Bailouts = Monopoly, Health Racket Version

 

I have a whole category dedicated to the fact that Bailouts Intensify Monopoly. We recall how, as soon as the TARP was on the books, Paulson and his people started saying, “our real intent is mergers and acquisitions, and we want the TARP and the rest of the bailout to help achieve this.” We want greater concentration, greater monopoly.

 

We’re already receiving confirmation that this is a core goal of Obama’s extension of the FIRE bailout to the health rackets. We’ve seen it with insurers, we’ve seen it with waivers and exemptions as an indirect tool toward concentration in general, in all sectors. Now we’re seeing it with providers as well.

 

Under the Orwellian name of “accountable care organizations”, hospitals and doctors in theory are supposed to combine to hold down costs and deliver better care. Under corporatist conditions, in practice this can only mean shift more costs onto patients and the people in general. Actually holding down costs is not a real goal; shifting them is. Indeed, the system encourages bloating costs. The smoking gun proof of this is that all “stakeholders” reject the one and only proven cost-cutting measure, Single Payer.

 

That proves that no one among the elites ever wanted to control costs or deliver better care. It proves that the very word “reform” was an Orwellian sham right from the inception.

 

When Congress passed the health care law, it envisioned doctors and hospitals joining forces, coordinating care and holding down costs, with the prospect of earning government bonuses for controlling costs.
Now, eight months into the new law there is a growing frenzy of mergers involving hospitals, clinics and doctor groups eager to share costs and savings, and cash in on the incentives. They, in turn, have deployed a small army of lawyers and lobbyists trying to persuade the Obama administration to relax or waive a body of older laws intended to thwart health care monopolies, and to protect against shoddy care and fraudulent billing of patients or Medicare.

 

No one who knows anything about the way the system works can be surprised by this for a second. Obama, the Dems, the liberal groups and bloggers, the MSM, Krugman – they all knew this is exactly what would happen. Therefore this is what they intended to have happen.

 

This is a form of disaster capitalism. Facing what’s in this case a real problem (often the problem itself is fake), you misdirect concern and use the problem as the pretext to not only extend the reach of greed, but to launch assaults on pre-existing safeguards. So here we see how Obamacare was, in addition to its many other crimes, a Trojan horse against existing anti-monopoly regulation.

 

Need I say it again? Under kleptocracy, regulation doesn’t work. You can never regulate oligopoly rackets. You can only destroy them.

 

And in this case, the “regulation” is designed to generate new rackets.

 

This is what we can expect from each and every policy advocated by liberals or conservatives. (Or in this case both, since Obamacare is just a rehash of the Heritage Foundation’s Romneycare. Obama himself called it a Republican policy.)

 

“If accountable care organizations end up stifling rather than unleashing competition,” said Jon Leibowitz, the chairman of the trade commission, “we will have let one of the great opportunities for health care reform slip away.”

 

There’s Orwell again in that quote. This is the shock doctrine “opportunity”. Remember what Rahm said about not letting a crisis go to waste?

 

The law itself is inherently reactionary, and now it’s being applied in further reactionary ways, to gut what little regulation existed in the first place:

 

Elizabeth B. Gilbertson, chief strategist of a union health plan for hotel and restaurant employees, also worries that the consolidation of health care providers could lead to higher prices.

“In some markets,” Ms. Gilbertson said, “the dominant hospital is like the sun at the center of the solar system. It owns physician groups, surgery centers, labs and pharmacies. Accountable care organizations bring more planets into the system and strengthen the bonds between them, making the whole entity more powerful, with a commensurate ability to raise prices.”

She added, “That is a terrible threat.”

Doctors and hospitals say the promise of these organizations cannot be fully realized unless they get broad waivers and exemptions from the government.

The American Medical Association has urged federal officials to “provide explicit exceptions to the antitrust laws” for doctors who participate in the new entities. The F.T.C. has accused doctors in many parts of the country of trying to fix prices by collectively negotiating fees — even though the doctors do not share financial risk and are supposedly competing with one another.

Hospitals and doctors have also asked the administration to waive laws intended to prevent fraud and abuse in Medicare.

In a recent letter to federal officials, Charles N. Kahn III, president of the Federation of American Hospitals, said, “To provide a fertile field to develop truly innovative, coordinated-care models, the fraud and abuse laws should be waived altogether.”

These laws are an impediment and, in some cases, “a total barrier” to creation of accountable care organizations, Mr. Kahn said, making it difficult for hospitals to reward doctors for cutting costs or following best practices.

 

It’s a lie that anyone wanted to cut costs, just like it’s a lie that anyone cares about deficits. Anyone who wants to cut health care costs wants Single Payer. Anyone who cares about the deficit wants Single Payer.

 

A major purpose of accountable care organizations is to encourage doctors to work closely with selected hospitals, and the rewards paid to doctors — typically, a percentage of the money saved — could run afoul of this law, hospitals and doctors say.

Dr. Donald M. Berwick, the administrator of the Centers for Medicare and Medicaid Services, hails the benefits of “integrated care.” But, Dr. Berwick said, “we need to assure both patients and society at large that destructive, exploitative and costly forms of collusion and monopolistic behaviors do not emerge and thrive, disguised as cooperation.”

 

But this monopoly was part of the purpose of the law. We see it right there – the law’s impetus runs directly counter to all existing antitrust legislation. (Of course, the Stamp rackets already had an antitrust exemption, which the bill wants to help them leverage even further.) Just like all the other bailouts, it rewards monopoly and wants further monopoly. This is what Obama wanted, this is what the Democrats wanted, and going forward this is clearly what any supporter of the whole policy wants.

 

But liberal myopics are congenitally incapable of understanding this.

 

Peter W. Thomas, a lawyer for the Consortium for Citizens with Disabilities, a national advocacy group, expressed concern about the impact on patients.

“In an environment where health care providers are financially rewarded for keeping costs down,” he said, “anyone who has a disability or a chronic condition, anyone who requires specialized or complex care, needs to worry about getting access to appropriate technology, medical devices and rehabilitation. You don’t want to save money on the backs of people with disabilities and chronic conditions.”

 

He’s unable to understand the underlying, immutable conflict of interest which defines the system. It’s intractable. You will the end, you will the means. Obviously the system “wants” to do this. And if you don’t want that result, you have to reject the entire system.

 

If you want decent health care for all the people, then you have to want and fight for Single Payer. If you don’t want Single Payer, you don’t want non-rich people to get care at all.