Dear America – We Have A Health INSURANCE System, Not A Health CARE System; They’re NOT The Same Thing

November 5, 2019 ~ A L Katz ~ Leave a comment

Until we get the framing right, we’ll never fix the problem: our health CARE system is broken because it’s NOT a health CARE system. It’s a health INSURANCE system.

The first question anyone gets asked when they walk into any facility for health CARE isn’t “How can we fix you?”, it’s “How ya gonna pay for this?” Right off the bat, that’s ass backwards. The inmates are in full control of the asylum.

No other industrialized nation has a system like ours — where most Americans get their health INSURANCE (not care) through their employer. There’s a reason — and it’s not because we’re so clever and exceptional. It’s a historical anomaly that we’ve simply never dealt with, addressed or even admitted to.

Back during World War II, every available dollar was put toward the war effort. Rules prohibited companies from giving employees raises or raising salaries for new hires. Big companies, wanting to compete for the best employees, needed another incentive so they began offering free health care — well, they’d pay the insurance premiums.

Note — big companies were able to do it because they could afford (at first) to handle the additional admin and cost of running a health insurance program. As the war went on, more big companies offered the same health insurance benefit. Then the war ended… but the health insurance benefit didn’t — even though it should have.

After the war, all those big companies looked to get out of the health insurance business. They subcontracted out the work to the burgeoning health insurance industry to serve as the “gatekeepers” between workers and their health CARE. To keep costs down, the insurance companies eventually cut deals with doctors to get better rates. All very reasonable except that the insurance companies had now created EXCLUSIVITY where there wasn’t any.

Suddenly insurance companies could control which patients a doctor could see. And then they made their gatekeeping integral to the whole health CARE system itself.

Corporations — like health insurance companies — have a fiduciary responsibility to their shareholders (the preferred class, not the regular class of shareholders) first and foremost. They have NO actual responsibility to “patients”. The insurance company doesn’t actually care what happens to any patient. It’s in their interest to spend the least they can get away with on each patient while collecting the maximum amount of income from him/her.

Is universal single payer perfect? FFS, there’s no such thing as “perfect”. But at least it takes the FOR PROFIT gatekeepers out of the health CARE equation. There will still be gatekeepers for sure — government gatekeepers. But We The People can control how they keep the health care gates for us. We can’t do the same with a corporation.

It is even more absurd to run around all Chicken Little-like about Elizabeth Warren says she’d pay for her Medicare For All plan — without comparing it to either 1) what our current health INSURANCE system costs each & every one of us in cold, hard cash terms or 2) ever asking a Republican EVER what their “health care plans” cost or how THEY might get around to paying for it.

FFS – the Republicans pulled off a massively destructive (to the middle class) tax cut to the rich that they had no intention of every paying for — except by gutting social security and welfare.

America keeps getting tripped up by greed. Greed is what allows Big Pharma to charge extortionist prices for insulin when it’s inside America’s borders and reasonable prices everywhere else.

Greed never makes anyone smarter. It ain’t gonna cure anyone’s ills either.

Hey, America — Here’s A Really Dumb Idea: Let’s Put PROFIT INCENTIVE At The “Heart” Of Our Healthcare System…

September 11, 2019 ~ A L Katz ~ Leave a comment

There’s a very good reason no other industrialized country has profit incentive built right into its healthcare system: a corporation’s bottom-line fiduciary responsibility is to its shareholders (the ones holding preferred shares, not the poor, dumb humps holding “common” shares) and NOT “health care customers” aka “patients”.

If a profit-driven health insurance company gave in to patients instead of providing a generous dividend next quarter, it might face a stockholder revolt. The price of its shares might plummet — and with it, the value of the company. All because it did the right thing instead of the financially expedient thing.

Ever wonder why pharmaceuticals are so much more expensive here in America than in pretty much any other country? Have you seen Big Pharma’s bottom line? They’re making money hand over fist from ;us. Be thankful you’re not a diabetic in America. The real production cost of a vial of insulin is between $2.28 and $3.42, while the production cost for a vial of most analog insulins is between $3.69 and $6.16, according to the study in BMJ Global Health.

“Anyone with Type 1 diabetes should be able to buy insulin for under $100 per year, including the long-acting forms,” said Andrew Hill, a study co-author and senior visiting research fellow at the University of Liverpool. “Pharmaceutical companies cannot justify charging governments $532 per person per year in the U.K. and $1,251 in the U.S. Yet, they do.

$100 vs $1251 for a year of insulin. That’s quite a mark up for a LIFE-SAVING PRODUCT. Know why that mark up exists? Profit incentive.

It’s the same reason an ibuprofen tablet that costs a few pennies to make costs $100 if a hospital hands it to you. It’s not costing $90 to make, package and transport that tablet. Virtually all of it is profit.

How did we get here? How did we let the biggest wolf of all – the insurance companies — become head gate-keeper in our health care chicken coop? That’s what insurance companies are — they’re gate keepers who get to decide which doctors we get to see. No one — repeat, NO ONE — loves their insurance company. They like that the company — with its clever “plan” — allows them (with deductibles and out-of-pocket costs) to see the doctors they like. They like that the GATEKEEPER says yes.

But the gatekeeper can say no, too. And often does. The gatekeeper can make up all kinds of bullshitty rules to “explain” why we CAN’T have the care we need.

The fact that we have insurance companies as gatekeepers is a historical anomaly. During WWII, all financial resources were poured into the war effort. Companies weren’t allowed to give employees raises. That made attracting new talent to a company (or retaining good talent) harder. To incentivize workers, large companies offered health insurance. People liked it. Why wouldn’t they? More big companies started to do it.

Then the war ended. But the employer-provided health insurance didn’t. In fact, it proliferated despite the fact that it really wasn’t good for any of the companies to keep providing it: it’s expensive — and when you factor in the cost of providing this perk, it makes the good or service that much more expensive. Example — in the competition between Boeing and Airbus to build and sell large commercial airplanes, Airbus always had a huge advantage. The cost of worker healthcare was built into the cost of every Boeing plane — making them more expensive to buy and less profitable for Boeing. Airbus, on the other hand, didn’t have to pay for its workers health insurance — that cost was born by whatever government the worker lived under because that country provided universal singer payer health CARE.

Europeans needing health care get it — no one asks how they’re going to pay for it first. Everyone KNOWS how it’ll get paid for. They skip that and move right on to the health CARE — like they’re supposed to.

America has great health care for those who can afford it. Otherwise, we have a system designed to make rich people richer and sick people die.

The Hardest Part Of Cannabis Legalization Is Overcoming The Mountain Of Bullshit & Lies

August 19, 2019 ~ A L Katz ~ Leave a comment

Poor cannabis. There’s bad press and then there’s the hatchet job that America’s first drug czar, Harry Anslinger, did to it.

When Anslinger first got hired in 1930, marijuana was hardly on his radar. Few Americans knew what it was. Fewer still smoked it (though many Americans benefited from its presence in various medicines). The Mexican Revolution in 1910 sent a wave of Mexican refugees across the border. They brought cannabis with them. That freaked out the white people. It wasn’t the cannabis that concerned them so much as the fact that Mexicans were smoking it and deriving pleasure from it. That meant (to the white people) that something had to be wrong with it.

Eventually, marijuana found its way to New Orleans where the black musicians assembled there were busy inventing jazz. While they couldn’t play or create on alcohol (it made their minds too fuzzy), marijuana had the opposite effect. It focused their minds and allowed their creativity to flow.

American soldiers in Vietnam encountered the same phenomenon. They were prohibited from drinking (because, as with the musicians, it fogs the mind). But, the American soldiers learned — having found marijuana both cheap and plentiful — that pot both relaxed them and focused them. They could smoke a joint then walk point in the jungle, their senses not diminished but, rather, heightened.

From time to time, New Orleans would shut down its whorehouses and banish all the musicians working at them When that happened in the mid 1920’s, musicians like Louis Armstrong headed up the Mississippi, stopping in places like Memphis and Nashville on their way to Chicago. Had all those black jazz musicians kept cannabis to themselves, that might have been the end of it. But they didn’t. Cannabis use spread to the white community — and that, from Harry Anslinger’s point of view, was a total non-starter.

Not once did Anslinger ask about marijuana’s health consequences. Even if he had, no research existed proving marijuana was good or bad for anyone’s health. But Anslinger had an agenda. He needed marijuana to be bad. And he knew that aside from the Mexicans, black jazz musicians and handful of white people using marijuana, no one knew a thing about it. Whatever Americans were going to know about cannabis would be what Harry Anslinger told them.

Virtually all of our current perceptions about cannabis flow from Harry Anslinger’s fetid imagination where every black man who smoked a joint then went on a mad raping spree (raping white women exclusively). Anslinger was a racist’s racist. But he was also a master bureaucrat who knew how to work the system.

We laugh now at Reefer Madness because it’s way over-the-top and way wrong about everything. But when Reefer Madness was released in the 1930’s, no one had that perspective. America and the world bought in to the Reefer Madness mythology.

Even in states where cannabis is now legal — like here in California — people remain squirrelly about cannabis. The thought of walking into a dispensary feels wrong to them. They worry about cannabis doing things to them, to their minds, that cannabis simply does not do.

If I get stopped by the LAPD — and they swab me — they’ll find THC in my system. The swab can’t tell how much THC is in me, what the accompanying turpene profile is (and how that might be affecting me), they can’t tell how much THC is in me or whether it’s an indica, sativa or hybrid. All the swab can tell is that there’s THC in my saliva.

We assume — because of the mythology’s enduring power that even a hit of cannabis will turn me into a danger on the highways. That’s because we apparently assume that alcohol and cannabis have the exact same effect on our brains and bodies. Nothing could be further from the truth.

The Nation Highway Transportation Safety Administration reported the following to Congress in 2017 — “…research has demonstrated the potential of marijuana to impair driving related skills. It does not show a relationship between THC levels and impairment.”

Get that? Research demonstrates “potential” impairment yet doesn’t show a “relationship between THC levels and impairment”. How is that possible? It’s not. It’s a leftover prejudice. In the very next paragraph of the NHTSA’s report, it says this: “… after smoking marijuana, subjects in most of the simulator and instrumented vehicle studies on marijuana and driving typically drive slower, follow other cars at greater distances, and take fewer risks than when sober…”. “In contrast,”, the report continues, “Subjects dosed with alcohol typically drive faster, follow at closer distances, and take greater risks.”

See how differently drivers with THC in them perform vs drivers who’ve been drinking? Why do we act like they have the same effect when they don’t? When even legitimate scientific research says they don’t?

Blame Harry Anslinger. Blame us, too. We know better. We simply refuse to acknowledge what we know. It’s like we prefer the effects that bullshit has on us.

Can We PLEASE Get This Straight? NO ONE Loves Their Health INSURANCE…

August 1, 2019August 1, 2019 ~ A L Katz ~ Leave a comment

Somewhere, an evil genius is smiling so hard his face hurts. It might be the same evil genius who came up with a “Mission Accomplished” banner for the background of a speech by George W. Bush — on an aircraft carrier — during a war he started for no reason.

Yeah, I know the banner SAYS “mission accomplished” but I doubt BushCo could have actually pointed to what mission they meant and what, if anything, had actually been accomplished. “Americans love their private health insurance” comes from the same wellspring of evil-genius-strength bullshit.

The core problem with American healthcare is that its emphasis is immediately on the wrong syllable. When anyone walks in the door of the American Healthcare System, the first question isn’t “How can we help you?”, it’s “How are you gonna pay for this?”. If you can’t answer that question satisfactorily, you might just be screwed. But, hey — even if you DO have insurance? Between the co-pays, the deductibles and all the other out-of-pocket bullshit, you could STILL be screwed.

No other civilized healthcare system anywhere on the planet has profit incentive at the core of its healthcare. There’s a reason. Profit incentive and human well-being are completely incompatible when they’re both dependent on the same dollar. A corporation has a fiduciary responsibility to do the very best it possibly can for its investors. That means a choice between an expensive but uncertain procedure that might save a customer’s life (that’s what they are to the insurance company after all — customers) and a happy board of directors able to announce a bigger dividend at the next shareholder’s meeting. Guess who the corporation’s gonna choose?

Like I said — it’s their responsibility to do that. It’s not their fault exactly — it’s history’s. Ever wonder why it is that only in America does anyone’s employer pay for their health insurance? For real. This doesn’t happen anywhere else. And there’s a reason. It’s bad for business.

FDR toyed with making universal healthcare part of social security but the AMA didn’t want doctor’s fees limited by the government (cost controls, in other words). FDR made the political decision not to risk losing on both social security AND universal healthcare. He put all the chips on social security alone. Then WWII happened — and history caused American healthcare to zig when maybe we should have zagged.

Because all available money needed to go to the war, employers were not allowed to give good employees raises. Those same frozen wages made it hard to lure new talent (who could go elsewhere to an employer whose wages were frozen at a higher level). Thinking outside the box — what other benefits could be offered that would feel like salary? — produced the first direct employee sponsored healthcare.

The idea spread. People liked the benefit. In their minds, it was saving them money and providing them comfort. What’s not to love? Then the war ended.

With the war over, companies were free again to offer whatever salaries or bonuses or raises they wanted. They also were free to end the war-time benefit (replacing it with salary). They didn’t. Hell, instead of ending these programs, the big companies held onto it. This was back at a time when your average middle class American (remember them?) entered the work force at 18 or 22 (if they went to college) and whatever employer they started with? That was likely to be the employer who’d be handing them a gold watch upon their retirement 40 years hence. Your employment relationship was supposed to be as durable as your marriage.

While the big companies (who’d done a shitload of the hiring during the war) held onto providing healthcare to their employees, they farmed out the work of administering this employee benefit — and the healthcare insurance industry was born. Didn’t take long before the baby took over the nursery. Then the whole house.

Ask a company like Boeing what having to provide healthcare insurance to its tens of thousands of employees does to its bottom line and its competitiveness. The cost of that healthcare is massive and it gets reflected in the cost of each airplane.

Airbus, by contrast, doesn’t have to pay for its employees’ healthcare. In Europe, the government takes care of it, paying for it with tax dollars. That gives Airbus an advantage because they don’t have to build that cost into what they charge for an airplane. See? Employer-based healthcare is bad for American business because it makes them less competitive.

As for the healthcare itself — all the employer is providing is the insurance coverage. What that coverage is? That’s up to the insurance company.

The insurance companies can make up any rules they want. And they do. The most important rules of all — to them — is who they contract with and therefore who their customers will be allowed (by their made up rules) to see. Every last bit of this, remember, is made up. By a company put there to administer this thing.

To gate-keep.

Insurance companies are gatekeepers. Border guards that — so long as we pay our premiums and stay employed by the same bosses — will smile at us benignly each time we pass by. But we fear them. We dread them. What if they don’t smile next time?

What if, next time — when we’re really sick — they turn us away? What if they point to language in their dense boiler plate (something on page 58) that says our particular situation (as they’re interpreting it) means they don’t have to cover the procedure we need. We’re free however to pay for it retail-retail out of pocket.

Hey — we charge hundreds of dollars for insulin that costs relative pennies in Canada. Every last penny of that difference is profit. Let me repeat: PROFIT. People are dying cos they can’t afford their insulin. Retail-retail in American healthcare means the cost of a procedure and the procedure’s actual cost have nothing to do with each other. It’s like being charged a million bucks to go three blocks in a taxi.

What’s wrong with America’s healthcare system isn’t that the inmates are running the asylum. It’s that insurance companies are. And they couldn’t give a rat’s ass what happens to any of us.

Revealed: The Secret 2020 GOP Health Care Plan: “TrumpCare PICK-AN-ORGAN”

April 2, 2019August 4, 2019 ~ A L Katz ~ Leave a comment

As everyone knows, Republicans leak like a sieve or an old guy’s pecker. That’s how we got ahold of their radical new healthcare proposal — “Trump-Care ‘PICK-AN-ORGAN”.

Who wants to pay for health care YOU won’t ever get — or “might not” ever need? Only a schmuck pays for other peoples’ healthcare, amiright?

Think of it THIS WAY: You have lots of organs. What are the chances any will ‘go south’ on you during your lifetime? Your lungs? Probably not — unless you smoke. Your kidneys — You have two — you’re playing with house money. Your heart? Well, okay — that one could be a problem but if your heart’s going south on you — you’re pretty much toast anyway, right?

The point is, Trumpanistas, you’re too smart to INSURE organs you don’t need to — or are worth the risk NOT to insure. And that’s why you’ll love “TrumpCare PICK-AN-ORGAN”! C’mon — I’ll show ya how it works —

LUNGS

Odds are nothing will happen to either of em. But you want to play it safe — so we offer options to allow YOU to decide: Insure Neither Lung, One Lung or Both Lungs!

See? Easy! Now, of course, the trick is, if you insure just one? Ya better hope like hell you insured the correct Lung — the one that’s gonna be needing insurance…

LET’S TALK INTESTINES!

If you’re like the average Joe, you have LOTS of this stuff inside ya. You have intestines to spare. In fact, you have so much intestine you even have two kinds (I know — weird, huh?) But do you really need to insure both? Do you really need to insure ‘ALL’ of it?

And what about your APPENDIX? You don’t even use it — hell you haven’t used it in millions of years. Only an idiot insures something he can’t use — amiright?

I KNOW THAT’S MY LIVER BUT WHAT THE HELL IS THAT ‘GREEN’ THING?

cartoon-of-human-liver-and-gallbladder-vector-7563173

The Truth is — Outside of your heart and lungs, your stomach and your anus, you haven’t a clue how any of your plumbing works. You know you HAVE a Liver and you remember somebody lecturing you once about alcoholism while you were passed out in a drunken stupor but that was so long ago.

Be that as it may — This is probably you: “What in hell’s name is that green thing — and please don’t say I have one…!”

Yeah, you have one all right — and it costs a BOMB to insure it — IF you insure it…

YOUR SPLEEN — 1-2-3-ANSWER QUICKLY: ‘WHAT’S IT DO?‘

human-spleen-visceral-surface-synthesizes-antibodies-53319933

Not a goddamned clue, amiright (and “The spleen ‘spleens’ ain’t it”)?

Here – we’ll even show you a spleen and point out all its bits. Does THAT help? No?

And you want to insure this WHY?

AND THEN THERE’S THIS ORGAN…

Insuring brains is expensive. In fact, it’s SO expensive, you’d have to be crazy to pay the freight. So why bother.

TrumpCare ‘PICK-AN-ORGAN’: ‘Hey — look at all the money YOU just saved!’

Something About This Kinda Shouts ‘Bullshit!’

December 14, 2018 ~ A L Katz ~ Leave a comment

My local 99 Cents Only Store was doing some product testing for the still nascent republican health care plan. It’s kinda ‘pay-as-you-go’. You pay, get nothing – that’s how it goes.

I wonder what the deductible will be…

Finally – The ‘Health Care’ Trumpanistas Deserve: “TrumpCare PICK-AN-ORGAN”

August 7, 2018March 26, 2019 ~ A L Katz ~ Leave a comment

Hey, Trumpanistas — Still fuming over ObamaCare? Still cursing the day your insurer was FORCED to insure your pre-existing condition without bankrupting you? Still hating on having to pay for other peoples’ health care — including WOMEN?

Well TrumpCo has exactly what you’re looking for — a ‘health insurance’ plan that has the same grasp of what ‘insurance’ is as YOU apparently do — NONE! Introducing, New Trump-Care ‘PICK-AN-ORGAN’: The Health Care ‘Plan’ designed for Trumpanistas.

The point is, Trumpanistas, you’re too smart to INSURE organs you don’t need to — or are worth the risk NOT to insure. And that’s why you’ll love ‘TrumpCare PICK-AN-ORGAN’ —

Pick An Organ Front Card