Ruling Class Racketeers

This is rich:

(Reuters:) U.S. Health Secretary-nominee Sylvia Mathews Burwell sought to allay a major Republican worry about Obamacare on Thursday, telling lawmakers that President Barack Obama's reforms would not lead to a government-run single-payer healthcare system on her watch.

Her assurance against an approach reviled by Republicans and industry leaders came during a two-hour Senate confirmation hearing at which Burwell received an important endorsement from Republican Senator Richard Burr of North Carolina. Burr sits on the Senate Finance Committee, which will decide whether to send her nomination to the floor for a final vote.

Awwwww. Burr hearts Burwell! Because when it comes to the perpetual enrichment of the ruling class at the expense of the poor, bipartisanship always has a way of magically breaking through the fake congressional gridlock. Sylvia Mathews Burwell is a dream come true from neoliberal heaven (or more aptly, hell) for the elites controlling both sides of the Money Party.

Not content to simply lick the boots of both Republicans and "industry leaders," a/k/a the predatory insurance cartel, the current White House budget director also used her Senate confirmation hearing to broadcast her disdain for ordinary people. Her message hovered somewhere between a dog whistle and a bullhorn:

"I am hopeful that we will have the opportunity to continue to work together closely in the months ahead to deliver impact for the American people," she said.

Ouch. What a weird choice of words. It kind of takes the whole TLC equation right out of Obamacare, doesn't it?  Then again, Burwell's comparison of medical care to a body blow is most likely an apt one, given the severe emotional impact of that first 50% co-pay bill from your Bronze Plan.

A millionaire centrist technocrat who was Treasury undersecretary under Robert Rubin, she was later named deputy chief of staff in the Clinton administration. Not only is she expected to sail right through the confirmation process, her corporate cred is even serving to mute the always-phony hatred of the GOP for the Affordable Care Act. The ACA was, after all, crafted in one of their own think tanks. 

And what self-respecting Republican can ignore the fact that the Obama nominee once ran the charity wing of the right-wing Walton Family of corporate welfare queens, as well as administering the charity begun by Bill Gates, the richest man on earth? She's worked for Erskine Bowles, he of safety net-slashing Catfood Commission fame. She's worked under Rubin, who helped orchestrate the repeal of Glass-Steagall in between his own stints at Goldman Sachs and Citigroup. She's sat on numerous corporate boards. She belongs to the Aspen Institute, the Council on Foreign Relations, and the Trilateral Commission.

She has no experience in health care administration. But so what? She's a member of the Club. She knows how to efficiently deliver impact, and deliver it good and hard.

 "I look forward to, if confirmed, making that system work as efficiently and effectively as possible, both in terms of cost and access," she gushed during the first part of her Senate confirmation schmooze-fest. Her testimony was to continue on Wednesday.

Meanwhile, now that Team Obama has blundered over the public relations hurdle of getting 8 million out of 45 million uninsured people "covered," the  Efficient Impact is finally starting to set in.... with a vengeance. The New York Times ran a front page story on Tuesday, all about how the newly-insured are finding the pickings mighty slim as they venture into the Obamacare Shopping Mall of America:

In the midst of all the turmoil in health care these days, one thing is becoming clear: No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider they want.

These so-called narrow networks, featuring limited groups of providers, have made a big entrance on the newly created state insurance exchanges, where they are a common feature in many of the plans. While the sizes of the networks vary considerably, many plans now exclude at least some large hospitals or doctors’ groups. Smaller networks are also becoming more common in health care coverage offered by employers and in private Medicare Advantage plans.

That must be what Burwell meant when she said more Americans will be impacted. They'll be covered with bruises trying to squeeze through all those tiny passageways, not to mention bumping their heads on those ridiculously low coverage ceilings. 

The Times article continues,

 Insurers, ranging from national behemoths like WellPoint, UnitedHealth and Aetna to much smaller local carriers, are fully embracing the idea, saying narrower networks are essential to controlling costs and managing care. Major players contend they can avoid the uproar that crippled a similar push in the 1990s.

Oh my. We're not only getting impacted and squeezed -- we're getting played. Under Obamacare, patients are hockey pucks or golf balls. We'll either get slammed into a net, or driven down a deep dark hole. Not that we have any choice in the matter:

“We have to break people away from the choice habit that everyone has,” said Marcus Merz, the chief executive of PreferredOne, an insurer in Golden Valley, Minn., that is owned by two health systems and a physician group. “We’re all trying to break away from this fixation on open access and broad networks.”

OK, now I get it: the quest for health care has become a bad habit, like heroin. And so it is up to the insurance cartel to break us of this tawdry addiction and deny us our fix. So get thee to rehab, proles! (and please don't expect reimbursement from the insurance racket.)

Employers remain concerned about the quality of the networks... and many are doing an analysis to see how disruptive changing the network would be for their workers.

Nonetheless, the bottom line is that more employers are considering smaller networks. Many, like Walmart and General Electric, have gone so far as to steer employees to specific hospitals for certain expensive procedures like joint replacements.

In the case of Walmart, employees will likely be steered to in-store Joint Replacement Clinics run by sleep-deprived moonlighting interns. Care will be provided during unpaid meal breaks. Post-op physical therapy will consist of returning to work ASAP.  Shoulder replacements, for example,  are most efficient when they are used to restock store shelves with cheap Chinese electronics.

Of course, I am being facetious. Right?

But seriously, Sylvia Matthews Burwell is full of baloney. When she talks about how efficient Obamacare is, what she really means is that Wall Street and CEOs and investors and revolving-door politicians will continue to profit most handsomely and efficiently from the market-based system that only pretends to deliver medical care to millions of desperate people.

The Physicians for a National Health Plan advocacy group efficiently cuts through the crap and delivers some real impactful true facts:

The Affordable Care Act (“Obamacare”) aims to expand coverage to about 30 million Americans by requiring people to buy private insurance policies (partially subsidizing those policies by government payments to private insurers) and by expanding Medicaid. However:

• About 30 million people will still be uninsured in 2023, and tens of millions will remain underinsured.

• Insurers will continue to strip down policies, maintain restrictive networks, limit and deny care, and increase patients’ co-pays, deductibles and other out-of-pocket costs.

• The law preserves our fragmented financing system, making it impossible to control costs.

• The law continues the unfair financing of health care, whereby costs are disproportionately borne by middle- and lower-income Americans and those families facing acute or chronic illness.

A handy chart comparing Obamacare and Single Payer can be found here.

So let's buck the system, and exercise some all-American free choice. We have the absolute right to be whatever sporting accessory we choose. But forget about the passive hockey pucks and golf balls.

Let them feel our impact. Let them feel it good and hard.