The Reasonably priced Care Act (ACA) was imagined to contain costs and make insurance for health / mental health care inexpensive. It did bring coverage to twenty million but 30 million remain uninsured.
Data indicate that the bad outweighs the nice. It’s too expensive, unsustainable, overly complex and bureaucratic. Even worse, it’s a present to non-public insurers and other 1% corporate stakeholders and profiteers within the neoliberal medical-industrial-Congressional complex.
For the reason that Reasonably priced Care Act (ACA) was enacted in March, 2010, Big Insurance has successfully lobbied Congress to be certain that most non-elderly Americans turn into compulsory customers of the private insurance industry and approve taxpayer financing of massive subsidies for that industry. The private insurance industry may be very comfortable with ACA. Americans are forced to buy the product of their private industry plus give huge tax-financed subsidies to their industry in the quantity of a half-trillion dollars per decade.
Since the for-profit, private insurance industry so thoroughly dominates our health care system, the essential concept, purpose and system of medical insurance is defined by them. The U.S. subscribes to a personal business model of medical insurance that defines insurers as business entities. Private insurers maximize profits mainly by limiting advantages, maximizing health policy premiums or by not covering individuals with health problems. Like all businesses, their goal is to generate profits. Under this business model, the greed of casual inhumanity is in-built and the common good of the residents and nation is ignored; excluding the poor, the aged, the disabled and the mentally unwell is sound business policy, because it maximizes profit.
Although medical insurance affordability for the vast majority of US residents still stays elusive, President Biden’s medical insurance plan desires to shift many more dollars into private, Wall Street insurance industry hands. The takeover of medical insurance by private Wall Street entities continues apace as Democrats/Biden propose to extend taxes and provides it to the private profit insurance industry—the essential source of our profound administrative waste, together with the costly administrative burdens they place on the delivery system that requires large profits. Profiteering continues unabated as private insurance sells us services we don’t need/want , corresponding to deductibles and other cost sharing, maintenance of narrow networks, requiring prior authorization with increased administrative costs, excessive ongoing paperwork/documentation requirements, all while avoiding paying for surprise bills and other denied advantages.
Fundamental Principles of the Neoliberal Health Insurance Industry:
- Promote deregulation—working/lobbying for the removal of presidency control over the industry. Historic examples of deregulated industries within the U.S. include the airline, telecommunication, and trucking industries.
- Maintain, strengthen and increase privatization—promote the transfer of ownership, property, or business from the federal government to the private sector. Examples of privatization include the medical insurance industry, the correctional system in the shape of for-profit private prisons, interstate highway system construction, privatization of public schools into private charter schools, privatization of medical diagnostic and treatment services corresponding to dialysis centers, specialty hospitals and other outpatient units.
- With neoliberalism, increase transfer of ownership and control of economic programs/services from the federal government to the private sector; promote the private sector’s influence on the economy by achieving deep reductions in government spending via austerity and huge cutbacks; discourage/block spending on all social welfare/mental health / public jobs programs (just like the Works Progress Administration (WPA) of the 1930’s) and other state/local/federal government programs. Governmental austerity paves the best way for more profiteering by those that seek to exchange government programs with private corporate entities.
Against this background, a burgeoning mental health crisis where hundreds of thousands of Americans cannot access or afford mental health care has emerged. Greater than 10% of Americans with mental illness haven’t any health coverage, but even those with costly business insurance policy can’t afford care. Business plans discriminate against mental health care by limiting selection of covered mental health providers; paying mental health providers far lower than other health providers; and restricting or denying common treatments corresponding to prescriptions, psychotherapy/counseling and hospitalization. A growing body of evidence shows that ignoring mental illness results in more sickness, more death and better health costs for everybody.
Sobering Mental Health Statistics:
- Suicide is the tenth leading reason for death overall within the U.S., and the second leading reason for death amongst youth and young adults aged 10-34. The suicide rate within the U.S. has increased by 35% since 1999.
- In 2019, 20.6% of U.S. adults suffered from no less than one mental illness, up from 17.7% in 2008. The share of Americans with serious mental illness in 2019 increased to five.2%, up from 3.7% in 2008
- Nearly one in ten (9.7%) youth within the U.S. had severe major depression in 2018. The State of Mental Health in America
- Drug overdoses caused greater than 70,000 deaths in 2019, a 57% increase from 2013.
- Mental health conditions have increased much more sharply amongst younger adults. The share of Americans aged 18-25 with mental illness went from 18.5% in 2008 to 29.4% in 2019. The share of young adults with serious mental illness greater than doubled, from 3.8% in 2008 to eight.6% in 2019.
Opposition to Public Mental Health/Health Programs and Insurances
Even with the harmful coronavirus pandemic, big insurance and large pharma proceed opposing laws for the brand new Medicare for All. These resistant, self-serving industries have essentially the most to lose if their huge profits are redirected to direct patient look after all. Individual and company predators regard democracy, government and community as obstacles to their greed and avarice, at all times placing profits over individual patients, families and public health. It’s no wonder so many beholden members of Congress wish to protect the interests of massive insurance and large pharma, industries that spent $371 million on lobbying in 2017 alone.
Health Insurance Profits 2020-2021
US medical insurance firms beat analyst expectations and reported billions in profits in the primary quarter of 2021, after making a windfall in the primary yr of the Covid-19 pandemic. The insurers’ success comes as small healthcare providers face unprecedented financial stress and hundreds of thousands of Americans struggle to cover health costs. The massive profits reaped by the insurance firms are also prone to increase criticism of the US healthcare sector.
Image by Angel Boligan
The nation’s largest health insurer, UnitedHealth Group, reported $4.9bn in profits in the primary quarter of 2021 in comparison with $3.4bn in the identical period in 2020 – a 44% increase. The upper than anticipated profits prompted the corporate to boost its projections for the yr. Anthem also beat estimates in its report of $1.67bn in profits in the primary three months of 2021, a 9.5% increase from the identical period last yr. Humana’s net income was $828m in the primary quarter, a 75% increase from the identical period the yr before.
CVS Health, which owns the Aetna medical insurance provider and drugstores, reported $2.2bn in profits, up from $2bn in the identical quarter a yr before. Cigna reported its net income fell to $1.17bn from $1.19bn in the identical period last yr, nevertheless it still raised its forecasts for the yr. Together, the businesses represent the country’s five biggest health insurers by membership. (The Guardian, May, 2021).
Neoliberalism support for privatization of medical insurance is grounded within the philosophy espoused by University of Chicago economist, Milton Friedman. Friedman said “the companies shouldn’t take note of the general public interest” and added that “the federal government itself shouldn’t take note of the general public interest. The job of the federal government is to easily let everybody make as much money as they’ll, nonetheless they’ll”.
Classical economist Michael Hudson notes that Big Pharma , like Big Insurance, doesn’t want any sort of anti-monopoly laws . “Essentially you will have what is named a free market, as advocated by Milton Friedman. A free market means the wealthiest people dominate the market and the provision of credit, the management of the economy that allocates credit, and who gets what shifts from Washington to Wall Street. It shift’s from the federal government to the private financial sector, and allows the financial sector to do the planning. One problem with that is the financial sector lives within the short run. So, it signifies that they only search for the subsequent three months, the subsequent yr’s balance sheet, since the free market is so complex you don’t know what’s going to occur. Well, after all, because you’re managing it from Wall Street you in point of fact do know what’s going to occur but you don’t wish to tell people exactly what’s going to occur”.
We’ve got several a long time of experience with neoliberal conversion of mental health services/insurance right into a business. Our health care is being rationed, with care guidelines determined by profitability and secrecy decided in private corporate boardrooms. To appreciate large profits demanded by Wall Street investors, our health system must attract the healthy and switch away the sick, disabled, the poor, most of the old, and the mentally unwell. Thus far, this country has been unable to eliminate private control of medical insurance even despite the small value it offers when 15 to 25 percent of the health care dollar is skimmed off for personal corporate profit and overhead. Neoliberals avoid the indisputable fact that if the prevailing public, non-profit Medicare program could possibly be prolonged to all residents for each mental and physical health and still containing lower costs.
Uninformed Voters Make Irrational Selections
American voters have fallen victim to an elections marketing system who’s task is to create uninformed voters who will make irrational selections. In a personal business-run society, you market commodities, you market candidates. Most electoral campaigns are designed to marginalize and avoid serious policy issues like inequality, insurances, mental health services, public health, Medicare, Medicaid, social services, women’s health, DACA, progressive taxation, climate change etc. Vital economic issues are avoided with political energy deflected onto wedge issues, superficialities, personality, rhetorical style, body language, mood swings, tweeting and other topics that quantity to us foolishly chasing our tails. In the long run, this enables the country to be run by a couple of big 1% economic interests looking only after themselves. Many citizens should not deluded because they only don’t really see any real selections or significant differences offered to them by Democrats or Republicans within the business-managed electoral system, where unfortunately essentially the most heavily funded candidate almost at all times wins.
Not only have each major U.S.political parties abandoned ideas and innovation, but additionally abandoned most voters. Republicans and Democrats alike are merely reactive to events/problems as demanded by their sponsors/donors in big business, oligarchs and huge unaccountable corporations. 2022 politics within the US has devolved into one party, the “business party”, with two branches, democrats and republicans., who engage in and promote distracting contests giving us the illusion that they’re principally different from each other on basic economic issues.
Since a reality TV star and real estate developer was elected president of the US, it’s clear that celebrity culture is a vital part of the company controlled financial system that govern our lives under the “business party”. Buffoon politicians from each parties have turn into shameless, beholden tools and lackeys of corporate America. They provide us a devil’s bargain mixture of self-serving toxic programs and policies, incessantly changing their positions as fast as others change socks. Will Rogers wrote: “A idiot and his money is soon elected”.
Conditions as described above have led to the statement that U.S.voters popular desires can’t be achieved because there’s no vehicle to precise their unhappiness, and there’s no way through which American voters can express what they need either within the Democratic or the Republican parties because they’re really the identical party and are in full agreement with what they’re doing.
The voters don’t matter; remember we’re talking in regards to the American definition of democracy, which is an oligarchy. Polls have shown large popular support by residents for Medicare for All, but neither political party has supported it. Michael Hudson writes that by “conquering the brains of a rustic by shaping how people think, you’ll be able to twist their view into ‘unreality economics’ and make them think you’re there to assist them and never to take money out of them, then you definately’ve got them hooked.” That is how Big Insurance and Big Pharma maintain control of U.S. medical insurance. Our system is privatized, financialized and unregulated so that non-public, big insurance firms can generate profits”.
President Biden and lots of Democrats have spent their careers defending the financial sector, including big insurance and large pharma, whose policy can be to keep up and further privatize basic health care financing and infrastructure. Economist Hudson further notes that, “Biden’s long political profession has been right-wing. He’s the senator from Delaware, the country’s most pro-corporate state—which is why most U.S. corporations are incorporated there. As such, he represents the banking and credit-card industry. He sponsored the regressive bankruptcy “reform” written and put into his hands by the credit-card firms. As a budget hawk, he’s rejected Modern Monetary Theory (MMT), and in addition “Medicare for All” as if it is just too expensive for the federal government to afford—thereby making the private sector afford to pay 18% of US GDP for health-insurance monopolies, way over every other country. Which means blocking governments from providing basic services at cost or on a subsidized basis—education, health care/medical insurance, roads and communications. Privatized and financialized economies are high-cost.”
Citizen’s United Decision: A Dark Day in American History
January 21, 2010 will go down as a dark day within the history of American democracy when editors of the Latest York Times wrote that the Supreme Court “Citizen’s United” decision that day “strikes at the guts of democracy” by having “paved the best way for companies to make use of their vast treasuries to overwhelm elections and intimidate elected officials into doing their bidding by reaching into the political process at hand unprecedented power to corporations.”
The Supreme Court ‘Citizen’s United’ decision opened the floodgates for giant money in our politics, allowing giant corporations and a handful of the wealthiest families to spend obscene amounts of cash in our elections. Residents United is just one in all a line of terrible Supreme Court decisions holding that cash equals speech and corporations are people under the First Amendment — thereby allowing huge corporations and the super wealthy/oligarchs to purchase undue access to members of Congress, and to effectively dictate legislative outcomes. This is important in policy decisions reinforced by influence of corporate lobbies, now further enhanced by the Court’s decision which favors the very small 1% sector of the population that dominates the economy. Our society is run by a class-conscious 1% business community dedicated to reducing the political and economic power of the 99%.
Resistance to true campaign finance reform, and powerful support for the usSupreme Court’s, ‘Residents United’ decision by unaccountable/unregulated large corporations and ultra-wealthy individuals/families, is predicated on their Machiavellian understanding of the aim of dark money in politics: to make use of dark money to alter political outcomes to favor themselves, the 001% oligarchs and becomes a threat to democracy because its source will not be made public. Dark money is corruption that erodes confidence and trust in local, state and national government and in each major political parties. It’s used to throw referendums and elections from which may come a lot of today’s social, economic, public health, mental health and environmental problems. Dark money is used to cover conflicts of interests and self promotion with bogus scientific controversies, fake news and pretend grassroots campaigns.
Corporate big business ideology asserts that human society is a market, and social relations are business transactions with a “natural hierarchy” of winners and losers. Attempts to limit competition, change social outcomes eg, estate tax issue, mandated medical insurance, etc. is treated as hostile to liberty and large business interests. Count on the neocons/GOP to crush unions and collective bargaining, minimize or eliminate tax and public protection regulations, privatize public services and promote privatization of all social/mental health/health programs. Inequality is okay because it’s a results of a reward for merit and generates wealth for the tiny .001%, which the false neoliberal myth says trickles all the way down to enrich everyone within the 99%. Tax and other social policies to create a more equal society are dismissed as counterproductive to the interests of the ultra wealthy.001%.
The belief that regardless of the market produces is rational and functional is the bedrock of Western economies. And it’s fallacious , says economist Michael Hudson, because It negates the indisputable fact that you really want some government power strong enough to override the self-serving special interests of oligarchs and other 1% corporate interests. And that takes a really strong government, which is why the free market people have at all times opposed strong government and why their economic models don’t give any acknowledgement for presidency investment in infrastructure that Biden wants or any government activity that’s in a position to override that of the 1% rentier class, the financial class, the property-owning class and the company monopolists. That’s the issue we’ve got.
“GOING THERE WITH DONALD TRUMP”: Adam Gopnik further describes how this problem is exacerbated in his 2016 Latest Yorker article,“ Going There with Donald Trump”:
(Gopnik excerpts prepared by Paul Street in CounterPunch, Aug 18,2022 article, “The Tendentious Mr. Brooks: the Chickenshit Conformist of the NYT”) …….. ‘an incoherent program of national revenge led by a strongman; a contempt for parliamentary government and procedures; an insistence that the prevailing, democratically elected government…is in league with evil outsiders and has been secretly attempting to undermine the nation; a hysterical militarism designed to no particular end than the sheer spectacle of strength; an equally hysterical sense of beleaguerment and victimization; and a supposed suspicion of massive capitalism entirely reconciled to the worship of wealth and “success” It’s at all times alike, and at all times leads inexorably to the identical place: failure, met not by self-correction but by an inflation of the unique program of grievances, and so then on to catastrophe. The concept that it could be bounded in by honest conservatives in a Cabinet or restrained by normal constitutional limits is, to place it mildly, unsupported by history…To associate such ideas too mechanically with the rise of some specific economic anxiety is to provide the movement and its leader a dignity and sympathy that they don’t deserve. In France, Jean Marie Le Pen’s voters are sometimes ex-Communists, working individuals who also consider their national identity to have been disrupted by immigration. That doesn’t alter, or make more sympathetic, the toxic nature of his program; the ideology that it resonates to is an ancient and protracted one, that thrives through good times and bad. That Trump can dominate an increasingly right-wing nationalist party with a right-wing, white-nationalist creed is neither surprising nor all that complicated. Anyway, the notion that a category cure will be had for a nationalist disease was the persistent, tragic delusion of progressive politics throughout the 20 th century.’
Private Health Insurance in Full Control of Mental Health Services – Still
With private business insurance firms in full control, they proceed to limit mental health care by limiting or denying claims for hospital stays, outpatient (office) visits, medication, psychotherapy/counseling, and other common treatments for mental illness and substance use disorders – as follows:
- Insurers are required by law to cover mental health and other health services equally, but courts have found that they routinely deny claims based on financial — not medical — reasons.
- In a single case, United Behavioral Health — the most important managed mental/behavioral health company within the country — was found guilty of denying 60,000 mental health claims for financial reasons. The lead plaintiff within the case was an insured patient who was denied coverage and had paid nearly $30,000 out-of-pocket for medically needed treatment.
- Business plans also restrict access to needed medications: A study of 84 different business health plans found that a majority of the plans covered fewer than 50% of antipsychotic medications, that are critical in treating illness like schizophrenia. In a single-third of those insurance policy, the vast majority of antipsychotic medications are only provided on a “restricted” basis, requiring that patients pay higher out-of-pocket costs.
- A review of greater than 90 studies shows that mental and behavioral services can reduce a patient’s overall health care costs by a mean of 20%. The Impact of Psychological Interventions on Medical Cost Offset: A Meta‐analytic Review
- Experience with Medicaid shows that eliminating the waste and greed of economic insurance improves outcomes and saves money. In 2012, Connecticut’s Medicaid program abolished its business insurance-run “managed care” model in favor of a nonprofit single-payer plan for enrollees. By eliminating the insurance middleman, Medicaid could invest directly in mental health by integrating physical and behavioral health care and adding community-based programs. Amongst Medicaid enrollees, emergency room visits have since fallen by 25%; administrative costs dropped dramatically, from 25% to three.5% of total costs; and overall health costs
Medicare for All Means Mental Health Take care of All
Business health insurers discriminate against mental health care and keep Americans from getting the services we’d like. There may be a greater way: Single-payer Medicare for All would eliminate the greed and administrative waste of economic insurance and canopy everybody within the U.S. for all medically needed care, including behavioral and mental health services, substance use disorder treatment, and prescription medications. With Medicare for All, coverage is lifelong and portable, and services are provided without the copays, deductibles, and surprise bills that keep patients from getting care. And in contrast to business insurance, Medicare for All provides free selection of any hospital or provider, including psychiatrists, psychologists, clinical social staff, licensed mental health counselors, and licensed marriage and family therapists.
Let’s always remember that Universal Medicare for All is a solid investment in all residents of our country by simply promoting a social service for universal access to inexpensive health care insurance for all. Aren’t we a society that cares enough to see that everybody receive the health care they need? That’s the essential purpose of Medicare for All, and it’s actually the suitable thing to do now with the Covid-19 pandemic.
The history of our most successful national medical insurance program, Medicare, provides among the best arguments for expanding this system to cover everyone. When Medicare was enacted 57 years ago, following a broad grassroots campaign, many believed the dream of a full national medical insurance system was right across the corner.
Unfortunately, five a long time later, Medicare still has not been expanded. Many of the changes have been contractions with higher out-of-pocket costs for beneficiaries and repeated attempts at privatization by big pharma, the medical insurance industry and its “champions” within the White House and Congress.
It’s time to finish inadequate and dangerous medical insurance programs. Insist on real medical insurance reform essential for people and families. American history is full of examples of fundamental, democratic change led to by successful mass motion and public pressure against the counseling of the neoliberal, privatization, 1% self-serving oligarchs/vested interest crowd. No more waiting! Ask your legislators to completely support Medicare For All now. Join the vast majority of Americans who support improved Medicare for All. Ask your legislator to support laws now filed within the House (H.R. 1976) and Senate (S. 4204) that may establish this badly needed reform.
Crossposted from Informed Comment.
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