Rush Limbaugh

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RUSH: We’ll start in Champaign, Illinois. This is John. Great to have with us, sir, hello.

CALLER: Mr. Limbaugh, hi.


CALLER: I’ve got a quick question about health insurance.

RUSH: Yes, sir.

CALLER: The government already mandates auto insurance, and there are hundreds, if not thousands of profitable auto insurance companies. Why wouldn’t the same thing work for health insurance companies?

RUSH: Have you been reading the Wall Street Journal today?

CALLER: No, I have not.
RUSH: Well, then you are amazingly bright, and I’m not surprised that you would be in this audience. I was going to mention this during our health care discussion today. It’s a piece in the Wall Street Journal written by Steven Burd. He is the CEO of Safeway and the founder of the Coalition to Advance Healthcare Reform. Now, the picture painted by the American left is that American corporations are evil, that they exist to rape and take advantage of their own employees, that they can’t be trusted, that they have to have their payment, their salaries controlled by Obama’s thugs. So when you know that that’s the template that this administration has painted and the American left for years has painted of CEOs, reading this op-ed by Steven Burd in the Wall Street Journal is amazing. It’s entitled: ‘How Safeway Is Cutting Health-Care Costs — Market-based solutions can reduce the national health-care bill by 40%.’

Here’s how he starts the piece: ‘Effective health-care reform must meet two objectives: 1) It must secure coverage for all Americans, and 2) it must dramatically lower the cost of health care. Health-care spending has outpaced the rise in all other consumer spending by nearly a factor of three since 1980, increasing to 18% of GDP in 2009 from 9% of GDP. This disturbing trend will not change regardless of who pays these costs — government or the private sector — unless we can find a way to improve the health of our citizens. Failure to do so will make American companies less competitive in the global marketplace, increase taxes, and undermine our economy. At Safeway we believe that well-designed health-care reform, utilizing market-based solutions, can ultimately reduce our nation’s health-care bill by 40%.’ They’ve done it at Safeway.

‘The key to achieving these savings is health-care plans that reward healthy behavior,’ and this gets to John’s question. ‘As a self-insured employer, Safeway designed just such a plan in 2005 and has made continuous improvements each year. The results have been remarkable. During this four-year period, we have kept our per capita health-care costs flat (that includes both the employee and the employer portion), while most American companies’ costs have increased 38% over the same four years. Safeway’s plan capitalizes on two key insights gained in 2005. The first is that 70% of all health-care costs are the direct result of behavior. The second insight, which is well understood by the providers of health care, is that 74% of all costs are confined to four chronic conditions (cardiovascular disease, cancer, diabetes and obesity). Furthermore, 80% of cardiovascular disease and diabetes is preventable, 60% of cancers are preventable, and more than 90% of obesity is preventable.

‘As much as we would like to take credit for being a health-care innovator, Safeway has done nothing more than borrow from the well-tested automobile insurance model. For decades, driving behavior has been correlated with accident risk and has therefore translated into premium differences among drivers. Stated somewhat differently, the auto-insurance industry has long recognized the role of personal responsibility. As a result, bad behaviors (like speeding, tickets for failure to follow the rules of the road, and frequency of accidents) are considered when establishing insurance premiums. Bad driver premiums are not subsidized by the good driver premiums.’ Good driver premiums are low. So all they’ve done at Safeway essentially is say, okay, here’s how they’re doing with auto insurance, that’s how they’re doing it at Safeway. They’re simply demanding responsibility from their employees, and that keeps the costs down. It’s exactly what I was talking about yesterday when Snerdley was so afraid that I had insulted the nation.

I reminded people of the story in a small Texas town where nine people had made 2,600 visits to an emergency room in six years. Basically we have gotten to the point in our society where health care — because it’s been drumbeat into us that it’s a right — is that health care is something as free as breathing, that you’re entitled to it as much as you are water coming out of the faucet. And if you get a sniffle or a sneeze, off to the doctor you go, or off to the emergency room you go if you don’t have insurance. It’s gotten to the point here where there’s no personal responsibility. Now, when you talk about behavioral things in terms of preventing obesity or diabetes, type two diabetes is related to obesity. And, of course, obesity can be controlled. It’s hard, but it can be done. Cancer is another thing. Sixty percent — I’m sure that’s a reference to smoking and this sort of thing.

But his point is nevertheless well made. You can go out and get an auto insurance policy that’s pretty affordable and makes sense. You have to have it, the state mandates that you have to have it. So you get it, it’s pretty low if you have a good driving record. That’s why people don’t want points. They don’t want to get pulled over, and so forth. What if the same attitudes could be applied to people in the way they live and their health? And that’s all they’ve done at Safeway and they’ve kept costs static for four years. They have not risen. Now, imagine this, a private sector CEO — supposedly the bane of our existence, evil people, they want to rape and exploit their employees — showing the way here. Now, you know what’s going to happen to this guy next week in the media. He’s going to be destroyed. The Obamaites will do it.


RUSH: You know, yesterday during our discussion of health care, I was trying to remember where I had read that doctors are reimbursed, you know, not a full 100% on their billing in Medicare cases and I have heard from a number of doctors who have told me it’s much worse than what I thought I knew. I want to read an e-mail from one just to give you a flavor of kind of e-mails I’ve been inundated with.

‘Dear Rush,

I am a Medicare physician, unfortunately. We do not get reimbursed 81% of anything. The old method of pricing services was called ‘usual, customary, and reasonable.’ That was before Medicare. That concept of ‘usual, customary, and reasonable’ is long gone. Nowadays we’re simply told by Medicare what the fee is for sure any given service we either agree to participate in Medicare and take their price fix or not. Now, if you wanted to use a percentage comparison, you would have to figure out what a physician would charge a patient in the free market and compare that to the Medicare fee — and I can tell you that number would be far lower than 81%. When I get the very rare patient who actually pays cash out of pocket for their cataract surgery, I charge them $2,500. Medicare pays me about $700 for a cataract surgery.

That’s 28%, Rush — and this is typical across all of medicine, not just cataract surgery. The Medicare fee schedule is not based on anything. It’s pulled out of thin air. Worse, they have managed to create an internecine class warfare among doctors. They’ve pitted primary care against surgeons. Every time there is a call for increased payments by primary care, they maintain those increased payments have to be offset by cuts in payments to specialists and this has been going on for years. This inter-doctor battle plays right into the hands of the socialized medicine takeover as you can well imagine. Over the last 44 years of Medicare the private insurers have seen that the doctors just roll over and take Medicare payments, so the private plans have slowly decreased their payments down to the Medicare rates. If we want to see patients we have no choice but to accept these fee schedules. I can tell you anything you want to know about these topics if you need the inside information.

This doctor is from Texas.

It is worse than I thought, and of course they’re ramming more and more people into Medicare — and this is what Obama meant when he said he’s going to put the squeeze on doctors. He’s going to squeeze ’em even more in order keep their fees down, and then that’s going to lead to, ‘Who’s gonna want to go into the profession?’ So it’s all messed up out there. And, by the way, the government pays you when they’re good and ready. There’s not a reimbursement schedule that makes sense that they can be held to, and it’s only going to get worse if the whole program is eventually nationalized and socialized because there’s going to be nowhere else for anybody to go to get paid and you have to put up with whatever you have to put up with dealing with a bureaucracy.


RUSH: Now, I shared with you the op-ed in the Wall Street Journal written by the CEO of Safeway, Steven Burd (B-u-r-d), who has devised a plan that has not cost his company additional money over the last four years. By the way, his employees pay a portion of their health care, too. It’s not totally company-provided. But they’ve modeled it after the auto insurance industry. The auto insurance has various premiums based on your driving record. The way Safeway is doing it, they’re offering insurance premiums and health care coverage to their employees based on their behavior, and do they take risks in their lifestyle or not, and if they do they have a higher premium. Now, what’s going to happen? This guy, Steven Burd, who with his op-ed today, has just blown a hole through the template that the left and people like Obama have been working on for the last 30 years, and that is that corporate CEOs are mean, evil, rotten people.

They exploit and use their employees. They don’t care about the welfare of their employees. They only care about their own payments. They rape their companies. They fly around on corporate jets. They go to parties. They don’t care whether the company makes money or not. They get paid anyway and we’re going to stop this, blah, blah, blah. Now, what’s going to happen to this Steven Burd guy if he’s not careful, is there’s going to be an investigation into how much money he makes. There will probably be an investigation into his political contributions. If his credibility can be undermined, it will be. Forget the results of his brilliant approach to keep health care costs down. This guy has just made Obama look bad.

He’s just made the Democrats look bad. All the stories about harmful food products will be Safeway centric. Safeway customers will be the only ones interviewed in stories about healthy foods and those people will be asked if they hold Safeway responsible for selling unhealthy foods. ‘Did Safeway market these products in a seductive manner? Did you feel they took advantage of you?’ Television will do these exact same stories outside of Safeway stores and we’ll see the Safeway sign in the background. This guy, if they take note of this piece — if this piece gets any traction at all, standard operating procedure on the American left is to go out and find a way to destroy this guy using their buds at state-controlled media, whose claim to fame is built on destroying people. I hope it doesn’t happen. But history suggests that there’s a good likelihood of it happening. Any stories about evil tobacco will somehow work Safeway stores into the story.

Same thing with soft drinks, snack foods, ice cream, butter, candy, obesity. They’ll claim he’s a hypocrite. While he’s out there demanding proper behavior from employees, selling all on that unhealthy food to mothers blah, blah, blah, blah, blah, blah, blah. Safeway going to be the default backdrop about any negative story with health food, corporate greed, you name it. Safeway just put itself in the crosshairs with this. This guy is gutsy. He’s very courageous, because this is not advancing Obama’s agenda. This is a piece demonstrating how we don’t need Obama’s agenda. What is this when you get right down to it? This is individualism, this is incentives, and this is personal responsibility all tied into a health care plan offered by Safeway. You see, I thought American corporations were evil, that they existed to abuse and take advantage of their own employees. You can’t trust these CEOs and so forth. So it’s going to be interesting here to see how it falls out.


RUSH: Here’s Emmett in Houston. Great to have you on the EIB Network, sir. Hello.

CALLER: Thanks, Rush. It’s great to talk to you.

RUSH: Thank you, sir.

CALLER: I wanted to go back to the Safeway op-ed piece in the Journal this morning, and I want to emphasize something that I thought was very important. The Safeway plan is a self-funded plan, meaning they’re self-insured and they can decide and design the plan the way they want to within the confines of state and federal regulations. And to me it’s a segue into discussing the mandates and things you talked about the other day in the insurance industry. I like to view the insurance companies as bookies. They’re not gambling on our health. They want and have been the source of medical inflation for the last quarter century because the more money goes in for the premiums; yes, the more they pay out in claims. But in the meantime, they hang onto the money, the same way the bookie takes his 10% cut or juice. And I hold the insurance companies mostly responsible for the medical inflation we’ve experienced the last quarter century.

RUSH: Well, everybody has their enemy in the health care industry. You don’t like the insurance companies. I don’t like the government. I don’t like Medicare, Medicaid. I don’t like the autocratic way they run it, the way they’re short-changing doctors. But you make a good point about Safeway. It’s electable. It’s not forced on them. The whole point of the Safeway CEO’s op-ed was to say we’re fashioning our health care insurance that’s offered to our employees after automobile insurance, and in automobile insurance, you have a pretty varied fee structure, or premium structure. Because if you drive well, and if your kids don’t bang up the car very much, you can get a lower premium and people get points on their license than if they’re running stoplights and having accidents. So the point is, the auto insurance agency has low fees, midrange and high premiums.

The Safeway guy was pointing out: We offer a bunch of different fee structures here based on the employee decision on behavior. But Safeway doesn’t force employees to quit smoking. They urge it and suggest it. They don’t force them to not eat trans fat. All this is coming with a government plan! You’re going to be forced. They’re going to be able to regulate every aspect of liberty because, folks… Remember the story earlier from today. The Democrats are saying they’re not even going to pay attention to the CBO scoring of this how much it’s going to cost because it’s going to be so high nobody would agree to pay for it. So they’re going to ask Obama’s Office of Management and Budget to do their own scoring and come up with a fake price that makes it look like we can support it. Regardless, it’s not going to be cheaper. There will be lines. There will be services not offered, particularly as you age. As you age, the federal government via its insurance companies will assess whether or not it makes sense to treat you if you’re going to croak in the next couple or three years anyway. And you could be left out. It’s the only way they can do it, and that’s going to be a part of it. But the government plan is gonna force everybody… They’re going to be able to get into every aspect of your life and regulate it, under the guise of ‘saving money’ and ‘covering everybody’ and so forth. Safeway is not doing that. They make it an elective. And their health care costs have not gone up in four years.

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