Monthly Archives: March 2024

Russia & the United States:  Two Different Countries, Two Different Styles of Kleptocracy

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Dave Kingsley

Stealing from Taxpayers is Kleptocratic Behavior in Any Government

    After the collapse of the Soviet Union, Russia began to transition from totalitarian communism to an oligarchy of politically connected apparatchiks and mobsters from the Soviet era.  The productive sectors of the economy such as oil and gas and manufacturing were looted in a crude takeover by a powerful criminal cabal including the KGB and high officials of the Communist Party.  There was nothing subtle about it.  The economy was dismantled and carried off by an in-group of thieves and criminal enterprises.  The health and lifestyle of the Russian people dropped precipitously.  There was no longer any pretense about an economy designed for the rise of the workers.  That era was over and kleptocracy became de rigueur.[1]

    As Soviet Communism was failing, the United States was transitioning from a “golden age of capitalism” to a dark age of government regulatory retrenchment, Wall Street dominance, loss of faith in government for the general welfare, a sinking middle class, stagnant working-class wages, and deteriorating population health.  The kleptocratic facet of the current U.S. economic dark age is far more refined than the brutish nature of the Russian oligarchy.  The conditioning of the American people has been sophisticated and in most instances difficult to recognize.

    The kleptocrats of Russia merely took what they wanted right out in the open.  U.S. kleptocrats applied an abstruse intellectual justification for weakening government checks and balances, dismantling regulatory agencies, and privatizing government services.  Mythical beliefs about a nonexistent free market were generated in leading universities and sold to legislators and the public.  Hence, a thing no more real than a unicorn was concocted by academic economists and marketed as the ultimate decision maker.  The idea of “the market” was reified into an entity – an entity has never been observed or measured – endowed by theorists with complete knowledge and the ability to make the best decision about how government should work vis a vis private industry.[2] Indeed, it has been working increasingly well for the rich and powerful.

A Kleptocrat by Any Other Name is Still a Kleptocrat: An Example

Peter G. Peterson: Multi-Billionaire Founder of Blackstone

    The late multi-billionaire Peter G. Peterson along with Stephen Schwartzman, founded the Blackstone Group, a financial services conglomerate.  Mr. Peterson dedicated a billion dollars to the privatization of Social Security and Medicare.  The trillions of dollars expended by the SS Trust Fund and Medicare program make an inviting target for a vulture capitalist.  Unfortunately, Peterson had a stellar reputation inside the Washington, D.C. beltway where cliques of corporate and individual wealth roam. His front groups such as the Committee for a Responsible Federal Budget (CRFB), the Concord Coalition, and the Peter G. Peterson Foundation, jelled into a highly influential network of “go to” organizations for public policy.

    Maya MacGuinness, CEO of CRFB, is frequently the only person quoted when federal budgeting is covered in leading mainstream publications such as the New York Times.  Her mantra is that Social Security and Medicare are leading causes of budget deficits. This is not true and she either knows that and is lying or she is seriously incompetent and ill informed.  Either way, representatives of mainstream media – including PBS – are irresponsible for consulting her.

    Medicare is undergoing rapid privatization, and an increasing amount of public funds are diverted from care to a bevy of private for-profit financial intermediaries.  This has increased the cost of Medicare.  But this increased expenditure is not devoted to better care.  Rather it is siphoned off into shareholder earnings and benefits a few wealthy individuals.

    Medicare wasn’t privatized solely under the influence of Peter G. Peterson.  The Medicare Modernization Act of 2003 included Part D – a prescription drug benefit – and was pushed by Big Pharma.  The insurance industry pushed the act because it included Part C –  privatization of the entire program under what has become known as Medicare Advantage.

    Social Security remains un-privatized and administered at a cost of ½ of 1 percent of revenue.  Wall Street would love to privatize it in the same manner as Medicare and earn huge management fees that would rake off up to 25% of revenue, which has been the experience in the privatized Chile SS program.

Nursing Home Kleptocrats

    Investors have a vast interest in frail elderly and disabled Americans institutionalized in the disgraceful U.S. nursing home system.  They can get by with a minimal, substandard, quality of care while extracting and pocketing optimal amounts of cash.  It is a shabby business carried out by sleazy businessmen in a weakly regulated government funded skilled nursing system.

    A richly funded propaganda machine and political contributions are responsible for a veil of secrecy around the corruption of an industry with little interest in optimal care of the people in their charge and from whom they are expropriating assets that would otherwise be passed to their heirs, thereby causing even more maldistribution of wealth.  While tunnelling excess amounts of government provided revenue through subsidiaries and shell companies, they have effectuated a first-class propaganda machine that has sold lies about financial hardship and underfunding from government.  I even see this lie promoted in peer reviewed journals – mostly from economists.

    Propaganda works.  The industry lobby has an effective PR campaign that leads the public to believe that it is tough to make money running nursing homes.  They rely on the lack of financial literacy among most people by noting a general low operating margin reported by most facilities. These misleading statements regarding nursing home facility cost reports submitted to state regulators and CMS are often taken at face value by academics, the media, and advocates.  Consequently, supposedly peer reviewed publications include findings from data dumps of information taken from facility-specific reports. 

Right Wing Fanaticism Didn’t Shrink Government.  However, It Did Shrink Democracy.

    A well-known anti-government fanatic once said that he wanted to shrink government down to a size small enough that he could drag it into the bathroom and drown it in the toilet.  Cute.  Grover Nordquist is the guy we are talking about here.  Although he is clearly an idiot, politicians have lived in mortal fear of his condemnation and avoided any hint that they might raise taxes – meaning individual and corporate taxes.  Reaganites, Nordquististas,  Paul-groupies (Ron and Rand) and indeed the libertarian extremist, government hating, right-wing of American politics believe that taxes feed “the beast.”  So, they were successful in collapsing individual income tax brackets, lowering corporate income taxes, and devolving taxes to the states in the form of regressive sales, excise, and user taxes.  At the same time, executive branch agencies with the purpose of protecting the public from corruption and abuse and implementing legislation have been weakened considerably.

    The middle- and lower-income classes are not paying lower taxes.  Billionaires and corporations are.  Furthermore, an increasing amount of middle- and lower-class income and wealth is being distributed to families and individuals with the highest level of income and wealth (think “spend downs” in nursing homes).  Along with privatization of government services – especially healthcare – a weakened regulatory system has been conducive to a refined form of looting through Medicare, Affordable Care Act, Medicaid, Pentagon/defense budgeting, and a multitude of other forms of privatization.  Well, maybe not so refined, if we just take a closer look at it.

    Without a robust federal regulatory framework, the rights of Americans are now trampled by special interests who have been able to tilt the tax codes in their favor and takeover government services at costs higher than would be if the services were provided by federal agencies.  One unfortunate result of this form of looting is that Americans are increasingly gouged by health insurers and paying more than their peers in Asia and Europe, but their overall health is worsening. 

The U.S. Supreme Court is About to Seriously Dilute Executive Branch Regulatory Power

    Federal laws can be sweeping and complex.  The Clean Water Act, the Occupational Safety & Health Act, and the Medicare Modernization Act are examples of laws that have induced systemic change in U.S. government and society.  These laws cannot anticipate, nor can they address every contingency in day-to-day implementation.  Congress has traditionally considered technically qualified agency personnel to be responsible for filling in the “gaps” in highly complex legislation.

    Industries affected by major legislative changes have typically fought administrative regulations issued by the EPA, OSHA, FDA, and a host of other regulatory agencies.  They have attempted to blunt regulations through the courts, propaganda, and the political process. However, in the 1984 case Chevron USA, Inc v. The Natural Resources Defense Council, Inc., the Supreme Court enhanced the legitimacy and legality of agency regulations and strengthened Executive Branch oversight.  The Court held that deference should be accorded to administrative agencies with the technical capability and scientific knowledge for addressing ambiguous issues in legislation.

    That precedent is likely to be overturned when the Court hands down decisions on two cases already heard this session: Loper Bright Enterprises v. Raimondo and Relentless, Inc. v. Department of Commerce.  The cases concern regulations issued by National Marine Fisheries Service (NMFS) under the Magnuson-Stevens Fishery Conservation and Management Act (MSA).  The forthcoming decisions will address two major questions:

 1. Should Chevron v. Natural Resources Defense Council be overruled?

2. Does statutory silence concerning controversial powers expressly but narrowly granted elsewhere in the statute constitute an ambiguity requiring deference to the agency?[3]

     The six conservative idealogues on the court are expected to answer question 1 in the affirmative and question 2 in the negative. This is a particularly horrendous prospect for the U.S. healthcare system, which has outsourced trillions of dollars to some of the largest corporations in the United States.  These corporate behemoths with very deep pockets or trade associations with vast resources will take their dislike of particular regulations into court and will often find  friendly judges who will interpret regulations in their favor even though they – the judges – will have no scientific credentials to make technial decisions.  This has already occurred in the Alliance for Hippocratic Medicine v. U.S. Food & Drug Administration[4], which was heard before the Supreme Court last week. 

    In that case, a federal judge in West Texas issued a ruling that overrides the scientific research undertaken by the FDA in the approval process for mifepristone (also known as “RU486” and “Mifeprex”) – more commonly called “an abortion pill.”  The S.C. will no doubt find that there is no standing to sue on the part of the anti-abortion doctors.  Nevertheless, the question of whether a judge can override reasonable regulations issued by the FDA will be left open.  That is where this case intersects with the Chevron deference principle that will most likely be overturned.

    This does not bode well for women’s reproductive rights specifically and for healthcare in the U.S. generally.  As these court cases pertain to kleptocracy, a corporate friendly and extreme right-wing majority on the S.C. is in a position to neuter federal agencies and strengthen the hand of kleptocrats.

Summary

    Acts of government sanctioned cheating and stealing from the American people are permeating the multi-trillion-dollar government funded healthcare system.  As government funded medical care is increasingly privatized and corporations in the business become bigger and more powerful than the agencies regulating them, more funds will be diverted illegally from care into owners’ pockets.  For instance, I’ve noticed an increasing number of nursing home facilities maltreating and underpaying employees, which discourages applicants for work and induces turnover.  At the same time, they contract for labor from subsidiaries of their parent/holding companies at an extremely high rate.  We have examples of facilities contracting with related parties for 50 to 63 percent of their labor.  State and federal agencies have failed to even notice let alone deal with this egregiously illicit practice.

    This example of labor contracting is only one of many, many forms of cheating.  MCOs often deny authorization for physician prescribed treatment in their networks to keep their cost below capitation rates.  Hiding and distorting information on cost reports, overcharging for services, upcoding therapy services, funneling funds through shell companies to hide excessive extraction of funds, and pressuring congress through bribes (campaign contributions) to unjustifiably increasing reimbursement, i.e., rent seeking are a few more examples of cheating and stealing.  It should come at no surprise that the American people pay two to three times more per capita for healthcare than the people of our Asian and European peer countries with universal, single payer, government managed healthcare systems.

    My purpose in writing this blog post is to encourage attention to psycholinguistics in advocacy, scholarship, and public discourse in general.  Professionals and scholars are reticent about applying terms such as kleptocratic to behaviors that are best described as that.  The media avoids harsh and condemnatory terminology – even when it called for in describing events and acts.

    Stealing is stealing, thievery is thievery, whether they happen through a home/business break-in, or through cheating on forms submitted to the federal and state governments.  White collar crime is unfortunately placed on a higher plane and is less punishable than street crime generally committed by the poor and powerless members of society. How we describe behaviors and what we call them has significant influence on how they are perceived and treated in political discourse and the criminal justice system.

[1] Terms such as plutocracy, oligarchy, and kleptocracy are not mere words and are not used in this blog for name calling.  In public discourse words should be taken seriously and utilized in a technically correct manner as scholars in political philosophy would theoretically utilize them.. Kleptocracy is defined as: “ a form of government by individuals who primarily seek personal gain at the expense of those they govern.” Kleptocracy | Definition, Examples, Kleptocratic Leaders, Dekleptification, & Facts | Britannica.”  Given this broad definition of kleptocratic behavior, examples of it abound in the U.S. and are manifested even more crudely in Russia.  Terms such as oligarchy, plutocracy, and kleptocracy can all apply to any one government in any one nation state. Oligarchy pertains to rule by a small number of individuals sans democracy.  Plutocracy is rule by the wealthy – also contrary to democratic governance.  As wealth is distributed away from the masses to a small number of superrich individuals, plutocracy is intensified and becomes more salient in political processes.  Hence, the system becomes more oligarchic because the power is posited in a smaller number of individuals.  The intersectionality of plutocracy and oligarchy is of importance in this discussion.  Furthermore, the correlative increase of rule by the few in their private interest, contrary to the public interest, and the concentration of wealth in a tiny minority leads to corruption on a wide scale.  Therefore, resources that could be dedicated to elevating the health and lifestyle of the masses are diverted to a wealthy few.  For instance, government tax receipts flowing from wage and salary earners have been increasingly and excessively diverted to shareholders at the expense of government services intended to improve the health and welfare of all classes of U.S. residents.  Kleptocratic behavior is expressed in the healthcare system by the proliferating number of financial intermediaries such as insurance companies, pharmacy benefit managers, etc. who drain resources from care without adding effectiveness and efficiency to the overall system.

[2] Reification is a frequent fallacy in pseudoscientific thought processes.  Naming and describing something abstractly do not prove that the thing exists concretely.  The free market as an abstraction is a description of trillions of daily interactions in which people buy and sell things.  It is fallacious to call all of those interactions a thing.

[3] Relentless, Inc. v. Department of Commerce | Oyez

[4] AllianceForHippocraticMedicineComplaint.pdf (windows.net)

How the Health Insurance Industry is Using Disinformation to Take Over and Defraud Medicare

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By:

Dave Kingsley

Corporate Greed in the Post-Truth Age

    Most Americans have never heard of the Better Medicare Alliance[1] – a Washington, D.C. think tank and front group for big health insurers such as UnitedHealth, Aetna, and Humana.  Also, the 2023 Super Bowl TV audience didn’t know who paid for a commercial at halftime claiming that President Biden had plans to “cut Medicare.” The ad included a message urging viewers to call the White House and “tell President Biden not to cut Medicare,”[2] but they – the TV viewers – didn’t know who was asking them to do it. Football fans had to be perplexed.  Medicare beneficiaries were most likely upset and worried by what they saw and heard.

    The ad, funded by Better Medicare Alliance, was a lie.  The truth is that President Biden had no intention and no plan to cut Medicare.  Contrary to what the ad claimed, he was planning to claw back $4.7 billion from UnitedHealth and other insurers for defrauding the program through false billing practices.  One illegal practice health insurers utilize to add unearned value to their Medicare Advantage (MA) reimbursement is called “upcoding.” Because sicker patients are reimbursed at a higher rate, the trick is to find ways to lie about how sick a patient is – to make them look sicker than they are.[3]

    MA beneficiaries tend to be healthier than Traditional Medicare (TM) beneficiaries.  Nevertheless, research indicates that when individuals move from TM to MA, their costs to the program increase.  The important point is that “total Medicare payments to MA plans in 2024 (including rebates that finance extra benefits) are projected to be $83 billion higher than if MA enrollees were enrolled in FFS Medicare.”  Furthermore, payments to MA plans average an estimated 122 percent of what Medicare would have expected to spend on MA enrollees if they were in FFS Medicare.”[4]

    After the Biden Administration’s proposal to recoup stolen money from MA insurers and prevent further fraud, the health insurance industry threw a conniption fit and went into overdrive.  The Super Bowl ad was only one tactic (costing eight figures, it was super expensive).  In addition, they sent their army of lobbyists crawling all over the Washington, D.C. beltway threatening and bribing legislators.  HHS backed down.  The cheating continues and costs the seniors of America – indeed all wage earners – hundreds of billions from their payroll deductions, premiums, co-pays, and nearly $200 out of every Social Security check.

Pulling Back the Curtain on the Washington D.C. Policy Planning Network:  What is the Better Medicare Alliance & Who is Behind It?

    The insidious thing about think tanks set up inside the Washington, D.C. beltway is that they enlist the aid of seemingly legitimate advocates and scholars.  It is hard to know if the advocates and scholars are merely naïve or whether they are self-serving. Perhaps unwitting would be a kinder word. For instance, the Better Medicare Alliance board consists of Dennis Borel, Executive Director of Texans with Disabilities, Caroline Coats, Humana, Inc., Daniel Dawes, Meharry Medical College, Mary Beth Dawes, Former Congresswoman (President & CEO), Joneigh Kaldhun, CVS Health, Dan Lowenstein, Visiting Nurse Service, NY, Richard Migliori, UnitedHealth, Elena Rios, National Hispanic Medical Association, and Kenneth Thorpe, Emory University.

    The organizational structure of these industry front groups is a form of disinformation itself. On the board are big players in the MA industry – Humana, CVS, and UnitedHealth.  Interspersed with the representatives of these health insurance behemoths are executives and professionals from organizations with an ostensible mission to improve society in some manner.

    By placing their imprimatur on an industry lobbying group, NGOs, nonprofits with a stated humanitarian cause, and universities  are participating in a duplicitous tactic to confuse the public about the real purpose of nefarious industry think tanks like Better Medicare Alliance. Their support for various entities with a mission to preserve and strengthen the medical-industrial complex helps divert funds needed for care into the coffers of executives and shareholders.

Privatizing Medicare was Supposed to Reduce Costs and Give Beneficiaries More Choice:  It Hasn’t Worked Out that Way.

    MA is a creature of the Medicare Modernization Act of 2003. The right-wing of American politics accomplished a coup by setting Medicare on the road to privatization.  Currently over 50% of all beneficiaries have selected it over Traditional Medicare ™.  Federal policy is unfortunately driving Seniors into MA by allowing manipulative practices such as low premiums and a few benefits not available to TA beneficiaries.  Seniors are being led like lemmings into the arms of the insurance industry by disinformation and deceit. Organizations like the AARP in partnership with health insurers like UnitedHealth are the Pied Pipers.  

    MA is one of the most serious threats to the health and well-being of American seniors.  It robs money from care and transfers it into the pockets of investors and executives.  Many beneficiaries are happy with low premiums and add-ons not available under traditional Medicare such as Silver Sneakers plus some dental and vision care.  I can understand why many people who have it are pleased with their coverage.  It works for healthier beneficiaries until it doesn’t.      

    If MA beneficiaries should incur a costly service that is not in network, their assets could be wiped out.  Some retirees have no choice in the matter.  If their company or institution includes health insurance as a retirement benefit, it is most likely MA. Furthermore, I can’t blame anyone who is trying to avoid the premiums for supplemental coverage under traditional Medicare.  Avoiding bankruptcy and depletion of assets through a catastrophic sickness makes perfect sense for TA beneficiaries. But the supplemental insurance is a heavy burden that could be avoided if the Medicare program weren’t diverting so much funding to MA (see discussion below).

Seniors and People with Disabilities Would not be Struggling as Much If Big Health Insurance were not Stealing from Them.

    For seniors and disabled Americans to lose nearly $200 per month of their Social Security and choose between a large payout for supplemental or the risk of bankruptcy, is an injustice when privatized healthcare is stealing hundreds of billions of Americans’ tax dollars, payroll deductions, and hard-earned money through out-of-pocket expenses. The Physicians for a National Health Program (PNHP) has estimated that MA overcharged taxpayers by a minimum of 22% or $88 billion and potentially up to 35% for a total of $131 billion in 2022. If the high end of the estimate were correct, all of Part B premiums ($131 billion in 2022) or Part D premiums ($126 billion in 2022) could be covered by excessive corporate extraction of funds from Medicare.[5]  

    UnitedHealth is noting $25 billion in cash and cash equivalents on its 2023 balance sheet, CVS has noted $12 billion, and Humana is noting $5 billion. They have multiples of these amounts in long-term and short-term investments; they spend hundreds of billions on stock buybacks, dividends, and board and executive compensation. By digging into their assets, the cash rich health insurance business would be able to charge fair prices and stop their criminal behavior without much of a dent in a reasonable return on their investments.

In this Dark Age of Plutocracy, the Superrich & Corporations are Lying and Blaming Government & Ordinary Americans for Poor Healthcare and Excess Expenditures

     Americans earning wages and salaries are being subjected to a corporate network of disinformation and gaslighting.  President Biden is blamed for cutting Medicare when he is in fact attempting to protect the program.  The growing elderly population is blamed for federal debt and deficits when Medicare and Social Security have little impact on the federal budget (SS has none and over half of MC is paid through payroll deductions, premiums, and co-pays).  The nursing home industry blames taxpayers for failing to provide them with enough money to adequately care for the elderly and disabled patients in their beds while they spin a false hardship narrative.

    The Medical-Industrial Complex has established a network of front groups with a duplicitous message of doing good for Americans and has enlisted the aid of do-gooder nonprofits, universities, and individuals. This system and its apparatchiks aren’t all that clever.  Their organizational tactics are rather easy to discern.  The problem is that it is happening stealthily behind the scenes in Washington, D.C. and the 50 state capitals. The media is ignoring it. We intend to expose it and encourage everyone we can to join us in that endeavor.

[1] https://bettermedicarealliance.org/

[2] You can see the ad here: https://www.ispot.tv/ad/2UHG/better-medicare-alliance-cutting-medicare-thats-nuts.

[3] Reed Abelson & Margot Sanger-Katz (2023), “Biden Plan to Cut Billions in Medicaid Fraud Ignites Lobbying Frenzy,” https://w.w.w.nytimes.com/2023/03/22/health/medicare-insurance-fraud.html?searchResultPosition=1.

[4] Medicare Payment Advisory Commission (MDPAC), 2024, p. March 2024 Report to the Congress: Medicare Payment Policy – MedPAC

[5] Physicians for a National Health Program, (2023), Our Payments their Profits: Quantifying Overpayments in the Medicare Advantage Program. MA Overpayment Report (pnhp.org)

WHY DO THE  AMERICAN PEOPLE TOLERATE A POOR PUBLIC HEALTH SYSTEM ALONG WITH BAD HEALTHCARE THAT COSTS SO MUCH?

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By:

Dave Kingsley

Unchecked Bigness is One Factor Threatening our Democracy & Our Health

    Big corporations and big unions can be and indeed are in many cases bad for our health.  For instance, UnitedHealth, Centene, Cigna, CVS, and other healthcare-related corporations in the top 30 of the Fortune 500 have interjected themselves into our publicly funded medical care system as financial intermediaries and major influencers of government policy.[1]  Their motivation is protecting and enhancing shareholder value in the uniquely privatized, taxpayer funded U.S medical delivery structure.  They make money from sickness not wellness.  Prevention does not add to their bottom line, but treatment is quite lucrative – never mind the public interest.

    Big unions, which initially have laudable missions and continue to do much good, sometimes tend to degenerate into self-serving actors without concern for the health and well-being of the public.  This is particularly the case when our federal, state, and local governments attempt to protect our health from the dangers of fossil fuel.  Public efforts to stop irrational projects such as the Keystone pipeline often fail due to the power of the building trade unions in concert with industrial interests.[2]  The United Auto Workers and the big three auto manufacturers have successfully tapped the brakes on the Biden Administration’s planned transition to electric vehicles. Air quality and the threat to humanity from climate system meltdown are secondary to the short-term interests of big unions and gas engine manufacturers.

Indoctrination, Manipulation & Conditioning of the American People

   Why are we, the American people, passive and compliant in the face of an assault by special interests on our dignity and well-being?  The deterioration of service and quality at excessive prices is not only happening in healthcare.  We see it in airline travel, brick and mortar and online retail, technology (computers, software, and apps) – you name it.  Predatory economics have become the name of the game, which is simply this: “How can we lower quality and squeeze more out of customers/patients through lying and deceitful propaganda?”

    Customers and patients are not at fault. The dystopian part of the U.S. economy did not come about as the result of a revolution.  The wealth and political power of investors, owners of vast amount of assets, and corporations have been able to move economic behaviors incrementally and deceitfully from the unthinkable to the normal.  Propaganda and duplicity by forces with the resources to falsely convince the public that they are living in the best there is in the best of all possible worlds have been effective.  People tend to trust officious and authoritative, i.e. powerful organizations and individuals.  So, they hunker down and take it as they get fleeced through small incremental price increases and lower quality of goods and services.

    The primary healthcare industry business model can be compared to the air travel industry.  They incrementally lower quality and add value to revenue for investors at the expense of patients and consumers of medical goods.

    Through dissemination of false advertising and stories promoted by industry PR, the mainstream media – perhaps unwittingly – is helpful to corporate predators. As airlines herd passengers around like cattle and stuff them into increasingly uncomfortable flying tubes at ungodly prices, the media takes up the airlines’ cause by spreading the image of travelers as “unruly.”  The poor airlines are forced to put up with all those bad people.  Should I believe that or my lying eyes? I have traveled on the airlines extensively over the past 60 years.  I used to love it.  Now I hate it.  Furthermore, mostly what I see are cooperative, well-behaved people trying to adapt and endure the indignities, discomfort, and stresses heaped on them by extremely profitable, oligopolistic, and deregulated airlines.   

     Industries have leveraged highly sophisticated techniques of mass psychology for the purpose of pacifying the traveler, nursing home patients and their families, customers of health insurance corporations, users of computer applications, and so forth.  You probably don’t know that A Place for Mom is owned by private equity, that they don’t choose the best place, rather they choose the place that will pay them.  Did you know that the ostensibly pro-retiree-AARP’s deal with UnitedHealth is designed to lead the elderly down a primrose path into the waiting arms of the health insurance industry while the pro-beneficiary-Medicare program is destroyed?

    When you don’t see that the fine print included autorenewal, too bad. That’s your problem.  You have a serious glitch and need help.  That’s been outsourced to the Philippines.  Good luck with that. You didn’t know that the 5-minute life flight from Taos to Albuquerque cost $70,000 and was out of network? Now you’re stuck with the bill and will never find out what a reasonable price would be and why it’s not covered by your Medicare Advantage plan. You hear that those unfortunate, underpaid nursing home corporations are not making enough money to treat us and family members humanely. You could check their finances and verify what they are saying but the government allows them to operate behind a veil of secrecy. 

Big Government is Not Always Bad

    As the bottom ninety percent of Americans in income and wealth make their slow descent into economic serfdom, government agencies that are supposed to protect us have been neutered and checked by the politics of self interest and pseudoscientific economic theory.  Nonsense from major university economic departments, indeed from the overwhelming majority of economists, has been adopted as gospel by politicians and the media. Despite of the obvious failure and detriment from this proto-religious canon, it continues unabated and is as strong as ever.  The EPA, FTC, and other major government regulators have been reduced to going along to get along. This all while the ecosystem is collapsing, public health is deteriorating, and wealth and power is increasingly concentrated in fewer entities and individuals.

    The free-market, trickle down, government-busting theories of faux libertarians such as Hayek and Friedman have proven to be a chimera.  But that has become the underpinnings of U.S. government and economics.  Political power resides in the so-called center right to center left.    The Democratic Party and the Republican Party are both responsible for deregulation of corporations and privatization of government services.  It was President Carter that deregulated air travel, trucking, and banking industries. He kicked off a deregulation craze that has left the American people in an extremely vulnerable position.  President Reagan was a fanatical government hater and adopted the right-wing worship of corporations along with a cynical view of people that our-constitutional government is designed to serve.  The Democrats have made a little noise about the dismantling of government but have for the most part gone along with it and have even participated in it.

What Can the American People Do About Their Economic Plight?

    The first step in changing a corrupt system is exposing it.  The first step in exposure is to stop believing propaganda.  The AARP is not a friend of retirees – they are selling us out with their UnitedHealth partner.  A Place for Mom is not interested in your mom – they are looking to turn a quick buck.  Prevagen is snake oil.  Balance of Nature is a worthless capsule.  The FEC is allowing false advertising and consequently you can be robbed of your hard earned money at CVS and Walgreens. All the available evidence we can amass tells us that the nursing home industry is quite lucrative for investors. But the investors’ narrative of financial hardship is dominating the conversation.  Let’s put a stop to that.

    The second step in systems change is changing the narrative. Government is not bad – it is good.  Regulation is important.  Not long ago, I confronted some state legislators at a hearing about weak oversight of nursing homes and their finances.  That hadn’t been done before in that particular legislative committee.  Advocates need to take a strong stand in exposing fraud. 

The status quo is not OK.  Believe it. Demand change. Pick up the phone. Send emails and get your friends, neighbors and relatives to call and write.  Politicians respond to volume.  So, learn about an issue and organize people to confront  senators, congresspersons, and state legislators.  Get people to pressure the media to stop selling lies.  Learned helplessness is our enemy.  If you think that Medicare Advantage is a good deal, it may be for you, but down the road all Medicare will be controlled by a few insurance conglomerates. They will continue to create financial intermediaries such as pharmacy benefit managers for the purpose of adding value to their revenue at the expense of our care.

    Support those think tanks in Washington that you know are on our side.  The Committee to Preserve Social Security & Medicare is fighting for us.  The Committee for a Responsible Federal Budget and the Concord Coalition are working to reduce Social Security and Medicare benefits. I know these organizations well and have dealt with all of them.  The Committee for a Responsible Federal Budget and the Concord Coalition were organized with the backing of the late multi-billionaire Peter G. Petersen who was on a crusade to privatize Social Security & Medicare.[3]  If you think that his legacy is not a major negative influence in your life, you would be wrong.  Furthermore, politicians and the media are treating the Washington network he left behind with deference and respect it doesn’t deserve.  Believe it! Fight it!

[1] In 2000, none of these companies were in the Fortune 500 top 30.  Now UnitedHealth is the 5th largest corporation in the U.S. and 10th largest in the world.  CVS is the 6th largest U.S. corporation and healthcare related corporations make up one-third of the top 30 U.S. companies in the Fortune 500. 

[2] I spent a career in labor relations on management’s side of the table.  Most of the unions with which I negotiated were building trades unions such as sheet metal workers, operating engineers, laborers, pipe fitters, boiler makers, and electricians in mining, construction, and heavy manufacturing.  I believe that unions are good thing until they aren’t.  The companies I worked for believed in good faith bargaining, but we took strikes and work stoppages that were counterproductive for the union members, companies, and the public. At this stage of our economic system, I don’t think that we can leave the plight of workers to the unlikely event that they will organize and improve their standard of living.  Politicians need to step up. I do not want to overlook the good that labor unions have contributed to the working classes.  They have fought for health & safety, an end to child labor, better pay and benefits so richly deserved by the people without whose labor corporations would not exist.  I think that they still fight hard for social justice.  We have much more good from the labor movement than bad.

[3] Working with the Committee to Preserves Social Security, the Gray Panthers, and other groups I have spent countless hours over the decades in Washington, D.C. fighting the duplicitous cabal of Peter G. Petersen funded think tanks and other Wall Street back entities trying to grab off the $trillions in tax-funded programs for investors.  It’s a tough fight and one that is undermined by organizations that appear to be do-gooders but are really representing the other side.