In recent months I've repeatedly heard a litany of scripted lamenting from self-styled Konservative or genuine Conservative Americans all concerned about the mechanics and costs of the Affordable Care Act. True to the partisan Republican/Konservative rhetoric that seems to script so many anti-liberal persons and perspectives, the question arose multiple times.
"How the heck are we ever gonna pay fer that?"
Fact is that the ACA is well-planned whether the new government website runs like a Dodge or a Toyota or not. The funding is there despite what Faux News and Konservative Koncerned have to say about it. But my task is not to defend the party of the President. They can do that for themselves quite nicely.
No, my task is the hunting and smacking of GORKs ... King Aragorn, Legolas and Gimli went after Orcs to make Middle Earth a safer place to live. Well, I quite enjoy hunting dumb but dangerous animals, Grand Old Party Konservatives.
"How are we going to pay for the GOP Medicare D boondoogle."
I was asking that question some seven years ago when an earlier crop of fiscally and civically irresponsible GORKs passed the "new" Medicare Prescription Drug Benefit. That was at a time when the know-it-alls and their lobbyist coaches controlled the House and the Senate and were abetted by a president who appeared to possess the economic depth and understanding of ... well ... Orcs.
Next time the money-wasters pretend to shed alligator tears over all the aspects of the American budget that they have yet to get to the lobby trough, remember ... they're only GORKs and you can't trust GORK wisdom that doesn't exist.
Here's something I wrote that was published in its entirety in the local papers back then about the Medicare legislation Bush, Hastert and Frist blessed us with ...
Thinking that congress had your best interests in mind when they legislated the new Medicare Prescription Drug Benefit?
To understand why your new Med D prescription benefit is so complicated, confusing and expensive for your budget, you must understand one thing about the economic theory of the elected Republican majority at the national level.
"What's good for corporate capitalism is good for the country."
They really believe that.
They really believe that economically and socially the wisest plan is for "pseudo conservative" legislation to force all of us to get out of the way while tax cuts to the rich and loopholes to business make our lives better.
Medicare D is modelled on one of our classic corporate capitalist national failures: our commercial health insurance system. That's the vaunted one that under the most powerful economic force in the world has left us in 37th place globally in terms of effective and quality national health care.
That's the vaunted one that any system modeled after Britain or Canda or any other country where EVERYONE is covered would never exceed the vauntedness of corporate America's capitalist dream.
Here's how they did it ... and you must remember the power of lobbying in this country and how senators and congress persons can't decide how to vote until a corporate capitalist prompts their wisdom with cash.
These wise lawmakers chose some 260 private insurers (corporations who supported this scheme with lobby money given primarily to - you guessed it - Republican lawmakers. Republicans, you surely remember, are the majority in congress and therefore have the power to turn the scheme into law). Now then, these wise partisan lawmakers have forced you to choose one of those elite insurers.
Who are these chosen 260?
Why they're private pharmacy benefit insurers, HMO's, pharmacy organizations like Walgreen's, Long's and Wal Mart.
You surely didn't think they are social-minded or populist organizations like the Grange did you?
Naw ... these aren't social minded do-gooders. They're the profit-minded self-interested.
Our economically "wise" lawmakers have now made it legal for our government to send YOUR medicare money - I mean it, the actual money that would be used as your individual medicare benefit - to the corporation you have to pick from among the 260.
It's an automatic revenue the corporation will spend advertising or marketing costs for in order to out-muscle the competition which will then be passed on to you as part of the additional premiums you'll pay out of pocket for your medicines.
This is a free-market system run amok.
In some areas seniors have 40-50 choices of plans. The plans have confusing choices of options, many of which involve differing monthly premiums (ranging from $0 to $60).
There are combinations of deductibles.
There are combinations of co-insurance (your percentage/their percentage of the medicine's price).
There are options to try cheaper generic drugs.
There are "tiers" (levels of priority and/or allowability) based on copays, generics, preferred brands, non-preferred brands, specialty drugs ...
and whether you buy from an "in-network" pharmacy with discounts or "out-of-network" pharmacy with no discounts.
There is no standardized nomenclature (no set of names, concepts, options and plan definitions that are standard among all of the 260 chosen corporate medical monopolists.)
One uses the phrase "co-pay";
another calls it "deductible".
What if we folks have questions?
Well, we can go on line to a web site with a complicated web answer-giver. If you're one of the 75% of seniors who have never gone on line - well, chin up! A whole new cyber adventure is out there just waiting for you to invest in another corporate hog-trough sector by buying a computer and joining the internet surfer society.
What's going to happen with this pick-your-pocket-because-you're-over-a-barrell scheme?
Remember, the Republicans got this doofus plan passed with a projected price tag of $400 billion - a little less than the current sub-total for war spending in Iraq and Afghanistan by the way.
We then learned that the Bush Administration told Medicare officials - in the tradition of Bill O'Reilly - to SHUT UP. They were told to keep the real cost which is in excess of $550 billion a secret.
What about the sacred chosen 260?
All vendors are not expected to remain "competitive." That means that not all vendors are expected to survive in the free-market system.
No, the biggest sharks with the biggest teeth and the biggest lobby dollars will win the survival of the health insurance fittest. We'll see the 260 reduced to perhaps 10 survivors; mega-innsurers who will slug it out for all the leavings of those other 250 who just couldn't make it.
And instead of free-market capitalism we'll have closed-market monopoly based on sending Medicare tax dollars to friends of the Republicans.
Who might that be?
Well, United Health Group is spending 75 million on marketing and operations for this new Republican give away.
Aetna= $50 million
Cigna: $40 million
Humana (a midwest regional insurer)= $80 million.
Pfizer's in there too. You know Pfizer ... Bob Dole sold his Viagra perspective for Pfizer.
But those investments are chump change compared to what happens when all the Medicare clients sign on to automatic directed payments to the chosen hog-trough recipient.
This is the Republican American Way of course and whatever premium you pay to your chosen insurer will include recovery of that marketing money.
Then there's this: You'll hear words of wisdom from the Medicare RX Education Network and may receive mailings in envelopes bearing a return address of the U.S. Chamber of Commerce.
You are forgiven if you mistakenly assume these are official government communications to you.
They are not.
They have been allowed by Republican free-marketer politicans to use the government's official logos.
And if you run into something called "Medicare Today," you'll be seeing a creation of the Healthcare Leadership Council.
Who's that you ask?
Well, a group of hospitals, drug companies, medical equipment makers and academic medicate centers joined up some 300 members. They then raised millions of dollars for "outreach" to get seniors to sign up and authorize one of them to receive government Medicare dollars earmarked in your name.
The 37th best medical care system in the world is 37th because that system functions in the tradition of Exxon-Mobil's double-digit billions of dollars quarterly profits.
However, the 37th best medical care system is #1 in what is the truest priority: Turning billion-dollar profits while at the same time failing to adequately treat and protect all of its citizens.
That's the linkage between corporate lobbyists and corrupt politicians. That linkage and system is more and more revealing itself as foundational to the failed economic politics of contemporary corporate conservative Republicanism.
© Arthur Ruger 2006
*Reference: The Nation, January 30, 2005 - KILLING MEDICARE by Trudy Lieberman who writes about healthcare for The Nation.