Health Care For America Now

NEWS

Obama Plans Bipartisan Summit on Health Care - New York Times

President Obama said Sunday that he would convene a half-day bipartisan health care session at the White House to be televised live this month, a high-profile gambit that will allow Americans to watch as Democrats and Republicans try to break their political impasse.

Democrats chafe as White House wavers on health care bill - Politico

President Barack Obama has left Democrats as confused as ever about how the White House plans to deliver a health care reform bill this year, after two weeks of inconsistent statements, negligible hands-on involvement and a sudden shift to a jobs-first message.

Pelosi: ‘We Will Pass Health Insurance Reform’ - New York Times

The House speaker, Nancy Pelosi, predicted on Friday that Democrats would succeed in winning passage of major health care legislation this year, and she described the bill as a core component of her party’s effort to improve the economy.

Clinton-era health aides push to save Obama's plan - Associated Press

Shock and awe. That's what survivors of the Clinton-era health care collapse are feeling as President Barack Obama's overhaul legislation wobbles in Congress.

Health care reform is about covering those who don't have health coverage. And health reform is just as much about the millions in America who have insurance that is too expensive or covers too little to be of much use.

There are millions of underinsured people in America. That underinsurance presents similar problems to uninsurance - delayed and denied care, bankruptcy due to medical costs, poorer health, and ultimately higher costs when these people have to seek emergency care or treatment for preventable illnesses. And many of the people with lousy insurance are those with individual insurance policies which they buy on their own instead of getting through work.

Unlike large businesses, who can bargain with insurance companies for good rates and good coverage because they have leverage in their numbers, the self-employed, unemployed, or people who don't get insurance through work have to buy coverage on their own. It's just them against their insurance company. So, people on the individual market tend to get hit with the highest rates, the most denials of care, and see the least of their premium dollars spent on their health care. Many small businesses face the same issues.

News today only underscores the problems in the individual market:

California's largest for-profit health insurer is moving to dramatically raise rates for customers with individual policies, setting off a furor among policyholders and prompting state insurance regulators to investigate.

Anthem Blue Cross is telling many of its approximately 800,000 customers who buy individual coverage — people not covered by group rates — that its prices will go up March 1 and may be adjusted "more frequently" than its typical yearly increases.

The insurer declined to say how high it is increasing rates. But brokers who sell these policies say they are fielding numerous calls from customers incensed over premium increases of 30% to 39%, saying they come on the heels of similar jumps last year.

Many policyholders say the rate hikes are the largest they can remember, and they fear that subsequent premium growth will narrow their options — leaving them to buy policies with higher deductibles and less coverage or putting health insurance out of reach altogether.

"I've never seen anything like this," said Mark Weiss, 63, a Century City podiatrist whose Anthem policy for himself and his wife will rise 35%. The couple's annual insurance bill will jump to $27,336 from $20,184.

"I think it's just unconscionable," said Weiss, a member of Blue Cross for 30 years.

Insurers already spend dramatically less of each premium dollar from individual policies on actual care. Where the average "medical loss ratio" of private insurance companies is around 86% - which means only 86 cents out of every dollar is spent on actual medical care and not CEO salaries, overhead and profit - medical loss ratios for individual policies can routinely be as low as 70%, or even lower. Now on top of that, Anthem, owned by WellPoint, is increasing rates in California by almost 40%.

This exact problem - individuals having to fight with insurance companies on their own for decent, affordable coverage - is what health reform is designed to solve. Individuals and small businesses would be able to purchase coverage in a new, regulated insurance marketplace, called an "exchange. " Insurers would be required to sell good policies, without caps on annual or lifetime benefits and would not be allowed to turn people away because of a pre-existing condition or charge more because someone has a health condition. Medical loss ratios would be regulated. The Congressional Budget Office says this will lower premiums dramatically.

And the strongest version of the exchange will be run by the federal government and include the choice of a public insurance plan to compete with private insurance.

Today's news of near 40% rate hikes simply underscore why Congress must finish health reform now and finish it right. We can't wait any longer.

NEWS

Anthem Blue Cross dramatically raising rates for Californians with individual health policies - LA Times

Policyholders are incensed over rate hikes of as much as 39%, which they say come on top of similar increases last year. State insurance regulators say they'll investigate.

Obama's "next step": Go back to Republicans - Politico

Months after Congress abandoned any hopes of a broad bipartisan deal on health care reform, President Barack Obama said Thursday the "next step" on health care reform involves going back to the negotiating table with Republicans.

Progressives Look For Ways To Get Public Option Revived - Congress Daily

Progressives plan next week to reach across the Capitol and plot a strategy to revive the public option, the single provision in the healthcare overhaul that dominated the debate for weeks only to die in the Senate at the hands of …

It's been said often, but given today's news, it deserves to be repeated. We can't do nothing about the health care crisis. We need to fix this problem and fix it now.

Overall spending on health care increased to 17 cents for every dollar spent in America last year, the largest one year increase since the government started keeping this record. For every dollar you make, almost one fifth of it goes to health care costs. And it's not stopping there, if health reform is not finished:

By 2019, health care spending will represent 19.3% of the nation's total economic output, according to a report released today by the Centers for Medicare and Medicaid Services.

…

The rapid increase in health care spending as a percentage of the economy — up from 16.2% in 2008 to 17.3% last year — can be partly explained by the recession. Although the nation's gross domestic product declined in 2009, health care spending rose to an estimated $2.5 trillion in 2009, or $8,047 per person, according to the report. That number will grow to $4.5 trillion in 2019, or 19.3% of the GDP, which is the entire economic output of the USA.

The skyrocketing trajectory of health care spending is hardly new, but it still spells doom for individuals, employers, and government alike. Health care costs will take more and more out of our pockets, out of small businesses, and out of government to finance Medicare and Medicaid unless costs are brought under control.

The report on these increases, done by CMS, didn't take into account what would happen if health reform passes. The CBO has previously estimated that under health reform, premiums would go down for individuals and businesses, and the federal deficit would be reduced as well. An earlier report by CMS estimated that overall health care spending increases would slow under reform, adding further weight to the analysis.

The key to getting cost under control is getting everyone in the system and making health care affordable, so people can get the care they need. A recent study in the New England Journal of Medicine affirmed the cost-cutting potential of increased coverage:

When Medicare plans raise co-payments for outpatient care, older people cut back on doctors’ visits, then wind up needing more expensive hospital care, a new study reports.

The study examined changes in the use of inpatient and outpatient care among people in Medicare plans that almost doubled co-payments, and compared the trends with similar plans that kept co-payments steady.

Though outpatient visits increased over time in all plans, health plans that raised their co-pays had slower increases: 19.8 fewer outpatient visits per 100 enrollees compared with plans that kept prices steady.

But they also had 2.2 additional hospital admissions per year, 13.4 more annual inpatient days and a 0.7 percent increase in the number of enrollees who had been hospitalized, when compared with plans that did not raise prices.

The Senate bill needs to be fixed before health reform can be finished right. Things like dealing with the excise tax on middle class health benefits, asking employers to pitch in their fair share, increasing subsidies to low-income people, creating a national exchange, and a public option will make health care more affordable to individuals and expand coverage. Those people will get the care they need early, preventing more expensive emergency care later. Health care costs will go down as a result.

If our country is to avoid financial ruin, health reform needs to be finished and finished right. Spending 17 cents of every dollar on health care is crazy and clearly not sustainable.

NEWS

Medical expenses have 'very steep rate of growth' - USA Today

Spending on health care consumed an estimated 17 cents of every dollar spent last year in the United States, representing the largest one-year increase since the federal government started tracking the number in 1960.

Health-care sector grew as economy contracted in 2009 - Washington Post

Health-care spending in the United States grew last year despite a contracting economy, amounting to 17.3 percent of the gross domestic product, according to estimates released Wednesday.

Soaring cost of healthcare sets a record - LA Times

Spending was 17.3% of the economy last year. The share paid by the U.S. will soon exceed 50%, a study says.

Therapy benefit cap looms over patients and providers as healthcare bill stalled - The Hill

Medicare beneficiaries face a steep cliff in their coverage for physical therapy and similar treatments due to Congress’s failure to enact a healthcare reform bill.

Rep. Tsongas joins Congress push on health-care reform - Lowell Sun

In the wake of the election of Sen.-elect Scott Brown, U.S. Rep. Niki Tsongas has not given up on passing health-care reform and continues to advocate for a "public-option" insurance plan that has been deemed all but dead following Brown's upset victory.

Ed Schultz Pleads For Health Care Reform, Calls Lieberman A 'Coward' (VIDEO) - Huffington Post

Ed Schultz made an impassioned plea for health care reform Wednesday during an on-location shoot at a temporary free clinic in Hartford, Connecticut.

Insurance is supposed to be about spreading out risk among a large number of people. In health insurance, the theory goes that everyone can pay a little bit every month into a large pool. If someone who pays into the pool gets sick, that large pool covers their expenses. Because there are enough people in the pool and only a certain percentage are sick at any one time, it's possible to design a system where people can afford to be covered for their illnesses when they happen.

Under this theory, wider coverage is a good thing. More people paying into the pool means the risk is more spread out. But Wall Street run insurance companies have perverted this system. Instead of striving for the largest risk pool, insurance companies can make more money by selectively insuring only the least risky people and cutting out the rest. In other words, they make money by cutting membership.

Insurance companies are just now disclosing their earnings and membership numbers from 2009. The changes from where they were in 2008 give a clear look into how these companies do business, and the human cost to their business practices.

For example, WellPoint is one of the nation's largest insurers. They have 14 state Blue Cross brands in their portfolio. In 2009, they made $4,746,000,000 dollars, up 91% from their 2008 earnings of $2,491,000,000. How did they achieve those profits? In a large part in two ways. First, they lowered their medical loss ratio - the amount of money they spend on actual health care as opposed to CEO profits and overhead - by 1%. This can cause big changes in the bottom line:

In 2008, [WellPoint] spent 83.6% of the premiums it took in on care - paying for doctors, drugs, and the like. In 2009, they spent only 82.6% of your money on your care. That seemingly small difference actually belies bigger discrepancies. An analysis by the Senate Commerce Committee [pdf] found that while WellPoint spends about 85% of every premium dollar on care in the large group market that big businesses can tap into, they spend as low as 73% of every dollar collected through individual plans, and 79% on small group plans purchased by small businesses.

A small change in this "medical loss ratio" means billions of more dollars that can be spent on CEO pay or reported as profit. Indeed, Martin L. Miller, a Senior Vice President at WellPoint, said that lowering the amount of money WellPoint spends on health care "really is the driver of profitability" and that the lowering of this percentage "is really what's driving our improved financial results this year."

WellPoint also aggressively cut membership. By pricing their services out of the reach of sick people, by cutting off policies of those who get sick (rescissions), by denying care due to pre-existing conditions, or by simply continuing to jack up premiums, 1,379,000 people were cut in 2009 from WellPoint's rolls. These people were undoubtedly sicker or less wealthy, and therefor less profitable for WellPoint. By cutting them as customers, perversely, WellPoint was actually able to make more money.

That's the twisted logic of Wall Street-run health care. Healthy people get coverage, but as soon as you get sick, you're pushed out. And for those still in the system, less of your premiums get spent on your care. By reducing medical spending and coverage, profits skyrocket.

This is a system that has nothing to do with insuring good health, and everything to do with making money. As Congress finishes reform right, they need to hold the insurance companies accountable and make sure they're in the business of keeping America healthy, not keeping shareholders fat with profits.

NEWS

Rangel: Lawmakers writing compromise health bill - Associated Press

Leading lawmakers hoping to revive President Barack Obama's stalled health care overhaul have started writing a compromise bill, but it's unclear when the legislation will be ready for votes, a top House Democrat said Tuesday.

Pelosi: Piecemeal Reform No Better Than A "Get Well Card" - Huffington Post

Amid the wreckage of the health care debate, some rescue workers have been searching for small pieces that could be salvaged. On Tuesday, House Speaker Nancy Pelosi (D-Calif.) suggested that the search was in vain. What good is a door, after all, without a building?

Stumping for Jobs Plan, Obama Pushes Health Bill - New York Times

President Obama hit the road again Tuesday to promote the new job-creation program he described as his No. 1 priority, but he refused to abandon his embattled health care legislation, vowing to “punch it through” resistance in Congress.

Nancy Pelosi's new health care plan - Politico

With the broader health care bill still perilously close to collapse, House Speaker Nancy Pelosi plans to take a shot at the health insurance industry next week by scheduling a vote on a smaller bill to revoke its half-century-old exemption from antitrust laws.

Poll Finds Dropping Health Care Plan Doesn’t Help Dems. So Pass The Bill! - Greg Sargent

The  latest poll from Public Policy Polling finds that Dems are in a tough spot heading into 2010 whether or not they pass health care reform.

THE INFLUENCE GAME: Health lobbying gears down - Washington Post

Notice you're not bombarded anymore by TV ads about President Barack Obama's health care overhaul plan?

Obama's Budget Increases Funding for Medical Research That Compares Treatment Options - Kaiser Health News

The Obama administration, in an effort to forge ahead with its sometimes-contentious effort to compare various medical treatments, is proposing a big boost in funding for the agency that oversees the research.

Every passing day brings more Senators saying their open to using the budget reconciliation process for finishing health reform. So far, nobody has compiled these statements into a comprehensive list, so here they are.

Senator Specter (D-PA) came out strong:

I believe we ought to pass comprehensive health care reform and we ought to do it now and there is a way to do it. I provided the 60th vote. We passed it in the Senate. Let the House accept it, simultaneously with a bill to make certain changes through reconciliation and 50 votes. There will be no disagreement about taking away the giveaway to Nebraska and Louisiana and the other inappropriate measures but let's move ahead and let's move ahead now.

Senator Franken (D-MN) was also pushing for the move:

The best way for that to happen, and as far as I can see – the only way for that to happen – is what I’m calling 'pledge and pass. If we in the Senate pledge to fix those elements through reconciliation – a budget process that requires only 51 votes, the House of Representatives should pass the Senate Bill.

Senator Ben Nelson (D-NE) walked back his earlier critisisms of the process and is open to reconciliation:

I’ve been asked about whether I’d support using the process known as reconciliation now. So, I want to make it clear: If I support a bill, then I will vote for it regardless of whether it takes 50 votes to pass or 60 votes to pass. My position doesn't change just because the House or Senate decides to change the process.

Senator Baucus (D-MT), who chairs the crucial Senate Finance Committee, says it's the only way:

Approving the Senate bill through the procedure, known as reconciliation, “is the only solution,” Baucus said, adding the Senate “was close” in getting enough votes to pass it.

Senator Conrad (D-ND), who chairs the other crucial commmittee in the process, the Budget Committee, says he would be open to fixes:

If the House passed the Senate bill, could reconciliation, that process, be used to fix things that might be improved upon? Yes. Would I support it? I can’t know that without knowing what would be included in the package.

Senator Bingaman (D-NM) said in a recorded call with reporters that reconciliation is an option (click for audio):

10:01 – Bingaman says that using the reconciliation process is an option for getting portions of the health care reform bill passed in the Senate.

Senator Carper (D-DE) has been reaching out to moderates in the House to convince them that the reconciliation "sidecar" option is the way to go:

Sen. Tom Carper, a centrist Democrat from Delaware who played an active role in Senate healthcare talks, said he would reach out to House Democratic centrists to persuade them to vote for the Senate-passed bill along with a sidecar.

“We’ve had some conversations with some of them already,” he said.

Senator Durbin (D-IL), the Senate Majority Whip, said reconciliation is an option:

We could go to something called 'reconciliation', which is in the weeds procedurally, but would allow us to modify that health care bill by a different process that doesn't require 60 votes, only a majority. So that is one possibility there.

Senator Pryor (D-AR) said he's open to it:

According to the Arkansas News, Pryor said reconciliation was not his first choice but "he was not necessarily opposed to the idea."

Someone familiar with Senator Feingold (D-WI) has said the Senator is open to the idea:

I spoke to someone from Feingold's campaign about his position on reconciliation in light of the Massachusetts special election. She informed me that while Sen. Feingold is no fan of reconciliation, now that it's reconciliation or nothing (apparently), he would be willing to support reconciliation if that's what it took to get a good bill passed. It wasn't the slightest bit equivocal or hedgy; it was a straight "yes". So that's a bit of good news. Hopefully the House can get their act together.

Senator Kerry (D-MA) says reconciliation is his preferred route to passing health reform:

Senator John Kerry said today his preferred route to completing health care reform is for the House to pass the Senate bill, and for the Senate to make it more digestible to the House by approving fixes through the reconciliation process, which allows legislation to pass the Senate by a simple majority instead of 60 votes.

Senator Klobachar (D-MN) is also open to the move:

Whether it's going to be [reconciliation] or whether it's going to be taking some of the main initiatives for the self-employed and small business to allow them to get better rates of insurance, and insurance reforms and prevention, and the Medicare cost reforms — which, some of us can't even imagine voting for health care without having some Medicare cost reform — the bill will move forward, and I think something will get done….

Senator Sanders (I-VT) definitely supports it:

Sen. Bernie Sanders, I-Vt., said he favors using a parliamentary maneuver known as reconciliation to get health care reform passed. Such a move would require only support of a simple majority of the Senate, not the 60 needed to prevent a filibuster threatened by Republicans.

"I support the reconciliation process or any other way we can get the votes we need to go forward," Sanders said in a statement.

Senator Menendez (D-NJ) supports it as well:

I’m not sure how we get where we want to be if reconciliation is not the process.

More statements will no doubt come in as the process moves forward, but for now there is building support for finishing health care reform using the reconciliation process. Of course, we need to encourage them not just to finish reform, but to finish it right by making health care affordable to all and holding the insurance companies accountable.

Update

@ProgressOhio points me to Senator Sherrod Brown (D-OH) and his support of reconciliation:

Brown said didn’t yet know for sure whether Reid would commit to the reconciliation fix approach, but added that there’s a widespread sense in the caucus that this is probably the only workable route forward.

“I can’t imagine another scenario,” Brown said. “We can’t start anew, and we can’t do piecemeal.”

NEWS

Specter: Democrats Must Use Reconciliation To Pass Health Care Fixes 'Simultaneously' - Huffington Post

Sen. Arlen Specter (D-Penn.) urged his Democratic colleagues over the weekend to unite around a plan that would allow them to move forward with health care legislation using a process that requires only 51 votes.

Obama Calls Health Overhaul ‘My Greatest Hope’ - New York Times

President Obama, in a question-and-answer session to be posted on YouTube, the online video-sharing site, said that “it is my greatest hope” that health care legislation be adopted “not just a year from now, but soon.” Yet he also referred to the effort in the past tense: “We came extremely close,” he said — a sign that the fate of the health care measure is now highly uncertain.

Obama Says He’s Counting on GOP Support on Health Care - Wall Street Journal

President Barack Obama doesn’t seem to think much about the prospects of Democrats moving health care legislation on their own at this point. He said today that he is counting on Republican support.

State health plans in jeopardy - USA Today

Sherie Brace fears the coming of summer. That's when a special health insurance program for low-income adults in Washington state is set to close, ending coverage for her and about 65,000 others.

The mainstream media has been speculating whether President Obama and Democrats will fail at reforming our hopelessly broken health care system since the reform process began. And they've been speculating whether that failure, like President Clinton's before it, will mean another election like 1994, which gave Republicans control of Congress for the first time in decades and curtailed the rest of Clinton's term. The latest in this storyline is a piece today in Politico from Carrie Budoff Brown and Chris Frates, complete with interviews from operatives around back then examining statements by Members of Congress that seem to say health care is moving to the back burner.

It's not 1994 all over again right now, but it could be if things go in a certain direction. What Ezra Klein said last week is true:

It is very, very, very important to be clear on what the death of health-care reform looks like. It is not a vote that goes against the Democrats. It is not an admission that the White House has moved on from the subject. It is continued statements of commitment from the key players paired with a continued stretching of the timetable. Like everything else in life, policy initiatives grow old and die, even if people still love them.

The danger is there, and the parallels of 1994 are an important warning. Things are different right now then they were. We don't have to go down that road again.