Today's Stories

November 24, 2009

Mary Lynn Cramer
Health Care Reform and the Skinning of Seniors

Dean Baker
Too Big to Kill? The Vampire Banks Rise Again

George Ciccariello-Maher
Occupy Everything! Behind the Privatization of the UC, a Riot Squad of Police

Eric Walberg
Canada's Guantanamo

Andy Thayer
Lessons From a Lynching: the Murder of Jorge Steven Lopez-Mercado

David Macaray
The Delphi Incident: How the White-Collar Tribe Got Shafted

Laura Carlsen
The Perils of Plan Mexico

Gary Leupp
Obama as Hamlet

Adam Federman
Poisoning Dimock

William S. Lind Mission Creep: Counter-Insurgency in Salinas?

Website of the Day
Geography of the Recession

November 23, 2009

Paul Craig Roberts
A Trial That Will Convict Us All

Jonathan Cook
Have Israeli Spies Infiltrated International Aiports?

Edward S. Herman / David Peterson
Vulliamy's Smears

Bouthaina Shaaban
What's New? It's Always Been Like This

Helen Redmond
Health Care's Historic Flop

Rannie Amiri
Saudi Arabia's Attack on Yemen

Dave Lindorff
Abortion and Health Care

Rev. William E. Alberts
The Self-Delusionary American Tragedy

Mike Whitney
Is American Casino the Best Picture of the Year?

Mark Weisbrot
Honduran Dictatorship is a Threat to Democracy in the Hemisphere

David Michael Green
The Placeholder Presidency of Obama

November 20-22, 2009

Alexander Cockburn
CounterPunch Diary
It's Show Trial Time!

Gareth Porter
New Light on the Qom Facility

Mike Whitney
The Great Stimulus Debate of '09: Crybabies need not apply

Fred Gardner
Mammography
Pushes Back

James J. Brittain
It's Really a War on the Poor
A War on Coca Nobody Believes

Jonathan Cook
Rabbi Followers 'Terror Cell in Parliament'

Alan Farago
Bulletin from the Dark Side: Florida's Republican Ultras

David Macaray
A Hindu Version of the UAW
Labor Strife in India

Binoy Kampmark
The Israeli Exception: Gilo and East Jerusalem

Ben Sonnenberg
Ashes and Diamonds
Retirement Norwegian Style

Ron Jacobs
Judge Roy Bean Takes Manhattan

David Yearsley
200,000 Testicles Offered Up to the Gods of Song

Brenda Norrell
A Border Runs Through Them:
The Struggles of the Tohono O'odham

Ron Ridenour
The Tamils and Equal Rights of Self Determination

November 19, 2009

Christopher Ketcham
The Dumbest Newspapers at the Center of the World

Shamus Cooke
A Fraudulent Jobs Summit

John V. Walsh
Impotent in China

Saul Landau
Dissidents Make Noise--Oops, News

Ralph Nader
Exiting Afghanistan

Nikolas Kozloff
Blackout in Brazil

Fred Gardner
Reputable MDs Buy NorCal Health Care

Charles R. Larson
Voices of the Silenced

John A. Murphy
Nader v. Dodd

Jayne Lyn Stahl
Obama's Gray World

November 18, 2009

Uri Avnery
A Religious Scoundrel

John Ross
Hot Oil!

Conn Hallinan
Strategic Towns: Why Gen. McChrystal's Plan Will Fail

Mike Whitney
Obama's China Junket

Ray McGovern
The Bogus Success of the Surge

Nelson P. Valdés
Cyber Cuba: Internet, Broadband and Foreign Policy

Ramzy Baroud
Globalization Unchecked

Ron Ridenour
Tamil Eelam: the Historic Right to Nationhood

November 17, 2009

Mike Whitney
Let's Get Fiscal

Jayne Lyn Stahl
Double Crossed: War Vets Deported

Brian M. Downing
Do They Subscribe to GQ at the Pentagon?

Jonathan Cook
Israel's Two-Tiered Justice System

Joanne Mariner
A First Look at the Military Commisions Act

Dean Baker
Obama's Nuclear Option on the Yuan

Martha Rosenberg
Pig Hell at Wal-Mart Supplier

Danny Weil
Fear in Nicaragua

David Macaray
Retail Sales as Combat

Laura Flanders
Buried Bonanza for Over-Builders

Walter Brasch
Rush to Judgment on Terror Trials

November 16, 2009

Alan Nasser
Obama's Flawed Case Against Single Payer

Jonathan Cook
Campus Watch Copy Cats

Mark Weisbrot
Obama, China and the Dollar

Carol Miller
We Need Health Care, Not Insurance

Gary Leupp
The Andolan in Kathmandu and the Revolution to Follow

Harry Clark
Justice Goldstone at Brandeis

Ray McGovern
Shining a Light on the Roots of Terrorism

Norman Solomon
California Democrats Urge Obama to Leave Afghanistan

Ron Ridenour
Genocide in Sri Lanka

Norm Kent
Doctors Light Up

Brenda Norrell
Torture Resisters Arrested at Fort Huachuca

November 13-15, 2009

Alexander Cockburn
A Man in a Hundred

Patrick Cockburn
Meet Our Afghan Ally: Stealing Money, Selling Heroin and Raping Boys

Tariq Ali
Short Cuts in Afghanistan

Douglas Lummis
Obama, Hatoyama and Okinawa

Vijay Prashad
Can the Major Speak?

Carl Ginsburg
Cornering the Market on Ambition

Manuel García, Jr.
The Purpose is Pork

Rannie Amiri
The Disastrous Presidency of Mahmoud Abbas

Mary Lynn Cramer
Death By Denial: the Militarization of Mental Health

Fred Gardner
Pot Doc Down

Dave Lindorff
Health Care Reform: DOA

Robert Jensen
How I Stopped Hating Thanksgiving and Learned to be Afraid

David Macaray
Wal-Mart Death Stampede Revisited

Corporate Crime Reporter
Exposing Timberland: Nike Foe Jeff Ballinger Zeros in on a New Target

Ron Jacobs
No More Star Spangled Eyes

David Model
NATO's Chimerical Enemy in Afghanistan

John V. Walsh
Godless China: What Obama Will Find

Jon Mitchell
Beggars' Belief

Stuart Easterling
Blaming the Narcos in Mexico

Dan Bacher
Big Oil Takes Over Marine "Protection" in California

Franklin Lamb
Lebanese Students Advise Obama on How to Get It Right

Farzana Versey
Moderns, Models and Martyrs

Charles R. Larson
War, Peace and Paramilitaries in Colombia

Saul Landau
The Coen Bros. Brutalize Job

David Yearsley
When the Cirque Meets the Beatles

Lorenzo Wolff
At the Side of the Frontman

Poets' Basement
Blaine, Rivas and Cox

November 12, 2009

Robert Weissman
Maniacal Deregulation

Franklin Spinney
The Afghan War Question

Nadia Hijab
After Fort Hood

Afshin Rattansi
Night Vision: Why US Sanctions on Syria Will Kill American Soldiers

Paul Craig Roberts
America's Dismal Future

Ralph Nader
Failing the People on Health Care

Belén Fernández
Tourists of the Honduran Counter-Revolution

Allan J. Lichtman
A National Peacemaker's Day

Dave Lindorff
President Peacenik's War

Jayne Lyn Stahl
Headline of the Year

November 11, 2009

Andrew Cockburn
The Crafting of a Loophole

Mike Whitney
A Small "d" Depression

Rev. Jesse Jackson
Where's the Jobs Stimulus?

Jeff Nygaard
Iranian Irrationality? Maybe Not

Stewart J. Lawrence
Honduran Regime Reneges on Political Deal

James Ridgeway
The End of the Little Red Cars: Memories of East Berlin

Eamonn McCann
Blood on Their Hands

Michael Ortiz Hill
Unbecoming War and Terrorism

Shepherd Bliss
From Oklahoma City to Fort Hood

Walter Brasch
"This is Jenna Bush Reporting ... "

November 10, 2009

Ellen Cantarow
Heroism in a Vanishing Landscape

Dean Baker
How to Raise $140 Billion a Year From Wall Street Banks

Rose Ann DeMoro
The Truth About the House Health Care Bill

Ramzy Baroud
Inch by Inch, House by House: How Israel Won the Settlement Battle...Again

Peter Lee
The Dalai Lama Sticks His Thumb in the Dragon's Eye

Dave Lindorff
Blaming the Workers

Roberto Rodriguez
Running Past PTSD (Or My Susto Profundo)

Winslow T. Wheeler
The Self-Dismembering F-35

Alan Farago
The Rising Tide

Joseph Grosso
The Legacy of Albert Parsons

November 9, 2009

Patrick Cockburn
Leave Afghanistan to the Afghans

Linn Washington
Fox Finds a New Black Boogeyman

Carl Ginsburg
To be Young and Unemployed Forever

Jeff Leys
War Funding, 2010

John A. Murphy
Can Lieberman Save Single Payer? Why Progressives Should Back a Filibuster

John Halle
Bard and the Lobby: Final Thoughts on the Kovel Affair

Bouthaina Shaaban
Clinton Dances With Netanyahu

James Ridgeway
Heath Care: Winning a Battle, Losing the War

Dave Lindorff
The Kafka Economy

David Macaray
The Philadelphia Transit Strike

Stephen Fleischman
The Tea Party System

Website of the Day
Cap-and-Trade: The Huge Mistake

November 6-8, 2009

Alexander Cockburn
Too Fat to Fight

Mark Grueter
Inside the American University of Iraq

Paul Craig Roberts
The Evil Empire

Patrick Cockburn
Friendly Fire

Gareth Porter
Karzai's Cabinet of Warlords

Mike Whitney
The Battle of Seattle, 10 Years Later

James Bovard
How the Media Enables Government Lies

Dean Baker
Don't Touch the Banks!

Robert Lawless
Empires and the Sullying of Anthropology

Saul Landau
Afghanistan: a War Without Logic

Jayne Lyn Stahl
Black Ops and Fort Hood

Stephanie Westbrook
My Memories of Fort Hood

M. Shahid Alam
How Eurocentric Are You?

Marc Levy
Walking With Mr. Muhammad

Franklin Lamb
Obama's Mid-East Mess

Ron Jacobs
A New Map of Hell

David Ker Thomson
Afternoon With Tulip

John V. Whitbeck
Moment of Truth

Julien Mercille
Drugs and Afghanistan: the UN's Misleading Report

Rannie Amiri
Egypt's Next Unelected President?

John Ross
Legalize It!

David Michael Green
Can You Hear Us Now?

Carl Finamore
Strike One for Hotels in San Francisco

Farzana Versey
The Farce of Fatwas and Political Expediency

Missy Comley Beattie
No to Single Payer, Yes to Prayer?

Charles R. Larson
Business as Usual in India

David Yearsley
Anna Magdalena, Music and the Art of Dying

Kim Nicolini
"Paranormal Activity:" a DIY Horror Film

Poets' Basement
Three Poems by Devreaux Baker

November 5, 2009

Pam Martens
The Fire Sale of America

Vijay Prashad
The Great Heretic

Brian Gallagher
The Soldiers From Standard Oil: Harvard, ROTC and American Foreign Policy

Norman Solomon
The Next Phase in Health Care Apartheid

Nadia Hijab
The Battle for Palestinian Representation

Joseph Shansky
And the Winner in Honduras is ... the United States?

Andy Thayer
Questions and Answers From Maine

Tracy Rosenberg
Pacifica and the Barbarians Who Pay the Bills

Website of the Day
All Folked Up

November 4, 2009

Stan Cox
The Inflated Promise of Natural Gas

Andy Worthington From Gitmo to Palau: Who are the Uighurs?

Robert Weissman
The Medicare-for-All Moment

Susan Galleymore
Of Veterans and Volunteers

Ralph Nader
Hoh's Afghanistan Warning

Michael Leonardi
Italy's Secret Ships of Poison

Bitta Mistofi
Death to No One: Isolating and Taunting Iran Will Only Empower the Regime

Robert Bryce
From Lahore to Copenhagen

Martha Rosenberg
Is Your Doctor's Continuing Ed Funded by Drug Makers?

Dave Lindorff
Democrats Crash and Burn

Website of the Day
Single-Payer Backtrackers

November 3, 2009

Patrick Cockburn
The Delegitimization of Karzai

Mike Whitney
Why the Crisis Isn't Going Away

Franklin C. Spinney
Katrina and the Paralysis of Fear

Laura Carlsen
The Little Coup That Couldn't

Serge Halimi
Don't Blame the Internet

John Stanton
Social Decay in America

Sophia Weeks
A Guatemalan Lament

Dave Lindorff
Country Joe, Kenny Rogers and Obama

November 2, 2009

Steven Higgs
Autism Spikes, Toxins Suspected

Ishmael Reed
White in America: Behind the Scenes at CNN

David Macaray
UAW Members Vote Down Ford; and the Media Attacked the Union

Bouthaina Shaaban
Settler Colonialism: Return to the Middle Ages

David Michael Green
Coming to Get You

David Swanson
The Two Percent Robustness

Ellen Brown
Cutting Wall Street Out

Adam Federman
Trading the Watershed to Trash the Catskills

James McEnteer
Doppleganger Politics: Star Wars, Clone Wars

Stephen Fleischman
Foot in the Door: Capitalism and Health Care

Website of the Day
Secret California Park Giveaway

October 30 - Nov. 1, 2009

Alexander Cockburn
The Long Gaze of the State

Jeffrey St. Clair /
Joshua Frank
Facing Down the Machine: Mike Roselle Draws a Line

Carl Ginsburg
Living in the Shadow of Yankee Stadium

Mike Whitney
Obama Goes Wobbly Over More Stimulus

Joe Bageant
The Iron Cheer of Empire

Gareth Porter
Security By Warlords: the CIA's Afghan Payroll

Saul Landau
The Cuban Embargo

Anthony DiMaggio
Conspiracy, Inc.: Wild Tales From the Reactionary Right

Dave Lindorff
Happy Talk Amid the Wreckage: Stocks Up, Jobs Down

Rannie Amiri
The Spooks of Beirut

Niranjan Ramakrishnan
An Afghan Travelogue

Jayne Lyn Stahl
Who Will Reform the Health Care Reform?

Rev. William E. Alberts
God's Favorite Team (and Nation and Religion)

Alvaro Huerta
The Abominable Mr. Dobbs

Martha Rosenberg
Marketing Drugs to Psychoneurotics

Binoy Kampmark
Don't Give Us Your Wretched: Refugee Policy in OZ

Norm Kent
Not Just Zig-Zag Any More: Medical Marijuana Goes Mainstream

Charles R. Larson Roth's "The Humbling:" Nothing Like a Novel From an Old Pro

Ron Jacobs
One Man's Truth, Another Man's Lies

David Yearsley
Not Loud Enough by Half

Lorenzo Wolff
The Vulnerability of Lauryn Hill

Kim Nicolini
"Big Fan:" Football, Class and Sexuality in America

Poets' Basement
Davies, Heyen and Orloski

Website of the Weekend
Coal Country Music

October 29, 2009

Michael Neumann
Criticism of Israel: a Wonderful Hiding Place

Mike Whitney
Housing Rebound? Not So Fast

Gary Leupp
Matthew Hoh Speaks Truth to Power

Conn Hallinan
Roman Roads and Modern Emperors

Marshall Auerback
Obama's Bogus Populism: Pay Curbs and Bank Loans

Laura Flanders
Palin's Pet Doug Hoffman Has Taliban Ties

Eamonn McCann
The War Criminal Vote: Blair or Karadzic for EU President?

David Macaray
Strange Invaders: Can Ignorance and Arrogance Win Hearts and Minds?

Mark Weisbrot
When Small Countries Lead the Way

Stephen Soldz
Psychologist Complicity in Torture Challenged

Christopher Brauchli
Will the Pope Bring the Taliban Into His Flock?

Website of the Day
The USS Liberty Affair and the Problem of Truth in History

October 28, 2009

Moshe Adler
How to Reduce Unemployment, Rebuild the Middle Class and Free Ourselves From Wall Street

Dave Lindorff
America's Drug Crisis: Brought to You by the CIA

Frank Joseph Smecker
Agaisnt Prometheus: an Interview with Derrick Jensen on Science and Technology

Alexandra Early
What a "Jobless" Recovery Means for Young Workers

M. Shahid Alam
Israeli Exceptionalism

Vijay Prashad
Sahelian Blowback: What's Happening in Mali?

John Ross
Three Years Later, Brad Will is Still Dead

Franklin Lamb
A Rare Victory for Lebanon's Palestinians

Gregory Travis
The Dismal Science: Elinor Ostrom's Nobel

Susan Galleymore
Peace Cycle to Palestine

Website of the Day
Newspaper Decline, a Graphic Display

October 27, 2009

Mike Whitney
Black Tuesday and How We Got Out of It

Patrick Cockburn
Bombs Will Go Off in Baghdad, Whether the US is There or Not

Stewart J. Lawrence
Honduran Coup Myths Dispelled

Alan Farago
Power Plays in Florida: Rate Increases, Nukes and Deception

Ralph Nader
Obama: Form Letters and Business as Usual

Dave Lindorff
Pentagon Dirty Bombers: DU in America

Bouthaina Shaaban
The Danger of Towing the Line Behind Israel

Brian M. Downing Elections in Afghanistan, the Second Time Around

Iain Boal
How You Can Save Pacifica

Carl Finamore
Hotel Workers and the Law of Momentum

Jayne Lyn Stahl
Here Comes That Third Party: Palin and the Constitutionalists

Website of the Day
How Bank of America Charges for Perfect Credit

October 26, 2009

Bill Quigley /
Deborah Popowski
When Gitmo and Abu Ghraib Come Home

Paul Craig Roberts
Are You Ready for the Next Crisis?

Uri Avnery
A Tsunami Called Goldstone

Mike Whitney
Will the Dollar Remain the World's Reserve Currency in Five Years?

Michael Snedeker
The Execution of Cameron Willingham

Shamus Cooke
Obama's Dirty War on Immigrants

David Michael Green
Paranoia for Breakfast

Martha Rosenberg
Gagging Michael Pollan

Patrick Bond
Gridlock on the Way to Copenhagen

Binoy Kampmark
Heading for the Tiber

Website of the Day
Goldman Sachs Abandons Kittens

November 24, 2009

Who Gives a Damn?

Health Care Reform and the Skinning of Seniors

By MARY LYNN CRAMER

The endgame is over for low-income senior citizens, but the national hoax continues.  Seniors in the state where I live don’t have to wait for the finale of “what is expected to be a bruising, full-scale health care debate after Thanksgiving” (AP) to find out how their health care costs and benefits will be impacted. No, the low-income elderly in Massachusetts already got notices in the mail, weeks ago, from their Medicare Advantage insurance providers announcing big premium increases for 2010. 

In anticipation of the long-promised cuts in government funding to Medicare Advantage plans under any new health insurance makeover bill, the Medicare Advantage providers have jumped the gun, and already passed their predicted losses in profits onto the backs of their fixed-income elderly “beneficiaries.”  In my case, monthly premiums will go up 52 per cent.  Services for which there previously were no charges---like physical therapy, for instance---will now require the same $20 co-pay paid to physicians.  The cost of drugs will also see huge increases in the revised “formulary” which sets out restrictions on which drugs can be prescribed.  Low-income elderly also got letters from “Prescription Advantage,” a program that helped them with the cost of drug coverage, that “Effective January 1, 2010, Prescription Advantage will no longer pay any portion of your Medicare Part D drug plan premium.” They suffered a $5.6 million loss in government federal funding for next year. (Personal phone communication with PA staff.)

No one in the mainstream media or in Congress has been willing to talk openly about this one element of any new health insurance legislation that Obama and his bi-partisan buddies agreed to months ago.  At least as far back as July 2009, media coverage often led with Obama’s exclamations of his intention to “eliminate waste and inefficiency in Medicare,” by cutting “more than $100 billion in ‘unwarranted’ insurance company subsidies to Medicare.” (UPI, July 22, ’09).  Every week The President seemed to identify more waste that could be cut from Medicare Advantage programs to help pay for his health reform. (AP/ Espo & Werner, July 29, ’09). 

As that amount continues to increase by $100s of billions, recent reminders that the now estimated $500 billion in Medicare “cost savings” will be taken out of the hide of poor seniors have been relegated to the final lines of press reports. For example: “To finance the expanded coverage Reid [Senate Majority Leader Harry Reid, D-Nev.]  proposed higher taxes as well as cuts totaling hundreds of billions of dollars in projected Medicare payments.  Hardest hit would be the private insurance Medicare plans, although providers such as home health agencies would also receive significantly less in future years than now estimated.” (AP/Espo, November 21, ’09). And, “About half of the bill Reid unveiled Wednesday would be financed by curbs in projected Medicare spending. While providers such as home health care agencies would absorb some of that, the biggest blow would fall on private Medicare plans.”  (AP/Espo, November 19, ’09). 

This issue inspires no drama, no colorful debate, no headlines.   Targeting low-income elderly for cost cutting has always been the one objective upon which the Obama administration and both “sides of the aisle” are in complete agreement.  (See my articles: The Myth of Medicare for All; Progressives Abet Obama-Fraud; Doublespeak on Health Car; Seniors on the Chopping Block).

Today, NPR’s “in-depth” discussion of who will pay for healthcare reform did not once mention the enormous contribution poor, aging citizens are being forced to make (“On Point” November 23, ’09).   The Obama administration, Congress, and the American public pretend not to be aware of the planned consequences for senior citizens; and worse, they ignore the fact that those hurtful consequences agreed to in close-door meetings with Obama’s chosen few have already been realized.  Frankly, Granny, they don’t give a damn.

Those who have not yet entered the growing ranks of enrollees in some form of Medicare, may not know that low-income seniors paying monthly premiums to Medicare Advantage plans also pay, in addition, the standard monthly premium for the wholly inadequate Medicare Parts A& B (sometimes called “Original Medicare” and more recently “FFS Medicare.”).  FFS Medicare does not cover monthly physical exams, nor eye exams, glasses, hearing exams, drugs, and a whole list of other medical services one would think the elderly in particular would require as they age.  That’s why we enroll in Medicare Advantage---to get comprehensive, affordable coverage of the basic services we need.  Whenever challenged about the impact on the elderly of drastically reducing funding to Medicare Advantage plans, Obama has repeatedly insisted that that $500 billion in cuts will have no effect on the cost or quality of services to seniors!  He repeatedly insisted those hundreds of billions of dollars in “cost savings” would only come from fraudulent and wasteful practices of Medicare Advantage programs that, he said, cost the government 14 per cent more than similar services provided by the original FFS Medicare.

At a recent Town Meeting on Health Care, my Congressman put the same spin on the aforementioned cuts when I asked him how he planned to protect my Medicare Advantage health insurance benefits. He responded, “Medicare Advantage costs the government and US taxpayers 14 per cent more than the same services under FFS Medicare. The cuts will only be from wasteful spending and fraud.”  I pointed out to the Representative the obvious fact that paying 14 per cent more for 95 per cent more coverage of essential medical services was a real bargain. However, what was not discussed in much more important: This excuse for skinning seniors is not only “spin,” it is such a distortion of the facts as to qualify for out and out lying to the American public.  To justify looting some of the most vulnerable and poor in our society--- in order to finance the forced purchase of private health insurance by the rest of the population---the President, Congress and the Free Press have joined forces in spreading the myth that Medicare Advantage overcharges by 14 per cent compared with FFS Medicare.

Most of the statistics on health care costs are designed to overwhelm the consumer, encouraging them to believe they should leave interpreting the data up to political and corporate experts who have their own interests -- not the consumers’ welfare — in mind.  Therefore, I refer you to some clearly understandable information provided by the “Report to the Congress: Medicare Payment Policy,” March 2009:  Close to one-quarter (23 per cent ) of Medicare beneficiaries are enrolled in Medicare Advantage plans which receive 23 per cent  of total Medicare funding.  Medicare Advantage plans include Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), Private Fee-For-Service (PFFS) plans, and Special Needs Plans (SNPs).  Enrollment in Medicare Advantage is growing rapidly, and the greatest growth is in the HMO plans.  Medicare Advantage HMO plans are more efficient, according to the “Report to Congress,” and their cost of providing the same services is less than the cost under FFS Medicare.

So, where does the ‘politically correct’ commentary about Medicare Advantage costing 14 per cent  more than regular FFS Medicare come from?  From the manipulation of statistics.  The Report states: “MA [Medicare Advantage] plans provide enhanced benefits to enrollees, but, except for HMOs (which finance a portion of those benefits through bids below FFS), the enhanced benefits are financed entirely by the Medicare program and by beneficiaries---and at a high cost.  For example each dollar’s worth of enhanced benefits in PFFS [Private Fee-For-Service] plans cost the Medicare program more tan $300.”

Low-income seniors in urban areas are unlikely to enroll in these more expensive PFFS that allow you to go to any physician or specialist your want.  Most urban elderly purchasing Medicare Advantage are enrolled in the much less expensive HMO’s, where choice is limited to particular “panels” of physician groups and hospitals that have agreed to conditions of capitated payment and coverage set by the HMO.  Not only do the Medicare Advantage HMOs provide services more cheaply than does the original FFS Medicare, the Report makes it clear that “Quality is not uniform among MA [Medicare Advantage] plans or plan types.  High–quality plans tend to be established HMOs.”  HMOs continue to enroll the most beneficiaries of all plan types and, “We estimate that HMO bids were on average 98 percent of FFS [regular Medicare].  This suggests that HMOs can provide Part A and Part B services for less than the cost of FFS [regular Medicare].” HMOs bid to provide the same services at a cost savings of 2 per cent  below the regular FFS Medicare spending. (My emphasis throughout).

But remember that Medicare Advantage covers many services, like annual physical exams, that FFS Medicare does not. These services beyond what FFS Medicare cover are called “Enhanced Benefits.”  With regard to these services, the Report states, “In the case of HMO’s…their bids for the Medicare benefit package are below Medicare FFS spending, the program subsidy is 97 cents for each $1.00 of enhanced benefits.  In the case of PFFS plans, on average, the program subsidy is $3.26 for each dollar of enhanced benefits.  In other words, HMOs are the only MA plan type that finances any part of enhanced benefits through plan efficiencies:  3 cents of every dollar. Enhanced benefits in other plan types are completely subsidized by Medicare.”

And, finally, the Report concludes “Our analysis finds that some plans are able to cover the same services as the traditional Medicare Part A and Part B benefit at a lower cost---namely, HMOs, which cover these services on average at 98 percent of Medicare FFS expenditures.”  The fact of Medicare Advantage HMOs lower cost and higher quality gets lost in the final analysis because the Report is “concerned with the “average” cost of all the services offered by all the various Medicare Plans---those of the very costly PPOs, PFFS, SNPs , together with the very efficient HMOs.  Thus, “in the aggregate” they paint all Medicare Advantage costs as 14 per cent  more than those of FFS Medicare, and de-emphasize the fact that Medicare Advantage HMOs are more efficient than the original FFS Medicare.

Why can’t politicians, journalists, and talk show experts read the “Report to Congress” on Medicare Advantage and figure this out for themselves.  Why do they walk in lock-step agreement with Obama that it is necessary to gut the higher quality, cheaper and more efficient HMO Medicare Advantage program to pay for a big hunk of the cost of privatizing nation-wide health insurance?  And why have the private providers of Medicare Advantage, and huge insurance lobbyists like AARP been on board with this deal from the very beginning?  Why are the providers of Medicare Advantage insurance plans not objecting to the cuts, but already passing their anticipated losses on to elderly subscribers in the form of outrageously higher premiums, co-pays, and drug costs?

Yes, why would AARP and other private health insurance companies go along with this scam? In his article “Cashing In, Selling Out: AARP’s Tradition of Betrayal,” Stephen Lendman exposes the myth that AARP is a nonprofit dedicated to improving the quality of its members’ lives. He quotes the Physicians for a National Health Program calling AARP “part of the problem, not part of the solution.”  AARP, he says, is “largely profit-driven, offering 17 types of insurance reaping hundreds of millions annually in royalties.  Millions more from selling drugs; other products and services including mutual funds; plus federal subsidies exceeding $80 million annually; and annual membership dues…[from] 40 million members.”  He adds that AARP is “also active on Capitol Hill with a 50-person staff and a 2008  $28 million lobbying budget, much like major corporations and for the same purpose – profits at the expense of member interest, unaware how they’re ill-served by an organization claiming to be their advocate.”

As you and I will never see the numbers, we can only imagine the trillions of dollars in new profits the private insurance companies and pharmaceutical industry plan to reap when every American is forced to purchase a private insurance plan on the “free market”.  The very idea of providing a consumer product—with no price regulation or cost controls attached-- that every citizen in the nation is required by federal law to purchase must have those CEOs on quite a high.  In the closed-door horse-trading that went on, the decision to give up government funding of seniors’ Medicare Advantage, in return for a lucrative new national  “market,” should have been a relatively painless one. Not only did it cover Obama with the illusion of being hard on private insurance companies while watching out for the “American taxpayers,” all parties involved no doubt knew they could count on the passivity of aging, anxious and insecure Medicare Advantage enrollees to absorb any short-run losses in corporate income.  Making a killing in the short run is the first rule of American Capitalism.

The entire scheme is, of course, just one more bailout for large corporations experiencing declining rates of profits in recent years.  As AP’s Calvin Woodward points out, “The insurance ‘industry’ like other parts of the economy has been in trouble for sometime, in spite of their skyrocketing premiums.   Health insurers posted a 2.2 percent profit margin last year, placing them 35th on the Fortune 500 list of top industries.”  Woodward gives several examples, including “HealthSpring, the best performer in the health insurance industry, post[ing] 5.4 percent.   That’s a less profitable margin than was achieved by the makers of Tupperware, Clorox bleach and Molson and Coors beers.” (AP/Woodward, October 21, ’09)

The President is doing the job his big money backers nominated him to do.  It is the same job any other President faced with an economic crisis must do:  Facilitate the transfer of as much of our national wealth and resources as is possible over to large private industries, while cutting spending on public programs through policies that reduce the consumption of working people, the unemployed, children, the poor and elderly -- without causing public unrest or revolt -- and, thereby, hopefully increase capital accumulation and  profits enough to encourage investment in expanded production and recovery in the “real economy.”  With all the silly charges of health care  “socialism,” it may be necessary to remind ourselves that our economy continues to be a Capitalist economy.  Capitalism is based on production for profit.  No profit, no production. As I said in my article “Whose Consumption Drives the Economy?  The Multi-Trillion Dollar Question:”

“Government spending on public works programs detracts from capital that could be spent in private profit-making industries. Military production has become big business for many private, for-profit, contractors. The US is the largest producer and distributor of military weapons in the world…But the real problem here is that, under our economic system (Capitalism), public (nonprofit) spending on domestic programs that directly benefit you and me will not jumpstart capitalist (for profit) production. It never has.

“With all the romantic (and a relatively few actual) recollections of FDR’s limited public works programs, it was WWII that provided Roosevelt with the authority to significantly increase employment; retool, redirect and plan industrial production. The US government has not been able to withdraw entirely from its role of propping up and intervening in the private economy. While postwar Europe created programs providing all citizens with healthcare, education, retirement, lengthy vacation time and other government-guaranteed benefits, the US left provision of the larger part of those services to the private sector. In our current economic recession, there will again be only a minimal amount of spending on domestic programs that benefit the citizens rather than private corporations. And that limited public spending will depend on how much ‘public unrest’ is feared…. the US increases competitiveness in the Capitalist world by lowering real wages, eliminating pensions, cutting employer-provided healthcare, and making higher education so expensive even two-income ‘upper middleclass’ families struggle to pay tuition. With this in-your-face everyday reality, it is difficult to understand how so many continue to believe that ours is a “consumer-driven” economy. Working people’s consumption of everyday necessities is being cut, while billions of taxpayer dollars goes to “bail out” financial institutions who have no incentive to loan those funds to low income people (or to companies) now that most of the fraudulent transactions and speculative securities are supposedly under closer scrutiny.”  (See also: Greenspan’s Higher Power,, Their Assets; Our Debts ).

Well, the senior sell-out is now a done deal.  And the “debate” over whether employers, insurance companies, or upper-income couples will be taxed (not!) to help pay for the cost of Obama’s health insurance makeover, sets the stage for more dramatic acting-out.  Backroom bargaining with the loyal “opposition” will abound, similar to the deal Sen. Mary Landrieu of Louisiana bragged about making in return for her holdout vote: “‘I've decided that there are enough significant reforms and safeguards in this bill to move forward, but much more work needs to be done.’ She also touted the $100 million included in the legislation to help her state cover its costs under Medicaid, the state-federal health care program for the poor [sic; poor children and disabled].” (AP, Espo, November 21, ’09).  We can look forward to more circus theatrics around whether a DOA “Public Option” will be run by the government or privatized, opted-in or out.

Last week there was a meeting at my town Senior Center, intended to explain the new Medicare and Medicare Advantage options.  Most of the attendees had gotten the letters advising them of big increases in the costs of their Medicare Advantage insurance plans. None of us had expected to see these painfully predicable results before the ink was even dry on that diabolical insurance bill. (Apparently they wanted to make sure we had the holidays to prepare for more belt-tightening and budgeting in 2010.) Their was much discussion about joining the original Medicare plan that is cheaper but does not cover physical exams, or eye exams, glasses, hearing exams, drugs, etc.  I honestly hate to say, “I told you so!”  I hoped that if I wrote and talked and yelled enough, this would not happen.  Magical thinking aside, I predicted months ago that low-income elderly would be forced into the option all the "progressive" physicians and other liberal professionals have been begging for: "Medicare For All.”   The original FFS Medicare -- the worst health insurance imaginable --  requires additional “supplemental plans,” or  '"free care" and "safety net" dollars (only available in Massachusetts for those poor enough to qualify), just to cover basic medical needs. This original Medicare plan is accepted by a shrinking number of physicians at federal and state subsidized hospitals and community clinics which are also experiencing huge cuts in Federal and State funding for low income patients.

No, Granny, they aren’t going to “pull the plug on you” without your permission; and there will be no “death panels” by that name. (Those fabricated threats were the kinds of distracting theatrics Obama and the “progressives” love to entertain rather than focus on the issues or details of real reform proposals.) The actual plan is more insidious and noxious.  Your “tin-plate” Medicare Advantage HMO policy will become as expensive as last year’s gold-plated option.  And you will, according to design, eventually have to enroll in the Original FFS Medicare---the most limited, inadequate health insurance available.  Maybe there is some consolation in realizing that with the deepening depression in our real economy, our aging population, and the declining “middle class,” many of those who don’t give a damn, will sooner or later also be forced to join the “beneficiaries” of the worst medical insurance plan in the economically developed world: Medicare For All!

Mary Lynn Cramer, MA, MSW, LICSW, a low-income senior enrolled in a Medicare Advantage HMO plan, has a background in the history of economic thought, and clinical social work.  She can be reached at mllynn2@yahoo.com

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