Health Care Reform, Think Tank Style

Don't underestimate the power of the think tanks, institutions and lobbies in Washington to influence government policies and programs. Remember that Obamacare was partly a takeoff from a right wing Heritage Foundation plan.

The American Enterprise Institute (AEI) is a conservative, right wing think tank established in Washington in 1938 located on Think Tank Row. This is a scumbag organization made up of greedy, power hungry bastards.

(Did I say that out loud? I'm sorry, I won't apologize.)

"Some AEI staff members are considered to be among the leading architects of the Bush administration's public and foreign policy.[5] More than twenty staff members served either in a Bush administration policy post or on one of the government's many panels and commissions. Among the prominent former government officials now affiliated with AEI are: John R. Bolton, former Ambassador to the United Nations; Lynne Cheney, former chairman of the National Endowment for the Humanities; Paul Wolfowitz, former Deputy Secretary of Defense. AEI current scholars include Kevin Hassett, Ayaan Hirsi Ali, Michael Barone, Nicholas Eberstadt, Jonah Goldberg, Phil Gramm, Steven F. Hayward, Glenn Hubbard, Frederick Kagan, Leon Kass, Jon Kyl, Charles Murray, Norman Ornstein, Mark J. Perry, Danielle Pletka, Michael Rubin, Gary Schmitt, Christina Hoff Sommers, Jim Talent, Peter J. Wallison, and W. Bradford Wilcox.[6]"

https://en.wikipedia.org/wiki/American_Enterprise_Institute

I visit some of these websites occasionally to see what they're up to, usually pertaining to foreign policy. I thought I'd check to see what their reaction to Trump was and the first article I see on the AEI website indicated health care reform is of the highest priority. And you know these right wing conservatives are not concerned about the people, that's not why health care "reform" is of the highest priority to them. Trump and the republicans take power and they're going to do just what they said they'd do.

"Despite, and in a sense because of, the enactment of the Affordable Care Act (ACA) in 2010, US health care is still badly in need of reform and revitalization. Instead of more federal regulation and subsidies, what US health care needs is adoption of market principles, starting with broad empowerment of the patient-consumer. The proposals advanced in this volume would replace many counterproductive and outdated federal policies with practical, market-based reforms that aim to provide all Americans with access to high-quality health care at affordable prices."

http://www.aei.org/publication/improving-health-and-health-care/

"Market based reforms". If you look through their proposal it's filled with "market based reforms", i.e., giving more power to the corporations over your health care. Here's their proposal for Medicare:

"Medicare is pivotal to an effective reform of US health care because of its dominant regulatory role. Medicare’s rules for paying hospitals, physicians, and other service providers heavily influence how care is delivered to all patients, not just Medicare enrollees.

The program would improve if there were fewer regulations and more emphasis on market-based reforms. The starting point should be conversion of the program, on a prospective basis, to a premium support model."

It's game on now for health care. Not only are we not going to move toward single payer, we're going to move further away. We've been set up for the kill and it's the republicans turn to finish the job. This is gonna be rough.
The United States already has the most expensive health care system per capita on the planet, by far. Trump and the republicans want to make it worse and you can bet the Democrat party won't stand in the way. When the think tanks push things you can be sure Congress hears about it, that's why they're there.

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for coming up with semi-plausible excuses for continued exploitation of people and resources. The 1% tells the think tank what it wants to do and the think tank comes up with what seems to be a coherent scheme in order to sell the scroogie to the people.
I think most of what come out of these places is preordained: only the verbiage is added at the tank.

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"The justness of individual land right is not justifiable to those to whom the land by right of first claim collectively belonged"

Big Al's picture

a big part of behind the scenes running of our government. This does not look good.

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divineorder's picture

And thanks for monitoring those propaganda spin factories which are key bad actors keeping us in endless war.

I have no love for ACA but also on Medicare/Teacher Retiree Health Benefit secondary. There are some that would like to keep it but I want single payer instead.

Wonder if the article I found from Brookings , another group of tanksters , which said that ACA premiums etc were not a reason to get rid of it because they are still overall less than they were before ACA signals that there are some of TPTB who want to keep ACA because they are making a killing off it?

Agree this does not look good. Hopefully it will just amount to Ryan et al posturing but not passing anything because it would leave Republicans in the hot seat for its failure.

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A truth of the nuclear age/climate change: we can no longer have endless war and survive on this planet. Oh sh*t.

That seems more appropriate.

I wonder what in roads they've made in the so called progressive think tanks? The fatcats need to be a bit more discrete there, but the potential dividends from weakening the opposition from the inside soul be hard to pass up.

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Big Al's picture

late 2014. Same kind of thing, market based reforms, supposedly allowing the consumer the "freedom" to control their health care and costs. Do you believe this? This is what will be pushed to replace Obamacare.

"Policymakers who reject increasing government control in health care can pursue an alternative path—based on the principles of patient-centered, market-based health care reforms. Such a path empowers individuals, gives them greater choice and control, and allows them to make their own health care decisions."

http://www.heritage.org/research/reports/2014/10/a-fresh-start-for-healt...

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of anything that humans need to thrive.

if they could, a nation as wealthy as ours would have nobody who was:
hungry
homeless
uninsured

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The earth is a multibillion-year-old sphere.
The Nazis killed millions of Jews.
On 9/11/01 a Boeing 757 (AA77) flew into the Pentagon.
AGCC is happening.
If you cannot accept these facts, I cannot fake an interest in any of your opinions.

a profit-skimming layer of parasites improve the system? Allowing Medicare to negotiate drug prices would improve the system but involving insurance companies, whose role is to deny coverage and add costly waste, hurts the system.

This is the type of crapola the think tanks come up with to gull the gullible and give the media something to talk about to try and convince people the pickpocket capitalists will deliver health care better than the government agency. They can't.

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"The justness of individual land right is not justifiable to those to whom the land by right of first claim collectively belonged"

to back up their ridiculous proposals.

They don't engage in even a minimal amount of analysis. Ridiculous.

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"If you can't eat their food, drink their booze, take their money and then vote against them you've got no business being in Congress."

reflectionsv37's picture

But, but, but... They have warehouse after warehouse filled to the ceiling with all the dry powder they saved up during Nancy Pelosi's term as speaker. Surely they'll take the padlocks off the doors and rush that dry powder to the front lines to be used by all the brave, fearless and unyielding democratic Senators and congress people to fight this war against the republicans. They'll take no prisoners and never accept defeat. They'll stand together and fight to the last breath of the last man standing!

Wow! That was a weird dream!!

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“Our enemies are innovative and resourceful, and so are we. They never stop thinking about new ways to harm our country and our people, and neither do we.”
George W. Bush

you're on, I'll take Two, please?
And thanks!

peace

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Ya got to be a Spirit, cain't be no Ghost. . .

Explain Bldg #7. . . still waiting. . .

If you’ve ever wondered whether you would have complied in 1930’s Germany,
Now you know. . .
sign at protest march

Thaumlord-Exelbirth's picture

it will be extremely difficult for Republicans to avoid the blame for health care falling apart if they do anything involving it.

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enjoy shopping for just the right drs. who are both qualified and affordable!
And choosing the perfect medications!
Just so I do not get accused of being ageist, the only 50-somethings I know who understand their health insurance policies work in the health care profession.
I just do not see how the many elderly people in this country who do not own a computer, who need assistance fueling their cars at the convenience store pumps, can be regarded as a savvy health care consumer class.
They are not the only vulnerable class, just the ones who will fare the worst from the changes to come.

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"We'll know our disinformation program is complete when everything the American public believes is false." ---- William Casey, CIA Director, 1981

PriceRip's picture

          I am more educated than the norm and I view the present situation as daunting. If it gets even less user friendly I will just "throw in the towel".

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in my policy means. Anything I think I understand gets blown out as soon as I enter a doctor's office.
And since I am working, I have no time to get on the phone, spend hours getting shit explained to me.
No matter what the fuckers tell me, the bottom line is there are always out of pocket expenses to be paid.
I work for a boat load of elderly people. They are embarrassed, vulnerable to scams, and in the last few years, I am preparing wills and medical powers of attorney, and "do not resusitate" directives for them, watching them choose to go to hospice very early on so their spouses will not be left with bills.
A government that lacks compassion is not worth having.

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"We'll know our disinformation program is complete when everything the American public believes is false." ---- William Casey, CIA Director, 1981

PriceRip's picture

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putting any remaining asset in the hands of the profit pirate scavengers waiting for my demise. I would rather choose my time and place or

go to hospice very early on so [my] spouse will not be left with bills

My end of life plan includes living in a state which allow my freedom to choose my time and place. I will not feed the parasites who profit over the illness and death that we all will some day face.

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“ …and when we destroy nature, we diminish our capacity to sense the divine,and understand who God is, and what our own potential is and duties are as human beings.- RFK jr. 8/26/2024

Cachola's picture

and when it was time to choose a Medicare plan I was so overwhelmed that I decided to just stay with the same people I had before turning 65.

ETA. Lawyer by training. I haven't practiced in 10 yrs due to major depression episodes.

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Mundus vult decipi, ergo decipiatur.

depend on choosing my Medicare supplements based upon what a friend has. He fell, broke his hip, had an ambulance ride to the hospital, had surgery, rehab, pt, home health, and didn't pay a cent.
Whatever he has, I will have, come May 1, 2017.
My 2 doctor clients steered me to BCBS. That has worked out much better for the drs. than for me.

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"We'll know our disinformation program is complete when everything the American public believes is false." ---- William Casey, CIA Director, 1981

PriceRip's picture

          As a state employee in Nebraska BCBS worked very well for me. It was the default option for most of the past 37 years. When I retired I specifically sought out the BCBS rep to help me file the appropriate forms.

          The lack of uniform high quality is distressing to the point of undermining ones health . . . ironic . . .

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and the general health insurance / health care dichotomy in the USA better than most, because I have been struggling with cancer and treatment costs since 2014. Currently in remission, thanks to good doctors and medical advances.

For me, the annual maximum out-of-pocket is the single-most important aspect of choosing a policy during open season. Copays, coinsurances, deductibles, HSAs, even the costs of premiums, they all are secondary to that single variable. In both 2015 and 2016 I reached the limit in the first few months of the year. (In 2014, unaware I was getting sick, I had stumbled in to a great health insurance policy, purely by accident). During both 2015 and 2016, my medical expenses (the negotiated expenses, not the MSRP) exceeded $250K. I am here today, smugly self-aware that I am worth $500K to someone. I never was worth $250K per year to an employer, but someone (bigPharma mainly) has made a bucketload of money in my name.

A second consideration, for most of us, is to recognize that to maximize your insurance benefits you need to stay in your network. That's not so easy these days, because almost all health service providers use contractors, and when you turn up for a treatment or an office visit or whatever, you are asked to sign (digitally, these days) that you are aware some of those contractors may not be in your network. I always sign with a note: I agree to hire only in-my-network contractors.

A third very important factor that comes as an ugly surprise to some new sicklings is that Medicaid comes with a twist. MEDICAID, for those 55 or over, has a clawback for $$$ spent for certain aspects of medical care (although the states can clawback for ALL of the money they spent on you, sometimes including $$$ they paid in your name when you never even visited a dr, presently only about 1/2 actually do). The clawback happens even if you've survived long enough to transfer over to MEDICARE, as I understand it. The clawback takes place upon your death, and reduces your estate (usually they take your house or put liens on it), except if there is a caretaker spouse or child who can prove they were your caretaker for a prescribed period of time and that they have a legal right to the property. This is a burden that falls on only seniors with estates who had to go on to (or were pushed by the ACA on to) MEDICAID.

This is especially ironic because the MEDICAID program is not allowed to negotiate drug prices so if you've been the beneficiary of MEDICAID $$$, upon your death your estate pays retail retroactively . The link explains how this problems is exacerbated under the ACA. The clawback was instituted by the democratic congress of 1993 (Gropey Clinton pre Grinch era). Another link, more details.

I belong to various cancer support groups, and can report that in the last few days, many members (some of whom voted for Gropey Trump in full awareness of the gotp war on the ACA) are now freaking out about the possible loss of ACA protections.

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~annominous

Your priority list is spot on.
I would point out that location and network providers can be killers.
My rural ambulance has a contract to er at 3 hospitals. None are in my network. None of the drs. are in my network.
Now, a lawyer pal of mine happened to have a massive heart attack while in downtown Houston. He refused the ambulance service because it would have taken him to the nearest hospital, which was out of network.
He never recovered. He tried to enter rehab to get strong enough to have open heart surgery, but died before it happened.
He had good insurance.
He just had a bad location.

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"We'll know our disinformation program is complete when everything the American public believes is false." ---- William Casey, CIA Director, 1981

Unabashed Liberal's picture

for folks who participate in Medicaid, most states have converted to managed care systems from what I've read.

And, that means that even folks who are on Medicaid--even those who never darken the door of their health care providers--are subject to the MERP for the recovery of their plan's monthly capitation fees.

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit and therefore– to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

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Everyone thinks they have the best dog, and none of them are wrong.

divineorder's picture

Hold him to his 'word' to not let the establishment Repugs fck with medicare as social security.

Futile, but a start.

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A truth of the nuclear age/climate change: we can no longer have endless war and survive on this planet. Oh sh*t.

The usual BS right wing idea for people with pre-existing conditions. Because everyone with a PEC can afford to pay $1500 a month for health insurance, right?

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"If you can't eat their food, drink their booze, take their money and then vote against them you've got no business being in Congress."

Big Al's picture

I think We the People had better wake up on this.

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And the profit over people ethos will kill and injure many more innocent people.

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Beware the bullshit factories.

Unabashed Liberal's picture

to HSAs--supplemented with either HD plans, or CDHPs.

Their language is very deceptive--I'm 'guessing,' intentionally. Ben Carson's rhetoric is especially confusing, if folks didn't hear his remarks/talking points during the Repub Debates.

To think that he might be the next US Surgeon General. Whew!

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit and therefore– to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

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Everyone thinks they have the best dog, and none of them are wrong.

"We did not lose the battles of ideas. We were not outsmarted and we were not out-argued. We lost because we were crushed. Sometimes we were crushed by army tanks, and sometimes we were crushed by think tanks. And by think tanks I mean the people who are paid to think by the makers of tanks."

This is the takeaway quote, but the rest of her speech is also spectacularly good..

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Unabashed Liberal's picture

bipartisan support (I'm sorry to say).

We are in the process of studying our options for enrolling in Traditional Medicare/Medicare Supplements/Part D.

Not even considering enrolling in Medicare Part C. Talk about a racket! Yet, from the paper you've posted, it sounds as though that's where Medicare 'reform' will take us. From my research, it appears that almost 25% of Medicare beneficiaries are already enrolled in one of these plans. (They're not too bad for healthy seniors, but can get very dicey if a beneficiary needs a specialist--due to the typically narrow provider networks.)

I think that the Heritage reform proposals are accurate, since I just read an excellent piece from one of the top health care reporters, who wrote that from the cryptic statements that are coming out of the Republican Leadership, she expects Medicare 'reform' to be pushed in the direction of 'reconciling' Traditional Medicare, with the managed care Part C, or Medicare Advantage.

Anyhoo, we're torn between going ahead and enrolling in Traditional Medicare when we're eligible--hoping that we'll be 'grandfathered' into a less bad Medicare plan, due to the coming 'reforms.'

Or, we're considering enrolling in only Medicare Part A, until Mr M retires, and no longer has an employer-sponsored group plan.

Of course, as the paper suggests, Medicare Parts A and B may be combined. In the past, Dems have pushed for 'combining the Medicare Parts A and B deductibles into a single larger deductible.' This policy change was probably in mind.

Also, for now, Part A does not have a monthly premium for folks who met the 40-quarter eligibility requirement. But, if Heritage and corporatist lawmakers have their way, sounds like there could soon be a Part A premium.

Our insurance premium costs will almost double, once we're on Traditional Medicare. In fairness, we are looking at the most comprehensive plans. But, we're not in a major city, and are nonsmokers. I'm wondering what seniors in metropolitan areas are paying, if we'll be out about $700 monthly for our total monthly premiums.

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit and therefore– to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

The SOSD Fantastic Four

Available For Adoption, Save Our Street Dogs, SOSD

Cole - SOSD

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Everyone thinks they have the best dog, and none of them are wrong.

divineorder's picture

that. We originally were on Medicare Advantage with our retiree state benefit as secondary but we were able to change to regular Medicare. Medicare Advantage is too limiting as to who is in network.

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A truth of the nuclear age/climate change: we can no longer have endless war and survive on this planet. Oh sh*t.

Unabashed Liberal's picture

to 'entitlement' programs.

Correction to the date that I cited, earlier,

Obama signs continuing resolution to keep agencies running through Dec. 9, 2016.

I've seen almost no articles on this topic (recently), since everyone, including the MSM and partisan media, appear to be totally distracted by the election results.

My 'guess' is that corporatist neoliberal lawmakers are quite grateful for the 'cover' that this provides, as they busily plot how to best to sneak 'reforms' past the American electorate (in the Ombudsman Budget Bill).

Help

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit and therefore– to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

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Everyone thinks they have the best dog, and none of them are wrong.

Big Al's picture

If we could only find a way to organize to not only stop these cuts but demand single payer and improvements to Medicare and Social Security instead of more war. Trump and his cast are going to do what Bush did in 2000, focus on "rebuilding" the military, exempting it from fiscal cuts and focus the cuts on social programs.
This should be really getting people pissed off.
For the life of me I don't know why some people on the left have some hope for a Trump administration. This is going to be disastrous.

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divineorder's picture

You may have already seen some of these?

From TPM:

http://talkingpointsmemo.com/edblog/ryan-plans-to-phase-out-medicare-in-...
SNIP

There are a couple key points to note here.

First, Ryan claims that Obamacare has put Medicare under deeper financial stress. Precisely the opposite is true. And it's so straightforward Ryan unquestionably knows this. The Affordable Care Act actually extended Medicare's solvency by more than a decade. Ryan's claim is flat out false.

Second, I've heard a few people say that it's not 100% clear here that Ryan is calling for Medicare Phase Out. It is 100% clear. Ryan has a standard, openly enunciated position in favor of Medicare Phase Out. It's on his website. It's explained explicitly right there.

Ryan says current beneficiaries will be allowed to keep their Medicare. Says. It's the cord is cut between current and future beneficiaries, everything is fair game. For those entering the system, Ryan proposes phasing out Medicare and replacing it private insurance with subsidies to help seniors afford the private insurance. That is unquestionably what it means because that is what Ryan says. So if you're nearing retirement and looking forward to going on Medicare, good luck. You're go on to private insurance but you'll get some subsidies from the government to pay the bill.

Through all the gobbledygook and bamboozlement, you'll find this line on Ryan's page: "For younger workers, when they become eligible, Medicare will provide a premium-support payment and a list of guaranteed coverage options – including a traditional fee-for-service option – from which recipients can choose a plan that best suits their needs."

This means, if you haven't gone on Medicare yet, when you do, you won't get Medicare. You'll get a "premium-support payment" - i.e., a check that will allow you to buy insurance from private insurers. The "support" in the phrase means it won't cover the whole amount. And in any case, rather than Medicare you'll have insurance from an insurance company, which everybody should love because haven't you heard from your parents and grandparents how bummed they were when they had to give up their private insurance for Medicare?

You'll hear lots of people calling this "reform" and other catchwords. But Medicare is a single payer, universal health care system. Replacing it with private insurance means getting rid of it. Even calling it "privatization" masks what is really afoot.

Every Democrat should be focused and talking about it volubly both as a matter of policy and politics. There isn't much time.

ABOUT THE AUTHOR
Josh MarshallFollow https://twitter.com/joshtpm
Josh Marshall is editor and publisher of TalkingPointsMemo.com.

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A truth of the nuclear age/climate change: we can no longer have endless war and survive on this planet. Oh sh*t.

Unabashed Liberal's picture

about the Chronic Care Act. Just found a couple of PDF summaries about the legislation. Again, I appreciate the heads up.

Glad you and JB got transferred into Traditional Medicare. According to the folks that we've consulted and/or the info that we've turned up online, it's the way that we've decided to go.

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit and therefore– to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

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Everyone thinks they have the best dog, and none of them are wrong.

Unabashed Liberal's picture

Priebus is one of Paul Ryan's best buds, and will be the Presidential 'gatekeeper,' guess so-called Medicare/Social Security 'reform' is a given.

Mollie


“I believe in the redemptive powers of a dog’s love. It is in recognition of each dog’s potential to lift the human spirit and therefore– to change society for the better, that I fight to make sure every street dog has its day.”
--Stasha Wong, Secretary, Save Our Street Dogs (SOSD)

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Everyone thinks they have the best dog, and none of them are wrong.

We have much to do to rally DC Dems to stop this.

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"If you can't eat their food, drink their booze, take their money and then vote against them you've got no business being in Congress."

Unabashed Liberal's picture

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Everyone thinks they have the best dog, and none of them are wrong.

Am coming back to the forums after sitting out a couple of months before election day. Oh, my, what a mess we have. Lots of work ahead.

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"If you can't eat their food, drink their booze, take their money and then vote against them you've got no business being in Congress."

riverlover's picture

Welcome to the new club!

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Hey! my dear friends or soon-to-be's, JtC could use the donations to keep this site functioning for those of us who can still see the life preserver or flotsam in the water.

Daenerys's picture

people will be rioting in the streets, at least I hope they will, more than they are now. And it will be violent, maybe it will spark a true revolution, at least I like to think so.

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This shit is bananas.

Big Al's picture

But efforts are going to be channeled, coopted, obfuscated, you name it. The dem party is going to get involved and that ends up in nothing but failed compromise. The task is getting the sheeple to understand they're being fleeced. .

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