by Stephen Lendman

Milliman calls itself one of "the world's largest providers of actuarial and related products and services."

It provides independent consulting services. It does so in areas including healthcare among others. It says it maintains "rigorous standards of professional excellence, peer review and objectivity."

It publishes a Milliman Medical Index (MMI). It represents the projected cost for employer-sponsored managed care preferred provider organization (PPO) healthcare coverage. It does so for a family of four comprised of two adults and two children.

On May 23, Physicians for a National Health Program (PNHP) featured its latest MMI.

It reveals America's deplorable state of healthcare coverage. Obama's Affordable Care Act (ACA) made things worse.

It's a ripoff. It's a healthcare rationing scheme. It's a boon to predatory providers. For growing millions it's unaffordable. It leaves tens of millions uninsured. Millions more are left underinsured.

The IRS is empowered as enforcer. Once ACA is fully implemented in 2014, it's responsible for enforcing 47 new tax provisions.

Coverage for most Americans is mandatory. Failure to obtain it incurs a fine. The IRS is authorized to collect it. Imagine putting tax collectors in charge of healthcare. Doing so runs counter to providing an essential service.

For a family of four with two adults and two children, typical PPO cost is $22,030. It's 6.3% higher than 2012. Costs rise annually. Since 2009, they've done so more slowly.

Depressed economic conditions affect them. Millions of Americans shifted from private coverage to Medicaid. ACA's reduced reimbursement rates lowered costs.

Analysts expect these and related factors to be temporary. At some point, costs will again accelerate.

In 2012, the total year-over-year dollar increase was $1,302. It was the fourth consecutive year over $1,300.

Wages for most Americans are stagnant. Adjusted for real inflation, they're declining. Each year healthcare costs rise, insurance coverage becomes less affordable.

Expect growing numbers to be increasingly denied enough of what's vitally important to have when ill with expensive health problems.

For workers in companies providing coverage, MMI said last year's $22,030 cost was apportioned as follows:

• employers paid about $12,886;
• workers paid the remaining $9,144; doing so combines $5,544 in payroll deductions and $3,600 in out-of-pocket costs.

MMI expects little difference in 2013. Most far-reaching changes come in 2014. It's when ACA becomes fully effective. Insurance costs may be much higher. They'll continue to be annually.

Affording proper healthcare is getting incrementally harder. Growing numbers have to settle for less than they need.

Employer coverage is flawed. Increasingly the cost burden falls on workers. Low and middle income ones are hard pressed. Modest income-indexed ACA subsidies are inadequate.

Financing healthcare through employer-sponsored coverage is regressive. Lower earners pay much more disproportionately than more affluent ones.

America's high cost healthcare is outrageous. Annually the system becomes more dysfunctional. On May 22, Dr. Pippa Abston headlined "Cruelty or Care? The Choice is Yours," saying:

ACA "is neither protective nor affordable to patients." She called the Patient Protection and Affordable Care Act the "Profiteering Protection and Affordable Cruelty Act."

She read it all. It includes a menu of "corporate protections." She called it a "convoluted mess." It's much worse than she thought. Instead of "essential health benefits," "minimal essential coverage" was enacted.

Cost limits aren't imposed. Minimal essential coverage is "minimally described." In other words, it can be bare bones. Legal loopholes let employers game the system.

Expect workers to get much less than what's needed.

Catastrophic illnesses won't be properly treated unless employees pay much of the cost out of pocket.

Cruelty is ACA's operative characterization. "I don't know what else to call a system that not only allows but entrenches the abuses," said Abston.

She's a pediatrician. She treats children whose parents are underinsured. Many earn too little to afford expensive out of pocket costs. Proper care is unaffordable. "Cruelty, brutality (and) callousness" describe America's system, she says.

Abston's a Physicians for a National Health Program member. "(E)xpanded Medicare for All is a simple, achievable, affordable, practical" solution, she stresses.

"It doesn't require revolution, utopia or socialism." It's up to ordinary people to demand what they've been denied. "Will you speak up," she asked?

On May 20, the Wall Street Journal headlined "Employers Eye Bare-Bones Health Plans Under New Law," saying:

ACA loopholes provide employers significant leverage. They can offer "very limited plans that can lack key benefits such as hospital coverage."

"Benefit advisers and insurance brokers" pitch these plans. They offer preventive services. Often they cover little more. Some plans exclude surgery, x-rays and prenatal care.

Others pay hospitalization costs up to $100. In 1980, a typical US hospital room cost $127. Today it's tenfold that amount or higher.

ACA's "minimal essential coverage" lets most employers avoid costly penalties.

ACA's rigged in their favor. Employees are betrayed and denied. The Journal said it's unclear how many employers offer bare bones coverage. Some already signed on. Others consider doing so.

"An industry is sprouting around the tactic. More than a dozen brokers and benefit-administrators in 10 states said they were discussing the strategy with their clients."

ACA was designed to exclude affordable coverage. Millions will be denied treatment when most needed. Large employers with more than 50 workers need only provide bare bones coverage.

Smaller ones are mandated to do more. They employ about 30 million of the 160 million with private coverage. In other words, over 80% of workers and their family members may end up with third world care or worse.

Unaffordability assures it. Expensive illnesses won't be properly treated. Obama and complicit Democrats bear full responsibility.

Insurers, other healthcare providers, and large employers game the system for profit. Minimizing benefits assures it. ACA shifts responsibility to consumers, offers inadequate or unaffordable coverage, increases out of pocket costs, and forces Americans to pay higher deductibles for less care.

Doing so means they're denied it when most needed. Throughout his tenure, Obama's been waging war on America's social contract. ACA is a key component.

America's being increasingly thirdworldized. Growing numbers face dystopian harshness. Bipartisan complicity force-feeds it. Race to the bottom cruelty assures denying millions vital services when most needed.

It's the new normal. ACA is one of many examples. It made America's dysfunctional healthcare system worse. The world's richest country won't take care of its own. Ordinary people are on their own to change things. It's their only chance.

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Stephen Lendman lives in Chicago and can be reached at lendmanstephen@sbcglobal.net.

His new book is titled "Banker Occupation: Waging Financial War on Humanity"

http://www.claritypress.com/Lendman.html

Visit his blog site at sjlendman.blogspot.com

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http://www.dailycensored.com/milliman-medical-index-on-obamacare/