High Health Insurance Premiums: The Lobbyist Attack

Article first published as High Health Insurance Premiums: The Lobbyist Attack on Technorati.

Throughout recent months many customers who talk to me at the register and fellow friends or co-workers complain about barely making enough money to pay their increased health insurance premiums. So what happened to the health insurance premiums and why are they so high?

I previously wrote a response to an article in the L.A. Times back in December 2008 that discussed the struggle of a primary care physician. I posted my response on my blog A Misguided Notion. 

I stated, "Working behind the scenes (HMO, major hospital, clinic, and medical equipment provider) I witnessed how both medical providers and recipients were being screwed across the board. Meanwhile, someone is making money, yes?"

Let's not waste time on the fancy language of health care, the bottom line is that money is being spent to try and make us pay more money. 

Ever since the health care bill passed in March of this year, the health care lobbyists have started to put the pressure on the U.S. public internally through high insurance premiums. 

The $267 million dollars spent in the second quarter of this year alone needed to come from someone, namely the insured. According to the Center for Responsive Politics (CRP), last year five of the top ten lobbyist spenders came from the health care industry. The five spenders are Pharmaceutical Rsrch & Mfrs of America, Pfizer, AARP, American Medical Association and Blue Cross/Blue Shield.

I spoke to a customer who told me that she had Blue Cross/Blue Shield her entire life even through her parents, but she had to change companies this year because the costs were ridiculous and they no longer covered her annual primary care check-up because she turned fifty.

The Patient Protection and Affordable Care Act or PPACA (part of the health care reform bill) will limit the amount of money the insurance companies can use as profit. Why should you care?

Say you pay $500 a month for health insurance. Out of that $500 the insurance company pays a small amount to your doctor. Primary care physicians who have a private practice might be in your health insurance network, but that doesn't mean your health insurance is paying the doctor a chunk out of your monthly payment. (See the L.A. Times article regarding struggling doctors.)

A large portion of the $6,000 does not go towards your medical costs. The insurance companies haggle down the payments to pharmaceutical companies, medical equipment suppliers, hospitals, physicians groups and any still existing private practitioners.

The PPACA has provisions that makes sure the money you spend goes towards your medical costs and not marketing ads or lobbyist functions. I'm not saying the entire bill is perfect, but the PPACA would eliminate part of the millions of dollars being spent to make us spend more money.

High insurance premiums are a direct result of insurance companies efforts to maintain their regime within the health care industry. Ads talking about hidden taxes and fees in the bill, well what about the skyrocketing costs due to lobbyist dinners or payouts?

Living check to check doesn't always allow going out to dinner, nor does it allow many of us to have a vacation other than not going to work for a week. While we sit and wonder about our premiums, there are people using our premiums to eat lavish dinners and go on lovely mini-vacations.

Just ask your health insurance company how much of your premium is going towards your medical costs? Or ask your doctor how much your insurance pays them? You might be surprised at what you learn.

Education and War: A Glance At U.S. Spending (Part II)

A Business Model or Bust?
Sure Duncan and Obama hold the reigns for now and talk a good game about education reform, while generating a plan to meet the current agenda. An agenda that consistently refers to education as an "economic imperative."  


In Duncan's November 4, 2010 address to UNESCO (United Nations Educational, Scientific and Cultural Organization), Duncan introduced "The Vision of Education Reform in the United States" with a running metaphor to our current economic instability.

With all this talk of "economics" in education, we sure do pinch the wallet when it comes to funding. What kind of business model makes money without spending money? 

In order for the "business model" in U.S. education to work, there has to be an increase in funding. The U.S. spends pennies to the dollar needed for the current agenda planned for national education reformation. Many of our competitors out-perform us for a reason.


How Do We Compare Globally?

I found myself sorely disappointed and upset. In my research I kept finding numbers and percentages that appeared inflated in comparison to what I viewed on the budget tables at the whitehouse.gov site.

In part one of this posting, I listed numbers that were displayed on budget tables in the millions. How is it that there are people out there saying that we spend more on Education than defense? What part of 32,409 million is bigger than 636,537 million? Again I did not add the defense budgets of four major agencies listed in my diagram in part I.


This is a prime example of why the U.S. was ranked as 27th in world math scores and 33rd in reading. Basic mathematics ran away when digital dependency infected the masses. Literacy does not just include the ability to phonetically read aloud the words viewed, but comprehending those same words.


We live in a society filled with misinformation and misguided notions. People walk around believing everything they hear without verifying the facts. 


Here are the facts with regard to U.S. spending. Millions of Americans have lost their jobs, millions of Americans struggle to survive in wars far from home and millions of children slowly ascend through a failing system riddled with all sorts of funding issues. 

What can we do? Start lobbying? Create a tea party movement? Ask for budget cuts in military spending and have the top officials take much needed money away from our troops, so they can keep their air conditioned tents when they are at war? Or maybe put a much needed salary cap on high government positions? 


I don't know the answer, but I do know one solution: place a higher bet on education.

Education and War: A Glance At U.S. Spending (Part I)

When did it happen? When did education in the U.S. become a failing business, and why hasn't the government offered a bailout to education?


The government has offered a significantly small bailout to our failing schools, yet the bailout comes with some very thick strings attached to the funding. I find it interesting how education, the key cornerstone in a society's foundation, has the hardest time receiving funding in the U.S.


Looking At the Budget

Banks and military institutions receive their money on a platter absent of strings, while an agency that should matter the most struggles to attain funding comparable to other departments.

I went to The Budget at the whitehouse.gov website to see what kind of numbers we are working with in the U.S.

The 2011 Fiscal year budget adds up to a total 192 page pdf download. (Just under two percent of the health care reform document, so more people should be able to get through the budget.)
Here are the numbers for Education (in millions):

• 2009 -- 32,409
• 2010 -- 56,024
• 2011 -- 71,479 (proposed not approved)

Next we have the numbers for Defense (in millions): 

• 2009 -- 636,537
• 2010 -- 688,041
• 2011 -- 718,795 (proposed not approved)

As I researched budgets dating back to 2001, when the war in Afghanistan began, I noticed something that tickled my curiosity a couple years back. How well do you know your government organization charts?

Money Matters in Defense 

You know, the layout of government that tells you what branch is under what department and etcetera. While looking into how much money is being spent on war, I had to think about the whole picture and not the pieces. To prove my point, I have a basic diagram below that describes what I'm talking about.

All four agencies can be viewed as branches under the D.O.D with their own budget allowances.

(Note: Any monetary disclosures regarding national intelligence in the U.S. are considered a threat to national security and are not available to the public. Just imagine the very large numbers in the billions.)


While I outlined the spending differences between education and defense above, I did not add into the defense amount the budgets for the four agencies described in my diagram above. Of course there are other agencies that have "defense" and "discretionary security" buried in their organizational charts, but the point of my research begins with education and our children.


How long will it take our government and many of the U.S. citizens to wake up and smell the gunpowder under our biggest land mine yet? The increasing failure of education in the U.S. 

Please continue reading in Part II

Contemporary Rap: Searching For The Beat

I'm searching for the beat, the heartbeat of a music style so hard to find. I remember hearing rap for the first time and envisioning the world that the rapper told because it was a world I knew and could understand like so many of my peers.


Somewhere down the road, the images described through the platform known as rap transitioned into a world of spoken images detailing only the artist. Repeated sentence fragments called chorus combined with samples from true musical artists paint images of fake lyricists calling themselves rappers.


Why am I so harsh? Because I can't listen to most rap music due to the images of ego and disgusting narcissism that pop-up in my head. All I see in my head is a bucket of money swinging over the heads of so many and it's just sad.


The continual beat of a chorus that condescendingly discusses how I can never be like them or I can never aspire to their dreams. Why would I wanna hear crap that talks down to me and any other listeners?


Music is about expression. Rap used to be about an expression of social commentary and thought provoking stimulation of the young masses. Both rap and hip-hop have fallen to a level of unknown depravity that only reflects the greed of the world in which we exist.


Greed-based commercialism on money-soaked airwaves continue to blast negative images of lost storytellers who cannot find their way back to the path they initially sought with a vengeance. There exists some storytellers who get no airtime on money-soaked waves because their controversial stories tell anti-commercial stories that go against the grind of making money.


All I can offer to young listeners is this piece of advice. Listen to the words and look for the images told. If you can't see yourself in their words than cut them off because they don't deserve your support. I train my children to hear the words and feeling expressed in the music because it is important for them not to be mindless sheep in the epidemic called consumerism.

The First Thought: On Lost Scholars

I finally graduated after a fifteen-year delay. My travels through the corridors of collegiate academia often paralleled a scholar's haunted house. In my travels I witnessed the drastic differences between the tiers and the years of university life in America.

I started my college career with a full-ride pre-medicine program at a tier one school; however, I received the biggest shock and disappointment in my life. I believe the best phrase to demonstrate my "shock" comes from the rapper Biggie Smalls when he stated in his song Juicy, "It was all a dream..."

College is propagandized as a stepping stone in the American Dream. Now I ask that the reader be kind and for you to not misconstrue my thoughts regarding education because my biggest strength is in learning. However, I had no false ideas regarding the boobie-trapped illusions of the "American Dream" and I learned about those traps as a child growing up on the outer fringes of some of America's many social issues.

I consumed books about classic scholars who went to college and ate intellectual bites for lunch, while flossing books after. My misguided notion of the search for knowledge on an academic level was so far off the path that I had no sense of direction with regard to where I really wanted to go.

There is this concept that a bachelor's degree will give you the key to open many of the locked doors of opportunity that exist within the world; however, that's just an assumption that people assumed because of the propagandized promotions of education. The elite of society attend university and those who wish to swim away from the dark waters of low-class society can do so by gaining a degree, or that is what the "invisible" commercial says. Is it true? Can you really swim away from the dark waters and become one of the "elite"?

I ask this question to those who take the leap and read this far, how much of yourself are you willing to sacrifice in order to become "number one"? Who will be on top because that is the goal of how we are trained from institutionalized primary school, high school, college, and the work place.

The reality of the situation focuses on the disregard and unappreciative approach by the younger generations. When something is given to you, or you have it all the time then it loses its value because it has always existed within your zone of connection. The cove in the above image is valuable because of its distance from my zone of connection. I have to wait for summer, I have to drive an hour, and I have to hike around a cliff-side to get to that cove; thus, its beauty carries a higher significance in my value system because of the lengths I crossed to capture the image.

In a recent lower level introductory English course, a fellow student made the following comment, "This class means nothing, like anyone who takes this stuff seriously is really...come on." I never forgot what he said because it nailed the true thoughts of most students today. Many of my recent and past classmates made the same statements, "I just want to get this over with."

Once upon a long-time ago, I entered the university with the thought that the word "student" was synonymous with "scholar". I learned then and I have learned since that a scholar is indeed a rare person and that the true goal that I set for myself was to become a scholar.

I love learning and I love being able to express myself in a manner that is congruent with my thoughts. I only hope that some day, other lost scholars will find their way and bring the population back to our universities and colleges throughout the world.

Response to: "Why the Doctor Won't See You Now"

Back in December 2008 I wrote a response on my then Facebook account to an article I read in the L.A. Times that can be found here.

Nowhere in this article is there talk about how the health insurance companies are screwing medical providers left and right. Also states like Massachusetts require a mandatory health insurance coverage for every resident, while many residents suffer under a misrepresentation of the facts with regard to the health insurance offered.

When I wanted to be a doctor, I wanted to help people, find cures and contribute to the greater cause of humanity. Working behind the scenes (HMO, major hospital, clinic, and medical equipment provider) I witnessed how both medical providers and recipients were being screwed across the board. Meanwhile, someone is making money, yes?

Viewing this article is a testament to how many individual physicians are not the recipients of such wealth, and nor are their patients; thus, again where is all the money going? 

Major hospital networks and physician groups have some of the best lunches provided by pharmaceutical companies and are given loads of Vegas style "comp" items (notepads, calendars, pens etc).

Notice how the physician interviewed joined a major physician's group, which is probably on the major HMO,PPO, POP provider lists for in-network co-pays. At a major hospital in my region, the main objective of the all-hospital meeting was to discover ways to increase  the hospital bed turnover rate. 

That's jacked up, but the hospital is out to make money because it is a business. Yes, there is a pool of "free-care" money allotted by major hospitals for those who cannot afford care, but that's if you want to take a gamble  to see if you qualify.

Mind you the doctor interviewed still owes 80G's to student loans, never mind malpractice insurance. As for residents of Massachusetts who are required to have health insurance, I have friends whose hours have been reduced to a point that does not meet their company's requirements for health insurance coverage. I tell them the state's medicaid program is for "everyone" not just welfare recipients and pregnant women, but the old social stigma is hard to overcome.

There are also thousands of newly unemployed citizens across the country who cannot afford the ridiculously offered benefits of Cobra. So, what should be on America's wish list for Consumer-Mas? I believe America needs to revamp its health care system on a nation-wide level. Not possible? Yes, it is because they have no trouble with revamping Medicare (often if you consider how the Medicare guidelines have changed within ten years alone).

Do I have a plan in mind? Nope, I'm not a specialist in the field, just an observer, a participant, a recipient, a patient, and a concerned citizen. Lot of people hating on socialist systems, but I like the idea of not worrying about my health :-P

 

A Nostalgic Halloween With Decorations Gone Wrong

Christmas Has Arrived in September

I think working in a seasonally advanced retail environment has ruined the "fun" of the seasons for me. I dreaded taking my daughter trick-or-treating until we arrived at the first house.


I watched her run up to the door and say, "Trick or treat." It warmed my heart and I looked forward to the remaining houses around the pond. The wind felt clear and brisk against the clear night.



I listened to the rustling of leaves along the ground as little feet swished their ways through people's lawns and driveways. The smell of wood smoke burning in a nearby chimney and the fluttering sounds of wind bristling the leaves off of the trees.


These were the sounds of a nostalgic Halloween. Have you ever noticed the smell of a pile of leaves? It's not fresh, but it's not disgusting. For some reason, people had lighted nets laying across portions of their lawn. The types that are put out at Christmas. Wait. What the heck is Christmas doing in October?


When did we merge Halloween with Christmas? Somewhere down the line the two have merged and now people decorate their houses vigorously for Halloween with lights on their shrubbery.

A kid came up to me, when trick or treating at the mall, and asks me "Why are there Christmas decorations? It's not Christmas." His mom smiled and tried to hush him up, but I told him "Actually I have no I idea kid."


On my own walk through the Halloween night, I saw many a home decking the halls way too early. They inadvertently tried to sneak in a couple bush lights here and there between the tack-a-licious display of Halloween kitsch.


Kitsch is a word used to describe a tasteless display of stuff that represents present day consumerism gone OCD. It's where people put a swarm of pink flamingos on their lawn and dress them up for every season: Christmas lights and bows, Easter eggs and bunnies, and ghosts intertwined with skeletons.

Now picture a perfectly lovely home with a lawn crowded with styrofoam cemetaries, skeleton hands, pumpkin lights, icicle lights hanging from the roof, and a porch dressed up to look like a ride at Disney World. 


My first thought was, "Man they sure aren't skimping on the light bill." Then as I kept walking, I saw that there wasn't just one or two houses, there were more than twenty. 


When I talked to my mom about it, she blew it off as "Well people do stuff like that to keep the kids spirits up?" I'm thinking what the heck does that mean? 


Halloween spirits will be just fine with the free candy in an economy where people lost their homes and jobs. The fact that people can get something for free, other than a cold, is a miracle.


I don't know about other countries, but in the U.S. we seem to be copying the retailers. We are starting the holidays earlier and merging them together. Pretty soon we'll have several months of Christmas decorations and who knows trees might stay up until Easter.

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