Originally Posted by ziggyX65

I would argue that an employer provides a ready, somewhat secure venue for labor to produce. I don't think taking a reasonable fraction of the fruits of their labor is "theft." I just don't see it.

That, I would say, is because you approach the question by starting with the existence of the capitalist system with its assignation of ownership based on capital, and within the confines of that system, asking yourself if individual businesses are to blame for what they do. I already said that the blame lies with the system itself, not with the individuals who operate within it.

Step back and broaden your field of view a bit more.

Given the choice between being hired for a steady $25 per hour in wages and benefits or being a "free agent" and having to market your own skills with an uneven $35 per hour income, many would freely choose the former.

Perhaps, but since they're not given that choice, that's a purely hypothetical consideration.

I just don't see how, in any rational universe, having money forcibly taken from you under the threat of jail time is less "theft" than a voluntary employment arrangement whereby an employer can keep a fraction of the output of an employee -- one where the employee is free to leave and won't face jail for noncompliance.

Emphasis added. As already pointed out, it's NOT voluntary.

The reasoning behind not considering taxes theft is that the money taken by the government is owed, and therefore not owned. It's no more theft for the government to enforce payment of an obligation to the general public, than for the court to enforce payment of a contractual obligation to a private creditor.

I get that. But your argument still seems to imply that private individuals never have any incentive to create a business that hires people, because it could never make them more money than if they only went into business for themselves.

Correct. In a worker-owned economy, however, there would never be a need on the part of anyone to be "hired" by another private individual, and so the absence of that incentive doesn't matter.

Look, I'm firmly against corporate influence in government. But I would not go so far to say that private, for-profit enterprise is immoral in pretty much all cases.

I realize what I'm saying here is radical and not practical in the immediate future and I'm not advocating it as such. I also don't have all the details worked out of how an alternative would operate. It's still useful, I think, to question things that we take for granted, as if they were artifacts of nature, when what they really are is artifacts of society, and don't necessarily have to be that way.

Originally Posted by Brian Rush

Perhaps, but since they're not given that choice, that's a purely hypothetical consideration.

Sure they do. My background is in software development.

I have a choice to either accept employment or to write my own software, market my own software and keep 100% of the proceeds.

That most people consider the latter impractical (or too risky) in today's world is a given, and maybe that's what you are getting at. But the choice is still there, even if circumstances and risk-aversion dictate most people take the more "sure thing."

As such I still maintain that accepting an employment offer is more voluntary than paying taxes. Again, I'm not saying taxation is immoral or "theft" here. But it is more coercive, IMO, than accepting a job offer (even when terrible economic times pretty much dictate that desperate job seekers *must* take a bad offer for practical purposes).

Originally Posted by Brian Rush

Correct. In a worker-owned economy, however, there would never be a need on the part of anyone to be "hired" by another private individual, and so the absence of that incentive doesn't matter.

I don't quite see how this would work. Who runs the company? If they get the same amount as any other worker, why start the business? This gets me back to the point that the only way this happens is if all private industry is nationalized as there would be no private incentive to grow. Then a business with X employees is effectively owned by each worker having a 1/X share in the business, and if they bring in another worker, another theoretical "share of stock" is created so that they all now own a 1/(X+1) share of the larger business? And how would you account for the fact that some workers add more value than others, whether it's because of productivity or the nature of their work? I know you said it seems unworkable for now; I'm just thinking aloud.

I don't see how you can fully eliminate the profit motive without nationalizing everything.

Has it occurred to anyone that a healthy population is a more productive population? That low-level workers with dental problems or vision problems or other problems can't do their best for you? Nor a mother whose child has been running a fever and screaming in pain but who can't afford either the money for a doctor or the time to take the kid to the emergency room and wait an incredible amount of hours. She's worried; she can't concentrate.

Of course, the answer there is simple enough: fire them and get someone else. And possibly complain that the poor are unproductive and that's why they're poor, rather than they may be unproductive because they're poor.

I had a dishwasher that slowly ceased to get the dishes clean. I had the repair tech in and had it fixed. Now it does its job. I myself had neither strength nor energy; I couldn't have put in a half days work if you paid me. I (being a retired parasitic state employee, namely bookkeeper for the University mailroom) (with a luxurious Cadillac health care plan) called my doctor, who sent me for one of those expensive, unnecessary high-tech rich folks' tests. And guess what? Like the dishwasher, I, too, had a malfunctioning motor-pump assembly. And if you got me a new one, I'd be as productive as I've ever been.

I could have scolded the dishwasher, sneered at it as being lazy and good-for-nothing, and kicked its mechanical ass out the door. And that could have happened to me as well. It didn't.

End of sermon. Please pass the collection plate.

It is just amazing to me that our leaders work for over a year and come up with a law that is intended, and will, help the people, though it's not good enough yet. But it will help people, and yet so many people have been deceived by the corporate bosses who want to continue to abuse us and rip us off, especially the poor tea-partiers who are led around by the nose by these corporate bosses and the slogans of "freedom" so that the bosses can continue to rip us off.

Originally Posted by ziggyX65

Sure they do. My background is in software development.

I have a choice to either accept employment or to write my own software, market my own software and keep 100% of the proceeds.

No, as a practical matter, you do not. But here's how a worker-owned system might actually operate. You would be a member of a cooperative that markets the work of software developers either as individuals or as a team. The cooperative covers the costs of marketing and takes a percentage of the proceeds to cover those costs. You would not keep 100% of the proceeds, but then, you wouldn't as a completely independent operator, either, since you would be covering those costs yourself at greatly reduced efficiency. But what you would own would be the net fruits of your own labor rather than an agreed-upon fixed salary.

That's more or less the way I operate as a self-published author. I use a platform to epublish my work. I handle the costs of editing, marketing, and cover art myself, but the platform provides the software and distribution network, and takes 15% of the proceeds to cover these costs. I keep 85% of the proceeds, which is actually a lot better than what I could do if I had to fund the format conversion, web sites, and servers myself. (Instead, I share those costs with every author who uses the platform, which makes things much more efficient.)

The problem with the capitalist system is entirely with the way ownership is assigned and labor is bought and sold. It does facilitate organization, but it may not be the only way of accomplishing that.

As such I still maintain that accepting an employment offer is more voluntary than paying taxes.

Using my own writing again as an example, most workers are in the position I would be in if the only way I could make money from writing were to sell my work for a fixed price, or a fixed payment per hour or per month, to a publisher who would then assume all of the financial risks and reap all of the profits. (Something like that prevails, or something even worse, in the relationship of authors to major publishers, but that business model is moribund.)

So I don't agree. For most workers, accepting an employment offer (by which I mean "some employment offer or other") is just as involuntary as paying taxes, no more, no less.

I don't quite see how this would work.

Neither do I in all the details. I may try to work those out and present a description in some format or other, somewhere. But here, the only point I'm making is this: let's not glorify the profit motive. The capitalist system is an outgrowth of the old system of hereditary feudal privilege (indeed, many of the earliest capitalists in England were hereditary aristocrats) and amounts to a modified and modernized privilege system. If we're going to leave it in place, we should not trust it to serve the public good without strict oversight, since serving the public good is not what it's designed for.

I don't see how you can fully eliminate the profit motive without nationalizing everything.

I'm pretty sure there is a way to do it on a decentralized basis. I may have some more to say about that later. Again, though, the point here is not to completely eliminate the profit motive but simply to point out that there's nothing noble about it, and it shouldn't be let out without a keeper.

September 21, 2010 07:00 PM
Health Insurers Up The Ante Over Pre-existing Conditions Rule By Denying Coverage To Children. What Next?

By Susie Madrak
Well! That worked well, didn't it? (As opposed to Medicare for all, I mean.) Possibly the president and our congressional leadership is beginning to understand just what happens when you invite the health insurance vampires into your house:


Several health insurance companies have announced that they are ending insurance coverage for children because the new law won't let them turn away the sick ones anymore. That's right - WellPoint, CoventryOne and others are refusing to issue new child-only policies because the companies will no longer be able to deny coverage to children with "pre-existing conditions." They blame their actions on the new health care law, not their own greed. Even for the insurance industry this behavior is surprisingly brazen. They don't like the rules, so they're going to take their ball and go home.

The insurance companies announced their plans to turn away sick kids only days before Sept. 23, when important parts of the health insurance law take effect. These include consumer protections that end the worst of insurance company abuses. The law puts an end to odious practices like dropping people because they got sick, putting annual and lifetime limits on how much coverage you can get from the insurance policy you rightly thought covered everything, and denying children coverage because they're sick.


http://crooksandliars.com/susie-madr...rowing-major-h

Originally Posted by Brian Rush

But here, the only point I'm making is this: let's not glorify the profit motive.

The profit motive itself is neither noble nor evil. The devil is in the details.

On one hand the profit motive does create incentives for being productive, and I don't think productivity is something we want to discourage through putting an end to a "more pay for better/faster/stronger work ethic". On the other hand, if not adequately managed and regulated it can lead to a situation where a few well-connected folks with access to large amounts of capital can exploit a heck of a lot of people. (Such as what happens when jobs are offshored and real unemployment is in the 16-17% range.)

I suspect you and I would agree with respect to which extreme we are closer to being at today. But I see some baby in the bathwater.

Originally Posted by Deb C

Several health insurance companies have announced that they are ending insurance coverage for children because the new law won't let them turn away the sick ones anymore. That's right - WellPoint, CoventryOne and others are refusing to issue new child-only policies because the companies will no longer be able to deny coverage to children with "pre-existing conditions." They blame their actions on the new health care law, not their own greed. Even for the insurance industry this behavior is surprisingly brazen. They don't like the rules, so they're going to take their ball and go home.

Sounds like justification to throw the "public option" at them to me. The thing is, the insurers probably wouldn't be doing this if they didn't see a Democratic rout coming in November. Because if they thought the Democrats would hold serve here, such action would bring new determination in the next Congress to create the public option.

Originally Posted by ziggyX65

But I see some baby in the bathwater.

Not if the insurance industry has anything to do with it. They have already shown that they are willing to throw the baby and anybody else who gets in the way of their bottom line under the bus.

If money comes before the health and welfare of a human being, then that profit is ill- gotten.

Originally Posted by Deb C

Not if the insurance industry has anything to do with it. They have already shown that they are willing to throw the baby and anybody else who gets in the way of their bottom line under the bus.

If money comes before the health and welfare of a human being, then that profit is ill- gotten.

Insurers are only one aspect of the "profit motive" in health care, let alone the profit motive throughout the economy. The "baby" I see in the bathwater has nothing to do with the health insurance industry in particular.

Originally Posted by ziggyX65

The "baby" I see in the bathwater has nothing to do with the health insurance industry in particular.

My intention was just a play on words in regards to the baby.

http://joan-mccarter.dailykos.com/

First provisions of Affordable Care Act begin

Yesterday, Nancy-Ann DeParle of the Office of Health Reform joined bloggers for a conference call to highlight the provisions of the Affordable Care Act that go into effect tomorrow, six months after enactment of the law. Those changes:

Ban on discriminating against children with preexisting conditions: as of tomorrow, insurance companies can't deny coverage to children under age 19 for a pre-existing condition. The ban will go into effect for adults in 2014.

Ban on rescission: insurers will be prohibited from dropping a customer when they get sick or to search for errors in customers' applications to use as a basis for rescinding coverage or denying payment for services.

Ban on limiting coverage, lifetime caps: Insurers will no longer be able to impose lifetime dollar limits on benefits--particularly hospital stays or expensive treatments for chronic diseases, cancer, etc. By 2014, they will phase out annual caps.

Ban on limiting doctor choice in new plans: insurers will have to allow primary care physician status for OB/GYNs and pediatricians so that patients don't have to get pre-authorization or referrals to see these providers.

Ban on restrictions on emergency services: insurers will have to cover all emergency care, in or out of network.

Guaranteed right to appeal insurer decisions to independent third party in new plans;
Young adults can stay on their parents' plans til 26 unless they have access to coverage in their workplace;

New plans will cover preventive care with no customer costs--well-baby, mammograms, colonoscopies, etc. will be covered with no co-pays or deductibles.

Surprise! Private Insurers Skirt New Health Care Law

Signs don’t point to sunny skies ahead

This most recent revelation, cutting out new child policies, combined with the latest massive and apparently unstoppable rate hikes is just more proof of what I spent months warning about: the new law leaves the health insurance companies completely unchecked and the regulations are almost meaningless due to a lack proper enforcement. Frankly, given the billions at stake, and the drive of the for-profit insurance companies to maximize profits, I don’t even know of a really well-designed regulator system could prevent insurers continuing to exploit loopholes.

This might be one of the first examples how, due to poor design, weak regulation, and weaker enforcement, the new law fails to live up to expectations, but I promise you (as someone who read the entire law thoroughly, which apparently even Sen. Max Baucus didn’t) it won’t be the last.


http://www.commondreams.org/view/2010/09/22-6

Originally Posted by Deb C

Surprise! Private Insurers Skirt New Health Care Law

Signs don’t point to sunny skies ahead

This most recent revelation, cutting out new child policies, combined with the latest massive and apparently unstoppable rate hikes is just more proof of what I spent months warning about: the new law leaves the health insurance companies completely unchecked and the regulations are almost meaningless due to a lack proper enforcement. Frankly, given the billions at stake, and the drive of the for-profit insurance companies to maximize profits, I don’t even know of a really well-designed regulator system could prevent insurers continuing to exploit loopholes.

This might be one of the first examples how, due to poor design, weak regulation, and weaker enforcement, the new law fails to live up to expectations, but I promise you (as someone who read the entire law thoroughly, which apparently even Sen. Max Baucus didn’t) it won’t be the last.


http://www.commondreams.org/view/2010/09/22-6

Technically, the child part of the new law was cut out and the insurance companies are right in not insuring children. Its a rush to vote and oversight on the Democrats part that missed it.

Originally Posted by wtrg8

Technically, the child part of the new law was cut out and the insurance companies are right in not insuring children. Its a rush to vote and oversight on the Democrats part that missed it.

Perhaps I'm not understanding your assertion. Please explain your reasoning in regards to how the insurance industry is right to not cover children. Thanks.

Originally Posted by Deb C

Perhaps I'm not understanding your assertion. Please explain your reasoning in regards to how the insurance industry is right to not cover children. Thanks.

The Democrats blundered when they wrote the HCR law and did not correct it. Insurance companies should insure small children under parents plan. This loophole allowed the insurance companies to do this and its perfectly legal now.

Originally Posted by wtrg8

The Democrats blundered when they wrote the HCR law and did not correct it. Insurance companies should insure small children under parents plan. This loophole allowed the insurance companies to do this and its perfectly legal now.

I understand. I'm afraid in the rush to 'look' like there was health care reform, there are way too many loopholes. This is just the tip of the iceberg.

Originally Posted by wtrg8

The Democrats blundered when they wrote the HCR law and did not correct it. Insurance companies should insure small children under parents plan. This loophole allowed the insurance companies to do this and its perfectly legal now.

"Blundered", my ass. They knew full well this law was written to benefit the existing power structure, and that people were going to get screwed by it, overall. They might not have known ('cared' is probably a more honest word) exactly who got screwed and in exactly which way. But not a phrase, nor word, nor even comma of the health-care abomination was in any way a 'blunder'.

Originally Posted by wtrg8

The Democrats blundered when they wrote the HCR law and did not correct it. Insurance companies should insure small children under parents plan. This loophole allowed the insurance companies to do this and its perfectly legal now.

The insurance companies have always been able to drop anyone including these kids. It is always a profit decision for them on the behalf of their shareholders. With HCR, the calculation simply changed. I think we can agree on that.

But to be fair, I think it important to point out this -

http://news.firedoglake.com/2010/09/...ance-industry/

DeParle responded with disappointment at insurance companies dropping child-only policies, noting that many insurance companies started doing this in April and May. “To put it in context, a few hundred thousand children are in child-only policies, because of employer plans that have coverage only for themselves and not dependents,” she said, “and insurers are not proposing to drop already written policies.” She hoped that children have more options now than before, through Medicaid and SCHIP, so that a very small number would be affected by the child-only policy shift.

i.e., because of changes due to the HCR, the damage here is limited and certainly does not compare to the companies now not being able to deny based on previous existing conditions.

and this -

As for the persistent effort from insurers to undermine the law, DeParle agreed that insurers have engaged in these efforts. She claimed that the difference now is the transparency around it. “We have new resources, new scrutiny, sunlight cast upon the regulatory framework, as well as what HHS will do to establish what a reasonable rate increase is.” In addition to the willingness of politicians to cast light on the practices of insurers, DeParle highlighted the fact that North Carolina Blue Cross and Blue Shield just announced $155 million dollars in refunds to about 200,000 customers because of the new law. It turns out that BCBS “over-reserved” and had excess funds above the medical loss ratio, and the Insurance Commissioner in North Carolina, working with the federal government, forced the return. “Insurance commissioners are doing the math,” said DeParle, citing a new aggressiveness from the state regulators. “It’s a new day when it comes to oversight. There’s a tension, it’s an inherent tension, but I’m happy about where it’s going.”

i.e., previous to HCR, the devious tricks played by the insurers barely got any attention by anyone except for the hapless person left with no or little coverage after they were done with them. Now, thanks to HCR, this stuff is national news and provides incentive for a whole network of state and federal regulators to take the insurers on across the board - some losses over there, but some wins over here.

That is reality.

On the other hand, what we have are some folks on the Left that continue to bash HCR because it tried and failed to provide their nirvana of universal coverage without the insurers. They bash it even though they observed nearly daily how Progressives tried hard in the political arena to do so and failed miserable. They bash it without considering that their nirvana is now even far less likely to happen particularly after this November. That would be fine except for the fact that their bashing is helping to bring about our going in the exact opposite direction that they want to go - by adding to the disheartening of Progressives which is the root cause for the coming to power of the Right - and the New Right wants to go far beyond just repealing the little protections that HCR provided and put even more power and money in the hands of the insurers that the bashers profess to despise - it's a little like how t-baggers despise the federal deficit but want to extent the Bush tax cuts. It's illogical and frankly, they are entering a realm previously populated solely by the Right - i.e., Idiot America.

By Don McCanne, MD

As more employers are moving to high-deductible health plans to take advantage of the lower premiums, private insurers, being the market innovators that they are, were not going to stand by as they watch potential premium dollars move into health savings accounts or other options such as flexible spending accounts or health reimbursement arrangements.

From the insurers' perspective, the high deductible is for the purpose of creating financial barriers to health care access. If the patient is forced to pay a significant amount out of pocket - the deductible - before insurance coverage kicks in, then the patient is going to forgo health care, much of it beneficial, simply because it is too expensive. Since it is less likely that the deductible threshold would be met, that reduces the chances of the insurer having to pay out any benefits at all.

The rationale of the health savings accounts, which pay health care costs before the deductibles are met, is that patients would be better shoppers since they are using their own funds from the accounts which they own, achieving the same purpose as the deductibles alone. In theory, the health savings accounts are funded by the premium savings - savings that reduce insurer revenues.

Now the insurers contend that the accounts allow patients to be spendthrifts. They insist that patients are much more likely to spend the funds if they come from a delegated savings account than they would if they came from other personal savings or current income. They are using this as an excuse to recover the premium discount for the high-deductible plans - in essence, reaching into the health savings accounts and stealing the employees' own funds (though indirectly through higher premiums paid by the employee in payroll deductions or forgone wage increases).

Although this is yet one more addition to the litany of reasons that high-deductible plans with health savings accounts are a highly flawed method of financing health care, it is much more a further indictment of the private insurance industry which will always find a way to make another buck off of our health misfortunes.

An improved Medicare for all would eliminate these thieves.

Originally Posted by Deb C

From the insurers' perspective, the high deductible is for the purpose of creating financial barriers to health care access. If the patient is forced to pay a significant amount out of pocket - the deductible - before insurance coverage kicks in, then the patient is going to forgo health care, much of it beneficial, simply because it is too expensive. Since it is less likely that the deductible threshold would be met, that reduces the chances of the insurer having to pay out any benefits at all.

This is a common attack on HSAs.

The truth is, many high deductible plans with HSAs (mine included) provides first-dollar 100% coverage for most annual preventative and wellness exams.

It's not perfect, but until someone comes up with a better way to control costs, I think they should remain. Over the last two years of open enrollment periods at my workplace, the traditional HMO/PPO options rose in cost by about 25% and 32%. My HSA/HDHP plan (which was actually improved in 2009 over 2008) is up only 2% over that time.

Frankly I think the primary ideological opposition to HSAs is that there is the perception that only the more affluent can afford the high deductibles and use these accounts and health plans as another way to avoid taxes on some of their earnings (i.e. it's a "tax break for the rich").

Originally Posted by Deb C

By Don McCanne, MD

As more employers are moving to high-deductible health plans to take advantage of the lower premiums, private insurers, being the market innovators that they are, were not going to stand by as they watch potential premium dollars move into health savings accounts or other options such as flexible spending accounts or health reimbursement arrangements.

From the insurers' perspective, the high deductible is for the purpose of creating financial barriers to health care access. If the patient is forced to pay a significant amount out of pocket - the deductible - before insurance coverage kicks in, then the patient is going to forgo health care, much of it beneficial, simply because it is too expensive. Since it is less likely that the deductible threshold would be met, that reduces the chances of the insurer having to pay out any benefits at all.

The rationale of the health savings accounts, which pay health care costs before the deductibles are met, is that patients would be better shoppers since they are using their own funds from the accounts which they own, achieving the same purpose as the deductibles alone. In theory, the health savings accounts are funded by the premium savings - savings that reduce insurer revenues.

Now the insurers contend that the accounts allow patients to be spendthrifts. They insist that patients are much more likely to spend the funds if they come from a delegated savings account than they would if they came from other personal savings or current income. They are using this as an excuse to recover the premium discount for the high-deductible plans - in essence, reaching into the health savings accounts and stealing the employees' own funds (though indirectly through higher premiums paid by the employee in payroll deductions or forgone wage increases).

Although this is yet one more addition to the litany of reasons that high-deductible plans with health savings accounts are a highly flawed method of financing health care, it is much more a further indictment of the private insurance industry which will always find a way to make another buck off of our health misfortunes.

An improved Medicare for all would eliminate these thieves.

It fits the crass conception that working people are 100% expendable -- disposable objects, mere statistics. Such is the MBA culture: plush lives for Insiders, and for the rest severe deprivations and (if the trend continues) those who lose their athleticism will lose their sustenance. In essence, slow down and go from bare subsistence to starvation.

The MBA culture is inconsistent with any liberal or humanistic tradition... and with human decency.

Originally Posted by playwrite

http://joan-mccarter.dailykos.com/

So they attacked the insurance companies for blaming rate increases on the health care bill, even though all of these mandates were about to go into effect. Makes sense. "Don't you dare call us out on the consequences of our crowning achievement!"

Originally Posted by JustPassingThrough

So they attacked the insurance companies for blaming rate increases on the health care bill, even though all of these mandates were about to go into effect. Makes sense. "Don't you dare call us out on the consequences of our crowning achievement!"

I just love the fact Democrats are now claiming ignorance on their vote for the bill in the first place. I would too, if I voted for a deemed bill.

Originally Posted by JustPassingThrough

So they attacked the insurance companies for blaming rate increases on the health care bill, even though all of these mandates were about to go into effect. Makes sense. "Don't you dare call us out on the consequences of our crowning achievement!"

Actually, it's called, "If you're going to call us out on the consequences, don't lie through your teeth about what they are."

Health insurers don't raise premiums because they have to. They raise premiums because they can. If they say they have to because of XYZ, they're offering excuses, not reasons.