Health Care For America Now

It's amusing to hear insurance company supporters assert that private health plans will go out of business if they have to compete against a public health insurance plan option. They claim that the government will set the rules to favor the public health insurance plan, creating an unlevel playing field that will eventually eliminate private health plans. Is it a realistic fear? A look at real world experience with the Medicare program tells us that government has done just the opposite: it has favored the private plans that contract with Medicare.

Read more…

Politico points out the obvious:

Republicans look across the health reform battlefield and see the Democrats organized, energized and flush with cash — with several groups lined up to promote the president’s plan, and a message honed by years of preparation.

Then they look into their own camp — and get nervous.

There’s no Republican plan yet. No Republicans leading the charge who have coalesced the party behind them. Their message is still vague and unformed. Their natural allies among insurers, drug makers and doctors remain at the negotiating table with the Democrats.

So Republicans now worry the party has waited so long to figure out where it stands that it will make it harder to block what President Barack Obama is trying to do.

This is just another reason we're going to win health care for all this year. But there's more to the story.

Republicans did start a "health care task force" led by minority leader John Boehner back in February. So far, all we've seen from them are a few quotes in the paper and some misleading press releases from Boehner. Certainly, there's been no serious policy proposals. As Politico points out, a lot of Republican "ideas" on health care died with John McCain's candidacy.

Boehner, of course, was the guy leading the charge on the GOP alternative to the budget, if by alternative you mean a budget without any details or numbers. I wonder if Boehner's health care plan will look similar. Judging by the health care section in the alternative "budget" (a budget document without numbers deserves those quotation marks), America may be able to look forward to a similar substance-less plan:

The Republican proposal, as you might expect, doesn't actually have a health care plan. But it does have this: "Republicans will be on the side of quality versus mediocrity, affordability versus unsustainable debt, and freedom of care versus bureaucrats in control. And we will be on the side of patients, doctors, and the American people." They are also in favor of good things rather than bad things, moving forward rather than going backwards, the hobbits rather than the orcs, and always twirling, twirling, twirling towards freedom. That said, the GOP does understand that some voters might be looking for specificity on their health plan. So they included this graphic:

It's like someone showed them a flowchart. Once. And only for a few seconds. And refused to explain it. My editor Ann Friedman just walked into the room. "It looks like they're building a budget molecule," she said.

A budget molecule. Maybe that's what they were doing.

I know I'm looking forward to the Republican health care molecule myself.

NEWS

GOP stumbling in health care fight - Politico

Republicans look across the health reform battlefield and see the Democrats organized, energized and flush with cash — with several groups lined up to promote the president’s plan, and a message honed by years of preparation.

Health care: Deal or no deal? Senators begin work - Associated Press

This time it's really going to happen. Or so they claim.

Senators get down to work this coming week on turning ideas into legislation to cover some 50 million people without health insurance and contain costs for everyone else. Hopes are high that Democrats and Republicans can find common ground for a bill to emerge by summer.

Report: NYC health insurance costlier than rent - Fox44 New York

How high is the cost of health care in New York City?

According to a New York Post analysis of new data from the state Insurance Department, it now costs more to buy health insurance than it does to rent a two-bedroom apartment.

Health Insurers Routinely Deny Claims of Civilian Workers Seriously Injured in Iraq, Afghanistan Wars, According to Los Angeles Times - Kaiser Health Report

Civilian contractors injured while serving the U.S. war effort in Iraq and Afghanistan often face delays obtaining or are denied insurance coverage for basic medical care, artificial limbs, psychological counseling and other services, according to a joint investigation by the Times and ProPublica.

Adversaries team up on health care - Politico

Two of the nation’s most influential health care adversaries are uniting to promote key portions of health care reform but leave unaddressed the debate’s most controversial element: the creation of a public insurance plan.

The new revelation about fake letters to the editor from a public relations firm hired by America’s Health Insurance Plans (AHIP) is nothing new in the world of health insurance. In fact, when it comes to Medicare Advantage, the insurers have engaged in much more devious schemes to take advantage of elderly people to increase their bottom line.

This profile in the Huffington Post shows how one man in Washington, DC was deceived into signing up for a plan that was more expensive than his regular Medicare plan, and didn’t cover all his medical needs:

The next time Smith went to his pharmacy, he was told he was no longer covered. When he went to Howard University Hospital for a colon cancer procedure, he was told the same thing. His wife sent him to the local Legal Aid Society of the District of Columbia.

The woman who'd knocked was a sales rep from EverCare ("We care about healthcare"), a company that sells Medicare Advantage plans, which are privately run and can be more expansive - with vision and dental coverage - but have a smaller network of providers that participate. In practice, the extra vision and dental coverage is often of negligible benefit and doesn't outweigh what's lost by leaving traditional Medicare - but it looks good at first.

This was not an isolated incident. It turns out that there was a plague of deception on the part of the Medicare Advantage sales representatives with a variety of companies. In an series of stories, Avram Goldstein of Bloomberg News, reported that many incidents were uncovered in Congressional hearing last year:

June 26, 2008 (Bloomberg) Residents of Judiciary House, a residence for the elderly in Washington, testified today that Coventry agents misled them in a February sales briefing at their building. Mentally disabled residents were signed up improperly, and some are still trapped in plans that won't pay for visits to their regular doctors, they said.

. . .

Edith Williams, a multiple sclerosis patient, broke down in tears during the hearing as she described life-threatening problems after she was enrolled without her knowledge in Coventry's Advantage plan. She couldn't fill her regular prescriptions, she said.

August 9, 2008 (Bloomberg) The Centers for Medicare and Medicaid Services received 2,700 complaints between December and May 1 from among more than 8 million Medicare Advantage members.

[Avram Goldstein is currently heading the research department for Health Care for America Now.]

It’s not surprising that they would go to such great lengths to fool people into signing up for these plans. As the Dallas Morning News explains, “the government pays the plans an average of $1,000, or 14 percent, more per beneficiary a year than it would for someone in traditional Medicare.” Medicare Advantage is a huge source of profit for the insurers, but not necessarily a better product for the consumers. The benefits to the companies for the Medicare Advantage programs are significant. Avram Goldstein:

August 27, 2008 (Bloomberg) Medicare, the government health program for the elderly and disabled, will pay Humana and the other Advantage providers $76.3 billion this fiscal year, about $9.2 billion more than traditional coverage would cost, government figures show. . . .

Pete Stark, the California Democrat who chairs the House Ways and Means health subcommittee, last month said Humana was making "huge profits at taxpayers' expense."

While some customers are happy with their plans, there are many who are surprised by how little they cover. Dallas Morning News:

Virginia Leconti of Grand Prairie, Texas, on the other hand, joined a Medicare Advantage plan only to discover that her home health care agency wouldn't accept it. To keep her in-home care, she switched back to traditional Medicare.

"When the plan's salesman visited me, he played up the fact that the policy came with dental and vision benefits at no extra cost," she said. "I just assumed that my home health care was part of the package."

Warner says some health care providers don't take Advantage plans because they don't want to deal with more insurers.

In the end the companies were fined for their deceptive practices. Avram Goldstein:

August 27, 2008 (Bloomberg) — Humana Inc., the second-largest provider of U.S. government-sponsored health plans for the elderly, paid a record fine after Oklahoma regulators said the company used unlicensed agents to sell coverage.

At least 68 unauthorized sales people employed by the Louisville, Kentucky-based company sold Medicare plans to Oklahomans, said Marc Young, a spokesman for the state's Insurance Department. Humana paid a $500,000 fine, the state's largest for an insurance company.

With evidence like this, it is hard to believe that AHIP has the gall to say on their web site, “Join us in working toward an uniquely American solution - Affordable, high quality health care for every American.” With friends like these in health care, who needs enemies?

It's amusing to hear insurance company supporters assert that private health plans will go out of business if they have to compete against a public health insurance plan option. They claim that the government will set the rules to favor the public health insurance plan, creating an unlevel playing field that will eventually eliminate private health plans. Is it a realistic fear? A look at real world experience with the Medicare program tells us that government has done just the opposite: it has favored the private plans that contract with Medicare.

Read more…

As part of the barrage of events organized by HCAN partners in April, Ohio HCAN is hosting a town hall with Sen. Sherrod Brown today at 10:30AM EST and you can watch the live stream. Here is the info:

WHO: Senator Sherrod Brown, health care advocates, and Ohioans
affected by the healthcare crisis
WHEN: Friday, April 17 at 10:15 AM
WHERE: Cleveland Heights, click here to watch the event LIVE online

You can also participate by telling us your health care story. We'll
make sure Senator Brown hears your voice.Click here to share your health care story.

Adoption Of Consumer-Driven Health Plans Accelerated By Recession - Medical News Today

HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that more employers are opting for consumer-driven health plans (CDHP) as they look for ways to reduce costs. The individual CDHP market is also growing as the unemployed look for affordable health insurance options. According to recent Health Plan Analysis reports, employers will continue to utilize account-based and high-deductible options in light of strained budgets and anticipated increases in premiums.

Health Plans: New Safeguards - The Wall Street Journal

Seniors will likely pay more for Medicare's private health plans next year, but new consumer protections that come with those plans could ensure they remain an attractive alternative to traditional Medicare.

The changes come as the Obama administration moves to tighten the screws on private plans offered under Medicare, the federal insurance program for the elderly and disabled. The Centers for Medicare and Medicaid Services, or CMS, recently unveiled stricter terms for insurers offering the so-called Medicare Advantage plans, taking effect next year, and will effectively cut payments to them by as much as 5%.

Doc shortage looms in Mass. - Boston Herald

Massachusetts is facing a severe physician shortage in the next decade, as one-third of the state’s practicing doctors enter retirement age, according to the Massachusetts Medical Society.The medical society also reported yesterday that only 13 percent of the state’s practicing physicians are 35 or younger. The American Medical Association has said that, across the nation, the percentage of physicians age 55 and older has increased from 34 percent in 1992 to 44 percent in 2008.

How AIG's Fall Helps Health Care Reform - GoozNews.com

Citing the systemic risk to the financial system created by AIG and credit default swaps, the chief executive officer of Allstate in an op-ed in the New York Times calls for the federal government to regulate his industry.

You can almost see the political landscape shift these days. Once, back in the days after the election, we weren't even sure if the public health insurance option was on the table. Then, when President Obama and Congress reassured us, and now, we're arguing over whether it should be able to bargain for rates or not:

Nancy-Ann DeParle, director of the White House health reform office, said a public plan could be designed to address concerns about the federal government overreaching in its role.

"I'm very hopeful we'll be able to reach an agreement on that," DeParle said in a session with reporters at which she fielded repeated questions on the issue.

"If it's a policy disagreement, there are ways of bridging that gap," said DeParle.

For example, she said one compromise might be that the public plan pays hospitals and doctors rates similar to what private insurers pay. That would address fears that government would use its muscle to pay rock-bottom prices for medical services, allowing the public plan to charge discounted premiums that private insurers couldn't compete with.

Even if the government plan paid private-market rates to doctors and hospitals, it could still cut costs, DeParle said. A government plan wouldn't have to turn a profit, and could also save on administrative expenses.

Now, without getting into the policy argument over whether allowing the public health insurance option to bargain for rates is a good or bad thing (see Jacob Hacker for why it's a good thing), it's clear the ball is moving. We're no longer arguing over basic existential questions - the public plan will be part of the deal, the question now is just what kind of plan will it be.

This means that our pressure is working, and with more pressure, we can make sure we get a robust public health insurance option that competes strongly with private insurance to drive down prices and is a great guaranteed backup for people who for whatever reason need health insurance.

NEWS

Obama Stands Firm on a Sweeping Agenda - New York Times

AS he spoke about the economy on Tuesday, President Obama invoked the parable in the Sermon on the Mount about two houses, one built on sand only to be blown away in a storm and another built on rock impervious to the swirling winds.

Dean re-emerging to push healthcare - The Hill

Former Vermont Gov. Howard Dean (D), who used healthcare reform as a signature issue during his 2004 presidential campaign, is using a call for universal coverage to raise his profile once again.

Push to Compare Treatments Worries Drug, Device Makers - Wall Street Journal

Federal health-care agencies are getting $1.1 billion in economic-stimulus funds for research comparing the effectiveness of various treatments. But drug and medical-device makers, along with some members of Congress, say they are worried the findings will be used to limit patients' options.

Sen. Blanche Lincoln visits area to discuss health care - Texarkana Gazette

As part of a statewide tour labeled “Call to Action: Taking the Pulse of Rural Health Care,” U.S. Blanche Lincoln, D-Ark., visited the Carter Day Center here Tuesday to discuss health care with patients, medical providers and health-care professionals.

Yesterday, Ken Johnson at the Eagle-Tribune in Massachusetts, noticed something fishy going on with the letters to the editor his paper was receiving:

Across Massachusetts, senior citizens are writing letters to newspapers demanding that their representatives in Congress protect a form of health insurance called Medicare Advantage.

At least that's what newspaper editors are supposed to think.

Some of those seniors are unaware that they have sent any such letters to newspapers. Some of them hadn't even heard of Medicare Advantage.

"I did not write a letter to the editor. It's not from me," said Gloria Gosselin, 75, of Lawrence.

Gosselin's name was on one of three strikingly similar letters touting the Medicare Advantage program that were sent to The Eagle-Tribune.

It turns out, these letters came from the Dewey Square Group, a Boston-based political marketing and consulting firm, who has been hired by America's Health Insurance Plans, the insurance industry lobby, to fight against President Obama's plan to stop subsidizing private insurers through Medicare Advantage.

The Dewey Square Group has been using some extremely deceptive practices to get AHIP's message out:

A tip-off to the true origin of the letters came when The Eagle-Tribune received a call from a man who turned out to be an intern at the Boston office of the Dewey Square Group, a national political marketing and consulting firm.

The man, who identified himself as Noah, wanted to know if Gloria Gosselin's letter had been published. Asked what interest he had in the letter, Noah replied that he was Gosselin's grandson.

Gosselin does not have a grandson named Noah working in Boston. Her only grandson is a student at Central Catholic.

If the people sending these letters have never heard of the issue or the paper "their" letter was sent to, and if hired consultants are impersonating these people's relatives, it's clear these Americans are being used by AHIP to promote their fake grassroots campaign.

Since AHIP paid the Dewey Square Group to run this campaign, and since a responsible signer of checks would have some idea of what their money is being used for, I think it's safe to assume AHIP had some idea of the tactics the Dewey Square Group is using here. I say it's safe to assume because at least up until now, AHIP has had no comment.

This is not the first time AHIP has engaged in astroturfing. Health Care for America Now activists confronted AHIP at the launch of its faux “listening tour” this summer, and the industry front group responded by altering its schedule and refusing to openly publicize future dates and times. We also exposed AHIP’s hollow solicitation for consumer feedback with a video proving AHIP’s toll free number went straight to voicemail and remained unanswered.

So, the question should be asked: Does the insurance industry, as represented by America's Health Insurance Plans, endorse using unsuspecting Americans in a fake grassroots campaign to combat a government giveaway that is in danger of being repealed? Are these the kind of tactics we can expect when the insurance industry tries to manufacture "grassroots" opposition to health care reform later this year?

The silence on the part of AHIP says all you and I need to know.