Anthem Sucks, Health Insurance Will Get Socialized, Water is Wet

Once again, Anthem Blue Cross/Blue Shield has denied me a prescription. It’s like the 4th time in the past couple of years. I spend $10,000/year on all the insurance I can get, while my company pays the other $20K of the mortgage-sized premium. Then I have — whatever it is — $1,500 of deductible, or something. Then I have co-pays. Then I go to the doctor, and he prescribes me something — after looking at their own guidelines, and choosing the worse of two formulations, because they won’t cover “the good stuff” — and then, after ALL OF THAT, Anthem looks over his shoulder, and says, “No, he can’t have it like you prescribed it. You can only prescribe it once a day instead of twice.”

So my doctor submitted a prior authorization, which they also denied. I finally got the letter “explaining” why. Apparently, someone in the bowels of this corporate behemoth went to a government web site which has label information for every drug, and the label for this drug says to take it once a day. Therefore, according to Anthem, a doctor cannot prescribe it twice a day. Period. I’m not sure which is more stupid, this one or their last excuse, which was to steadfastly claim that I have a disease my bloodwork repeatedly shows I do not have.

In the 80’s, when “the bean counters” took over corporations, we made fun of them. We watched as companies who actually built things lost the will to invest in R&D, and abandoned long-term planning for a focus on quarterly returns. It was kind of funny to us at the time, one, because we couldn’t do anything about it, and, two, because the long-term effects wouldn’t be felt for decades.

You don’t have to look too hard to see what it’s done to the American corporate landscape. There’s no heart or soul; there’s only a question of how can they extract another dollar from the operation to return to the shareholders, whether by squeezing the customer or the employees. (I saw a comment the other day that this trend started with Jack Welch of GE fame, and I think that’s probably true.)

When it comes to, oh, I don’t know, making mufflers, this whole attitude and approach is one thing, but when that capitalistic machine gun is aimed — not at health insurance — but actual health care — well, this is what we get.

Big Pharma

But how will new medicines and treatments get approved if we force American health insurance companies to sell at reasonable prices? </SpongeBob mocking> I don’t know, but maybe the hundreds of millions the insurance companies pay their executives would be a good place to find a little funding.

The only reason I can think of that this is not being sold in the US is to preserve cash flows for the testing being done at clinics, doctors offices, and CVS.

PhRMA sues to stop state’s new insulin affordability program – StarTribune.com

“A state cannot simply commandeer private property to achieve its public policy goals,” said PhRMA’s complaint, filed Tuesday in district court. “The Takings Clause of the Fifth Amendment of the U.S. Constitution prohibits states from attempting to solve societal problems in this draconian manner.”

Source: PhRMA sues to stop state’s new insulin affordability program – StarTribune.com

If their “alternatives” were working, people wouldn’t be dying from rationing insulin. The only thing “draconian” about this situation is the feudalistic caste system we seem to have recreated in modern America.

This country was started so that we wouldn’t have to live under the regime of a bunch of wealthy landowners who controlled the lives of those who worked their land. The large corporations — who don’t just control the means of production — but use the courts to prevent competition — get to unilaterally dictate their will to us serfs. This move is a complete abrogation of the implied social contract of a corporation. We wouldn’t even be in this position if they hadn’t been so greedy, and extracted so much from society for the past 5 decades.

Go ahead, I dare you to read up on how much money pharmaceutical companies have taken from the US government to develop all those medicines they advertise constantly on television, how much it costs to make them, and then how much they charge for them. The insurance companies have allowed this situation to develop, and get so bad that society cannot bear the weight of it any longer.

When the US finally adopts socialized medicine, the capitalism-lovers who wring their hands and call it communism will have nothing to blame except the corporatocracy that made it inevitable, and no one to blame except themselves for continuing to support a system that is leaving more and more people to fall through the cracks, and fend for themselves when they are the most vulnerable, until they become the majority, and vote with their pocketbooks to rebalance the equation.

Don’t tell me horror stories about health care systems in Canada or England. I hear horror stories from our own stupid system every single week, from rich and poor alike, and you do too, even if you ignore them.

Coronavirus in N.Y.C.: Why Closing Public Schools Is a ‘Last Resort’ – The New York Times

New York City has the largest public school system in the United States, a vast district with about 750,000 children who are poor, including around 114,000 who are homeless. For such students, school may be the only place they can get three hot meals a day and medical care, and even wash their dirty laundry.

Source: Coronavirus in N.Y.C.: Why Closing Public Schools Is a ‘Last Resort’ – The New York Times

So, in addition to all the roads, the electricity, the water and sewer, the welfare, the Social Security, the Medicare/Medicaid, the farm subsidies, Fannie/Freddie/FHA — and, apparently, now, homeless shelters running on top of the public education system — tell me again how nationalizing health care would be some sudden, unimaginable lurch into communism.

The best answer is to deregulate the industry and let the market truly sort it out, but the Anthems and the Uniteds and the Aetnas of the country are not going to let that happen, so the system will eventually fall over on itself, and the government will be forced to nationalize the system. This is what they’re waiting for: all those companies will become part of the government, and their C-levels are going to get some sort of huge payout/off.

An American who was quarantined to check for signs of coronavirus says he’s facing more than $2,600 in bills from his government-mandated hospital stay

Frank Wucinski and his 3-year-old daughter Annabel evacuated Wuhan, China, in February and were then quarantined at Marine Corps Station Miramar, near San Diego, for two weeks.

Source: An American who was quarantined to check for signs of coronavirus says he’s facing more than $2,600 in bills from his government-mandated hospital stay

Forced quarantine for coronavirus? Check. Uncovered medical bills from multiple providers? Check. For ridiculous amounts? Check. GoFundMe? Check. Yep! It’s health care in America!
 
I’m not really worried about this thing being as bad as everyone says, but IF it is, the half of the country who live paycheck-to-paycheck and who are underinsured — thanks to wage stagnation in a booming economy, and an out-of-control medical insurance industry — will make for a lot of personal catastrophes.
 
People may not like the idea of socializing medicine, but when folks have to declare bankruptcy due to medical bills, we’re already socializing that cost, and it happens all the time. Don’t tell me that companies just eat those bills. They raise rates to keep their profits looking good, and pass those costs on to insurance companies, who then charge higher premiums.
 
This feedback loop avoids the righteous, self-correcting “market” that capitalism is supposed to provide, because only companies are involved in making the decisions about health care now (almost), and thanks to monopoly trends, they have almost no more choice in the matter. The “market” is broken.
 
If we could get an honest-to-God market in health care insurance, I think the problem could actually sort itself out in a generation. But the people in charge — the Anthem’s, Aetna’s, United’s, etc. of the industry — surely won’t let Congress let that happen. So we’re going to go on squeezing the middle class over health insurance until the system collapses, and we’re forced into nationalized health care.