Quote:
Originally Posted by Tatooine
Was any of this brought up at all in the debate over ACA? Was it ever considered?
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Holy cow....whatever it is you're drinking or smoking, you need to give that recipe to the others. I'm seriously considering having your post bronzed......I had to read your post 50x it was so rational and sane.
I was not there, so I don't know for sure, but a reading of the legislative history, including
Congressional Quarterly, and the committee notes, it was never discussed.
There is a legal reason why it would not be discussed.
Congress has no power over intra-State Commerce. Healthcare has been since its inception intra-State Commerce. The US Supreme Court recently affirmed that healthcare is intra-State Commerce, and that Congress has no power or authority (which means for at least the limited future a national health system like Britain or Sweden is unconstitutional).
The PPACA is however, a tax, and Congress does have constitutional authority to regulate taxes, including levying, increasing, decreasing or nullifying taxes.
It also means that the Federal Trade Commission -- the federal agency responsible for enforcing anti-trust laws and other violations related to commerce (such as the Fair Debt Collection Practices Act and the Fair Credit Reporting Act, TILA, etc etc etc) --- has no authority to investigate or regulate healthcare systems or healthcare fee-for-service providers.
The other reason it would not have been discussed, is the fact that the Special Interest Group responsible for those illegal cartels, wrote nearly all of the PPACA.
That Special Interest Group is the American Hospital Association.
While the quality of healthcare in the US is excellent, the structure, organization and delivery of healthcare is the failure.
The American Hospital Association is the sole non-government entity responsible for this nightmare.
The history of the American healthcare system is well-documented, I've provided numerous sources from government documents, and I'll just briefly outline it here, because understanding this is critical to solving 99% of the "problems" which have nothing to do with insurance.
There are no health insurance companies.
1925: 1925 Recession and collapse of the "housing bubble" signals start of Great Depression.
1927: In order to maintain streams of revenue, hospitals begin offering insurance.
1928: 1928 Recession results in more hospitals offering insurance plans. Not the first, but the best documented is the insurance plan offered by Baylor University Hospital to any teacher in Dallas County (Texas) public schools: 21 days of hospitalization for $6
1933:
The End of Free Market Health Care in America: the American Hospital Association starts reviewing the health insurance plans by member hospitals, and then dictating to member hospitals minimum services that must be offered, and minimum prices of services and prices of health insurance plans.
1939: The American Hospital Association starts grouping member hospitals together by city or region in an attempt to drive out competition from non-member hospitals and create a healthcare monopoly. A unique feature of the new hospital insurance plans offered by member hospitals is the "Out-of-Network" clause designed to punish Americans for using non-member hospitals or those hospitals allied with the American Medical Association.
1939-1946: the several States, still cash-strapped and reeling from the Great Depression start seeing these hospital insurance plans for what they are: insurance. The States move to start regulating the hospital insurance plans. The American Hospital Association embarks on a massive lobbying campaign in each State to enact legislation that will exempt its member hospitals from any form of insurance regulation by the States. This campaign is known as "enabling laws" or "enabling legislation" (since it enabled the American Hospital Association to escape State insurance regulation).
1942:
The End of Universal Healthcare in America: the National War Labor Board and the IRS at the insistence of the American Hospital Association allow health insurance plans offered by hospitals to be fringe benefits not subject to taxation, provided the benefits do not exceed 5% of the employee's annual salary.
1946: Successful in its campaign to enact "enabling laws" the American Hospital Association announces the formation of the first health insurance company in America: the Blue Cross, a for-profit insurance company operated as a not-for-profit. The "Out-of-Network" clause continues to be used to punish Americans for exercising freedom of choice for doctors and hospitals.
1946: Later the same year, the American Medical Association forms the second health insurance company in America....the Blue Shield to shield Americans from the harm caused by the American Hospital Association's monopoly attempts, and to shield doctors from being under the control of hospitals (meaning under the control of the American Hospital Association).
1949: Pivotal
In Re: Inland Steel decision by US Supreme Court permanently ties health plan coverage to employment, excluding large numbers of Americans.
1954:
The End of Health Insurance in America: After the Inland Steel decision, insurance companies start offering health insurance coverage competing with the American Hospital Association's Blue Cross. To avoid being regulated as insurance under State laws, the American Hospital Association adopted the community rating scheme. Health insurance companies were using Actuarial Science and so could offer the same coverage provided by the Blue Cross at a lower price. The Blue Cross loses 80+% of its Market Share in just a few years. The American Hospital Association lobbies Congress and the IRS for a change in the tax laws to gain an unfair competitive advantage over health insurance companies.....thus the 1954 IRS Tax Code which prohibits an insurance company from stipulating a value. i
1965: Having created an healthcare system in which Millions of Americans were excluded, the American Hospital Association offers up Medicare in its continued quest to gain monopoly control:
"Introduced by various House and Senate sponsors and subject to extensive hearings, the basic framework of part A began to reflect accommodations between the sponsors, the Administration and the American Hospital Association (AHA).
It ranged all the way from principles of institutional reimbursement, which has been pretty thoroughly already worked out in a general way for their own purposes between Blue Cross and the Hospital Association over a period of several years
The American Hospital Association has already nominated the Blue Cross organization for its membership, although some member hospitals will undoubtedly elect out of this arrangement. We have proceeded very far in the development of working arrangements with Blue Cross, although no formal approval as a fiscal intermediary has yet been given them."
Source: Report to Social Security Administration Staff on the Implementation of the Social Security Amendments of 1965, Robert M. Ball Commissioner, November 15, 1965
2008: The American Hospital Association moves further toward monopoly control of America's healthcare system with the PPACA.
In the interim, the Blue Cross eventually took over the Blue Shield, and then the Blue Cross now owns lots of insurance companies.....
America's Health Insurance Plans - Board of Directors
Anyway, healthcare in the US is over-inflated and exclusionary...that's how it came to be that way....the path to less expensive healthcare and access for everyone is to undo all of the damage over the last 80 years.
Can the States take any action against these healthcare monopolies? Depends on the State, and even then it depends on who has the political will to take on such a powerful Special Interest Group like the American Hospital Association.
Monopolies are inherently inefficient and over-inflate prices. I can't speak for the rest of the US, but in this MSA, normal child-birth is $9,320 and getting rid of the hospital cartels would drop that over-night to about $2,650.
And then what happens to the price of health plan coverage? That drops, too.
That's what happened...
Mircea
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