Saturday, November 07, 2009
I've been watching the debate on CSpan all day - very busy over on Twitter...
If you were watching and playing a drinking game where you took a drink every time a Republican said "government takeover" or "freedom" or "liberty," you would have had alcohol poisoning early in the day.
If you have not been watching here are some must read about events:
We got off to a bad start when Pelosi gave into a vote on the Stupak Amendment barring funding for abortion.
Late yesterday, the United States Conference of Catholic Bishops met with leaders in the House of Representatives in their bid to eliminate women's access to abortion care under health care reform.
We have just received news that their efforts are working, and Representative Bart Stupak has introduced an amendment to the health care reform bill that will result in women losing health care coverage for abortion.
We urgently need you, and your friends and family, to call your representative. After you call, just reply to this message and let us know how it went.
If the bishops and their anti-choice partners in the House succeed, they'll permanently alter health care in America, even taking away benefits from women that they have today. The bishops want to effectively eliminate abortion coverage in both private plans and the public option. We simply cannot stand for such a discriminatory, mean-spirited attack on women.
Twitter was a flutter with all of use reporting in calls to our reps urging them to NOT support this amendment in the vote. It does not cut off funding just for those in a Public Option, but cuts off funding for a legal medical procedure from any insurance policy purchased through the health care exchange.
Then the fun began... GOP Gone Wild: Unruly Republicans Silence Women Lawmakers With Screams, Shouts, And Delay Tactics - be sure and watch the video. Remember how it is to try and debate a 2 year old? It was like that.
This morning, the House began consideration of the rule for debate of the House health care bill. As the Democratic Women’s Caucus took to the microphone on the House floor to offer their arguments for how the bill would benefit women, House Republicans — led by Rep. Tom Price (R-GA) — repeatedly talked over, screamed, and shouted objections. "I object, I object, I object, I object, I object," Price interjected as Rep. Lois Capps (D-CA) tried to hold the floor.
President Obama pays a visit to the House Democratic Caucus and says: 'Vote Yes' - GOP Will Attack Regardless Of How You Vote
The president, according multiple attendees, played the role of political prognosticator during his roughly 30 minute address before Democratic caucus members on Capitol Hill. Addressing, implicitly, those conservative Democrats who are worried about voting for a nearly trillion dollar health care overhaul, he insisted that they would not be safe from partisan attack even if they opposed the bill.Back at the White House, he gave another short speech:
"He certainly talked about the politics and he said that the Republicans want us to fail and no one should feel if they as a Democrat helped us to fail that they would be [free of their attacks]," said Rep. Henry Waxman, chair of the powerful Ways and Means Committee.
"None of you can expect the Republicans not to go after you if you vote against this bill," Waxman continued, channeling the president. "They want this bill to go down for their own partisan reasons."
Now, no bill can ever contain everything that everybody wants, or please every constituency and every district. That's an impossible task. But what is possible, what's in our grasp right now is the chance to prevent a future where every day 14,000 Americans continue to lose their health insurance, and every year 18,000 Americans die because they don't have it; a future where crushing costs keep small businesses from succeeding and big businesses from competing in the global economy; a future where countless dreams are deferred or scaled back because of a broken system we could have fixed when we had the chance.
What we can do right now is choose a better future and pass a bill that brings us to the very cusp of building what so many generations of Americans have sought to build -- a better health care system for this country.
Millions of Americans are watching right now. Their families and their businesses are counting on us. After all, this is why they sent us here, to finally confront the challenges that Washington had been putting off for decades -- to make their lives better, to leave this country stronger than we found it.
I just came from the Hill where I talked to the members of Congress there, and I reminded them that opportunities like this come around maybe once in a generation. Most public servants pass through their entire careers without a chance to make as important a difference in the lives of their constituents and the life of this country. This is their moment, this is our moment, to live up to the trust that the American people have placed in us -- even when it's hard; especially when it's hard. This is our moment to deliver.
I urge members of Congress to rise to this moment. Answer the call of history, and vote yes for health insurance reform for America.
I am betting there thare has never been a debate on a bill watched by so many people. Blogs, Twitter and places like Reddit and Digg are full of citizens watching CSpan and live blogging, commenting, posting articles and links. Technology has allowed us to come together in a huge virtual living room. We've done it on election nights - but probably never before on debate on a bill on the floor of the house. Amazing.
Final remarks from both sides are being made before the vote. This bill is not all I wanted - far from it. But it is now, the bill we have. And it is a start. I'm going back to watching and twitter now. Want my attention on the votes as they are cast - which should start soon.
MUCH OF the health care debate is focused on whether the country can afford the $850 billion the Congressional Budget Office estimates it will cost. The debate centers on whether the bundle of new taxes, credits, efficiencies, and Medicare spending cuts will be sufficient to offset the new spending so as to deliver health care reform without, in President Obama’s words, “adding a dime to the federal deficit.’’
This debate misses the point. It assumes that doing nothing will cost nothing. It turns out that not expanding health insurance is a pretty costly option, because uninsured people impose big financial and economic costs that are not properly appreciated.
The key question is: what difference does it make if you have health insurance? Several major medical studies have determined that people with health insurance have lower death rates compared to the uninsured, fewer medical ailments, and better all-around health. This means more individuals contribute to the economy for longer. Not having health insurance means these economic benefits are lost.
A number of studies confirm the significance of this impact. For example, a landmark study by the Institute of Medicine estimated that 18,314 Americans between 25 and 64 die each year because of a lack of health insurance. These deaths are largely because of failures to diagnose illness and to limited access to good quality care. However, that study was based on data from 1993. A new study, to be published in the December issue of the American Journal of Public Health, puts the number of deaths among Americans between the ages of 18 and 64 associated with lack of health insurance at 44,789 a year.
The premature death of thousands of Americans can be translated into monetary terms using the economic “value of a statistical life.’’ Government economists use this methodology to help determine whether the cost of new government regulation (stricter pollution controls, for example, or food safety rules) is worth the value of lives saved. Insurance companies also use this approach to help estimate compensation levels for wrongful death. These estimates vary widely, from around $3 million to $12 million.
US government agencies typically use a figure around $7 million to represent the lost economic output from each death. If we conservatively use only half of the government figure, or $3.5 million, it suggests that the annual cost to the US economy of 40,000 deaths is about $140 billion. That adds up to a cost of more than a trillion dollars over a 10-year period - even taking future inflation into account - well above the cost of enacting a health care package.
A second way to estimate the cost of not enacting health care legislation is in terms of life expectancy. US life expectancy - at 78.11 years, ranks around 40th in the world and well below countries with universal health care. If we were to match Canadian life expectancy, for example, that would translate into an extra two years and 1 month of life expectancy for every American.
Economists use another measure for the value of an additional year of life, adjusted for the quality of life. A recent study by Stanford economists has demonstrated that the average economic value of a year of human life is about $129,000. Most insurance companies, and many countries around the world, already use a variant of this concept. They implicitly ascribe the value of an additional year of human life at $50,000 by setting that as the threshold for approving treatments. (Any treatment that costs $50,000 will be reimbursed if it is predicted to add another year of life for the patient).
Without health care reform, the economic cost imposed by premature deaths and avoidable illnesses will continue to grow, to the detriment of the economy. As it enters the final debate on health care reform, Congress needs to weigh carefully the substantial cost of doing nothing.
Friday, November 06, 2009
Speaker Nancy Pelosi
November 6, 2009
Pelosi Statement on Congressman Anthony Weiner’s Single Payer Alternative
Washington, D.C. – Speaker Nancy Pelosi issued the following statement today on Congressman Anthony Weiner’s single payer alternative:
"Within the next few days, the House will vote on the most comprehensive health care legislation in our history. Our bill will provide affordability to the middle class, security to our seniors, and responsibility to our children by not adding a dime to the deficit. While our bill contains unprecedented reforms, including an end to discrimination for pre-existing conditions and a prohibition on raising rates or dropping coverage if you become ill, our bill cannot include provisions some strongly advocated. The single payer alternative is one of those provisions that could not be included in H.R. 3962, but which has generated support within the Congress and throughout the country.
"Congressman Anthony Weiner has been a forceful and articulate advocate for the single payer approach and our legislation. His decision not to offer a single payer amendment during consideration of H.R. 3962 is a correct one, and helps advance the passage of important health reforms by this Congress. While single payer, like other popular proposals, is not included in the consensus bill we will vote on this week, Congressman Weiner has been a tireless and effective advocate for progress on health care, and his work has been a vital part of achieving health care reform."
Committee on Energy and Commerce
Chairman Henry A. Waxman
November 6, 2009
Chairman Waxman's Statement on Rep. Weiner's Single-Payer Amendment
Today Chairman Henry A. Waxman released a statement in response to Rep. Anthony Weiner's decision not to offer a single-payer amendment to the House Democratic health care legislation.
"Rep. Anthony Weiner has been one of the most tireless and effective advocates for health care reform. His decision not to offer his amendment on the floor was a difficult one for him, and for supporters of the measure. I believe Rep. Weiner's choice will be enormously helpful in passing the health care reform package. His step is a correct and courageous one. I thank Rep. Weiner for it, and look forward to working with him closely. Rep. Weiner deserves a great deal of credit for helping to make quality, affordable health care more available to millions of Americans."
Comment by Ida Hellander, M.D., Executive Director, Physicians for a National Health Program:
Next steps and interpretation -
1) The fact that single payer got so far along in the House is a testament to the strength of our single payer movement. The huge number of calls by single payer advocates in support of single payer and the Weiner amendment in recent days have been noted by several members of Congress.
2) It appears that nobody, particularly the President, expected our single payer option to be alive in the Congress for so long. As you know, they attempted to keep it "off the table" from the very beginning.
3) The President was directly involved in the decision to not hold a vote on the Weiner single payer amendment, and Weiner will be meeting with him later today. Stay tuned.
4) We need to increase pressure on the Congress and the White House for Medicare for All through lobbying, civil disobedience, media outreach, and grassroots organizing. Sen. Sanders will call for a vote on single payer in the Senate - this could come up anytime in the next month. Encourage your Senator to support the Sanders bill and also an amendment he will offer for a state single payer option. The California Nurses Association/NNOC has already started lobbying visits in the Senate in D.C.
5) We have been asked how to tell members to vote on the House bill. Our response is that the bill is "like aspirin for breast cancer."
Note from David Swanson and Action Items below...
It was expected that the Weiner Amendment would get a vote today, but Representative Weiner has withdrawn it:
Washington, DC – Today, Representative Anthony Weiner (D - Brooklyn and Queens), a member of the House Energy and Commerce Health Subcommittee, released the following statement on his decision to withdraw his single payer amendment to H.R. 3962, the House health care reform bill:Source
"I have decided not to offer a single payer alternative to the health reform bill at this time. Given how fluid the negotiations are on the final push to get comprehensive health care reform that covers millions of Americans and contains costs through a public option, I became concerned that my amendment might undermine that important goal."
"I am going to continue to press the case for health care reform in every venue I can. And I also will continue to press for a smarter, less-expensive, more-comprehensive alternative to the employer-based health insurance system we have today."
"I've discussed the issue with Speaker Pelosi, Chairman Waxman, and agree with them that the health reform bill is so close it deserves every chance to gain a majority."
Last Night, Representatives Dennis Kucinich and John Conyers, Sponsors of HR-676, the Single-Payer bill that Weiner's amendment was about, posted statements on several blogs and news sites warning about this vote because they feared it would not get the votes needed in the current political landscape and could harm future reform actions by setting a low benchmark.
Tomorrow, the House of Representatives is scheduled to consider a single payer bill. As the two principal co-authors of the Conyers single payer bill, we want to offer a strong note of caution about tomorrow's vote.
The bill presented tomorrow will not be HR676. While we are happy to relinquish authorship of a single payer bill to any member who can do better, we do not want a weak bill brought forward in a hostile climate to unwittingly accomplish what would be interpreted as a defeat for single payer.
Here are the facts: There has been no debate in Congress over HR676. There has not been a single mark-up of the bill. Single payer was "taken off the table" for the entire year by the White House and by congressional leaders. There has been no reasonable period of time to gather support in the Congress for single payer. Many members accepted a "robust public option" as the alternative to single payer and now that has disappeared. The Congressional Budget Office (CBO) has scored the bill scheduled for a vote tomorrow in a manner which is at odds with many credible assumptions, meaning that it will appear to cost way too much even though we know that true single payer saves money since one of every three dollars in the health care system goes to administrative costs caused by the insurance companies. Is this really the climate in which we want a test vote?
While state single payer movements are already strong, the national single payer movement is still growing. Many progressives in Congress, ourselves included, feel that calling for a vote tomorrow for single payer would be tantamount to driving the movement over a cliff. The thrill of the vote would disappear quickly when the result would be characterized not as a new beginning for single payer but as an end. Such a result would be seen as proof that Congress need not pay attention to efforts to restore in Conference Committee the right of states to pursue single payer without fear of legal attacks by insurance companies.
We are always grateful for your support. We are now asking you to join us in suggesting to congressional leaders that this is not the right time to call the roll on a stand-alone single payer bill. That time will come. And when it does there will not be any doubt of the outcome. This system of health care injustice will not be able to endure forever. We are pledged to make sure of that.
Congressmen John Conyers and Dennis Kucinich
So... we live to fight another day.
Andy Cobb has had enough. A former pitchman for BlueCross Blue Shield of Florida, Cobb is breaking with the firm and speaking out in favor of health care reform and a public health insurance option.
"This is the time when Americans have to choose which side we're on," Cobb told HuffPost, quoting Rep. Dennis Kucinich (D-Ohio). "Is it the insurance companies or the American people?"
Cobb calls on what he dubs his fellow "spokes-jerks" -- singling out the FreeCreditReport.com guy -- to stop hawking products that hurt the American people.
Cobb teamed with Brave New Films to create the short video.
"I do know that 19 percent of every dollar of our premiums goes to administrative costs, for executive compensation and people like me. We can't afford people like me any more in this country," he said.
Thursday, November 05, 2009
"Despite spending more than twice as much as other developed countries, the United States still lags behind in terms of access and quality, an international survey said Wednesday," Agence France-Presse reports. The Health Affairs study, which was based on survey responses from thousands of primary care physicians, also found that people in the United States were more likely to struggle to gain access to or pay for treatment than patients in 10 other countries evaluated because of insurance restrictions and high health care costs. "The United States is the only industrialized democracy that does not ensure that all of its citizens have health care coverage, with an estimated 36 million Americans uninsured," the French news agency reports (11/5).
The Seattle Post Intelligencer's travel writer shares the views of some residents of other developed countries on their native health systems. A person from Sweden – one of the countries covered in the Health Affairs survey – says, "The health and medical services have an obligation to strengthen the situation of the patient, for example, by providing individually tailored information, freedom to choose between treatment options, and the right to a second opinion in cases of life-threatening or other particularly serious diseases or injuries. Having lived here all my life and raised my family here in Stockholm, I honestly do not see anything bad with our health care system" (Steves, 11/4).
As House Democrats prepare to vote Saturday on a bill to overhaul the nation's health care system, they picked up an important endorsement Thursday from the 40-million-member AARP, the nation's largest senior citizens group and the nation's largest doctor group.
AARP, which has been pushing for a health overhaul for more than a year, had withheld a formal endorsement of any of the bills being developed by Democrats. That endorsement was followed by a noon Central time announcement from the Chicago-based American Medical Association in which the nation's largest doctors group voiced its support for the measure.
AARP Executive Vice President Nancy LeaMond said Thursday that the group saw the House Democratic bill as the most promising proposal.
More at chicagotribune.com
Congressman Weiner's office is saying that because of our phone calls, faxes, and demonstrations, Speaker Pelosi is keeping her promise to allow the Weiner single-payer amendment a vote on the floor of the House. I am getting conflicting opinions about whether or not a full floor debate is going to be allowed.
After nearly being shut out of the discussion completely, single-payer Medicare for All will get a vote for the very first time in history - probably tomorrow - Friday, Nov. 6th.
This is the one opportunity for your elected officials to go on record as supporting the only universal, comprehensive, cost-effective solution to the health care crisis. There are currently 87 cosponsors of HR 676, but this vote will make it clear to the movement which elected officials are truly with single-payer, Medicare for All.
We need you to call today!
Ask your Representative to vote YES for the plan that most American people, nurses, and physicians want and so desperately need: Medicare for All - Rep. Weiner's single-payer amendment.
If you know who your Rep. is, the Congressional Switchboard number is (202) 224-3121. If not, go here to use the tool provided by Healthcare-NOW!--it's easy and toll free.
NEXT: After you have called your representative, please call Speaker Pelosi and thank her for allowing this promised vote and ask her to make sure it is allowed a full debate. Ask her to release CBO scoring for this amendment. The public deserves to see how much money Single-Payer would save while providing all citizens with affordable, accessible and sustainable access to health care.
Speaker Nancy Pelosi:
- Washington, DC, office (202) 225-4965;
- San Francisco office (415) 556-4862
Now, pat yourself on the back - then get back to calling!
Wednesday, November 04, 2009
The House is moving toward a floor vote Saturday on its big health care overhaul, after Democratic leaders worked to nail down votes from some of their members who want stronger anti-abortion language in the bill.
The House vote is expected at 6 p.m. Saturday. The Rules Committee would have to meet 24 hours before the debate to prepare the bill for floor action, but Slaughter declined to say exactly when Rules would meet.I had CSpan on in the background and at one point, when reporting this, they said that CQ also said that Rep. Slaughter also said the Weiner Amendment would get a vote then. That is not in this CQ article, so I don't know right now if that is true.
Tuesday, November 03, 2009
Sen. Orrin Hatch says that the Healthcare reform bills threaten survival of two-party system because it would make the Democrats too popular and thus the citizens would not want to vote in Republicans who might fuck it up. Hatch is effectively saying he would rather 47,000 American citizens die per year because it helps the GOP's election chances.
Read it at The Hill
The US Catholic Conference of Bishops is telling priests to oppose health care reform in upcoming weekly masses with both leaflets and in sermons - by saying that it will provide for abortions.
This is a lie and a shame for all Catholics and people who view providing basic health care to the 47 million without health care in the US a moral obligation.
Sebelius: No public abortion funding in health care bill
WASHINGTON -- Health and Human Services Secretary Kathleen Sebelius pledged Sunday that President Barack Obama will support barring public funding for abortion in any health care overhaul legislation.
"That's exactly what the president said and I think that's what he intends, that the bill he signs will do," she said on ABC's "This Week."
Currently, federal money can only be used for abortions that deal with pregnancies resulting from rape, incest or that endanger the mother's life.
"There's no intent to change the language that's in the current Medicaid statute, which has been there for years and provides insurance to millions of Americans," Sebelius said Sunday.
Monday, November 02, 2009
There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care. As Halvorson explained, and academics and consultancies have repeatedly confirmed, if you leave everything else the same -- the volume of procedures, the days we spend in the hospital, the number of surgeries we need -- but plug in the prices Canadians pay, our health-care spending falls by about 50 percent.
In other countries, governments set the rates that will be paid for different treatments and drugs, even when private insurers are doing the actual purchasing. In our country, the government doesn't set those rates for private insurers, which is why the prices paid by Medicare, as you'll see on some of these graphs, are much lower than those paid by private insurers. You'll also notice that the bit showing American prices is separated into blue and yellow: That shows the spread between the average price (the top of the blue) and the 90th percentile (the top of the yellow). Other countries don't have nearly that much variation, again because their pricing is standard.
The health-care reform debate has done a good job avoiding the subject of prices. The argument over the Medicare-attached public plan was, in a way that most people didn't understand, an argument about prices, but it quickly became an argument about a public option without a pricing dimension, and never really looked back. The administration has been very interested in the finding that some states are better at providing cost-effective care than other states, but not in the finding that some countries are better at purchasing care than other countries. "A health-care debate in this country that isn't aware of the price differential is not an informed debate," says Halvorson. By that measure, we have not had a very informed debate. But download this pack of charts (pdf), and you'll be a bit more informed.
The lobbying expenses of the top 13 health insurers and their industry association, America's Health Insurance Plans (AHIP), spent nearly $8.2 million in the third quarter of 2009 to influence Congress on upcoming health care legislation, according to analysis released today by the nonpartisan campaign finance watchdog Public Campaign Action Fund (PCAF). The total marks an 11 percent increase over the pace of their spending in the first half of the year.
According to PCAF analysis, which was based on figures compiled by the Center for Responsive Politics, these top insurers and AHIP have spent $22,957,382 to lobby Congress and the Administration from January through September. AHIP, the insurers' trade association, has spent more than $6 million this year. The analysis reviewed data for the top insurance companies as identified by Fortune magazine's rankings.
Coventry Health Care
Health Net Inc
Universal American Financial
"These insurance industries have invested heavily in expensive lobbyists and campaign contributions to make sure their needs are met while the rest of us are stuck with a broken health care system and little way to have our voices heard in Washington," said Donnelly. "It's time to sever the ties between special interest money and our elected officials. It's time to pass the Fair Elections Now Act."
ACTION NEEDED TODAY: Democratic House leaders can insert what is called a "Manager’s Amendment" into legislation, even when it is closed to any other amendments. The managers are the majority and minority members who "manage" debate for the bill on each side.
Today, tomorrow, and beyond, we need to call these "managers" and insist that the Kucinich Amendment is restored into the healthcare bill.
The "gang" that holds our future in their hands - the people you need to call NOW - are:
* Speaker Nancy Pelosi:
- Washington, DC, office (202) 225-4965;
- San Francisco office (415) 556-4862
* Majority Leader Steny Hoyer:
- Washington, DC, office Phone - (202) 225-4131 - Fax - (202) 225-4300
- Greenbelt office (301) 474-0119;
- Waldorf office (301) 843-1577
* Rep. Henry Waxman:
- Washington, DC, office (202) 225-3976;
- Los Angeles office (323) 651-1040
* Rep. Charles Rangel:
- Washington, DC, office (202) 225-4365;
- New York office (212) 663-3900
* Rep. George Miller:
- Washington, DC, office (202) 225-2095;
- Concord office (925) 602-1880;
- Richmond office (510) 262-6500;
- Vallejo office (707) 645-1888
NOTE: When talking to Waxman and Pelosi's offices be sure to also tell them you want the vote on the Weiner Amendment she and Waxman promised on July 31st - We also need and have a right to see the CBO scoring on the Weiner Amendment.
Sunday, November 01, 2009
The American Medical Student Association (AMSA) urges Speaker Nancy Pelosi to keep her promise and allow a vote on a single payer substitution amendment to the House health care reform bill, to be introduced by Representative Anthony Weiner [D-NY].
Rep. Weiner plans to submit an amendment that would replace much of the House health care reform bill with single payer language modeled upon Representative John Conyers [D-Mich.] HR 676. He withdrew this amendment from committee proceedings in July in response to a promise by Congressional leaders, including the Speaker, that legislators would be given an opportunity to vote on the amendment in a full session of the House.Read it all.
Now, Speaker Pelosi indicated she may restrict any House floor amendments - a backpedal on her promise. In addition, the merged House bill, unveiled yesterday, removed language from an earlier approved amendment in committee by Rep. Dennis Kucinich (D-Ohio), that would facilitate states' ability to enact single-payer within their borders. The Speakers' restriction on amendments removes any chance to reinsert this language that has already seen bipartisan support.
Friday, October 30, 2009
Seven Members of Congress have now signed a letter to House Speaker Nancy Pelosi requesting that Democratic Leadership restore the Kucinich Amendment to the health care reform bill before bringing the bill for a vote.
Added to H.R. 3200 in the Education and Labor Committee, the Kucinich Amendment removes an obstacle for states that seek to enact a statewide single payer health care system.
In addition to Congressman Kucinich (D-OH), Representatives John Conyers, Jr. (D-MI), Eric Massa (D-NY), Neil Abercrombie (D-HI), Janice D. Schakowsky (D-IL) Lynn C. Woolsey (D-CA), Raúl M. Grijalva (D-AZ) have signed the letter.
The full text of the letter follows:
October 30, 2009
The Honorable Nancy Pelosi
Speaker of the House
U.S. House of Representatives
H-232 The Capitol
Washington, D.C. 20515-0001
Dear Madam Speaker,
We write to request that the Kucinich amendment that would grant a waiver of the application of ERISA to a state single payer plan be included in the Manager’s amendment to H.R. 3962.
Like many other important reforms included in the underlying bill, the Kucinich amendment is the object of attack by the insurance industry. Unlike other reform measures, Leadership has chosen to strip the Kucinich amendment of the protection it deserves. In view of the power of the insurance industry to divide and conquer good ideas for reforming health insurance in this country, we believe that a simple vote on the floor would be a setback for the amendment and for single payer health care, because it would be exposed to the full brunt of the insurance industry’s attacks.
Progressives are firm and emphatic in their support for the single payer health care. A single payer, Medicare for All health system is the best way to control costs, drive up quality and extend care to all. Allowing states to opt for a single payer plan is a compromise. It is an incremental reform. But it allows the country to move incrementally in the direction that is needed.
The Kucinich amendment strikes a balance between where we need to go and where we can go in the next week. We urge you to include it in the Manager’s amendment.
From the Center for American Progress:
Consumers have a strong interest in picking a company that will reliably pay their legitimate claims when they need medical treatment. But health insurance companies don’t disclose the percentage of claims they reject and decline to pay. And inquiries by the Center for American Progress show that the nation’s insurance regulators have not asked them to do so.
CAP in recent weeks launched an investigation to determine whether data on commercial health insurers’ claim denial rates is available nationwide or in any states. The research included interviews with multiple senior officials of the National Association of Insurance Commissioners, other current and former insurance regulators and government officials in states around the country, officials at health insurance companies, academic experts, and others. All said that no such data is available. No state insurance regulators or federal agencies require insurers to disclose their claim denial rates, except in California. California’s Department of Managed Health Care requires insurers to include it in reports they file.
CAP also asked each of the nation’s seven largest for-profit health insurers—Aetna, Anthem Blue Cross Blue Shield, Cigna, Coventry, Health Net, Humana, and UnitedHealth care—if for the purposes of this report they would disclose their overall rates of claims denials and breakdowns by reason for the denials. All of the companies declined or did not give any direct response to the request. Spokesmen for the companies in general said that the insurers pay the vast majority of claims, and that denials are fair, with most occurring for routine reasons such as a patient erroneously submitting the same claim twice or a physician sending a claim to the wrong company.
But the reports from California indicate why health insurance companies may be reluctant to disclose their claim denial rates. That data shows that three of the six largest health insurance companies in the state each denied 30 percent or more of all claims filed in the first six months of 2009. It also showed wide variations in denial rates among the companies.
The most sensitive and potentially controversial claims are those based on medical criteria—such as whether a treatment is medically necessary or should not be covered because it is deemed experimental. CAP learned in interviews with former senior medical personnel at several of the largest insurers that big insurers—including Aetna, Cigna, and UnitedHealth care—made internal changes in recent years that gave business executives more direct authority over the companies’ doctors who evaluate claims based on these medical criteria.
Insurance companies had previously maintained a separation between the medical evaluation staff and the executives responsible for financial performance. The doctors and nurses reported to the companies’ chief doctor—known as the chief medical officer—who had final say on whether coverage for a particular individual’s treatment should be granted or denied based on medical criteria. But beginning about a decade ago, in a shakeup that evidently received no public attention, companies changed their policies so that the medical staff reported to regional business executives. These executives were given the authority to determine the doctors’ pay, bonuses, and promotion, and consequently they gained the power to influence the doctors’ decisions. The new systems generally kept “dotted line” reporting to the chief medical office, who would still weigh in on the most difficult claims decisions
Read it all...
Wednesday, October 28, 2009
Reconciliation gained new relevance on Tuesday, when Sen. Joe Lieberman (I-Conn.) said that unless the public option is stripped out, he's prepared to join a GOP filibuster of the health care reform package. Without Lieberman, Democrats would only have 59 votes to end a filibuster -- one short.
Majority Whip Dick Durbin (D-Ill.), who is in charge of corralling and counting votes, also said that reconciliation is still being considered. "The failsafe on this is reconciliation," Durbin said. "I hope we don't reach it because you can only do a limited amount of things on reconciliation."
Durbin was referring to the Senate parliamentarian's ability to strip out parts of any bill going through the reconciliation process that don't have a direct impact on the budget. (More on reconciliation here.)
But reconciliation is also a club that Reid can swing at conservative Democrats and Lieberman.
Read the rest at Huffington Post
The goal of the Charter Oak Health Plan is to provide affordable health care coverage to Connecticut adults, aged 19 to 64, of all incomes. It’s the first time every uninsured adult in Connecticut can get quality, affordable health insurance, and it costs as little as $75 per month in premiums, depending on your income.Read more at Daily Kos
Looking to build pressure on moderate Democrats, the U.S. Chamber of Commerce says it will begin airing new TV ads in seven states and on national cable television attacking the emerging legislation, including a government-run insurance option.Read more....
Members of Hispanic organizations from all over the country on Tuesday presented Latinos United for Healthcare, a platform to support the health care reform currently being debated in Congress and designed to inform Hispanics about changes in the system.
The National Hispanic Leadership Agenda, representing 29 organizations, and the League of United Latin American Citizens decided to create an organization to channel their efforts in favor of health care reform, which they said is at "the most critical time" in the debate in Congress.
Guess what happens when you stand in the way of something the public really wants... like a government run health care program...
From The Center for Public Integrity
After raising $1.1 million from January to June, the committee raised less than $87,000 between July and September — less than it brought in during any one of the preceding five months. And in just three months, the Blue Dog PAC's monthly fundraising average dropped by more than $50,000 — probably not the sort of fiscal conservatism the 52-member coalition was hoping for.
California One Care is the focal organization for the Single Payer movement in California. Their plan is as ambitious as it is well planned and will be as visible as it will be instrumental in bringing about to the whole country the ONLY Public Option framework that makes sense.
The main attractions included the outrageous Paula Poundstone and the outstanding California Senator Mark Leno, author of the centerpiece of this 3 year plan Senate Bill 810 (SB 810).
But perhaps THE main attraction was the 32 30 second spots featuring Hollywood celebrities such as Lily Tomlin, Elliott Gould, Ed Begley Jr., Valerie Harper, Ken Howard, Connie Stevens, Laraine Newman, Susan Savage and many more.
The spots which will air starting in February 2010 after SB 810 is passed in Sacramento were produced by the indefatigable Don Schroeder who is the liaison between California One Care and Hollywood. He also presented the 3 year plan to make California be the first state to adopt Single Payer.
Read it all
Tuesday, October 27, 2009
Sen. Joe Lieberman (I-CT) said Tuesday that he’d back a GOP filibuster of Senate Majority Leader Harry Reid’s health care reform bill.
Lieberman, who caucuses with Democrats and is positioning himself as a fiscal hawk on the issue, said he opposes any health care bill that includes a government-run insurance program — even if it includes a provision allowing states to opt out of the program, as Reid has said the Senate bill will.
Asked about Lieberman’s threat to filibuster a final vote on the Reid plan, White House press secretary Robert Gibbs said: "I haven't seen the report from Sen. Lieberman or why he's saying what he's saying. I think Democrats and Republicans alike will be held accountable by their constituents who want to see health care reform enacted this year.”UPDATE - Be sure and take the time to read Marcy Wheeler's piece:
Lieberman said that he’d vote against a public option plan “even with an opt-out because it still creates a whole new government entitlement program for which taxpayers will be on the line."
His comments confirmed that Reid is short of the 60 votes needed to advance the bill out of the Senate, even after Reid included the opt-out provision. Several other moderate Democrats expressed skepticism at the proposal as well, but most of the wavering Democratic senators did not go as far as Lieberman Tuesday, saying they were waiting to see the details.
Lieberman did say he's "strongly inclined" to vote to proceed to the debate, but that he’ll ultimately vote to block a floor vote on the bill if it isn’t changed first.
Hey Reporters??? It Might Be Worth Pointing Out Lieberman Is Stupid or Lying…
So here’s what Joe Lieberman claims the public option will do:
* Be costly to taxpayers
* Drive up premiums
* Involve cost-shifting to private plans
* Create an entitlement
* Increase the national debt
* Put more of a tax burden on taxpayers
As DDay points out, this is utter nonsense.
Lieberman’s justification on this is just nonsense – the public option would SAVE money for the government, to the tune of $100 billion dollars over 10 years according to the Congressional Budget Office. It also would cost nothing to the taxpayer, being financed by individual premiums.Now, there’s the possibility that if the public option was set at Medicare +5, there might be cost shifting, if you ignored challenges to that claim, if you ignored the way insurance companies will game the system to push high cost people into the public option, and if you ignored the many other ways the insurance companies will be cost shifting themselves once this system is set up.
But everything else Lieberman said is horse puckey. He is either completely ignorant about health care works (unlikely, for a Senator from Connecticut). Or, he’s lying his ass off as to his rationale.
Don’t you think the press ought to call him on that?
During an appearance on Rachel Maddow's program, Senator Ron Wyden said that he would fight all the way to floor to open the public option to everyone, not just the 10% who cannot get private insurance as is the case now. He says this is the time for progressives to demand that the rhetoric of choice matches reality in policy. As Wyden says,
The bottom line is that the public option can’t really hold private insurers accountable if it is only competing for 10 percent of the insurance market, because private insurance companies aren’t going to change their business practices if 90 percent of their customers can’t take their business elsewhere.
Real reform means empowering Americans to choose insurance that works well for them and their family, while rejecting plans that don’t. Including a public option is a step in the right direction, now let’s remove the firewalls in this bill that prevent Americans from choosing it,'' Wyden said in a statement.
Currently the Public Options being discussed would be open to 10% who have no other access to health insurance. This population would be disproportionately filled with very medically high risk people, and the cost of insuring them, even under a government sponsored public plan, could quickly skyrocket. Dumping by the big insurers during the first couple of years while reforms were still "kicking in" could further exacerbate this, effectively bankrupting the public plan (which must be law be self-sustaining) before it ever has the chance of succeeding.
Employee based coverage, Mandates and Opt-Outs:
Some additional thoughts I want to make sure you understand. Right now, only small businesses, those who can't get insurance and those who buy insurance on the individual market will be eligible to purchase insurance on the exchange. If you work for a large employer who offers bad insurance coverage, you can't purchase something better for yourself through the exchange or public option.
Most citizens no longer count on remaining with the same employer for 5 years, much less 20 and in the last few years, we've seen that it is not uncommon to have to change jobs multiple times within a few years. Should you also have to be switching insurance companies and doctors every time you change jobs? An individual able to buy their own insurance on an exchange or through the Public Option would not be burdened with that constant change - which frequently depending on the insurance plan, may require changing healthcare providers.
If states are allowed to opt-out of the Public Option, then shouldn't the citizens of those states who do want and need a public option have access to it on their own? Especially if there are mandates that everyone must have insurance.
The entire health care exchange along with the Public Option should be open to all citizens. Wyden's Free Choice amendment is not mere icing; it is essential. We should definitely rally to support this.
The New Republic had a forum in Washington, D.C. this morning and Representative Anthony Weiner shared his thoughts on this issue. Ezra Klein reports:
Monday, October 26, 2009
Reid says he’s moving forward with a Senate bill that has a public option with an opt-out in it "with the support of the White House, and Senators Dodd and Baucus." He says that the Senate bill will also have co-ops included - which confuses me a bit. My hope is that he is not considering the co-ops a public option. And of course, just who will be allowed to participate in the Public Option is still fuzzy. So while we don't know just what the Public Option will look like, the best news is that we don't have the "trigger" deeply disappointing Olympia Snowe.
From the Los Angeles Times:
Fueling the push for a new government insurance plan, Senate Majority Leader Harry Reid (D-Nev.) said today that his chamber's healthcare bill would include a compromise that would create a nationwide public option but give states the right to opt out.
"The public option is not a silver bullet, [but] I believe it's an important way to ensure competition and to level the playing field for patients with the insurance industry," Reid said. "Under this concept, states will be able to decide what works for them."
Reid sent the proposal to the nonpartisan Congressional Budget Office to be analyzed today, a key step before he can bring a bill to the floor for debate.
His decision does not settle the debate roiling Democratic ranks over how to create a government plan that would give consumers who don't get coverage through their employers an alternative to plans offered by commercial insurers.
The "opt-out" compromise is still two votes shy of the 60 Reid needs to overcome a Republican filibuster, according to a senior Democratic aide on Capitol Hill who requested anonymity when discussing the plan.
Reid and House Speaker Nancy Pelosi (D- San Francisco) are advancing separate healthcare bills in the Senate and House, which would have to be reconciled later this year before they are sent to the White House for President Obama's signature.
But Pelosi indicated Friday that the opt-out alternative could be included in a reconciled bill.
For now, House Democrats are poised to pass a bill that would create a nationwide government plan, although there is still disagreement about how much such a plan should pay doctors, hospitals and other medical providers.
Liberals, including Pelosi, favor a proposal that would link those payments to the existing Medicare program, which often pays providers less than commercial insurers. Proponents believe such an arrangement would save money and help drive down costs.
But many conservative Democrats, particularly from rural areas where Medicare typically pays less, want the government plan to negotiate its rates with providers, as commercial insurers do.
Pelosi hopes to settle those differences in time to unveil a bill later this week, according to her office.
The U.S. healthcare system is just as wasteful as President Barack Obama says it is, and proposed reforms could be paid for by fixing some of the most obvious inefficiencies, preventing mistakes and fighting fraud, according to a Thomson Reuters report released on Monday.
The U.S. healthcare system wastes between $505 billion and $850 billion every year, the report from Robert Kelley, vice president of healthcare analytics at Thomson Reuters, found.
"America's healthcare system is indeed hemorrhaging billions of dollars, and the opportunities to slow the fiscal bleeding are substantial," the report reads.
"The good news is that by attacking waste we can reduce healthcare costs without adversely affecting the quality of care or access to care."
One example -- a paper-based system that discourages sharing of medical records accounts for 6 percent of annual overspending.
"It is waste when caregivers duplicate tests because results recorded in a patient's record with one provider are not available to another or when medical staff provides inappropriate treatment because relevant history of previous treatment cannot be accessed," the report reads.
Some other findings in the report from Thomson Reuters, the parent company of Reuters:
"American physicians spend nearly eight hours per week on paperwork and employ 1.66 clerical workers per doctor, far more than in Canada," it says, quoting a 2003 New England Journal of Medicine paper by Harvard University researcher Dr. Steffie Woolhandler.
- Unnecessary care such as the overuse of antibiotics and lab tests to protect against malpractice exposure makes up 37 percent of healthcare waste or $200 to $300 billion a year.
- Fraud makes up 22 percent of healthcare waste, or up to $200 billion a year in fraudulent Medicare claims, kickbacks for referrals for unnecessary services and other scams.
- Administrative inefficiency and redundant paperwork account for 18 percent of healthcare waste.
- Medical mistakes account for $50 billion to $100 billion in unnecessary spending each year, or 11 percent of the total.
- Preventable conditions such as uncontrolled diabetes cost $30 billion to $50 billion a year.
- "The average U.S. hospital spends one-quarter of its budget on billing and administration, nearly twice the average in Canada," reads the report, citing dozens of other research papers.
A group of 51 legislators - including two area lawmakers - is trying to push the state's landmark 2006 health care reform law even further by establishing single-payer health care.
"Could the reason this bill enjoys so much support by legislators be because only 60-70 percent of our health care dollars are actually spent on health care," Patrick asked of the Joint Committee on Public Health yesterday. "Could it be that legislators deal directly with the discontent of constituents under the current 'revamped'system in Massachusetts?"Contact Congress in support of the National Single-Payer Amendments Now. Of special importance to the Massachusetts legislation is the Kucinich Amendment to H.R. 3200 on the House, which enables states to enact their own single payer programs without running into problems with ERISA laws.
Patrick said a single-payer system would control the problem of rising health care premiums, which he said have increased by 130 percent nationally since 1999. Patrick said the problem of rising premiums is even more pronounced in Massachusetts, and have made the state's current health care system unsustainable.
"We have the highest cost for health care, per capita, in the history of the world," Patrick said.
Dr. Stephanie Woolhandler, professor of medicine at Harvard University, testified that studies in the New England Journal of Medicine have shown a single-payer system would reduce state health care costs by 15 percent, amounting to $9 billion in savings.
UPDATE: I neglected to mention that Pennsylvania is also experiencing a push for Single-Payer:
Close to 1500 Pennsylvanians packed the main capitol rotunda recently to call for passage of a bill that could make their state the first in the nation to put a single payer health insurance plan in place.
Following the rally, the crowd broke into smaller groups, and many headed for the offices of key legislators to urge support for the two key bills which would bring a single payer plan to the keystone state. House Bill 1660 and its companion Senate Bill 400 have the support of organizations ranging from PNHP and the Progressive Democrats of America to the Pennsylvania AFL-CIO, represented at the rally by its president Bill George, to the non partisan League of Women Voters. Governor Ed Rendell has said he would sign single payer legislation if it reaches his desk.
According to news reports, Senate Majority Leader Harry Reid is sending the Senate's health care bill to the Congressional Budget Office today, and may unveil the bill publicly as early as tomorrow.
The bill reportedly includes a public option, but states may opt out of the program.
According to the Wall Street Journal, it also includes a $750 fine per employee for employers who don't provide insurance and whose workers receive government subsidies for health insurance.
It will also prohibit insurers from dropping or denying coverage to sick patients.
Sunday, October 25, 2009
Businesses would not be required to provide health insurance under legislation being readied for Senate debate, but large firms would owe significant penalties if any worker needed government subsidies to buy coverage on their own, according to Democratic officials familiar with talks on the bill.Read it all at NYTimes.com
For firms with more than 50 employees, the fee could be as high as $750 multiplied by the total size of the work force if only a few workers needed federal aid, these officials said. That is a more stringent penalty than in a bill that recently cleared the Senate Finance Committee, which said companies should face penalties on a per-employee basis.
These officials also said individuals would generally be required to purchase affordable insurance if it were available, and face penalties if they defied the requirement.
Single-Payer would be so much less expensive and less confusing... Keep telling your Senators and Representative that is what you want.
One of the reasons that I am a strong proponent of a single-payer, Medicare-for-all proposal is that it is much less complicated than what we are going to end up with in Congress. A single-payer approach saves hundreds of billions of dollars a year because you don’t end up with thousands of different health insurance programs appealing to all different kinds of people and costing a fortune to administer. I am going to continue the fight for single-payer. I am cautiously optimistic that we may end up with legislation that will allow states to go forward with single-payer if they want to.
Saturday, October 24, 2009
Progressive Change Campaign Committee will air a new TV ad, and is gathering signatures on an emergency petition, warning the administration not to support a health care compromise, favored by Sen. Olympia Snowe (R-ME), that could kill the public option.
Rate this video up at YouTube | Sign The Petition
Keep making those calls! We got a little more time than we thought Thursday night. Don't stop now. While you are talking to them be sure you ask for their support for the Weiner Amendment and to keep the Kucinich Amendment in the final bill.
Updates from the Washington Post and Representative Raul Grijalva below...