Townhall Where The Disruption Tactics Were Exposed Ahead Of Time Still Wild

Run time: 01:09 https://www.youtube.com/watch?v=eBa3dSGt0aE   Posted on YouTube: August 04, 2009 By YouTube Member: Views on YouTube: 0   Posted on DU: August 04, 2009 By DU Member: masuki bance Views on DU: 1580

 
August 3rd, 2009

A staffer at the beginning of the townhall opens up with -"There's an elephant in the room..." "the tea bag patriots have put out directives that say..." and describes the memo from freedomworks and goes on to warn people to "think twice" if they want to use those tactics.

That opening is here- http://www.youtube.com/watch?v=4NQCJAfmhQw

An important part, but only part:

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6217096&mesg_id=6217096

out there for the insurance giants via shopping on the internet for a health care plan....If I heard it correctly.
If that is her claim, then it just needs to be called out for the bullshit it is. I can't imagine that there is comparable or better option just floating out there on the internet just waiting for Joe public to realize it....Hell anytime there is a good sale down at the local piggly wiggly, people come out in droves...so I can't imagine that her argument holds any merit. I will however investigate it for myself.

I am too lazy too look for one, but if somebody has the same video (and posts a link to it) with better audio quality I will watch it.

I feel sorry for her family.

The person who uploaded the video to YouTube goes by "Cincinnati912Project", which I imagine denotes the exquisite silliness being promulgated by Glenn Beck. So I doubt it will come through.

Anyway, the thing I caught was the woman saying that there is "competition out there". Anyone who has done even the most cursory examination of the health insurance industry knows that such claims are laughable. The AMA has published six consecutive studies on insurance concentration and competition. The current one (2009) isn't available in PDF form yet, but you can see the previous one (2007-2008) here: http://www.ama-assn.org/ama1/pub/upload/mm/368/compstudy_52006.pdf

What many people don't realize is that, essentially, insurance companies operate as local monopolies or duopolies. In all but a few areas of the country, two corporations control well over 50% of the market, and this number can rise to above 95%. In Cincinnati-Middleton metro area, where this Town Hall took place, WellPoint Inc. has a 76% market share. This means that three out of every four people in that area who have private insurance, either through their employer or through individual plans, are covered by a single corporation. Claiming this is healthy competition flies in the face of the basic fundamentals of economics. The woman in this video is either being misleading or doesn't know what she's talking about.

To elaborate further, when the DoJ gives its two cents on corporate mergers and acquisitions, they use a formula to analyze market concentration. It's called HHI, or the Herfindahl–Hirschman Index of Competition. Basically you take the market share of each firm doing business in a particular area, square them, then add them together. To illustrate, let's say we have 10 firms in a market, and they each have a 10% share.

10^2 + 10^2 + 10^2 ... + 10^2 (or 10^2 * 10) = 100 * 10 = 1000. 20 firms with 5% each would yield 500. 4 firms with 25% each would yield 2500. A single firm controlling 100% would yield 10,000.

A HHI of 1000 indicates a concentrated market. An HHI of 2500 indicates a "highly uncompetitive" market. The AMA uses this formula to gauge insurance concentration, and there are a grand total of four states with HHIs under 1800 (not including PA, DC, ND, SD, WV, and KS, because the AMA can't get reliable data in those states).

There is no such thing as competition in health insurance, and insurance companies want to keep it that way. Such high levels of concentration give insurers greater ability to set artificially high prices and cut necessary costs. Anyone who is even moderately interested in free markets would not point to this sector of the economy as the gold standard of free and fair competition. What they're defending are corporate fiefdoms.

A little truth is just what is needed to smack these idiots down.

You're best bet is simply to know more than they do. Fortunately, and I mean this in the most civil way I possibly can, that isn't very difficult.

I've come across a lot of libertarians in my time. The paid-for-performance ones you see on TV are mostly just well-funded demagogues. A variety of corporate foundations have funneled hundreds of millions of dollars into think tanks that make arguments even an Econ 101 student could tear to pieces with a little research and an eye for bullshit. But a lot of them, who you don't see on the squawk-box, genuinely believe this stuff. And defend institutions and practices that run 100% counter to their professed ideology.

And in a vast majority of cases, this is because they genuinely have no idea what they're talking about. They just spout nonsense that they consider the Gospel truth, supplemented by anecdotal arguments, block-quotes of people who've been dead for a hundred years or more as if it adds anything of relevance, and cries of "statist!" and "socialist!". And that's when they feel they can't just make shit up anymore.

and a couple of other insurance companies have about 44%. I have difficulty believing that, and I must say, Kaiser is probably the best of the insurance companies.

Kaiser is the closest thing to the single payer insurance I knew in Europe.

First, I believe (I do not know for sure but I as far as I know this is the case) that Kaiser is owned by its senior doctors. They charge pretty reasonable rates and provide good service in my experience. Of course, one of my neighbors disagrees with me.

You are assigned a Kaiser GP or internist. (That's what is different. In Europe I could choose any doctor I wanted. Maybe I could at Kaiser too but I don't know.)

My daughter worked at Kaiser in her first job as a physician. She liked it and left only because she wanted to practice in a slightly different kind direction. Kaiser trains the doctors well and are already implementing some of the technological and other improvements for care that Obama is suggesting. Kaiser's records are computerized. That means your doctor sees all your test results no matter what. You never go into the emergency care to a doctor who has to ask about what medications you are taking. And, by the way, whether a doctor knows what medications you took so far today or even this week can determine whether you live or die.

Also, Kaiser is pretty good about making sure doctors have information about the latest research and tested treatment methods. I gathered that pharmaceutical reps don't wine and dine Kaiser doctors like they do other doctors although I may be wrong on that. Because of what I know about Kaiser, that Kaiser has 24% of the market doesn't bother me.

I had some terrible coverage plans before I chose to go to Kaiser. People don't realize how bad their insurance coverage really is until they have some strange problem that their GP cannot diagnose and has never heard of. That's when you find out that the choice of specialists on your insurer's network is a lot more limited than you would ever have believed and that your specialist doesn't really know much about you. At Kaiser, they can see your medical history, test scores, everything right on the computer screen in their office.

Their health plan is not-for-profit (as are, I believe, some if its hospitals), but virtually everything else about the company, including all of its medical groups, is for-profit. That kind of mix works well in some areas, but ends up making their entire model obscure.

Nationwide, it's possibly the top ranked HMO in terms of cost containment and outcomes, but probably only after it had to shed most of its holdings on the east coast, midwest, and south. It was hemorrhaging money during the early 90s, through a combination of rubbing certain state insurance regulators the wrong way and butting heads with unions. In my opinion, its triumphant return in recent years is largely due to a series of group acquisitions and careful marketing. From everything I've read, its emphasis on prevention is little more than smoke and mirrors, but it has made some pretty big efforts at record portability.

That all said, there are three things I generally don't like about the company.

1) Kaiser requires its customers to go through mandatory arbitration in just about everything, particularly malpractice claims. This allows them to delay resolving such claims, despite the fact that the arbitration review board has the word "Independent" in its title, which is very dangerous because they have a financial incentive to do so. Especially in cases where the patient could die.

2) I don't know the details about their plans off-hand, but I would be surprised if they covered out-of-network care. Even if they did, they won't do it to any substantial degree. HMOs just don't operate that way. For myself, I have to deal in-network and out-network crap all the time with Aetna.

3) Kaiser has been repeatedly accused of denying treatment in autism cases (specifically, Applied Behavioral Analysis methods) that have been approved by independent medical review boards. The California Department of Managed Health Care (which regulates Kaiser and other HMOs) is currently being sued for allegedly letting Kaiser and several other insurance providers circumvent these review boards and basically decide approved methods of care in-house. Legally, HMOs aren't allowed to do that.

I have a friend with a daughter on the spectrum who's been given some degree of a normal life because his insurance plan covers the behavioral psychologist that comes to his house twice a week, so that kind of rubs me the wrong way. In fairness to Kaiser, though, insurance companies hate covering mental health with a passion. In that respect, most of them are terrible.

If those things don't affect you or your family, than you should probably try to stay with Kaiser.

The out-of-network issue is a very big one since Kaiser is not my closest hospital (as an example). In fact, Kaiser concentrates its hospital services. The Kaiser offices used to be fairly near my home, but were moved to a larger facility way, way in the suburbs.

The arbitration clauses are a problem. But, virtually every doctor includes them in contracts, so they are not unique to Kaiser. Arbitration, of course, can be a good thing. It is a lot cheaper and less public than litigation, possibly faster too. The difficulties with arbitration could possibly be ameliorated by passage of laws setting up a government sponsored agency that hires private mediators/arbitrators with the potential for review of the arbitration ruling. One of the biggest problem with arbitration is that some agreements severely limit how much discovery a plaintiff may do. There should be standard discovery rules for arbitration that give plaintiffs the right to broad discovery. Federal law generally governs arbitration. As you may know, states can challenge arbitration agreements on the basis of unconscionability or some other issue placing the enforceability of the contract requiring arbitration in question.

I did not know about the autism problem. I am hoping that health care reform if not now in the near future will provide a pool for out-of-network coverage and require coverage of mental health care.

I would prefer (by far prefer) a single payer plan. But if we can't get that, we need to work with what we can get. We should never give up trying to educate people about the benefits of single payer. It's just so much less expensive than giving the insurance companies their ransom. And let's face it. That's all insurance companies are in the game for -- the ransom they get. They are like the ancient collectors of the salt tax. They stand at the door of the hospital (figuratively speaking) and require you to pay them a sum just for the privilege of entering the hospital. And if you haven't paid enough or they don't like the looks of you or your past history, they refuse you safe passage through the hospital system.

The health insurance companies serve no earthly purpose that could not be served by a government pool created with tax revenue dedicated, strictly dedicated for health care purposes.

Of course, in this United States of armies and military empires, it might be hard to enforce laws strictly dedicating money for health care purposes. That is the only argument I can think of for health care insurance companies -- that they prevent health care dollars from going into the purchase of more military equipment that we don't need.

I've been thinking about it and the only thing I can thing of is to make an announcement that recognizes the plans by some to disrupt and that at the first sign that disruptors are taking ovcer, the remainder of the towhhall will be silent and replaced by a projected real time computer "chat" wherein all questions will be submitted from the audience to staffers and answered on the projected display. After that decision is made, anyone loudly interjecting or protesting will be removed.

This would so suck, that I imagine peer pressure would effectively take over. I honestly don't know what else they can do.

just being in front of the RNC and then put in cages.

Hitler liked to send his nascent Brown Shirt thugs to disrupt opposition party gatherings. The danger is not having to listen to middle age housewives and old coots rant, but rather that they may well be testing the water prior to the plunge of serious head busting muscle into the waters of national discourse by a minority conservative movement.