Friday, October 30, 2009

Leaders in Congress Join Kucinich Call to Restore State Single Payer Amendment

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.

Insurers’ Black Box

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

Reid, Durbin Open To Majority Vote To Beat Health Care Filibuster

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

Earth to Lieberman: Connecticut HAS a Public Option

Ha!

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

Chamber Of Commerce To Begin Ads Against Health Care Reform

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....

Hispanics Join Forces to Push For Health Care Reform

From the Latin American Herald Tribune

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.

Blue Dogs' Fundraising Totals Plummet in Third Quarter

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.

The Single Payer movement in California - The 3 year plan for CA Senate Bill 810 (SB 810)

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

Joe Lieberman: I'll block vote on Harry Reid's plan - Updated

POLITICO reports:

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.”

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.
UPDATE - Be sure and take the time to read Marcy Wheeler's piece:

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?

Wyden's Free Choice Amendment, Generic Drugs and the Exchange

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: Health Care Bill Includes Public Option with an 'Opt Out' Provision

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.

New Thomson Reuters Report: Healthcare system wastes up to $800 billion a year

From Reuters:

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:
  • 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.
"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.

Legislators push single-payer health care in Massachusetts and Pennsylvania

From the The Milford Daily News

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?"

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.
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.

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.

Reports: Reid's Bill Is Ready, Includes 'Opt Out' Public Option

From TPM LiveWire

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.

MSNBC, Reuters, the Wall Street Journal, CNN, Fox News and the Washington Post are all reporting this timeline.

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

Health Bill May Cut Employer Mandate

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.

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.
Read it all at NYTimes.com

Single-Payer would be so much less expensive and less confusing... Keep telling your Senators and Representative that is what you want.

Senator Sanders: A single-payer approach saves hundreds of billions of dollars.

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

President Obama: It's Time To Fight

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...

Friday, October 23, 2009

Liberal groups take on Rahm

From The Hill

"We respectfully ask that the Office of the President take a stronger stand on a robust public option in order to enact true health care reform this year," says the letter, signed by representatives of MoveOn.org, Campaign for America's Future, and NAACP

Rep. John Dingell (D-MI) To Nervous Dems: If We Fail On Health Care, We Lose | TPMDC

In a tense, closed door caucus meeting this morning, during which House Democrats were made to go on the record on the question of whether they'd vote for a health care bill with a robust public option, some of the caucus' most nervous members got a bit of perspective from its longest serving members.

"It was really fairly simple speech," said Rep. John Dingell (D-MI). "All I did was to remind the members that the Republicans are out there to beat us by seeing to it that we accomplish nothing during this Congress especially on health care. It's exactly the same tactic, the same strategy they used in 1993. And I reminded them that that tactic took control of the House from us, because, one of the principal reasons was, we were not able to pass a health insurance bill."

Dingell tells me, "I reminded them that Democrats were divided on the issue. And I told them that if they want to come back and control the Congress they should get behind this bill."
The more immediate point, though, is that these members have made the wrong political calculation. "I told them that this country will support members that do what they think is right and go home and defend it," Dingell said, reminding them that the real danger is not that some of the bill's provisions, particularly the robust public option, might be unpopular in their districts, but that they go home empty handed.

Dingell's optimistic. "I think we're going to win--I think we very well have to win."

And he's putting that onus on the freshman and sophomore members who are still sitting on the fence on a robust public option bill, despite a week of intense lobbying on the part of Democratic leadership. "I also pointed out something--that this leadership is working much harder, and much more effectively on this legislation than last time on health care. It failed by only one vote that time. I pointed out that I don't think any of us would want to be the one vote that pulled this bill down."
Read it all at TPMDC

Action Alert: Keep Whipping in the House!

Updates from mcjoan at Daily Kos

There's good news and so-so news coming from the House. With votes still in a state of flux, Pelosi has decided to wait until early next week, probably Monday, to make the decision on whether to include the robust public option based on Medicare Plus 5%, or the negotiated rates public option

All of the "lean yes" members from earlier today have been confirmed as yes votes on the robust public option. Meaning now we're down to about eight that we really need to get. Luckily, folks whipping on the Hill know the most likely folks for us. As CaptUnderpants diaries, these are the members most likely to join in:
* Gabrielle Giffords (AZ-8): 202-225-2542, 520-459-3115, 520-881-3588
* Dennis Cardoza (CA-18): 202-225-6131; 209-383-4455, 209-527-1914
* Joe Donnelly (IN-2): 202-225-3915, 574-288-2780
* Curt Schraeder (OR-05): 202-225-5711, 503-588-9100
* Lincoln Davis (TN-04): 202-225-6831, 931-490-8699, 931-473-7251
* Glenn Nye (VA-2): 202-225-4215 757-326-6201
* Jim Costa (CA-20): 202-225-3341, 661-869-1620, 559-495-1620
* Rick Boucher (VA-9): 202-225-3861, 276-628-1145

If you live in the district of any of these Congresspeople, please call and urge him or her to pledge their vote to a robust public option, based on Medicare rates plus 5%. Make sure to call their district offices as well as DC offices. The impact of constituent calls in district offices is much greater because they generally don't get the same volume of calls as the DC office. The House needs to pass the strongest bill possible going into negotiations with the Senate. All of the things that House members have fought to have included in this bill, not just the public option, will be best preserved with the strongest possible bill being passed by the House.

As usual, leadership needs to hear from us, too. Here they are.

* Steny Hoyer (MD-05): 202-225-4131, 301-474-0119, 301-843-1577
* Chris Van Hollen (MD-08): 202-225-5341, 301-424-3501
* Jim Clyburn (SC-06): 202-225-3315, 803-799-1100
* John Larson CT-01): 202-225-2265, 860-278-8888
* Henry Waxman CA-30): 202-225-3976, 323-651-1040
* Chuck Rangel (NY-15): 202-225-4365, 212-663-3900

Below the fold, I have the list of members who have moved into the solid yes column. If you are so inclined, give them a thank you call.

Fox News' War on the White House

More great work from Media Matters:


Thursday, October 22, 2009

New Weiner Study Shows 151 Members of House and Senate Get the "Public Option" Now

Weiner Calls on GOP Opponents of the Public Option to Give Up Their Medicare
 
From Representative Anthony Weiner:

A new study by Representative Anthony Weiner (D – Queens & Brooklyn), member of the Health Subcommittee and Co-Chair of the Caucus on the Middle Class, revealed that 151 members of the House and Senate currently receive government-funded; government-administered single-payer health care - Medicare.

On the list of recipients are 55 Republicans who have steadfastly opposed other Americans getting the public option, like the one they have chosen.

Weiner said, "Even in a town known for hypocrisy, this list of 55 Members of Congress deserve some sort of prize. They apparently think the public option is ok for them, but not anyone else."

The list of congressional recipients of Medicare who also oppose the public option is below:

House Democratic Caucus to meet Friday Morning to Decide on Public Option



Calls Needed Before Noon Friday
Caucus Meeting starts at 9:30 a.m.

 


From Chris Bowers:
I am told that if the leadership does not confirm 218 "solid" yes votes by the end of the 9:30 a.m. Democratic caucus meeting tomorrow morning, they will probably include the negotiated rate public option in the bill that is sent to the floor, not the Medicare +5% public option. At the very latest, we have until 2 p.m. to get the votes.
Note that "the list" is at the bottom of this post or in PDF format here.
If you member of Congress is on the list, call and leave a message tonight. We have to get through before 9:30 a.m., if possible.

If your member of Congress is not on the list , but you are represented by a Democrat, call your member of Congress and urge them to support the Medicare +5% option at the caucus meeting tomorrow morning.

If you are represented by a Republican, call either a member of the Democratic leadership or a Representative on the list who is from your state.

Call and leave a message. The campaign could really go either way depending on what happens in the next 14-18 hours.
---
The leadership and Democratic Caucus will be meeting Friday morning to determine which version of the Public Option they will include in the House bill.

Nancy Pelosi has said that she believe they have 218 representatives on board for a good public option. That means that they are only 12-15 votes away from the strongest version of the bill - the Medicare Plus 5 version that ties public option rates to Medicare reimbursement rates.

We desperately need the strongest possible House bill going in to conference with the Senate if the final bill is going to help us at all.

As soon as you get up in the morning, please make calls to the following "leaning" Dems. [Set your alarm a bit early so you will have time to call before leaving for work!]

It takes longer to get through - but if you need to, use this 800 number so there will be no cost to you:
1-800-828-0498

These are Representatives we believe are considering supporting the Medicare Plus 5 version. The first number is their DC office, the others are their district office numbers - thanks to Chris and mcjoan at Daily Kos for pulling this information and the the numbers together.

* Ron Klein (FL-22): 202-225-3026, 561-544-6910
* Dennis Moore (KS-03): 202-225-2865, 913-621-0832, 913-383-2013
* Stephen Lynch (MA-09): 202-225-8273, 617-428-2000
* Bob Etheridge (NC-02): 202-225-4531, 919-829-9122, 919-829-9122
* Dina Titus (NV-3): 202-225-3252, 702-387-4941
* John Boccieri (OH-16): 202-225-3876, 330-489-4414
* Steve Driehaus (OH-1): 202-225-2216, 513-684-2723
* Charles Wilson (OH-06): 202-225-5705, 740-633-5705, 330-533-7250
* Christopher Carney (PA-10): 202-225-3731, 570-585-9988, 570-327-1902
* John Sprat (SC-05): 202-225-5501, 803-327-1114
* Ruben Hinojosa (TX-15): 202-225-2531, 956-682-5545, 361-358-8400
* Solomon Ortiz (TX-27): 202-225-7742, 956-541-1242, 361-883-5868
Additionally, it never hurts to put some pressure on leadership. Most of these committee chairs haven't yet committed precisely because they're the committee chairs negotiating with leadership, but they need to hear from us as well to know the strength of public support for the strongest public option possible.

* Steny Hoyer (MD-05): 202-225-4131, 301-474-0119, 301-843-1577
* Chris Van Hollen (MD-08): 202-225-5341, 301-424-3501
* Jim Clyburn (SC-06): 202-225-3315, 803-799-1100
* John Larson CT-01): 202-225-2265, 860-278-8888
* Henry Waxman CA-30): 202-225-3976, 323-651-1040
* Chuck Rangel (NY-15): 202-225-4365, 212-663-3900

Below the is the full list of Dems who haven't fully committed one way or the other on the public option and on the most robust public option possible.

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AHIP Lobbyist To GOP: Don't Give "Comfort To The Enemy" On Health Care

Sam Stein fills us in on what's happening at AHIP's annual State Issues Conference:

A top lobbyist for the major private insurance industry trade group, America's Health Insurance Plans (AHIP), urged Congressional Republicans to not even consider helping Democrats pass health care reform lest they aid an 'enemy who is down.'

Steve Champlin, a lobbyist for the Duberstein Group who represents AHIP, declared that the road to a bipartisan health care reform bill was, essentially, dead. And he urged GOP members to keep it that way.

"There is absolutely no interest, no reason Republicans should ever vote for this thing. They have gone from a party that got killed 11 months ago to a party that is rising today. And they are rising up on the turmoil of health care," said Champlin. "So when they vote for a health care reform bill, whatever it is, they are giving comfort to the enemy who is down."

Wednesday, October 21, 2009

Rape Is a Pre-Existing Condition?

By taking anti-AIDS medicine after a rape, Christina Turner discovered that she had made herself all but uninsurable.

Christina Turner feared that she might have been sexually assaulted after two men slipped her a knockout drug. She thought she was taking proper precautions when her doctor prescribed a month's worth of anti-AIDS medicine.

Only later did she learn that she had made herself all but uninsurable.

New poll from CNN: 61% favor a public option

From CNN

According to the survey, 61 percent favor a public health insurance option that would compete with private plans. That's a six-point increase in support since August.

The CNN/Opinion Research Corporation poll joins an ABC/Washington Post survey released Tuesday in indicating an increase in support for a government option.

Dems Aim To Strip Insurance Industry Of Anti-Trust Exemption

From Huffington Post:

A House committee has voted to strip the health insurance industry of its exemption from federal antitrust laws as senators announced plans to take the same step.

The moves Wednesday signaled a growing determination by Democrats to punish the insurance industry for its criticism of President Barack Obama's health care overhaul agenda. The House Judiciary Committee voted 20 to 9 to repeal a 1940s law that exempted the health insurance industry from federal controls over certain antitrust violations including price-fixing.

Lawmakers said they wanted to include the legislation in a larger health care overhaul bill taking shape in the House. In the Senate, Majority Leader Harry Reid announced plans to repeal the antitrust exemption as part of its health care legislation.

Tuesday, October 20, 2009

Pelosi Prepares To Move Ahead With Robust Public Option

From TPMDC

A preliminary analysis from CBO may have sealed the deal. Speaker Nancy Pelosi is preparing to move ahead with a "robust" public option--one that reimburses hospitals and providers at Medicare rates, plus five percent--in the House's health care bill. She is briefing her caucus about the plan's savings tonight, and, pending the approval of a sufficient majority of members, will adopt the measure as part of the complete reform package
The bill remains nominally more expensive than the Senate Finance Committee proposal, but would cover 96 percent of all Americans, providing greater bang for each federal dollar spent. And, aides note, the bill that comes to the floor of the Senate will be a hybrid of the Finance and more expensive HELP Committee bills, so the price is expected to rise.

Meanwhile, since the Weiner Amendment for Single Payer will get a vote on the floor, the CBO is in the process of scoring it.

Most support public option for health insurance, poll finds - washingtonpost.com

From washingtonpost.com

A new Washington Post-ABC News poll shows that support for a government-run health-care plan to compete with private insurers has rebounded from its summertime lows and wins clear majority support from the public. Click Graphic to enlarge.  Read the article.

Medicare for All is still on the table

Medicare for All--

  1. The Weiner amendment [PDF] --will be submitted for a floor vote in the House, in the coming days,  - This will be a historic vote - the fist time ever Single-Payer has gotten a floor vote.

  2. The Kucinich amendment, [PDF] which will more easily allow states to implement single-payer plans, is already within the bill and must be retained.

Please contact your member of Congress (and members of the Congressional Progressive Caucus (CPC)) to ask them to vote in support of both amendments.

Passing these amendments will be difficult, but the votes on them will help set the benchmarks for the next debates on health care so they really do matter. Win or lose, we’ll know who our friends in Congress are...

  1. Sen. Bernie Sanders is sponsoring a Medicare for All bill in the Senate, S. 703. Tell your Senators to support it; find contact info here.  He has said that he will be introducing amendments to the Senate Health Care bill, so keep your eyes and ears open for them.
Why it is important to keep fighting for real Health Care Reform:

As Kip Sullivan points out in "Public option" bait-and-switch campaign fools pollsters"
The New York Times reported on Saturday, October 17, that Sen. Ron Wyden (D-OR) is warning his constituents that the “public option” is not going to be available to the great majority of Americans. No one who has actually read the Senate health committee’s “reform” bill or the House “reform” bill (HR 3200) disputes this. According to the Congressional Budget Office, the “option” will be available only to about 30 million people, or about one American in ten. As the Times put it (slightly inaccurately), the “option” in the Democrats’ legislation “would be out of bounds to the approximately 160 million people already covered through employers.”

Does the public understand this? According to Wyden, they don’t. Wyden says his constituents are shocked when they are told the "option" will not be available to the vast majority of Americans. When he began informing his constituents about this truth last summer, "They nearly fell out of the bleachers," he said.
Once a bill is passed and signed by President Obama, voters will start to learn just how little help the current reform policies will provide. While it is probable that the reforms will continue to funnel money to the Health Insurance companies to fund their lobbying machines, the relief for citizens maybe too little and/or too complicated and I don't believe anything currently being offered will be sustainable in the long term. So we will come back to this table. And that is why good support for the current Single Payer amendments to H.R. 3200 in the House are critically important.

More Info About How To Help, Here

Saturday, October 17, 2009

New York Times Admits Shutting Out Single-Payer

From the Center for Media and Democracy

The media analysis group Fairness and Accuracy in Reporting (FAIR) issued an action alert September 22 titled "NYT Slams Single-Payer" that described lopsided reporting in a New York Times article about "Medicare for all," a form of a single-payer health care system.

FAIR noted that the article, titled "Medicare for All? ‘Crazy,’ ‘Socialized’ and Unlikely", laid out a list of arguments against single-payer while failing to include any balancing responses from the option's supporters.

In explaining the slant, article author Katharine Seelye said she was trying to explain why Medicare-for-all was "not going anywhere." "I thought the substance of [single-payer] had been dealt with elsewhere many times," she said.

On October 13, Times public editor Clark Hoyt conceded that FAIR "had a point," and agreed that the article excluded the point of view of single-payer health care system supporters.  FAIR said it finds Seelye's defense "alarming," and points out that the Times, like the rest of the corporate-owned media, has given the issue of single-payer health care "scant attention."
ACTION:
Ask New York Times public editor Clark Hoyt to have the Times run a piece devoted to the case for single-payer healthcare - Medicare for all. The public deserves to have the full story.

    CONTACT: New York Times Clark Hoyt, Public Editor public@nytimes.com Phone: 212-556-7652

Senate Procedure. What happens if the Health Care bill goes to the floor without a Public Option

From David Waldman in a Comment at Daily Kos

If the bill comes to the floor with no public option in it, and the "deal" is that opponents are to be allowed a vote on an amendment that would add it in, here's what will happen:
  1. The "deal" will be a unanimous consent agreement that the public option amendment (and possibly other amendments) will require 60 votes to pass
  2. The public option amendment will garner majority support on the Senate floor -- say, around 55 votes -- but because Senators agreed unanimously that 60 would be needed, the amendment would fail
  3. The Senate would pass a bill with no public option, and would go to conference with the House to settle that difference (and all others)
  4. The House and Senate would vote on whatever settlement they reach in conference, and the fate of the public option would be in the hands of the conferees

Now, why would there be such a unanimous consent agreement?
  1. Opponents of the public option will threaten to filibuster an amendment to add it
  2. leadership on both sides will know that the filibuster will be useless if there are 60 votes to end it
  3.  leadership also knows that ending a filibuster means:
    •  the trouble of conducting that filibuster
    •  filing a cloture motion which takes one day plus one hour (at minimum) to become eligible for a vote on it. 
    •  the trouble of running out the clock on the 30 hours of post-cloture debate permitted by the rules
  4. So instead of going through all of that, they agree ahead of time to transfer the 60 vote threshold onto the vote on the amendment itself
Transferring the 60 vote threshold directly onto the amendment itself puts the amendment at no disadvantage relative to the hurdle of overcoming an actual filibuster, so in that sense it's not a concession at all. But it does relieve opponents of the public option amendment of the burden of having to go on record as opposing cloture on that amendment. Instead, all they have to do to require 60 votes to pass it is silently assent to a unanimous consent agreement.
Read the diary this was posted to, also by David Waldman: Remember the "Painless Filibuster?" See also: Is there a (scary looking) deal that can help the public option survive the Senate?

Jon Stewart Takes On the 30 Republicans Who Voted Against Franken's Anti-Rape Amendment

Must watch, if you missed this segment. Women who vote for these 30 Republican jerks really need to take a hard look in the mirror, or maybe their daughters' faces.

The Daily Show With Jon Stewart
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In The Nation, Emily Douglas provides some background info if you need it, along with a reminder of the bravery it takes for rape victims to speak out:
Upon hearing the amendment passed, Jamie Leigh Jones told the Minnesota Post: "It means the world to me...It means that every tear shed to go public and repeat my story over and over again to make a difference for other women was worth it." It's a reminder that rape survivors go public with their stories at a serious emotional cost, and the onus is on political leaders and advocates to make it worth what could be only in the most euphemistic sense be referred to as their while.

At the end of his segment on the bill, John Stewart tied it all up with a bow. Now we get it! Comparing this move to regulate government contractors to ACORN's frozen funding, he says, "You don't want to waste taxpayer money on someone who advises fake prostitute how to make imaginary crimes. You want to give it to Halliburton, because they're committing real gang rape. You cut out the middleman! And they say government doesn't work."

Friday, October 16, 2009

C-Sections are "pre-existing conditions." No Insurance coverage until you are sterilized

Peggy Robertson was denied insurance coverage because she had a c-section. She was later told that if she was sterilized, she would be able to gain coverage.


CBO scores two House bills at or below cost of Baucus bill

From Daily Kos a report on a Washington Post story:

Congressional budget analysts have given House leaders cost estimates for two competing versions of their plan to overhaul the health-care system, concluding that one comes within striking distance of the $900 billion limit set by President Obama and the other falls below it.

House leaders have been working to lower the cost of the $1.2 trillion health-care package they offered in July. The report from the Congressional Budget Office, a copy of which was obtained by The Washington Post, puts the cost of one plan at $859 billion over the next decade and the other at $905 billion.

....

Both packages are based on the original House framework, which proposes to extend coverage to more than 30 million Americans by expanding Medicaid eligibility and subsidizing private insurance for people who lack access to affordable coverage through an employer. Each would expand the ranks of the insured to more than 95 percent of Americans by 2019, and each would create a government-run insurance plan to compete with private insurance companies.

Thursday, October 15, 2009

Without Drastic CO2 Cuts Immediately, the World Faces a Massive 'Oh Shit' Moment

A frightening new climate change study says the United States must eliminate its enormous rate of carbon emission within ten years. Read it all at AlterNet

Blog Action Day 2009: Climate Change Resources


1. Google has built a site where you “explore the potential impacts of climate change on our planet Earth and find out about possible solutions for adaptation and mitigation, ahead of the UN’s climate conference in Copenhagen in December.” They’ve got a Google Earth mashup, a introductory video featuring Al Gore, and more. Visit: Climate change in Google Earth

2. Climate change is a human issue. It isn’t just about saving the planet and communities around the world face serious threats from the climate crisis. The TckTckTck campaign has created a great tool for learning the stories behind the human face of climate change. It’s called the Climate Orb and it is an animated interactive tool housing first-hand stories searchable by country, keyword and timeframe. Explore the Climate Orb.screen-capture

3. There’s a lot more to solving the climate crisis than just sitting back and leaving it to world leaders and policy wonks to figure everything out. Need inspiration? Meet Alec Loorz, the creator of Kids vs. Global Warming. He describes it as “group of kids that educate other kids about the science of global warming and empower them to take action.” The site shows that everyone really can play a role in tackling climate change.

4. Just the facts, that’s what some people want—as long as there are lots of cool charts, graphs and clear explanations of course.  That’s what’s great about the Pew Center for Global Climate Change’s "Facts and Figures" site, it is filled with all the charts and graphs you need to get a much clearer picture of what causes climate change and what effects it has. If you want even more information you can also check out their entire Climate Change 101 series.arctic-sea-ice-decline

5. At this point you’ve probably heard of “carbon footprints” and you might have even used an online calculator to figure out what yours is (and thus what your impact is on climate change). The problem is that there are just so many calculators out there now it can be hard to figure out which one to use. Thankfully you can learn about your options from MNN’s 15 Best Carbon Calulators survey.

6. OK, but how will climate change affect you? What are the consquences that are mostly likely to impact your day-to-day life? Take a look at this list of The Top 100 Effects of Climate Change. From “Say Goodbye to Pinot Noir” to “More Bear Attacks” to “Malaria Spreading in South America” to “More Stray Kitties” it seems like climate change is going to have a lot of consequences, some big, some not so big.

wine
7. On the other side of the coin, you might want to be a little more optimistic and review the science behind “10 Solutions for Climate Change” which details what we can actually do to solve these problems personally and as a larger society.

8. Finally, don’t forget that people all around the world are getting involved and taking action.

Next week, on October 24, 350.org is organizing the International Day of Climate Action. You can visit their site and see what people all around the world are planning to do next week to demonstrate their commitment to stopping climate change.

Learn More at Blog Action Day 2009: Climate Change

Wednesday, October 14, 2009

Health Care State of Play

From Chris Bowers at Open Left

# In the House, the public option tied to Medicare rates has 200 confirmed supporters. However, that appears to include the leadership at this point. Further, the count will drop to 199 when Robert Wexler leaves Congress, and his replacement will not be sworn in before the health care vote. The CA-10 and NY-23 special elections will both take place on November 3rd, with the former guaranteed to send another public option supporter to Congress and the latter guaranteed to send a public option opponent.

Worth noting: Of the four dozen undecided and "lean no" members the Progressive Caucus is targeting at this point, half were first elected in 2004, 2006 or 2008. As such, it really shouldn't be difficult for the overall House leadership to pass a public option with Medicare +5% rates if they wanted to. If they want access to the party treasury for re-election, then they better not sink the policy aims of the overwhelming majority of the party.

# In the Senate, despite Lieberman's recent grumblings, everything I hear still points to Evan Bayh, Mary Landrieu, Blanche Lincoln and Ben Nelson as the main obstacles to passing a public option. As leader of the Conservadems (looking in to increase power), as someone who voted against the budget (appears to oppose even the principle of universal health care), and as a scorned Vice-Presidential short-lister who shifted sharply to the right in 2009, Evan Bayh strikes me as particularly problematic. Check out this quote of his in the Politico, where he basically says he will join in a Republican filibuster against virtually any health care bill:
"It's not fair to ask people to facilitate the enactment of policies with which we ultimately disagree," said moderate Sen. Evan Bayh (D-Ind.). "So the closer we get to the end of the process, the more, for me, the process and policy will be one and the same."
It isn't fair, eh? How about the fairness of the Senate elevating itself to unicameral status through its culture of 60-votes? Is it "fair" to use the filibuster to destroy the branch of Congress that actually has equal representation for the American people?

Grayson, Progressives Push Reid To Strong-Arm Lieberman, Conservative Dems; Schumer tells Reid to put Public Option in and make 60 vote it out

Now that the primary responsibility for health reform has shifted to Senate Majority Leader Harry Reid, progressives are pushing him to get tough with conservative Democrats looking to delay progress of a unified Senate reform bill.

Progressive Caucus member Rep. Alan Grayson (D-Fla.) and representatives from the Progressive Change Campaign Committee delivered their respective petitions to Reid's office Wednesday afternoon. With some 87,000 signatures collected in the past week, the PCCC urged Reid to strip leadership powers from members of the Democratic Caucus who do not vote for cloture to prevent a Republican filibuster -- a clear shot at Sen. Joseph Lieberman (I-Conn.), who chairs the Homeland Security committee and said Monday he "wouldn't rule out" allowing a filibuster to proceed.

Reiterating the urgent need for reform outside the Hart Senate office building Wednesday afternoon, Grayson didn't single out any congressmen or senators, but said he was baffled by continued delays given the Democratic supermajority and the cost of delay.

"Every single day in America, 122 more Americans die for lack of health insurance. That means that as we stand here in front of you right now, one or two or three more Americans have died because we have not acted yet," Grayson said. "I apologized to the dead and their loved ones for our inaction. Now it's time to move beyond that and get the job done."
Reid's deputy, Sen. Dick Durbin (D-Ill.), said the PCCC and Grayson ought to "count to 60 and understand we need to be together, and there are times when we need to work out our differences."

Grayson wasn't sympathetic to that argument Wednesday, noting that other Americans are paying the price while the Senate tries to work out its differences. Pulling a large American Journal of Public Health study from his jacket pocket, he said, paraphrasing the study authors, "You take two Americans who are otherwise identical in every single way -- same age, same gender, same race, same smoking habits, same weight -- you put them side by side, if one has insurance and one does not, the one without insurance is 40 percent more likely to die."

Read it all at Huffington Post

Update:
Reid pushed back Wednesday afternoon against the consensus that health reform is on him -- after Sen. Chuck Schumer (D-N.Y.), laid the fate of the public option in the Majority Leader's hands Tuesday night. "He would rather say anything so it wasn't up to him," Reid snapped Wednesday, en route to a meeting with White House Chief of Staff Rahm Emanuel and Sens. Chris Dodd (D-Conn.) and Max Baucus (D-Mont.).

Dodd said he expects the Senate finance and health bills to be reconciled by the end of next week. "The Leader will set the agenda," he said.

Here is Schumer with the best plan:

SCHUMER: "Well, first, Leader Reid has the option of putting it in the final bill. If he puts it in the final bill, in the combined bill, then you would need 60 votes to remove it. And there clearly are not 60 votes against the public option."


"...it is our professional responsibility to educate and advocate for effective reform"

On Monday October 5th, Drs. Margaret Flowers and Paul Hochfeld led a delegation of 15 physicians and nurses to the White House gate. The occasion was a Rose Garden ceremony with over 100 physicians in white coats invited, a photo-op to showcase support among doctors for the President’s effort at health reform.


Dr. Margaret Flowers, Congressional Fellow of Physicians for a National Health Program, was later contacted by one of the doctors allowed in the gates. The following is her response:
Don’t let the good be the enemy of the perfect

Thank you for inviting me to this conversation. I understand your concern to get some type of reform now. I hear your desperation. I have felt it myself. There is so much suffering that it is tempting to say – we must get something even if we know it is not the solution.

At some point we have to look at the facts that incremental change and compromise when it comes to health reform in this nation have not gotten us anywhere. While SCHIP is great, it has merely held the level of uninsured children at bay, not decreased it. Medicaid expansions have similarly not been able to keep up with the rising uninsured or been able to provide a financially sustainable and high quality solution. Why is this?

It is because the greatest impediment to health reform in this country is that the for profit (and not for profit in some cases, such as BCBS) health industries control the political process. No amount of incremental reform will change that. Regulation of the industry is expensive and has been ineffective. The industry can do an end-run around regulation so fast that it would make your head spin. With the proposed legislation, we will be throwing more money into an already overpriced and dysfunctional situation. We will delay enactment of better reform while we wait to see if this reform works, all the time knowing that it won’t. In the meantime, thousands of people will die unnecessarily, thousands of people will suffer, families will continue to go bankrupt and lose their homes, physicians will continue to leave practice.

Single payer was not supposed to be on the table this year, yet despite having little in the way of funding and no paid organizers (like HCAN has), we were able to move it forward and break through some of the media blackout through perseverance and dedication.

We must ask ourselves, how long are we willing to play the incremental game (knowing that while a few more get access to healthcare, many more continue to be left out)? When will we decide that we’ve reached the tipping point, and like other social justice movements, dig in and do the necessary work to enact change?

I am tired of hearing that we can’t have single payer or that it is not on the table. It will never be on the table and we will never get it until we do the work to put it there. We, as physicians (and the other health professionals), hold a unique position in society. For the most part we are seen as advocates for our patients and acting in the best interest of our patients (although sadly this vision is truer for nurses than for doctors). We are seen as "experts." Thus, I believe that it is our professional responsibility to educate and advocate for effective reform. If we work together we can create real change. But it is harder than showing up for a photo shoot. It takes a lot of time and travel and writing and speaking and money and a willingness to put our bodies on the line.

Until more of us are willng to do this, we will have to continue to settle for crumbs. I am not willing to settle for crumbs. My part in this drama is to be a strong voice for single payer. And I won’t give in until we get there. The stories that I hear from patients and docs keep me going. Nobody should be left out. Everybody should have the same level of care. It is our responsibility to fight for this. Anything less is unacceptable.

My two cents, for what it’s worth.

Respectfully,
Margaret


Additional comments from Dr. Andrew Coates:
Single-payer advocates should take note. Dr. Hochfeld was allowed to attend the ceremony, uninvited and at the last minute, because single payer cannot be ignored. Our persistence has proven effective. The goal of the mainstream discussion, orderly consensus for incremental change, with nary a ripple of discord, as remained elusive. Yet experience proves again and again that single payer swims just below the surface.

All year long it has become more and more clear – to more and more people – that single payer national health insurance is in fact the very least we need when it comes to health care reform that will work to improve our lives. As Dr. Flowers explains, "Anything less is unacceptable."

This just-below-the-surface dynamic, combined with clear and persistent advocacy, that has taken single payer from "off the table" to "on the floor" this year. We now learn that the vote on HR 3200 – and with it, the Weiner amendment that would substitute single payer legislation for the text of the bill – may be imminent. Activists around the nation are pulling out all the stops.

So the single payer presence within the beltway continues, even now, to increase, not diminish. We also recognize that soon we will begin a new chapter in our efforts to educate and advocate for a single-payer national health program.

Source: PNHP's Blog

Senior Doctors Make The Case for National Health Care Reform and A Public Option

From PNHP

Fifty-nine members of the Harvard Medical School Class of 1959 are convinced that reform of the American health care system is essential, must be substantial and carefully designed, and must include a public health insurance option.
Each of the signers has 50 years of experience and leadership in clinical practice, medical education, administration, and/or research. Our collective careers cover a wide variety of primary care and specialty fields in a range of organizational settings, in both private practice and academia, across the United States.
Excluding a public option would throw away a vital opportunity to test different ways to provide quality care for all. A public plan would help develop and evaluate new standards of practice, malpractice reform, and reimbursement of physicians, and would emphasize preventive care. To be affordable, it would have to avoid financial incentives for unnecessary services and contain measures that curb financial abuse and waste by some hospitals and, unfortunately, by some of our medical colleagues.

A public option would also identify and encourage use of demonstrated best practices shown to be effective at less cost, offer greater access, and provide higher quality of care. Administrative overhead, as now in Medicare, would be significantly lower without for-profit intermediaries. These innovations could help lift the competitive burden that health care places on American employers in the global marketplace, while also offering portability and continuity of coverage during job changes and illness.

Common sense demands a planned, full comparison of the relative benefits of public vs. private options. At the outset, there must be clear and uniform ground rules for measuring, reporting, and evaluating cost, access, and quality of care for all plans.

We urge Congress and the President to take this courageous step at a vital time in our nation’s history.

Unions Spurn White House to Oppose Senate Health Bill

From Bloomberg.com

Twenty-seven U.S. labor unions defied White House Chief of Staff Rahm Emanuel and announced their opposition to the $829 billion health-care measure passed yesterday by the Senate Finance Committee.

The unions say in a full-page newspaper advertisement today that lawmakers need to make "substantial" changes to the bill or they will urge their members to seek its defeat on the Senate floor. Emanuel asked organized labor not to go public in opposition, said Gerald McEntee, president of the American Federation of State, County and Municipal Employees.

"He told us that we really don't want to be looked upon as the group that stopped meaningful health-care reform," McEntee said in an interview yesterday. "We would love to be on the exact same page as the White House, but we see ourselves as fighting for our members."

Tuesday, October 13, 2009

Baucus Committee OKs a Health Bill, But Not Reform

From John Nichols at The Nation

So it is in the U.S. Senate, where the Finance Committee finally got around to finishing its health care reform assignment.

The vote on the measure -- which does not include a public option to hold insurance companies to account -- was 14-9, with all Democrats on the committee and Maine Republican Olympia Snowe voting Tuesday to toss the measure into the legislative sausage-grinder that will eventually produce final legislation for the Senate to consider.

The important thing to remember is that for all of Tuesday's attention to the finance committee vote, the full Senate will never vote on this particular measure.

Senate Health, Education, Labor and Pensions Committee chair Tom Harkin, D-Iowa, has said throughout the process that "the bill that (the Finance Committee) proposes is just that – a proposal."

Harkin is too polite to state the obvious: The Finance Committee proposal is no more likely to become law than the slacker student's last-to-be-handed-in homework assignment is to be awarded academic honors.

That's a good thing because the Finance Committee bill falls far short of real health care reform. It steers billions of taxpayer dollars into the accounts of insurance companies while failing to provide a realistic, humane or fiscally-responsible alternative to their profiteering.
The problems with the Finance Committee's proposal extend far beyond the fact that it fails to establish a government-run alternative to compete with the private insurers that will be ridiculously enriched by it.

But the lack of a "public option" should make the Baucus bill a nonstarter. As insurance-industry insider turned whistleblower Wendell Potter explained in an advertisement produced by MoveOn.org, the Baucus bill would, if enacted effectively, "kill health reform."

"Take it from me," argues Potter, "the Senate Finance bill is a dream come true of the health insurance industry. If there is no public option insurance companies aren't going to change. The choice of a public health insurance option is the only way to keep insurance companies honest."
Perhaps that is why the other four congressional committees that produced health-care reform bills – three in the House and the Senate Health, Education, Labor and Pensions (HELP) Committee -- have included far more robust language with regard to alternatives to for-profit insurance companies.
It is Harkin, not Baucus, who is the serious health-care reformer in the Senate.

It is Harkin, not Baucus, who has consistently promoted the public option and who continues to argue that it can and will be a part of any final legislation. "Look," says Harkin, "five committees have reported a bill out on healthcare. Four of them have a public option. One doesn't. So you would think the weight would be on the side of having a public option in the bill – and that's where it is."

And it is Harkin, the chairman who gets his work done on time and right, that we should be paying attention to now that Baucus has finally finished his silly sideshow.

Monday, October 12, 2009

Insurer Industry takes aim at Senate Finance Committee healthcare reform bill

AHIP - the insurance industry, has funded a new study attacking the Senate Finance Committee health reform bill, claiming it will hike family premiums.

  • The White House to then issued new talking points attacking the study as a “self serving” effort to defend its “profits."
  • While the study seems to help reform foes, it actually makes a good case for Single-Payer or a Medicare like Public Option and should make it easier for Dems to cast opposition to reform as orchestrated by the insurance companies.
  • Even some GOP aides are worried about this.
  • Ezra Klein shreds the report on the facts, as does Jonathan Cohn who got MIT economist Jonathan Gruber to review AHIP's PriceWaterhouseCoopers report and says that the AHIP Claim on Benefits Tax is "Implausible".

msnbc.com reports:
The health insurance industry has been working until recently to help draft legislation, while publicly endorsing President Barack Obama's goal of affordable coverage for all Americans. The alliance has grown strained as legislation advances toward votes in Congress.

Late Sunday, the industry trade group America's Health Insurance Plans sent its member companies a new accounting firm study that projects the legislation would add $1,700 a year to the cost of family coverage in 2013, when most of the major provisions in the bill would be in effect.
I think they make an excellent case for Single-Payer... Medicare For All:

Study: Premium increase
Premiums for a single person would go up by $600 more than would be the case without the legislation, the PricewaterhouseCoopers analysis concluded in the study commissioned by the insurance group.

"Several major provisions in the current legislative proposal will cause health care costs to increase far faster and higher than they would under the current system," Karen Ignagni, the top industry lobbyist in Washington, wrote in a memo to insurance company CEOs.

The study projected that in 2019, family premiums could be $4,000 higher and individual premiums could be $1,500 higher.
But the PricewaterhouseCoopers analysis attempted to get at a different issue — costs for privately insured individuals.

It concluded that a combination of factors in the bill — and decisions by lawmakers as they amended it — would raise costs.

The chief reason, said the report, is a decision by lawmakers to weaken proposed penalties for failing to get health insurance. The bill would require insurers to take all applicants, doing away with denials for pre-existing health problems. In return, all Americans would be required to carry coverage, either through an employer or a government program, or by buying it themselves.
Other factors leading to higher costs include a new tax on high-cost health insurance plans, cuts in Medicare payments to hospitals and doctors, and a series of new taxes on insurers and other health care industries, the report said.
While I do believe the Insurance Industry through AHIP is being disingenuous with this report, it does still demonstrate how current plans under review are far more complicated and expensive than they need to be. We have a historic opportunity for members of Congress to go on the record in support of single-payer legislation and we should push for those votes. A significant of YES votes helps establish a benchmark so with healthcare reform returns for debate again - as it will given the plans offered - we won't have single payer taken off the table before then negotiations begin.

Note that the text in the above forms will need a bit of revising - which you are free to do and should do. I would also urge you to ask them to request that the Congressional Budget Office score HR-676. Let Congress and the public see where the real efficiencies are.

More Info on upcoming Single Payer votes here.

Saturday, October 10, 2009

Health Insurers Threaten Rate Hikes

Industry representatives put Congress and the Obama administration on notice that if health-reform legislation doesn’t send even more new customers the industry’s way or if a windfall profits tax is included, the industry would hit businesses, individuals and the government with higher premiums, effectively defeating one of the initiative’s top goals, reining in ever-rising costs.

The industry’s chief complaint, which was raised in connection with an already-industry-friendly bill cobbled together by Senate Finance Committee chairman Max Baucus, is that the legislation would push 29 million more Americans into the insurance market, but that they might be the sickest and thus costliest people.

The industry wants more of the estimated 25 million still uninsured – especially healthy, young people – to be compelled to buy policies, too. Without more healthy customers added to the mix, the industry says it will have no choice but to raise rates.
Read it all at Truthout

Bill Moyers on Max Baucus and Senate health insurance reform bill

BILL MOYERS: You know from the news that early next week the Senate Finance Committee is expected to vote on its version of health care reform. And therein lies another story of money and politics.

Polls show the overwhelming majority of Americans favor a non-profit alternative -- like Medicare -- that would give the private health insurance industry some competition. But if so many Americans and the President himself want that public option, how come we're not getting one?

Because, the medicine has been poisoned from day one, in part because of that same revolving door that Congresswoman Kaptur and Simon Johnson were just talking about. Movers and shakers rotate between government and the lucrative private sector at a speed so dizzying they forget who they're working for.