Seven Members of Congress have now signed a letter to House Speaker Nancy Pelosi requesting that Democratic Leadership restore the Kucinich Amendment to the health care reform bill before bringing the bill for a vote.
Added to H.R. 3200 in the Education and Labor Committee, the Kucinich Amendment removes an obstacle for states that seek to enact a statewide single payer health care system.
In addition to Congressman Kucinich (D-OH), Representatives John Conyers, Jr. (D-MI), Eric Massa (D-NY), Neil Abercrombie (D-HI), Janice D. Schakowsky (D-IL) Lynn C. Woolsey (D-CA), Raúl M. Grijalva (D-AZ) have signed the letter.
The full text of the letter follows:
October 30, 2009
The Honorable Nancy Pelosi
Speaker of the House
U.S. House of Representatives
H-232 The Capitol
Washington, D.C. 20515-0001
Dear Madam Speaker,
We write to request that the Kucinich amendment that would grant a waiver of the application of ERISA to a state single payer plan be included in the Manager’s amendment to H.R. 3962.
Like many other important reforms included in the underlying bill, the Kucinich amendment is the object of attack by the insurance industry. Unlike other reform measures, Leadership has chosen to strip the Kucinich amendment of the protection it deserves. In view of the power of the insurance industry to divide and conquer good ideas for reforming health insurance in this country, we believe that a simple vote on the floor would be a setback for the amendment and for single payer health care, because it would be exposed to the full brunt of the insurance industry’s attacks.
Progressives are firm and emphatic in their support for the single payer health care. A single payer, Medicare for All health system is the best way to control costs, drive up quality and extend care to all. Allowing states to opt for a single payer plan is a compromise. It is an incremental reform. But it allows the country to move incrementally in the direction that is needed.
The Kucinich amendment strikes a balance between where we need to go and where we can go in the next week. We urge you to include it in the Manager’s amendment.
From the Center for American Progress:
Consumers have a strong interest in picking a company that will reliably pay their legitimate claims when they need medical treatment. But health insurance companies don’t disclose the percentage of claims they reject and decline to pay. And inquiries by the Center for American Progress show that the nation’s insurance regulators have not asked them to do so.
CAP in recent weeks launched an investigation to determine whether data on commercial health insurers’ claim denial rates is available nationwide or in any states. The research included interviews with multiple senior officials of the National Association of Insurance Commissioners, other current and former insurance regulators and government officials in states around the country, officials at health insurance companies, academic experts, and others. All said that no such data is available. No state insurance regulators or federal agencies require insurers to disclose their claim denial rates, except in California. California’s Department of Managed Health Care requires insurers to include it in reports they file.
CAP also asked each of the nation’s seven largest for-profit health insurers—Aetna, Anthem Blue Cross Blue Shield, Cigna, Coventry, Health Net, Humana, and UnitedHealth care—if for the purposes of this report they would disclose their overall rates of claims denials and breakdowns by reason for the denials. All of the companies declined or did not give any direct response to the request. Spokesmen for the companies in general said that the insurers pay the vast majority of claims, and that denials are fair, with most occurring for routine reasons such as a patient erroneously submitting the same claim twice or a physician sending a claim to the wrong company.
But the reports from California indicate why health insurance companies may be reluctant to disclose their claim denial rates. That data shows that three of the six largest health insurance companies in the state each denied 30 percent or more of all claims filed in the first six months of 2009. It also showed wide variations in denial rates among the companies. The most sensitive and potentially controversial claims are those based on medical criteria—such as whether a treatment is medically necessary or should not be covered because it is deemed experimental. CAP learned in interviews with former senior medical personnel at several of the largest insurers that big insurers—including Aetna, Cigna, and UnitedHealth care—made internal changes in recent years that gave business executives more direct authority over the companies’ doctors who evaluate claims based on these medical criteria.
Insurance companies had previously maintained a separation between the medical evaluation staff and the executives responsible for financial performance. The doctors and nurses reported to the companies’ chief doctor—known as the chief medical officer—who had final say on whether coverage for a particular individual’s treatment should be granted or denied based on medical criteria. But beginning about a decade ago, in a shakeup that evidently received no public attention, companies changed their policies so that the medical staff reported to regional business executives. These executives were given the authority to determine the doctors’ pay, bonuses, and promotion, and consequently they gained the power to influence the doctors’ decisions. The new systems generally kept “dotted line” reporting to the chief medical office, who would still weigh in on the most difficult claims decisions
Read it all...
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
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
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....
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.
Guess what happens when you stand in the way of something the public really wants... like a government run health care program...
From The Center for Public Integrity
After raising $1.1 million from January to June, the committee raised less than $87,000 between July and September — less than it brought in during any one of the preceding five months. And in just three months, the Blue Dog PAC's monthly fundraising average dropped by more than $50,000 — probably not the sort of fiscal conservatism the 52-member coalition was hoping for.
California One Care is the focal organization for the Single Payer movement in California. Their plan is as ambitious as it is well planned and will be as visible as it will be instrumental in bringing about to the whole country the ONLY Public Option framework that makes sense.
The main attractions included the outrageous Paula Poundstone and the outstanding California Senator Mark Leno, author of the centerpiece of this 3 year plan Senate Bill 810 (SB 810).
But perhaps THE main attraction was the 32 30 second spots featuring Hollywood celebrities such as Lily Tomlin, Elliott Gould, Ed Begley Jr., Valerie Harper, Ken Howard, Connie Stevens, Laraine Newman, Susan Savage and many more.
The spots which will air starting in February 2010 after SB 810 is passed in Sacramento were produced by the indefatigable Don Schroeder who is the liaison between California One Care and Hollywood. He also presented the 3 year plan to make California be the first state to adopt Single Payer.
Read it all
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?
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:
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.
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.
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.
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.
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.
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