I am neither a Murrican nor a lawyer (but I repeat myself....); would someone who is both like to comment on the chances of getting the insurance companies indicted under RICO?

I'm not a lawyer, but I believe RICO implies a conspiracy to commit a criminal act (it's used, for instance, to convict mob bosses who order criminal activities but don't directly participate in them). What we really have here is not conspiracy to commit a criminal act of that nature, but rather something closer to anti-trust violations (laws against efforts by organizations to dominate and artificially shape commercial markets). unfortunately, anti-trust laws are geared towards industrial organizations, where trust violations involve the control and manipulation of easily trackable material resources. financial markets are too much smoke-and-mirrors for anti trust laws to find any purchase.

Insurance companies are exempted from antitrust laws. Better to try RICO. The criminal act here is that they are committing fraud by pretending to sell insurance and instead merely collecting premiums.

I'm wondering if the same will be true if the the health care reform bill is passed. Maybe, it won't be the insurance companies but the employers themselves that will usurp your benefits.

It will be true for the insurance companies if there is no public option because they'll have no competition. They clearly don't compete amongst themselves, except to get the healthiest clients and drop the most sick ones.

As for employers, that's another matter altogether. Corporations shipping $50,000/year US jobs to the Chinese at $5,000/year aren't going to be concerned over health costs until they can't continue to ship those jobs.

It's not just the insurance companies, you need to look at the providers, too.

Consider the way insurance companies set their reimbursement rates. They take a survey by asking various providers what they charge for different services and then take an average. From there, they negotiate with the providers to provide the service at a discount and that is what they pay for the service. (different methodology for things like durable medical equipment, supplies, etc.)

And that is why an office call is $100, but the insurance companies only pay $50 for a visit. Providers are smart people and they know how to play this game. When the next survey comes around, of course the standard fee is going to be outrageous because they know they are only going to collect half that fee. It's a shell game where everybody makes out fine except the poor sap who doesn't have insurance.... he gets to pay double.

Sure it's a shell game, but look at who's running it: The insurance company runs the survey, then tries to force fees to below the average! They can do that by getting some of those just above average to drop to the average rate, thus lowering the average for the next year, putting pressure on everyone. If the providers don't play the game then that hundred dollar fee drops to 90, then 80, 70, 60,... at some point it drops below cost and the provider is out of business.

I'm not saying there isn't waste on the provider end, just that the biggest source of problems by far is from the insurers. You only have to look at who's making the most money to see that. Hospitals are struggling, doctors are getting out, and insurance companies are making huge profits while patients are going bankrupt.

It seems I am not the only one who thinks we're getting sold a bill of goods....

http://news.yahoo.com/s/ap/20091216/..._overhaul_dean

Howard Dean agrees.

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Well, given that the selling of influence is truly a bipartisan practice, and that lobbyists exert massive power on both sides of the aisle, it is difficult to imagine how substantive Health Reform can be achieved.

There is no way Medicare or Medicaid would be implemented today!

In more advanced democracies the election financing system practiced in the USA would probably well result in corruption charges... ;)
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It certainly would in Canada.

Yes, but it is not election finance, you see, contributions are a form of free speech. Makes absolutely no sense to me either.

Also, it was Obama who raised so much money he opted to not use public election financing and all the rules that go along with that. No public involvement, no rules.

But all is not lost. If the Senate can pass anything, then we are in a situation where the House has already passed a bill and the two bills go to a committee to resolve the differences. House bill is much stronger, so I would assume the resulting bill coming out of joint committee might possibly be better than the Senate version.

Still think we are going to get taken to the cleaners. BTW... the taxes to support this starts next year despite the fact that nobody can actually access any of the health care provisions for another 3-4 years (should something actually get passed).

Now the insurance companies seem happy with what is coming. You should be afraid. Be very afraid. You'll probably be required to buy health insurance or pay a fine and they'll be able to charge whatever they like, with no competition to drive down prices.

Yup. I'm a little confused, though, why the insurance companies oppose a public plan. If we had a public plan, they would have a place to dump all the people with a health problem and continue to cherry pick the rest. Guess they decided competition was the greater long term risk or something?

Maybe a mandatory requirement to buy from them will be more profitable in the long run since they will be free to pass the costs of serving everybody on to, well, everybody. A "no lose, guaranteed profit" proposition will make them more money than the cherry picking did I guess.

Pardon a Canadian's viewpoint.
 

I'm thinking that Howard Dean (an MD) has got it right; kill the Senate Bill -- it doesn't represent a change at all. Think about it: Big Pharma gets its way; no Canadian drug imports to compete, no negotiating lower prices. Big Insurance gets its way too; no public single-payer option, no expansion of Medicare to younger uninsured, mandatory purchasing from the big players.

Health is going along with the the financial industries in my view: no real action on derivatives, loopholes for foreign currency swaps so that most derivative trading won't even be reported. Taxing obscene bonuses: ain't gonna happen. Regulating credit default swaps: no way. Lots of help for the big guys, none for the poor slob whose mortgage is underwater or for the worker without a job.

How about climate change? Ridiculously weak house bill and upcoming senate version will amount to nothing when they're consolidated. The big polluters win.

How about indefinite detentions and unconstitutional invasions of privacy initiated by the past administration? I don't see any changes there, either.

The current administration talks a great talk, but doesn't seem to be walking the walk at all.

For many years, I just voted against the incumbent regardless of party.... if they hadn't fixed anything, why give them another term to not fix anything again.

We need a voter revolt. Throw them all out and bring in some people willing to solve some problems..... and EVERYBODY knows US health care is a problem. Not fixing it or making progress toward fixing it is just unacceptable to me.

Yep, I'm in agreement with Howard Dean on this one. They allowed Joe Lieberman to basically gut any real competition the public would have against the insurance companies. It odd, because the new proposal seems to be more of what the republics wants but they still want support it.

We have to find a way to get these lobbyist out of politics otherwise they are going to seriously and irreversibly wreck this country.

It's not just that they cherry pick the healthy. They make huge profits by dumping the sick, and if people continue to see them finding ways to drop clients and deny claims from those who get sick then very few will choose them over a public plan. Don't think that just because a health "reform" bill might pass they intend to stop abandoning sick people.

I don't see why your conspiracy to commit criminal acts should not apply to mail fraud, which is what it is when you sell insurance and then deny indemnity. CWT gets it, though he missed that RICO was my original suggestion. Why are you guys discussing things with these mobsters? Make with the SWAT teams and have the top executives shot while resisting arrest. Then you sit down and create a public plan. :D

The lobbyists are paying the legislators, and the legislators are paying each other to get the Senate bill though. It would seem it is now common practice for politicians to vote for something only if they get a pay off.... as in something special for their state, which of course will help with reelection.

Now days I guess they just call that "compromise." Personally, I call it theft.

http://news.yahoo.com/s/cq/20091221/...olitics3271696

Yep, but this sort of things has been going on in congress for a long time. The compromise part of this is standard procedure in the Senate. Senators, after all, are there to represent their states. They are essentially making these agreements to the detriment of the federal government. I believe that the federal government and state government can enter agreements with one another as spelled out in the constitution.