Wednesday, June 17, 2015

Health Insurance Companies feeding at the public trough

by Richard Mellor
Afscme Local 444,retired

Between January and April 2014, the federal government paid health insurers $2.8 billion in subsidies, premiums or deductibles for those covered under the new health law according to an inspector general's report published this week.  As the law began to take effect and millions of formerly uninsured or underinsured finally got some sort of coverage, insurance companies began billing the US government or sending in claims. The government or the taxpayer to be more precise, has been paying these "estimated" claims, "...without knowing for sure whether they are accurate ---or if enrollees are even current on their share of the premiums.", the Wall Street Journal reports. *

The Health and Human Service of Inspector General isn't impressed either and is unable to determine if the payments to the insurers are correct and considers the "situation to be risky" according to the paper.  The politicians of the 1% have no problem with risky situations mind you when it comes to working people's money.  The Centers for Medicare and Medicaid Services (CMS) that is supposed to determine the actual amount the government/taxpayer owes for each enrollee has not yet been able to do so and says that it cannot "verify the accuracy" of the $2.8 billion figure already paid out.

What is referred to as the "back end" of the system will not be completed until the end of 2015 and the Obama Administration says that it will be able to then "work out any over-and under-payments then." the inspector general's report states. Interesting that the insurance companies don't have to wait in this situation; their bill is paid. They will pay the taxpayer back if they're overpaid. Won't they?  Excuse me one moment an uncontrollable fit of laughter has overcome me.

Perhaps I am too much the cynic  Firstly, for some strange reason I am not convinced the insurance companies have not over billed the taxpayer and come 2016 the likelihood of the federal government and its officials, in one way or another connected to the health care industry, the insurance industry or some section of the 1%, will be able to recoup our taxpayer losses despite claims to the contrary: "CMS takes seriously our responsibility to makes sure this financial assistance is paid accurately and that taxpayer dollars are protected", says Meaghan Smith representing the Obama Administration.

Let's check the record: Hundreds of millions of dollars in aid to the US puppet regime in Afghanistan is unaccounted for, billions of dollars of military equipment, (the tanks the former CIA guys now in ISIS are using) are missing in Iraq.  The Pentagon, another thieving agency, is unable to account for $500 million in military aid it gave to the US stooges in Yemen. This is not so bad for the military industrial complex as the US supplies more weapons of mass destruction globally than the rest of the world combined and increased production can come from any area as far as the investors in this industry are concerned.

In another example of the massive waste and outright theft of the wealth that working  people create, USA Today reported last year that a government website, "intended to make federal spending more transparent was missing at least $619 billion from 302 federal programs, a government audit has found."

The US has one of the worst health care systems of all the advanced capitalist economies and one of the most expensive eating up over 17% of GDP, no other country comes close.  Obama's health care plan is a boon for the sickness industrial complex as it forces more people to pay insurance companies for what should be a human right.  What sort of civilized society pays a group of financiers and investors, middlemen basically, billions of dollars a year to provide a public service? A civilized society does not, that's for sure.

In all, the CEOs of America's 10 largest health insurance companies made $228.1 million in salary and stock options during 2009, according to the liberal advocacy group Health Care For America Now. Stephen Hemsley, CEO, of UnitedHealth Group took home $106 million in 2014.

Health care is a human right but the only human right recognized in the capitalist mode of production and the political superstructure that defends and perpetuates it is profits.  I should add that this commentary is not in defense of the "small government" crowd who's small government doesn't include the arms industry which is one of the most profitable or the massive amounts of subsidies an\d tax breaks corporations get. What they object to is any government expenditure that serves people's needs, parks, transportation, public education, libraries, public swimming pools etc.  This is money out for them and also occupies an economic niche that could be filed by private capital, just like the insurance companies that consume massive amounts of public money providing us with social needs that should not be private or determined by the so-called free market.

It will take a huge movement and independent working people's political party to win any sort of
decent public health system at all in the US. Neither the Democratic or Republican parties are capable of such a reform as they are both parties that are owned and financed by the 1% and Wall Street.  We should expect nothing less than a free national health system that provides services on demand at the point of need.

It is true, that even public agencies in a capitalist economy are bureaucratic and wasteful at one level or another but nothing compared to the extent that a private sector for profit health care industry is as the US model shows. The profits of big Pharma and health care services are staggering.  It is not waste or bureaucracy in a public agency that the 1% and their politicians despise, it is that public services that can provide decent results (the USPS is an example) undermine their propaganda in the schools, universities, the entertainment industry, and media, that the market is the answer to all things when in actuality it is the most inefficient when it comes to human needs and a secure and productive life.

The answer to inefficiency, corruption and bureaucracy in a public agency like health care in a capitalist economy is public ownership in the real sense, by the nurses, doctors, patients and communities they serve. This is only possible through the transformation of society to a democratic socialist economy which would also include the collective ownership and allocation of the capital needed for such services.

* US Pay to Insurers Still Lacks Verification WSJ 6-16-2015

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