quarta-feira, 13 de janeiro de 2010

Naked Capitalism blog: Quelle Surprise! Health Insurers Pretended to Play Nice, Lobbied Against Reform

Quelle Surprise! Health Insurers Pretended to Play Nice, Lobbied Against Reform

by Yves Smith, Naked Capitalism, January 13, 2009

The headline above would normally be seen as “dog bites man” save for the fact that during the health reform debate, the insurers went to considerable lengths to profess they really, really had changed their ways and were now going to be good corporate citizens.

But it was pretty clear that this change of heart was just a charade. After all, if Obama was going to give the industry the store, they had to look like nice guys. You don’t give massive subsidies to people who are obviously predatory, unless they are from the financial services industry and thus can credibly threaten to destroy the economy. And from the insurance industry’s standpoint, what’s not to like about the new program? Tens of millions of formerly uninsured people will be required to buy policies from them, plus the percent of premiums they are mandated to pay out in benefits is considerably less than what they spend now (meaning the legislation in no way threatens their margins; in fact, it legitimates them and would even permit them to enlarge them). And as we will discuss soon, some of the advantages claimed for the bill are hollow.

We were very leery of the industry’s charm offensive. As we wrote last August:
My bullshit meter went into high alert earlier this week with this New York Times story, “For Health Insurers’ Lobbyist, Good Will Is Tested,” which was clearly a PR plant. It featured Karen Ignagni, a $1.6 million-a-year earning lobbyist to the health insurance industry as a heroine (I started getting nauseaous as soon as I saw the deliberately low-key picture of her in her office). And why should we see a representative of one of the biggest forces undermining democracy in America, the usually-successful efforts of well-funded industry groups to steam-roll legislative process, as a good guy, or in this case, gal? Because she supposedly talked a mean and obstructionist industry into playing nice.

This NYT article thus manages to be a two for one, trying to re-image both the health insurance industry and lobbyists. Consulting my Divine Comedy, I find lobbyists are relegated to the eight circle of hell no matter how you cut and slice it, as either flatterers (second bolgia) or false advisors (bolgia eight) or falsifiers (bolgia ten, along with alchemists and perjurers). This puts them on the same general level as corrupt politicians (bolgia 5), although one could make a case they belong in the ninth circle, traitors.

To the Times’ puff piece:

For the insurance industry, long an opponent of health care reform, it was a striking change: with a new administration coming to Washington, insurers agreed to abandon some of their most controversial practices, like denying coverage to applicants with pre-existing medical conditions.
The truly offensive bit of the piece was the Grey Lady running full bore with the line that they were being unfairly castigated, they really had turned a new leaf, and those people who were Calling Them Bad Names were risking breaking up Ms. $1.6 million woman’s fragile coalition:

For a while, it seemed to be working — until recently, when the insurance industry re-emerged as Washington’s favorite target. “Villains,” Nancy Pelosi, the House speaker, called health insurers. And Mr. Obama derided the industry for pocketing “windfall profits.” 
Taken aback, Ms. Ignagni, the 55-year-old chief executive of the trade group America’s Health Insurance Plans, wondered on Tuesday why insurers were being singled out when, in her view, they had accepted that change was necessary.
“Attacking our community will not help get anyone covered,” she said.
The last statement was very revealing. It’s tantamount to “We still hold the whip hand.” And it appears they do.
Back to today’s update. Notice that the big concession that the industry supposedly made was its stand on pre-existing conditions. But the bill has a giant loophole: insurers can continue to cancel policies in the case of “fraud or intentional misrepresentation” as they do now. Readers have no doubt hear of or read about how low the permitted bar is now for insurers to rescind policies. And when are insurers most likely to look to find grounds not to pay for treatment? When you most need it, of course, when you have a serious, expensive ailment.

National Nurses United, a 150,000 member organization, opposes the bill. Some of its reasons:
As Jean Ross, NNU co-president noted, “the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the healthcare industry lobbyists and the lessons of this year in which all the compromises have been made to the right.”….

Individual mandate was the top priority of the insurance industry, which also succeeded in fending off meaningful restraints of its predatory pricing practices. The likely outcome is that far too many people will still face healthcare insecurity or medical bankruptcy due to ever rising out-of-pocket costs, or continue to skip needed medical care because of the high prices.

Indeed, discouraging provision of care as the preferred way to control costs, rather than rein in the pricing practices of the insurance and drug giants, is a central tenet of the insurance industry and conservative policy wonks.
So the story thus far is that Team Obama was handing the insurance industry everything it wanted on a silver platter (recall the shameful incident in which the public option was dropped despite Congressional support; it was a mere trading chip, not something Obama was ever serious about). The industry was supposed to play nice.

Well it didn’t even hold up that part of the bargain. Admittedly, Congress started calling the insurers bad names. Please. The dealings with Team Obama had been so cozy that a little roughing up would have good PR value for both sides. It would create the appearance that the powers that be had not caved in to the insurers.

And a general rule: in a good negotiation, both sides come out feeling a little bruised and unhappy. No one gets everything they want. But the insurers weren’t about to adhere to the new posture they had pretended to adopt to win over the public. As soon as they started encountering opposition, they cranked up the attack ads. But rather than fund them directly, they channeled money through the Chamber of Commerce. From the National Journal:
Just as dealings with the Obama administration and congressional Democrats soured last summer, six of the nation’s biggest health insurers began quietly pumping big money into third-party television ads aimed at killing or significantly modifying the major health reform bills moving through Congress…

The fundraising started last September and continued through December using AHIP as a conduit to avoid a repeat of the political flak that hit the insurance industry after it famously ran its multimillion-dollar “Harry and Louise” ads to help kill health care reforms during the Clinton administration…

Publicly, the group has stressed repeatedly that it supports health care reform legislation…
Since last summer, the chamber has poured tens of millions of dollars into advertising by the two business coalitions that it helped assemble: the Campaign for Responsible Health Reform and Employers for a Healthy Economy.

In late October, the chamber helped cobble together a larger coalition, Employers for a Healthy Economy, which became the key advertising vehicle for attacking provisions in the House and Senate bills being developed…The ads sharply criticized the high costs of the separate bills, especially the House version. The commercials warned the legislation would raise taxes for Americans and hurt the economy as it tries to recover from the recession. And some chamber-financed commercials attacked setting up a government run plan to compete with private insurers — a special sore point for the insurance industry — which is part of the House measure.

The U.S. Chamber has spent approximately $70 million to $100 million on the advertising effort….Sources say that the chamber-backed ads will likely continue as the two bills are combined in coming weeks.
Yet if any bill passes, the industry will show greater earnings, which will allow them to spend even more on lobbying and advertising, which will enable them to secure even more favorable legislation.

Link:  http://www.nakedcapitalism.com/2010/01/quelle-surprise-health-insurers-pretended-to-play-nice-lobbied-against-reform.html

8 comentários:

the gritty poet disse...

I think you have a liberal take on the universal health care issue. Nothing wrong with that but how about offering a different perspective like this one http://www.theonion.com/content/video/study_most_children_strongly


Tenney Naumer disse...

You be funny! hahahaha

the gritty poet disse...

I looked at your profile and was wondering if you wouldn´t mind writing a post about the region you live in. I am thinking of taking a Chapada Diamantina + Bahia oceanside trip. Perhaps Chapada then Boipeba since Morro de São Paulo is a bit too hectic for me.
I don´t need info about getting there, logistics etc etc. I am looking for a personal opinion. What do you think is enjoyable about your region? Perhaps some tips on where to eat and stay in those enjoyable places could be included.
Thank you.

Tenney Naumer disse...

Up in Chapada, I recommend going to Mucujé. Somewhere before Mucujé is a nature reserve -- I believe it is called Sempre Viva, after the flowers that are collected there (when they dry out, they can be dyed many colors, and they are the ones that you often see stuff on the little cacti for sale in florists' shops).

The area where I live has been completely deforested for hundreds of kilometers in all directions. There is little to see.

Morro de São Paulo is very small and extremely crowded with young people, so try to go in the off season. I haven't been there for about 10 years.

I prefer simpler places like Ilha Grande de Camamu, which will likely disappear under rising seas.

Although I have been here for 12 years, I have not travelled a lot. This was due to my ex-husband. Let's not go there.

Good places to eat...hmm.
I have a friend who knows fab places in Ilheus, and another who knows places in Salvador, but beyond those two cities, I cannot help you. Just let me know if you want info on them.

the gritty poet disse...

Thanks for the info. I use this site www.cidadeshistoricas.art.br to plan for many of my trips, just thought I´d leave the url here since it may be of use to someone.
I am thinking of driving since bus fare has gotten to be as costly as taking your own car. In my mind there won´t be a problem storing the vehicle at Chapada and if you decide to visit the islands leaving from Camamu I can place the car in a private garage and pay a fee. Does this sound reasonable?
Oh I have heard wonderful things about Bahia but a reoccurring complaint is that of a certain tolerance Bahianos have with mosquitos in their establishments. True?

Tenney Naumer disse...

Listen, I have lived in Bahia for 12 years, so the shine is off.

As far as this city of 300,000 goes, I was one of the first to have screens put on the windows of my apartment and later on my house.

You will definitely want to bring repellant. Dengue is no joke. Sand fleas also carry parasites. Do not walk barefooted anywhere. Untreated sewage goes straight out to the Atlantic. Drink only bottled water. I contracted a parasite 3 years ago, and some of them are already drug resistant, as is this one.

Never drink out of a coke can without washing it first.

Since Wagner became of governor of Bahia, things in Salvador have gone downhill drastically. Five years ago, it was pretty clean and safe. Now, it is getting to be as bad as Rio.

Where are you anyway? Do you have any experience driving on Brazilian highways? Well, the buses crash all the time anyway, so I suppose a car is just as safe. Lots of drivers have no license, no insurance, no idea of the traffic laws or why they should follow them, and they drink.

I suppose I am jaundiced because this city has one of the highest per capita accident rates in Brazil. Seems worse than Pakistan. Have you ever been on the highway in Pakistan?

Carjacking is also rampant.

I personally know someone who had a big soy farm out in Barreiras. He and his wife flew into Brasília, rented a big SUV, and began to drive to their farm.

On the way, they stopped to get gas in the middle of nowhere.
When they left the station, they were followed by a car, the occupants of which eventually began to shoot at them.

They survived because he slowed down until they were alongside, then he rammed them so hard they went off the road.

I also know a Canadian who drove a brand new BMW motorcycle all the way down here from Canada and then on to Rio and did not have a single problem, but then some people lead charmed lives.

the gritty poet disse...

"When they left the station, they were followed by a car, the occupants of which eventually began to shoot at them.

They survived because he slowed down until they were alongside, then he rammed them so hard they went off the road."

Reading this makes me happy. The criminals got the worst of it, just wished your friend had hit them hard enough to capsize their vehicle.

Thanks again for the tips.

Tenney Naumer disse...

I should have said that I "know of" this couple. I have only had a phone conversation with the wife, but I heard the story from another American who used to live here who knows them.

A bunch of Illinois farmers bought land in western Bahia because it was so cheap and apparently great for growing soybeans. However, it was not the fab deal they thought it would be once they experienced their grain trucks being hijacked before they could sell it, etc.

Except for around Salvador, there are only two-lane, badly patched, asphalt highways -- that goes for the so-called "national" highway, as well.

One thing I have seen a lot of is a driver coming from the other direction will pass even if there is no room, meaning that you simply must get over and get out of the way or crash head-on.

They also pass large vehicles while going up hills, and when going around blind curves.

When you are behind a bus or large truck, the driver will signal to you that it is not a good time to pass due to on-coming traffic by turning on their left-turn signal.

They will also signal when the coast is clear by turning on their right-hand turn signal -- if you feel like trusting their judgment.

In the U.S., when your car breaks down and you have to park it in the emergency lane or somewhere where it might impede traffic, you are required to get that triangle sign out of your trunk and put it down the road behind your car.

Here, it seems most people do not own a triangle.

Instead, you are likely to see some small branches pulled off trees or bushes, with green leaves, hopefully. This signals that there is a car stopped up ahead on the side of the road. Not of much use at night, of course.

In towns and cities, you will often see the car in front of you swerve, suddenly, either to the right or to the left, and then you will see that they were trying to avoid a manhole cover. They don't trust them to be stable.

Sometimes, the manhole covers are stolen. Then, you might see a leaf-covered branch sticking out of it, to warn drivers that it is an open hole.

Stops signs are not obeyed. They appear to be mere suggestions.

Yield signs are just meant to give offense.

Motorcycles break every known law. While they are doing this, they fully expect you to move out of their way. They die by the thousands every year.

Then there is the custom of pulling over to the right side and letting the cars behind you pass until you think it is safe to make a left turn.

Fewer and fewer drivers still do this, but some still do.

If you are driving on a one-way street with two lanes, drivers on your right will turn left in front of you at the intersections and vice versa. Motorcycles especially.

Never expect a pedestrian to look both ways before they cross a street, especially not expectant mothers.

In this city (I can't speak for the rest of Brazil), when it gets dark, people will start their cars, back completely out into the street, put the car in forward, start to drive down the street, and then and only then will they turn on their headlights. Sometimes, of course, they forget.