The House GOP plan was a four-page exercise in public relations that left out how many of the 47 million uninsured Americans would be covered, how it would be paid for or even how much it would cost.
Over the past five years, almost 20,000 individual insurance policyholders have had their policies rescinded by the three insurance companies who testified today: Assurant, UnitedHealth Group, and WellPoint.
Responding to a budget preparation request I had made recently, Santa Monica’s Director of Finance has calculated that universal single-payer healthcare would save the City six million dollars a year in employee health-benefit costs.
A universal health-care system based on the single-payer model appears to be a bridge too far for politically attuned President Obama.
A single-payer system -- such as Medicare for everyone -- would solve the problem of out-of-control costs and would provide health care for all.
President Lyndon B. Johnson had the courage to weigh in with all his political clout to win passage of Medicare and Medicaid, star accomplishments of the Great Society.
President Franklin D. Roosevelt put all his chips on the table to win passage of the Social Security Act that makes the elderly more financially secure.
All around the world, governments have long made medical care available for their citizens. Why not us?
Obama clearly has no stomach for the political battle that any single-payer plan would ignite. So he's endorsed a step that would allow the government to provide health insurance coverage -- not health care -- to eligible people.
Such government-sponsored health insurance -- the so-called public-plan option -- is now being considered in Congress as it writes health-care reform legislation.
While the public-plan option gets full consideration in Congress, the single-payer model -- such as universal Medicare -- has been unwelcome at the White House or on Capitol Hill. It's too hot politically.
Even the public option faces a struggle. Believe it or not, opponents of that plan -- including many lawmakers beholden to the health-insurance industry -- are still using the bugaboo "socialism" scare word in an effort to intimidate would-be supporters.
Obama said part of the fierce opposition to health-care reform has been fueled "by some interest groups and lobbyists -- opposition that has used fear tactics to paint any effort to achieve reform as an attempt to, yes, socialize medicine."
He made it clear that his idea of health-care reform would allow patients to choose their own doctors and keep their own health plans. Somehow government bailouts have been more palatable for Wall Street plutocrats who happen to be broke and needy.
Obama, apparently fearing to be labeled a liberal, stressed in a speech to the AMA in Chicago this week that he does not favor socialized medicine. (We won't ask him whether he favors government- financed public schools, libraries, roads and parks, just to name a few examples of socialism in our midst.)
Some 47 million Americans are uninsured, many of them because some employers have dropped coverage in the economic downturn. Others lack insurance because pre-existing illnesses deny them access to private insurance. There also are millions with no way to pay for soaring health insurance payments because they have lost their jobs.
Nearly all Republicans and some moderate Democrats are opposed to any public-plan option. These are the same lawmakers who receive many government-provided perks including health insurance coverage.
Sen. Chuck Grassley, R-Iowa, exemplified the dominant Republican viewpoint on the public option when he wrote in the newspaper Politico that as many as 119 million Americans "would shift from private coverage for the government plan" if one were created.
The Obama administration scoffs, contending that such an option would increase competitiveness and lower private-insurance costs.
In his remarks to the AMA, Obama warned against "scare tactics" and "fear mongering" by opponents of the public-plan option, which the president said it should be available to those who have no health insurance.
Obama also told the AMA that a "public option is not your enemy, it is your friend." He rejected the "illegitimate concern that's being put forward by those who are claiming that a public option is somehow a Trojan horse for a single payer system."
Obama should tear a page out of LBJ's vote-getting manual and shame the heartless opponents.
Montana Senator Max Baucus, the chair of the Senate Finance Committee, is the Senate’s point man on healthcare reform. A new article in the Montana Standard finds that Senator Baucus has received more campaign money from health and insurance industry interests than any other member of Congress. The article says, “In the past six years, nearly one-fourth of every dime raised by Baucus and his political-action committee has come from groups and individuals associated with drug companies, insurers, hospitals, medical-supply firms, health-service companies and other health professionals.”
Bill Clinton advised President Obama to stand strong when it comes to a including a single payer option in the healthcare reform bill. Clinton urged Obama not to sell the store, just to get 60 votes to get a healthcare reform bill passed.
Call Sen. Dodd, who is Kennedy's standard-bearer on this one, and tell him you want Single Payer, but if not that, a robust Medicare like public option must be included in the draft that goes to markup:
Tel: (202) 224-2823 | Fax: (202) 224-1083.
You can also e-mail the committee: help_comments@help.senate.gov.
While you're at it, here's the rest of the Democrats on the committee:
Capitol Hill Toll Free Number: 800-828-0498
Tom Harkin (IA): (202) 224-3254
Barbara A. Mikulski (MD): (202) 224-4654
Jeff Bingaman (NM): (202) 224-5521
Patty Murray (WA: (202) 224-2621
Jack Reed (RI): (202) 224-4642
Bernard Sanders (I) (VT): (202) 224-5141
Sherrod Brown (OH): (202) 224-2315
Robert P. Casey, Jr. (PA): (202) 224-6324
Kay Hagan (NC): (202) 224-6342
Jeff Merkley (OR): (202) 224-3753
Help the HELP committee help all of us, by telling them you want Medicare for All- Single Payer and that they must hold the line on a Medicare like public option.
While you're at it, call the White House at (202) 456-1414.
And keep on calling Baucus, Waxman and Rangel as well as your own Senators and Representative.
-Obama's Approval 56% (was 61%) -When told details of Obama's health care plan 55% favor, 35% opposed -3/4 of Americans believe that the public option is extremely or quite important in health care reform
On health care, the public remains open to persuasion. Without being told anything specific about the Obama plan in the survey, about a third of people said it's a good idea, about a third said it's a bad idea and the rest had no opinion. When given several details of his approach, 55% said they favored it, versus 35% who were opposed.
There was also support for the Democratic push to let people sign up for a public health-care plan that would compete with private companies, one of the toughest issues in the health-care debate. Three in four people said a public plan is extremely or quite important. But when told the arguments for and against the plan, a smaller portion, 47%, agreed with arguments in support of the plan, with 42% agreeing with the arguments against it.
At the same time, nearly half the participants said it was very or somewhat likely that their employer would drop private coverage if a public plan were available.
In terms of how to pay for health care reform, Americans do NOT like the Baucus/McCain plan of how to pay for it which is taxing health care benefits.
As for how to pay for the package, estimated at more than $1 trillion over 10 years, the public favors proposals to require all Americans to get insurance, to raise taxes on the rich and, to a lesser extent, to require all but the smallest businesses to offer insurance or pay into a fund.
But majorities oppose plans to tax health benefits, even if the taxes only apply to particularly generous plans. The public is divided about cuts to Medicare.
People want a way to get the health care they need at prices they can afford without fear of financial ruin. It is that simple. If the plan the Democrats decide to offer is so complicated it is hard for the majority of Americans to grasp - they will fear it and we will all lose.
The United States has the best “sick care” system in the world, but our “health care” delivery system is lacking. We have the best doctors, the best hospitals, best academic health centers, best nurses, the best drugs, and we are leaders in research.
Our problem is that the system is not available to all of our citizens. In addition, our health care is not equitable, coherent, comprehensive and cost-effective, nor do we have choice. The United States has 5 percent of the people of the world and 25 percent of the world's wealth. We are the richest country in the world and the only industrialized country that does not provide health care for its entire people.
Health care, which now consumes 17 percent of the U.S. Gross Domestic Product, or $2.4 trillion in 2007, continues to grow in its appetite for our economic resources, while the United States continues to fall in overall health care for its citizens in comparison with the remainder of the industrialized world.
We do not have the best health, ranking 46th in life expectancy, 42nd in infant mortality and 57th in overall goodness and fairness as compared to 192 other members of the Organization for Economic Development and Cooperation.
If the rest of the industrialized world can manage to serve all its citizens on less, why can we not?
Lives at risk The lack of access to health care for so many is literally bankrupting our people and endangering all our lives.
We have depended upon employers to carry much of the burden of health insurance over the years. However, now we find in this global economy that they are at a disadvantage trying to compete with countries that have a public health care system. Health insurance expenses are the fastest-growing cost component for employers. Unless something changes dramatically, health insurance costs will overtake profits.
President Obama’s desire for a health care plan is one that improves coverage for the 45 million to 50 million uninsured citizens, contains costs, and offers high quality, cost-effective, equitable, portable and affordable care for everyone.
We must simultaneously address, integrate and solve the three major components of health care reform: Financing, organizing the delivery system, and educating patients and community, in order to facilitate behavioral and lifestyle changes.
Quality of care would improve if every patient had access to a medical home and an accountable care organization with electronic medical records where care was patient-centered, coordinated and cost-effective.
Monitoring of many of our procedures, techniques, new technologies and drugs needs to be evaluated. We need to replace our inefficient, inequitable financing system with one that works. It needs to include everybody with subsidies for the young, poor and sick. It must require all to pay their fair share.
Physicians must have the information (electronic medical records), infrastructure and incentives they need to improve quality and control cost.
Physicians, heal this system Physicians must become involved in population health. Health is influenced by factors in five domains, which are genetic, social circumstances, environmental exposures, and behavioral patterns and health care. The single greatest opportunity to improve health and reduce premature death lies in personal behavior.
On an individual level, we can do more to improve our own health than all the medical discoveries in the past 100 years.
We must dream big; our vision is for healthy people in healthy communities with a health care system that is right for all of our citizens. It needs to be available, affordable, accessible, patient-centered, prevention-focused, purpose-driven and solution-oriented. It must empower individuals to take care of themselves, foster responsibility and human dignity, improve health and enhance quality of life.
Any new health care system must contain a provision for a public health care policy; this is a single-payer system. People who prefer private insurance can always purchase it instead of purchasing a public health care policy. In this public health care policy, we must provide every person with access to basic health care, including physical and cultural access through transportation and language sensitivity.
We also must provide education to promote health maintenance, preventive measures in order to thwart disease, basic dental health care, mental health care, emergency services and necessary medicines.
A public option Ask Medicare patients if they would like to give up their insurance and I think few would answer in the affirmative. Public health care is well liked in the United States. People who do not receive Medicare may not know that each person pays almost $100 per month for the insurance, which is deducted from Social Security checks automatically. After a yearly deductible, Medicare pays 80 percent of most medical care but not dental care. There is a prescription Medicare (Part D) that is separate from other Medicare and has a variety of plans.
A public health care policy would likely be similar to purchasing Medicare. With Medicare, about 98 cents of every dollar paid in payroll taxes are spent on actually providing health care. When you look at the private insurance companies, it is more like 80 cents. The rest goes to administrative expenses and profits. There are many additional costs imposed on the doctors and health care providers themselves, who have to deal with a fragmented, complex system in which they have to negotiate, amend, or cajole payment from many different insurers.
Both business and individuals are breaking under the strain of our very expensive health care system. We must overhaul our system now; its condition is beyond tweaking to make it function for our people. We have tried to tweak the way we perform health care for many decades with disastrous results. We have tried HMOs, PPOs, indemnity with an assortment of public health systems to catch some of our people who fall between the cracks. It has failed while costing us precious lives, health and money of our people along the way.
We need an overhaul of the health care system to save lives, money and American business.
*Elders, a United Methodist, served as the U.S. surgeon general under President Bill Clinton from 1993 to 1994. She received degrees from United Methodist-related Philander Smith College in Little Rock, Ark., as well as the University of Arkansas Medical School. She is currently professor of pediatrics at the University of Arkansas Medical Center in Little Rock.
U.S. Sen. Sherrod Brown (D-OH), member of the Senate Committee on Health, Education, Labor, and Pensions (HELP), today joined Sen. John D. Rockefeller (D-WV) to introduce the Consumers Health Care Act. The legislation would establish a public health insurance plan that provides an affordable and accountable health insurance option for consumers.
“Congress must include a real public plan option if we want to see truly transformative health care reform this year,” said Rockefeller. “I created the Consumers Health Care Act so we can give the American people the complete coverage they need at an affordable rate. As we move forward with health care reform in the Senate Finance Committee and beyond, I will continue to fight for a public plan option. It is time to end our days of private health insurance charging too much for too little, at the expense of the American people.”
“A strong public health insurance option will help reduce health care costs and improve the quality of health insurance plans,” said Brown, who authored a resolution cosponsored by 28 senators calling for a public health insurance option to be included in health reform. “A public health insurance option will keep insurance companies honest and set a gold standard for medical care. I’m proud to work with Sen. Rockefeller on this legislation which will protect consumer choice, improve patient care, and lower health costs.”
President Obama, House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid, and many consumer-advocate and health care organizations have come out in support of a public plan option in health reform. Over 60 percent of Americans also want to see a public plan option on the table (source: Kaiser Family Foundation, June, 2009).
The Consumers Health Care Act has been endorsed by many groups including Health Care for American Now (HCAN), the Children’s Defense Fund, and the American Academy of Pediatrics.
Overview of the Consumers Health Care Act
Offer a “Consumer Choice Health Plan” as an option alongside private insurance. By bringing a competitive public plan option to the table, private insurance companies will be driven to provide Americans with better value for their health care at a better price, in contrast to the current private insurance framework, which is focused on avoiding risk and increasing their profits.
Establish America’s Health Insurance Trust as a “good housekeeping seal of approval” to give consumers a voice in health insurance oversight. This nonprofit, consumer-driven organization will evaluate and give ratings to all health insurance products offered through the national health insurance exchange – based on factors such as affordability, adequacy, transparency, consumer satisfaction, provider satisfaction, and quality.
The Consumers Health Care Health Care Act can be found by clicking here. [PDF]
Executives of three of the nation's largest health insurers told federal lawmakers in Washington on Tuesday that they would continue canceling medical coverage for some sick policyholders, despite withering criticism from Republican and Democratic members of Congress who decried the practice as unfair and abusive.
The hearing on the controversial action known as rescission, which has left thousands of Americans burdened with costly medical bills despite paying insurance premiums, began a day after President Obama outlined his proposals for revamping the nation's healthcare system.
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Blue Cross of California encouraged employees through performance evaluations to cancel the health insurance policies of individuals with expensive illnesses, Rep. Bart Stupak (D-Mich.) charged at the start of a congressional hearing today on the controversial practice known as rescission.
But documents obtained by the House Committee on Energy and Commerce and released today show that the company's employee performance evaluation program did include a review of rescission activity.
The documents show, for instance, that one Blue Cross employee earned a perfect score of "5" for "exceptional performance" on an evaluation that noted the employee's role in dropping thousands of policyholders and avoiding nearly $10 million worth of medical care.
WellPoint's Blue Cross of California subsidiary and two other insurers saved more than $300 million in medical claims by canceling more than 20,000 sick policyholders over a five-year period, the House committee said.
The committee investigation uncovered several rescission practices that one lawmaker called egregious, including targeting every policyholder diagnosed with leukemia, breast cancer and 1,400 other serious illnesses. Such investigations involve scouring the policyholder's original application and years' worth of medical and pharmacy records in search of any discrepancies.
"These practices reveal that when an insurance company receives a claim for an expensive, life-saving treatment, some of them will look for a way -- any way -- to avoid having to pay for it," said Stupak, chairman of the commerce committee's Subcommittee on Oversight and Investigations.
Todays kerfuffle over the phony release of the grossly incomplete CBO report, is a reminder that what we really need is a complete and honest analysis of all the major health care proposals out there.
Complete is the key word here, because most of what is being talked about, regardless of whether it is Enzi and Grassley, or Baucus and alas sometimes Obama, is just the Federal government cost. That is a dishonest, incomplete picture. What about the costs to State government? What about the costs to Employers? What about the cost to Individuals/families/households...? What about total costs to the U.S., in dollars and as a percent of GNP, showing whether it will really control total costs?
What we really need is a complete, honest, side-side comparison of all proposals, including single payer.
That comparison must NOT bee limited to just the costs to the Federal government, but also the total costs (e.g., currently about 2.5 trillion and 17% of GNP) as well as the costs to State government, employers, and individuals and household of different income levels.
The closest we have is the analysis and report done by the liberal leaning pro-reform Commonwealth Fund think tank, which supports the Obama "Building Blocks" approach, with both individual and employer mandates and a moderately strong public option (essentially the same as Jacob Hacker, HCAN, Campaign for America, Edwards and Clinton from the campaign, etc). Their partner in analysis is the industry gold-standard Lewin Group (which is actually owned by United Health and so if biased, certainly is biased against single payer as well as strong public option.
The Building Blocks plan, like the Obama and Baucus plan, would increase costs overall, and to the federal government and for employers. The Wyden plan dumps even heavier on employers.
Regardless of what the CBO or GAO or beltway mainstream may say, being "revenue neutral" and saving the Federal government money is not the most important goal of health care reform.
We do need to control costs, but it is overall total costs that are what really count.
And, we also need to provide coverage that is truly Universal for all people, Comprehensive in covering all health needs, and does not bankrupt you if you get sick.
I suppose this isn't surprising. Among other things, the AMA represents an ever-shrinking portion of the physician population. And, by all appearances, it represents the profession at both its most craven and conservative. Remember, this is the organization that funded pro-tobacco candidates even as its top public health priority was to reduce smoking. And, remember, this is the orgnaization that in 1995 endorsed Newt Gingrich's plan to savage Medicare by, among other things, forcing beneficiaries to pay more for their care. What convinced the AMA to make this deal? Chiefly, it was Gingrich's agreement to strike a provision that would have cut physician fees.
Of course, not all physicians agreed with the AMA back then. The American College of Physicians, a more liberal group, protested the cuts because of what it would mean for the eldery. And the same is true today. Smaller, more liberal physician groups are lining up behind reform. They want malpractice relief and a Medicare fix, too. But they also want what's best for their patients--and their country. They want to help construct a deal, one that works for everybody.
So the question going forward is how the medical profession as a whole chooses to act. Whatever their lobbying presence in Washington, physicians have enormous influence over the public as individuals. Health reform is a complex issue; patients will be asking their doctors, whom they trust, what to think.
Physicians say they have a higher obligation than other professions, that they are healers and not just tradesmen looking to make a buck. And many really believe that, I know. Now is the time to show it.
