Drugs: A Good Reason To Fly To Thailand More Often

I love Thailand. I’ve been going there for 4 decades and have explored every part of the country— from Chiang Rai and the Golden Triangle, through Mae Hong Son, Chaing Mai, Udon Thani, down through Hua Hin, Ko Samui (back when there were no hotels, no phone service and no airport), Surat Thani, Phuket and Yala. And, of course Bangkok. They call it the Land of Smiles and the Thai people are the biggest asset the country has, of course. The food is great too. And I usually get off the plane and head right for Health Land for a 2 and a half hour massage. But now I have a new reason to visit Thailand— drugs.

After cancer treatment I was left with several side effects that have to be treated. Insurance pays for some. For example, I need albuterol to spray into my lungs twice a day. The co-pay is between $70 and $80. In Thailand it’s $6. Yeah, six. All the drugs I take are like that. The worst though is an experimental drug my doctor has me on, locosamide (VIMPAT). My doctor is an award-winning cancer doctor and, in the midst of her research and award winning, she saved my life. When I felt my ability to walk was being threatened by a severe case of peripheral neuropathy caused by one of the chemo drugs, we tried lots of standard stuff that didn’t work. She then prescribed the VIMPAT. The good news is that it’s working. The bad news is that Humana, the insurance company, refuses to pay. The worse news is that it costs $3,000 a month. In Thailand the VIMPAT only costs $600 a month. The savings pays for a vacation!

My own story made me recall a feature David Sirota wrote last summer, although I live in California, not Connecticut, Why Are Drug Prices Going Up? Democratic Power Players Help Pharmaceutical Industry In Connecticut Battle. His set-up should sound familiar to anyone who pays attention to this kind of thing at all: “Wide majorities of voters want public officials to reduce American medicine prices, which are the highest in the world and have become a key driver of skyrocketing healthcare costs. And yet as politicians including Donald Trump and Bernie Sanders have continued to call for a crackdown, corporate power players have successfully blocked even minimal reforms— with the help, at times, of industry-connected Democrats, whose party portrays itself as a consumer-defending critic of the healthcare industry.”

Democrats control the state legislature and the governor’s mansion in Connecticut but the Democratic Party  there is at least partially controlled by the insurance industry. “The clash between populist outrage at rising drug prices and the industry’s political clout in Hartford,” wrote Sirota, “illustrates why seemingly straightforward consumer protection measures still face steep odds.” Keep in mind when you read this that Governor Daniel Malloy is the most hated governor in America.

Fresh off a presidential campaign that saw both parties’ candidates promising to make prescription medicine more affordable, Connecticut lawmakers in January introduced legislation to bring more transparency to drug prices. The bill, which mirrors similar initiatives in other states, also aims to stop insurance companies from effectively forcing their policyholders to pay more for medicine than it actually costs— a lucrative scheme that critics say allows insurers and their affiliated pharmaceutical benefit managers to pocket the difference.

Despite the pharmaceutical industry’s opposition, the Connecticut legislation initially seemed headed for approval: It was sponsored by the Senate Democratic and Republican leaders and was backed by high-profile officials like the Democratic state comptroller.

But a few weeks ago, bill proponents say, Connecticut’s insurance commissioner Katharine Wade pressed for changes that would weaken the penalties in the legislation and leave enforcement of its provisions to the healthcare industry itself.

Democratic Gov. Dannel Malloy, who appointed Wade, came to her defense. “We must take much greater care in considering the impact our actions have on Connecticut insurers,” he said. House Majority Leader Matt Ritter, a Democrat, suggested lawmakers were not sufficiently listening to insurers— and then sponsored an amendment to implement Wade’s proposals. He also backed an amendment to strip out a separate provision in the bill designed to compel insurers to more explicitly disclose all their fees to policyholders.

Much of the pushback was framed as an effort to preserve the roughly 58,000 insurance industry jobs in Connecticut at a moment when Aetna is threatening to move its headquarters out of the state. However, left unmentioned was a web of familial and financial links between the Democratic officials floating changes to  the bill and the industries with a potential financial interest in the legislative outcome.

- Wade is a former vice president of Cigna— the insurance behemoth that runs its own pharmacy benefit manager (PBM) and that is facing a class action lawsuit in Connecticut over its role in an alleged drug price-gouging scheme. As Wade’s department regulates Cigna and its PBM, her husband is an in-house Cigna attorney and her father-in-law, James Wade, is a partner in a law firm working for the PBM, OptumRX, named as a defendant in the Connecticut price-gouging suit. That same law firm lobbies for Cigna and for the health insurance industry’s trade association in the state.

- Ritter’s father, a former Connecticut House Speaker, runs the government relations division of Brown Rudnick— a law and lobbying firm that represents drug manufacturer Boehringer Ingelheim and the Healthcare Distribution Alliance. The latter describes itself as “the national organization representing primary pharmaceutical distributors.”

- Malloy is the chairman of the Democratic Governors Association, which raised more than $6 million from donors in the health insurance and drug industries during the 2016 election cycle, according to data compiled by the Center for Responsive Politics. Malloy was reelected chairman of the group in December— and days later the DGA received $100,000 from UnitedHealth, whose PBM is a defendant in the same Connecticut class action suit over drug prices. With insurance money flowing into the DGA— which directly supported Malloy’s own election campaigns— the Democratic governor has pressed for insurance industry tax cuts, pushed state subsidies for Cigna, and blocked the creation of a publicly run health insurance option.

Katharine Wade, Malloy and Optum did not respond to IBT questions. A spokesman for Ritter said the majority leader “has not been involved in negotiating this bill or the amendments,” despite the fact the amendment, which was eventually dropped, that sought to add Wade’s language back into the bill had his name on it.

James Wade said in an emailed statement, “I have had nothing to do with this case. My appearance was filed merely to accommodate an out of district attorney to enable him to be admitted pro hac vice in this district. Other than that I have not participated in the case.”

Cigna declined to comment. Malloy and Wade have previously said that, despite their attempts to change the bill, they support the larger aims of the legislation.

That assertion has not satisfied lawmakers pushing the bill. Noting that Wade faced a state ethics probe last year over her regulatory involvement in Cigna’s proposed merger with Anthem, Democratic and Republican senate leaders criticized her work on the new prescription drug bill.

“Since you are the chief public officer charged with regulating health insurers, reviewing their financials, and approving their rates in a manner consistent with both the letter and intent of the law and the public interest, we would have expected you to support legislation that improves public transparency regarding drug prices, protects consumers from secret price gouging and prevents the off book accumulation of what is essentially premium revenue,” state Sens. Martin Looney (D) and Len Fasano (R) wrote in a May letter. “Please accept this letter as an expression of our concern regarding your attempt to influence pending legislation in which Cigna, your former employer and your husband's current employer, has a direct financial interest. We believe we have been down this path before and we fear we are heading in that direction yet again.”

America spends more on healthcare per capita than any other industrialized nation— and ever-pricier prescription drugs have fueled that trend. Spending on medicine has in recent years increased more than the overall rate of health spending— and drug expenditures now comprises roughly 17 percent of all healthcare costs, according to a recent study by Harvard University researchers Aaron Kesselheim, Jerry Avorn and Ameet Sarapatwari.

Much of the outrage about high medicine prices has been aimed at pharmaceutical manufacturers— especially after drugmakers’ headline-grabbing price spikes for EpiPens and emergency therapies to combat lead poisoning. Connecticut’s legislative fight, by contrast, spotlights the labyrinthine system of intermediaries between drug manufacturers and American consumers. In the middle of that maze of doctors offices and pharmacies are PBMs, which administer the drug benefits promised by insurers to their policyholders.

When they were first conceived in the 1960s, PBMs held out the promise of using their power to negotiate price discounts, and in recent years, three companies— OptumRX, Caremark CVS, Express Scripts— have accumulated control of the vast majority of the market. That consolidation in the $250-billion-a-year market has not coincided with lower drug prices for consumers. Instead, spending on prescription medication spiked 20 percent between 2013 and 2015, according to Harvard researchers. This year, drug prices for Americans under age 65 are expected to rise nearly 12 percent, almost five times the expected growth in wages for 2017.

In October, lawyers representing Cigna policyholders brought a class action case against the insurer, asserting that, through its deal with OptumRX, the company had illegally conspired to inflate the drug prices charged to thousands of its policyholders.

Cigna, the complaint alleged, either independently or in conjunction with a PBM, required pharmacies to jack up the prices of their prescription drugs— sometimes to more than the full price of the drug. After the patients would pay the inflated fee, usually for generic medicines, the pharmacy would funnel the difference between the drug’s original price and its newly-elevated price, also referred to as the “clawback” or “spread,” to either the insurer or the PBM, according to the suit.

The suit also alleged that the pharmacies were contractually prohibited from alerting patients of the practice or directing them to lower-priced options. In a February report, Bloomberg obtained contracts prohibiting pharmacists from publicly criticizing the PBMs or recommending less expensive ways to purchase the drugs, such as paying the pharmacy directly out of pocket.

The system, lawyers argue, is a violation of the promise that a policyholder’s payment is a shared “copay” between the consumer and the insurer— and that the consumer will never have to pay more than insurers are paying a pharmacy for the covered medication.

“PBMs can serve a helpful role in managing drug insurance, and copays can be a useful strategy when applied to expensive drugs with similarly effective lower-cost alternatives that are assigned lower copays,” Harvard’s Kesselheim told IBT. “But when copays are high and there are literally no other alternatives, then patients have a problem.”

The clawback practice is far from uncommon, according to a June 2016 survey of 640 pharmacists, conducted by the National Community Pharmacists Association. Only 16 percent of respondents said PBMs imposed clawbacks fewer than 10 times per month. More than a third said the practice occurred more than 50 times on a monthly basis, and nearly half said it happened between 10 and 50 times over the same period. A full 87 percent said the clawbacks “significantly affect their pharmacy's ability to provide patient care and remain in business.”

The survey buttressed the lawsuits’ allegations that pharmacists were prevented by “gag clause” rules from telling patients about the alleged scheme or lower-cost alternatives— even if the patient asked. Nearly a fifth of the pharmacists who participated in the study reported “gag clauses” preventing them from telling patients about cheaper options more than 50 times a month, and 39 percent said it happened between 10 and 50 times.Those cheaper options mainly included paying out of pocket— meaning patients paid more for their drugs using their insurance than if they had simply paid the cost of the drug without involving their insurance provider.

“It's really not insurance, is it?” Randal Johnson, the president and CEO of the Louisiana Independent Pharmacies Association, told New Orleans TV station Fox 8 of the alleged Cigna and UnitedHealthcare schemes. “I mean, what is that if you go in and they're negotiating a price for you, and it's actually costing you more to acquire the drug with your insurance than you could if you walked in off the street and you didn't have insurance?”

While the PBMs allegedly extracted the spreads from the pharmacies, it’s unclear whether the insurers or their PBMs are pocketing the difference between what they’re allegedly pushing the pharmacies to charge and the drugs’ wholesale prices.

“We don’t really know what happens to the money. That’s where the lack of transparency makes everything very confusing,” John Norton, the communications director of the National Community Pharmacists Association, told IBT.

“I could break into Fort Knox easier than being informed by the PBMs or insurers the portion of the clawback amount retained by either the insurers or the PBMs,” said Susan Hayes, a founder of and principal at the consulting firm Pharmacy Outcomes Specialists. But unless sponsoring companies— usually very large ones— are contracting directly with their PBMs, in which case the PBM keeps all of the clawback, the insurer and the PBM are probably splitting that spread, she said.

With polls showing that most Americans want lawmakers to move aggressively to lower drug prices, legislators have intensified their scrutiny of insurers and PBMs.

Sens. John McCain (R-AZ) and Tammy Baldwin (D-WI) introduced bipartisan legislation in May to bring transparency to prescription drug pricing. But with the pharmaceutical industry’s lobbying muscle in Washington and huge campaign donations to both national parties, consumer advocates are trying to take the fight local.

“The pharmaceutical industry has spent literally $80 million lobbying in the first quarter this year. They have two lobbyists for every member of Congress in D.C.,” Ben Wakana, executive director of the newly formed Patients for Affordable Drugs, told IBT. “State capitols can provide an opening where people are a little more open-minded because they have not been bought out by pharma.”

Nearly 80 bills have been introduced in 30 states to tackle prescription drug costs, according to the National Academy For State Health Policy (NASHP). Almost all of these bills seek to bring more transparency to the pricing of pharmaceutical drugs.

In Connecticut, the legislation prohibiting both clawbacks and the “gag” contract restrictions came at a particularly sensitive time for the industry— it was introduced just as the drug-price lawsuits against Cigna and OptumRX began moving forward in the state.

During the initial hearings, consumer and physician groups argued that the bill represented an important step in shedding more light on opaque drug pricing policies.

“Pharmacists, like physicians cannot negotiate terms of their contracts with insurers,” said a coalition of medical societies in a statement to lawmakers. “Many physicians believe that if these clawbacks were outlawed and patients were given the information and allowed to choose the cheaper option they would have more disposable income for other medications and other needs.”

The pharmaceutical industry countered by arguing that the current system helps consumers.

“Any provisions that would call for manufacturers to publicly justify the price of certain therapies by detailing the input costs to develop and market them can interfere with the market-based ecosystem that works to bring down prescription drug costs through robust private-sector negotiations,” testified Patrick Plues of the Biotechnology Innovation Organization, a drug industry trade association.

State records do not reflect the insurers publicly lobbying on the legislation, and it is unclear how much insurers are directly receiving from clawbacks. Still, the bill’s sponsors suggested the opposition has been fueled by the industry.

“We naively assumed the health insurance industry would support these common sense reforms designed to save their policyholder's money,” Looney and Fasano wrote in May. “However, we now realize that many insurers have formed their own separate but related PBM businesses which engage in this very same practice...it is clear that the goal of insurer affiliated PBMs is to generate off book revenue that is not subject to regulatory review or public accounting.”

Among the biggest players in the legislation has been Wade, who was Cigna’s top lobbyist from 1992 to 2013. According to Looney and Fasano, Wade “proposed language that would essentially limit the enforcement of the anti-gag and anti-clawback provisions and cede that enforcement to the health insurers and PBMs themselves”— a proposal the lawmakers called the “fox guarding the hen house.” In an interview, Looney told IBT: “I think the pharmacology groups, the manufacturers, are actually for the bill— they’ve been quite helpful. The PBMs and the insurers tend not to be as supportive. The insurers actually own some of the PBMs... I think their interests were being represented by the language the insurance department was suggesting to add to the bill.” A spokesperson for Wade told the Hatford Courant that the senators “omitted an important part” of the language that Wade had proposed be added to the bill. Wade’s office did not respond to repeated IBT requests for comment and for the full language that Wade wanted added to the bill. Malloy defended his insurance commissioner, saying in a statement that “to accuse the commissioner of 'interjecting' herself into an open legislative process by offering appropriate language is ridiculous on its face. It's especially ridiculous given that our administration has been consistently supportive of the underlying bill concept— to imply otherwise is disingenuous at best, and a lie-by-omission at worst.

" Malloy’s statement chastised the senators for their “unnecessary and antagonistic approach toward Connecticut’s insurance industry.” The governor repeated that critique Friday, saying the senate had “turned a deaf ear on the insurance industry” when lawmakers passed a bill that would require insurers to provide additional health benefits for women, children and adolescents and expand contraception benefits.

“They are a very, very powerful lobby here in the state,” Ellen Andrews, executive director of the Connecticut Health Policy Project, told IBT about the insurance industry.

“Honestly, this is a very small thing. If a drug costs $5 why should we be overpaying? Pushback from the administration speaks to how powerful the insurance industry is here.”

Despite Malloy and Wade’s pressure, Connecticut’s senate unanimously passed the drug pricing bill— but the bill’s fate in the House remains uncertain in the waning hours of the legislative session. [Subsequnetly the bill passed in the House.] Ritter, the Democratic Majority Leader, along with the Democratic chairs of the Public Health and Insurance and Real Estate Committees, drafted an amendment containing nearly the exact same language that Wade sought to add into the bill. A later amendment ultimately scrapped the language.

When it comes to health insurance issues, Ritter told reporters that lawmakers should be “careful what they propose.”

“Even if it’s a concept and you want to get a public hearing, be careful. That’s a very important industry to the state of Connecticut,” Ritter said.

But while the bill could be watered down, it is also possible that time to pass it will simply run out. The session ends Wednesday, and it is unclear if the Democratic leadership will bring the bill to the floor for a vote before then, despite the bill’s unanimous passage in the Senate.

Republican Rep. Fred Camillo, a co-sponsor of the legislation, told IBT that although Connecticut politics has changed and “bills that normally would have flew through years ago are not,” he hoped the anti-clawback bill would reach the floor of the House.

“It certainly has a lot of support. We’re hoping it gets called,” he said.

…Matthew Katz, the executive vice president and CEO of the Connecticut State Medical Society, a physicians’ group and a state-level entity of the American Medical Association, said the class action lawsuit’s allegations against Optum should “at least” warrant some sort of review by the state’s health insurance department. But he raised concerns about the familial connections of Wade, the insurance commissioner.

“The wisest thing would be for her to recuse herself if there was an ongoing investigation in this matter. If there is an investigation, she should step back, as there’d be at least a perception of a conflict of interest,” he told IBT.

“There’s a lack of transparency that could rise to the level of deception,” he said. “What seems to be happening here is the patients are getting the short end of the stick.”

The Third Way Has Always Been A Fancy Excuse For Politicians Taking Massive Special Interest Bribes

Remember the other day when we looked at how centrism sucks? We were looking at American politics. But we're not the only ones with the problem. Remember the British avatar of neoliberal assholism, New Labour's Tony Blair? New Labour is very much like New Dems, the same disease. Monday morning Blair showed up at the Global Politico podcast with Susan Glasser. One of the earth's worst human beings wanted to remind everyone how lucky we are he's no longer spreading his toxins from inside government. Glasser warns her audience that "the former British prime minister, a perennial lightning rod for controversy across on both sides of the Atlantic, has in recent months chosen to return to the political fray" and is running around like a chicken without a head squawking "that the left-wing populism peddled by Sanders and Labour leader Jeremy Corbyn in Britain are not the answer" to neo-fascist movements like Trumpism.

Blair, the onetime wunderkind of British politics who led the Labour Party and the country for 10 years from 1997 to 2007 preaching a Clintonian centrism he called the “Third Way” only to see his tenure end amid recriminations over his support for Republican George W. Bush’s invasion of Iraq, still punches hardest when he’s hitting to his left. In our conversation, he bashed today’s liberal leaders in both countries for “solutions that look back to the ‘60s or ‘70s” and for preaching a form of feel-good “identity politics” that will flop as an answer to Trumpism.

“You can go for what are very good-sounding things like, we’re going to abolish tuition fees, or we’re going to give you this for free, or that for free,” he says, calling out both America’s Democrats and Britain’s Labourites. “In today’s world, and in particular, in the absence of a vigorous change-making center, that’s very attractive. But I don’t think it’s answer, and I’m not sure it would win an election. Maybe it would, but even if it did, it would worry me. Because in the end, I think a lot of these solutions aren’t really progressive. And they don’t correspond to what the problem of the modern world is.”

But it’s Blair’s comments about Trump as much as his disdain for Sanders and Corbyn that are likely to infuriate many U.S liberals.

Just a few months ago, Blair stirred outrage when he told his former communications chief Alastair Campbell in a British GQ interview that Democrats “just go mental with you” at even the suggestion of working with Trump and that the divisive U.S. president who has spoken of the mainstream press as “enemies of the people” may have a point about his “polarized and partisan” media coverage.

Blair did not back away from that in our interview, saying it’s a mistake “just to go in flat-out opposition” to Trump, that the American president may well end up as a traditional Republican at least on foreign policy and arguing Trump has “actually been helpful” in the Middle East, where Blair has served as a mediator for the quartet of Western powers trying to achieve a long-elusive peace settlement.

Trump, he says, has correctly identified “an extraordinary and one-off opportunity” to move toward a deal between Israel and Arab states that may finally be willing to “move on” from the Palestinian issue. “I do think there’s a big opportunity there, and I think that the White House understands that,” Blair tells me, voicing an optimism that few other peace-process veterans share.

“I can’t afford to be in a position of just treating President Trump as if he’s part of a sort of interesting comedy show,” Blair says.

...[I]t’s almost impossible to overstate the extent to which Blair is excoriated across the British political spectrum these days-- “his reputational currency has fallen as his bank account has swelled” over the last decade, says his old colleague Campbell, acknowledging not just Blair’s political unpopularity but the opprobrium he’s gotten for what’s perceived as buck-raking from advising autocrats from the Persian Gulf to Kazakhstan.

Even those who don’t outright condemn Blair see him as a man without a party, tilting at Brexit without being able to propose a realistic scenario by which it could be overturned, given that neither Labour nor the ruling Conservative Party is willing to officially campaign on undoing it. “Brits hate him. They really hate him,” says one American who spent the better part of two decades living in London. “His international stature, even now, masks how low is the esteem in which he is held back home.”

In contrast, Blair has remained well regarded here, and tends to get positive notices from centrist-minded American commentators who see him as a rare liberal willing to take a moment away from Trump-bashing and Brexit-bemoaning to trash the rising populism and “riding the politics of fear,” as he put it to me, that is now increasingly seen as the only acceptable response to angry voting publics in both countries. Just as Hillary Clinton is touring the country now peddling a version of What Happened in her campaign memoir, Blair acknowledges that he and others in the Clintonian middle opened the way for this challenge-- they became “complacent” in power, he says, entitled “managers of the status quo”-- though as with Clinton there are many critics who feel he is hardly introspective enough about his own role in the current mess.

And that brings us to the only thing behind political centrism: corrupting cash. That, after all, is all the Third Way has ever been about. That's the basis of the New Dems more than any political entity in the history of America. They have no real set of beliefs and what holds them together is an opportunity to soak up corporate cash in return for their services. This morning, Lee Fang and Said Jilani penned an Intercept piece about how the insurance and pharmaceutical lobbyists are behind the move to undermine Bernie's Medicare-for-All efforts.

Yesterday we looked at which politicians take the most bribery from Big Pharma. Since 1990, the Insurance industry has spent $387,502,675 in bribing candidates for congressional office-- $236,652,744 to corrupt Republicans and $147,762,884 to corrupt (mostly conservative) Democrats. These are the dozen worst whores to the insurance industry (currently in Congress):

• John McCain (R-AZ)- $3,702,426
• Paul Ryan (R-WI)- $2,327,530
• Richard Neal (D_MA)- $2,207,506
• Mitch McConnell (R-KY)- $2,121,451
• Chuck Schumer (D-NY)- $2,098,920
• Pat Tiberi (R-OH)- $2,057,243
• Rob Portman (R-OH)- $2,049,640
• John Larson (D-CT)- $1,656,115
• Ed Royce (R-CA)- $1,621,899
• Chuck Grassley (R-IA)- $1,603,475
• Joe Crowley (D-NY)- $1,549,465
• Jeb Hensarling (R-TX)- $1,480,784

And, yes, if these 12 men woke top in prison tomorrow on bribery charges, America would be on the road to Medicare-For-All. As Jilani and Fang pointed out, "The for-profit health care industry and its political surrogates were quick to criticize the sweeping universal Medicare legislation unveiled this week by Sen. Bernie Sanders and more than a dozen Senate Democrats." David Merritt, vice president of America’s Health Insurance Plans, a lobbying group for health insurance companies, said in a statement to reporters "Whether it’s called single-payer or Medicare for All, government-controlled health care cannot work." The Council of Insurance Agents & Brokers, another insurance lobby group, released a statement declaring that it "adamantly opposes the creation of a single-payer regime, and our guard is up on these efforts... These are worrisome developments, and the increased volume on single-payer is setting off alarms on what Democratic priorities could represent following seven years of failed ACA repeal efforts."

The Congressional Leadership Fund, a super PAC funded by a number of health care interests-- including health insurance giant Anthem, pharmaceutical firm Amgen, and the Biotechnology Innovation Organization, a lobby group for biotech companies-- also sprung to attack the proposal.

The group called the bill the “latest radical and expensive plan for government-run health care” in an announcement on the CLF website.

Former Rep. Bruce Morrison, the Connecticut Democrat who left Congress and is now a lobbyist for the American Hospital Association, dismissed the plan as doing too much to disrupt employer-based coverage.

“Half of America gets their health insurance coverage on the job,” Morrison said. Single payer would replace coverage for some 150 million people, he noted. “If you just leaped to Medicare for All, you would totally disrupt the expectations of all those people. And that would not be a good idea.”

A similar argument was made by former Democratic Rep. Earl Pomeroy of North Dakota, who lost his seat and is also now lobbying for a number of health care interests, including health insurance firm Aetna and drugmaker Novo Nordisk.

Until he was defeated in 2010, Pomeroy, a ultra-corrupt Blue Dog, accepted a mind-boggling $2,232,597 from the insurance industry, slightly less than Paul Ryan has taken in bribes from them! Pomeroy was never charged with taking bribes and now hands them out to his former colleagues.

“Pretty consistently, people value the coverage they have. Any proposal that says you have to give up the coverage that you know for coverage that we’ll create under a new government program will be a difficult sell,” Pomeroy told The Intercept.

“I think this is an organizing tool to continue to build support for a dramatic further overhaul of the health reform system. And I think that’s its fundamental purpose, and no one thinks it’s going to pass anytime soon,” he concluded.

The universal Medicare proposal released this week extends health insurance coverage to every single American free of copays, premiums, and deductibles-- and has long been viewed as a direct threat to highly profitable health-related industries and providers.

The bill calls for gradually expanding Medicare coverage, starting with the young and phasing in other segments of the population. The plan would cover all essential services, including routine doctor visits, emergency room care, mental health, dental, outpatient care, and forms of treatment.

Sanders’s office also released a statement this week laying out various financing methods for the bill, including an employer tax, closing tax loopholes, and a variety of progressive income-based taxes.

Private health insurers hate the plan because it would largely replace them. Drugmakers fear single payer because the Sanders bill calls for price negotiation on pharmaceutical products, a policy now barred by a provision created by drug lobbyists and their allies in Congress. Other providers are worried that an empowered single health provider will be able to use its collective bargaining power to cut waste and investigate price gouging.

The unrivaled political power of health care industries--  health interests are routinely near the top of rankings for lobby spending and campaign donations-- have made controlling costs incredibly difficult. Americans spend far more on health care per person than any country in the world while consistently ranking fairly low on a range of health outcomes, including life expectancy.

The aforementioned lobby group America’s Health Insurance Plans secretly spent $86 million on dark money efforts in 2009 to derail the Affordable Care Act, with a special focus on eliminating the public option provision. As The Intercept first reported, the Council of Insurance Agents & Brokers, the other insurance group blasting the Sanders effort, similarly mobilized part of the effort to defeat a ballot measure in Colorado last year to establish a state-based single-payer plan.

Sam Husseini Corrects Schumer Fudging What Medicare Privatization Would Mean and He Pretends He Was Being Honest All Along

-by Sam Husseini

The new Democratic Senate Leader Chuck Schumer began his remarks at the recent "Hands Off Medicare" event [video below] by noting that he and Bernie Sanders-- another speaker at the event-- both went to James Madison High School in Brooklyn. Said Schumer: "Bernie was on the track team and they won the city championship. I was on the basketball team. We weren't that good our motto was 'we may be small-- but we're slow.'"

The quip turned out to be rather apt.

At the event, Schumer went on about about how privatization of Medicare would mean that doctors could charge what they wanted. I call him on this-- he was totally omitting the role of the insurance companies-- and he responded by basically pretending that he was saying that all along.

In contrast, Sanders in his opening statement railed: "The leadership of the Republican Party in the House, in the Senate and Mr. Trump have got to start listening to the American people not the drug companies not the insurance companies-- not the billionaire class." Similarly, Sandra Falwell of National Nurses United argued the U.S. needed to stop wasting "tax dollars by subsidize profit making health insurance corporations."

In contrast, that wasn't what Schumer was saying in his opening remarks at all. Like other speakers, he criticized Rep. Tom Price, Trump's HHS nominee, who, like House Speaker Paul Ryan is a longtime nemesis of Medicare, but then he said the following: "Doctor Price seems to say we ought to let doctors run the whole show because he's a doctor. There are some good doctors and there are some not such good doctors. We've all seen both. And too many doctors and other health care providers, without some oversight, will charge every senior as much as they can. That's what privatization means: Let your doctor charge you whatever he or she wants. We don't want that to happen." [at 11:30 in the video.]

So, when question time rolled around [at 26:30], I asked: "You claimed just now that privatization of Medicare would mean your doctor gets to charge you whatever they want. That's not my understanding, privatization of Medicare would mean that they would cut a deal with the insurance companies." I also noted that his comments almost seem to minimize the role that the insurance companies, which he of course, along with other sectors of finance, takes a lot of money from-- including Trump's nominee for Treasury secretary, Steve Mnuchin, a former Goldman Sachs partner. (Indeed, four of Schumer's top funders through his political career are in insurance and finance: Goldman Sachs, Citigroup, JPMorgan Chase & Co, Credit Suisse Group.)

So I asked: "Can you defend that remark?"

Schumer responded: "Yes absolutely. I can absolutely defend it. First of all of course it lets the insurance companies do what they want...

Husseini: Right.

Schumer: But it also lets individual doctors do what they want and they're going to tell the insurance companies together will get together and decide the price.

Sam: Right...

Schumer: Right now Medicare...

Husseini: So why did you...

Schumer: No no no. I'm going to answer your question now please sir. Medicare right now sets limits on prices because it's government run. Privatization means the private sector, both the insurance companies and the doctors, set the price without regard with what the patients can afford. OK. Yes.

Schumer tried to forestall a follow up with: "Yes, go ahead, next question!"

I noted, though barely audible on the video: "I trust you'll include the role of insurance companies from now on."

Basically, what Schumer wants to have happen is people to blame their doctors for all the ills-- pretending that the insurance companies are not a huge part of the problem and threat. Only after confronted did Schumer acknowledge the role of insurance companies in threatening to privatize Medicare. His closeness to finance means that he can't speak honestly about problems and threats even when he's taking a reasonable stance of "Hands off Medicare."

Still, it was somewhat satisfying to basically shame Schumer into talking about the role of the insurance companies. It illustrates that asking pointed, timely questions can change to course of a politician's remarks on an issue.

But this highlights a real problem in the current setup of the Democratic Party. Sanders-- whatever shortcomings he might have-- is in the position of largely of bringing people in with his populist rhetoric as "outreach chair" for the Democrats in the Senate. But ultimate policy is largely determined by Schumer as minority leader, who is very closely tied to big finance and will act as a sophisticated apologist for it on the major issues at any opportunity.

New Jersey May Be Very Democratic, But The Political Machines Make That Pretty Irrelevant

Norcross and Christie, the two grotesque crooks who run New Jersey

Earlier today we mentioned, in passing, an insurance-related dust-up in the South Jersey congressional race for the open NJ-03 swing seat being vacated by Jon Runyan. It pits multimillionaire insurance executive Tom MacArthur against Burlington County Freeholder Aimee Belgard, a Democratic. Belgard, who studied Environmental Science before getting a law degree, has been endorsed by both the progressive, grassroots Sierra Club and the more transactional, less trustworthy and more Beltway-oriented League of Conservation Voters. But this battle isn't over Belgard's desire to deal with Climate Change and MacArthur's desire to bury his head in the sand. It's about insurance-- and the insurance business is especially important in South Jersey, where political boss of bosses George Norcross, ostensibly a kind of "Democrat," makes some of his millions as chairman of Connor, Strong & Buckelew, a huge insurance brokerage which specializes in selling health plans to governmental entities.

Norcross has put talk of single-payer healthcare off the table among South Jersey politicians. Although his power is mostly among state legislators and county and officials, he has complete control of Democratic Party politics in South Jersey and pretty much has veto power of everything and anything. Senator Cory Booker, for example, is his guy. There are 4 districts in which Norcross calls the shots: NJ-01, where corrupt hack Ron Andrews is retiring and Norcross' equally corrupt brother is taking over the congressional seat; NJ-02, where Machine candidate Bill Hughes is making a pitifully weak challenge to GOP incumbent Frank LoBiondo; NJ-03, the site of the MacArthur-Belgard contest; and NJ-04, the most Republican of the 4 districts (R+7) and where the DCCC is, once again, giving Republican anti-Choice sociopath Chris Smith a free ride.

Let's go back to MacArthur for a minute before we deal with Norcross. During the primary, his lunatic fringe opponent, Steve Lonegan, attacked him for cheating hurricane victims unfortunate enough to have been insured by MacArthur's company, York Risk Services, part of AIG.

Tom MacArthur, a multi-millionaire former mayor who is battling a prominent tea party challenger for the Republican congressional nomination in a New Jersey district, ran an insurance company accused of cheating disaster victims, MailOnline can reveal.

From 2002 until late 2010, MacArthur was chairman of the board of York Risk Services Group, a unit of the global insurer American International Group. He was also the company's president and CEO from 1999 to 2009 and a major shareholder until at least 2006.

York boasts on its website that 'We re-price 500,000 medical bills per year and save clients an average of 61% on each bill.' That cost-cutting focus caught up with the company in 2008 after Hurricane Ike devastated the U.S. Gulf coast and a massive wildfire laid waste to hundreds of homes in Sylmar, California.

It ended up settling two Ike-related lawsuits and paying a sizable fine to the state of California in connection with allegations of underpaying claims from the fire's victims… York's apparent hand in determining the size of claim payouts, however, has landed it in the same legal hot water as the companies it serves, facing legal accusations along with them of unfairly slow-walking, low-balling or denying claims.

…York, along with another AIG unit, paid the state of California a $285,000 settlement following charges that they violated the state's Fair Claims Settlement Practice regulations while handling damage claims following a massive November 14, 2008 fire in the town of Sylmar.

That blaze, known in the American West as the Sayre fire, burned more than 11,000 acres of forest and destroyed 600 structures and 480 mobile homes.

It also produced hundreds of 'total loss' homeowners claims, including those covering 370 mobile home policies held by AIG's New Hampshire Insurance Company.

The California Department of Insurance claimed that the two companies had underpaid the devastated homeowners by 10.8 million.

York, led by MacArthur, was responsible for processing and evaluating those claims as part of New Hampshire Insurance's outsourcing strategy. The two companies each paid half the penalty, or $142,500, according to court documents.

Both denied wrongdoing, but agreed to a settlement in August 2012 to end California's years-long investigation into 125 separate alleged violations of the California Insurance Code.

The two suits related to Hurricane Ike, the massive 2008 storm that swept through the Gulf Coast and crippled coastal Texas, were settled with undisclosed terms.

One, filed by Houston Baptist University, alleged that York low-balled its settlement offer after the hurricane laid waste to its main administration building and student center.

…The Republican National Committee has embraced MacArthur as one of its so-called 'young guns,' suggesting a vigor and fearlessness usually associated with strong retail campaigners.

But according to the Newark Star-Ledger, a $2 million cash loan from MacArthur's personal wealth makes up nearly his entire election war chest.

It rarely matters which party wins when it comes to Norcross' business interests, which have become paramount in the state. He is extremely tight with Christie, as big a crook as he is. And beyond making sure insurance companies stay in positions where they can continue cheating the public, Norcross' latest shenanigans involve his role in bringing a new nuclear power manufacturing facility to Camden. Local politicians are not allowed to say anything against it because Norcross is on the board of Holtec International, a local corporation that makes equipment for it and-- lo and behold-- that the firm has just received the third-biggest tax break in New Jersey history in exchange for agreeing to locate its new plant in Camden, NJ instead of in South Carolina.

Since Gov. Chris Christie took office in 2010, New Jersey has distributed more than $4 billion in tax breaks-- far more than under any previous governor-- yet private-sector job growth has been one of the slowest of all 50 states, according to federal data.

New Jersey Policy Perspective, a liberal research organization, said the tax break awarded to Holtec was one of the largest ever bestowed in the United States. The state is paying $658,228 for each job-- "a sky-high number that has never been seen before in New Jersey and is even far higher than the average per-job cost of the largest 'megadeals' across the country," Jon Whiten, Policy Perspective's deputy director, said.

[Republican state Sen. Michael] Doherty said the real cost was even higher, since 160 of the jobs already existed in the state.

"It looks like New Jersey is paying over $1 million for each new job that's being created, and this is a disturbing trend," he said.

Doherty added: "My understanding is that small businesses create 98 percent of the jobs in the state of New Jersey. Let's provide tax relief for small business-- a broad-based program of tax relief-- not a bunch of insiders sitting around a table picking the winners and losers, government picking the winners and losers."

The Democratic-controlled Legislature revamped New Jersey's tax-incentive programs last year, carving out looser provisions solely for Camden and opening the door to larger subsidies in general.

"New Jersey's policymakers need to revisit last year's legislation and rein in this reckless surge in business tax subsidies," said Gordon MacInnes, president of NJPP. "Instituting a cap on the amount of tax breaks the state can approve would be a simple and common-sense place to start."

Daryn Iwicki, state director for the anti-tax group Americans for Prosperity, said subsidies are pointless unless New Jersey first tackles its high income- and property-tax rates.

"The biggest problem we have here is it's another politically connected individual getting a tax break," Iwicki said, referring to Norcross, an influential insurance executive who entered into a partnership with Singh and others to buy the Philadelphia Inquirer in 2012. The Norcross group recently sold its share of the newspaper company.

Iwicki noted there were only two larger subsidies ever awarded in New Jersey-- and that they had not panned out as expected. One of them, a $261 million subsidy spread out over 20 years, went to Revel Casino in Atlantic City, which is facing its second bankruptcy in two years. The other, valued at as much as $350 million, went to the stalled American Dream project in the Meadowlands, formerly known as Xanadu, with its own troubled financial history.

Looks like South Carolina dodged a bullet. New Jersey will regret that in time. Listen to this hustler:

Is The Republican Party On A Collision Course With Their Allies At Big Insurance Over Climate Change?

Since 1990, the Insurance Industry has contributed $306,387,653 in congressional races, almost two-thirds of it to Republicans. So far this year, they've doled out $17,600,207, again, most of it to Republicans. So far in the cycle they have carefully selected the incumbents who have been most willing-- in each house-- to put the special interests of the insurance industry ahead the interests of their own constituents and of the American people. No one on this list of the dozen topic recipients of insurance industry legalistic bribery is fit to serve in Congress:

This week Republican legislators in Oklahoma passed a bill to prevent science teachers tackling the question of Climate Change. But now there may be an interesting new "special interest" insurance companies may be taking into account: yes, Climate Change. Listen to this report from Marketplace from Wednesday afternoon about Farmers Insurance suing local governments for not taking climate change seriously enough to protect homeowners whose property was damaged by flooding:



This could put the insurance industry at serious odds with their conservative allies in Congress.

Illinois Farmers Insurance Co. is suing Chicago for failing to prevent flooding related to climate change in what experts say could be a landmark case that accelerates local efforts to grapple with the impacts of climbing temperatures.

The insurance company filed nine class-action lawsuits last month alleging that dozens of Chicago-area municipalities are responsible for the damage caused by a two-day downpour last year in April. The company claims that local officials are aware that climate change is causing heavier rainfalls but failed to prevent sewage backups in more than 600 homes by draining water from the region's system of tunnels and retention basins before the storm.

Farmers is asking to be reimbursed for the claims it paid to homeowners who sometimes saw geysers of sewage ruin basement walls, floors and furniture. The company says it also paid policyholders for lost income, the cost of evacuations and other damages related to declining property values. But some analysts say that Farmers likely has a bigger prize in mind.

The company, which is a subsidiary of global giant Zurich Insurance Group, could be positioning itself to avoid future losses nationwide from claims linked to floods, sea-level rise and even lawsuits against its corporate policyholders that emit greenhouse gases, said Andrew Logan, an insurance expert with Ceres.

In 2012, a different Zurich subsidiary, Steadfast Insurance Co., won another high-profile climate fight: Steadfast fought a claim submitted by its policyholder AES Corp., an electric utility, stemming from a lawsuit by Kivalina, Alaska, that accused AES of contributing to climate change by emitting carbon dioxide. The Virginia Supreme Court ruled that Steadfast wasn't liable for AES's pollution.

When viewed together, Zurich's two climate cases might represent a broader strategy to insulate itself from climate losses, Logan said. The company protected itself from corporate claims related to emissions with the Steadfast case; now it seems to be separating itself from municipal losses in Illinois.

"I guess if you're an insurer that's really worried about the scale of liability that you might face from climate change, this would be a pretty smart way to begin to put up some walls around yourself," Logan said. "The dollars at stake [in the Illinois case] are much smaller than the precedent that's being set."

…A book-length analysis of the legal challenges faced by insurers notes that the industry's climate expertise related to natural catastrophes, climate science and adaptation resembles its level of knowledge around asbestos. One of the authors is Lindene Patton, Zurich's climate expert in North America.

"This could lead to claims against insurers arising out of their particularized knowledge of any of these issues," says the book, titled Climate Change and Insurance.

Similarly, the lawsuit by Farmers uses the climate assertions by local officials to show that they knew about the risks of a warmer and wetter atmosphere but didn't do enough to avoid damage. The suit points to the Chicago Climate Action Plan as evidence that the city is aware of the dangers.

"The defendant knew or should have known that climate change in Cook County has resulted in greater rain fall [sic] volume, greater rainfall intensity and greater rainfall duration than pre-1970 rainfall history evidenced, resulting in greater stormwater runoff," the lawsuit says.

The Chicago Tribune is a very right-wing newspaper, a Republican bastion you would expect to support crackpot Republican tactics and strategies. An OpEd this week, however, did not support the crazy, unsubstantiated, theories expressed by Marco Rubio that fly in the face of climate change science, a science the Chicago region is well aware of-- as is Rubio's own Florida. "In an interview yesterday, Florida Republican Sen. Marco Rubio, a possible presidential candidate in 2016, took about as extreme a position on global warming as he possibly could. 'Our climate is always changing,' he said. 'I do not believe that human activity is causing these dramatic changes to our climate the way these scientists are portraying it.' In short, he thinks that if the climate is changing, it is not attributable to anything people have done."

Rubio's statement is not just meant to firm up support from the fringe Republican base who have been brainwashed by Fox and Hate Talk Radio, it is a public pledge to the Koch brothers, that even if climate change makes Orlando beachfront property and drowns his own Miami-Dade, his fealty to their cause is undying. So far, in his short time in Congress, Rubio has taken $464,470 from the insurance industry. The Chicago Tribune points out that his position "departs not only from the vast majority of climate scientists but even a skeptic as prominent as Patrick Michaels, a professor of environmental sciences at the University of Virginia and a fellow at the Cato Institute. In his book Climate of Extremes: Global Warming Science They Don't Want You to Know, co-written with Robert Balling Jr., Michaels says, 'Humans are implicated in the planetary warming that began around 1975. Greenhouse gases are likely to be one cause, probably a considerable one.'"

So Rubio is repudiating even scientists who reject the scientific consensus, not to mention scientists who once were skeptical but changed their minds. He intends to defend the position that if any warming is underway, humans didn't cause it and humans can't contain it.

In 2012, Rick Santorum called global warming a "hoax." Mitt Romney originally acknowledged humans were causing the climate to heat up, but reversed course, saying, "I don’t know if it’s mostly caused by humans." That position is what primary voters demand. So expect the Republican Party to keep denying what is increasingly untenable to deny.

A congressman from Orlando, whose district would be beachfront property if numbskulls like Rubio are given a hand in formulating environmental and climate policy, is Alan Grayson. "It’s insane, " he told John Amato last week in regard to Rubio's statements about climate change, "but that’s what passes for political discourse these days. It’s a complete rejection of facts, evidence and logic-- the “Endarkenment.”

So far this cycle, the insurance industry has given Rubio, who is not up for reelection, $64,830. And Grayson, who is up for reelection? $750. Many in Florida want to see Grayson run against Rubio for the Florida Senate seat in 2016. Perhaps the Insurance Industry will stop funding Rubio by then… maybe not. But one thing is certain… Grayson will continue drawing his support from grassroots progressives, which is why we're asking DWT readers-- and insurance companies-- to consider sending money to GutsPAC right here-- to help avoid more endarkenment.


UPDATE: Getting Played… By Big Insurance

Mike Obermueller released this awesome TV spot today. I happen to be reading the part of Elizabeth Warren's book where she talks about the lobbyists barreling down the halls of Congress-- so sure of themselves and so positive that the weak and pathetic congressmembers would bend to their will (and wads of cash). This clip reminded me of how hard it is to fight that kind of force. The insurance industry has given John Kline $430,000-- and he's worked hard for their money… betraying his own constituents. Watch the ad:

Will the infotainment noozers ever ask serious questions of Paul "Why the F*&k Aren't You Dead Yet, Granny?" Ryan?

DOONESBURY: A Banker's Progress

[Don't forget to click to enlarge.]

"Ryan’s pieties notwithstanding, his budget is a prescription for diminishing prosperity and security, a road map, in fact, for national decline."

-- Harold Meyerson, in his Washington Post column,

"Who's hurt by Paul Ryan's budget proposal?"

by Ken

I don't want to talk about it. You name it, I don't want to talk about it. I don't even want to talk more about Charlie Sheen's "show."


But let me just say a couple of things about the Bold New Economic "Vision" of Paul Ryan. (I reckon that this slug's "vision" is to actual vision very much what Charlie Sheen's "show" (see link above) to actual shows.)

* How come when the chorus of lying hooligans of the New Right were spreading their fabrications about "death panels" contained in the health care legislative package, every infotainment nooze outlet picked it up and treated the lies seriously, but now when Paul "Drop Dead, Grandma" Ryan unveils a plan to turn the health care of the elderly over to the tender mercies of the predatory health care industry, hoping to sign -- not figuratively but literally -- a suffering-and-death warrant for the non-rich elderly, there's nary a peep?

* Speaking of Paul "You've Lived Long Enough, Grandma" Ryan and the predatory health care industry, while I realize it would be asking too much to hope that infotainment noozers, who are predominantly economic illiterates themselves (their interest in economics tending to extend only to the point where their inflated paychecks clear the bank), to raise any questions about the supposed economics credentials of a man who is a total and unequivocal economic ignoramus. Still, how come none of the noozers ever ask the hideous troll about any of those nauseating numbers Howie passed on the other day from Public Campaign Action Fund:

1. Over his career, Paul Ryan received more than $2.1 million in campaign contributions to his campaign account and his leadership committee, Prosperity PAC, from health and insurance interests.

2. Insurance interests alone accounted for more than $850,000 of that total, with health professionals providing more than half a million dollars and pharmaceutical interests giving more than $250,000.

3. Among Ryan’s biggest backers were:

* Blue Cross/Blue Shield, whose PAC and executives gave him $75,650 in campaign contributions;

* America’s Health Insurance Plans, whose PAC and executives gave him $29,500; and

* Koch Industries, whose PAC and executives gave $100,500, including $2,500 from billionaire David Koch.

Shouldn't the little toad be fighting for his political life against a growing chorus of cries of blatant corruption, rather than getting away with his pretense to being anything but the sleaziest kind of megacorporate whore?


* And speaking of those selfsame predatory insurance companies, would it be possible to nominate them to the role of senior seniors liquidators if the Baucus-Emanuel-Messina-Obama axis hadn't made it an inviolable principle of health care "reform" that not even the slightest whisper be allowed to surface regarding their thieving, murderous performance and its role in the economy-destroying explosion of health care costs? Is there any limit to the price we will pay for that profile in gutlessness? (No, I don't think there is any limit.)

* And on the general subject of the extremely special interests represented by the economic "vision" of Paul "Why the F*&k Aren't You Dead Yet, Granny?" Ryan, Harold Meyerson has another great column in today's Washington Post, the one from which I quoted at the top of this post ("Who's hurt by Paul Ryan's budget proposal?").

Here are the final paragraphs:

The cover under which Ryan and other Republicans operate is their concern for the deficit and national debt. But Ryan blows that cover by proposing to reduce the top income tax rate to just 25 percent. He imposes the burden for reducing our debt not on the bankers who forced our government to spend trillions averting a collapse but on seniors and the poor. The reductions in aid to the poor, says the budget blueprint that Ryan released, will be made “to ensure that America’s safety net does not become a hammock that lulls able-bodied citizens into lives of complacency and dependency.” That’s a pretty good description of America’s top bankers, but Ryan’s budget showers them with tax cuts.

Republicans can’t take sole credit for creating a vision of a diminished America. Most of the Washington-based commentariat has focused on the debt over the past year, ignoring both the persistence of high unemployment and the absolute stagnation of wages even as profits have soared. Those who applaud the macroeconomics of Ryan’s cuts should at least be compelled to explain how ordinary Americans, whose incomes haven’t risen since the late ’90s, can take up the slack, in their own purchasing and in the nation’s economic activity, created by these cuts. They might even want to think about raising taxes on profits and capital gains, since these forms of income are rising even as wages flatline.

And, finally, there’s talk that we have a president who’s a Democrat — the party that created the American social contract of the 20th century. Initially, he focused on reshaping and extending that contract into the 21st. Now that the Republicans want to repeal it all, he’s nowhere to be found. Has anybody seen him? Does he still exist?

Sure, the banksters and the rest of the megacorporate elite are entitled to buy as much government as they can afford, especially as the thug imbeciles of the Supreme Court Far Right prepare to extend the crackpoint notion-turned-constitutional "principle" that money = free speech. But at the very least, shouldn't their bought whores be encouraged, if not actually required, to label themselves as Wholly Owned Stooges of Your Corporate Masters?

#

Health Insurance Makes No Sense At All

Every year my health insurance goes up. This year it was $803.00 a month. I only went to one doctor and I had to pay a deductible of $203.00. (It was for an ear canal cleaning.) The insurance doesn't cover holistic doctors or my masseuse. It's pretty much useless in practical terms although I guess it gives me some kind of peace of mind-- even though, as I mentioned yesterday (What Do Doctors Know)-- I think of hospitals as places were one goes and gambles with a good chance of being killed by a system only tangentially concerning itself with health.

TimeWarner had a special sweet deal for retiring division heads which allowed me to keep my COBRA coverage until Medicare kicks in. It looked like a good deal at the time, although it hasn't worked out that way at all. Every now and then I get a letter from the plan administrator. It's always a rate increase. ALWAYS. I don't think a single year has gone by without one. And, more often than not, the rate increase is accompanied by a reduction in services and benefits. Here's the most recent list of bad news that came along with the most recent rate increase:

• In-network deductibles have been added, however, in-network preventative care services will still be paid at 100% with no deductible.

• Deductibles and annual out-of-pocket maximums have increased.

• In-network and annual and out-of-network coverage has changed:

• Select Plan: In-network coverage: 90%; Out-of-network coverage 70%

• Standard Plan: In-network coverage: 80%; Out-of-network coverage: 60%

• Coinsurance will replace flat-fee copays. Coinsurance is a percentage of the cost for health care services thatyou must pay in addition to your deductible. For example, if you see an in-network doctor, under the Standard Plan you will pay 20% of the doctor's negotiated rate and the Plan will pay 80% after you meet yoyur deductible.

The first time I met Howard Dean he was an asterisk in the presidential primary polling. He came over to my house for breakfast and I had no preconceptions at all. Then he started talking about the inherent corruption of the health insurance industry and how the country had to fix the problem in order for our society to thrive. He won me over entirely. I wish he would have told Obama about how he saw it too.

Odd That The DCCC is Picking On Poor Paul Ryan Again

Paul Ryan, the most corrupt politician in the history of Wisconsin

You know, Blue America didn't open a special page dedicated to attacking any individual conservative slimebag but one: Paul Ryan. Not one for Michele Bachmann, Jim DeMint, Patrick McHenry, Mean Jean Schmidt, Dan Boren, Virginia Foxx... none of the arch rogues and crooks masquerading as servants of the people. Ryan is more dangerous than any of them, because, unlike them, he has a patina of respectability. It's undeserved, and in American politics all you need is a patina. Just look at how well Obama has done.

Anyway, yesterday's full frontal against Ryan by the DCCC-- which, ironically, still refuses to give the time of day to his opponent, progressive activist Paulette Garin-- asks the straightforward question, "As insurance premiums skyrocket, will Representative Paul Ryan continue protecting insurance company profits?"

It's an easy question to answer, and the best place to start looking for clues is at OpenSecrets.org. The Insurance Industry was the sixth biggest briber of politicians in the 2010 electoral cycle ($10,570,732 so far), just between real estate crooks and lobbyists. This year Ryan was the seventh biggest GOP recipient of Insurance Industry favor, odd for so junior a member. He's gotten $75,200 so far, considerably more than over 400 other House members, and certainly more than anyone else from Wisconsin. The top GOP bribees were caucus leaders Eric Cantor ($130,750) and John Boehner ($98,390).

Since 1990 the Insurance CEOs and their lobbyists have also done very well by Ryan-- $534,071, more than almost anyone else in Congress as junior as he is and far more than anyone else from Wisconsin, including members who were already serving when Ryan wasn't old enough to wear long pants, like Jim Sensenbrenner (R- $254,898), Appropriations Committee Chair Dave Obey (D- $122,056) and Tom Petri (R- $114,720).

It's easy to see that the Insurance Giants are banking on Ryan. The DCCC has noted Ryan's immense haul as well, but they're shy-- for obvious reasons-- about calling it bribe money, even if it obviously is.

As the House prepares to vote on health insurance reform, Representative Paul Ryan must decide whether to continue siding with the big insurance companies who have given him $534,071 in campaign contributions or with the people in Wisconsin who have seen their health insurance premiums rise by 108 percent.

“Considering that Representative Paul Ryan has taken $534,071 in contributions from insurance companies, Ryan’s vote on health insurance reform will show whether he cares more about protecting the profits of his big insurance company contributors or about helping the folks back home being hit by premiums they can no longer afford,” said Ryan Rudominer, the National Press Secretary of the Democratic Congressional Campaign Committee. “Families and small businesses in Wisconsin can’t afford another vote by Representative Ryan to put big health insurance companies first.”

Now, anyone who knows Paul Ryan knows he's one of the most disgraceful whores in the Congress, 100% owned, lock, stock and barrel, by special interests. Ryan was the GOP point person to turn out the Republican votes for the big Wall Street bankster bailout (TARP)-- and the banks love him even more than the Insurance Giants do! But, what's odd about the DCCC going down this road is that of the 39 Democrats who voted against healthcare reform last November, more than a few, though not quite in Ryan's league, are widely known Inside the Beltway as whores for sale to the highest bidder. Some of the worst are (with their own Insurance Biz takes in brackets):

John Adler (NJ- $105,667)
John Barrow (Blue Dog-GA- $80,250)
Dan Boren (Blue Dog-OK- $135,985)
Allen Boyd (Blue Dog-FL- $274,881)
Artur Davis (AL- $236,649)
Lincoln Davis (Blue Dog-TN- $81,886)
Stephanie Herseth Sandlin (Blue Dog-SD- $126,196)
Tim Holden (Blue Dog-PA- $190,729)
Suzanne Kosmas (FL- $123,116)
Jim Marshall (Blue Dog-GA- $99,300)
Jim Matheson (Blue Dog-UT- $243,844)
Mike McIntyre (Blue Dog-NC- $98,270)
Charlie Melancon (Blue Dog-LA- $189,335)
Mike Ross (Blue Dog-AR- $185,312)
John Tanner (Blue Dog- TN- $595,709)

So is that D-trip hypocrisy? I mean, sure, Ryan is a disgrace to America. But what's Suzanne Kosmas, who they are pointlessly pouring resources into protecting? And John Barrow has a thoroughly progressive and incorruptible former state senator, Regina Thomas, running against him in the primary. If the DCCC can denounce Ryan, they can denounce Barrow for the exact same crime. Of course, like I said, they're not supporting the progressive running against him either!

Meanwhile Joe Conason had a far better take on Ryan Monday over at Salon, the gist of which is that his cynical "roadmap" is to further debilitate and diminish the middle class in favor of his corporate paymasters.

In the mainstream media, the Wisconsin Republican is often presented as a straight-shooting prophet whose prescriptions for privatizing Social Security and eviscerating Medicare can only be ignored if we want to jeopardize America's future, and so on.

Fortunately, the Center on Budget and Policy Priorities has studied Ryan's proposals with its usual perspicacity and issued a clear warning that his road map would only lead us-- after a series of hard-right turns-- to the same old plutocratic dead end. Like so many Republican speeches about fiscal responsibility, the Ryan promise to balance the budget is a scam whose real purpose has more to do with redistributing taxes downward and wealth upward-- that is, more of the same.

...[As a result of Ryan's proposals which cater entirely to the Wall Street bankers who have him parked for a long and powerful career] middle-class taxpayers would end up paying a larger percentage of their annual income to the government than now, while the wealthiest taxpayers would pay a smaller percentage. According to the CBPP-- which many conservatives acknowledge for its tradition of honesty and accuracy-- Ryan's plan would damage health coverage for most Americans and endanger if not destroy the safety net for the elderly, whose rise from mass poverty began with Social Security and Medicare.

He's as bad as... Rahm Emanuel, Mark Kirk, Roy Blunt, Mike Castle or Harold Ford, several other of the politicians who have been singled out by the Masters of the Universe for higher office where they can do them the most good, and us the most damage. What the DCCC didn't mention was how harmful to the residents of southeast Wisconsin it will be if Ryan's bought-and-paid-for point of view prevails in the healthcare battle coming to a head this week. The Commerce and Energy Commttee has come out with a review of the impact of the bill on Ryan's constituents. Highlights of what the bill will achieve there:

* Improve coverage for 506,000 residents with health insurance.

* Give tax credits and other assistance to up to 153,000 families and 14,000 small businesses to help them afford coverage.

* Improve Medicare for 112,000 beneficiaries, including closing the donut hole.

* Extend coverage to 19,500 uninsured residents.

* Guarantee that 8,000 residents with pre-existing conditions can obtain coverage.

* Protect 1,600 families from bankruptcy due to unaffordable health care costs.

* Allow 51,000 young adults to obtain coverage on their parents’ insurance plans.

* Provide millions of dollars in new funding for 4 community health centers.

* Reduce the cost of uncompensated care for hospitals and other health care providers by $23 million annually.