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Aug. 13, 2013 - Rush Limbaugh Program
36:41
August 13, 2013, Tuesday, Hour #2
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Hi, everybody.
Rush Limbaugh, America's real anchorman, America's truth detector and the doctor of democracy, all combined here as one harmless, lovable, adorable fuzzball.
Executing assigned host duties flawlessly, zero mistakes.
Here at the Limbaugh Institute, telephone numbers 800-282-2882, the email address, lrushbaweibnet.com.
An extensive discussion of the latest chicanery involving Obamacare being delayed in order to not harm Democrats.
The 2014 midterm elections, and we now go back to Stacey from the wilds of Georgia.
She's a regular, semi-regular caller to the program when she gets to itch.
She's an expert in the health insurance field in this country and has the unique ability to take all this complicated stuff and synthesize it down to make it somewhat understandable.
So let's pick up where you left off.
We're talking about the rising premiums, talking about the lower caps, but you say that there's something in this that involving pharmaceuticals, prescriptions, and so forth.
Why don't you pick up there at that point where we left off?
Sure, Rush.
And I want everyone to understand this is way more complicated than I'm making it sound, but I'm trying to explain it in a way that everybody will understand the impact to every single person who walks into a pharmacy or walks into a prosthetic store, who walks into any place that you're going to purchase a product that is supposed to be covered by your health insurance.
Okay.
Okay.
And the New York Times article claims that the insurance company's computers can't handle this.
Well, I'm here to tell you that's a load of bull.
We can do it.
It's a database change.
It's no big deal.
Here's the problem.
There's not real-time connectivity between all the pharmacies, all the pharmacies in your town, all the mental health providers in your town, all the prosthetic providers in your town.
They don't communicate real-time with your insurance company.
But we're supposed to be able to, in real time, tell these people how much you have to pay to buy your prescription or to see your shrink or whatever it is you're doing.
So emphasis.
That's for those who see a shrink.
Exactly.
Well, and the pharmacy is the one everybody, pretty much everybody's done.
You know, you've been to your doctor for an antibiotic or whatever.
You go to your pharmacy to buy your prescription.
Now, what happens in the background that you don't see?
There's three entities involved.
There's your pharmacy, your pharmacist, you're standing there at the counter.
There's what's called a pharmacy benefits manager.
You can think of them like AT ⁇ T or Verizon.
They're the people who are connecting the information from your insurance company to the pharmacy.
Okay?
Here's the problem.
They don't connect real time with the insurance company.
Usually it's a batch process that happens overnight.
So when you go to your pharmacy and you present your prescription for amoxicillin, your pharmacist enters the information into a computer and you see that happen.
What you don't know is that computer is going to the pharmacy benefits manager.
Where is this person?
Let's just say CVS.
Pick any pharmacy.
It doesn't matter.
But is he on site?
Is he in the pharmacy?
You're standing there at the counter waiting for this pharmacist to give you your medicine so you can go home and take it because you're sick.
You don't care what happens.
You just want to go home.
I understand.
I'm just trying to get a physical layout of where the pharmacist benefits managers actually end up.
They can be anywhere.
They can be in three states away.
They can be in India.
It doesn't matter where they are.
They'll be in Mumbai.
Okay, I just wanted to establish.
It doesn't matter.
What they're doing is they have the connectivity to your pharmacist.
And what happens is your pharmacist says, okay, pharmacy benefits manager, is this drug covered?
What tier is it covered?
How much does this person standing at my counter have to pay me to get this medicine?
Okay?
That's how it works today.
Under what is they're trying to do in Obamacare, and here's what happens when you have bureaucrats and politicians who have no idea how anything works try to mandate something like this.
At this point, the insurance company is processing claims.
You've been to your doctor.
You paid a co-payment, right?
So your daughter submits a claim.
We're processing that claim.
We're updating, okay, you had $1,000 and we're adding $30 to your out-of-pocket.
Well, you're staying there at the pharmacist, and your pharmacist has no idea how much you have to pay legally to get that medicine.
Well, but he charges you something because everybody gets out of there with their medicine.
Well, but here's the problem.
Okay, now you've got Obamacare that says that you can't charge over this amount.
If the pharmacist takes your money and legally he wasn't supposed to, he can get sued.
If your pharmacy benefits manager tells the pharmacist to take your money, they can get sued.
Stacey, how can he even set a price if they're not connected in real time?
This pharmacist manager, benefits manager, he can't possibly.
Sure he can because they're not connected to your health part.
It's a different, you can think of it as a bucket.
Think of it as a bank account.
Okay?
The pharmacy bit is coming out of its own bank account.
And then on the back end, the pharmacy benefit manager tells us, okay, Enos spent $100 worth of heart medicine at our pharmacy today.
We update our database with that.
No big deal because it's not critical today to know that.
But when all this Obamacare crap goes in, then it's critical to know real time, and that's the key.
Real-time exchange.
Why?
What's changing?
What about Obamacare is making real-time relevant?
Because if you, let's say you're almost at your out-of-pocket max, okay?
Let's say you got 20 bucks till you're there.
And you've been to your doctor, you paid a $20 co-payment, you go to your pharmacist to get your medicine.
Okay, by the law, you don't have to pay a dime for that medicine.
But the pharmacy benefit manager doesn't know that.
So the pharmacist doesn't know that.
So they're going to say, okay, you owe me $20 because that's what it was last night.
Okay, so what happens?
You pay the $20 that you don't owe.
Right.
Do you ever find out you didn't owe it?
Well, I'm sure you will at some point.
How?
We don't know yet.
Is it a report that's coming out the back end of us?
Is it a report coming out of the PBM?
We don't know.
Here's the problem.
You mean to tell me that if a consumer is charged $20 he doesn't have to pay, somebody in a week or two is going to get a hold of it and say, by the way, we owe you $20?
Sure.
Or you can credit it to you some, you know, that's the problem, Rush, is figuring out the money end of all of this.
The money end is very complicated.
And now, not only is it just that we don't want our patients to have to pay extra money, now it's a legal risk.
Now it's you take your $20 at the pharmacy, and then the patient can sue the pharmacy or the PBM or the insurance company.
Now, who's going to want to do that?
Who's going to want to hand you that over the counter for 20 minutes at CVS?
Right.
So here's what's going to happen.
They implement this stuff before 2014.
And you've got pharmacies who can't do the connectivity.
The PBMs aren't ready yet.
Remember, they're not covered under Obamacare.
They're not legislated to communicate in real time.
Never?
Never.
They don't have to.
They don't do it today.
They don't care.
It's not their problem.
But ultimately, it is because it's money.
And when money is in the market.
Ultimately, it is, but legally, their legal risk isn't as great as the insurance companies or the pharmacists.
But Stacy.
Think about it.
They're just mobile.
They're plugging it in.
Stacy, you know as well as I do that your industry is in the crosshairs now.
Oh, I know.
All of this is designed to practically make it impossible for you all to function.
I know, but here's the problem for 2014.
When Enos goes into a diabetic coma standing at the CVS counter because Enos can't get his insulin because the connectivity doesn't exist to tell him how much he owes, what's that going to do to the elections?
But all that's been delayed, hasn't it?
Well, it has now, and that's why.
Because people like me who work in this who know are going, you're going to have mass chaos.
But how is this any different under Obamacare?
Because there were caps before Obamacare.
And you could still be about to go over your cap now.
It doesn't matter whether it's now or 2050.
You can still be about to go over your cap.
Well, sure, but the difference is.
I just don't see how Obamacare changes this.
Because now it's one bank account instead of two.
Remember before I said you think about your pharmacy stuff coming out of one bank account and your doctor and hospital stuff coming out of a separate bank account?
Yeah.
Now it's one bank account.
And it's yours.
And you're pulling.
Money's coming in and out from all over the place.
It's the insurance company's account.
That's what you're saying here.
I'm using that as an example to try to visualize reality.
No, but I'm trying to understand the perspective.
You're in the insurance business.
You're describing problems for you.
For me and for everybody who needs medical care.
And this is going to impact everybody at the point of sale when you're standing there at that pharmacy counter with the flu waiting for your tamel flu.
I'll tell you something else they've done, Rush, that nobody's talking about.
I don't see how Obamacare changes any of this.
It seems to me that what's in the New York Times and Forbes today about these caps and delaying these massive premium increases, now that I can see.
Yes, but that, and that's the easy part.
That's the stuff that everybody gets.
This stuff that I'm talking about is the day-to-day impact to you standing there at your pharmacist or standing there at your, you know, waiting for your wheelchair, whatever it is you're doing.
And the fact that we, insurance company, cannot communicate real time with the pharmacist, with the prosthetic guy, with whomever it is.
So basically, this is a legal liability concern that you've got here.
Well, it's legal liability.
It's financial liability.
I mean, 20 bucks doesn't sound like a lot, but multiply 20 bucks by a couple of million subscribers.
Then you've got a financial disaster on the back end trying to figure out where all this money needs to go.
Remember, our goal is to never pay out more or less than we're supposed to.
You're speaking when you say our the insurance company.
Correct.
I mean, we want to pay what we're contractually obligated to pay.
No, you don't.
Let's be honest.
You don't want to pay.
You don't want to ever pay.
No, we don't.
You know what's funny, Rush?
Talking about the lifetime max.
Now, this is a totally different topic.
The lifetime maximum in my company, the standard is $2 million.
That was increased from $1 million about 15 years ago when an employee of the insurance company's wife came down with the necrotizing fasciitis, the flesh-eating bacteria.
I read about that.
She came down with it, and within six months, she had already had like $1.5 million in claims to save her life.
So the insurance company looked at these rare cases and said, okay, when you have this kind of infectious disease, your claims exposure is going to be greater.
So they bumped it up all by themselves to 2 mil.
But the problem with that is, and it's not so much a problem with $2 million as it is with Unlimited.
You as a subscriber or your employer, whoever it is that's paying those premiums, are never going to pay that much money in your whole entire lifetime.
You will never pay that much money to the insurance company for your premium.
Because you're not going to be in business long enough.
I don't care.
Whoever you are, you are never going to pay that kind of money.
That's true.
So basically, Obama just made us welfare distributors.
That's what we do now.
Okay, there you have it.
We don't do math anymore.
Strip it all away.
That's what you're doing.
It's just like the old general manager, the CEO of GM.
So, you know, I thought I got in the business to sell cars, and I'm a healthcare manager.
It's insane.
There's so many ways that you can fix this, and this definitely is not it.
But guys, guess what?
Now, it's not just your antibiotics or your insulin or your heart medicine.
Obamacare also has made it so that if your doctor prescribes aspirin daily aspirin for you, we now have to pay that.
No cost.
Who prescribes aspirin?
Doctors.
It's considered a standard treatment for heart problems.
Oh.
It's a blood thinner.
It's a low-dose blood thinner.
And now we have to pay for that.
You don't have to pay a dime for it.
If your doctor writes you a prescription, we have to pay for that.
We have to pay for breast pumps.
We have to pay for all this stuff that used to be paid by you if you wanted it.
You go get it.
Great.
But leave us out of it.
Now we have to pay in total for it.
Okay.
Look, I have dwindling time here, and I'm still confused.
I don't understand why one bank account or two bank account in your explanation.
Okay.
I don't know what's different now.
Okay.
As opposed to what's going to happen.
Let me ask you a question.
For this pharmacy benefits manager guy, whoever the hell he is in Mumbai.
Okay.
He's got his information that we link up nightly, okay?
And we say, Enos has met $1,000 of their out-of-pocket.
And we tell them that nightly, and then they send us a file that says, well, Enos went and got a $50 prescription, so add $50 to your bucket, and then the pharmacy benefit manager adds $1,000 to their bucket.
You see that?
Yeah.
How that data crosses?
That only happens once a night.
It's a batch process.
OK, so basically what you're saying, it's going to it's going to lead to a lot of incorrect payments and reimbursements.
Absolutely.
Absolutely.
That's what it's all about.
And the legal risk to the pharmacy is such that a pharmacist may just say, especially your independent guys, may say, you're going to pay me total out-of-pocket, and then you can submit a paper claim to your insurance company.
This is just nightmare.
This is ridiculous.
Bottom line here is this is just absolutely unnecessary ridiculous.
And there isn't anybody at the government level who's going to be able to make this happen, understand it, design it, oversee it, manage it.
This is, you know, I can see, I can see where a diabetic goes into diabetic shock at the counter, at the pharmacy, waiting for the prescription because all this stuff is going on because everybody's going to be scared to death if they don't do what the government says they have to do.
That's going to be the primary objective, staying out of trouble with the government rather than servicing the patient there on the other side of the counter.
And I can see it.
So somebody goes into diabetic shock because they don't have their insulin, who are they going to sue?
Stacey, thank you for holding on during the break.
I really appreciate it.
It's always enlightening to hear from you, always.
And thanks for your time today.
Sticking with the telephones, Billings, Montana.
Hi, Linda.
You're next on the Rush Limbaugh program.
Hi.
Hi, Rush.
First time listener, or first-time caller, long-time listener.
Just wanted to tell you how much I love you.
Thank you very much.
I was asked, I wanted to ask you, is anybody suing President Obama for not following through on this legislation?
You know, that is a fascinating question.
And constitutionally, Obama can't do this.
Yes.
The legislation is the legislation.
He cannot write legislation.
He cannot unilaterally change legislation.
He is not a dictator.
This is not an imperial presidency, although he's acting like it.
But if nobody is going to hold him accountable for these kinds of things, he can't do all of this.
He can't grant these waivers.
He can't do all these exemptions.
He can't just decide, I'm going to delay that part of the bill that I signed into law.
He cannot write legislation other than during the process, of course, he has a liaison with Congress and they might work.
But after it's signed into law, he can't go in and change it.
This is not how this happens.
This is extra constitutional, meaning outside the Constitution.
This is this.
It's the law of the land now.
He just can't decide willy-nilly when it is and when it isn't.
So what we have here is another change in Obamacare, which we're told is now the law and therefore can't be changed.
We're told we can't repeal it.
Obama himself says, we can't repeal it.
And the Republicans don't want anybody to have health care and all those lies that he tells.
And we can't repeal it because of the law of the land.
Well, he is, he is in effect repealing or delaying parts of it that are harmful to him politically.
Can't do this.
Suing him, somebody should.
This is not permitted.
You let a Republican president try to do this?
Change legislation to benefit him at the next election?
You wait and see how far he'd get.
Now, let me add one other thing to this, folks.
This move today of delaying this whole business on the caps, out-of-pocket caps, expenses, and so forth.
This is going to really increase the profitability of insurance companies.
And because it's going to do that for just this next year, the insurance companies are going to be paying out far less.
Their profits are going to skyrocket.
Now, I expect it will not be long until a bunch of far-left extremist kook networks and websites figure this out.
And they are going to start screaming bloody murder.
And Obama knows this.
This is the thing about this, when I first learned of this today, that was the main point that confused me.
Because what Obama is doing here, make no mistake, he is delaying this implementation of consumer cost protections.
Stop and think of that for just a second now.
In relationship to the elections in 2014, the Democrats want to win the House, hold the Senate, of course.
He is delaying consumer cost protections.
He is increasing insurance company profits.
Why?
How in the world is that going to help the Democrats?
That's going to anger a lot of people.
Well, there's a bunch of things at play.
I really don't think there are too many consumers who know the nuts and bolts details of how it is they are going to save money.
They just think they are.
Start talking to them about caps on out-of-pocket experience.
I mean, they might actually understand that in more numbers than I think.
But on one hand, insurance company profits skyrocket, consumer cost protections delayed to help Obama and the Democrats in 2014.
How does that work?
There must be something worse.
What's worse than this?
What's the other side?
The other side is if this is not delayed, everybody's premiums are going to skyrocket.
And it is clear to me that Obama has made his own cost-benefit analysis.
And the Democrats have decided that there is less damage to their electoral chances by delaying all this and making sure that insurance premiums don't skyrocket than the other way.
So insurance company profits are going to be much higher this year when the left wing, all that the pajama-clad bloggers and the anonymous lunatics that post comments to their websites and the doom costs at MSNBC, I mean, profit is like showing Dracula the cross.
Insurance companies are among the most hated of all capitalistic entities on the left.
So you combine increased profit for the hated insurance companies and you are going to have a bunch of really ticked off leftists.
Then you tell them that the insurance company profits are going to skyrocket because consumer cost protections are being delayed.
You are going to have, you've got a recipe here for genuine anger and disgust on the left.
But on the other side of it, skyrocketing premiums for everybody.
And they've obviously made the judgment that not delaying this presents them less of an obstacle than delaying it.
Now, I still go back to our last caller.
Legally, this can't be done.
I'm alarmed here at how many people simply sit here and accept it.
Oh, we're going to delay that?
Okay, fine.
We're going to delay it.
Oh, president cannot do this.
Our Constitution does not permit the President of the United States to willy-nilly decide what parts of a law he's going to employ or implement and not.
This is not legal.
What Obama is doing and has done on three major previous occasions where this law is concerned.
And while that's happening, the Republicans, some of them are making a noise about repealing it by way of not funding it in the next continuing resolution fight at the end of September.
And the Democrats say, you can't do that.
It's the law of the land.
You can't tamper with it like that.
Obama's even saying that.
You can't cancel a law.
It's the law of the land.
You can't defund it.
Why not?
The president can decide the parts that hurt him politically are not going to be implemented right now.
It can delay them.
This is banana republic kind of stuff, folks.
It really is.
But if there is nobody in the opposition that's going to push back against it, then guess who it's going to be left up to again?
You, the grassroots.
Or as Jocelyn Elders would say, the grass ruts.
It's going to be up to you to make, you know, raise hell about this.
But it really, this is a dramatic violation of the Constitution.
Obama has already delayed more than one-third of the deadlines in Obamacare.
And for a host of reasons.
A, they can't meet them.
B, it would be too damaging politically.
And the media runs around, well, Obama, he's only doing it for the people.
He's only doing it for everybody's benefit.
There's nothing really to see here.
You let any Republican president try this.
You let a Republican president say, you know what, I'm going to delay.
I'm going to delay that increase in food stamps.
We can't afford it right now.
I'm just going to delay that.
There would be smoke and fire and hell to pay in the Democrat Party and in the media.
And this is serious.
This is a serious violation of law.
This is a serious violation of the Constitution just to do this willy-nilly.
Then when you add to it, Obama's doing it for his party's political benefit.
That's the only reason this is being done.
And then the final point to be made is: here's this wonderful health care reform law that's supposed to be just compassionate and finally make sense and be beneficial to everybody and make it accessible and affordable.
It's so damn good.
We can't dare let it be implemented.
Maybe it isn't so damn good.
Maybe it is an absolute disaster.
And as long as there is an election out there in the future, we're going to delay the disaster until after the election so that you people voting do not have the full scope of information at your disposal to make the decision on how you're going to vote.
And this is what is going on.
It is pure, raw partisanship and unconstitutionality.
It really is.
Just stop.
Our last call had a great question.
Is anybody suing Obama for this?
No.
And that's essentially what it would take, a congressional action, go to a lawsuit or something.
But Congress is just idly standing by letting this happen.
And he doesn't write the law, folks.
No president does.
Presidents do not write the law, no matter what our low-information population thinks.
In fact, Obama's even said so at some of his public appearances where low-information voters have been demanding immediate relief on something.
Well, you know, I don't write law.
I can't write law.
We have our laws.
The Constitution I can't write.
Doesn't matter.
And you let anybody on the Republican side start talking about defunding.
You can't do that.
It's the law of the land.
That's not the way you can't.
You can't take the money away.
Well, Obama can certainly take the money away from it.
Obama can certainly deny implementation, delay it, or what have you.
And nobody raises a peep.
And again, a large reason why is the president's race.
It simply strikes fear in the hearts of the opposition.
Okay, I got to take a break when I get more of your phone calls.
Pete Rose says, you know what?
If I'd have beat my wife, if I'd have gotten hooked on cocaine, I'd still be in baseball.
I picked the wrong vice.
If I'd have beat my wife, if I had a bunch of illegitimate kids, if I went out there and was doing cocaine or heroin, alcoholic, I'd still be in this game.
But I chose gambling.
We have the audio soundbite.
The shopkeeper over in wherever it was, Switzerland, Sweden, wherever it was, Stockholm, really ticked off.
Oprah, apparently, in her view, lying about what happened in that little store where Oprah went in and wanted to buy a $38,000 Jennifer Anniston purse used, by the way.
Back after this.
Don't go away.
Pete Rose was on the radio in Pittsburgh yesterday, and he's using this performance-enhancing drugs scandal.
Pete would love to be reinstated.
Pete Rose loves baseball.
I mean, to this day, Pete Rose talks baseball.
He just loves it.
He'd love to be back in the game.
And he was on the radio in Pittsburgh yesterday and talking about the fact that he just chose the wrong vice.
I picked the wrong vice.
I should have picked alcohol.
I should have picked drugs or I should have picked beaten up my wife or my girlfriend because if you do those three, you get a second chance.
But they haven't given too many Gamblers second chances in the world of baseball.
Well, he's got a point.
It's hard to argue with that.
He's got a point.
There are all kinds of second chances given for all kinds of violations.
But not for him, because he was gambling.
Players, known alcoholics, drug addicts, a whole bunch of people that have personal lives, even professional, who skirt the edge, who have led dishonorable lives in many ways, found their way into the Hall of Fame, and are still part of the fabric of Major League Baseball.
He was banned in 1989, lifetime ban.
And I was going to say that he bet against his own team, and I don't think that's ever been really proven a long time ago now.
And I'm not sure about that.
Anyway, Oprah Winfrey's account of being racially profiled in a Swiss boutique is not true, according to the shop clerk.
Now, my memory is we've got audio in this.
I guess.
No, it doesn't matter anyway.
The Zurich Boutique clerk, accused of racially profiling the Oprah, is firing back, claiming that the Oprah's account is not true and that it's absurd.
She says, I would never say anything like that to a customer.
Really, never.
The woman still unidentified.
She's Italian.
And she was speaking to a Swiss newspaper on Sunday.
I don't know why the Oprah is making these accusations.
She's so powerful, and I'm just a shop girl.
I don't know why somebody as great as her must cannibalize me on TV.
The Oprah says that she wanted to take a closer look at a handbag that sells for around $38,000, but that the salesperson at the store refused to take it off the shelf.
The Oprah claims that the salesperson told her, nah, it's too expensive.
You couldn't afford it.
And so the Oprah went on TV to tell the story.
Isn't that a little bit fascinating?
Of all places to go on TV to tell the story at, well, yeah, while she's out promoting this movie, right?
She's on TV, and it's at this movie that she's in called The Butler, which is all about racism in the White House, right?
So quite naturally, she'd be asked about, have you ever been racismed against Oprah?
Yeah, you know what?
It just happened to me.
I was over there for Tina's wedding, and I wanted to buy this $38,000 bag, and this woman said, you can't afford it.
Now, why would she tell me that?
And the media was off to the races.
I mean, the Oprah didn't come off the airplane landing claiming it.
Yeah, she was asked about it.
Now, there is a further development here.
The Oprah now says that she is sorry that a media frenzy emerged after saying she experienced racism during this trip to Switzerland.
I think that incident in Switzerland was just an incident in Switzerland.
I'm really sorry it got blown up.
I purposely didn't mention the name of the store.
I'm sorry that I said it was Switzerland.
I was just referencing it as an example of being in a place where people don't expect that you'd be able to be there.
Oh, now I think the incident was an incident in Switzerland.
That's all it was.
I'm sorry it got blown up.
I purposely didn't mention the name.
You didn't have to mention the name.
All that has to happen here is the Oprah has to tell a fawning, sycophantic entertainment media in America that somebody misrepresented or was not kind to her when she wanted to buy something and implied it was racism.
And the media will pick the ball up and run with it.
And don't forget now that the clerk is saying that the Oprah's version never happened.
So this has not yet been fully, I don't think, fully dealt with here.
My guess is that the Oprah didn't expect that there would be any pushback from the store.
I think it was supposed to just end, and it is all about, not all about, it is happening in conjunction with the promotion of the movie that, by the way, the Oprah is already being touted as an Oscar winner.
Yes.
She's already being touted as giving an Oscar winning performance in this movie.
No question.
So you got to put all this stuff in context, folks, not leave it in the isolated sense that it sometimes appears.
It is the fastest three hours in media, and two of them are already there.
Yeah, that's right.
The shop owner, where the Oprah went in and was supposedly told, you know what, you can't afford that bag.
Look at you.
You can't afford it.
The shop owner was at Tina Turner's wedding.
So why didn't the Oprah talk to the shop owner there about it?
She didn't know her?
You know, what are you defending the Oprah for?
You believe her?
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