http://readersupportednews.org/opinion2/272-39/8753-bomb-buried-in- obamacare-explodes-hallelujah
Bomb Buried in Obamacare Explodes - Hallelujah!
By Rick Ungar,
Forbes , 05 December 11
The 'time-bomb' Ungar refers to actually 'exploded' on December 2nd, the day this piece first appeared on Forbes. However, Ungar's point is not only still relevant, but the 'bomb' has been widely ignored by the mainstream media. -- JPS/RSN
I have long argued that the impact of the Affordable Care Act is not nearly as big of a deal as opponents would have you believe. At the end of the day, the law is - in the main - little more than a successful effort to put an end to some of the more egregious health insurer abuses while creating an environment that should bring more Americans into programs that will give them at least some of the health care coverage they need.
There is, however, one notable exception - and it's one that should have a long lasting and powerful impact on the future of health care in our country.
That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers' premium dollars they collect - 85% for large group insurers - on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.
This is the true ‘bomb' contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we've seen in quite some time. Indeed, it is this aspect of the law that represents the true ‘death panel' found in Obamacare - but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.
Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most.
Today, that bomb goes off.
Today, the Department of Health & Human Services issues the rules of what insurer expenditures will - and will not - qualify as a medical expense for purposes of meeting the requirement.
As it turns out, HHS isn't screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers.
Here's an example: For months, health insurance brokers and salespeople have been lobbying to have the commissions they earn for selling an insurer's program to consumers be included as a ‘medical expense' for purposes of the rules. HHS has, today, given them the official thumbs down, as well they should have. Selling me a health insurance policy is simply not the same as providing me with the medical care I am entitled to under the policy. Sales is clearly an overhead cost in any business and had HHS included this as a medical cost, it would have signaled that they are not at all serious about enforcing the concept of the medical loss ratio.
So, can private health insurance companies manage to make a profit when they actually have to spend premium receipts taking care of their customers' health needs as promised?
Not a chance - and they know it. Indeed, we are already seeing the parent companies who own these insurance operations fleeing into other types of investments. They know what we should all know - we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it.
Whether you are a believer in the benefits of single-payer health coverage or an opponent, mark this day down on your calendar because this is the day seismic shifts in our health care system finally get under way.
If you thought that the Obama Administration chickened out on pushing the nation in the direction of universal health care for everyone, today is the day you begin to understand that the reality is quite the contrary.
If you believe that the end of private, for-profit health insurance is some type of nefarious step towards a socialist society, then you might want to attend church this Sunday to mourn the loss of health insurers being able to worm out of covering the bills of a cancer patient because she forgot to write down on her application that she had skin acne for three months when she was a teenager.
Of course, those of you who fear the inevitable arrival of universal health care really shouldn't be too fretful. There will always be a for - profit health insurance industry for those who want to pay for it. The only difference will be that those who cannot afford private coverage will also have an opportunity to get their families the medical care that they need.
Everyone wins - except the for-profit health insurers.
I can live with that.
* * *
American Enterprise Institute Admits The Problem With Iran Is Not That It Would Use Nukes
MJ Rosenberg,
Media Matters, December 02, 2011
Suddenly the struggle to stop Iran is not about saving Israel from nuclear annihilation. After a decade of scare-mongering about the second coming of Nazi Germany, the Iran hawks are admitting that they have other reasons for wanting to take out Iran, and saving Israeli lives may not be one of them. Suddenly the neoconservatives have discovered the concept of truth-telling, although, no doubt, the shift will be ephemeral.
The shift in the rationale for war was kicked off this week when Danielle Pletka, head of the American Enterprise Institute's (AEI) foreign policy shop and one of the most prominent neoconservatives in Washington, explained what the current obsession with Iran's nuclear program is all about:
"The biggest problem for the United States is not Iran getting a nuclear weapon and testing it, it's Iran getting a nuclear weapon and not using it. Because the second that they have one and they don't do anything bad, all of the naysayers are going to come back and say, "See, we told you Iran is a responsible power. We told you Iran wasn't getting nuclear weapons in order to use them immediately." ... And they will eventually define Iran with nuclear weapons as not a problem."
[...]
Hold on. The "biggest problem" with Iran getting a nuclear weapon is not that Iranians will use it but that they won't use it and that they might behave like a "responsible power"? But what about the hysteria about a second Holocaust? What about Prime Minister Netanyahu's assertion that this is 1938 and Hitler is on the march? What about all of these pronouncements that Iran must be prevented from developing a nuclear weapons because the apocalyptic mullahs would happily commit national suicide in order to destroy Israel? And what about AIPAC and its satellites, which produce one sanctions bill after another (all dutifully passed by Congress) because of the "existential threat" that Iran poses to Israel? Did Pletka lose her talking points?
Apparently not.
Pletka's "never mind" about the imminent danger of an Iranian bomb seems to be the new line from the bastion of neoconservativism.
Earlier this week, one of Pletka's colleagues at AEI said pretty much the same thing. Writing in the Weekly Standard, Thomas Donnelly explained that we've got the Iran problem all wrong and that we need to "understand the nature of the conflict." He continued:
"We're fixated on the Iranian nuclear program while the Tehran regime has its eyes on the real prize: the balance of power in the Persian Gulf and the greater Middle East."
This admission that the problem with a nuclear Iran is not that it would attack Israel but that it would alter the regional balance of power is incredibly significant.
[...]
On Monday, Sen. Mark Kirk (R-IL) - AIPAC's favorite senator - will keynote an event at AEI, with Pletka and Donnelly offering responses. It will be moderated by Fred Kagan, another AEI fellow and Iraq (now Iran) war hawk. The event is built on the premise that "ongoing efforts to stop Iran from acquiring nuclear weapons have failed."
We all know what that means. AEI will, no doubt, continue to host these "it's time for war" events through 2012 and beyond, or until President Obama or his successor announces either that the United States has attacked Iran or that Israel has attacked and we are at her side.
If you didn't know any better, you might ask why - given that Pletka and Donnelly are downgrading the Iranian nuclear threat - AEI is still hell-bent on war. If its determination to stop Iran is not about defending Israel from an "existential threat," what is it truly about?
Fortunately, Pletka and Donnelly don't leave us guessing. It is about preserving the regional balance of power, which means ensuring that Israel remains the region's military powerhouse, with Saudi Arabia playing a supporting role. That requires overthrowing the Iranian regime and replacing it with one that will do our bidding (like the Shah) and will not, in any way, prevent Israel from operating with a free reign throughout the region.
This goal can only be achieved through outside intervention (war) because virtually the entire Iranian population - from the hardliners in the reactionary regime to reformists in the Green Movement working for a more open society - are united in support of Iran's right to develop its nuclear potential and to be free of outside interference. What the neoconservatives want is a pliant government in Tehran, just like we used to have, and the only way to achieve this, they believe, is through war.
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