Citizen Healthcare and the Government Class: The Abuse Model
If your child or friend was dating someone who began the relationship with lavish promises and declarations of love and respect backed up by actions that mimicked those sentiments but slowly over time the partner began withholding the actions expressing love, the trinkets, the recognition and ultimately made your child or friend jump through hoops to avoid punishment, you'd likely be advising your child or friend to GET OUT.
Yet, President Obama has made this recognizable abuse model not only the hallmark of our healthcare system but of our government--with the undeniable rise in the government class' well-being and status at the expense of the now-victim partner, the non-government class citizens.
Lavish Promises: For a moment think back to why you voted for Obama the first time. I too was enamored with the promises of healthcare reform promising the end to the most insidious business practices of healthcare including exorbitant price increases coupled with less coverage and more difficulty in obtaining the benefits we paid for from these businesses in the form of premiums and taxes. Saving $2,500 a year sounded good, no denying benefits based on pre-existing conditions sounded good, the same benefits as Obama's family enjoyed (meaning federal employees) sounded good. As a voter for Obama in 2008, I joined my fellow voters in CHOOSING Obama.
Oh yes, in the beginning, we felt recognized as valuable, we would be choosing a champion in office, someone who was addressing a persistent and worsening problem we were being exposed to in our society, the tyranny of the healthcare industry.
Actions that "Proved" We'd Chosen Well: Obamacare's introduction and TIMING was an excellent way for the abusers to seal the deal, as the requirements for insurance companies to provide coverage for the (overstated, but still existing) number of those who had been denied the right to purchase health insurance because of pre-existing conditions was immediately addressed in 2010 (with a temporary federal program option). Immediately, parents of children in states that had not changed how long parents could pay for their children's health insurance were provided with the up to 26 option of paying for their children's health insurance. The Medicare donut hole was going to be corrected. We felt we'd chosen well.
Not quite what was promised: We felt GOOD about our new chosen partner, the Federal government, even as we felt disappointment that Obamacare NEVER provided what was promised. After all, the President explained that the government as our partner WANTED to give us everything promised, but after all, this was the real world with real costs and he simply couldn't get it all done.
Ignoring the Obvious: As in the case of any victim of abuse, we ignored the obvious failures in our new chosen partner. We noticed that "affordable" meant that our partner was denying us and reducing amounts spent per capita on individuals in order to prop itself up (ignoring how much it spent on itself). We ignored it even when we were told the government wouldn't calculate its costs on Obamacare (CBO Publication 49892, 1/15/15, page 1), even when the government itself bragged about how it had abused its partner the non-government employee citizens: "…the Bureau of Labor Statistics reveal that the gap concerning benefits between the private and public sectors has been growing-in favor of the public sector,” http://gogovernment.org/government_101/benefits.php.
We happily excused the government class as it exempted itself from Obamacare (yeah, it's not called an exemption because the federal government is the employer of these liars, so as the employer, it simply provided better options to its employees--in other words, fed employees were exempted from Obamacare). After all, they must deserve the reward because they're making our lives better too.
Should we stay with it or not? Even with the excuses and our irrational loyalty in the face of failure, we were on the fence in 2012--Should we keep with this partner or take a chance on another?
The Introduction of Fear: In 2012, many of us realized we were with a bad partner. Many more of us didn't, having learned little about how much worse things would get we remained hopeful that as he once again needed us to retain his own position, the President embarked on a new strategy--the imaginary enemies. With speech after speech of how things could be worse, with threats of what a different choice would mean for us, with highlights of the evil-outside-of-him world, President Obama prevailed.
We knew our copayments, coinsurance, and for most Americans, premiums went up not down, let alone down by $2,500. But still…Obamacare was trying, right?
We realized that the promises made were not to be kept, that the gifts of extra money in our pocket (saving $2,500? How about paying more.) more jobs for our children and ourselves, (jobs number languishing, wages for non-government workers stagnant, health expenses based on what was being charged for care, up, health expenses based on premiums up), but we were convinced that choosing someone else or something else would be worse.
From Promise to Punishment: And so we lined up and decided to stick with our abuser, hoping against evidence, history and common psychological concepts that we'd be able to change the course of events. We weren't noble, we were desperately trying to prove we'd chosen right, that the federal government really cared about us and the healthcare crisis and that besides, there was no other choice that was better, only worse.
And so we were desperate--Willing to accept and support our abuser in the face of the obvious course of such relationships. We blandly accepted that not only were all promises being broken, but that we were having to work harder to stay in our already reduced position, and that now we needed to toe the mark or our abuser would come in and punish us.
We enrolled in health insurance plans to the tune of millions (9.4 to 11.4 this year), paying more, getting less, merely to avoid the punishment of the individual mandate. We desperately tried to avoid the punishment of being declared "unworthy" as we tried to be cooperative enough, healthy enough to be worthy of these reduced benefits and not make our abuser angry that our own humanity, unwise choices or aging were the REASON we needed to be punished with higher premiums, less coverage or simple rejection by providers.
We protested but did nothing amounting to real objection when we realized we were NOT keeping our plans if we liked them, that we could no longer afford to insure our dependents (the family glitch), that we were paying more for health insurance and that the out-of-pocket maximum was still going up as were premiums even as our wages and job participation rates were in such dire condition. We loyally did ANYTHING, including believe liars who recited how great our new partner was--even though we knew better.
National Stockholm Syndrome? Defined as "an emotional attachment to a captor formed by a hostage as a result of continuous stress, dependence, and a need to cooperate for survival," consumers were officially relegated to victims of Obamacare.
Why else would we continue to defend the law but for our dependence cultivated by fear that without Obamacare things could be worse?
Why else accept the continued arbitrary changes and fluctuations to the provisions of the law so that we were never quite sure whether we'd be able to get needed medical services or not or whether we'd be able to afford them or not if not for the continuous stress based on the government class' irrational interpretation, rule-making, and self-accommodation making both the law, its effective dates, its changes outside of our control?
Why else would consumers embrace the record-keeping tallying of defensive medicine, forced wellness or forced testing or forced hoops we must jump through to merely get the benefits we PAY for if not for the fear that we would be perceived as "uncooperative"?
Why else would we willingly forfeit our former rights of choice to purchase a consumer financial product, our former rights to communicate what we desire from providers, our former view that defensive medicine was not a good thing for consumers being forced to undergo testing and testing in an effort for providers to protect themselves and for insurers to gather information to "better" price their offerings EVEN WHEN MEDICAL ERROR IS THE THIRD LEADING CAUSE OF DEATH IN THE US?
Barriers to Detachment: As a population our reaction indicates what an effective abuser the government class has been when it comes to healthcare. We've shown signs of being unable to react to our abuser in healthy ways. We remain afraid of anything different from Obamacare. We remain "hopeful" in the face of fact that Obamacare will NEVER do better. We remain convinced that it is someone else's fault, the sick people, the old people, the people who make bad choices who are to blame for the fact that insurance companies "must" charge more in defiance of the reality of their insurance company profits and their continued expansion of information gathering to justify price increases.
Detaching from the Abuser: There is hope. The first hope is to re-examine whether a government class is FIT to determine healthcare choices and the answer is very possibly, at least for now, "No." The government class is sort of like the HMOs self-regulating in the '90s, it doesn't work. Until our government class recognizes that their anointment is not from God but from voters, and that their right to remain is also from voters, and that their PAY is also from voters, we cannot continue to support a "government" solution. Thanks to Obamacare we know that.
But there's also further action we need to take as we read proposals to change or modify Obamacare from both Democrats and Republicans, Hillarycare the obvious and the less obvious proposal from Republicans for the "World's Greatest Healthcare Plan."
Government for the benefit of government is NOT what consumers need. If government chooses to provide superior benefits for itself, a claim proudly included on the government website, (http://gogovernment.org/government_101/benefits.php) this should have and should be met with a resounding, "NO," from the population.
What population would support a government employee handout at the expense of their own well-being? No truly sane population would. Therefore, our FAILURE to demand that there be a LAW OF THE LAND INCLUDING ITS APPLICATION TO THE GOVERNMENT CLASS is a critical step for Obamacare detachment, because the law does not have that requirement.
IF the government class is not bound by Obamacare without using the loophole of "government employee," thereby making the government the "employer" choosing to provide superior benefits to itself then the law's provisions should be immediately SUSPENDED until such provision is made.
A government solution that provides for payoffs to consumers who participate in exchange plans as Obamacare does MUST comply with the law as written, including recovering overpayments and scrutinizing eligibility: The government class must earn its keep. It was tasked with overseeing the eligibility of people obtaining the Obamacare premium assistance and cost sharing. It has failed year after year to the tune of unknown dollar amounts (2014, https://www.cbo.gov/publication/45397), 2016, (http://www.gao.gov/products/GAO-16-29). This must be done or the law should mandate the suspension of such payments until it is done.
A government solution that provides for MEANS TESTING for payouts of premium assistance and cost sharing payments--This means that the law MUST BE REVISED so that millionaires and richer cannot be eligible for Obamacare payouts which they currently are as long as they can submit "income" levels that fall within Obamacare boundaries.
A government solution MUST provide for firing incompetents, bypassing federal employee protections that keep individuals employed in the face of failure, excusing it as "unintended." Gross incompetence is enough, just like for the rest of us.
A government return to CALCULATING the costs to taxpayers of GOVERNMENT expenses of Obamacare, not merely the costs of how little they're spending on individuals insured by government programs, disallowing the CBO's excuse that it "can't" calculate the costs: [CBO Publication 49892, 1/15/15, page 1, “…estimates address only the insurance coverage provisions of the ACA and do not reflect all of the act’s budgetary effects…because the provisions of the ACA that do not relate directly to health insurance coverage generally modified existing federal programs (such as Medicare) or made various changes to the tax code, determining what would have happened since the enactment of the ACA had the law not been in effect is becoming increasingly difficult.”]
DOING AWAY WITH THE INDIVIDUAL MANDATE: Forced purchase is not a solution to our healthcare crisis, it merely ties the hands of consumers to vote with their feet and their dollars. How do we know? Because already the individual mandate forcing us to buy health insurance has left insurers dissatisfied and health insurance plans have continued to go up in price.
The government has NOT negotiated but instead has promoted health plans that were cheaper based on narrow networks and cheaper providers which was unsustainable according to the CBO and as proven by the 8.5 percent increase in prices overall on the exchanges this year, as well as the looming threat of Hillary Clinton's efforts to keep feeding the monster by creating a new class of purchasers, illegal immigrants. This temporary fix will do nothing based on what the fix of Obamacare has done--nothing-- insurers are dropping out because they're not getting enough of the "healthy" enrollees or because they want MORE enrollees. It's unsustainable.
Reduction in the Obamacare budget related to the REAL numbers of enrollees, this year estimated at between 9.4 and 11.4 million. Continued budgeting based on the falsehood of 10s of millions gaining insurance coverage is wasteful and considering the costs of Obamacare, including new restrictions to save money on Medicare and such is government wastefulness.
Penalties for providers and practices that DO NOT accept insurance plans. Instead of paying off providers who accept patients using health insurance plans punish providers who don't. Use a reasonable number of plans and REWARD providers who accept that. Narrow networks are NOT because of a provider shortage, but because providers choose NOT to participate.
A Summary of Benefits and Coverage that allows consumers to compare their health benefits to those of federal government employees. Sure, the Summary of Benefits and Coverage is required for insurers, but the government excludes such transparency when it comes to government. Transparency should not be required in some cases and not in others. We're paying for those benefits we should be aware of them compared to what our money gets us. This concept should also be expanded to how the government pays for its Obamacare payouts for the 9.4 to 11.4 million on exchanges so that instead of rhetoric we can get the facts of where our taxpayer dollars are going. If Obamacare pays X dollars for the exchange members and pays for it using Medicare coverage or Medicaid coverage or by raising all or our payroll taxes, or simply by writing itself a check, we should know that.
The government as abuser model requires an upset, a detachment from the fear and dependence and wrongfully placed confidence that the federal government is necessarily working on our behalf. This requires more than rhetoric and also requires concrete reforms for any consumer to reasonably support Obamacare or some other version of Obamacare in the future.
Yet, President Obama has made this recognizable abuse model not only the hallmark of our healthcare system but of our government--with the undeniable rise in the government class' well-being and status at the expense of the now-victim partner, the non-government class citizens.
Lavish Promises: For a moment think back to why you voted for Obama the first time. I too was enamored with the promises of healthcare reform promising the end to the most insidious business practices of healthcare including exorbitant price increases coupled with less coverage and more difficulty in obtaining the benefits we paid for from these businesses in the form of premiums and taxes. Saving $2,500 a year sounded good, no denying benefits based on pre-existing conditions sounded good, the same benefits as Obama's family enjoyed (meaning federal employees) sounded good. As a voter for Obama in 2008, I joined my fellow voters in CHOOSING Obama.
Oh yes, in the beginning, we felt recognized as valuable, we would be choosing a champion in office, someone who was addressing a persistent and worsening problem we were being exposed to in our society, the tyranny of the healthcare industry.
Actions that "Proved" We'd Chosen Well: Obamacare's introduction and TIMING was an excellent way for the abusers to seal the deal, as the requirements for insurance companies to provide coverage for the (overstated, but still existing) number of those who had been denied the right to purchase health insurance because of pre-existing conditions was immediately addressed in 2010 (with a temporary federal program option). Immediately, parents of children in states that had not changed how long parents could pay for their children's health insurance were provided with the up to 26 option of paying for their children's health insurance. The Medicare donut hole was going to be corrected. We felt we'd chosen well.
Not quite what was promised: We felt GOOD about our new chosen partner, the Federal government, even as we felt disappointment that Obamacare NEVER provided what was promised. After all, the President explained that the government as our partner WANTED to give us everything promised, but after all, this was the real world with real costs and he simply couldn't get it all done.
Ignoring the Obvious: As in the case of any victim of abuse, we ignored the obvious failures in our new chosen partner. We noticed that "affordable" meant that our partner was denying us and reducing amounts spent per capita on individuals in order to prop itself up (ignoring how much it spent on itself). We ignored it even when we were told the government wouldn't calculate its costs on Obamacare (CBO Publication 49892, 1/15/15, page 1), even when the government itself bragged about how it had abused its partner the non-government employee citizens: "…the Bureau of Labor Statistics reveal that the gap concerning benefits between the private and public sectors has been growing-in favor of the public sector,” http://gogovernment.org/government_101/benefits.php.
We happily excused the government class as it exempted itself from Obamacare (yeah, it's not called an exemption because the federal government is the employer of these liars, so as the employer, it simply provided better options to its employees--in other words, fed employees were exempted from Obamacare). After all, they must deserve the reward because they're making our lives better too.
Should we stay with it or not? Even with the excuses and our irrational loyalty in the face of failure, we were on the fence in 2012--Should we keep with this partner or take a chance on another?
The Introduction of Fear: In 2012, many of us realized we were with a bad partner. Many more of us didn't, having learned little about how much worse things would get we remained hopeful that as he once again needed us to retain his own position, the President embarked on a new strategy--the imaginary enemies. With speech after speech of how things could be worse, with threats of what a different choice would mean for us, with highlights of the evil-outside-of-him world, President Obama prevailed.
We knew our copayments, coinsurance, and for most Americans, premiums went up not down, let alone down by $2,500. But still…Obamacare was trying, right?
We realized that the promises made were not to be kept, that the gifts of extra money in our pocket (saving $2,500? How about paying more.) more jobs for our children and ourselves, (jobs number languishing, wages for non-government workers stagnant, health expenses based on what was being charged for care, up, health expenses based on premiums up), but we were convinced that choosing someone else or something else would be worse.
From Promise to Punishment: And so we lined up and decided to stick with our abuser, hoping against evidence, history and common psychological concepts that we'd be able to change the course of events. We weren't noble, we were desperately trying to prove we'd chosen right, that the federal government really cared about us and the healthcare crisis and that besides, there was no other choice that was better, only worse.
And so we were desperate--Willing to accept and support our abuser in the face of the obvious course of such relationships. We blandly accepted that not only were all promises being broken, but that we were having to work harder to stay in our already reduced position, and that now we needed to toe the mark or our abuser would come in and punish us.
We enrolled in health insurance plans to the tune of millions (9.4 to 11.4 this year), paying more, getting less, merely to avoid the punishment of the individual mandate. We desperately tried to avoid the punishment of being declared "unworthy" as we tried to be cooperative enough, healthy enough to be worthy of these reduced benefits and not make our abuser angry that our own humanity, unwise choices or aging were the REASON we needed to be punished with higher premiums, less coverage or simple rejection by providers.
We protested but did nothing amounting to real objection when we realized we were NOT keeping our plans if we liked them, that we could no longer afford to insure our dependents (the family glitch), that we were paying more for health insurance and that the out-of-pocket maximum was still going up as were premiums even as our wages and job participation rates were in such dire condition. We loyally did ANYTHING, including believe liars who recited how great our new partner was--even though we knew better.
National Stockholm Syndrome? Defined as "an emotional attachment to a captor formed by a hostage as a result of continuous stress, dependence, and a need to cooperate for survival," consumers were officially relegated to victims of Obamacare.
Why else would we continue to defend the law but for our dependence cultivated by fear that without Obamacare things could be worse?
Why else accept the continued arbitrary changes and fluctuations to the provisions of the law so that we were never quite sure whether we'd be able to get needed medical services or not or whether we'd be able to afford them or not if not for the continuous stress based on the government class' irrational interpretation, rule-making, and self-accommodation making both the law, its effective dates, its changes outside of our control?
Why else would consumers embrace the record-keeping tallying of defensive medicine, forced wellness or forced testing or forced hoops we must jump through to merely get the benefits we PAY for if not for the fear that we would be perceived as "uncooperative"?
Why else would we willingly forfeit our former rights of choice to purchase a consumer financial product, our former rights to communicate what we desire from providers, our former view that defensive medicine was not a good thing for consumers being forced to undergo testing and testing in an effort for providers to protect themselves and for insurers to gather information to "better" price their offerings EVEN WHEN MEDICAL ERROR IS THE THIRD LEADING CAUSE OF DEATH IN THE US?
Barriers to Detachment: As a population our reaction indicates what an effective abuser the government class has been when it comes to healthcare. We've shown signs of being unable to react to our abuser in healthy ways. We remain afraid of anything different from Obamacare. We remain "hopeful" in the face of fact that Obamacare will NEVER do better. We remain convinced that it is someone else's fault, the sick people, the old people, the people who make bad choices who are to blame for the fact that insurance companies "must" charge more in defiance of the reality of their insurance company profits and their continued expansion of information gathering to justify price increases.
Detaching from the Abuser: There is hope. The first hope is to re-examine whether a government class is FIT to determine healthcare choices and the answer is very possibly, at least for now, "No." The government class is sort of like the HMOs self-regulating in the '90s, it doesn't work. Until our government class recognizes that their anointment is not from God but from voters, and that their right to remain is also from voters, and that their PAY is also from voters, we cannot continue to support a "government" solution. Thanks to Obamacare we know that.
But there's also further action we need to take as we read proposals to change or modify Obamacare from both Democrats and Republicans, Hillarycare the obvious and the less obvious proposal from Republicans for the "World's Greatest Healthcare Plan."
Government for the benefit of government is NOT what consumers need. If government chooses to provide superior benefits for itself, a claim proudly included on the government website, (http://gogovernment.org/government_101/benefits.php) this should have and should be met with a resounding, "NO," from the population.
What population would support a government employee handout at the expense of their own well-being? No truly sane population would. Therefore, our FAILURE to demand that there be a LAW OF THE LAND INCLUDING ITS APPLICATION TO THE GOVERNMENT CLASS is a critical step for Obamacare detachment, because the law does not have that requirement.
IF the government class is not bound by Obamacare without using the loophole of "government employee," thereby making the government the "employer" choosing to provide superior benefits to itself then the law's provisions should be immediately SUSPENDED until such provision is made.
A government solution that provides for payoffs to consumers who participate in exchange plans as Obamacare does MUST comply with the law as written, including recovering overpayments and scrutinizing eligibility: The government class must earn its keep. It was tasked with overseeing the eligibility of people obtaining the Obamacare premium assistance and cost sharing. It has failed year after year to the tune of unknown dollar amounts (2014, https://www.cbo.gov/publication/45397), 2016, (http://www.gao.gov/products/GAO-16-29). This must be done or the law should mandate the suspension of such payments until it is done.
A government solution that provides for MEANS TESTING for payouts of premium assistance and cost sharing payments--This means that the law MUST BE REVISED so that millionaires and richer cannot be eligible for Obamacare payouts which they currently are as long as they can submit "income" levels that fall within Obamacare boundaries.
A government solution MUST provide for firing incompetents, bypassing federal employee protections that keep individuals employed in the face of failure, excusing it as "unintended." Gross incompetence is enough, just like for the rest of us.
A government return to CALCULATING the costs to taxpayers of GOVERNMENT expenses of Obamacare, not merely the costs of how little they're spending on individuals insured by government programs, disallowing the CBO's excuse that it "can't" calculate the costs: [CBO Publication 49892, 1/15/15, page 1, “…estimates address only the insurance coverage provisions of the ACA and do not reflect all of the act’s budgetary effects…because the provisions of the ACA that do not relate directly to health insurance coverage generally modified existing federal programs (such as Medicare) or made various changes to the tax code, determining what would have happened since the enactment of the ACA had the law not been in effect is becoming increasingly difficult.”]
DOING AWAY WITH THE INDIVIDUAL MANDATE: Forced purchase is not a solution to our healthcare crisis, it merely ties the hands of consumers to vote with their feet and their dollars. How do we know? Because already the individual mandate forcing us to buy health insurance has left insurers dissatisfied and health insurance plans have continued to go up in price.
The government has NOT negotiated but instead has promoted health plans that were cheaper based on narrow networks and cheaper providers which was unsustainable according to the CBO and as proven by the 8.5 percent increase in prices overall on the exchanges this year, as well as the looming threat of Hillary Clinton's efforts to keep feeding the monster by creating a new class of purchasers, illegal immigrants. This temporary fix will do nothing based on what the fix of Obamacare has done--nothing-- insurers are dropping out because they're not getting enough of the "healthy" enrollees or because they want MORE enrollees. It's unsustainable.
Reduction in the Obamacare budget related to the REAL numbers of enrollees, this year estimated at between 9.4 and 11.4 million. Continued budgeting based on the falsehood of 10s of millions gaining insurance coverage is wasteful and considering the costs of Obamacare, including new restrictions to save money on Medicare and such is government wastefulness.
Penalties for providers and practices that DO NOT accept insurance plans. Instead of paying off providers who accept patients using health insurance plans punish providers who don't. Use a reasonable number of plans and REWARD providers who accept that. Narrow networks are NOT because of a provider shortage, but because providers choose NOT to participate.
A Summary of Benefits and Coverage that allows consumers to compare their health benefits to those of federal government employees. Sure, the Summary of Benefits and Coverage is required for insurers, but the government excludes such transparency when it comes to government. Transparency should not be required in some cases and not in others. We're paying for those benefits we should be aware of them compared to what our money gets us. This concept should also be expanded to how the government pays for its Obamacare payouts for the 9.4 to 11.4 million on exchanges so that instead of rhetoric we can get the facts of where our taxpayer dollars are going. If Obamacare pays X dollars for the exchange members and pays for it using Medicare coverage or Medicaid coverage or by raising all or our payroll taxes, or simply by writing itself a check, we should know that.
The government as abuser model requires an upset, a detachment from the fear and dependence and wrongfully placed confidence that the federal government is necessarily working on our behalf. This requires more than rhetoric and also requires concrete reforms for any consumer to reasonably support Obamacare or some other version of Obamacare in the future.
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