This article highlights how issues are framed into the polarized polemics. It begins and ends with a personal story that illustrates the battle of corporate interests against the individual.

In this post, I will discuss:

  • The inevitability of illness and the need for healthcare reform
  • The real agenda behind the move to turn back the clock on healthcare reform
  • How the healthcare failure impacts individuals

A personal anecdote will illustrate the real consequences of turning back the clock on health care reform.

Coming to Grips With Illness

A Buddhist practitioner (I say this because Buddhist practice is a form of mental cultivation as opposed to a religion) wrote a moving account of his own difficult path in life, which I will recount later in this article. Lest you find yourself feeling sorry for him, remind yourself of the First Noble Truth of Buddhism: that suffering in life is inevitable. And the reason for that is that we are all subject to sickness, decay and death.

In other words, we all face the trauma of loss in our lives, and during our brief sojourns on earth, we will all suffer the effects of physical decay. Another way to put it, as put forth by a hospice worker:

There are two kinds of people in this world – those of us who have cancer…and those of us who will get it.

Debunking The Myths About the ACA

While the ACA (ie. Obamacare) isn’t a perfect solution, a number of false myths have been perpetrated about it.  Lies of this sort are systematic and have been debunked elsewhere in this blog, such as in my article, Affordable Care Act Fact and Fiction: 5 Whoppers.  The latest falsehood is  the dogwhistle racist one that it “steals” $716 billion from Medicare patients to pay for Obamacare, which Politifact generously rates “half true. ” Actually Romney’s voucher plan is the one that cuts benefits for Medicare recipients while aiming to kill Medicare itself, and replace it with market solutions that amount to a giveaway to private healthcare providers.

Myth: Romney says Obama ‘cuts’ $716B from Medicare to pay for Obamacare

Half-True

Politifact Florida shows that Romney’s favorite attack line that Obama took $716 billion from Medicare to pay for Obamacare is spurious. Romney made the claim in an Aug. 15, 2012, one-on-one interview with Tampa Bay’s WTSP 10 News:

“Under the president’s plan, he cuts Medicare by $716 billion, takes that money out of the Medicare trust fund and uses it to pay for Obamacare. I think this is something that people are just now focused on and find it very, very difficult to understand why he would cut Medicare for our current seniors.”

According to Politifact:

Was the money moved to pay for the national health care law? Neither Obama nor his health care law literally cut funding from the Medicare program’s budget. Rather, the health care law instituted a number of changes to try to bring down future health care costs in the program.

What kind of spending reductions are we talking about? They were mainly aimed at insurance companies and hospitals, not beneficiaries. The law made significant reductions to Medicare Advantage, a subset of Medicare plans run by private insurers. Medicare Advantage was started under President George W. Bush, and the idea was that competition among the private insurers would reduce costs. But the plans have actually cost more than traditional Medicare. So the health care law scales back the payments to private insurers. Hospitals, too, will be paid less if they have too many re-admissions, or if they fail to meet other new benchmarks for patient care.

Obama and fellow Democrats say the intention is to protect beneficiaries’ coverage while forcing health care providers to become more efficient. Romney has said he will repeal the health care law and institute a new overhaul of Medicare that brings more private insurers into a competitive marketplace. Beneficiaries would receive “premium support,” a voucher-like credit, to buy their own plan.

We should point out that the overall Medicare budget is projected to go up for the foreseeable future, even with the health care law’s cost-saving measures. The law tries to limit the program’s growth, though, making it less than it would have been without the law, but not reducing its overall budget. So claims that Obama would “cut” Medicare need more explanation to be fully accurate.

If you’ve been following the Medicare debate for awhile, you may have heard previous claims that Obama cut Medicare by $500 billion. How did that become $700 billion? Because Medicare spending gets bigger every year, the cost-saving mechanisms in the health care law also get bigger. And, it takes a few years for the health care law’s savings mechanisms to kick in. In fact, the effects of time are the main reason the $500 billion number has turned into $700 billion.  The CBO determined in 2011 that the federal health care law would reduce Medicare outlays by $507 billion between 2012 and 2021. Ina more recent estimate released this year, the CBO looked at the years 2013 to 2022 and determined the health care law affected Medicare outlays by $716 billion.So it’s timing that’s making the cuts bigger, not changes to Medicare.

Romney also said that the spending reduction ” takes that money out of the Medicare trust fund and uses it to pay for Obamacare. Romney has a point here, but it’s not about money being moved from one account to another…

At the time the health care law was being finalized and passed, Democrats said it was important to them that the new law not add to the deficit. So the reductions in Medicare spending were counted against the health care law’s new spending. Some new spending is within the Medicare program, such as increasing coverage for prescription drugs and offering preventive care with no out-of-pocket costs. More significantly, though, the law moves to cover the uninsured, by giving them tax credits to buy private insurance. It also expands Medicaid, the state insurance program for the poor. The savings from Medicare offset that spending. We should note that the health law also imposes new taxes, primarily on the wealthy and on the health care industry. That too offsets the new spending.

Our ruling

Romney said, “Under the president’s plan, he cuts Medicare by $716 billion, takes that money out of the Medicare trust fund and uses it to pay for Obamacare.” This wording isn’t as troublesome as other statements we’ve seen on this topic, including from Romney himself. Still, Romney’s most-recent attempt at this claim needs significantly more explanation. In this instance, Romney’s claim gives the impression that the law takes money that was already allocated to Medicare and funds the new health care law with it. In fact, the law uses a number of measures to try to reduce the rapid growth of future Medicare spending. Those savings are then used to offset costs created by the law – especially coverage for the uninsured – so that the overall law doesn’t add to the deficit. We rate his statement Half True.

Why the Drive to Repeal the ACA is Misguided

The drive to repeal the ACA is reprehensible for 3 main reasons:

  1. First, the drive to repeal represents the efforts of special interests – such as hospital group king and Medicare fraud perpetrator artist Rick Scott (currently the governor of Florida which has the third highest rate of residents without health insurance) to increase the population of uninsured prospects for his subpar discount medical chain.
  2. The repeal lobby ignores the basic issue that our budget deficit is a healthcare problem (see the graph above) and that the ACA is the first of several steps that actually approaches rather than exacerbates the problem.
  3. Eliminating the ACA not only explodes future deficits by at least $230 billion according to the CBO, but is a sentence of death and poverty to thousands of Americans who desperately need the reforms against a healthcare system that is abusive and internationally substandard. The facts show that while the U.S. hospitals provide superior care for the wealthy, it increasingly fails those of us who are not wealthy. The fact is projected to expand health coverage 30 million people.

The reforms of the ACA, including the elimination of lifetime benefit caps and pre-existing conditions, and a focus on preventative care are long overdue, and the ACA begins to approach the important issue of lowering healthcare costs, which are bankrupting the nation. It is the beginning of a process of necessary reforms – there is no credible argument that reforms are not needed – that requires dispassionate thinking rather than strident partisan rhetoric.

Florida is a particularly noteworthy example, where Governor and Hospital Group CEO Rick Scott announced that his state is opting out of an expansion of Medicaid, and choosing not to build a state-based health insurance exchange. By opting out of the Medicaid expansion, Scott is leaving a significant portion of Florida citizens without health care. According to the nonpartisan Kaiser Family Foundation, Florida has the second-highest rate of uninsured Americans at 21 percent. If Scott did not opt out, Medicaid expansion would have covered 951,622 people according to Kaiser.

Who Stands to Gain from ACA Repeal?

A Personal Agenda  

How does Rick Scott explain away his support for policies that hurt his state’s citizens? His explanation is the lie that Florida can’t afford the expansion. In fact, for the first two years the federal government pays 100% of the Medicaid expansion, and after 2017 when states begin paying their share they will never contribute more than 10% of the cost. Depending on the number of states opting out, the Medicaid expansion helps provide healthcare coverage for more than half of the 31 million Americans without healthcare insurance, or 16 million Americans who are mostly children, seniors, and the working poor according to the non-partisan Congressional Budget Office.

Follow the Money

Solantic, based in JacksonvilleFlorida, was co-founded in 2001 by Rick Scott and Karen Bowling, a former television anchor to provide urgent care services, immunizations, physicals, drug screening, and care for injured workers. The corporation attracts patients who do not have insurance, cannot get appointments with their primary care physicians, or do not have primary care physicians as an alternative to the emergency room care that these types of patients often seek. In 2006, Scott said that his plans for Solantic were to establish a national brand of medical clinics. In August 2007, the company received a $40 million investment from a private equity firm and said that it expected to open 35 clinics by the end of 2009, with annual revenues of $100 million once all these clinics were open, compared to $20 million at the time. As of March 2009, Solantic had 24 centers, all located in Florida.

Scott’s $62 million investment in Solantic represents the biggest single chunk of his $218 million in wealth, has been put in a trust under his wife’s name as an attempt to show that he is longer involved in the company as governor of Florida, as it represents a conflict of interest.  This attempt to profit from the misery of the uninsured has put him and his money at the forefront of the fight against the ACA. As governor, Scott has also aggressively pursued policies like testing state workers and welfare recipients for drugs, switching Medicaid patients to private HMOs and shrinking public health clinics – all these changes could benefit that $62 million investment, even though Scott denies that there is any legal conflict between his public role and private investments. According to the Tampa Bay Times:

But In Florida, nothing bars Scott from promoting policies that could benefit a company from which his family benefits financially.

  • Scott supports bills that would move nearly 3 million Medicaid recipients into private managed care plans. Solantic accepts traditional Medicaid at only one location but it contracts chainwide with several private Medicaid plans. If passed, the law would dramatically increase Solantic’s potential patient base.
  • Scott favors legislation that would require all adult welfare recipients — about 58,000 people — to have drug tests at their own expense. About 100,000 more would be affected by his plan to do random drug screenings of all state employees at a maximum cost of $3.5 million to the state. Bowling said Solantic would not bid on that job as long as Scott’s shares remain in the trust.
  • Scott’s budget slashes funding to public health departments, which handle checkups, immunizations and travel shots for many people who don’t have private physicians. Solantic, which charges $50 for a basic physical and recently started catering to international travelers, could pick up some of this business.
  • Scott appoints the heads of the Agency for Health Care Administration and Department of Health, which license, inspect and investigate complaints against providers such as Solantic. Herron, the ethics lawyer, said it’s legal. “It’s counterintuitive to our understanding of how the world works, but that’s the law, strictly construed,” he said.
  • As Solantic has grown, so too have the number of state agencies using its services. And in the urgent care business, high volume, along with low overhead, is crucial to profits…Solantic billed state agencies $110,657 for services in 2010 and $20,061 so far in 2011.

What Interests Finance Repeal?

Questionable characters like Mike Huckabee, who appears in ads by Super PAC “Restore America’s Voice” recruiting citizens to pressure Congress to repeal the healthcare act, would prefer to substitute ideology and medical profiteering for practical solutions. Huckabee played a key role as “Restore America’s Voice” spokesman when the organization took a lead in the fight against passage of Obamacare. It is resuming its lead role in a new TV campaign featuring Mike Huckabee.  Who are “Restore America’s Voice?”

The group is a Super PAC that reported spending a total of $112,315 on independent campaigning through October 2010, with 100% benefiting Republican candidates. The latest numbers show them raising over a million dollars.  As a  Super PAC, it may raise unlimited sums of money from corporations, unions, associations and individuals, then spend unlimited sums to overtly advocate for or against political candidates, and as of August 26, 2012, 803 groups organized as Super PACs have reported total receipts of $349,763,463 and total independent expenditures of $214,759,909 in the 2012 cycle.

Additionally, Karl Rove’s Crossroads GPS and the American Action Network comprise a $1 billion campaign by the he extreme right to bring down President Obama and healthcare. This plan, which includes ending Medicare as we know it and dismantling Medicaid, is a coordinated effort is funded largely by secret contributions from millionaires, billionaires and special interests. The  HCAN Blog (Health Care for America Now) provides the facts:

Here’s a snapshot of the money behind Obamacare repeal and other conservative causes:

An explosion of political advertising: 

  • Opponents of Obamacare have spent $235 million on ads, including $18 million from Crossroads GPS, $27 million from the U.S. Chamber of Commerce and $9 million from the American Action Network. There has been little public disclosure of where that money came from, but the health insurance industry has a history of funding both the Chamber and American Action Network.
  • A conservative group called Concerned Women of America is currently spending $6 million to run negative ads. That’s more than the group’s entire budget in recent years, but the organization isn’t explaining where the money came from – and it doesn’t have to.

Secretive spending to fund efforts to block the law:

  • The lobbying group America’s Health Insurance Plans transferred $86 million to the Chamber during 2009 and another $16 million in 2010 to fight Obamacare, bringing the total to more than $102 million. Figures for 2011 and 2012 have not surfaced yet. Even as the health insurance trade group paid the Chamber, AHIP was publicly professing to support the law.
  • Health insurer Aetna Inc. contributed $3.3 million to the American Action Network and $4.5 million to the Chamber of Commerce in 2011, according to areport by SNL Financial.
  • American Action Network yesterday announced a $1.2 million campaign urging 35 GOP House members in competitive races to stand firm and vote for repeal.

Engineering a failed lawsuit:

  • The National Federation of Independent Business, the lead plaintiff in the case decided last month by the Supreme Court, accepted million-dollar contributionsfrom outside, non-member sources to cover the costs of the lawsuit, including a payment of $3.7 million from Crossroads GPS in 2010.
  • The American Action Forum filed three amicus briefs urging the Supreme Court to overturn the 2010 health reform law.

Arranging to buy the current Congress – and possibly the White House:

  • In February, Politico reported that billionaire industrialists Charles and David Koch, leading benefactors of the anti-Obamacare front group Americans for Prosperity, planned to contribute or steer a total of $88 million to conservative causes during the 2012 election cycle. In May, Politico updated the story, reporting that Koch-related organizations planned to spend about $400 million in the 2012 election cycle.
  • American Crossroads and the affiliated Crossroads GPS are expected tocontribute $300 million to support the White House bid of Mitt Romney, who has pledged to reverse the Affordable Care Act on his first day in office.
  • American Action Network spent $26 million in the 2010 election cycle, including more than $20 million in election communication and $4.9 million in negative ads against Democrats, according to the nonpartisan Center for Responsive Politics.
  • During the 2010 election cycle, Crossroads spent $14 million on independent expenditures while refusing to register as a political committee, while the GOP front group 60 Plus Association made more than $1 million in independent expenditures to spread lies about Obamacare and Medicare.

A Personal Story: The Inevitability of Deteriorating Health

We all need healthcare, and while we might not recognize this fact right now, all of us will experience deteriorating health that will eventually overtake us. This is poignantly demonstrated in the following account 

Two Notes

I exchanged doctor’s note with my friend  before our dharma class.  We both smiled as we passed the notes. It was not fake smiles. It is an accumulation of what we have learned in Buddhism. I will give her a fake name of Beautiful Lotus, to protect her identity.

Beautiful Lotus:
She worked very hard at two jobs to send her kids to college and for advanced degrees. Now in old age – like my children – she rarely hears from them.
Had open heart surgery.
Had breast cancer.
Had a colon damaged during a colonoscopy.
Recently   in the hospital several times for intestinal bleeding.
It started bleeding again last week.
She ended up in a wheel chair.
She had the type of insurance that Obama as banned. It had a cap.
She sold her house to get the money to pay for rehabilitation.
She now can walk with a crutch, and is happy that she is out of the wheel chair.
The manager of her retirement fund is in prison. She and others lost their savings.
She sought refuge in the Buddha studying hard  to ease her suffering.
Bắc Minh (That’s me)
Suffered extreme physical abuse from parents when I was a child.
Worked with mononucleosis to support family.
Alcoholism.
Wife ran off with young woman leaving me with the kids. Divorced she went to college with her lover.
Sold the house in Wyoming. Profits went to ex-wife.
Father and adopted son died in the same week.
I had a Prostatedectomy that had the worst complication that involved 3 minor and 4 major surgeries. I had 3 bags. Ileostomy bag, abdominal cavity drain and urine bag over the span of 2 years.
I take care of adult son with mental illness. He doesn’t work.  Ex-wife doesn’t help.
Ileostomy reversed no bags.
Declared healed I will wait one month before discontinuing antibiotics. Prostate is cancer gone.
What was in the notes that we exchanged with smiles?
Her note from the doctor said that she is in in early stages of dementia and Alzheimer.
My note from the doctor said that I have cancer in my neck and throat. It is not related to prostate cancer that was cured.
Both of us have come a long way.
We did more than go to the pagoda and chant. That is not enough. We mindfully meditate 15 minutes a day.  There is no need to go overboard with the meditations.   During the day we make it a point to be mindful about 3 times a day. For example, I am mindful when I peel potatoes, or when I drive the car, or when I do my back exercises, or when I take a shower.  Both of us like to chant at the pagoda a couple of times a week. We go to dharma lessons where we continually learn how to apply the Buddha’s teaching to our life.  It is one think to talk the dharma it is another thing to walk the talk. I also studied Zen from a teacher who did not intellectualize Zen.
We just want to be happy. At this stage in the game that is enough for us. Don’t worry. Be Happy.

 More Articles on Healthcare Reform

Lessons Learned

Political Lessons: The political right has coopted the political left’s rhetoric about protecting the rights of the individual against authoritarian control and profiteering, and are using this false argument to justify an agenda that supports the wealthiest special interests against the welfare of the American public at large.

The Democrats, who supposedly represent the interests of the middle and lower classes against the profiteering of the wealthiest class, are also subject to the same lobbying pressures as the Republicans, and attempts to reform the economic, political system have been weak to meaningless.   It is difficult to envision any political solution to the problems that beset the American economy and healthcare system.

Meanwhile, the media can’t be relied upon to present the issues clearly, as they prefer to frame the debate according to essentially meaningless ideological partisan lines.

Personal Lessons: So how can we as business leaders and citizens cut through rhetoric to get to the facts? What’s needed now more than ever are critical thinking skills, not taught in school. Since there is so little critical thinking in evidence today, this is a subject I plan to highlight in future articles.

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