UnitedHealth $7 billion more than Medicare to pay less than 10% of Medicare’s bills.

In 2007 UnitedHealth Group made a net profit of $4.65 billion on revenues of $75.43 billion.  6.2%, which sounds reasonable and fair.  That’s NET profit of course.  UnitedHealth Group also paid $2.6 billion in income tax.  Now, they don’t have a choice in this last bit, but the fact remains that a government run alternative would save the profit and the income tax UHG takes out of the healthcare system and which amounts to 9.8% of the insurance premiums they collect.

But that’s just the beginning. I’m not here to make a case that the government should run businesses solely because it doesn’t have a profit motive.  We have good reason to believe that in lots of cases that’s a bad idea.

United Health’s 2007 Cost of Goods Sold (their actual insurance payouts) were $56.2 billion or, 74.5% of their $75.43 billion of revenues.  We know that of the remaining $25.5% is $7.3 billion in tax and profit.  Now, as it turns out, UH wrote off $796 million in depreciation and amortization which the government also does in its own way, which left it with $10.583 billion in operating expenses, or 14% of gross revenue.  This 14% is where the REAL pain is.

A large portion of this goes to doing their damndest to not insure people who might need insurance and to cut them off from insurance in the instance that they ever do.  So, this really is the heart of our healthcare issue, which is that insurance companies make money by NOT paying for healthcare costs people pay them to pay for.  But the heart of the problem isn’t the only problem.

The other problem with the 14% (and actually, lets go ahead and make it the whole 25.5% again) is that the comparable cost for the combined Medicare and Medicaid program is… are you ready?  2.6%.  That’s right.  Medicare and Medicaid expect to pay out $709 billion of medical payments covering healthcare for 95 million Americans (about 1 in 3) with administrative overhead of $18.6 billion.  Actually, a lot of this 2.6% covers fraud and abuse prevention and loss accounts, quality improvement programs, research, and grants to states for various things.  The actual program administration costs are one half of one percent.  That’s right.  0.5%

Another way to look at it is that if Medicare had a similar cost structure to United Healthcare, it would spend $180 billion on administration and profit to provide services to all those people instead of the $18 billion it actually spends.  Or, if UnitedHealth were as efficient as Medicare, its overhead would be less than $2 billion.


United Health Group 2007 Financial Statements.

Centers for Medicare and Medicaid Performance Budget for FY 2009.

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Liberals Head Into the Weeds on Right Wing Angst About Obama Speech

So, of course I can understand why liberals are incensed that after being called traitors, and unpatriotic, and being told to move to other countries, and beaten up sometimes, for even questioning the wisdom of a war that turned out to ultimately be a scam and a debacle based on deliberate lies that cost over a trillion dollars (and counting) and four thousand young Americans lives (and counting) and got us NOTHING, that conservatives would have the balls, yes the fucking balls, to suggest that even listening to the first legitimately elected President of the United States of America in a decade talk about anything at all, let alone the value of an education, could be anything but a blessing for their children…

And I have to admit that I am so incensed that I’m more than happy to let them know that I think they are pathetic substitutes for human beings, that they are so clearly the unwashed, uneducated, bible thumping, illiterate, shoeless, toothless, rusted pickup truck driving, unskilled laboring, snuff chewing, warm Miller beer drinking, sibling screwing, greasy haired, wife-beating, dirt floor shack living, car on blocks in the side yard having, faded plastic Mary in a bathtub in the front yard having, hair lipped, brown-shirt wearing, gay bashing, better to have an abortion with a wire hanger than a surgeon believing, underarm stinking, crotch crab infested, swamp-assed, bastard, worthless, piece of shit mother-fuckers that those of us who actually graduated 9th grade always knew they were…. where was I?

Oh ya.  The difference between being a liberal and a conservative is that while I find them despicable in all the above ways and more, I fully support their right, if their fetid little maggot infested minds lead them to want to, to have their children wait somewhere else while the rest of the kids benefit from a wholesome message about the value of an education from the President of the United States of America, the greatest nation on Earth.

Would that when we have an issue with our kids being arm-twisted to say that America is a nation “under God” which it MOST CERTAINLY IS NOT since THERE IS NO GOD EVEN THOUGH THEY INSIST THERE IS, that they would be as generous as we, and look out for our rights as individuals as much as we look out for theirs.

Filthy, buck-toothed, rat-faced, acrid, bug infested, little creep bastards.

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We need 6,000 more Congress Critters

When the Founding Fathers designed the House of Representatives in the Constitution they sought to ensure that there would be no more than one representative for every 30,000 people AND NO LESS THAN one representative for every 50,000 people.

Each representative today has over 600,000 constituents and this inestimably cheats the citizenry of their fair say in Congress.

Remember that the Senate represents states as a whole. The House is to represent communities and neighborhoods. At 600,000 constituents per representative, neighborhood concerns are almost entirely lost and Representatives are left to only focus on the big, national issues of the day… those that the Senate is already designed to master.

At 600,000 constituents representatives must campaign via expensive, mass media which shifts their attention from voters to fund raising and campaign contributors… Most of whom come from OUTSIDE their districts and demand representation that actually harms the representative’s voters.

The people’s voice has been stolen and we need it back. We need our other 5,500 representatives.

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Caveat emptor this

Let the buyer beware is wise advice in a world known to have dishonest businessmen.

As a government policy it is immoral. We have a right and an obligation to shut down predatory businesses when we find them and no choice but to use caution knowing that we’ll never find them all.

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Public option will NOT automatically cause most companies to drop insurance.

There are exceedingly few companies in the United States today that are required by law to provide insurance for their employees.  So why do they do it when it is such a huge expense?

Companies provide insurance benefits to compete in the labor market.

No matter what the unemployment rate, sooner or later companies have to hire new employees.  When they do, it doesn’t matter whether there are three employees available or three hundred… no company wants the 3rd best.  They compete for the best.  They don’t always win the competition, but they try to.

When was the last time you met an electrical engineer with ten years of experience who would even consider working for some fly-by-night company that doesn’t offer medical benefits?  Or a Director of Advertising.  Or a Senior Database Security Analyst.  Or a Vice President of Finance and Accounting?  Or a District Manager of Food Service Operations?  Or a damn good Administrative Assistant?

To compete for the best talent, companies have to offer the most competitive compensation packages, and in today’s world that means health insurance as a benefit is mandatory.

Now, if a company is paying 15% of its payroll to provide insurance and it finds that it can stop doing that and pay just an 8% penalty… of course it is going to want to do that.  But it is only going to be able to do that if workers find that option to be competitive.  If the best quality employees, the ones with the most choices and options of where to work, feel that the public insurance and private insurance are equally as good, but their out of pocket cost is $300 a month for the company that provides private insurance (because of the employer contribution) but $900 a month for the company that makes them use the public option, they will work for the company that offers them the private insurance.  Until, or unless, the company not offering insurance pays them the $600 a month in cash to make them whole.  Likewise, if the out of pocket costs are the same, but the public insurance turns out not to be as good as the private insurance, the best employees are going to either demand to be compensated financially… or flat out refuse to work there.

If it turns out that the public option insurance is as good as the private insurance, and that after paying the 8% penalty and whatever amount they have to pay employees in cash to continue to be competitive it is still economically beneficial for them to do that… well, that will be the proof of the pudding that government can do it better!  We should all applaud.  The employees will be happy, the company will be happy, the taxpayers will be happy… everyone will be happy except the insurance company CEO that can no longer command a $10 million a year annual salary.


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Fascism Anyone?

So often when we think of Fascism we think of genocide and anti-semitism.  For that reason when people see real fascism and it doesn’t look like genocide and anti-semitism, they assume that it must not be fascism.  But it is.

Fascism Anyone?. by Laurance W. Britt

The article above is very readable and discusses, briefly, these 14 characteristics that the fascist regimes of Hitler’s Germany, Mussolini’s Italy, Papadopolous’ Greece, Franco’s Spain, Pinochet’s Chile, and Suharto’s Indonesia shared in common, and that are found to a much lesser degree, or not all together, in non-fascist regimes.

1. Powerful and continuing expressions of nationalism.

2. Disdain for the importance of human rights.

3. Identification of enemies/scapegoats as a unifying cause.

4. The supremacy of the military/avid militarism.

5. Rampant sexism.

6. A controlled mass media.

7. Obsession with national security.

8. Religion and ruling elite tied together.

9. Power of corporations protected.

10. Power of labor suppressed or eliminated.

11. Disdain and suppression of intellectuals and the arts.

12. Obsession with crime and punishment.

13. Rampant cronyism and corruption.

14. Fraudulent elections.

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What if the House of Representatives had 9,000 members instead of 435?

Remember from civics that the House of Representatives was intended to be the volatile, nearly direct voice of the people and the Senate was to be the staid, deliberative voice of the states? Aside from the rules of the two houses and the terms of office, the far greater number of Representatives was intended to ensure that Representatives were very closely connected to the people they represented. Hence… the name of their body. The limit on this was set that there should never be more than one representative for every 30,000 citizens. At this level, Representatives had very little individual power compared to Senators, but their numbers and their close connection to their constituencies were to ensure that the will of the people had a strong voice.

In 1911, public law 62-5 was passed, which limited the number of members of the House of Representatives to 435, maintaining Congress’ authority to change that number if it wants to. The effect of this has been the steady increasing in size of Congressional Districts and the diminishing of the connection between a Representative and his or her constituents. Indeed, each member of the House of Representatives has a constituency of nearly 650,000 people today. That’s a far cry from 30,000.

At 650,000 constituents, the typical Representative is little more connected to his constituents than the Senators. They are somewhat more connected, to be sure. The focus of a representative whose district includes a mid-size city is going to be different from a representative whose district covers thousands of square miles of rural farmland. But the intimacy of the representation is clearly lost.

  • Williamsport, PA
  • Rochester, NH
  • Ithaca, NY
  • Prattville, AL
  • Newark, DE
  • Cooper City, FL
  • Poughkeepsie, NY
  • Marysville, OH
  • Saratoga, CA
  • Texarkana, AR
  • Walla Walla, WA
  • Juneau, AK
  • Roseville, MN

These are some US cities that have populations of more or less 30,000 people. I can pretty much guarantee you that any citizen of these cities can get an appointment with the mayor. Probably, they can walk into the mayor’s office and get a quick audience in between meetings. The mayors of these cities know their citizens and the issues that concern them like the back of their hand. They know the families. The know the kids. They know not just the big businesses, but the small ones.

I can also pretty much guarantee you that many, many of the citizens of that city are intimately aware of the quality of the mayor’s representation. They know whether decisions are being made because they are good for them or for their neighbors and they certainly know when something has gone amiss and suddenly decisions are being made for some company 1,200 miles away that doesn’t even have any employees in the city.

At one representative per 30,000 people, the House of Representatives would have over 9,000 members. We would have to do some work to make sure that a governing body of 9,000 could get anything done. But we live in an extremely connected world. The Internet and telecommunications, the highway system, and air travel, have vastly changed the way most of us do business. It really would not be necessary that all 9,000 members of the House assembled at the same time and place. If we wanted to, we could find ways for them to telecommute like so many of us do now. And what a change that would be to have our Representatives living with us again, in our communities, every day. Wouldn’t it be something if they always showed up at little league games, and you ran into them a couple of times a month at Burger King it seemed, and your kids went to school with his kids, and he jogged past your house in the morning…

Think of how difficult it would be for lobbyists to gain sway with them and steer them toward representing interests other than those that truly are important to their close friends and family and to their neighbors.

Now, perhaps 9,000 is too many representatives, although, for the life of me I don’t know why it would be. But it seems that 435 is ludicrously too few. At this ridiculously low level, each member of the House has way more power than was intended for them to have. They are nowhere near as closely connected to their constituents as was intended. No matter where they come from, they end up living and working in a major metropolitan area in the mid-Altantic. Whether they represent farmers, lumberjacks, a college community, or a bedroom community, they all end up dealing with the Metro in Washington DC. They live in a culture, often for years and years and years, that is not remotely like the one they represent.

We need to have some national think time about this. We need to increase the number of Representatives in the House of Representatives probably well into the thousands so, once again, they can be people you know and work with, people you grew up with. The need to become again people of modest, normal, everyday backgrounds instead of being limited only to millionaires and people with completely atypical American experiences.

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