We're distracted, and it's gone from bad to worse. While politicians egg on consumers to fight with one another, there's been a clear winner, and that's public employees working for themselves. It is here contended that until and unless US voters use public employee entitlements as the starting point for health care reform, that we will not see progress in terms of solving the challenges of expensive and-or inadequate health INSURANCE coverage for unexpected, but NEEDED health care services.
Consider: The 2018 federal civilian workers' rise in public employee wages and the entitlement gift of taxpayer funded benefits that has created a situation where a trend that began in the '90s has now reached the absurd level that with salary and benefits "In 2018 total federal compensation averaged $135,971 or 80 percent more than the private-sector average of $75,381," See "Downsizing the Federal Government," 8/2/2019, https://www.downsizinggovernment.org/federal-worker-pay. That's for "federal civilian workers," public employees, including Congress.
Politician Trick 1: Keep us at each other's throats in order to distract us away from lawmakers benefiting themselves. As each partisan manipulator talks about how bad the other guy is, there's one thing that's clear, nobody's watching the lawmakers as public employees creating opportunity, job security, cash and entitlements for life for themselves as public employees.
Politician Trick 2: Dazzle us with phony promises of cuts to citizen programs as "improvements for all," while bestowing upon themselves ever-increasing coverage and salaries. It should be making us angry to listen to ideas for health reform that inevitably has lawmakers hone in on cutting "entitlement" programs like Medicare (which has been paid into by workers) and Medicaid (which also is supported by the public) while they make sure to protect themselves and their entitlements. Yet, with all the anger around, no anger about that.
Obamacare should have taught us this lesson as we listened to lawmakers, the biggest fans of Obamacare "explain" why they weren't to be covered by the new law, because their employer, the federal government, provides them with their rich benefits. For some reason, there was little consumer outrage that they'd effectively exempted themselves through the employer-provided benefits, though their employer, the federal government uses OUR money to finance their benefits and that THEY make the rules for what their employer provides.
We didn't learn the lesson and now we have Bernie Sanders' Medicare For All proposals with the very obvious protection of that sweet deal for public employees:
Medicare For All preserves that taxpayer funded entitlement for public employees in its section 701, "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, that looks nice and fair, that the money spent on Federal employee benefits goes into the Medicare Trust Fund. Nice and Fair if you don't also read about how employers can provide all the supplemental insurance they want as long as it doesn't duplicate the basic Medicare for All and put that together with the fact that that's exactly how public employees got out of Obamacare off our backs, by providing that their employer, the federal government provided superior benefits at reduced cost, which just happened to be financed by us.
(See "Bernie Sanders and President Trump Agree About Health Care and Consumers Lose," full cite at https://conoutofconsumer.blogspot.com/2019/10/bernie-sanders-and-president-trump.html).
Politician Trick 3: Pacify people with lists of free stuff while leaving the most needed, expensive procedures and treatments unattainable for consumers:
Originally, free checkups were a device that insurance companies desired because those free checkups incentivized people to get checkups which helped insurance company profits by getting sick people needed health treatment earlier. No more.
Today, we see a warped version of the free checkups concept memorialized in Obamacare, where those checkups are used as excuses for insurance companies to charge more in premiums and as an excuse to increase consumer costs for needed health care services in the form of higher deductibles, higher copays, higher coinsurance or outright exclusions.
These free checkups are also used to increase defensive medicine payments to providers who, ignoring the risks of medical harm and injury from over-testing, often use the "free" provisions to force consumers to go for any and all tests they can, just to protect themselves. This is anti-consumer as it presents increased costs, risks and problems for consumers.
Further, since Obamacare created the opportunity for any additional testing beyond the free checkup to cost more, there's incentive for providers to send individuals for additional testing to tap into those increased income channels, so if you go for a free checkup and you're told to go for some additional testing ,it's no longer free, but more expensive than ever because insurers use the excuse of having provided the free test to raise the costs to consumers of follow-up care.
We also see that these new "exclusions" and limitations create the opportunity for insurance companies to create new products outside of the bare minimum protections required by Obamacare in the form of supplemental plans, eg for cancer, etc.
Medicare For All is NOT doing away with insurance companies, it's giving them the opportunity to fill in the gaps of what will be covered under the public program with any type of supplemental insurance they can sell, at whatever price. Sanders' Medicare For All bill states in Sec. 107:
"Prohibition against duplicating coverage.
(a) In general.—Beginning on the effective date described in section 106(a), it shall be unlawful for—
(1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act."
Politician Trick 4: Lie to Voters: President Obama set a precedent of lying to the voters about health care reform, including his famous lie of the year of 2013 about keeping our doctors. He also lied with claims that we'd get insurance like his family has, that separate but equal claim about public employee insurance which of course is not the case. Obama also claimed every family would save $2,500 a year in premiums, also a lie, as our premiums soared.
Of course, we're still being lied to as we hear the promises of Medicare For All and again, instead of reading the details we're hearing the false campaign promises that candidates are spewing with immunity that are as stale and untrue as they've been for decades.
Including lies like, "for all," though in Sec 102 of Sanders' Medicare For All we're told that universal entitlement applies to "every individual who is a resident of the United States" and that " The Secretary shall promulgate a rule that provides criteria for determining residency for eligibility purposes under this Act."
Consumers should not be confused, there will be no effective governmental reform for health care or health insurance until public employees, including our lawmaking Congress are bound by the same laws that we are. Until that moment, it's a scam, there will be no blanket changes for improvement for consumers and we can all save at least a lot of time in listening to the trick campaigns for 2020.
