their first year of life, they do fine with it…Again, the body can actually handle this…The body manages to deal with this.

So, Dr. Jha, dosing doesn't matter in the new world of COVID? This ridiculously unscientific dismissal of the idea that there could be too much in whatever number of doses being advised for vaccines and boosters is yet another soft science scenario, some other entity weighing risks-benefits.

Rob Finnerty continued: Is it unhealthy to get that much inoculation in a short period of time?

Dr. Jha: I don't think so. I have no reason to believe it is.

Rob Finnerty: Does science support that?

Dr. Jha: Tell me why it would be unhealthy to get that much inoculation?

Rob Finnerty: Injecting myself with up to five shots in a 12-month period that just doesn't feel right.

Dr. Jha: There is no either biological basis or clinical basis to think somehow it's going to be bad for your immune system. It's just immune training. Your body gets immune training all the time, it's a different way to train your immune system.

In the world of pandemics defined without numbers, emergency use authorizations given without a definite end to an emergency, big pharma assuring us that their vaccines are the way to go while asking to keep their own research secret until at least 2076, where government is trying to get us all used to their new permanent "temporary" emergency powers, where silly people believe there is a connection between illness and political party, why should we expect anything besides the bizarre response of Dr. Jha to say, "Tell me why it would be unhealthy to get that much inoculation," as if dosing is irrelevant to medicine.

The COVID outbreak required a temporary suspension of our accustomed "normal." It is the sloppy, politically motivated, financially motivated goals of big government and big pharma that have manipulated the hard science of an outbreak into a permanent pandemic and as consumers, unless we demand hard science, the soft sciences of psychology, sociology and political science will continue to encourage a perma-pandemic for their benefit.

A politician, a bureaucrat and a big pharma rep walk into a bar…

2021-11-19T08:05:00.001-08:00

It's like the start of a bad joke. Vaccines are a tool in the toolbox of fighting disease. The COVID vaccines are a new tool in that toolbox. The vaccines are not an amulet against illness, not even COVID and they are new so science is evolving. There are also side effects of the vaccine that are still being discovered. Like all drugs, hopefully the benefits outweigh the harms.

Addressed here are mandates regarding a COVID vaccine and how through a marketing campaign the COVID vaccine has been used as a political tool to further divide the country's population and to strengthen the authority of government and the wealth of big pharma by lumping a medical treatment into the make believe world of identifiers as to who is "progressive" and "the others." I am against mandates for the COVID vaccine. That is enough to characterize me as an "other," and I'm proud of it.

It's ethically impossible to believe that anyone is "certain" enough of the COVID vaccines to force them upon another. I wouldn't even dream of forcing someone to take a vitamin! COVID marketing and alleged "information" is so wrapped up in agenda and money that has nothing to do with health that the punch line to the title joke is that's who today's extreme self-labeled progressives worshp.

For me, without marketing the COVID vaccines with behavior- modification tools it would likely cause even the most desperately entrenched to pause before they insisted, supported and bullied anyone to take a COVID vaccine.

Behavior-mod is part of marketing, make people feel like they belong, that their lives are richer, more colorful, more meaningful if they buy your vodka, your car, your product. Reinforce the idea through behavior mod. Positive reinforcement, punishment, ignoring the "problem" behavior are "acceptable" methods of behavior mod. And then are the more sinister cousins of these behavior mod techniques, force, shaming, blaming, shunning and peer pressure.

The rapid leap to not only approve these drugs, but to ignore WHAT'S DIFFERENT about the COVID vaccines and their mandates has unfortunately only strengthened people's mistrust of the motivation behind the mandates.

Even before there was "approval," the different status of a governmental emergency use authorization and approval was played down as most marketing and talk about the vaccines used the two terms interchangeably. They're not interchangeable.

Even as late as the OSHA mandate, now delayed, side effects were carefully downplayed as people compared side effects to the risks of getting COVID. These risks did not emphasize, at first, the variation in risk if precautions were taken or the risk faced by certain age groups. There is still no clarity on the effect of these vaccines on those with a variety of health issues, co-morbidities.

The marketers let the marketing campaign fly but it wasn't working fast enough, and so we started shaming and blaming the unvaccinated for COVID as murderers or any other number of character assaults, even dumping them in with the devil-image itself (sarcasm intended) of Trump supporters despite numbers that indicated the falsehood of both these claims.

So, the "vaccinated" went from early adopters at best to suddenly somehow seeing themselves as morally superior. Sorry, that doesn't fly. Because these forced-vaccine supporters actually IGNORED the very significant and ongoing groups who are not included in their morally superior fury.

They quickly started spouting the next twisted reasoning used by some "fact-checkers" regarding reports of "exempt" individuals. So here let's dispense with the word exempt and address the swaths of people NOT mandated, from the postal service which is not subject to federal mandates and is governed by OSHA to the judicial branch and to Congresspeople and their staffs, these groups are NOT mandated. The millions of illegals being "absorbed" also not mandated because allegedly this is a "job-based" mandate.

Of course, forced-vaccine supporters ignore these people as they viciously support forcing their peers to get the COVID vaccine as if COVID recognizes these distinctions or perhaps because they don't hang out with judges, Congresspeople, postal workers or illegal immigrants. Not persuasive reasoning.

The certainty about the safety and efficacy of COVID vaccines is absurd. The true believers are certain. Certainty isn't even true of other drugs that have been around a lot longer than the COVID vaccine. None of them is 100 percent effective. If you're part of the 40 to 60 percent for whom the flu vaccine isn't effective is it the unvaccinated's fault that you got flu? There are always a percentage of people who do not get the immunity they desired from a vaccine.

With the COVID vaccine it's even more unknown because there's already a lot of evidence that the vaccine works a bit differently than promised, it's not the amulet expected but instead requires boosters, and more boosters to remain effective. The variants could be transmitted by those already vaccinated and they can still get COVID.

But the marketing continues that somehow the variants are coming from the unvaccinated lepers of our society passing it on to the vaccinated. Not even worth addressing, just a sign of a great marketing campaign.

And remember the emergency attached in front of emergency use and OSHA's emergency mandate? What is an emergency? A pandemic? Great. How do we define pandemic. The numbers are not established and by law such emergency powers should have a closing, an end, otherwise they're not temporary, they're permanent. Without a number, there is no end. Yeah, true believers don't care, the marketing worked.

The sheer ignorance, that's what it is, of believing what the politician, the bureaucrat and big pharma are pushing and selling absolutely without a doubt has gotten even worse. Suppressing side effects. OSHA came right out and said its mandate would not allow reporting/recording of side effects (in violation of federal law) because it didn't want to discourage people from getting the vaccine and the endless boosters. The politicians, the bureaucrats and big pharma should never get to decide what truth we need to make a decision.

The FDA has asked a federal judge to give it till 2076 to release all its documents relating to the drug approval of the Pfizer vaccine in response to a Freedom of Information Act lawsuit.

Mandates are part of a marketing extravaganza pushed by extremists who support governmental overreach as some sort of way of achieving "fairness" in society, though even expanding government power through using the COVID excuse already should illustrate that caution is best, after all, the "those who aren't mandated" list includes "lawmakers," not the rest of us.

The politician gets to brag that he's got 150 percent of people vaccinated (ignoring those who were not mandated or are illegal or have a legitimate exemption). The bureaucrat gets to write children's books about how he's the hero (not acknowledging his hand as perpetrator) in getting us safe with his ever-changing messages. And big pharma, well, they just need more time to really let us know how that approval went through, you can't intelligently decide that until 2076 if the judge goes for their plan.

We all fall for marketing because marketing works. However, when it comes to forcing a person to take a vaccine or else face unemployment, ineligibility to go places or worse, COVID vaccine-forcers are perpetrators. No one wants COVID and everyone is somewhat afraid, but your fear does not justify becoming a perpetrator.

Six Signs You are a COVID vaccine Hypocrite

2021-11-17T09:59:00.002-08:00

Most of us are pro-vaccine, but the twist of vaccine choice and mandates has created some new monsters, the COVID vaccine extremists who flaunt their hypocrisy without thought or reason. Here's six ways that you can tell if you're a vaccine hypocrite.

If you claim you are pro mental health but you are shunning, ignoring or cutting off people who are not vaccinated, you are an abuser, not a mental health advocate. After all, you can stay away from each other without the "breaking off all ties," ultimatum.

If you are belittling, shunning or excluding those who choose not to get a vaccine and you support wide open borders and the continued "exemption" for these law breakers who might be in your area, you are a hypocrite unless you demand that they too have vaccine passports to be near you.

If you are belittling, shunning or excluding friends and family but still eat in restaurants that don't require vaccine passports for their employees and guests, you are a hypocrite. Obviously, choosing to be around strangers who are unvaccinated is as dangerous as choosing to be around anyone who's unvaccinated.

If you mingle your views about a vaccine choice with political parties, you are a hypocrite. There are people who are of every political party who choose not to obtain the COVID vaccine.

If you believe that the suppression of side effects reporting, including by the government, such as OSHA, which discourages such recording/reporting on its website, contrary to federal law in order to seemingly reduce such side-effect occurrences to the anecdotal rather than meaningful but then you snicker at anecdotal reporting of someone who is anti-vax mandate and becomes ill, you are a hypocrite. Anecdotal is anecdotal, why are you so pleased with the latter?

If you believe that all these actions based on the emergency of a "pandemic" are justified but don't care that we have not defined "pandemic," in terms of numbers that indicate it's no longer a "pandemic," then you are a hypocrite. Neither science nor math appreciates the generalized and imprecise use of terms.

FDA Approval and COVID Vaccine: Emergency Use Authorization Without End

2021-04-05T06:44:00.000-07:00

Cart before the horse is the best one can reasonably argue about a COVID vaccine passport. While government always finds a way, in this case through marketing and nonspecific language about the scientific and legal status of COVID vaccines, MANDATING anything to do with vaccines NOT APPROVED by the Federal government is problem #1 with the rush to vaccinate.

If you are informed and you choose to be an early adopter, that's your choice and if you're not an early adopter of non-approved vaccines, that too, is a choice.

What is the purpose of the distinction between an EUA and an FDA approval? You can read about this on the FDA website. Here, note, that the EUA explained on the FDA website states:

"How will vaccine recipients be informed about the benefits and risks of any vaccine that receives an EUA?

FDA must ensure that recipients of the vaccine under an EUA are informed, to the extent practicable given the applicable circumstances, that FDA has authorized the emergency use of the vaccine, of the known and potential benefits and risks, the extent to which such benefits and risks are unknown, THAT THEY HAVE THE OPTION TO ACCEPT OR REFUSE THE VACCINE, and of any available alternatives to the product."

And now we understand the motivation for the Vaccine Passport, an incentive program of perks you get if you CHOOSE to be vaccinated, like the free gym bag that workout gyms used to offer with membership. However, the passport for COVID is negating CHOICE to have an EUA vaccine put into your arm because it's being used to DENY certain rights, such as travel, opportunities such as attending sports events or working at certain jobs if individuals CHOOSE not to take the EUA vaccine.

Imprecise language and marketing: What we haven't seen covered is the obvious question that should be posed to consumers, "Do you believe the FDA has approved COVID vaccines?" In my own small world, the majority of individuals I've spoken to believe the vaccines have received FDA approvals.

In this day and age when people lose jobs over the misuse of pronouns or the parsing of words out of context for any reason whatsoever, why is it that there's no backlash over the deliberate MISUSE of the word "approval" regarding vaccines rather than "authorization"? EUA is EMERGENCY USE AUTHORIZATION, not FDA APPROVAL.

Shaming as a marketing tool: Shaming those who are HESITANT to have a non-approved drug injected into their bodies is NOT the same as the more extreme versions of hesitancy attributed to people who others seek to marginalize by calling them anti-vaxxers. Shame on you if you're engaging in this conduct, period. It's the same bullying, illogical hate that motivated some to claim all Republicans are Nazis or all white people (only) are racists. Your opinion is AGGRESSION, not supported by the current SCIENCE.

When does EUA end? Here again we've got some government slipperiness going on. The government is motivated to keep us in "pandemic" mode in order to continue to push vaccinations based on EUA. The creation of "passports" showing that you've bought in also involves business time and money that motivates the stretching out of "pandemic" into endless time periods. It also buys time for government to push the use of such passports for other vaccinations and other intrusions into our private health information and status.

As "The Atlantic" noted, there is no standard for when the COVID pandemic ends. https://www.theatlantic.com/health/archive/2021/02/how-know-when-pandemic-over/618122/. The CDC also has an equally unclear means of determining deaths attributed to COVID, as you can read on https://www.cdc.gov/nchs/nvss/covid-19.htm#understanding-death-data-quality. In addition to widespread testing, the loosey-goosey guesswork of cause of death can also maintain "pandemic" status. Further, with the "variants," there's no distinction, it's still COVID, keeping numbers up and maintaining "forever pandemic" status which will conceivably keep EUAs in business for current COVID vaccines that might not be effective on these variants.

Vaccine Exemption Passports: If for WHATEVER reason, you don't CHOOSE to take an unapproved drug into your body, there should also be a provision for VACCINE exemption. Not even the most dogged bullies about COVID vaccines would argue that EVERYONE should have the vaccine, I would hope. Whether it's comorbidities or other drugs being taken by individuals, age, risk based on lifestyle or age or morality or religion, EXEMPTION cards must be issued. Remember that EUAs mean people can CHOOSE to accept or reject a vaccine.

Fraudulent Passports: The issuance of "passports" will no doubt lead to a subculture of phony passports which undoubtedly will lead to government participation in the issuance of passports, rendering these current vaccine cards void.

Duration: Right now, all we know is that some vaccines seem to be effective for at least six months. Now we have a rinse and repeat cycle regarding the non-approved drugs. Every year, every two years? Is once enough? We don't know. We don't know about the new strains. The false security of a "temporary passport" is outweighed against the threat to the deprivation of constitutional rights to privacy or travel.

People should be laughing about articles talking about "laminating" your COVID passport because it's premature, NOT justified based on the risk-benefit analysis of what you're giving up in terms of choice, privacy and rights relative to the benefits to public health based on all of the above reasons. This is not cool, hip or woke, it's deliberate misinformation being used to bully individuals and segregate individuals based on science that is not yet sufficient for even government approval of the vaccines.

COVID-19 Vaccines and Shamer/Blamers

2020-12-31T08:33:00.000-08:00

Of science, facts and zealots. Already I've seen cartoons making fun of those who are hesitant about the COVID-19 vaccinations, read articles and listened to zealots whose virulent shame/blame strategies are directed to those who are hesitant, and zealots who are already infecting social media.

Worse, we're hearing about businesses and other entities getting ready to require a "vaccination card" type verification from people. This is NOT science or math but at its best must be labeled "premature."

Unfortunately, it's not at its best and the shamer/blamers are already implementing their familiar strategies of manipulation of the population into accepting injections into their bodies using their tools of peer pressure, shaming by misusing words like anti-vaxxer and science and following a herd bully mentality that would appall most people if it was utilized in a different way, like, let's say to mandate people to use pharmaceutical birth control despite the dangers associated with those APPROVED drugs.

Imagine if the use of mechanical/pharmaceutical birth control was MANDATED. I'm certain, we'd hear about choice, the science of risks and how different individuals want to choose for themselves, though the dangers of population growth are well documented and according to the CDC short of sterilization the implant and IUD are the most effective methods with injectables coming in second.

The COVID-19 vaccine bullying is worse because the vaccines are NOT approved by the FDA and newly on the market have documented and notable side effects.

So, a word of caution, you are responsible for the consequences of your zealotry with the premature implementation of shamer/blamer approaches to getting people vaccinated with the COVID-19 vaccine. You are a perpetrator if you dismiss, name-call, or talk about people "deserving to get COVID-19," or support penalizing individuals for believing based on the current SCIENCE that for themselves getting vaccinated is PREMATURE.

There are FACTS about the vaccines.

So far there are two vaccines Moderna and the Pfizer have received FDA Emergency Use Authorization. No vaccine has received FDA approval, a much more rigorous process.

The CDC right now does RECOMMEND the vaccination but NOT for everybody including those under 16 for the Pfizer and those under 18 for the Moderna and those with certain allergies. So already, your zealotry is just that, non-scientific belief bullying, NOT everyone should get the vaccine.

Pfizer and Moderna cannot be sued unless there is "willful misconduct" for any bad results that occur in individuals who are vaccinated.

You will not be charged for the COVID-19 vaccine as of now. You WILL be charged if you are admitted to the hospital or visit a physician in connection with side effects, etc.

If your side effects are severe, right now you are not provided by law with additional COVID-19 vaccine sick days.

There are already companies talking about MANDATING a proof of vaccination which will be the FIRST TIME a vaccine that is NOT approved by the FDA will be mandated at the risk of loss of rights, such as travel, or opportunities, such as work.

OK, so now you see why the shamer/blamer gang of perpetrators trying to persuade, convince and manipulate are doing just that, the science is not nearly definitive as their conjured conclusions based on what they believe.

The Emergency Use Authorization is a big deal whether it's used to "mandate" a vaccine or justify a "vaccination card," or is used by irresponsible big mouths trying to blame/shame people into getting something they've decided is OK, but the US government has not yet given approval to. This is a slippery slope and shortcutting rigor in the approval process as method of forcing a population to do anything is PREMATURE.

The Emergency Use Authorization by the FDA of the Pfizer and Moderna vaccines is NOT FDA approval and that is SCIENCE. Like the COVID-19 outbreak itself, the vaccines are new and promising, but not FDA approved. Pressuring people to do something based on conclusions contrary to the FDA, which has not approved the vaccine except under the EUA, demanding that people inject a vaccine into their bodies as a cure or having them face the ignorant herd's condemnation is BULLYING, is PEER PRESSURE, is UNFAIR, is DANGEROUS, but it certainly is NOT science.

The FDA has issued EUAs for the two vaccines. The FDA has NOT approved the vaccines. This is also significant to those who consider SCIENCE. While encouraged and encouraging vaccination, the FDA has NOT approved the vaccines. Remember, the FDA also gave an EUA for chloroquine or hydroxychloroquine on March 28, 2020 and the FDA revoked that EUA on June 15, 2020 [https://www.fda.gov/media/138945/download.]

Johns Hopkins Medicine has reported on: "IS THE COVID-19 VACCINE SAFE?" and in a section entitled, "Does Johns Hopkins Medicine recommend I get a COVID-19 vaccine?" states that "You alone make the decision about whether to get a COVID-19 vaccine."

The same article discusses "Authorization for emergency use," and that it"…provides temporary authorization of a vaccine or mediation under emergency situations, such as the coronavirus pandemic." https://www.fda.gov/news-events/press-announcements/fda-takes-key-action-fight-against-covid-19-issuing-emergency-use-authorization-first-covid-19

So what did the FDA report? On December 11, 2020, the FDA stated: "The FDA has determined that Pfizer-BioNTech COVID-19 Vaccine has met the statutory criteria for issuance of an EUA. The totality of the available data provides clear evidence that Pfizer-BioNTech COVID-19 Vaccine MAY BE effective in preventing COVID-19." (emphasis added)

The FDA also discusses sample size: "The available safety data to support the EUA include 37,586 of the participants enrolled in an ongoing randomized, placebo-controlled international study, the majority of whom are U.S. participants. These participants, 18,801 of whom received the vaccine and 18,785 of whom received saline placebo, were followed for a median of two months after receiving the second dose."

The FDA also discusses side effects: "The most commonly reported side effects, which typically lasted several days, were pain at the injection site, tiredness, headache, muscle pain, chills, joint pain, and fever. Of note, more people experienced these side effects after the second dose than after the first dose, so it is important for vaccination providers and recipients to expect that there may be some side effects after either dose, BUT EVEN MORE SO AFTER THE SECOND DOSE." (emphasis added)

The FDA also stated: "At this time, data are not available to make a determination about how long the vaccine will provide protection, nor is there evidence that the vaccine prevents transmission of SARS-CoV-2 from person to person."

As research continues, "The FDA also expects manufacturers whose COVID-19 vaccines are authorized under an EUA to continue their clinical trials to obtain additional safety and effectiveness information and pursue approval (licensure). "

On December 18, 2020, the FDA issued another EUA for Moderna COVID-19 vaccine. Just as with the Pfizer vaccine the FDA stated: "The FDA has determined that the Moderna COVID-19 Vaccine has met the statutory criteria for issuance of an EUA. The totality of the available data provides clear evidence that the Moderna COVID-19 Vaccine MAY BE effective in preventing COVID-19. (emphasis added) The data also show that the known and potential benefits outweigh the known and potential risks—supporting the company’s request for the vaccine’s use in people 18 years of age and older." (Pfizer is 16 and older)

Again the FDA included sample size: "…analysis of 30,351 participants enrolled in an ongoing randomized, placebo-controlled study conducted in the U.S. These participants, 15,185 of whom received the vaccine and 15,166 of whom received saline placebo, were followed for a median of more than two months after receiving the second dose."

Again side effects: "The most commonly reported side effects, which typically lasted several days, were pain at the injection site, tiredness, headache, muscle pain, chills, joint pain, swollen lymph nodes in the same arm as the injection, nausea and vomiting, and fever. Of note, MORE PEOPLE EXPERIENCED THESE SIDE EFFECTS AFTER THE SECOND DOSE THAN AFTER THE FIRST DOSE…" (emphasis added) Based on the lists, Moderna's vaccine seems to have more severe side effects.

While socially and politically we've seen the cowing of diverse opinions through the shame/blaming manipulation of population, it's time for that crowd to at a minimum realize that SCIENCE is not part of any shame/blaming acts as perpetrators of bullying and intolerance when it comes to the COVID-19 vaccines.

Biden's Fierce Re-Promising of Obamacare: Debate 2020

2020-10-26T07:12:00.001-07:00

Recycling the Obamacare wordplay dishonesty that earned President Obama, the lie of the year status in 2013 and made Obamacare an albatross around Democrat candidates' necks, debate 2020, Biden has repackaged the same law. Amazingly, for some reason now we're buying into Obamacare, ignoring its failures and fatalities, ignoring its unprecedented selling out of the American people.

BIDEN: "What I’m going to do is pass Obamacare with a public option, and become Bidencare. The public option is an option that says that if you in fact do not have the wherewithal, if you qualify for Medicaid and you do not have the wherewithal in your state to get Medicaid, you automatically are enrolled, providing competition for insurance companies."

MEDICAID not Medicare, so Biden's promising that he'll provide the public option of Medicaid for those who meet poverty guidelines (DO NOT HAVE WHEREWITHAL) and who QUALIFY for expanded Medicaid even in states without expanded Medicaid (so if your state doesn't have Medicaid AND you meet expanded Medicaid poverty guidelines THEN you'll get Medicaid).

Anything new here? No it's a RE-PROMISE, simply removing the unconstitutional original Obama aspect of expanded Medicaid making federal funding dependent on adopting expanding Medicaid. Remember in 2012 the Supreme Court declared unconstitutional Obama's strong-arming efforts threatening to cut off all Medicaid funding if states did not opt into expanded Medicaid. (In 2012 National Federation of Independent Business v. Sebelius that Obamacare's provision requiring expansion of Medicaid or loss of all federal funding for Medicaid was unconstitutional.)

Now that we know it's a RE-PROMISE instead of a new promise, remember another unresolved issue for consumers, the MANDATORY clawback of Medicaid funds from the estates of those who receive Medicaid who are over 55. That's still law and states are considering expansions of clawback provisions to recover their contributions to Medicaid payments. OBRA 93, the law REQUIRING states to recover, at a minimum, all property and assets that pass from a deceased person to his or her heirs under state probate law, which governs both property conveyed by will and property of persons who die intestate when people are on Medicaid over the age of 55.

OK, Biden's just promised you a public option that already exists, Medicaid, an assets-based option for those meeting poverty guidelines that can put your assets in jeopardy after death.

Biden goes on: Biden: "Secondly, we’re going to make sure we reduce the premiums and reduce drug prices by making sure that there’s competition, that doesn’t exist now, by allowing Medicare to negotiate drug prices with the insurance companies."

You'd have to live under a rock to avoid knowing that this idea has been floated around for years and that not only is there no legislative agreement on an "answer," but big pharma already has a trick up its sleeve as we've seen with the increase in drug costs…If they lower the price on one drug, then another drug NOT on the government or insurance formulary goes sky high. They're getting their money. Obamacare didn't even touch big pharma also well-known and easily located with a search. So this is an empty re-promise that at best will reduce the price of some drugs while leaving others to reach new highest levels.

Biden re-promises more! Biden: "Thirdly, the idea that I want to eliminate private insurance, the reason why I had such a fight with 20 candidates for the nomination was I support private insurance. That’s why. Not one single person with private insurance would lose their insurance under my plan, nor did they under Obamacare. They did not lose their insurance unless they chose they wanted to go to something else."

This is just a flat-out lie, and you can read about Biden's re-promise of Obama's lie in lots of places like Reason, "On Obamacare, Biden Repeats Obama's 2013 Lie of the Year," Peter Suderman, 10/23/2020.

Biden re-promise: Biden: Lastly, we’re going to make sure we’re in a situation that we actually protect pre-existing. There’s no way he can protect pre-existing conditions. None, zero.

The trade-off for pre-existing condition coverage was proposed by the insurance industry in 2008, (AHIP) and adopted by Obama. The deal: IF OBAMA made the government a partner with INSURANCE COMPANIES and forced people to buy their product THEN the insurance industry would cover pre-existing conditions.

That was the individual mandate that Biden will bring back and quite honestly the insurance companies are so powerful that no one can really UNTEACH THEM THIS TRICK. For Republicans, the gimmick is CONTINUOUS COVERAGE, penalizing people with higher premiums for lapses in coverage, for Democrats it's the individual mandate, penalizing people with a tax expense for lapses in coverage. So right off the bat, we know there is a way to protect pre-existing conditions because we've seen what the insurance companies are willing to do for politicians, charge consumers and force them to buy insurance or pay a penalty.

Then of course, there's the reality that pre-existing conditions ARE penalized as insurance companies have shown us for 10 years where they make up the money with new exclusions to coverage (simply don't have it in the policy whether it's life saving drugs in a formulary, or something else outside the minimal requirements of Obamacare), increased copayments so they cover LESS, increased coinsurance so they cover less, higher deductibles. Come on Biden, as you would say, you're just re-promising the same failed promises.

Finally, in response to the "socialized medicine, run by government" accusation, Biden rightly responds, "I say it’s ridiculous. It’s like saying that the fact that there’s a public option that people can choose, that makes it a socialist plan. Look, the difference between the president and I… I think healthcare is not a privilege, it’s a right."

Biden's simply re-promising Obamacare, not socialized health insurance, unfair health insurance that creates a small entitlement for the max of around 11 million people who have used Obamacare exchange plans at the expense of astronomical cost increases for those purchasing private health insurance through employers, with lower standards and provisions of coverage, preserving the public employee superior benefits off taxpayer backs….It's simply Obamacare.

The last Obama-era lie-promise that health CARE is a right, as you can or should be able to see, of course not. Even Sanders' plan didn't go that far, it gave basic clinic-type services like Obamacare for "free" (taxes) and anything else was subject to sky's-the-limit pricing by contract.

In the words of Joe Biden….Come on.

Bias isn't Science: COVID

2020-08-04T09:12:00.030-07:00

The political manipulation of the COVID crisis is not surprising, but certainly should be sifted out by consumers when they listen to how it was or wasn't handled and what someone else might do in the same situation, (which of course wouldn't be the same since we have the experience of COVID).

What is the danger of confirmation bias re health policy or actions? Using the definition of confirmation bias as "making people less likely to engage with information which challenges their views. ... Even when people do get exposed to challenging information, confirmation bias can cause them to reject it and, perversely, become even more certain that their own beliefs are correct," is likely to create decision-making that is wrong.

So, let's get to Nancy Pelosi's latestspin of conspiratorial theory and bias against President Trump by indicating she doesn't "trust" Dr. Birx, implying that Dr. Fauci's the one to follow instead since he's not a Trump appointee. Naturally, neither Pelosi nor Trump nor Biden nor Cuomo nor most of commentators and politicians are physicians nor physicians with expertise, so like the rest of us, they rely on what the "experts" are saying.

However, by picking and choosing their citations and snippets of text,or even which experts they trust in order to FIT with their bias against President Trump, we risk politicized health care, which is by definition NOT SCIENCE.

What emerges from an examination of COVID response is that Biden's prediction that he would've done better is just that, hot air, that Cuomo's self-congratulation that he did well is just that (at least according to nursing homes)and that the SCIENCE we've been informed about indicates that the President's actions/inactions regarding COVID are not unreasonable.

On January 21, 2020, Dr. Fauci said during an interview regarding COVID-19: "This is not a major threat to the people of the United States and this is not something that the citizens of the United States right now should be worried about."(Politifact)

Relying on this science expert's advice, there was NO justification for worry for a President relying on the expert.

In a separate interview, Dr.Fauci repeated his view on January 26, 2020, "It’s a very, very low risk to the United States, but it’s something we, as public health officials, need to take very seriously."

Relying on this expert Fauci advice, what would a President do? President Trump created the State Department's "White House Coronavirus Task Force," on January 29, 2020 that "coordinates and oversees the administration's efforts to monitor, prevent, contain, and mitigate the spread of coronavirus disease 2019(COVID-19)." [Wikipedia]

This was a reasonable response to Fauci's "low risk" but "take very seriously."

In a conversation with JAMA, on February 6, 2020, Fauci said, "So, I think that we can say we don't know everything about this virus, but it's evolving in a way that looks like it's adapting itself to infecting much better. But we're going to start seeing a diminution in the overall death rate."

During this same interview on February 6,2020, Dr. Fauci said, "Once you get a broad global pandemic, it's folly to do any travel restrictions because you can't cut yourself off from the rest of the world."

Despite Fauci's advice that travel restrictions are folly, on February 2, President Trump issued an executive order blocking entry to US of anyone in China 'during the past 14 days' became effective, though seemingly Dr. Fauci on February 6 called such action and travel restrictions as "folly."

March 3, 2020, the White House issued guidance(whitehouse.gov), with advice for people to obey state and local authorities and additionally advising to stay home if sick, if your children are sick keep them home, if someone tests positive keep them home, if you are older stay home, if you have an underlying health condition stay home, and other recommendations such as avoiding social gatherings of more than 10 people.

As an example, such gatherings weren't banned until 3/20/2020 in New York.

On April 6, 2020 the WHO said that healthy people had no need to wear masks, though the CDC at the time was advising wearing masks. Dr. Fauci joined the side of the WHO in advising AGAINST wearing face masks by healthy people, though he changed his mind much later.

During July, Dr. Fauci defended his decision stating that "it was right in the context of the time in which I said it."

In mid-July, the President started wearing a mask himself, clearly, like Fauci, taking the action in the context of the time.

Note, there are still face mask discussions about the quality of the face masks and their effectiveness and in the meantime, Fauci's gone even further,recommending goggles and eye shields as of 7/31/2020.

Joe Biden's claim that Donald Trump told people to drink bleach? Well, that's just a lie, rated "Mostly false" by Politifact. See, "No, Trump didn’t tell Americans infected with the coronavirus to drink bleach," https://www.politifact.com/factchecks/2020/jul/11/joe-biden/no-trump-didnt-tell-americans-infected-coronavirus/. OK, so now we know what Biden will do…Lie.

If you look at the FDA website, on March 28 2020, the FDA issued an Emergency Use Authorization (EUA) for emergency use of oral formulations of chloroquine phosphate (CQ) and hydroxychloroquine sulfate (HCQ) to be distributed from the Strategic National Stockpile (SNS).

On May 25, 2020, President Trump said he'd "just finished" taking hydroxychloroquine for two weeks.

About two-and-a-half months from its first 3/28/2020 recommendation, the FDA on June 15, 2020, revoked EUA (Emergency Use Authorization) for chloroquine phosphate (CQ) and hydroxychloroquine sulfate (HCQ).

Dr. Fauci was consistently opposed to COVID uses of hydroxychloroquine, though as of July 1,2020, the FDA states, "FDA cautions against use of hydroxychloroquine or chloroquine for COVID-19 outside of the hospital setting or a clinical trial due to risk of heart rhythm problems."

Many of the rest of the complaints about are largely political stances, including from governors who wanted the President to do "MORE," which translated into more federal dollars, but still demanding that they, the governors run their own jurisdictions.

How do we know? The NEW YORK TIMES on April 13, 2020, itself reported on the disagreement among governors but overall commitment of governors to be "in charge" of their own states, objecting to the President's efforts to create a national approach, criticizing: "Trump Insists He Has ‘Total’ Authority to Supersede Governors."

A note about reopening. Since at least July, 2020, the CDC recommends reopening schools citing the benefits vs risks of not attending schools. (Look up CDC.gov). But of course, citing the increased risk of infection the CDC also says that this doesn't mean that all schools should open five days a week. Dr. Fauci agrees on reopening schools, though he hedges his bets by indicating hot spots should remain closed.

So, were Trump's responses to COVID ignoring science, in spite of science, counter to science? No and claims of the same are political smear, not reality of the science journey of COVID.

Where does that leave us without political spin and malice, and heavy confirmation bias? It may take some real working with ourselves to realize it, but President Trump responded to COVID-19 appropriately.

Maine Community Health Options Case Highlights Flawed Obamacare

2020-06-02T11:40:00.001-07:00

This spring, 2020, the Supreme Court decided in favor of enforcing Obamacare's federal government risk corridor payments to insurance companies that lost money on Obamacare exchanges during the years 2014-2016. While the decision "upholds" what Obamacare states regarding such temporary payoffs to insurance companies created under the law to essentially give insurance companies incentives to join the exchanges in 2014-'16 by guaranteeing they wouldn't "lose" money, the decision is essentially meaningless for consumers and even for insurers moving forward.

For consumers, we've seen the Supreme Court bend over backwards to preserve the law, which currently seems "popular" in the face of the defeat of Sanders and Warren and their Medicare for all discussion and as Joe Biden imagines the glories of Obamacare.

Short of other reasonable fixes to the outrageous consumer costs of our health industrial complex, even those in the current administration seem to be trying to work with Obamacare.

Lest we completely forget reality, the Maine Community Health Options decision should remind us that above all Obamacare was a deal, a partnership entered into between the federal government and insurance companies that not only used the force of government to lower the bar of coverage into some cheap fix preventive care guarantees of services that nationalized crummy coverage and that also justified insurers reducing coverage for needed medical care and services, but made the federal government a tool in forcing people to purchase health insurance through the individual mandate.

The Maine Community Health Options decision isn't a bad decision on its face because it simply holds that federal payoffs to insurers promised by Obama's Administration through 2016 for insurance companies that participated on exchanges and lost money should be upheld as per the ACA, the Affordable Care Act.

In this instance, the Supreme Court upheld the payments owed to insurers for the years 2014 to 2016 that participated on exchanges and lost money as the temporary provisions of the ACA regarding such payments described.
But the decision presents some tremendous warnings for consumers moving forward.

The Affordable Care Act Section 1342 provides “ESTABLISHMENT OF RISK CORRIDORS FOR PLANS IN INDIVIDUAL AND SMALL GROUP MARKETS…The Secretary shall establish and administer a program of risk corridors for calendar years 2014, 2015 and 2016,” to limit overall LOSSES AND GAINS that an insurance company has and certain LOSSES are paid by the government, HHS (CMS).

First, the original provision of risk corridors and payments by the federal government to insurance companies to incentivize their participation were TEMPORARY, not an ongoing payoff for insurance companies. We already survived year 2017 when insurers pulled out of the exchanges with the expiry of these payoffs. With Joe Biden at the helm of the Democratic Party, consumers should be wary of any ideas of resurrecting the taxpayer expense of paying off insurance companies that lose money on exchanges either as a temporary additional payoff or an indefinite arrangement of paying off insurers simply to keep them participating on exchanges.

In this context, consumers must also remember that enrollment in exchange plans has NEVER met anticipated numbers and has never really exceeded 11 million for any benefits year. Talking about Obamacare as some national option for uninsured Americans is inaccurate UNLESS we're talking about the expanded Medicaid aspects of Obamacare, not the exchange plans because exchange plans are ONLY available for individuals with INCOME that falls within certain guidelines.

Second, we must remember that though in the Maine Community Health Options decision relies on actual wording of the Affordable Care Act in order to pay insurance companies, that the Supreme Court has not shown such loyalty to the actual text of the ACA in other instances, specifically in King v. Burwell, re premium assistance payments and cost sharing specifically available for STATE established exchanges in the Act, or in addressing the legitimacy of the individual mandate and the shaky distinction between fine and penalty in order to uphold that.

Many states have enacted their own individual mandate style provisions which again, work for insurance companies, guaranteeing them customers BY LAW.

Finally, the persistence of Obamacare is in part an indictment of all lawmakers who having protected their own rich benefits ALWAYS look to cut corners on what our tax dollars buy us, break the deal and promises of our continued taxation for Medicare and Social Security,because after all, their benefits are never at stake. This is the real challenge for voting consumers because all politicians come down on the side of saving government money by essentially screwing the rest of us and that's why blatant Obamacare problems such as the family glitch persist to this moment under Obamacare.

The decision in favor of paying insurance companies that participated in exchanges from 2014 to 2016 only with the guarantee of federal reimbursement for their losses is NOT a consumer win, it's an insurance company win and no surprise under Obamacare, the law that codified a partnership between the federal government and insurance companies.

COVID-19, Beware Saying, "The New Normal"

2020-04-27T08:44:00.001-07:00

We should NOT accept COVID-19 responses as a "NEW NORMAL," because there is no scientific justification for such permanent changes. While many may wear masks and gloves way into the future, policies based on the limited understanding of COVID-19 and "emergency" responses to handling the virus should be avoided, because we may never regain rights yielded under "emergency" conditions.

Already, different segments of society are using the COVID-19 virus as a wedge for eroding consumer rights to privacy, to work, to associate, or even to have authority over our own bodies and medical records. There is also the emerging risk of "off-label," unintended consequences, of allowing any emergency measures to become the "new normal."

What is absolutely critical for consumers is that we understand that every emergency action taken in response to COVID-19 be deemed temporary and that it be limited in scope with protections and consequences in the event such emergency powers are used and/or abused in any way by either government or private entities.

Start with drones. As reported in "GT," on 4/22/2020 by Jed Pressgrove in, "Drones Become Part of Local U.S. Responses to COVID-19," "A number of U.S. police departments have utilized drones as part of their efforts to slow the spread of COVID-19, though public safety agencies differ in the way they employ the emerging technology."

Not only are the drones employed "differently," under law enforcement's public safety powers, but consumers are given only the "assurance" that the data collected is or isn't being used by government in specific other unlawful ways. What we don't know is: The public safety power being utilized in response to COVID-19 ends when? After the peak, at a certain time definite, or is this a PERMANENT new tool that will be used by law enforcement?

There are also non-law enforcement individuals invading their fellow citizens' privacy rights using drones. For example, rogue drone operators are currently comfortable going on the news to show how they're photographing people and telling them to disperse because they're in violation of social distancing rules without any official authority and notably without any enforced prohibition against such conduct.

Mayor De Blasio of NY actually took to the airwaves telling citizens to take pictures and report any groups not following social distancing. Fearful individuals or those with a penchant for vigilante conduct or voyeurism now have an "in" to invading their neighbors' privacy. This should have been smacked down immediately as unlawful and should NEVER be a NEW NORMAL.

Cell site location information, CSLI, is being employed by states trying to "track" COVID-19, individuals gathering and/or tracking who someone deemed "infected" had contact with. Right now, whether it's claims that such data is anonymized or claims that the data is used ONLY for a certain purpose, scared individuals seem willing to expand government authority to monitor our movements via our cell phones, or worse, let entities like Facebook do the tracking and share that information with government.

In Carpenter v. US, 2017, the Supreme Court addressed whether a search warrant was required BEFORE tracking someone's movements via cell phone. In this instance an individual was convicted of crimes based on law enforcement tracking him via cell phone. You can read the opinion, but the good news was that the Court slightly reined in law enforcement's use of the tracking tools, CSLI, identifying them as a "search" requiring a warrant, though leaving no doubt that in most cases law enforcement could obtain search warrants in addition to already existing and legal warrantless searches established.

CSLI presents a giant risk to the already eroded rights against search and seizure and COVID-19 should NOT be tolerated as a back door to further erode those rights as a NEW NORMAL.

Then there's right to privacy of our medical health with shared information, forced testing before being allowed to return to work in the face of unreliable testing, contact "tracing." Again, FEAR, should not dictate policy. There are reasons for protecting your medical information, and just like cases where stigma or fear results in unlawful and unjustified discrimination, protection from the ADA, or other such federal law must go hand in hand with any policy that demands us sharing our medical information.

Lockdowns can NOT become permanent NEW NORMALS for COVID-19 or any new virus. In addition to the questionable authority for such long-term state actions (expect to see court cases), the practicality of waiting for either reliable testing, reliable treatment, reliable vaccine means such lockdowns could last for years.

Further, lockdowns are currently unevenly mandated and enforced, meaning that while lockdowns are working now, because people are scared, in the future people might realize that we're not all in it together since public employees are still collecting benefits and paychecks while many others are being furloughed or laid off. NY's Governor Cuomo and his successors might be less convincing in their call for volunteers when he and his public employee coworkers are still collecting paychecks showing it really is not an "in it together" scenario.

The NEW NORMAL cannot be the passage of various emergency measures as a means of bypassing lawmaking. For instance, once restaurants open, should we continue to rely on the vigilante photographers in terms of social distancing or cleanliness? Probably not. Health inspectors would have to be given new criteria for assessing establishment cleanliness. New occupancy numbers would have to be issued for restaurants to establish safe social distancing as places that could hold 250 might only be permitted to serve half or a third of the people they did before. This could make the difference between survival and death of businesses and must be done by law.

We must also beware the NEW NORMAL of "protecting" financial interests of individuals affected by COVID-19 while avoiding INCENTIVIZING claims of COVID-19. Should hospitals create permanent additional space for "outbreaks," based on this outbreak? Likely not, because paying for that space will be carried by every taxpayer and hospital patient and will raise hospital bills even higher. Right now we know that current statistics are NOT accurate, so such hospital expansion and its expense would be as inappropriate as it would be to keep a banquet hall on retainer in case you have a party.

Even the death counts are not reliable. The CDC currently has the provision that "In cases where a definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the circumstances are compelling within a reasonable degree of certainty), it is acceptable to report COVID–19 on a death certificate as 'probable' or 'presumed.'" This maybe-maybe not death certificate information promises to skew statistics for years and years to come.

When it comes to special COVID-19 funding, whether it's employees using extended family leave or providers using special COVID-19 provisions for funding, or even for information gathering, it is crucial that these provisions be temporary, because there is not enough known about COVID-19.

Already, without reliable testing and therefore without reliable diagnosis, medical coding has addressed COVID-19 in terms of provider billing and reimbursement (https://revcycleintelligence.com/news/what-providers-need-to-know-about-covid-19-coding-and-billing) opening up a new area of patient testing that could very well become part of the "covered" preventive testing we currently have that has had the unintended consequence of becoming a tool for defensive medicine and often ranges in results from an inconvenience, to an increased cost, to a barrier to care and even a risk to patients exposed to additional tests as a matter of course merely because they're "covered" by health insurers, though we know or should know such testing is often used to raise premiums.

It is premature to call anything a NEW NORMAL in terms of responses to COVID-19. We've received a flood of different, conflicting and evolving information and though social distancing seems to be and logically works if something is contagious, permanent lockdowns are not feasible.

When it comes to basic rights of privacy, association, protection against unlawful search and seizure, consumers must act with caution and should consider EVERYTHING happening right now as temporary therefore requiring limitations of time and scope as well as protections from off-label uses of these temporary government actions taken in response to the COVID-19 emergency, the very opposite of a NEW NORMAL.

COVID-19 Testing Should NOT Dictate Policy

2020-04-21T09:06:00.000-07:00

Whatever consumers' views about COVID-19 testing, we should NOT support policies based on testing, such as return to work options, and we should NOT support the narrative that "testing" is some kind of magical key to reopening the economy, or we will be faced with the choice of relying on fantasy or delaying openings for much longer than is being discussed now.

Right now ALL COVID-19 testing should be taken with a grain of salt because it has proven wildly inaccurate and the conclusions that can legitimately be drawn from such testing is limited to one person's results of either a specific COVID-19 virus test or COVID-19 antibody test administered on one date that indicated one result.

There is no definitive evidence that someone who "tested" negative was truly negative, or vice versa, there is no indication that the person the very next day won't test positive, there is no definitive evidence that a person can or cannot become reinfected. Regarding the antibody tests, even when antibodies are detected, the tests cannot definitively state that the presence of such antibodies indicates any level of immunity from COVID-19, nor whether such antibodies will last.

The current urgency for flooding the market with tests is foolish based on the quality of current COVID-19 testing and policies based on such inaccuracies can only foster arbitrary methods of taking actions that can negatively impact individuals.

A good example of the arbitrary bad policy that comes from ignoring the inaccuracy of current testing has been floated by NY's Mayor Bill De Blasio requiring "testing" before a public employee can return to work.(see "Politico," NYC NYC requiring public employee coronavirus testing," Nick Niedzwiadek and Madina Toure, 3/6/2020.)

The tests both for the virus and for antibodies are notoriously unreliable. When it comes to COVID-19 testing for detection of the virus, from "Business Insider," (4/2/2020) to the "Washington Post," 3/26/2020, to "The Guardian," 4/5/2020, to NPR, 4/15/2020, we're being warned about inaccuracies in COVID-19 testing.

Similarly, when it comes to antibody testing, report after report states that the tests don't work, such as reported in the UK on April 6, 2020, by Camilla Hodgson and George Parker, "UK government admits Covid-19 antibody tests don’t work," "Financial Times," or, "Antibody Test, Seen as Key to Reopening Country, Does Not Yet Deliver," Steve Eder, Megan Twohey, Apoorva Mandavilli, 4/19/2020, "The NY Times," or, "What Immunity to COVID-19 Really Means: The presence of antibodies to the SARS-CoV-2 virus could provide some protection, but scientists need more data," Stacey McKenna, 4/10/2020, "Scientific American."

Therefore requiring some people or all people to take such a test as a condition of returning to work does nothing to add protection from COVID-19 spread and could easily result in unfair stigma, unfair delay in returning to work, unfair requirements for continuous and repeated "testing," and other non public health-related agendas.

This is not a case of better than nothing…An unfairly administered, or processed or flawed test is worse than nothing because its results falsely indicate that people can RELY on such results.

Even if there was today a test with reliable results, reliance on such test would be inappropriate in terms of policy because no presence of COVID-19 or the presence of antibodies today means little for tomorrow, let alone longer into the future. If you don't test positive for COVID-19 one day, who knows if you will test positive for the virus the next unless you are tested again?

We cannot know if you are COVID-19 free beyond the moment of taking the test, because this is a contagion and you can become infected and reach thresholds detected by the test at any time. There is no guaranteed time period that a negative test is good for. Yet, the frequency of testing is not part of policy ideas like De Blasio's and the costs of time, test kits, and associated other costs of administering daily tests seems impractical and unreasonable, especially before the tests are deemed reliable.At best and if there is a reliable test, a policy of testing someone before that person returns to work is only a one-day assurance.

Relying on some alleged "immunity," discerned from an antibody test is also an opportunity for unjustified reliance on test results, even if those tests become more accurate because it is unknown what levels of antibodies are necessary to amount to "immunity," and because again, it is unknown whether the antibodies will remain sufficient long-term for a lasting immunity.

Neither a false sense of security that we're not infected nor that we're immune is helpful to consumers. Instead, we should be against any policy that uses COVID-19 testing as a barrier to employment, freedom to travel, or invasion of privacy or anything else and view the same as suspect and likely the result of an ulterior motive, such as making it appear that leadership is "addressing" a problem, or is attempting to keep certain people out of the workplace, or perhaps even using testing as an excuse to stigmatize certain people, just a few of many possible and suspect scenarios.

The science is unequivocal, today the testing is unreliable and its conclusions are unclear. Therefore, social distancing, sanitary conditions and precautions, are the best tools available for consumers as we reopen the US and all arguments that testing, current testing, is key to reopening the economy are nothing but a false narrative because of the inaccuracies of testing and the limitations of testing and its conclusions.

The Lessons of Coronavirus and Health Insurers

2020-04-08T06:59:00.002-07:00

Unsurprisingly, health insurers are far closer to villains than heroes on the spectrum of coronavirus responses as they continue their single-minded money grab from consumers. Are there rebates for consumers unable to use their insurance when providers are closed or unavailable for anything but coronavirus-related situations? Nope. Are there extended grace periods for individuals who have lost their jobs and insurance? No.

As a matter of fact, as reported in Salon on April 5, 2020, "Health care insurers expected to raise premiums by as much as 40% to recoup coronavirus losses: Insurance companies may respond to cost increases as high as 21% by hitting individuals with 40% premium hikes," by Igor Derysh, insurers who are putting in requests for premium increases for 2021 beginning next month are expected to put in requests for some hefty increases.

The article includes a warning from Covered California, the California Obamacare marketplace: "'Covered California's analysis shows the impact of COVID-19 will be significant, and that absent federal action, consumers, employers and our entire health care system may be facing unforeseen costs that could exceed $251 billion,' said Peter V. Lee, the executive director of the marketplace. 'Consumers will feel these costs through higher out-of-pocket expenses and premiums, as well as the potential of employers dropping coverage or shifting more costs to employees.'"

What is the insurance lobby doing? Oh, sure, we're hearing how they've been cooperating by, "waiving fees for diagnostic testing for coronavirus," and some insurers are supposedly waiving copayments and coinsurance for treatment of the virus.

However, this week's "Statement by the AHIP Board of Directors: Taking Action to Address Coronavirus COVID-19," promises one thing, health insurers are not changing THEIR behavior and will continue lowering the bar of their performance to maximize their profits.

The insurance company lobby AHIP, in its statement announces that it is addressing "Prevention, testing, and treatment." The insurance lobby promises to cover "diagnostic testing when ordered by a physician," (for coronavirus).

OK, so that's the cost of the coronavirus test, theoretically. Of course, that's if you can get a test, but more importantly it points out that under our current low-bar for health insurer performance, in fact DIAGNOSTIC testing is often NOT covered.
While we preferred to be dazzled by coverages for preventive screenings, etc., under the Obamacare partnership with insurance companies, we neglected to address or acknowledge the UNCOVERED costs of diagnostic testing if those screenings show something requiring additional testing, like an irregular result, etc., often with lower coverage rates percentage-wise for those diagnostic tests.
Interestingly, the health insurers are "covering" these costs as a political gimmick, with no such humanistic concerns about the 10 years of diagnostic testing costs to consumers for cancer or any other diagnostic testing justified by "screening" results.

We then get to the insurers' number two, "Partner with doctors, hospitals, and other care providers to ensure that effective treatment is available for those who are infected," which promises information sharing with providers.

This is a big nothing promise in terms of benefits for consumers and might actually LIMIT the availability for best care as insurers specify that they will use "Care management programs," which is most commonly a means of insurers controlling their costs by limiting acceptable treatments for individuals.

And there's more as the lobbyist memo states that insurers are "…encouraging the use of telehealth, at-home care, and other technology-enabled options to expand access to care and avoid potential risks of infection."

Dial-in help might be useful instead of forcing people to go to and pay for in-office visits for medication renewals, therefore effectively denying individuals whose physician's offices are unavailable for these in-person mandates or exposing them to infection, but they also represent the insurance company agenda of reducing insurance company costs in terms of paying providers whose payments are less for such "telehealth" options.

Interestingly, telehealth has never before been considered for the double-dip requirement that patients get an office visit every three months in order to get prescription renewal for medications, but suddenly it might be "good enough."

And finally, AHIP's third action step is merely the non-insurance action that insurers like calling "education" which by now mostly means that insurance companies identify and blame and penalize individuals for certain lifestyle choices, such as tobacco use, and for things which consumers cannot control, such as age.

Two classes of people Obamacare created a discriminatory exception for in terms of federal government partnering with insurance companies to charge these people more in premiums. While insurers had for decades used different factors such as pre-existing conditions, drug use, hypertension, obesity, etc. to charge individuals more in premiums because statistically they might cost the insurer more in coverage, when Obamacare outlawed any such cost-centered premium increases EXCEPT for tobacco use and age, it effectively chose to DISCRIMINATE against those two groups by prohibiting increased premiums for and ignoring other cost centers.

This is important because AHIP, a lobbying group also states in its coronavirus memo, "We are proactively engaging the American people, particularly those who are most at-risk for infection such as seniors and patients with chronic diseases, on common-sense steps that everyone can take to stay healthy." Consumers are warned, look for the lobbyists working towards legislative changes to the already discriminatory permission granted by the Federal government under Obamacare that older people can be charged up to 1.5 percent of premium charged to everyone else (except tobacco users) including drug users, alcoholics, obese individuals and every other cost center.

This is where the health insurance lobby is going and Federal participation and partnership with the same will cost consumers dearly.

Coronavirus and Layoffs…Health Insurance

2020-03-18T05:35:00.000-07:00

As of right now, layoffs due to coronavirus create no nationally mandated special options for employees. So, the first step is to consider the layoff as just that, a layoff with the same options available to us as before, apply for unemployment, see whether the former employer is providing a grace period of a month or longer before health benefits are terminated and we become uninsured, COBRA (which is usually very expensive).

Further, short term limited duration health insurance plans may be a resource for us. Price them out, see what they cover.
If the person losing health benefits is in a household, determine whether you can be added to your fellow householder's health insurance, loss of job is a changed circumstance that bypasses usual enrollment periods.

A person who is laid off might be eligible for Medicaid, especially in states with expanded Medicaid, so look for this option as well, but the process could take over a month, month-and-a-half.

The first priority as always is to get the care you need.

We should ALL be looking for health insurance companies and government, both federal and state to address coronavirus specific issues, especially where local governments are using their authority to close down businesses. (Yes, we understand the public health concern, but it doesn’t change that these business are being closed by government).

WE NEED:

Free testing: While we're all reading about "waiving" fees for TESTING for coronavirus, the waiver is being provided by INSURANCE COMPANIES for the most part. Every individual should be covered for FREE testing regardless of whether they have health insurance or not.

Premium Refunds: Right now many providers are shutting down or drastically limiting their practices making them inaccessible for usual visits. This situation means we're paying for coverage that is not in reality available and insurance companies should REFUND a portion of premium to policyholders.

Automatic or Telehealth Prescription Renewal: We would also be looking for automatic prescription renewal or a TELEHEALTH substitute for an office visit in the event a person cannot see their provider for the three-month office visit often required to "renew" prescriptions in order to prevent disruption of needed prescriptions.

Beyond merely shutting everything down and again ignoring the public employee protections not available to the rest of us, we must demand that state and federal government pay attention to the real needs of our communities.

Health-Con 2020: Ignoring Underinsurance

2020-01-27T08:21:00.001-08:00

Con spotting for election 2020 should include the red flag of the regurgitation of old-time failed Obamacare ideas as "great news." Yet, there are still those whose own self-interests prompt them to seek to distract consumers from the worsening cost barriers of USING our INSURANCE (underinsurance) as a tool to regain or maintain health, for NEEDED health care.

These individuals are those who apparently are willing to tolerate the peril in which they place others and perpetuate the risks consumers face from the health industrial complex in order to promote their own political or other agenda, because their claim that "having health insurance" alone is some sort of societal victory has already been proven to be an INVALID measure of access to needed health care.

This is the distraction put forth in Politico's opinion piece 1/27/2020, "Obamacare’s Secret Success: With little notice, the ACA has racked up a big win – near-universal coverage," by Ezekiel Emanuel, Cathy Zhang, and Aaron Glickman.

The proper answer to this distraction is: "Obamacare's partnership with insurance companies and forcing people to purchase health insurance with the governmental imposition of the individual mandate has increased those who have insurance, but has neither protected most Americans from financial ruin when facing the costs of needed healthcare services, nor prevented the endless increased costs consumers face in attempting to obtain those needed services, and in fact,has made cost barriers worse for consumers in many ways."

From enormous and rising deductibles, increased consumer payments for coinsurance and copayments, as well as the now decade-long trend in DECREASED coverage, and the increased costs we pay for excluded drugs and services, we know that merely "having" a product that calls itself health insurance often DOESN'T WORK as insurance, protecting consumers from the devastating risk of cost barriers and inevitable choices that must be made for regaining and maintaining health.

The increasing costs of obtaining and using health insurance magnifies the danger we face if we believe those who persist in weirdly tooting Obama's "universal coverage" horn, resorting to the fallacy that having insurance is progress no matter how much the cost, the exclusions and the limitations of that product leave us in physical and financial jeopardy.

Certainly by now, before swallowing Obama's untruthful claims yet again, we should discern who's repeating that lie. You can bet your boots it's being put forth by a partisan individual whose own health insurance is better than yours and who has a higher income to go along with that better coverage.

Why my use of the word "weirdly"? Because we've got 10 years' worth of experience proving that merely HAVING INSURANCE does nothing for consumer health UNLESS they can afford to use that insurance for regaining/maintaining health with NEEDED medical services and care coverage, which Obamacare made decidedly worse.

Yes, worse. By focusing on minimum standards for non-insurance checkups and preventive medicine and incentivizing insurers and employers to merely meet this new lower minimum coverage standard, we have seen deductibles, copays, and coinsurance go up in costs to consumer astronomically AND premiums have gone up as well, the worst of both worlds.

Don't think so? Just remember, the advocates and lawmakers made very sure that their insurance wasn't this coverage.

Still not persuaded? Obama's own government stated in 2015, "Over the period from 2005 to 2014, premiums for employment-based insurance grew by 48 percent for single coverage and by 55 percent for family coverage. CBO and JCT expect them to grow at similar rates over the next decade," https://www.cbo.gov/publication/51130.

Worse coverage by insurance policies as they all race to the bottom of minimum standards under Obamacare and at best according to Obama's own government, with a similar pace of increased pre-Obamacare costs in premiums--More cost for less coverage. That is not success.

'Universal coverage' is the positive spin on stakeholders explaining what's good enough for you, hoping you don't notice that it's not good enough for them.

'Universal coverage' is the fallacy that having any crummy health insurance improves access to NEEDED health care services, when actually, having health insurance means NOTHING if you can't afford to use it because of high deductibles, copays and coinsurance, especially with providers requiring upfront down payments on their services and ever-climbing government established out-of-pocket maximums.

'Universal coverage' is a fallacy based on an assertion that in today's census environment governments and politicians KNOW how many people are uninsured in the first place.

The Politico "opinion" asserts the fallacy that any government, the federal or states, especially with increasing populations of undocumented and illegal immigrants, can tally the total number of their population and determine the percentage of that unknown population is now insured (in their minds thanks to Obamacare.) Not true. Even Obama's government admitted that this number is guesswork.

In 2015, Obama's Congressional Budget Office, after five years of Obamacare revealed a, “…[S]lightly lower estimate of the number of people who will gain insurance coverage because of the ACA,” (CBO, Pub. 49973, page 19). Naturally, this little tidbit was only revealed after years of less-than-anticipated enrollment in Obamacare exchange plans.

We also know that the numbers of people who had insurance that was no longer available after Obamacare and therefore were forced onto exchange plans were not even addressed, so these double-counted individuals were used to pad numbers of insured with Obamacare.

In 2014, on behalf of Obama's HHS, Gary Cohen responded to the issue of previously insured versus newly insured with the statement, “That's not a data point that we are really collecting in any sort of systematic way."(http://www.upi.com/Top_News/US/2014/03/07/Gallup-Majority-of-uninsured-say-theyll-get-insurance/35011394207335/#ixzz3MLXDSS9C).

'Universal coverage' pretends that we're all in it together, and now "we all have insurance," as if this faux-community argument would ever inspire its proponents to face the choices the rest of us face.

Most significantly, 'universal coverage' PREVENTS consumers from advocating for a consumer financial product of health insurance that works as insurance, giving us peace of mind that WE PAY FOR IN PREMIUMS OR TAXES that in the event of NEEDED MEDICAL SERVICES AND CARE we won't face financial ruin as well as the suffering of illness or injury. To the extent we continue to face this added stress on top of injury or illness even when we have insurance is the underinsurance problem.

Health insurance is a TOOL we purchase to make sure we can afford the care we need when we need it without facing financial ruin. To the extent the tool doesn't work it is the wrong tool. Arguing that everyone should have a hammer when a screwdriver is what's needed is as idiotic as claiming that universal coverage solves the problem of ever-worsening cost barriers to obtaining needed medical services.

In the US, around 66 percent of bankruptcies cite medical expenses. That's a universal indictment of our health industrial complex and an indictment of Obamacare proponents and con artists, especially by pretending that "achieving" "universal coverage," on its own is a success in the environment of worsening underinsurance.

Actually, such bragging about universal coverage, meaning people having insurance, is a tremendous mark against Obamacare, since even going along with the unproven claims of lots of people having insurance we also know that 66 percent of our US bankruptcies are attributable to medical expenses illustrating how bad that insurance is…Underinsurance.

These universal coverage con artists ignore the crisis and growing underinsurance problem, reported periodically in articles like NPR's, "When Insurance Won't Cover Drugs, Americans Make 'Tough Choices' About Their Health," 1/27/2020, Patti Neighmond.

Worse yet, to belabor the health-insurance-as-wrong-tool analogy, when stakeholders defend universal coverage, merely having coverage, they consider it a success that everyone has a hammer even though that hammer is useless for the screwdriver's job.

It does not appear that this strategy is accidental when put forth by stakeholders, but instead is a sneaky way of trying to convince everyone that now we've all got the same shot at obtaining needed medical care and services, a claim which even the most gullible among us should suspect as a con put forth by partisan or health industrial complex stakeholders in keeping things as they are now, or making them worse.

Beware the damaging con of partisan brags about "universal coverage," such as that put forth in "Politico," "Obamacare’s Secret Success: With little notice, the ACA has racked up a big win – near-universal coverage."

The Politico article is all about those "enrollment" numbers, because after all, in a faux display of, "We're all in it together," much like Obama, the partisans will neither discuss nor attempt to address the excruciating, persistent, and known inhumane failures of Obamacare and our health industrial complex.

They ignore the increased underinsurance faced by consumers from Obamacare's deal with lobbyists and ignore or support provider charges that are through the roof, drug prices through the roof, exclusions increasing, ever-increasing out-of-pocket maximums established by government, Obama's legacy of making it harder to get the medical expense tax deduction by allowing the 7.5 percent threshold to lapse and thus raising that to 10 percent, balance billing, Congress' de facto exemption of themselves from the law, to name just a few of Obamacare's intended menu of brutal results.

In arguing some throwback fallacy of enrollment as success, these partisans argue the imagined and never existent good ol' days of Obama and Obamacare where by partnering with insurance lobbyists Obama's government increased the number of those who had insurance by forcing people to purchase the consumer financial product of health insurance. Why are they still arguing enrollment? Because after 10 years of relentless failure, what else do they have?

Des Moines Dems on Health Care: Prescription Drugs, "Negotiation" Not Enough

2020-01-23T09:12:00.000-08:00

As with other insurance, it is the RISK of needing expensive care, services, devices and, in this instance, drugs to regain and-or maintain health that is the measure of the effectiveness of any insurance policy.

With its lists of low-hanging fruit of service contract type inspection-style checkups and screenings combined with the permission to raise prices to consumers for treating anything discovered, Obamacare nationalized a policy of greater financial and physical risk for consumers by establishing MINIMUM standards when Obama partnered WITH rather than TOOK ON insurance companies for Obamacare.

This is not supposition, but fact as we know it, that Obama embraced the insurance lobby's proposition to help Obama fulfill a flashy political promise of illegalizing denial of health insurance for those with pre-existing conditions AS LONG AS he also committed to using the power of the federal government to force everyone to purchase health insurance…the individual mandate with ample room for insurance companies to raise out of pocket costs for needed care in the form of deductibles, copays, coinsurance and exclusions.

We know that Obamacare raised costs of using health insurance from report after report and because Obamacare's strategy as revealed by Obama's own Congressional Budget Office indicated that rather than using government to strengthen "negotiations" with insurers and obtain the best options for healthcare plans on Obamacare exchanges on behalf of consumers that instead, in partnership with insurers, Obamacare perpetuated and embraced the insurance company game of narrow networks and restricting patient usage of insurance.

So, in 2015, we were informed by Obama's Administration: "Plans initially offered through the exchanges appeared to have, in general, lower payment rates for providers, narrower networks of providers, and tighter management of their subscribers’ use of health care than do employment-based plans. CBO, Pub. 49973, page 22)."

We also know that Obama basically left big pharma free to do what they've done, raise their prices on more and more drugs putting them out of reach for consumers even as insurers cover FEWER and FEWER of them.

As explained in many places, but specifically in THE HILL on December 15, 2016, by Peter Sullivan: "Obama administration scraps controversial drug pricing proposal," because "[T]he proposal had faced intense opposition from the powerful pharmaceutical lobby, but also from other areas, like doctors groups."

And so, we consumers face ongoing UNDER-INSURANCE, having insurance but still unable to pay for necessary prescriptions to regain-maintain health.

Against this backdrop we get the Des Moines Dems' ideas which will perpetuate and could WORSEN the under-insurance problem of prescription drugs, because of their inability or unwillingness to take on the pharmaceutical industry.

The most time was spent by candidates talking about giving the government the power to NEGOTIATE on behalf of Medicare. While this addresses a current specific prohibition against negotiation on price by government on behalf of Medicare with big pharma, NEGOTIATION is not enough for consumers.

Too often "negotiation" is used by politicians as a throw-away word to protect themselves against failure…"We meant well, but we failed." This worked very well for Obama whose long list of failures were never attributed to bad intention, regardless of the evidence that emerged.

As important as empowering the government to "negotiate" is the requirement there be a clear indication of who they're negotiating on behalf of and what the specific minimum deal they're willing to accept is. This means consumers need more information.

We have our current state of under-insurance for drugs necessary to regain-maintain health and unfortunately,the candidates are still in the Obamacare mindset whereby consumers are supposed to look at long lists of formularies and be impressed rather than notice what's not covered, typically the most expensive prescriptions they MIGHT need to regain or maintain health AND have their insurance product do what it's supposed to do, use consumer money in the form of premium or taxes to cover that RISK.

Without this, we get what we have and worse, paying insurance companies and they're simply keeping that money without paying out for the most expensive needed medical services, devices, drugs, arguably the only reason we need insurance. Worse becomes obvious when we consider the tremendous taxation increases that come from the candidates with their same-old ideas.

Every time we see the "FORMULARY" lists, consumers should be alarmed because we know that by providing a long list of "covered stuff" that likely the most expensive drugs are not included. This is more critical under today's Medicare and under the Sanders Medicare For All because there is NO OUT OF POCKET MAXIMUM for excluded services or drugs. That's why the Sanders bill has private insurance contract provisions, completely outside of government. So, when we see a list, we know we're being conned about "coverage."

To date and through Obamacare, we've been advised to read through these formularies to see if our drugs are on them before we enroll in a plan and we've tolerated this bit of exploitation. Exploitation, because most commonly, we're buying insurance pre-diagnosis, and we're anticipating that INSURANCE works as insurance and covers our risk, otherwise they're just taking money.

Second, even if we have pre-existing conditions requiring a drug, we are not able to pre-determine whether there's a drug that will become FDA approved and become the gold standard during the year, or whether there's another omitted drug that will become necessary because of a drug recall, or whether our drug will be dropped in the next benefits year, and so on. For consumers, formularies are a loser's game.

So formulary peddling is a means of payers controlling THEIR costs, not OURS and if you listen beyond the bragging, the insurance lobbyists and pharmaceutical lobbyists are going nowhere, and the politicians are not standing up to either.

We'll start with Bernie Sanders' Medicare For All Plan because it's actually already a bill in Congress. A good summary of Sanders' plan is much like an HMO, "We'll give you some services and some providers and some drugs, but anything outside what we give you, you're on your own." There is no out of network protection at all.
Sanders provides for the Secretary to determine those drugs that will be covered by Medicare For All, also empowering the Secretary under Sec. 614(b)(4), Payments for prescription drugs and approved devices and equipment, "USE OF OFF-FORMULARY MEDICATIONS.—The Secretary shall promulgate rules regarding the use of off-formulary medications which allow for patient access, but do not compromise the formulary."

This seems to indicate empowering the Secretary even more authority to further place hurdles in front of consumers to obtain even the formulary-approved drugs.

Senator Elizabeth Warren supports the Sanders bill but also floats out the idea of maybe having the government create competition with big pharma by running its own manufacturing by contracting out the manufacturing of generics.

But, Warren's big talk comes up empty as anything but a political manipulation for setting the stage for an Obama-like, "I tried and failed," instead of a real plan. Why? First, because in her brief statements she mentioned only three drug types where she was determined to make drugs more affordable, epi-pens, insulin, and HIV-AIDS drugs. That group was mentioned twice, they won the Warren lottery.

Secondly, Warren's idea for a government drug manufacturer is based on her statement that "…there are a whole lot of drugs, about 90 percent of drugs that are not under patent they're generic drugs. But the drug industry has figured out how to manipulate this industry to keep jerking the prices up and up and up."

However,Warren makes no statement that the imagined government generic drug manufacturer will manufacture all those 90 percent of drugs off-patent would be part of the manufacture, and therefore, like the three drugs Warren names twice, consumers are left hoping their prescription necessary for regaining-maintaining health makes the formulary.

Further, Warren makes it very clear she's not going up against big pharma through the use of price controls, a direct way that government can legislate access to needed prescriptions: "My view is, let's give them a little competition. The government lets contracts for all kinds of things, to build buildings, to build military weapons. Let's let the contracts out so that we can put more generic drugs out there and drive down those prices. Not to try to move away from the market, you don't even have to use price control get drug generics down."

Got it? NOT to try to move away from the market…and "YOU DON'T EVEN HAVE TO USE PRICE CONTROL."

VP Joe Biden seems to want to continue the misery we have. He states, "The proposal I lay out does in fact limit drug costs. It allows Medicare to negotiate with drug companies for the price it sets, a system where you cannot raise the price of a drug beyond the rate of inflation."

Not good for consumers. There is no evidence that government "negotiates" well and while Biden says his "negotiation" will provide for the formulary Medicare drug prices not to go up beyond the rate of inflation, we already know or should know that this means the formulary will shrink for Medicare as big pharma preserves its profits.

Mayor Pete Buttigieg is onboard with the idea to "Allow Medicare to negotiate prescription drug prices."
Further, Pete Buttigieg states: "On prescription drugs we'll have an out of pocket cap even if you don't get the subsidies that would make it free a $250 monthly cap." (That applies to those on Medicare For All Who Want It, and so again, means that the rest of the population is in the same position they were, or worse, because of rising drug prices.)

Obviously, we know or should know that we can also anticipate shrinking formularies as big pharma preserves its profits.

Senator Amy Klobuchar is dreaming small and uses her track record of failure to support it.
She bragged, "And if you talk…about Medicare and having negotiation, I actually have led that bill for years. I have 34 cosponsors. As president, I can get it done--Medicare can negotiate and lift the ban that big pharma got into law that says they can't negotiate better prices for our seniors. I will get it done."

So, admitting that the effort to lift the government ban on negotiation on behalf of Medicare with big pharma has been an utter failure FOR YEARS, Klobuchar makes the leap that somehow as president, she WILL GET IT DONE. Her idea promises more formularies and shrinking formularies with a vague strategy of "negotiation for better prices for seniors."

Tom Steyer stated: "Between what Senator Warren and Senator Sanders said it's clear there are two problems. We're spending way too much, because corporations own the system and we're not negotiating with those corporations and we've given tax cuts to the richest Americans and the biggest corporations for decades…"

OK, so the two problems for Steyer are too much spending (on the part of whom, government or consumers?) and tax cuts to the richest Americans and biggest corporations.

Steyer recommends: "We need to redo Washington, DC and actually take back the government from the corporations who bought it." Steyer's comments, at best, to me, are an unclear contribution to the big pharma discussion.

So what are consumers looking for? Again, if the problem is as Elizabeth Warren stated it, "I started this by talking about 36 million Americans including Americans with insurance who just can't afford to have a prescription filled," the very definition of under-insurance, then the solution must move towards insurance, which we pay for through direct premiums or taxes, that MUST cover the risk of the cost of needed prescription drugs to regain-maintain health.

Obviously, repeating the mistakes of Obamacare on health services, providing a whole bunch of low-level coverages to make up formularies, lists that include certain drugs and exclude others, is bad, a lottery approach to health care much like any list of services.

The major problem with such lists is first of all, insurance companies forced to cover SOME things will, make up those profits somewhere else. Same thing with big pharma, if they're forced to offer certain formulary drugs for cheap, then they'll make it up by raising prices elsewhere.

Piecemeal legislation will make the cost barrier to needed drugs worse for people not lucky enough to land on the winning side of the lottery of "covered" drugs.

So underinsurance is caused by high pharma prices and poor insurance company coverage, much like the problems we have with needed medical services. And, just as is necessary in healthcare reform for those under-insurance problems, governmental authority and power should be used to control the COST of drugs, through price controls, fines, penalties, loss of tax benefits for pharmaceutical companies that fail to cover the most expensive effective drugs for regaining and maintaining health AND…

Government should be using its authority and power to require that insurance companies provide coverage for the most expensive medically necessary prescription drugs.

Anti-monopoly enforcement, price-gouging enforcement, national price controls on any medication, even those under patent, SOMETHING to rein in big pharma.

OR, in terms of a single payer, government, not some new minimum standard junk plan like Obamacare, but instead start at the other END the ridiculously expensive needed medical services and care that are becoming more and more out of reach for consumers, a catastrophic government prescription plan available to individuals with drug needs that exceed a certain percentage of income, where the federal government picks up any cost beyond 20, 30, percent of a family or individual's income.

OR, caps on any prescription drug, not simply those in the formularies (as Buttiegieg supports) with a policy understanding that big pharma will undoubtedly raise the costs of all drugs to reach that cap thereby making every prescription drug cost $250 a month.

Further, lifting the negotiation ban will do nothing without strict requirements of the limits of how much negotiators negotiating on our behalf can give up in order to obtain their deals with big pharma. It's a fool's game to authorize a negotiator with no limits, so that the negotiator can come back with any deal for the sake of saying, "There's a deal," which only bolsters their ego without assuring that it actually IS a deal we can live with.

Similarly, if there is no strategy and methodology for negotiation to reach specifically defined goals, then it's simply an Obama like political maneuver to show, "I meant well, but I failed."

Des Moines Dems on Health Care: The Under-insured, Perpetuating Obamacare's Mistakes

2020-01-21T06:55:00.004-08:00

Obamacare had two major provisions for reaching the "uninsured," Obamacare exchange plans, the biggest part of Obama's plan and the public option of expanded Medicaid for those within certain limited financial guidelines. Obama took the simple view that some insurance is better than none, over-simplifying the problem to the point of coming to the inaccurately strange solution that having health insurance equals having access to health care.

Over simplifying findings of "studies," [like a 2012, New England Journal of Medicine study: “Mortality and Access to Care Among Adults After State Medicaid Expansions,” by Benjamin D. Sommers, Katherine Baicker, Arnold M. Epstein, New England Journal of Medicine, online July 25, print September 13, 2012, that found that “…expanding Medicaid to low-income adults leads to widespread gains in coverage, access to care, and—most importantly—improved health and reduced mortality,"] Obama created a mythology that magically "having insurance" somehow led to better health CARE, instead of reporting the more accurate [and obvious] conclusion that going from uninsured to Medicaid improved access to care and improved health and reduced mortality, because near free costs of obtaining and of USING health insurance led to better health care than having none.

But Obama stuck with his magical over-simplified thinking that having any health insurance improved health, which even the silliest among us knows is untrue, because having health insurance that you can't use because of the expense of deductibles, copays, coinsurance and exclusions means all you have is a card that says you're insured, which does not improve your health.

And so, we know from Obamacare that focusing on the number of uninsured is only relevant if the insurance available actually COVERS the risk of becoming sick or injured. This is the persistent problem of being UNDER-INSURED, a problem that Obamacare arguably worsened by selling the false premise that having insurance was equal to health care, regardless of how little risk was covered.

In fact, with the false premise that having health insurance magically equals access to health care, Obamacare was off and running, and embracing that false concept, went on with its next false concept that having free checkups would improve health even as we saw the cost of TREATING any illness discovered by such free testing skyrocket from the cost of further testing required, to provider care, to the cost of medications.

In other words, the cost barrier represented by the increased costs to consumers of actual needed health CARE skyrocketed under Obamacare. This was for many reasons, but most obviously because the law embraced low-level preventive care guarantees and then merely required that insurance policies cover certain things (10 essential benefits) WITHOUT imposing limits on how those needed services were covered in terms of raising consumer out of pocket costs for deductibles, copays, coinsurance and exposure to increased exclusions from coverage.

OK, so merely addressing the number of uninsured without addressing the under-insured, is a political numbers game and what consumers should look for are candidate solutions to the problem of under-insurance. The problem of under-insurance will not improve under Medicare For All, and in fact could get worse for consumers because Medicare For All washes its hands of anything it doesn't cover and leaves it to the private sector of "INSURANCE CONTRACTS."

To their credit, Bernie Sanders and Elizabeth Warren at least noted the problem of having insurance that is too expensive to use, under-insurance. However, under-insurance under all candidates remains and is perpetuated, much like the Obamacare myth that somehow having insurance is some magical thing that will improve access to health care without paying serious attention to what that insurance covers.

The debate moderator started with a question directed to Bernie Sanders about how Sanders has consistently refused to say how much Medicare For All will cost. "Don't voters deserve to see the price tag?"

Senator Sanders began: "Medicare for all will end the absurdity of the United States paying by far the highest prices in the world for prescription drugs and healthcare in general while we have 87 million uninsured and underinsured and why 30,000 people die each year waiting for health care because of the cost."

While media will try to hone in on the accuracy of 30,000, which is another "maybe" number like all the numbers thrown out, much like the 87 million uninsured and under-insured, or Obama's offered number of 49 million uninsured, Sanders at least acknowledges that the problem is the uninsured AND under-insured if you're addressing cost as a barrier to health CARE, which using his number of 87 million is about TWICE AS MANY PEOPLE as Obama used to justify his plan a decade ago.

But there is a problem with Bernie Sanders and that is that Sanders asserted in the debate that "Medicare For All, which will guarantee comprehensive health care to every man, woman and child will cost substantially less than the status quo." That statement is only truthful regarding the word "COMPREHENSIVE," if you refer to the fact that in the Sanders bill there is a section called "Comprehensive benefits," under Section 201, which are in fact NOT COMPREHENSIVE.

Look for yourself and find out that cancer care, surgery, transplants, all the bankrupting needed services for the sick and injured are NOT included. Which means that Medicare For All's Section 303, private insurance contracts which could easily lead to consumer financial ruin are all the more relevant.(Further consideration in this blog, "2020 New Year Concerns: Why the Hell Are Consumers Trusting Congress on Health Insurance? Part IV").

VP Joe Biden doesn't address the problem of under-insurance in the debate.

Tom Steyer doesn't address under-insurance.

Senator Klobuchar also didn't address underinsured.

Mayor Buttigieg merely embraces the Obamacare mythology that "having health insurance" means having health care and in the debate brags that his priority is, "making sure that there is no such thing as an uninsured American," AND he supports the individual mandate, "because the system doesn't work if there are free riders."

Senator Elizabeth Warren touches on the under-insurance problem stating: "I started this by talking about 36 million Americans including Americans with insurance who just can't afford to have a prescription filled." She goes on to state that she'd make three things more available, and she mentions them twice, HIV-AIDS drugs, epi-pens and insulin. Those are the Warren lottery winners, everyone else is left with Elizabeth Warren's agreement with Bernie Sanders' plan which leaves consumers in physical and financial jeopardy "INCLUDING AMERICANS WITH INSURANCE," which is the very definition of under-insured.

The candidates' statements lead to a single conclusion, COST AS A BARRIER TO NEEDED HEALTH CARE AND SERVICES is not going to improve under their plans.

If the problem of under-insurance is that consumers with insurance STILL can't afford the care they need for medical illness or injury, the ANSWER is to ensure that these costs are covered, whether it's through the product of health insurance or some other government-created mechanism.

No such luck from these candidates.

While they all brag about thinking big for this decade's ideas, their ideas are throwback models of failure, leaning heavily on the weaknesses of Obamacare where service contract type coverage of finite costs of checkups is provided "free" while the bankrupting costs of needed medical services and care leave consumers vulnerable to both physical and financial ruin because of cost.

For all the big talk, our government is NOT ready to actually reform our industrial health complex. There is no talk of ABSOLUTE out-of-pocket maximums, whereby a public funding option is available for individuals who spend a certain amount annually for any NEEDED medical expense that is NOT covered, eg is excluded by insurance that a person carries.
There is no talk about governmentally imposed LIFETIME PRICE CONTROLS on the MAXIMUM AMOUNT that can be charged for any NEEDED MEDICAL SERVICE.

There is no talk about DEBT FORGIVENESS, [much like proposals for the elective choice of student loans,] where if a person pays a percentage of their medical bills, whether it's at once or over a period of years, that the rest of that bill is forgiven.

There isn't even talk about a government policy and plan that prioritizes for government and rewards private insurance companies for effectively going after fraud instead of merely "accepting" the billions of dollars in insurance fraud that are passed on to consumers, or, which, like Obamacare DISCOURAGE efforts to go after fraud with the 80/20 idea that talked about 80 percent of premiums going for payment for claims and 20 for everything else so that going after fraud eats into insurance company profits.

The candidates leave us where or worse off when it comes to under-insurance, paying for health insurance through taxes or direct premiums AND being unable to afford needed medical care and services.

Des Moines Dems on Health Care: SERVICE CONTRACT or INSURANCE?

2020-01-20T06:05:00.001-08:00

What does insurance mean to you? This is really the crux of it, because Obamacare moved us dangerously away from INSURANCE coverage to a service contract, the coverage of a bunch of finite-cost checkups, screenings that were used by insurance companies as yet another justification to RAISE premium prices. No thank you. Finite costs of an inspection, a checkup, a screening are not INSURANCE. We pay the increased cost of a premium to insurance companies for the financial risk of UNKNOWN expenses that might arise as a result of illness or injury.

This decade's dem plans continue and worsens the financial barriers to obtaining needed medical care and services for consumers through the SERVICE CONTRACT MODEL of Obamacare. The Obamacare model INCREASED cost barriers to NEEDED medical care because they first, allowed insurers to raise PREMIUM prices for the coverage of finite one-off costs of checkups and second, because Obamacare also allowed insurers to decrease coverage of needed medical services in the form of USING our health insurance for illness or injury through higher deductibles, higher copays, higher coinsurance, and increased numbers of exclusions.

The candidates on stage promise to continue and worsen this dangerous service contract trend by calling service contract provisions "Insurance" items. So, what's covered? The answer is, "Less than what we need as consumers."
How do we know? The question wasn't even addressed, but what we do know is that we can read the candidates' plans. Bernie Sanders' plan is actually a bill, S.1129, not merely a "plan," so that's the one to watch, for now.

Joe Biden and Tom Steyer are still supporting Obamacare, the service plan versus insurance coverage model.

Most noteworthy on this issue is Bernie Sanders' Medicare For All Bill that Senator Elizabeth Warren also supports.
Under the Sanders bill the problem of service contract coverage for more money at the expense of coverage of the RISK of needed medical services gets worse, because Medicare for All simply says nothing will be covered except for those items chosen by the Secretary. Everything else, every other needed medical service will have to be covered by PURCHASING an insurance contract with an insurance company offering such coverage, such as the supplemental plans under Medicare today, or the consumer will have to pay whatever a provider charges, using another contract, without limits as to what the provider charges.

So, what should consumers demand, in addition to demanding that we be charged insurance premiums for the RISK of needed healthcare services instead of being charged premiums for the one-off costs of an annual inspection in the form of screenings and checkups?

We should be demanding that public employees, like Congresspeople be forced to live with the laws they're advocating for the rest of us as the basic test of determining whether we're being conned. Had we done this with Obamacare, we would have realized how bad the law was.

Obamacare's untruths were immediately apparent as its public employee and lawmaker advocates made very sure that they wouldn't have to suffer under the Obamacare plan.

How did they do it under Obamacare? They effectively provided an exemption to the very people making the law. That exemption was using their status as public employees, therefore making the federal government their employer, and thereby enabling the federal government to make provisions for their healthcare that were far superior to ours in terms of special health plan options for them and special payment provisions whereby taxpayers pay for the bulk of their premiums.

As consumers who have EXPERIENCED Obamacare, we do or should know that the word OPTION should jump out at us as a RED FLAG that public employees and Congress aren't joining us in this new decade's "experiment," but rather will make sure their "employer," the federal government, continues their superior benefits with OUR money.

We can dismiss BIDEN'S plans for positive consumer reform in terms of closing up the public employee loophole as he intends to continue the Affordable Care Act and "provide a public option, Medicare for those folks who want it." In other words, he's not bound by the law he's touting for us.

Tom STEYER agrees "…with Biden," Affordable Care Act with public OPTION. OK, so public employee, Congresspeople continue their superior benefits off our backs.

Mayor BUTTIGIEG also fails consumers with his plan, "Medicare For All who want it." Yep, an option, and you bet as a Veteran and public employee that he's sticking with his health insurance over what's good enough for the rest of us.

Senator Elizabeth Warren is with Bernie Sanders and they also fail consumers. Medicare For All, seemingly brings public employees under Medicare For All. BUT, not true. Sanders also provides for superior employer plans (there's that federal government as employer lingo)where employers can provide additional coverage, in the form of paying for insurance contracts for Medicare style supplemental policies to cover all the stuff that won't be covered. This is the Sanders Insurance Contract.

This means that in addition to the crappy Medicare For All Coverage, anyone can pay for additional insurance coverage plans OR employers could choose to provide them as a benefit…Whoops. Not OK, been there done that, no doubt Congress will make sure they have those cushy benefits.

Senator KLOBUCHAR pretty much confirms the cushy status of public employees, including Congress, when she stated to Bernie Sanders: "Over two thirds of the Senate are not on the bill that you and Senator Warren are on," (which makes sense, they're not voting away their superior benefits) and instead proposed "a nonprofit public option." Whoops, there it is again, OPTION.

Unfortunately, Congress will "represent" us the same way it did for Obamacare, deciding what's good enough for the rest of us AFTER making sure their self-interests are preserved, that their superior benefits, paid for by taxpayers are protected.

This means that without calling the candidates out and demanding change, this practice continues to our detriment. Public employees must be bound by whatever "new reform" they come up with, without the escape hatch of increased wages to cover increased costs, or superior benefits created by their "employer" the federal government, once again keeping public employee Congress out of living the nightmare imposed on us.

2020 New Year Concerns: Why the Hell Are Consumers Trusting Congress on Health Insurance? Part IV

2020-01-08T12:35:00.003-08:00

Part IV addresses the October, 2019 findings that more children are uninsured in the years 2016 through 2018, which are already being used in partisan politics in 2020 campaigning.

Here it's pretty obvious that the number of uninsured, the argument relied upon to justify many of Obamacare's features, including the individual mandate, even when the uninsured are children, should NOT be a reason to vote one way or the other necessarily.

We're already living with the consequences of President Obama's approach of over-simplifying the health industrial complex problems facing consumers into "the number of uninsured." That has already proven to be a focus that might sound great politically, but in reality made the barrier of cost to access to needed health CARE services, in many instances, worse, even for those with insurance.

Number of Uninsured is NOT the key cause or solution to COST as a Barrier to Needed Health Care Services:

Flashback: Obamacare focused on the number of uninsured, as if lack of health INSURANCE was the primary factor responsible for COST of CARE becoming a barrier to access to needed health care. Some might still nod their heads at this assertion, ignoring the dangerous consequences of concluding that merely getting more people insured is a solution to the cost barrier to needed medical care instead of a focus on the type of health INSURANCE that would protect people from the financial risk of ruin from illness or injury.

Obviously, to the extent insurance FAILS to cover the costs associated with illness and injury and thereby prevent financial ruin, it is a less useful tool and therefore, merely having insurance does NOT prevent COST from being a barrier in obtaining needed medical services.

It cannot be argued that this was an Obama "mistake," because Congress and Obama made very certain, from the outset, that their health insurance would be not only remain superior in its coverage compared to what they deemed good enough for the rest of us, but that taxpayers would continue to pay for their public employee superior coverage. Ignored but known, Obama distracted the public from the fact that the quality of health insurance coverage and its cost matter as much or MORE than merely "having" health insurance.

Flash Forward: Medicare For All continues the dangerous trend of focusing on getting people insured rather than making sure that the health insurance product does what it's supposed to, protect consumers from the financial ruin IF they need medical services. Like Obamacare, there are no promises to make the consumer financial product of health insurance adequate to protect us against the financial risk of illness or injury, AND Medicare For All gives government even more authority and decision-making power on what our health CARE options will look like, specifically with enormous powers granted to the Secretary of HHS:

Go to Section 401(a)(1), Administration: "The Secretary shall develop policies, procedures, guidelines, and requirements to carry out this Act, including related to— (A) eligibility for benefits; (B) enrollment; (C) benefits provided; (D) provider participation standards and qualifications, as described in title III; (E) levels of funding; (F) methods for determining amounts of payments to providers of covered services, consistent with subtitle B; (G) the determination of medical necessity and appropriateness with respect to coverage of certain services; (H) planning for capital expenditures and service delivery; (I) planning for health professional education funding; (J) encouraging States to develop regional planning mechanisms; and (K) any other regulations necessary to carry out the purpose of this Act.
(2) REGULATIONS.—Regulations authorized by this Act shall be issued by the Secretary in accordance with section 553 of title 5, United States Code."

Further, under section 201, the Secretary is authorized "on a regular basis, evaluate whether the benefits package should be improved or adjusted to promote the health of beneficiaries, account for changes in medical practice or new information from medical research, or respond to other relevant developments in health science, and shall make recommendations to Congress regarding any such improvements or adjustments." (Sec 201 Comprehensive Benefits, (b) Revision and adjustment)."

Note, in addition to Medicare For All's enormous power and authority granted to the HHS Secretary, there appear to be no time limitations on how long Congress can take to assess and act on those HHS Secretary 201 recommendations EVEN IF THEY ARE essential for consumers. Medicare For All therefore creates a worsening two-fold problem, governmental overreach and dependence on a functioning Congress to make needed adjustments to protect consumers.

Cost Sharing:

Flashback: Obamacare resulted in increased cost sharing by consumers. Not only did consumers see steep increases in their deductibles, copays and coinsurance, but insurers increased the prices of premiums for their plans upwards of over 100 percent, in many cases.

Of course, these increases for exchange participants were disguised through the Obamacare government payments in the form of premium assistance, and for some, government cost-sharing provisions, yet STILL COST, even the reduced cost to participants on exchanges didn't prevent the COST of obtaining and using health insurance from remaining a persistent hurdle for consumers purchasing Obamacare exchange plans.

We know this from outcomes, first and foremost that in 2020 no candidates support Obamacare as is and instead are talking about either improving, replacing or repealing it.

We also know from reporting on enrollment in Obamacare exchange plans the such enrollment overall has never met promises or expectations and that even enrollment among all metal level plans has indicated that consumers sought cheaper bronze plans if they could, if they were healthy, specifically, which provide premium assistance, federal money for buying insurance, but unlike silver plans do not provide the option of the added benefit of cost sharing funds for USING health insurance for enrollees within lower income guidelines.

We also know that in 2015, Obama's Administration raised the prices for silver plans, but a lot less than prices were raised for bronze plans in that benefits year to further lure people into silver plans by offering better "value."

We also know that Obama's Administration changed the law regarding short-term health insurance plans, restricting those plans in 2015, in another effort to get people onto exchange plans.

Flash Forward: Without even attempting to calculate the tax increases that likely will be never-ending to support Medicare For All, what we are informed of is that OUT OF POCKET PAYMENTS could very well skyrocket causing more financial ruin for citizens under Medicare For All than we have now (where already 66 percent of bankruptcies include medical expenses as a cause).

This is for two reasons, first, because we have an unlimited tax increase potential as government determines what funding is needed and secondly because Medicare For All is presented as a bare minimum preventive care plan, primarily, with specific provision of all the uncovered services, drugs, and needed medical care being covered by the PURCHASE of private supplemental insurance plans with no limitations on what's charged for such supplemental coverage and-or the cost of services these private supplemental "contract" plans cover.

Even under Medicare For All, in Section 202, No Cost-sharing, we find that (a) The Secretary shall ensure that no cost-sharing, including deductibles, coinsurance, copayments, or similar charges, be imposed on an individual for any benefits provided under this Act, except as described in subsection (b).
(b) Exceptions.—The Secretary may set a cost-sharing schedule for prescription drugs and biological products." 202 (b)(1)(a) notes that such cost sharing be limited to $200 per person each year, adjusted annually for inflation.

We've already got experience with the Federal government determining our out of pocket limits. Under current law, this number has jumped significantly. In 2011 the out of pocket maximum for self-only was $5,950, and for a family was 11,900. As of 2020, it is 8,200 for individual plans and 16,400 for family plans.

We might be tempted to say, "Well, 200 bucks is a lot better than the thousands of today," but remember, Medicare For All doesn't EVEN CONSIDER all the out of pocket expenses to consumers purchasing private health insurance contracts for uncovered services, which we know will be an enormous part of insurance purchasing because of the bare minimum coverages of Medicare For All, AND we know that there is no LIMIT to what can be charged not only for those supplemental insurance coverages, but for the health care services provided for under those contracts.

Further, we have no idea how much our taxes will go up to cover the costs of the bare-minimum Medicare For All coverage, but we do know that cost sharing of at least 200 bucks per person per year for prescription drugs and biological products is built in, with provision for increases in that amount for inflation.

Flashback: Obamacare did not address balance billing or surprise billing except for emergency stabilizing treatments in emergency rooms. Today, we see that Congress is still "working" on a federal fix to balance billing (and surprise billing) though many states have begun to address this devastating financial risk to consumers.

Flash Forward: Under that same NO COST SHARING section 202 of Medicare For All, (which actually provides for cost sharing) we are also promised no balance billing: 202 (c)Notwithstanding contracts in accordance with section 303, no provider may impose a charge to an enrolled individual for covered services for which benefits are provided under this Act.

Basically, Medicare For All as outlined is like an HMO, authorized providers giving authorized services (as yet unknown and always subject to change by the HHS Secretary), and likely pretty "basic," meaning lots of preventive stuff with inadequate opportunities for real care for NEEDED medical services are not subject to balance billing, everything else, you're on your own.

An enormous part of medical services are likely NOT to be covered by Medicare For All, and only covered by private insurance contracts, which is why the law spends much time in describing such contracts under section 303.

Starkly drawing a difference between balance billing (those charges uncovered by insurance for which a consumer is financially responsible) and surprise billing (those charges uncovered by insurance for which a consumer was unaware," Medicare For All only prohibits SURPRISE billing.

Let's get to that Sec 303: Use of private contracts. Subject to the provisions of this subsection, nothing in this Act shall prohibit an institutional or individual provider from entering into a private contract with an enrolled individual for any item or service" as long as neither the provider, his institution or we, the consumer are making any claim that such service is covered under the Act, which we already know or should know will be the bare minimum as outlined in the Act's "list."

This one goes to the heart of our financial ruin.
Section 303 reminds consumers under (2)(C) that the beneficiary (consumer) "acknowledges that no limits under this Act apply to amounts that may be charged for such items or services," and that consumers are ultimately responsible for the costs charged by providers.

Medicare For All legislation advises us that what providers charge for such services covered by contracts is UNLIMITED as long as the consumer signs a contract saying they're aware of the cost and that they the consumer know they the consumer are responsible for it.

This is even more financially risky because outside of the Medicare For All basic insurance, consumers who purchase policies to cover these UNLIMITED expenses from insurance companies will not be protected by how much can be charged in premiums or copays or coinsurance or deductibles.

This alone should be enough to warn people off the Medicare For All as outlined by Bernie Sanders in his bill.

So what about that specious argument to vote one way or another because of a growing number of uninsured children?

Flashback: Even with Obama fans' determination to boost Obama's long list of failed promises about Obamacare by narrowing and focusing on the singular goal that Obamacare would "solve" the problem of the uninsured, we know even this didn't happen. There remain millions upon millions of people without health insurance, including the increase of children uninsured.

Flash Forward: Although conceivably, all would eventually have insurance under Medicare For All, we cannot be certain because we know all the changes to Obamacare that occurred after the law's enactment changing the original law. See https://galen.org/2016/changes-to-obamacare-so-far-3/, which includes "43 that the Obama administration has made unilaterally, 24 that Congress has passed and the President has signed, and 3 by the Supreme Court," 70 Changes to Obamacare… — So Far," POSTED BY Grace-Marie Turner, January 28, 2016.

What we do know is that under section 106, Medicare For All promises an effective date of FOUR YEARS after the law's passage (though for children under 106(b) coverage (through age 19) would begin January 1 of the first year after enactment, leaving plenty of time for similar changes to the proposed law.

There is no reason to suppose that President Trump has been worse for children than President Obama when it comes to health insurance. Actually, arguably the opposite is true.

Here we'll go to one of those October, 2019 anti-President Trump articles that desperately tries to lay the "blame" for the increased number of uninsured children at the Trump Administration's feet, an October, 2019 report out of Georgetown by Joan Alker and Lauren Roygardner, "The Number of Uninsured Children is on the Rise," https://ccf.georgetown.edu/wp-content/uploads/2019/10/Uninsured-Kids-Report.pdf. All cites will be from this report unless otherwise indicated.

The article begins: "From 2016 to 2018 there were more than 400,000 more children uninsured in the United States." OK, so from one year before Trump's presidency, which began on January 20, 2017, the number of uninsured children has been on the rise. That's right, from BEFORE Trump was President.

Spoiler alert, to get to the meat of the report's partisanship reasoning let's go straight to the report's conclusion:
"This serious erosion of child health coverage is likely due in large part to the Trump Administration’s actions that have made health coverage harder to access and have deterred families from enrolling their eligible children in Medicaid and CHIP.

These actions include attempting to repeal the ACA and deeply cut Medicaid, cutting outreach and advertising
funds, encouraging states to put up more red tape barriers that make it harder for families to enroll or renew their eligible children in Medicaid or CHIP (or ignoring it when they do), eliminating the ACA’s individual mandate penalty,
and creating a pervasive climate of fear and confusion for immigrant families. That has left many of these families
reluctant to enroll their (largely) citizen children in public coverage for fear of having this held against them."

OK, let's get rid of the easiest fallacy first, that somehow eliminating the ACA's individual mandate penalty increases the number of uninsured children. Financially this makes little sense since the individual mandate penalty funds collected by government are not destined to be spent on healthcare. As a matter of fact, it's unclear where these penalty dollars are spent by government. So, unless this is a sneaky way of arguing for a higher individual mandate penalty, which many Democrats have advocated because people chose to pay the penalty rather than purchase health insurance, this is not persuasive.

Nor is it persuasive that the argument that the repeal of the individual mandate accounts for the increased cost of Obamacare exchange plans, thereby somehow increasing the number of uninsured children. Most obviously, because the elimination of the individual mandate penalty was not effective until 2019, meaning that only for 2020 tax filings might the elimination of such penalty come into play.

Further, if partisans try to stretch it further and claim that anticipation of actions attempting to repeal Obamacare somehow influenced individuals' annual choice of health insurance for a year prior to President Trump's presidency or that elimination of the individual mandate encouraged people to opt out of purchasing health insurance, somehow retroactively inspiring insurers to raise prices for consumers on Obamacare exchange plans, this would be a lie.

Obama's own government told us that Obamacare plans would continue to rise in price way back in 2015, long before Donald Trump and before the 2016-2018 statistics of more uninsured children.
That's right, in 2015, Obama's Administration, Congressional Budget Office stated, "For the years 2016-2018 the cost of silver plans on the exchanges is expected to rise “…at an average rate of 8.5 percent per year… for two reasons: REINSURANCE PAYMENTS THAT THE GOVERNMENT MAKES TO INSURANCE PLANS whose enrollees incur particularly high costs for medical care WILL BE PHASED OUT over the next two years, placing upward pressure on exchange premiums [AND] PLANS INITIALLY OFFERED THROUGH THE EXCHANGE APPEARED TO HAVE, in general, lower payment rates for providers, NARROWER NETWORKS of providers, and TIGHTER MANAGE OF THEIR SUBSCRIBERS' USE OF HEALTH CARE than do employment-based plans. CBO and JCT anticipate that many plans will not be able to sustain such low provider payment rates or such narrow networks over the next few years, placing upward pressure on exchange premiums.” (CBO, Pub. 49973, page 22). [caps added].

It wasn't the only warning issued by the CBO under Obama: "Private Health Insurance Premiums and Federal Policy," https://www.cbo.gov/sites/default/files/114th-congress-2015-2016/reports/51130-Health_Insurance_Premiums.pdf:
"Over the period from 2005 to 2014, premiums for employment-based insurance grew by 48 percent for single coverage and by 55 percent for family coverage. CBO and JCT expect them to grow at similar rates over the next decade." -CBO

That's right, premiums went up by 55 percent for families from 2005 to 2014, that's according to the CBO under Obama, and there was NO SLOWDOWN of those increases anticipated by Obama's Administration over the next 10 years, so doing our math, that brings us to 2024. Not at all an indication that President Trump had much to do with premiums rising.

Back to the Georgetown report's next claim blaming Trump for more uninsured children: "These actions include attempting to repeal the ACA and deeply cut Medicaid," both cited by the report as apparently creating the increased number of uninsured children from 2016 to 2018. This must also be immediately dismissed because note the magic word "attempting." In fact, the ACA is not repealed and Medicaid has not been deeply cut.

Back to the Georgetown report's next claim: "…creating a pervasive climate of fear and confusion for immigrant families. That has left many of these families reluctant to enroll their (largely) citizen children in public coverage for fear of having this held against them." This is just straight-up partisanship drivel since even the irrationality of Trump haters can't blame the President for immigrant families not enrolling their children in public health insurance for which they're eligible.

Remember under Obamacare, (see healthcare.gov), "Immigrants who are 'qualified non-citizens' are generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if they meet their state’s income and residency rules." There were already restrictions under Obamacare for non-citizens only, also not singling out their citizen children at all beyond state residency requirements that apply to all.

Contrary to its own reasoning, the Georgetown report under the heading "Sources of Coverage," states that In 2018, the largest source of coverage for children continued to be employer-sponsored insurance, though there was no statistically significant change between 2017and 2018 despite the continued strong economy and low unemployment rates."

The report acknowledges a strong economy and low unemployment, in addition to the fact that most children are insured through their parents' employer sponsored health insurance.

Obviously then, changes to employer-sponsored health insurance that would discourage dependent coverage of children would contribute to more uninsured children.

Well, that's Obama's gimmick of the family glitch, unaddressed and uncorrected for a decade because it would cost the federal government too much to fix. The family glitch also NOT President Trump. The family glitch gets a dismissive mention by the Georgetown folk: "The 'family glitch' may be contributing to the difficulties that families are facing in accessing marketplace subsidies."

Difficulties accessing marketplace subsidies to insure their children? That IS the family glitch under Obamacare, because employees who have access to affordable employer-sponsored self-only health insurance are INELIGIBLE for premium assistance if they purchase an Obamacare exchange plan.

This left full-price individual insurance plans, short term health insurance or CHIP to cover these employees' children. (Which is addressed further on.)

The Georgetown writers assert: "Children from higher-income families are also seeing increases in their uninsured rates, though those rates are still considerably lower than the national average. This likely reflects the rapidly increasing cost of employer-sponsored family coverage, reduced participation in subsidized Marketplace coverage, and the repeal of the individual mandate penalty."

As noted, the rapidly increasing cost of employer-sponsored family coverage was part and parcel of Obamacare, predicted by Obama's own government for many years. The family glitch, we know is laid at Obamacare's feet and remains ignored and uncorrected for a decade. We've already addressed the "repeal of the individual mandate," which only took effect for year 2019, tax filing in April, 2020.

What about families that tried to deal with gaps in insurance from unemployment or inability to afford employer-sponsored dependent coverage or individual marketplace plans for whatever reason by choosing to purchase short-term health insurance as a stopgap for making that decision?

Well, we know that it was Obama's administration in 2015 considered that a "loophole,' a means of avoiding participating in the marketplace and instead of expanding premium assistance coverage to such "ineligible families," the Obama Administration in 2015 severely restricted the availability of short-term plans. That Obama decision, President Trump has reversed.

But what about CHIP, that plan that covers children whose parents earn too much for Medicaid but still fall within some income requirement guidelines? This is where the "report" gets even more twisted in its reasoning. Switching to public insurance, Medicaid/CHIP, the report states that Medicaid/CHIP "administrative data clearly show that Medicaid/CHIP enrollment has declined substantially for children."

The report states that "children from low- and moderate-income families earning between 138 percent and 250 percent of the federal poverty level ($29,435 - $53,325 annually for a family of three) had the sharpest increase in their
uninsured rate and the highest uninsured rate compared to other children. Most of these children are likely eligible for Medicaid or CHIP but not currently enrolled."

Well, if they're eligible but not enrolled, that isn't on Donald Trump unless you argue that by reducing the budget for advertising for Obamacare, President Trump is somehow responsible for uninsured children. This seems pretty unlikely primarily because MEDICAID AND CHIP do not have an OPEN ENROLLMENT PERIOD. You CAN APPLY FOR MEDICAID OR CHIP AT ANY TIME.

Instead of partisan politics, a little reality check indicates that Obamacare actually wanted to get rid of CHIP and anticipated moving those children either into expanded Medicaid or onto Obamacare exchange plans.

FLASHBACK: Though often categorized together, Medicaid and CHIP, the children's health insurance program, are not the same in some very important ways. CHIP typically covers children whose families do NOT MEET the poverty level required for Medicaid. That's right, CHIP usually requires different income guidelines so the threshold for obtaining CHIP is usually less restrictive in terms of limits on income, eg those with higher incomes can utilize CHIP. CHIP also often includes state residency requirements.

As KHN.org explained in 2014, "ACA And The Children’s Health Insurance Program," https://khn.org/news/aca-and-the-childrens-health-insurance-program/, "The Children’s Health Insurance Program (CHIP) was enacted in 1997 to extend health coverage to children in poor families with modest incomes too high to qualify for Medicaid. The Affordable Care Act now offers many of those same families federal subsidies through the health insurance exchanges, calling into question whether the program should be continued over the long term."

However, as we know, or should know, Obamacare plans were always considered still too expensive by many, including the vast majority who received premium assistance, and especially for families unlucky enough to be victims of the family glitch who were ineligible for premium assistance, making it obvious that some preservation of the old CHIP program was necessary. Although Obamacare deemed the CHIP program dispensable and thereby merely included funding only through 2015, with a provision that after that Congress would have to authorize additional funding, under President Trump, in 2018, Congress funded CHIP for a full decade, that's right, 10 years.

The article concludes that "There are no signs that this disturbing trend in children's health coverage will abate unless national and state leaders fully rededicate themselves on a bipartisan basis to the goal of ensuring that all children have access to affordable, comprehensive health insurance."

Ah, and therein lies the next problem. Medicare For All will not be comprehensive health insurance, which should be pretty obvious if you read Section 201, Comprehensive Benefits which continue the trend of listing coverages, many of which are preventive rather than NEEDED medical services. Further, Medicare For All anticipates the inadequacy of its basic coverage with its Section 303, Use of Private Contracts provisions.

In other words, Obamacare created the conditions that could foreseeably cause an increase in uninsured children with his "vision" of doing away with CHIP and moving everyone onto exchange plans or into Medicaid, with the uncorrected family glitch, meaning that even those who couldn't afford dependent coverage might shop on exchanges but were ineligible for premium assistance, by limiting the availability of using short-term health insurance which might provide some protection to children whose parents earned too much for Medicaid but could not be insured under another program.

Medicare For All as proposed, will, like Obamacare focus on making sure everyone has some kind of health insurance, and therefore in its simplest terms could address the "problem of the uninsured," including the "problem of uninsured children." However, as written, Medicare For All will not likely protect children who are ill from the cost of treating their illness because it continues the Obamacare preventive care focus at the expense of truly protective illness/injury coverage and because private contracts will likely be necessary for purchase in order to obtain meaningful risk coverage, much like today's Medicare supplemental insurance, and because such uncovered services by Medicare For All will remove any limits to how much can be charged both for the supplemental policies and by providers to people who purchase such plans.

Under Medicare For All, there is also the "idea" that everyone, even public employees will have the same coverage within Medicare For All, but like Obamacare, it is unlikely Congress will legislate away their superior benefits paid for by taxpayers. Read carefully, Medicare For All anticipates getting rid of the Title 5 chapter 89 of United States Code for federal benefits, it doesn't say there won't be new ways enacted by Congress for public employees to be funded by taxpayers.

In fact, it's obvious from our Obamacare experience that public employees and Congress will protect themselves through the excuse that the federal government is an employer, and therefore, as an employer can choose to provide superior benefits to employees, including Congress who not only just happen to pass the laws for themselves, but are funded by taxpayers for those choices. Even without the "employer" door, old-time tricks of increases in their salaries to cover those "uncovered" costs, or other money allotments to cover the cost of purchasing supplemental plan style contracts funded by taxpayers could easily be used by Congress.

The federal government has proven itself inadequate in addressing the cost as barrier to needed medical services problem in the US. These risks to children's health and all of our health continue with each party's proposals and rather than being a justification to vote one way or the other, should be an inspiration for consumers to focus on what we need from the product of health insurance in order to make it a useful tool in protecting us from the risks of financial ruin that today accompany illness or injury and then communicate that to our government representatives.

2020 New Year Concerns: Why the Hell Are Consumers Trusting Congress on Health Insurance? Part III

2020-01-02T07:52:00.001-08:00

We were lectured by the Affordable Care Act's boosters, key among them President Obama, that reducing the number of uninsured was a chief goal that depended on decreasing COST barriers to obtaining health insurance. Like so many Obama statements, the use of a study cited to support this idiotic claim that merely having health insurance would solve our problems of cost barriers to obtaining health care, as if health insurance is some magical amulet rather than a consumer financial product that varies in what it provides and how much it costs, was manipulated into justifying Obama's agenda of amorphously "reforming" health care with the Affordable Care Act which in most measurable ways has made the COST barriers for the majority of Americans worse.

In Obama's repetitive self-promotion of the false equivalency that "health insurance=health care" it's increasingly clear that Obama deliberately misled consumers. Obama didn't accurately state what the findings of the study were. [See What if I Said that "Obamacare Was Killing Americans"? http://conoutofconsumer.blogspot.com/2015/02/what-if-i-said-that-obamacare-was.html].

The study used to justify the Obama government con that health insurance=health care was 2012 research, “Mortality and Access to Care Among Adults After State Medicaid Expansions,” by Benjamin D. Sommers, Katherine Baicker, Arnold M. Epstein, New England Journal of Medicine, online July 25, print September 13, 2012, that found that “…expanding Medicaid to low-income adults leads to widespread gains in coverage, access to care, and—most importantly—improved health and reduced mortality.”

Now with Obama in our rearview mirror, it should be less difficult for his protectors to notice that the "study" actually found that basically free health insurance (Medicaid) with basically free health care (Medicaid services) led to gains in coverage (some health insurance versus none) and access to basically free care, improved health and reduced mortality. It was not the FACT of simply having or not having insurance, but the FACT of what that insurance provided, meaning that the affordability of care was as integral as the affordability of purchasing health insurance in order for the study to prove anything.

Having no health insurance did not impact health EXCEPT to the extent it meant you could not afford health CARE. Similarly, having all the health care available to you in the world is only useful if you can AFFORD it, and health insurance was one way people afforded health care. The two are integrally tied together, health insurance doesn't equal health care except to the extent it covers the COSTS of needed health care. Obamacare worsened both and therefore INCREASED barriers to health care with increased costs.

So, the study found, unremarkably, that getting needed medical care improved health and reduced mortality and that when both obtaining Medicaid and getting that care is free, COST barriers are reduced and health and longevity improve. This is NOT AT ALL what Obama and Obamacare was selling with the false equivalency justifying the real meat of Obamacare, the creation of health exchanges.

Flash Back: With the false equivalent that health insurance = health care, Obama was off and running with the myth that having any health insurance would naturally improve health care, a fallacy because if you can't afford care, you are facing a cost barrier whether or not you have health insurance, therefore the QUALITY of that health insurance in terms of coverage matters. This part of the con is also borne out today as up to 66 percent of US bankruptcies cite medical expenses as part of the reason for families' financial ruin and most of those individuals HAVE health insurance.

Obamacare ignores that Obamacare WORSENED the COST BARRIER TO HEALTH CARE FOR THE MAJORITY OF AMERICANS WITH EMPLOYER SPONSORED HEALTH INSURANCE. Obamacare and its deals with insurance companies ended up in increased premiums (the cost of obtaining health insurance) and increased cost of using health insurance for getting needed medical care (increased copayments, coinsurance payments, higher deductibles) for the majority of Americans.

The cost of OBTAINING health insurance went up over a hundred percent in most cases, which as recently as 12/16/2019, Drew Altman noted the increased costs of private insurance https://www.axios.com/health-insurance-costs-private-medicare-medicaid-c40bb6f1-c638-4bc3-9a71-c1787829e62e.html. And the cost of using health insurance also has left Americans in need of medical care and services in increased financial jeopardy.

Even the LA Times, which bent over backwards to justify all things Obama including Obamacare, noted in May of 2019, in an article by Noam N. Levey, "Health Insurance Deductibles Soar, Leaving Americans with Unaffordable Bills," https://www.latimes.com/politics/la-na-pol-health-insurance-medical-bills-20190502-story.html, stating that of those polled with employer-based health insurance "Half said that costs had forced them or a close family member to delay a doctor's appointment, not fill a prescription or postpone some other medical care in the previous year."

Still eager to never criticize Obama, the article implied it was simply an oversight and that "as Democrats and Republicans fought over the law, Altman said, neither focused on the rapid run-up in costs for people covered through work." [LA TIMES, 5/2/2019, Noam N. Levey] in other words, lawmakers were stupid.

Hold it right there. This claim is not supported by the facts which more closely support an assertion that OF COURSE Obama's Administration knew they were screwing the majority of Americans by creating the entitlement program of Obamacare exchanges with the false equivalency that any health insurance improved health care, even if the insurance is so bad that it leaves individuals unable to afford to get needed medical care.

Instead, Obama prioritized his political agenda and focused on the falsehood that ANY HEALTH INSURANCE improved HEALTH CARE and therefore the fewer number of uninsured there were, the healthier the population would be. Nonsensical. If you can't afford to use your health insurance because like Obamacare it costs you more than you can afford to get NEEDED HEALTH CARE, then health insurance is meaningless EXCEPT for satisfying the political agenda of a President like Obama. This is borne out by the LA Times poll of December, 2019, "Half said that costs had forced them or a close family member to delay a doctor's appointment, not fill a prescription or postpone some other medical care in the previous year."

Obama KNEW his false equivalency was a lie, otherwise he wouldn't have made sure that public employees like Congress not only got taxpayer funded health insurance, but that those plans provided superior coverage to the garbage that was deemed good enough for the rest of us.

So early on we got duped into believing that ANY insurance would improve access to health care because of the false equivalency laid out by Obama et al that health insurance=health care, therefore having health insurance meant you had health care. Clearly not true and only used by Obama as a means of claiming that reducing the number of uninsured was the solution Americans needed.

Obama ignored the quality of the insurance necessary to make that claim true…Health insurance is a tool to help us afford needed medical care, if we can't afford needed medical care with health insurance then it is a failed tool. Therefore, having mislabeled the problem as one of merely having health insurance, and thereby misidentifying the solution as just making sure people were insured without caring that his ideas encouraged insurers to cover less and charge more, Obama worsened the problems facing the American public in need of medical services.

And if they knew then, as outlined below, then they know NOW as the same garbage is included in Medicare for All that will again injure consumers and further worsen COST as a barrier to needed health care for the majority of Americans.

Obama claimed that his exchange plans sought to "equalize" the playing field for consumers (NOT public employees like himself, just other consumers). Obama supported a law that established bare minimum, low-hanging fruit coverage for individual insurance shoppers (the exchanges) as an entitlement that the rest of us would pay for to address those "uninsured." So the exchanges began.

First, using taxpayer money, Obama had to figure out how to get insurance companies to offer plans on his pet project entitlement, the exchanges, and since this was not group insurance, the government wasn't negotiating but arranged for a legislative quid pro quo for insurance companies: The law promised that if insurance companies participated on exchanges then the Federal government would make sure they didn't lose money. That was the three Rs, reinsurance, risk corridors and risk adjustment. The first two of which were temporary, only through the end of the 2016 benefits year.

Not only did Obamacare establish a new low bar for insurance coverage opening the way for employers to glom onto savings (but not the FEDERAL GOVERNMENT 'EMPLOYER') by providing cheaper options to their employees with the same low-bar coverage, but Obamacare intended to PENALIZE employers who provided better coverage (remember the Cadillac tax that never was put into practice that would put a 40 percent tax on generous employer-provided health insurance plans?) clearly indicating that Obama, having misidentified the problem as not having insurance, didn't care about the quality of insurance that people had (outside of public employees like Congress) because his political goals merely meant he'd declare victory as long as he reduced the number of uninsured.

Then Obama had to figure out more ways to force people to purchase besides having enacted legal penalties by federal law if we didn't (the individual mandate). Obama's Administration realized they weren't getting enough forced purchases by the law as it stood and went to court to expand who was forced to purchase off exchanges in King v. Burwell, which the government won in expanding the credits of "state-established exchanges" to the federal government in states that didn't establish exchanges. Still enrollment was low and lopsided, with money-conscious consumers forfeiting the discount in cost sharing available on more expensive silver plans and opting instead for bronze plans with premium assistance only. In 2015, Obama's Administration did two more things to try to force people onto his exchange vision, raising the cost of bronze plans significantly more than those of the silver plans to try to get people to enroll in more silver plans and further restricting the availability of short-term health insurance which was capturing a portion of the population unable to overcome the COST barrier of purchasing exchange health insurance.

Obama's Administration even unapologetically counted fraudulent enrollees to keep those enrollee numbers up. When Obama's own government called the Administration out for fraudulent applicants and enrollees in Obamacare, CMS revealed it didn't worry about fraud. In 2015, CMS explained to the GAO regarding its findings: "According to CMS, its document processing contractor is not required to authenticate documentation; the contractor told us it does not seek to detect fraud..." GAO-14-705T: Published: Jul 23, 2014, repeated in July 2015,"HealthCare.gov's document-processing contractor 'is not required to seek to detect fraud,' said Bagdoyan." That's right, authenticating documentation is unnecessary as is detecting fraud…That'll help boost numbers, and it's only taxpayer money anyway.

Obama continued his claims of victory based on the false premise that health insurance=health care, that individuals seemingly bought into, yet we also know that the number of enrollees on exchanges didn't separate out those who had insurance before Obamacare that was no longer offered because of Obamacare and therefore were forced onto exchanges, rendering them not "newly" insured in terms of reducing the uninsured number, but merely newly insured on Obama exchanges.

We also know that Obama's Administration, after repeated anemic enrollment numbers decided to change the number of uninsured downward, as if to explain why more people hadn't grabbed onto exchange participation (as stated by the CBO in 2015, “…slightly lower estimate of the number of people who will gain insurance coverage because of the ACA,” (CBO, Pub. 49973, page 19).

Deliberately miscommunicating what the study on the relationship of health insurance was to better health care, Obama fraudulently identified the basis of "success" for his pet project as whether he could reduce the number of uninsured. This commitment was a deal with insurance companies that they wouldn't deny anyone coverage (pre-existing conditions) in exchange for the federal government forcing people to purchase the consumer financial product of health insurance.

The quality of health insurance dropped the bar to low-hanging fruit so that again, Obama could argue about the free stuff he was guaranteeing, without explaining that it was at the cost of coverage for NEEDED medical care which would cost more (and has proven to cost more) in terms of copays, coinsurance and deductibles.

Again, Congress made sure that public employees like themselves would not be exposed to the HIGHER premium costs or the HIGHER costs of using their health insurance since they effectively exempted themselves from Obamacare, indicating that Congress KNEW that the Obamacare plans were sub-par.

Obamacare included PREMIUM ASSISTANCE and COST SHARING for exchange plans to help DISGUISE the costs of the coverage to the consumers in the marketplace because the government picked up the tab for Obamacare enrollees, but for the majority of Americans, we were simply price-gouged more by the costs of premiums and of using our health insurance.

Flash Forward: So Medicare for All fans SHOULD read the next installment of the Obamacare con. In this scenario, according to the published Senator Sanders Medicare for All plan, the continuation of bare minimum sub-par coverage will be provided for all, for free.

Of course, Medicare for All preserves the untrustworthy government as the decider of what is covered and what is not. Of course, it will be bare minimum coverage which is why the Medicare for All Plan specifically creates the opportunity for private provider contracts, basically all sorts of new supplemental policies consumers can PURCHASE for all the things not covered (Section 303).

Of course, the public employees in GOVERNMENT are again exempted and promised a continuation of their superior pre-Obamacare benefits paid for by taxpayers. (See Section 701, "Bernie Sanders and President Trump Agree About Health Care and Consumers Lose," http://conoutofconsumer.blogspot.com/2019/10/bernie-sanders-and-president-trump.html.

Of course how much our taxes will increase is also up to government.

Of course, even if the tax increase is kept remarkably low until post-election they will go up.

Of course, the problem of drug coverage is preserved and will likely be as bad or worse what is currently going on with formularies where Medicare for All uses preserves big pharma's chokehold on us: Under Section 614: Payments for Prescription Drugs and approved devices and equipment: (a) Negotiated prices.—The prices to be paid for covered pharmaceuticals, medical supplies, and medically necessary assistive equipment shall be negotiated annually by the Secretary."

NOTE "Prices paid for COVERED pharmaceuticals…" That's right, the ever -shrinking formulary game whereby drugs covered are often omitted from insurance company lists leaving patients in the catastrophic position of being unable to afford whatever-the-market-will-bear drug prices is preserved by Medicare for All.

The first step to believing any candidate-described, Congress endorsed solution to the Obamacare WORSE problems of access to needed HEALTH CARE based on cost as a barrier is that consumers demand that if we're being sold something then public employees like Congress better be bound by it too, without a blatant exemption like under Obamacare or a more insidious exemption where they're given pay increases to cover increased costs. If it's good enough for us, it should be good enough for them.

2020 New Year Concerns: Why the Hell Are Consumers Trusting Congress on Health Insurance? Part II

2019-12-30T06:12:00.000-08:00

When the Supreme Court upheld the individual mandate as a legitimate tax in 2012, consumers lost because we became required to purchase the consumer financial product of health insurance or pay money to the government to finance other things, because the tax penalty money does not have a designated place where it must go, eg funding other government run health insurance programs for non-public employee consumers.

The individual mandate is another government piggy-bank paid for by consumers to benefit providers who are assured payment, and insurers who stand to benefit from the forced purchase because they are guaranteed, by the imposition of government responding to their lobbyists, a client base for their products, regardless of how poorly those products (insurance plans) give consumers what they need the consumer financial product of health insurance for: Protection from the contingent risk of economic devastation and inability to obtain needed medical services and care IF they become ill or disabled.

Instead of outrage when the individual mandate was first hinted at, consumers bought into Obama's claims that he'd been a strong leader with insurance companies on behalf of consumers and had agreed to the mandate in exchange for the promise by insurers that they wouldn't deny coverage for pre-existing conditions. This was bunk, because the proposal came in 2008 FROM the insurance lobby, AHIP in their publication that mirrored the plan Obama pretended he negotiated instead of the deal he made.

Led like ninnies, with little examination, consumers bought-in, in theory, though this clearly is not the same as a tax to pay for libraries or schools or other public services available for everyone, because in fact the dollars paid as tax penalites are not by law required to be used to pay for programs that might benefit everyone such as Medicaid or Medicare. Nope, these dollars go into the undefined coffers of government to be used for undefined purposes, untraced like a petty cash account used by lawmakers.

Flashback: Obamacare using the Affordable Care Act's repetitive "timing" con where provisions were carefully timed to avoid Obama facing defeat in his bid for re-election if consumers were tuned into what he'd really done with Obamacare, created a legal partnership between government and private insurance companies to bilk the American consumer, and "surprised" consumers with the individual mandate provision's effective date at the end of the 2013 benefits year, (after his re-election).

In 2012, the individual mandate was upheld by the Supreme Court as a legitimate exercise of Congress' taxing power rather than a penalty because it was indefensible to argue that the failure to purchase a consumer financial product, health insurance, should result in a penalty. After all, that would be like penalizing consumers for not having a credit card to establish credit and requiring them to pay a fee to the government for a failure to have a credit card.

Still, the effect was the same, the government muscle stood behind insurers and said, "Buy their product or pay what amounts to a fine." Now, since Obama's Administration protected government public workers, of course, their employer (the federal government ignoring that we pay for their benefits) preserved their pre-Obamacare health insurance providing superior coverage at our expense.

Obamacare also provided unclear pathways for spending the money collected in individual mandate "taxes," failing to require those funds be spent on behalf of taxpayers in public insurance plans like Medicare/Medicaid or Veterans benefits, Social Security and instead merely created an additional petty cash source for government.

Under Trump, first the penalty was defunded, to an amount of zero and now there is no individual mandate. However, state governments strapped by their irresponsible spending and bloated government benefits to public employee pensions, etc. have glommed onto the Supreme Court's "tax" concept and are instituting their own individual mandate. California is the latest. Similarly, the funds collected by states have unclear pathways of whether they're required to be spent on the consumers they're taxing creating simply another government piggy-bank tool.

Flash Forward: The shenanigans involved in creating the individual mandate unfortunately have benefited the most powerful voices in the health industrial complex, insurance companies that get forced customers for their products, providers who like dealing with insurance companies rather than individuals for payments because a) they negotiate higher prices and b) they have less hassle in getting paid, and government which gets a new piggy-bank stream of petty cash to spend how it likes.

Consumers remain the losers. Medicare for All is the same, with unknown tax increases to cover a program of health insurance that promises nothing except that government will decide what services and medicines and treatments are covered for consumers unlucky enough not to be them, public employees, as they preserve and expand their own benefits, and with a no-limit government determination of how high those taxes will go for consumers. With a track record of mismanagement of consumer funds, Medicare for All promises to simply be a bigger petty cash account for government.

Even without the individual mandate, which actually was proposed by insurance companies to Obama's Administration by the insurance lobby (AHIP) in exchange for a political quid pro quo to Obama who gained political clout claiming he'd protected consumers from being denied coverage for pre-existing conditions, insurers are not backing off the forced purchase of their products and include continuous coverage provisions that penalize those without insurance for a certain length of time with higher premiums. Continuous coverage requirements are simply another individual mandate.

Under Medicare for All, these forced payments to insurance companies for their products and to government for failing to purchase these products are expanded under the same tax reasoning to some unknown amount regardless of how bad coverage is under Medicare for All.

Consumers should first and foremost require detailed information from government and require legal obligations of government to spend any and all taxpayer funded mandates and taxes on the programs that are used to justify the tax penalties and-or taxes to benefit consumers directly, not amorphous government infrastructure or public employee expenses associated with administering programs or allowing a general fund-type provision where government can use the money for its own expenses and the raise taxes on consumers as currently is proposed.

Further, unlike the fallacy of the zero balance social security funds, which allows government to raid any amounts left in social security each year for other government purposes and then claim that social security is bankrupt, the balance should be clearly limited by law to payments on behalf of consumers only associated with these programs with balances, if there are any, carrying over from year to year.

This also means not an 80/20 rule like Obamacare's rule for insurance companies, which is basically a joke, but a 100/0 formula where direct payments on behalf of consumers to government associated with health insurance must be 100 percent and 0 is permissible to be used for government public employees and infrastructure which already have ballooned and are subject only to audits by government for government, which like public employee benefits ALWAYS end up benefiting the public employee class only.

New Year Concerns: Why the Hell Are Consumers Trusting Congress on Health Insurance? Part I

2019-12-29T05:25:00.001-08:00

Tempted to jump on the bandwagon of Medicare for All? Well, you know what they say, "Fool me once, shame on you, fool me twice, shame on me." Just like the Affordable Care Act, Medicare for All preserves by law the inequities of our health CARE system by preserving inequities in our health INSURANCE system.

Currently, Congress gets a pretty sweet deal, superior benefits coverage reducing the amount they spend to use their health insurance AND premiums paid for by taxpayers upwards of 72 percent, reducing the amount they spend to obtain health insurance compared to the people they're supposed to represent. Now for those who want to immediately jump in and defend this public employee perk for Congress, we've heard it all before thanks to the Obamacare con.

Flashback: There was a tiny outcry by people subjected by our lawmakers to Obamacare who weren't among the minority of Americans who benefited from the insurance exchange plans made available to individuals based on income or didn't become eligible for expanded Medicaid, two distinct and separate parts of Obamacare. At that time, Congress neatly carved out an exemption for itself, though they'd double-talk and lecture the rest of us on how it wasn't truly an exemption, they just happened to pass laws that their employer (the federal government) would provide them with cushy benefits and premiums artificially lowered by contributions by us, the taxpayer.

Flash Forward: Like the sounds of Medicare for All? Guess what, Congress again will preserve its superior benefits for a taxpayer funded price under that law too. Go take a peek at section 701 under the proposed Medicare for All, "There are hereby appropriated to the Trust Fund for each fiscal year, beginning with the first fiscal year beginning on or after the effective date of benefits under section 106, the amounts that would otherwise have been appropriated to carry out the following programs: …
(C) The Federal employees health benefit program, under chapter 89 of title 5, United States Code."

Now, perhaps you think that sounds great, the Federal employees health benefit program funds will be put into the Medicare for All trust, but the Obamacare loophole for calling the Federal government an employer and thereby effectively exempting Congress from Obamacare persists because under Medicare for all employers can still provide their employees with superior benefits as long as they're not duplicative of Medicare for All coverage. The best way to consider this provision in the contracting for medical services provision is as supplemental insurance that will not only be outside the scope of Medicare for All legislation but will not be regulated, seemingly in terms of cost. So, what do you think Congress will provide for itself with our money?

Further, there is no assertion that the back-door funding of superior medical benefits through public employee pay raises or other dollar amounts won't be enacted. Yep, it's just another loophole that makes it seem like we're all in it together.

Flashback: Obamacare established national legislation for minimal coverage, padding its inadequacies with "preventive" checkups and essential benefits used by insurers to justify increases in out-of-pocket costs for consumers to use their health insurance from copays to coinsurance to deductibles, and by increasing the needed health care services uncovered as insurers complied with Obamacare's bare minimum coverage requirements.

Flash Forward: Medicare for All preserves this two-tiered bizarre system of covered health care services for the HEALTHY but increased cost barriers to needed medical care. In section 107 of the proposed Medicare for All bill you'll find that private insurance isn't going anywhere, as a matter of fact it will expand its profitability because it can't "duplicate" the bare minimum services provided under Medicare for All but allows for PRIVATE CONTRACTS for services NOT covered by Medicare for All.

This would be an option for needed medical services that would only be available to the rich able to purchase the sky's the limit insurance coverage for the myriad of services not covered by the basic Medicare for All, which is much needed medical services. So, you want a checkup, you're good, that's not needed medical care. You need cancer treatment, drugs, etc. probably not so much. (And don't forget, Congress' benefits are preserved by themselves for themselves, so they needn't worry).

Buying Additional Coverage: Congress Protecting Itself

Flashback: Obamacare disincentivized employers from providing quality benefits to employees by allowing insurance companies to raise their plan costs for anything beyond the bare minimum coverage supplied by Obamacare. Insurance companies went along with these requirements not out of the kindness of their hearts but because they knew they could make more money under Obamacare with a few simple strategies…The first one is the downside of lists, which insurance companies are masters of: Yes they would comply with uniform premiums for whole populations (rather than high-risk groups such as those with pre-existing conditions) BUT the cost of USING health insurance in the form of copays, coinsurance, and deductibles as well as non-coverage of things not on the Obamacare "list" would increase astronomically. Of course, Congress made sure its employer, the federal government would continue to protect them.

Flash Forward: Medicare for All expands this inequity with its contracting for supplemental plans to cover all the stuff insurers won't cover. So now, after disincentivizing employers from providing superior benefits to their employees, because after all, why would they provide more than the law requires and pay astronomic prices for the same, Medicare For All provides that employers CAN provide such superior benefits to their employees. This one should be crystal clear, because having made the federal government the "employer" and making the rules for their employer, Congress will make damned sure that their employer provides such superior benefits at no increased cost to them (just us, the taxpayers) while other employers continue the price shopping of bare minimum plans that meet federal guidelines.

So let's start with the obvious: Why would consumers support Medicare for All and trust that Congress which is preserving its pre-Obamacare and pre Medicare for All public financing of superior benefits is really doing anything but making sure it preserves the current system? The answer is: We shouldn't.