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The Inevitability Of Single Payer

I’ve always maintained that a single payer health care system is not only the way to go, but the inevitable endgame for the US. I didn’t love Obamacare, but I saw it as a first step. A first step by the way, that we’ve been trying to make since Nixon was president. Unlike with financial “reform”, when Obama refers to the ACA as “historic”, he would be correct since we historically haven’t made a damned thing happen.

I was incredibly skeptical on where the savings we were being told to expect were going to come from. But they did come, and they came in in bigger numbers than anyone had expected. So I was wrong, and I admitted I was wrong. And then when the rates were announced for 2015, and they stayed completely flat, I was elated to have been wrong.

Republicans were 100% wrong about every single thing they said about Obamacare. Wanna know how you can tell? They haven’t brought it up in a really long time.

On the other side, some liberals can’t take a good day and accept that it’s a good day because Obamacare was a giant giveaway to big pharma and the private insurance companies. I’m talking to you in this post.

Yes it was a giant giveaway but you also had a good day so spare me your analysis about how horrid everything will be tomorrow. When the norm is that you never win and big business always wins, it’s not rational not to celebrate the small victories when you get them. You really have to be a special kind of ideological partisan not to be happy about the savings we’ve seen, regardless of how long they last. The liberals who are so rigid in their ideology, whether it be as advocates for single payer, or as demonizers of Obama for not being a liberal irritate me the most. Obama isn’t remotely liberal enough for me either. That doesn’t mean that I have to demonize every single thing he does and conflate the drone disaster in Pakistan with the brilliant Iran and Cuba deals, in order to make forming an opinion about him easier on myself. That kind of ideological purity is how republicans ended up where they are today.

But back to Obamacare. Of course it’s is going to cave in on itself. Yes, it was a giveaway to private insurance companies, whose business model was fatally flawed. We got a respite on premiums because of the influx of people coming into the system. But corporate greed will eventually prevail. By eventually, I mean in the near future.

This meme showed up in one of my social network feeds:

CignaCEOOf course I got to fact checking, not because that salary sounded high to me. I remember the CEO of United Healthcare collecting over 100 million dollars in 2009. But I didn’t want to reshare until I confirmed the information. The information that I found reaffirmed my belief that single payer is the inevitable endpoint for us. David Cordani did in fact make $27.16 million dollars last year. That was a fifty-three percent increase from his 2013 salary of $17.76 million dollars in 2013.

Are you completely disgusted? Well buckle up, we’re just getting started. Cordani’s compensation in 2013 was an increase of forty-two percent from the $12.5 million he was getting paid in 2012.

I took a look at what was happening with our buddy Stephen Hemsley at United over that same period of time. In 2014, his total comp was just over $66 million dollars. That’s way the fuck up from his 2013 compensation of just over $28 million dollars. He was at $34.7 million in 2012. In his defense, the poor bastard did take a huge cut from his totally reasonable salary of $102 million in 2009.

Jay Gellert, who is the CEO of the worst health insurance company in America (Health Net) saw his salary increase from $5.79 million in 2012 to $12.48 million in 2014.

Do you see the pattern here? 2014 was a very good year for these vultures, who aren’t talented enough to make something you actually want to buy (like Steve Jobs was), so they make money on your back (literally). In Q1 2014, nine of the eleven biggest insurance companies in the US saw their stock prices hit a fifty-two week high because of Obamacare. Health insurance stocks outperformed the rest of the stock market in 2014, as did hospitals. The “big five” health insurance companies are feverishly working on whipping up new plans to offer on the exchange next year. That means that 2016 will likely bring us another year of flat or slightly declining premiums.

As I said earlier, I’ll take it. Am I bothered that the vultures are making out like bandits? Of course I am. They’re talentless hacks, paying themselves blood money and patting themselves on the back for a job well done, because President Obama did all the work for them and brought in higher profits. But we all won too, and that almost never happens for us thanks to the way campaign finance laws have devolved. I’ll take it for as long as it lasts.

It definitely won’t last. We can see the scorpion and the frog dynamic unfolding already. Health insurance companies are scorpions and they will always sting. We’re going to end up in a single payer system because when this caves in on itself, there’s nowhere else to go. Unfortunately, there are going to be some painful years between the collapse of Obamacare and the acquiescence from our politicians to a single payer system. I think we’re going to see skyrocketing uninsured rates that parallel the trajectory of skyrocketing premiums. The more unaffordable insurance is, the fewer the people will buy it. And that will bring the private insurance industry back to its failing business model, and it will cause hospitals to hemorrhage money again.

But I’ll take the respite in the meantime, and I will call this law the success that it is. I don’t need to conflate what I’m positive will happen in the near future with what is happening now.

Here’s the best part of Obamacare; President Obama took the republican health care plan away from them and implemented it successfully. Democrats are now officially the experts on improving the health care system. There is no plan left for republicans to put on the table. Single payer is all that’s left. I’ve studied health care systems all around the world. They’re all either single payer or a much more effective version of Obamacare. Switzerland has a 100% private insurance system, just like Obamacare. Of course, their regulations and cost controls are much more “big governmenty” than ours. They regulate the shit out of drug prices, the cost of medical procedures, and even the profit margin their 90+ private health insurance companies can make (I think they can make a 5% profit vs the 20% that Obamacare allows). They also have the second most expensive health insurance system in the world, after ours. A couple of other places have single payer with private insurance available for those who want it to cover extras.

Trust me when I tell you that single payer is the end of the road. It’s either that, or everything collapses for us, for insurance companies, for doctors, and for hospitals.

Make no mistake, Obamacare was a necessary first step to single payer. We were never going to go from the shit show we had, straight into sanity. I do wish he had fought for it a little bit, just to put the term “single payer” in the minds of more Americans who have no idea what that means, even though they know they want it. But my premiums were cut in half so Obamacare goes in the Obama success column.

Yes, that’s right I have columns. It’s much more complicated than just lionizing or demonizing someone, but I use excel so it works for me!


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