Tuesday, June 30, 2009

Monday, June 29, 2009

Got Health Insurance? Fighting for a Public Option Might Just Get You a Raise!

By Joshua Holland

The best argument for overhauling our ridiculously expensive and dysfunctional health care system -- an argument one doesn't often hear in the corporate media -- is that fixing it would put more dollars in your pocket, even if you already have health coverage.
But at the end of the day, people are most interested in the heft of their wallets. Ezra Klein argues that if people understood the health care debate in these terms -- reform the system and control costs; get a handle on costs and get a pay raise! -- it'd be a political game-changer.

"Most workers think stagnant wages mean their employer is paying them less," he writes. "They don't know that the main reason for stagnant wages is that their wage increases are going to pay for their health insurance premiums."

Over the past 30 years, economic growth hasn't made its way into most working people's paychecks. But -- and this is key -- the amount businesses have to pay for an hour of work has increased.
In a column debunking the industry's "propaganda," syndicated columnist Froma Harrop dispatched the spin with ease:

What about freedom to choose providers and treatments? Well, private insurance also sets rules on what it will cover and typically provides lists of preferred doctors and hospitals. If your plan lets you go out of the network, you have to pay extra for the privilege. Nothing wrong with that, but we must drop the romantic notion that private coverage affords total freedom at popular prices.

And while the whole point of a public option is to compete with private insurers -- using the same efficiencies and economies of scale that big corporations employ all the time to cut costs -- the notion that a public option would kill off private insurance is nonsense.

Harrop points out that, "Contrary to the propaganda, a government plan doesn't tell you what you can have. It tells you what it will pay for. You can buy whatever you want with your own money. And any well-designed plan would allow people to purchase private insurance to cover things the government plan doesn't."

In France, where they have a "single-payer" system, 9 out of 10 people buy supplemental insurance from the private sector.
It's a hybrid plan -- somewhere between the fractured for-profit insurance we have now and the kinds of health care systems the citizens of other advanced countries have. And while single-payer advocates (like myself) believe that creating a tax-financed universal insurance system that offers basic care to everyone is the cleanest, most straightforward way of financing health care (and has the greatest potential for savings), the thinking behind the hybrid plan is that it's vitally important to allow those who enjoy their current insurance to hold onto it.

Those who do would benefit from bringing health spending in line with overall economic growth. Getting a hold of rising health care costs frees up money for other priorities -- we currently pay more to Big Health than we spend educating our children, building roads or eating.

And contrary to the spin, getting the uninsured covered will cost less, over the long haul, than leaving them without care. Each and every one of us who has insurance is already spending almost a $1,000 per year to subsidize emergency care (and various unpaid hospital bills) for the uninsured, according to the National Coalition on Health Care.

And even discounting the moral questions of leaving people living in one of the wealthiest countries in the world to fend for themselves, the economics make no sense -- it's far cheaper to treat someone for a cold in a doctor's office than in the ER. It's far cheaper to prevent an illness than it is to treat it.

Read it all at AlterNet

Health-Care Market Characterized By Consolidation, Not Competition

94% of the health care insurance market is now under monopoly or near-monopoly conditions -- the official term of art is 'highly concentrated'. In other words, there's no mystery why insurance costs keep going up even as the suck quotient rises precipitously. Because in most areas there's little or no actual competition.
Read it all at TPMMuckraker

The Netroots and the House Progressives: Toward More Progressive Policy

A solid left flank is absolutely necessary for our Democratic leaders in giving them the room they need to make policy more progressive--the Overton Window, if you will. That means ongoing pressure on even our left to keep shoring them up, to keep giving them the reason to push policy leftward. It means helping them to draw those bright line criteria for what is acceptable progressive policy.

The health care reform fight is the most critical policy fight this Congress will face, not just because of the stakes for the entire country and the economy, but for the progressive movement. If the progressives in the House of Representatives can force this Congress into passing a health care reform bill with a solid, robust public option, the dynamics not just in the House, but in the entire Congress, will be dramatically altered. Harry Reid won't have to worry about whether he can get Ben Nelson or Mary Landrieux on a bill, he'll have to worry about whether he can get Senate legislation past the House progressives.

As it should be.

Read it all at Daily Kos

Saturday, June 27, 2009

Small business owner discusses the need for health reform

Mike Draper, owner of SMASH of Des Moines, IA, testifies before the House Ways and Means Committee on how the cost of health care is affecting his small business, and his support for the choice of a public health insurance option.

Blue Cross to pursue increase in R.I. health-insurance rates

Blue Cross & Blue Shield of Rhode Island won’t withdraw its proposed double-digit rate hikes, as requested by state Health Insurance Commissioner Christopher F. Koller, which means the request will now be aired at a formal rate hearing.

The nonprofit insurer notified Koller on Thursday that it is still seeking to raise its rates — an average of 13.9 percent for small employers and 16.3 percent for large employers — beginning Oct. 1.
Koller also rebuffed rate hikes sought by UnitedHealthCare of New England and Tufts Health Plan and asked the companies to withdraw their requests. Neither has stated its intentions, said John A. Cogan, legal counsel for Koller’s office. One of the insurers did ask for an extension of Friday’s deadline to respond. As a result, said Cogan, the deadline was extended to Thursday.

Read more at The Providence Journal

Friday, June 26, 2009

Healthcare debate: 100 years later, still the same

Look at this amazing Google timeline of the national debate about health care reform over the past 100 years. At a glance, it’s clear that the anti-reformers have won the debate by throwing lots of money and hysterical arguments at the issue, leaving us where we are today.

There’s only one lesson to learn from this timeline: Health care reform is routinely defeated by the insurance and medical industries’ insistence that there is no need for a government mandate, that socialized medicine is bad, bad, bad, and that the industry and the markets can self-regulate themselves, covering more for less money.

100 years later, more Americans are losing more of their assets as a result of out-of-control health care costs, 47 million Americans are uninsured, jobs are being lost or eliminated because of the cost to employers to ensure the workforce, and yet, the debate still centers around the medical-pharma-insurance industry claims that market-based coverage is the best option.

While the health care argument can be framed in terms of economics, there’s an important social component that’s being buried in the current hysteria over costs and budgets. As our current system stands, the rich get the very best health care available, the elderly get better health care than they did before they were elderly, and the very poor get the basics.

The ones left in the cold? The unemployed, the self-employed, the small business owners, the middle class, people suffering from chronic illness and their caretakers. There is a fundamental social inequity built into the structure of health insurance and health delivery systems that cannot be solved by the markets because the markets are designed to be efficient and efficient markets cannot accept known risk.

Read More....

Strategist Michael A. Cohen to Dems: "No time for Caution"

As for the notion that Obama should be tied down by perceptions of what he thinks the country “can accept,” frankly this is even worse advice. As Galston notes, voters “have little confidence in government as an effective instrument of public purpose. Trust in government remains near an historic low and has not improved significantly since the beginning of Obama's presidency.”

But the way to change that perception is not to nibble around the edges, but instead move forward a piece of legislation that changes the entire political equation for Democrats: something like passing a sweeping health care package. The negative perception that voters continue to have toward government is because, as Obama suggested during the campaign, they don’t see it being responsive to their needs.

Forget the polls for just a second. In November 2008, the electorate voted not only for change, but they voted to send someone to Washington who would change the tone, bring new ideas and get things done. Passing comprehensive health care reform is the best way I can think of to not only fulfill the promise of Obama’s campaign, but also expose the rigidity of Republican opposition. If Democrats are dealing with a down economy in 2010 they will likely pay a price at the polls, but the best response to bad economic news is evidence that Congress and the President have worked to fulfill their campaign promises. As I asked a few days ago at Politico: “Would Democrats prefer to go to the voters and say, 'I shrunk the deficit' or would they rather say, ‘I passed health care legislation that improves access and care for 50 million people — and, by the way, my opponent voted against it?"

I can already imagine the likely response to my confidence: 1993 and 1994. The political path I’m advocating, of course, bears striking similarities to President Clinton’s ambitious domestic policy agenda. The critical difference, however, is the lack of confidence voters have not only in the Republican Party, but for conservatism in general. In addition, there is simply no question that the electorate trusts Obama far more than it did Clinton. I understand, Galston’s pleas for caution and no one who lived through 1993 and 1994 would ever question the dangers of overreaching. But if ever there were a time for overreaching it would be right now

Read it all...

Health Care Can't Wait - June 25th 2009

Thousands rallied and lobbied Members of Congress in Washington DC on June 25.

Health-care spending in rich countries

AMERICA'S health-care system is the costliest in the world, gobbling up about 16% of the country’s economic output. Comparisons with other rich countries and within the United States show that its system is not only growing at an unsustainable pace, but also provides questionable value for money and dubious medical care. Economists at the OECD found that America does indeed do well on some measures, such as breast-cancer survival rates and cervical-cancer screening, but does worse in others. Infant mortality was 6.7 per 1,000 births in 2007, against an OECD average (excluding Mexico and Turkey) of 4.0. Reforms are being considered to extend coverage for the 49m people with no health insurance, possibly by obliging individuals to buy insurance.
Source: The Economist

The Skeptical OB: Yes, the patient might die, but I'm not going to help unless I get paid.

Nonetheless, I was shaken up by the experience. She had only gotten the appropriate treatment because I had been willing to fight with the radiologist. In some ways, it had been a matter of luck. I wasn't busy with other things; the radiologist had aggravated me, and was determined to prevail. I was uncomfortably aware that had circumstances been different, I might have failed to force the issue, and the patient would probably have died.

Why did the radiologist refuse to do the scan? He was simply responding to the incentives and punishments put in place by the insurance company. They didn't want to pay for emergency scans so they made the requirements onerous. The insurance company was not wrong in assuming that patients without classic signs of DVT probably don’t have one, and they didn't want to pay for needless scans. The radiologist was not wrong in assuming that this patient didn't have a DVT and in assuming further that if he did the scan he would not be paid for it.

Almost everyone who has health insurance has fought with the insurer at some point because the insurance company has refused to pay. If you've done so know you just how frustrating that can be and how much time it takes. Doctors fight with insurance companies all the time, both to get approval for tests and procedures that patients need, and to get paid for visits, tests and procedures that have already occurred.

Most people don't realize that doctors are often forced to fight with each other. The perverse incentives and punishments of the existing insurance system mean doctors who are trying to treat a patient must argue with other doctors who fear they will not be paid for their work. Sometimes, rather than fight to the bitter end, a doctor will give up and a patient won't get a test or treatment that she needs. And sometimes, giving up could have fatal consequences.

Click here to read it all...

Thousands Turn Out for Health Care Reform

An estimated 10,000 people convened on the Capitol to call on Congress to move swiftly and decisively to pass legislation for sweeping health care reform, reform that will help millions and millions of Americans who are uninsured and underinsured. The rally, organized by Health Care for America Now, heard repeatedly from individuals crying out for quality, affordable health care. The placards saying that health care reform cannot wait rose high above the throngs of community groups, labor activists, nurses, doctors, and ordinary people who came from all corners of the U.S. to make their case.

If you aren't following the health care debate, you should be. It affects every single individual in the U.S., and the very bedrock of our ailing economy. As one speaker explained it, it's always been a morally-imperative thing to do to provide insurance to all Americans, but now, it's an economic necessity, as our lack of universal health care interferes with our ability to prosper as a nation.

Some 50 million individuals have no health insurance at all. With more and more individuals losing jobs, the number is growing quickly. Millions more people do have insurance but it doesn't deliver when it is most needed. Or, payments are repeatedly delayed by insurers who conveniently hold onto money while dilly dallying paying claims.
Among the protesters was a large and readily visible group of physicians wearing white coats and dangling stethoscopes around their necks. Calling themselves the National Physicians Alliance, they called on Congress to implement a system of equitable, affordable, high quality care for all people. One doctor, from West Virginia, said that both his parents have no health insurance. Like so many others without insurance, his mother, who recently suffered from a urinary tract infection, was forced to seek care in the emergency room.
Protesters repeatedly cried out for a publically-operated insurance program to compete with private insurers. President Obama has said again and again that such a public option is needed to keep health care costs down, and to keep the health insurance industry "honest." The insurance industry is fighting the idea of a public option, naturally, as they see it as a threat to their unfettered control of the insurance market, a market that serves them up huge profits.


Paul Krugman: Not Enough Audacity

The point is that if you’re making big policy changes, the final form of the policy has to be good enough to do the job. You might think that half a loaf is always better than none — but it isn’t if the failure of half-measures ends up discrediting your whole policy approach.

Which brings us back to health care. It would be a crushing blow to progressive hopes if Mr. Obama doesn’t succeed in getting some form of universal care through Congress. But even so, reform isn’t worth having if you can only get it on terms so compromised that it’s doomed to fail.

What will determine the success or failure of reform? Above all, the success of reform depends on successful cost control. We really, really don’t want to get into a position a few years from now where premiums are rising rapidly, many Americans are priced out of the insurance market despite government subsidies, and the cost of health care subsidies is a growing strain on the budget.

And that’s why the public plan is an important part of reform: it would help keep costs down through a combination of low overhead and bargaining power. That’s not an abstract hypothesis, it’s a conclusion based on solid experience. Currently, Medicare has much lower administrative costs than private insurance companies, while federal health care programs other than Medicare (which isn’t allowed to bargain over drug prices) pay much less for prescription drugs than non-federal buyers. There’s every reason to believe that a public option could achieve similar savings.

Indeed, the prospects for such savings are precisely what have the opponents of a public plan so terrified. Mr. Obama was right: if they really believed their own rhetoric about government waste and inefficiency, they wouldn’t be so worried that the public option would put private insurers out of business. Behind the boilerplate about big government, rationing and all that lies the real concern: fear that the public plan would succeed.

So Mr. Obama and Democrats in Congress have to hang tough — no more gratuitous giveaways in the attempt to sound reasonable. And reform advocates have to keep up the pressure to stay on track. Yes, the perfect is the enemy of the good; but so is the not-good-enough-to-work. Health reform has to be done right.

Read it all at NYTimes.com

Thursday, June 25, 2009

Rockefeller wants to cut private health insurance influence

Today, Rockefeller [Sen. Jay Rockefeller, D-W.Va.] is an outspoken political leader seeking to create a public health plan and cut the profits made by private insurance companies.

"To me, there is nothing that ultimately makes more difference to Americans than health care.

"People often talk about 45 million uninsured Americans, but rarely mention the 25 million Americans who are underinsured."

Rockefeller estimates at least 100 million Americans face major problems paying for health care today.

"We can't count on insurance companies. They are just maximizing their profits. They are sticking it to consumers.

"I am all for letting insurance companies compete. But I want them to compete in a system that offers real health-care insurance. I call it a public plan," Rockefeller said.

Earlier this month, Rockefeller introduced the Consumers Health Care Act that would give all consumers the option to participate in a government-run plan competing with private plans.

Government-backed programs are big enough to bring medical costs down, Rockefeller believes.

"Back in 1993, all our Veterans Administration hospitals got together and agreed to buy prescription drugs as a group. The next week, the costs of those drugs went down by 50 percent.

"Today, the insurance industry runs this whole deal, spending $1.4 million every day to fight health-insurance reform. The government has a lot of power to lower prices," Rockefeller said.
"I think the anger against insurance companies is going to spread," Rockefeller said Thursday. "But a public plan, run by the government, will make sure doctors get paid, hospitals get paid and people get good health care.

"Today, an extra 15 percent, 20 percent or 25 percent [of health-care costs] goes to pay private insurance companies. In a public plan, you just pay for what you get. There are no marketers, no people shuffling paper, no one making television ads."

Read it all at The Charleston Gazette

CD-ROM Converter Service Center HSI Doubles As The GOP’s Favorite ‘Academic Think Tank’

This morning on MSNBC, Rep. Eric Cantor (R-VA) ripped into health reform, calling legislation to introduce the a public option “crazy talk.” “You’ve seen the cost,” Cantor said, “the latest estimate being discussed here on the House plan is three trillion dollars.”

Republicans are seizing upon a study produced by HSI Network LLC to claim reform will cost $3-3.5 trillion over the next ten years. They are taking to the floor, firing off press releases, and making nonstop television appearances, using the HSI figure to demonize health reform. But we’ve seen this dog-and-pony show before, when HSI played exactly the same role in 2008. They armed John McCain with friendly numbers for his health plan, while tearing into Barack Obama’s plan.

This is how it worked: Stephen Parente, one of the owners of HSI, was tapped by McCain policy adviser Doug Holtz-Eakin to formulate the McCain health plan. Then over the course of the summer, Parente and his colleague at HSI Roger Feldman, who is a former Bush economist, were quoted in various friendly media outlets praising the McCain plan without noting that they had authored the plan they were analyzing:

– “Roger Feldman, a professor at the University of Minnesota who focuses on health insurance, said the Minnesota program shows that high-risk pools can work. He added that Sen. McCain ‘will have the same question — how much does he want to subsidize these plans?’” [WSJ, 6/2/08]

– “Steve Parente, a professor of finance at the University of Minnesota, estimated the effects of an earlier version of McCain’s plan, with a $4,000 tax credit. He found that even that less generous plan would increase the number of people with insurance by 23 to 27 million.” [National Review, 3/3/08]

Indeed, the McCain campaign paid $50,000 to HSI, the same firm that wrote their health plan, to produce “independent” comparisons between the McCain health plan versus Obama’s. Trying to conceal the payment, the McCain campaign reported the $50,000 as “legal consulting.” Strangely enough, the McCain campaign also paid HSI $10,000 in the final weeks of the campaign for “get out the vote consulting.”

Unsurprisingly, the HSI study found that McCain’s plan would cover “more than half of the nation’s 47 million uninsured — and two million more than the plan put forward by Senator Obama.” But as NPR has noted, the HSI study of the McCain and Obama plans was an extreme “outlier” compared to almost every major academic think tank that had surveyed the two candidates’ health plans. HSI’s model of the Obama campaign plan predicted a Federal cost more than 4 times than that predicted by the independent Tax Policy Center.

Reprising their role during the Presidential campaign, HSI is now spreading misinformation about the House health bill. The Ways and Means Committee has noted:

– The HSI analysis assumes substantial erosion of private coverage that rests on two likely false assumptions: (1) that private plans sit idly by and fail to offer products at lower prices to compete with the public option for business; and (2) that an employer shared responsibility requirement is ineffective and leads to massive dropping of ESI, despite contrary experience in Massachusetts and in today’s market where the majority of employers already offer coverage on a voluntary basis.

– The analysis says there are no offsets in the discussion draft, yet the bulk of the text consists of payment and delivery system reforms in Medicare and Medicaid that will yield hundreds of billions of dollars in savings.

In addition to serving as the GOP’s favorite health care think tank, HSI doubles as a data service conversion center. The latest “Data Conversion Special!” advertises that for $100, HSI will convert mainframe cartridges into CDs or DVDs.

Though HSI has yet to produce their actual methodology for analyzing the the House health reform bill, they certainly have a unique revenue model.

Source: Wonk Room

Healthcare Stories from America - Debt, foreclosure, bills, tragedy....

I survived cancer last year. I have been in remission for one year. My employer laid me off when I was diagnosed and I was off work for a year while I had chemo. I used my 401k and my credit cards to survive during that year while I fought for my life. I thought I would be able to refinance my house to cover the $7500 max out of pocket for my treatment. However, I find myself with over $30,000 in outstanding medical bills at this point and I still need expensive tests every 6 months to make sure the cancer is still gone and have to have my port flushed every 8 weeks - $200 a pop. I figure I will max my out of pocket every year until I reach the 5 year mark. Since my insurance company doesn't even pay what is covered, being deeply in debt is my new way of life. In fact, I figured out the other day that my medical expenses - with my insurance premium and my co-pay and "co-insurance" up to the max out of pocket - are 40% of my net pay every year....and will continue to be for the next 5 years. Add the bills the insurance rejects and makes excuses for and I'm bankrupt many times over. I've worked for the last 25 years and always had health insurance. Little did I know that when I needed it, I would be abandoned by the system. I am effectively bankrupt but alive. I refuse to let it make me sorry that I survived. I don't care what it takes.....affordable health care must be available to the working class of America.
Dear President Obama, I am thirty one years old and am in several thousand dollars debt because I was unable to get insurance for several years because of a "pre existing condition". In m early twenties I was diagnosed with malignant melanoma. I was fortunate enough to have caught it early and had a minor surgery to have it removed. I did not have insurance at the time because my full time job did not offer it. I tried to get private insurance but because I have had a history of skin cancer, the only type of insurance I could buy was high risk/emergency medical coverage. This cost between $300.00 and $500.00 a month. Obviously, this was not something I could afford when making $12.00 an hour. Each I became ill and could not afford to go to the doctor, I had to go to the Emergency Room. I knew that the ER has to see patients' whether or not they could pay at the time of service. I also could never afford to pay the hospital bills once they arrived so the debt started to pile up. I naturally didn't have dental insurance so I have had six teeth pulled because I could not afford to have them repaired. I'm wearing partial dentures at age 31. Affording implants just isn't realistic. I also have had to wear torn contacts because I could not afford to have them replaced. I was hospitalized for two days in 2005 and when I received the bill I honestly just started to laugh because it was so absurd. $24,000.00 for two days. I didn't have a job and lived in a converted garage that was infested with mold. Was there really any way I was going to be able to afford that bill? I have been at my current job for a little over a year and now have benefits. The benefits are basically horrible and it's like not having them at all. I don't complain about it to the owners because they are just trying to keep the doors open in this economy and do the best they can. We also do not have vision or dental. I am still not at a place where I can start paying off these bills. I would love to be debt free but at this time it just isn't realistic. I'd like to point out that I do not have any credit cards. My debt is 90% from medical problems. I don't see how I will ever afford to pay off these debts and fix my credit. I am well aware that I will probably never be able to qualify for a home loan because of my low credit score. This is all because I had skin cancer once, in my early twenties.
I am a Family Physician who works in a community health center and I fully support this much needed change in the U.S. heath care system. I see approximately 60% uninsured patients and about 30% Medicare and Medicaid. The uninsured are causing so much stress on hospitals, clinics, and health care providers because there is just too much demand and too little supply. We do everything we can for our patients but we just don't have the resources we need to get them good care. We are getting more and more overwhelmed with new patients who have lost their job and lost their insurance. I have patients who have to wait 6-10 months to see certain specialists. What do you think happens when someone who has major health issues has to wait for months for appropriate care? They end up in the ER. And that happens over and over and guess who pays for all those uninsured people in the ER or the hospital? We all do.
I am a pediatrician caring for many children whose families struggle with the current health care system. Yesterday I saw a child whose mom said he wasn't sick, she just wanted to get him checked because her insurance will run out at the end of the month. She is a single parent working hard for an hourly wage, and her job does not provide health benefits. All of her friends are telling her to quit work so she can go on welfare and get free medicaid. This mother takes pride in her work and her ability to provide for her family. She does not want to go on welfare but feels she may have no other choice if she wants health insurance for herself and her children. No one should be in the position of choosing to give up work in order to obtain medicaid. We need to help working parents keep their jobs and help small businesses who employ them keep their workers by providing a better alternative. We need a health care system that does more than extend the system of insurance -- we need an option of medicare for all!

Many More stories like this at Health Care Stories for America | BarackObama.com

Congress suspends health care debate as crowds rally for plan | McClatchy

Senators who are negotiating how to overhaul the nation's health care system broke off formal talks Thursday until after the July Fourth holiday, saying that they lack consensus on how to pay for the $1 trillion or more that the changes could cost over the next decade.

Thousands of their constituents rallied outside the Capitol to show their support for change, and the Obama administration called for action.
At the end of the day, however, three Democrats and three Republicans on the Senate Finance Committee, which determines funding — who had been seeking common ground for days — issued a three-sentence statement saying that while the issues are "difficult and complex," they have made "progress toward workable solutions."


Uninsured putting stress on emergency rooms

According to a report out this week, the average total waiting time in a U.S. emergency room in 2008 was four hours and three minutes, a 27-minute increase in nationwide average wait times since 2002.
The recession is one chief reason for the increase, according to the American College of Emergency Physicians. In a survey in January of more than 1,700 emergency doctors, 66 percent said they'd seen an increase in the number of patients in their emergency rooms over the preceding six months. Most of the physicians -- 83 percent -- reported seeing patients who'd lost their jobs and health insurance and delayed medical care.

"Some of these people come to the ER because they've been turned away by their primary care physician, because they've lost their insurance," said Dr. Angela Gardner, incoming president of the physicians group. "Sometimes they've delayed care because they have no insurance and end up with a much more serious condition."

Gardner, who works in the ER at Parkland Hospital in Dallas, Texas, said these newly uninsured people are taxing an overburdened system.

Read More at CNN.com

Under The Influence -- Health Industry Lobbying Tops $1.4 Million Daily

By Eliza Krigman at National Journal Online

In a new report released today, the government watchdog group Common Cause found that major health care interests have spent upwards of $1.4 million a day to lobby Capitol Hill so far this year.

According to the report, entitled 'legislating under the influence,' political spending by the health industries has increased 73 percent since 2000. Health interests contributed $94 million to candidates in Congress during the 2008 election cycle, a $40 million jump from the 2000 election cycle figure.

The top recipients of health industry campaign contributions from 2000 to 2008 are new Democrat Sen. Arlen Specter, Pa., and Sen. Blanche Lincoln, D-Ark., at $7.3 million and $6.3 million respectively. All of the campaign finance data used in the report came from the Center for Responsive Politics.

With the health industry's tremendous financial clout in Washington, Common Cause is concerned that chances for meaningful reform will be stymied. The report concludes that members of Congress face a disheartening conflict of interest: side with their large campaign donors or back reform measures that have support from the public, like the public plan option which would create a publicly-funded health insurance entity to compete with private insurers.

Click here for report [PDF].

Big Capitol Hill rally for health care

Thousands of grassroots activists and labor workers from across the country flooded Capitol Hill Thursday for a high-volume rally for health care reform.

The rally came as President Barack Obama’s plan encounters its toughest resistance on Capitol Hill yet. Republicans are mounting stiff opposition to a public option, and members of both parties have sticker shock over the projected costs of reform.

Supporters vowed Thursday not to back down.
AFSCME President Gerry McEntee and Sen. Sherrod Brown (D-Ohio) urged supporters to lobby their members of Congress to support a reform bill – and told them not to let well-funded health industry opponents bring the effort to a halt.

“Let it be known that our opposition will fight hard, they will fight dirty, they will outspend us,” said McEntee.

“The private health care industry will not hijack this process,” Brown said. “We’re counting on you…to persuade, to cajole, to do whatever you do to get a public option.”

Read it all at POLITICO.com

Robert Reich: Why the Critics of a Public Option for Health Care Are Wrong

Without a public option, the other parties that comprise America's non-system of health care -- private insurers, doctors, hospitals, drug companies, and medical suppliers -- have little or no incentive to supply high-quality care at a lower cost than they do now.

Which is precisely why the public option has become such a lightening rod. The American Medical Association is dead-set against it, Big Pharma rejects it out of hand, and the biggest insurance companies won't consider it. No other issue in the current health-care debate is as fiercely opposed by the medical establishment and their lobbies now swarming over Capitol Hill. Of course, they don't want it. A public option would squeeze their profits and force them to undertake major reforms. That's the whole point.


Tracking The Money In The Health Care Debate

Millions of dollars are pouring into Capitol Hill this summer, as lobbyists jockey to have their clients' interests represented in three major pieces of legislation just beginning to take shape. The objects of the lobbyists' attention: massive bills on health care, banking regulation and energy.

In "Dollar Politics," a multipart, multimedia series beginning this week, NPR examines this extraordinary intersection between money and politics and what it could mean for public policy.
Two NPR correspondents attended the first legislative action on health care reform: a meeting of the Senate Committee on Health, Education, Labor and Pensions. We also sent a photographer to take pictures — not of the senators, but of the audience, the people watching the committee meeting, many of them lobbyists.

These days, just about every interest has a lobbyist. Drug manufacturers, hospitals, doctors, pharmacists, marriage counselors, chiropractors, unions; they all have people working the Hill for them. And that's just a fraction of the groups. After all, the health care industry now represents one-sixth of the U.S. economy.

Read more at NPR

Senate Panel Hears of ‘Raw Deal' Consumers Get From Health Insurer


Health insurers have forced consumers to pay billions of dollars in medical bills that the insurers themselves should have paid, according to a report released yesterday by the staff of the Senate Commerce Committee.
At a committee hearing yesterday, three health-care specialists testified that insurers go to great lengths to avoid responsibility for sick people, use deliberately incomprehensible documents to mislead consumers about their benefits, and sell "junk" policies that do not cover needed care. Rockefeller said he was exploring "why consumers get such a raw deal from their insurance companies."

The star witness at the hearing was a former public relations executive for major health insurers whose testimony boiled down to this: Don't trust the insurers.

"The industry and its backers are using fear tactics, as they did in 1994, to tar a transparent and accountable -- publicly accountable -- health-care option," said Wendell Potter, who until early last year was vice president for corporate communications at the big insurer Cigna.

Read the rest at washingtonpost.com

Wednesday, June 24, 2009

Krugman: Obama messes up on health care, big time

My big fear about Obama has always been not that he doesn’t understand the issues, but that his urge to compromise — his vision of himself as a politician who transcends the old partisan divisions — will lead him to negotiate with himself, and give away far too much. He did that on the stimulus bill, where he offered an inadequate plan in order to win bipartisan support, then got nothing in return — and was forced to reduce the plan further so that Susan Collins could claim her pound of flesh.

And now he’s done it on a key component of health care reform. What was the point of signaling, right at this crucial moment, that he’s willing to give away the public plan? Let alone doing it at the very moment that he was making such a good case for it?

Maybe there’s a way to recover from this. But it’s up to the health reform activists to stiffen the administration’s spine. Obama may be satisfied with “broad parameters” — but the rest of us aren’t, and have to make that known.

Read more at the Paul Krugman Blog

Perils of the Public Plan

There are a lot of ways to defeat reform, not just by blocking it entirely, but by setting it up for failure. Those who think a public plan is a good idea no matter how badly designed are not thinking ahead.

Read More at The American Prospect

Robust Health Care Reform is the Moment of Truth for Obama and the Democrats

If at this remarkable juncture Obama and the Democrats cannot enact a robust health care reform -- with a strong nationwide public option, cost controls, and nearly universal coverage -- I would not want to be in charge of fundraising and mobilization for them in the 2010 and 2012 elections! Most of us who supported them last time will of course not vote for a Republican.. But if Obama and the Democrats cannot act now on a once in a half century challenge and opportunity, they are not worthy of extra energy. And those of us who wrote big checks last time will tell the Democrats -- especially in the Senate -- to hold pharmaceutical fundraisers instead.

Key leaps forward for U.S. public social provision -- Social Security, Medicare, etc. -- have NEVER happened through "bipartisan" compromises and they always happen in close votes. They have always sqweaked through after gargantuan effort, strong presidential pressure, and refusal to allow eviscerating compromises. Think of Social Security if the Clark amendment -- allowing corporate opt-out -- had passed in 1935. We would not have it. And conservatives and the medical and insurance establishments cried "socialism" in 1965, too. We would not have Medicare if we had listened.
Because let's not kid ourselves: WHATEVER passes this year will make the Democrats owners of the health care mess going forward. If they just throw more subsidies and piecemeal regulations into the current system, they will ensure galloping public costs for residual arrangements and for subsidies to private insurers who will easily find ways to avoid sick or costly patients. Businesses and citizens will grow more and more irritated as time passes, and will blame the Democrats. Rightly so.

And to return to my theme at the start: no matter if Senate Democrats still think they are operating in the world of the 1980s or 1993, they are not. Activist Democrats -- mobilizers, volunteers, bloggers, analysts, and donors -- are watching them. We will know exactly who blocks or eviscerates real reform here. We WILL blame the Senate and the responsible individual Senators. And many of us will blame the Obama adminsitration if it does not take a strong stand on the public option and real reform, starting right now. Whatever he says in public, Obama needs to draw lines in the sand with Democrats in private -- and get tough. If he does not, and this fizzles into no legislation or reform in appeance only, energy will dissipate from the Demorats and the Obama movement. There will be the wrong kind of turning point for them -- and for America.


Read more at the TPMCafe

Monday, June 22, 2009

Millions of 'Dangerous' Socialists Massed on Northern U.S. Border!


Canadian commenters rallied to the defense of their single-payer health-care system at this site on my previous post.

At least half the 1400 comments came from Canadians furious at the way their cherished health-care system is being trashed by the American right. And, as I wrote, we Americans who've used the "socialistic" Canadian health system know it works quite well.

From Bill Mann

GOP Talking Point Fail - because people know who stands between them and health care

Cokie Roberts: "What people now have is an insurance agent standing between them and their doctor, and everybody knows that"

Exactly. So we are not so afraid of a Federal plan acting as our insurance agency. God know it could not be any worse than what we have now.

Democrats May Unite On Public Health Plan

Keep sending those emails and making the calls to Congress...

Emboldened by polls that show public backing for a government health insurance plan, Democrats are moving to make it a politically defining issue in the debate over the future of medical care.

Read more at CBS News

An American living in Canada says, "Socialized" Healthcare Works

"I am an American now living in Canada and cannot sing the praises of the Canadian healthcare system enough... And I have worked in the American healthcare system for 16 years (non-clinical support services)... so I know a ~little bit~ about it..."

Read it all here.

The history and mediocrity of Baucus' "deal" with PhRMA

A must read...

"One piece of alleged news this weekend has been a deal between Senator Baucus (D-corporate lobbyist) and Billy' Tauzin, president and chief executive of PhRMA and a former congressman from Louisiana (D to R to corporate lobbyist). It is important to remember that as a congressman, just before exiting via the rotating door to his official lobbyist gig, Tauzin was a leader in fixing Medicare Part D to be a huge protected benefit for the drug companies.
Remember: When they say that Medicare was not allowed to negotiate a lower price, this means they were not allowed to even get the same "discount" ("special, just for you") rate the U.S. government was already getting for benefits under Medicaid, DOD, Veterans and those eligible for 340B pricing.

One horrible, but deliberately planned result, is that many seniors and the disabled, who had been dually eligible for lower drug prices under Medicaid, wound up paying (either under Medicare or out-of-pocket) HIGHER prices to the drug companies under Medicare Part D, than they had before. Expensive for taxpayers, poor seniors and the disabled, but a windfall for the drug companies.

In one of the more blatant examples of the corrupt system, Tauzin was a leader in making Medicare Part D so bad for government, taxpayer and the elderly but so good for the drug industry, while he was at the same time secretly negotiating his near future job as chief lobbyist for the same industry. This was of course with the Bush white house and the corrupt D.C.-lobbyist leadership of the AARP (which is to a great extent a for-profit insurance company, and not a senior-rights organization).
We already subsidize most of the underlying research (and the training of the drug companies' researchers) via the National Institutes of Health. When the same drug is offered to at a lower cost to purchaser -- be it at DOD or France or Canada, etc -- and at a higher cost to us, then we are suckers being asked to subsidize that too.

The Baucus-Tauzin "deal" is just an attempt to cut-off the debate and fast-track a great deal for PhRMA and a really bad deal for America.

Read it all here:

Can Health Co-Ops Do the Job of a Public Plan?

"The history of cooperative is that it's very hard to set these things up, and while we're trying to set them up, there's not going to be accountability and pressure [on private insurers]," says Hacker. "They would be weakest when they're most needed — at the outset." In addition, cooperative health policies would not be portable, meaning if you had one and moved to another state, you would need to drop coverage and enroll elsewhere. Rates could also vary dramatically, depending on regional differences in health costs and the size and makeup of co-op pools.

Assuming state-based health co-ops could offer lower premium costs by being nonprofit and creating large risk pools, an equally crucial question is when they would be created. Even with federal seed money, setting up 50 co-op boards, signing up enough members to make each co-op viable and establishing administrative systems to set premium rates and pay claims would not happen overnight. "The principle of eliminating some of the profit motive and placing it with the motive to get value out of care is a good principle," says Karen Davis, president of the Commonwealth Fund, a nonpartisan health-policy think tank. "But there are a lot of ifs, and it's not a strategy for a nation in an economic crisis when we need a solution soon."

Read it all at TIME

Single Payer vs a Public Option #2

Better than my earlier table.. a graphic prepared by Dr. Klein for the Arizona League of Women Voters - click to enlarge:

Found via a comment on Paul Krugman's blog.

How do Canadians feel about their health care system?

In 2000 there were moves to privatize the Canandia health care system - the one all the GOP talking heads are bashing as being so horrible. Here is what Canadians thought about a bill to make their system more like ours...

Some 6,000 people turned out in Edmonton on Sunday for a rally against Bill 11, the Klein government's proposed private health-care legislation.

It was the largest protest against the legislation to date.

A similar rally in Calgary on Saturday drew 2,500 people.
Ann Isaac, who was at Edmonton's protest, says it was her first rally ever. "I object to the way our government has systematically tried to downsize our health system to open the door to private health care." she told CBC Radio News.
"What were they doing other than hoping the system would fail, so that the people would say we've had enough, we want a private American-style health system?" Douglas asked Sunday's crowd. "Well, the people did not say that for them."


Sunday, June 21, 2009

Frank Rich: Obama’s Make-or-Break Summer - NYTimes.com

The test for Obama is simple enough. If the fortunes in American households rise along with Wall Street’s, he is home free — even if his porous regulatory fixes permit a new economic meltdown decades hence. But if, in the shorter term, the economic quality of life for most Americans remains unchanged as the financial sector resumes living large, he’ll face anger from voters of all political persuasions. When the Fox News fulminator Glenn Beck says “let the banks lose their tails, they need to,” he illustrates precisely where right-wing populism meets that on the left.

It’s still not too late for course correction. Before rolling out his financial package, Obama illustrated exactly what’s lacking when he told John Harwood on CNBC: “We want to do it right. We want to do it carefully. But we don’t want to tilt at windmills.”

Maybe not at windmills, but sometimes you do want to do battle with fierce and unrelenting adversaries, starting with the banking lobby. While the restraint that the president has applied to the Iran crisis may prove productive, domestic politics are not necessarily so delicate. F.D.R. had to betray his own class to foment the reforms of the New Deal. Lyndon Johnson had to crack heads on Capitol Hill to advance the health-care revolution that was Medicare. So will Obama for his own health-care crusade, which is already faltering in the Senate courtesy of truants in his own party, not just the irrelevant Republicans.

Though television talking heads can’t let go of the cliché that the president is trying to do too much, the latest Wall Street Journal/NBC News poll says that only 37 percent of Americans agree. The majority knows the country is in a crisis and wants help. The issue has never been whether Obama is doing too much but whether he will do the big things well enough to move us forward. Now that the hope phase of his presidency is giving way to the promised main event — change — we will soon find out.

Read it all at NYTimes.com

One Nation Under Medicare - Obama Must Make Insurers Compete

But why would we want more Medicare? Isn't Medicare a mess? Well, yes and no. The fabulously popular free health-insurance program for the elderly is running out of money, thanks to exploding costs. But the administration of Medicare is a miracle of low overhead and a model, despite all the fraud and abuse, of what government can do right. Three percent of Medicare's premiums go for administrative costs. By contrast, 10 to 20 percent of private-insurance premiums go for administrative costs. Roll that figure around on your tongue. When you swallow and digest it, you'll understand that any hope of significantly reducing health-care costs depends on a public option.
That takes us back to a public option, which would force insurers to redraw their business models and accept lower profits. The House bill will include it, but the Senate's almost certainly won't. Instead, moderates there are pushing health-care "cooperatives." Nobody has a clue what that means. Would the co-ops be like utilities? Farm cooperatives? Starting fresh with a quasi-public/quasi-private organization might bring some much-needed creativity to health-care financing. But without a federal charter and some seed money to help them enroll millions, co-ops will get swamped by the private-insurance lobby, which has become expert at marginalizing state-run experiments.

When it comes time to hammer out the final plan in the House-Senate conference committee, Obama and Rahm Emanuel will likely make the House accept a reduction in the deductibility of employer-based plans and make the Senate accept some kind of public option or co-op with teeth. Anything less means the president didn't get the sucker.

Read More - Jonathan Alter at Newsweek.com

Single payer removes the complications, is affordable and sustainable - yet they still keep it off the table...

Regional lawmakers, doctors join campaign supporting a public-health plan

Pushing back against Republican attacks on President Obama's vision of a public health plan, a nationwide coalition of state lawmakers, small-business owners, physicians, community groups and others Wednesday launched a public-relations campaign aimed at building support for an option they believe is essential for meaningful health reform.

Read More at the Seattle Times

Single Payer vs the Kennedy/Dodd Public Option

Read and weep.

The "Public Option" vs. Single Payer Compared
 Single-Payer"Public Option"
Number InsuredUniversal CoverageMillions remain uninsured or underinsured
CoverageCoverage for all medically necessary services.Insurers continue to strip-down policies and increase patients' co-payments and deductibles.
CostRedirect $350 billion in administrative waste to care; no net increase in health spending.Increase health spending more than $1 trillion over 10 years.
Savings$350 billion in administrative waste. Further systemic savings achieved through negotiated fee schedule with physicians, global budgeting of hospitals, bulk purchasing of pharmaceuticals, rational planning of capital expenditures, etc.Add further layers of administrative bloat to our health system through the introduction of a regulator / broker "exchange."
SustainabilityLarge scale cost controls (global budgeting, capital planning, etc.) ensure that benefits are sustainable over the long term.Uncontrolled costs ensure that any gains in coverage are quickly erased as government is forced to hike spending or slash benefits.
Download this in printable PDF format

"Rationally, single payer is the best system","our system is the worst, most expensive and least effective." - Ex-President Bill Clinton

Costs are keeping patients from care

People with robust health insurance are putting off doctors’ appointments and skimping on prescriptions because they can’t afford the increasing costs of copayments and deductibles, according to managers of patient-assistance hot lines in Massachusetts.
“Previously it was the uninsured,’’ Rukavina said. “Now we are seeing people with insurance, but they are struggling to pay their bills.’’

The problem appears particularly acute for people with chronic illnesses such as diabetes, asthma, and cancer. They make frequent visits to doctors and often take multiple medications.

The issue has become so widespread that state lawmakers have scheduled a hearing Wednesday to address aspects of the problem, including a proposal to allow residents with chronic illnesses to buy prescribed medications and medical devices without facing a copayment or deductible.

As healthcare costs rise and the recession’s grip has tightened, more employers have slashed their health costs by shifting more costs onto their workers, according to Families USA, a Washington-based consumer group. As a result, more employees are shouldering heftier copayments.

Read more at The Boston Globe

Saturday, June 20, 2009

Poll: 72% Back Public Health Care Option - CBS News

"A clear majority of Americans -- 72 percent -- support a government-sponsored health care plan to compete with private insurers, a new CBS News/New York Times poll finds. Most also think the government would do a better job than private industry at
keeping down costs and believe that the government should guarantee health care for all Americans."
When presented with the option of a government-administered health insurance plan similar to Medicare to compete with private health insurance companies, 72 percent are in favor and just 20 percent oppose. Even 50 percent of Republicans favor that option.

Still, the debate over government involvement in health care is highly partisan, with 61 percent of Republicans saying it is not the government's job to provide health care. Meanwhile, 85 percent of Democrats think the government does have this responsibility. Similarly, 63 percent of Republicans think government will do a worse job providing medical coverage, and 53 percent think it will do worse holding down costs. Among Democrats, about seven in 10 thinks government will do a better job on both.

Reactions are mixed as to whether the government should go as far as requiring all Americans to have health insurance, as long as it provides financial help to those who can’t afford it on their own. Forty-eight percent think the government should require this, while 38 percent think it should not.

The public, however, has acknowledged the need for sweeping changes to U.S. health care, with 51 percent saying it needs fundamental changes and another 34 percent saying there is so much wrong with it that it needs to be completely rebuilt. Just 13 percent think only minor changes are necessary.

More at CBS News

The GOP Keeps Trash Talking Health Care

by Charley James

Like when it rolled out its laughable 18-page “budget” five months ago that forgot to include any numbers, yesterday John “Man Tan” Boehner, Eric “Ralph Wiggums” Cantor and a handful of other Congressional Republicans unveiled a four page health care “plan” Wednesday that not only had no numbers, it had no substance, no ideas – good or bad – and the closest it came to being a plan was calling it one on the cover.
As Paul Krugman points out Thursday morning, there are four insane components to the Republican’s latest piece of garbage:

  • Republicans who rail against wasteful government spending are taking action to prevent the government from … reining in wasteful spending.
  • Politicians who warn that the burden of entitlements is killing the federal budget are stepping in to block the single most painless route to reducing the growth of entitlements.
  • They’re doing it in the name of avoiding “rationing of health care” but they’re specifically addressing taxpayer-funded care. If you want to go out and buy a medically useless treatment, Medicare won’t stop you.
  • These same politicians are opposed to expanding coverage because it’s evil for government to “ration care” by only paying for things that work; it is, however, virtuous to ration care by refusing to pay for any care at all.

"You’re assuming people watching CNN are thinking,” a staff member to a Republican Senator tells me this morning. “We’re simply trying to make the point that government-sponsored health care is a terrible idea."
Wednesday’s GOP talking point was warning about “inserting bureaucrats between you and your doctor,” and it was repeated at least a half-dozen times by interchangeable Republican faces popping up on cable news and C-SPAN.

Uhm, shouldn’t Republicans watch something besides Fox News occasionally? It is insurance company “bureaucrats” who keep inserting themselves between patients and doctors, denying coverage or treatment for people who are ill. Earlier this week Keith Olbermann treated us to the latest outrage: AIG, US Airways liability insurer, is telling a survivor of the airline’s Hudson River crash that she and her three year old daughter would not be covered for psychological counselling to deal with the on-going trauma of watching themselves almost die.

Oh, and by the way, dear Republicans: Not even the strongest proponents of a universal, single payer health care reform package is suggesting that doctors, nurses, and other health professionals will work for the government. So why are you comparing them to postal workers and the Department of Motor Vehicles the way you did Thursday? Are you crazy, stupid or just plain liars trying to scare Harry and Louise into opposing health care reform one more time?

“OK, so likening a public plan to the DMV is an exaggeration. So what? The point is to stop this thing cold,” the Republican staffer admits reluctantly. “No one likes bureaucrats and everyone hates the Post Office and DMV. It’s a good ‘word picture’ that people who watch cable news can understand.”
Whatever talking point the GOP rolls out today in its fight to keep America sick, remember that Republican staff people on the Hill admit all the party is trying to do is create scary “word pictures” to frighten the average cable news viewer. Republicans have always been good at twisting emotions and playing on fear. It’s past time for progressives to borrow a page from the Republican playbook and talk emotions, not just facts and figures.

Read it all at The LA Progressive

More of the same...

Hannity, Limbaugh, and Boortz Engage in a Healthcare Scarefest
The right wing media fear machine was hard at work trying to derail healthcare reform this week. Last night on his Fox News program, Sean Hannity claimed that healthcare reform will deny treatment to women with breast cancer. Neal Boortz claimed that Obama’s healthcare reform will kill people, and Rush Limbaugh denied the very existence of a healthcare crisis.

Hannity said, “There is not one person who can walk into a medical facilty that can legally be denied because of their inability to pay, so we already have a system in place…and we’re going to have a government rationing body that tells women with breast cancer, you’re dead.” (Hannity is referring to Emergency Medical Treatment and Active Labor Act, which does not cover all medical treatment, only minimum emergency care. However part of the escalating cost of healthcare is that people without insurance head to the emergency for minimal care at maximum cost).

Boortz said, “Obama’s healthcare plan is going to end up killing people. You can call it his healthcare plan. Ted Kennedy’s healthcare plan, whatever, especially among the ranks of the elderly there’s going to be people who die, there’s going to be people who die…” (What Boortz neglects to mention is that most of the elderly are on Medicare, and that won’t be changing).

Limbaugh said, “The crisis in healthcare is like the crisis in everything else, manufactured…There is no crisis. The crisis in healthcare is in the U.K. The crisis in healthcare is in Canada. The crisis in healthcare is in Cuba…The crisis in healthcare is in a lot of other places. The crisis in healthcare here has been manufactured.” (Limbaugh went back to the tried and true Republican tactic of head in the sand denial).

As you can see and hear, the Republican strategy is first to deny that there is a healthcare crisis, then to move to scare tactics in order to distract people away from the problem. All three of these hosts claimed or inferred that Obama is promoting government run healthcare. This is a tactic that won’t work because Obama has been consistently telling people that if they have insurance, they can keep it.

Audio and video at Politicususa.com

700 State Legislators Back Public Health Insurance Option

The signatures of over 700 state legislators speak loud and clear for numerous Americans who want us to act now to give them a full range of choices of the best quality, affordable care our country can offer.

It doesn’t matter if you’re shopping for a car or a washing machine or health insurance. Your best bet for getting a good deal is if two things are present: choice and competition. And that’s exactly why Americans need to have the option of a public plan as they shop for insurance under a reformed health system.

Texas state Rep. Garnet Coleman says the lessons in health care reform states have learned can be a valuable lesson on the national level.

For decades, states across the country have done the best we can to help working families cope with a broken health care system. We’ve learned many lessons about what works and doesn’t work, and we’re looking forward to sharing them with our colleagues in the White House and Congress.

More at the AFL-CIO NOW BLOG

Paul Begala: Health care outrage goes uncovered

Stupak, and the Energy and Commerce Committee chairman, Henry Waxman, D-California, did their job. Why didn't the media do its? Why were the outrages uncovered by Stupak and Waxman un-covered by most of the media?

Maybe because the Obama White House drew the spotlight away from health care. They'd diverted the media to cover Obama's proposed reforms of the financial regulatory system.
Clinton gave his health care address to the Congress on September 23, 1993. October was supposed to be "Health Care Month" in the White House, but so many other issues got in the way that he had just one public event focused on health care in the entire month -- just one.

I understand that Obama's White House team has to juggle a lot of issues; I've been there. And I'm sure the Obama financial reforms have merit. But if the president wants to pass his ambitious health care reform, he's going to have to put other, worthy, ideas on the back burner and shine the media spotlight on the plight of people like Robin Beaton.

Read it all at CNN.com

Sen. Max Baucus's Health Care Bait and Switch

This is Max Baucus, the head of the Senate Finance Committee... he's gotten more money from the health and insurance industry than any other member of Congress

Rate it up at YouTube

Insurance interests total 1/4 of Baucus' fundraising

HELENA — As Sen. Max Baucus has taken the lead on health-reform legislation in the U.S. Senate, he's also become a leader in something else: Campaign money received from health- and insurance-industry interests.

In the past six years, nearly one-fourth of every dime raised by Baucus, D-Mont., and his political-action committee has come from groups and individuals associated with drug companies, insurers, hospitals, medical-supply firms, health-service companies and other health professionals.

These donations total about $3.4 million, or $1,500 a day, every day, from January 2003 through 2008.

Baucus, who chairs the Senate Finance Committee that is drafting a major health-care reform bill this month, insists this cavalcade of money is not unduly influencing his work.

"No matter the issue, Max always puts Montana first," said his spokesman, Ty Matsdorf. "Max will continue to do what's right for our state, and groups like SEIU (a union representing thousands of health-care workers) and AARP (a senior citizens' group) wouldn't line up in support of his health-care reform effort if this wasn't true." Baucus' office also lists numerous examples of how his proposed reforms are challenging the health-care and insurance industries, such as requiring insurers to accept all customers, regardless of health condition.


Max Baucus & The Wolves

Senator Max Baucus threw a little party in the woods of Montana instead of delivering a health care reform bill ...It only cost $2,500 per person to frolic in the forest with the Senator...

A price that health industry lobbyists gladly...since Max Baucus is the biggest recipient of their money....

So listen closely, children...That's the sound of health care reform being killed..

Rate it up at YouTube

"Enjoy fly fishing on the world-renowned Madison, Gallatin and Yellowstone rivers during peak salmon fly hatch season, or golf the scenic 18-hole par 72 golf course designed by Arnold Palmer," says an invitation for a June 19-21 fundraiser for Sen. Max Baucus, D-Mont.

The same invitation offers a second event July 31-Aug. 2: "Camp Baucus is a trip for the whole family. Bring everyone to enjoy Big Sky's fly fishing, golf, horseback riding and great hiking."


Why must health reform be isolationist?

Why won't Congress consider how other countries do it?
By Timothy Noah

Every day Washington's leaders tell us that we live in an interdependent world with a globalized economy. A butterfly beats its wings in Guangdong province, and four Wal-Marts materialize in Duluth. The peso plunges, and 30 Honda workers get laid off in Marysville. A coal-fired power plant belches carbon dioxide in Prague, and Lohachara Island sinks into the Bay of Bengal.

But change the subject to reform of the health care system, and the community of nations abruptly vanishes. No France, no Canada, no Germany, no Japan. Let there be no mention of any industrialized democracy save that of the United States, which is proud to claim 37th place in the World Health Organization's rankings of the world's health systems and 15th in the Commonwealth Fund's ranking by avoidable mortality of 19 industrialized countries (the highest rank indicates the fewest such deaths). To achieve a better score would be unpatriotic!

The political establishment's hubristic refusal to consider how other countries manage health care is encapsulated in the cliché "uniquely American," which is what Sen. Max Baucus, D-Mont., the lead legislator on health care reform, says he wishes his bill to be. It therefore goes without saying that the finance committee Baucus chairs could find no place in this year's exhaustive health care hearings for a single expert on how other countries achieve better health outcomes for their populations while typically spending, on a per capita basis, half what we do. When the finance committee releases its draft bill this week, it will be almost completely free of foreign influence.

Read it all at Slate Magazine

Progressive economists' critiques missing from coverage of "compromise" health co-op plan

Media figures and outlets have characterized Sen. Kent Conrad's cooperative health insurance proposal as a 'compromise,' 'hybrid,' or bipartisan 'alternative' to a public insurance option without noting the argument by progressive economists that a public option is necessary for health care reform to be successful.

Read more at Media Matters for America

A Story of "Murder by Spreadsheet"

She was covered by her employer's health plan and also, of course, by Workman's Comp, since her injury happened while she was on the job. You'd think this would be a good situation, right? More insurance coverage is better because if company A can't cover you, company B will, right?


Instead of getting her into surgery to repair the rotator cuff, the two insurers started a battle over who was responsible for her care. Neither one wanted to pay for it, because it would cut into their profits. So while she waited for them to come to some kind of an agreement, she had to stay at home, on full workman's comp disability, and her doctors prescribed megadoses of painkillers - specifically, ibuprofen - for her to use to deal with the pain. And, of course, she was in excruciating pain, so she took them.

Rad More...

Is a Medicare plan for everyone the answer? - Framingham, MA

Activism pays off:

Those who rallied outside the Framingham and Medford offices of U.S. Rep. Edward Markey to get him to become a co-sponsor of a bill that would provide universal health insurance were thrilled when they achieved their goal.


A Doctor's View of Obama's Healthcare Plans

By Dr. Abraham Verghese

I mention this because I have similar problems with the way President Obama hopes to pay for the huge and costly health reform package he has in mind that will cover all Americans; he is counting on the “savings” that will come as a result of investing in preventive care and investing in the electronic medical record among other things. It’s a dangerous and probably an incorrect projection.
But I’d like to officially let McAllen off the hook and say that having practiced in five states, including 15 years in the great state of Texas, we are all complicit in practicing just that kind of medicine if you look hard enough and if you looked at us individually. Conflicts of interest are rife; they are almost the rule. So is the ability to wear blinders so we are (mostly) oblivious to our conflict.

Which brings me to my problem with the president’s plan: despite being an admirer, I just don’t see how the president can pull off the reform he has in mind without cost cutting. I recently came on a phrase in an article in the journal “Annals of Internal Medicine” about an axiom of medical economics: a dollar spent on medical care is a dollar of income for someone. I have been reciting this as a mantra ever since. It may be the single most important fact about health care in America that you or I need to know. It means that all of us—doctors, hospitals, pharmacists, drug companies, nurses, home health agencies, and so many others—are drinking at the same trough which happens to hold $2.1 trillion, or 16% of our GDP. Every group who feeds at this trough has its lobbyists and has made contributions to Congressional campaigns to try to keep their spot and their share of the grub. Why not?—it’s hog heaven. But reform cannot happen without cutting costs, without turning people away from the trough and having them eat less. If you do that, you have to be prepared for the buzz saw of protest that dissuaded Roosevelt, defeated Truman’s plan and scuttled Hillary Clinton’s proposal. The good news is that the AMA, representing perhaps 15% of active practicing physicians, is not as powerful as it was in Truman’s time, and in the eyes of the public and many in medicine, it’s identity in the reform debate, is that of a protectionist, self-serving, organization; as a result, even their most progressive statements are viewed with suspicion. I’ve found the views of the American Medical Student Association particularly exciting—the next generation of physicians I sense has a deeper commitment to affordable health care for all than ours; they are, simply put, better people.

We may not like it, but the only way a government can control costs is by wielding great purchasing power to get concessions on the price of drugs, physician fees, and hospital services; the only way they can control administrative costs is by providing a simplified service, yes, the Medicare model (with a 3% overhead), and not allowing private insurance to cherry-pick patients (some of them operating with 30% overheads, the cost passed on to you).

Contrary to what we might think, comparative studies show us that the US when compared to other advanced countries, does not have a sicker population: we actually use fewer prescription drugs and we have shorter hospital stays (though we manage to do a lot more imaging in those short stays—got to feed the MRI machines). The bottom line is that our health care is costly because it is costly, not because we deliver more care, better care or special care. Alas, a solution that does not address the cost of care, and negotiate new prices for the services offered will not work; a solution that does not put caps on spending and that instead projects cost-savings here and there also won’t cut it. Leaders have to make tough and unpopular decisions, and if he is to be the first President to successfully accomplish reform there does not seem to be much choice: cut costs.

—Abraham Verghese is Professor and Senior Associate Chair for the Theory and Practice of Medicine at Stanford University. He is the author of the novel “Cutting For Stone.”

Read more in at WSJ.com

Friday, June 19, 2009

Democrats push for new government health plan

In the latest draft of the healthcare bill, Democrats in the U.S. House of Representatives suggested all citizens should be able to get insurance regardless of medical history and that coverage should be mandatory for individuals and businesses.

The proposal would create a new government plan to help cover the uninsured -- a move backed by President Barack Obama but resisted by Republicans and some centrist Democrats who fear it will overwhelm private insurers and require vast amounts of public funding.

Read More at Reuters

Obama's Personal Doctor Prescribes Medicare for All

Scheiner, 71, was Obama's doctor from 1987 until he entered the White House; he vouched for the then-candidate's "excellent health" in a letter last year. He's still an enthusiastic Obama supporter, but he worries about whether the health care legislation currently making its way through Congress will actually do any good, particularly for doctors like himself who practice general medicine. "I'm not sure he really understands what we face in primary care," Scheiner says.
"He doesn't see all the pain, it's so tragic out here," he says. "Obama's wonderful, but on this one I'm not sure if he's getting the right input."

What should the president be focused on? Scheiner thinks that a good health reform would be "Medicare for all," a single-payer system where the government would cover everyone and pay for it by cutting out waste in the system.

Read the reast at Forbes.com


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Insurers Fight Public Health Plan

Health care reform could be the insurance industry's greatest nightmare or a dream-come-true, depending on the fate of some of the most sweeping proposals. And health and accident insurers, in addition to HMOs and health services, are hoping that the $586 million they've spent on lobbying since 1998 will pay off now.

What these insurers want more than anything, of course, is to get some help in improving their bottom line, and they can't do it if the system maintains the status quo. According to the Chicago Tribune, private insurers have been rapidly losing customers since 2000 and this trend has only accelerated since the start of the recession, when people lost their jobs en masse. They're also worried about what will happen to their business when baby boomers are eligible for Medicare and no longer need private insurance. The perfect fix, the industry says, is the government requiring all people to buy medical coverage, which would add millions of new customers and generate a steady revenue stream, the Tribune reported.

Read more at OpenSecrets

June 25th Rally in Washington, DC

Join us on June 25 to tell Congress, "Health Care Can't Wait!"
Text HEALTH to 94553 or go to http://www.healthcare09.org.

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Unhealthy numbers: Bankruptcies, uncontrolled costs argue convincingly for health-care reform

At a glance, the plight of these 47 million appears to be much if not most of what needs fixing. But, as Chronicle business columnist Loren Steffy observes in his column this past Sunday (“Insured but not covered”), things are far from copacetic for those millions of Americans supposedly adequately covered by health plans through their employers.

They are not. As Steffy puts it, this umbrella leaks, and thousands of families are going under financially because their health insurance does not perform as advertised. Steffy cites a study in the American Journal of Medicine showing that two-thirds of all bankruptcies over the past six years were related to medical expenses, and that a surprising three-fourths of those filing for bankruptcy for medical-related reasons had medical insurance when they did so.

Or perhaps this is not so surprising. Certainly it will not astonish anyone who has attempted to navigate the maze of co-pays, deductibles, explanations of benefits and frequently inscrutable bills from hospitals, laboratories and other care providers. For the unwary and uninformed health-care consumer, these can all be a source of emotional and financial stress on top of whatever medical condition may afflict them or a family member.

Harvard Professor David Himmelstein , author of the study mentioned above, doesn’t mince words. “Private health insurance is a defective product, he says, “akin to an umbrella that melts in the rain .”

The notion of competition in the health-care insurance industry is mostly myth, Himmelstein contends. For most consumers, the choices are limited by what their employers offer and at what cost they choose to offer it. For some lucky ones the choices may be made broader by the option of insuring through a spouse.

Read more at the Houston Chronicle

Senate Finance Committee: We're Going to Make You Buy Insurance With No Public Option

A Senate source just passed me the latest outline of the Senate Finance Committee's health reform proposal. This is the post-CBO revision. Apparently, after the committee staff received the scores, they dug deep and quickly developed this proposal to circulate among members and then send back to CBO. It was presented earlier today at a closed-door meeting.

Sources say that it's a major scale-back of the outline they had before. Specifically, subsidies have dropped from 400 percent of the poverty line to 300 percent. Medicaid eligibility has been tightened to 133 percent of poverty for children and pregnant women and 100 percent of poverty for parents and childless adults. The plans being offered in the exchange have seen their actuarial values sharply lowered.

read more from Ezra Klein

Thursday, June 18, 2009

Lobbyists Daschle, Dole Release Health Care Plan; Do Not Note Health Care Clients of Their Law Firm

Today, former senators Tom Daschle and Bob Dole released a plan for health care reform that is being hailed a bipartisan way forward. Headlines blare about the Daschle/Dole plan for health care. But were these two to not have had illustrious careers in the Senate, the headlines would tell a far different story: “Health Care Lobbyists Release Health Care Plan.”

Both Daschle and Dole work for a major Washington, DC lobbying firm, Alston & Bird. Many of Alston & Bird’s major clients are from the health care sector including the American Hospital Association, HealthSouth Corp, and pharmaceutical companies Abbott Laboratories, Bayer, Celgene, and Mylan Laboratories. In total, Alston & Bird is currently representing 31 clients from the health care sector. Of the $2,730,000 reported income received from clients, nearly 50% of that, $1,070,000, comes from these 31 health care clients.

This looks like another benefit of the revolving door. You can release a legislative proposal from outside of Congress and the first thing anyone thinks of is your previous job and not your current one.

Read the rest at the Sunlight Foundation Blog

Affordable Health Insurance Elusive In Rural U.S

Fast Facts On Rural Health Insurance - June 12, 2009 ·

* Percentage of noncorporate farmers and ranchers with health insurance: 95
* Percentage of all Americans with health insurance: 84.7
* The likely rate of underinsurance in rural areas compared with cities and suburbs: double
* Percentage of the rural poor covered by Medicaid: 45
* Percentage of the urban poor covered by Medicaid: 49
* Percentage of all Americans dependent on individual health insurance policies with reduced benefits and high deductibles: 8
* Percentage of farmers and ranchers dependent on individual health insurance policies: 33
* Percentage of farmers and ranchers carrying medical debt: 20
* Percentage of all Americans carrying medical debt: 28
* Percentage of rural workers who have jobs with small businesses: 50
* Percentage of urban workers who have jobs with small business: 37
* The likely rate of having no insurance for small-business workers compared with all workers: double
* Percentage of non-elderly urban workers insured at work: 72
* Percentage of non-elderly rural workers insured at work: 61
* Percentage of U.S. physicians working in rural America: 10
* Percentage of U.S. population defined as rural: 25
* Number of dentists practicing in urban areas per 100,000 people: 60
* Number of dentists practicing in rural areas per 100,000 people: 40

Sources: National Rural Health Association, The Access Project, Office of Rural Health Policy, U.S. Census Bureau, The Commonwealth Fund and Center for Rural Affairs

Read the rest and listen at NPR

Why must health reform be isolationist?

By Timothy Noah

Every day Washington's leaders tell us that we live in an interdependent world with a globalized economy. A butterfly beats its wings in Guangdong province, and four Wal-Marts materialize in Duluth. The peso plunges, and 30 Honda workers get laid off in Marysville. A coal-fired power plant belches carbon dioxide in Prague, and Lohachara Island sinks into the Bay of Bengal.

But change the subject to reform of the health care system, and the community of nations abruptly vanishes. No France, no Canada, no Germany, no Japan. Let there be no mention of any industrialized democracy save that of the United States, which is proud to claim 37th place in the World Health Organization's rankings of the world's health systems and 15th in the Commonwealth Fund's ranking by avoidable mortality of 19 industrialized countries (the highest rank indicates the fewest such deaths). To achieve a better score would be unpatriotic!

The political establishment's hubristic refusal to consider how other countries manage health care is encapsulated in the cliché "uniquely American," which is what Sen. Max Baucus, D-Mont., the lead legislator on health care reform, says he wishes his bill to be. It therefore goes without saying that the finance committee Baucus chairs could find no place in this year's exhaustive health care hearings for a single expert on how other countries achieve better health outcomes for their populations while typically spending, on a per capita basis, half what we do. When the finance committee releases its draft bill this week, it will be almost completely free of foreign influence.

Read the rest at Slate Magazine

GOP's New Health-Care Alternative: Death by 1000 Paper Cuts

The House GOP plan was a four-page exercise in public relations that left out how many of the 47 million uninsured Americans would be covered, how it would be paid for or even how much it would cost.

Read more at TIME