Health Care For America Now

Guess what! Almost 100% of health insurance markets in this country are monopolies.

That's according to a new report released by Health Care for America Now today:

Some argue that health insurance industry competition across the U.S. is ample. In fact, research shows a startling and consistent absence of competition as the industry consolidates with more mergers and acquisitions. For example, according to a nationwide survey by the Government Accountability Office, the median statewide market share of the largest insurer selling coverage to small employer groups increased to 47 percent in 2008 from 33 percent in 2002. Americans pay for this consolidation in the form of higher health plan premiums, surging insurance company profits, and a growing number of uninsured people.

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The U.S. Justice Department considers a market “highly concentrated” if one company holds more than a 42 percent share of that market…

94% of insurance markets in this country are highly concentrated. When markets are highly concentrated, the Department of Justice begins to get concerned about anti-competitive behavior.

This anti-competitive behavior is not speculation, either:

These are not theoretical behaviors. Insurers have been exposed numerous times rigging the system. An investigation by the Boston Globe in December 2008 exposed a, “gentleman’s agreement that accelerated [the] health cost crisis.”

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When small, independent providers want to negotiate with multiple health plans, large insurers exert enormous pressure to stop them. The statewide trade group for doctors in New York sued UnitedHealth Group Inc., the nation’s second-largest health insurer by enrollment, for allegedly using illegal coercion in just such a scheme to limit competition.

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In a separate matter UnitedHealth agreed to pay $400 million to settle multiple suits alleging price fixing and other anti-competitive behavior. The attorney general of New York, Andrew Cuomo, stated that this was, “a huge scam that affected hundreds of millions of Americans [who were] ripped off by their health insurance companies.” Numerous other insurers were implicated in the same scheme, including Aetna Inc., Cigna Corp. and WellPoint Inc.

Senator Chuck Schumer (D-NY), is appalled:

This is the starkest evidence yet that the private health care insurance market is in bad need of some healthy competition. A public health insurance option is critical to ensure the greatest amount of choice possible for consumers. We believe that it is fully possible to create a public health insurance plan that delivers all the benefits of increased competition without relying on unfair, built-in advantages. If a level playing field exists, then private insurers will have to compete based on quality of care and pricing, instead of just competing for the healthiest consumers.

Health Care for America Now has sent a letter to the DOJ [pdf], asking them to investigate these mergers and the resulting anti-competitive behavior, challenge mergers and anti-competitive behavior where there is grounds for challenge, and present a report to Congress with the findings.

Anti-trust lawyer David Blato had this to say about the anti-competitive nature of the insurance industry:

"For a market to work effectively, you need two things: choice and transparency. Neither of those are present in the insurance market," said Balto, who served in a senior position at the Federal Trade Commission during the Clinton administration. "Relying on the current insurance market as the foundation for health care reform is like trying to cross the Atlantic in a raft."

Of course, I agree.

In a country where virtually 100% of the insurance markets are uncompetitive (including areas where the market share of one company reaches 60, 70, or 80 percent), it's clear Americans are at the mercy of the insurance industry. Our skyrocketing premiums attest to this. If you have no choice, you can't take your business elsewhere when your insurance company denies your claim or makes you jump through hoops to get normal treatments reimbursed. Without competition, insurance companies that control your local market can raise premiums and cut benefits with impunity, and there is nothing you can do about it.

Decades ago America realized monopolies were bad  for the country. Today, we must continue on in that tradition. There is no competition in the insurance markets, and that has caused the health care crisis we're facing today. To fix the situation, we need to give everyone in America a choice.

Overnight, Congress could fix this situation. By passing a public health insurance option that is open to everyone, people will suddenly have a choice for their health insurance. Congress can break these monopolies and allow people to take their business elsewhere if they want to.

In America, when we are dissatisfied with something, we send a message with our feet. We go somewhere else, to a competitor who can provide better services at lower prices. The whole system hinges on choice, which is why anti-trust policing is so important. We need that choice again in the health insurance market, because private industry has proved to be more collusive than competitive. We need a public health insurance option.

"The truth is there's nobody else trying to do anything bold," said Burr.

That's Senator Burr's reasoning for releasing a woefully inadequate Republican "alternative" to health care reform proposals now being formulated in Washington, DC. What a ringing endorsement!

Indeed, the plan formulated by Sens. Burr and Coburn, with the help of Chuck Grassley, reads very much like a default proposal as opposed to something with, say, some new ideas.

Let's go down the list, shall we?

• A tax credit to pay for health care? Check.
• Health savings accounts? Check.
• More folks in private insurance? Check.
• Specifically, pushing people out of Medicare and Medicaid in favor of private insurance? Check.

The heart of the plan, like John McCain and George Bush's defeated plans, is a tax credit of up to $5,710 per family to pay for private health care. As Media Matters Action Network points out, this isn't nearly enough to make health care anything close to affordable:

According to the National Health Care Coalition: "The annual premium for an employer health plan covering a family of four averaged nearly $12,700. The annual premium for single coverage averaged over $4,700."

That means a family that makes, say, $30,000 a year and can only find expensive private health insurance in their area because of the insurance industry's monopoly (more on that later today), will have to pay about one quarter of their income in health care costs every year after the tax credit. Does that sound affordable to you?

We already defeated this plan in the November elections, remember? Barack Obama won the election because of his health care plan, and McCain was defeated because of his. This plan is McCain's plan (and Bush's plan). It won't work. It's old news. And it was already rejected.

NEWS

Activists seek Justice Dept. probe of insurers - Associated Press

Activists backing President Barack Obama's health care overhaul are asking the Justice Department to open a wide-ranging investigation of what they say is monopoly-like power in the hands of major insurers.

Congress' conservatives offer health proposal - Associated Press

Congressional conservatives, convinced voters need to see a Republican health care plan and frustrated their party hasn't offered one, are introducing legislation of their own.

Your guide to distortions on health care - PolitiFact

With high-profile support from President Barack Obama, Congress is preparing a major overhaul of the nation's health care system. The details have yet to be revealed, but that hasn't stopped critics in Congress from going on the attack.

As was revealed yesterday, Blue Cross Blue Shield of North Carolina is planning attacks on President Obama's health care plan, just a week after their national leaders stood next to Obama and promised to work for reform.

They are attacking Obama's plan, particularly the public health insurance option, as rationed care, the predictable right-wing line. But, as Media Matters Action Network has thouroughly documented, they're hypocrites.

In their planned ads, Blue Cross says the public health insurance option would deny care to those with pre-existing conditions. Blue Cross in North Carolina was found guilty of doing exactly that, and forced to pay $1 million in damages.

They then attack the public health insurance option by saying it will lower payments to doctors. But they themselves lowered payments to doctors, losing a $128 million lawsuit for fraudulently underpaying their providers.

They claim the public health insurance option will drive up premiums, but their premiums have gone up 119% in the last ten years.

Blue Cross claims the public health insurance option would do all the awful things it is doing right now!

And that's the key here. Rationed care? We've got it now, with insurance industry bureaucrats getting in between you and your doctor. Expensive premiums? We've got it now; the number one cause of bankruptcy in America is medical expenses. Everything the insurance industry can throw at a public health insurance option is happening right now.

The public health insurance option, first and foremost, provides choice. Nobody will ever force you into the public health insurance option, guaranteed. And so, the insurance industry's attacks ring false:

But ironically, by attacking the new public option the industry is showing it’s hand. They oppose the public plan not because it will do what they claim — force patients to “wait moths for appointments” and not allow them to “choose their own doctors.” If that were the case, who’d sign up for such a thing? If the public health care plan really rationed care, then most Americans would stay with their private insurers.

They fear a public option because it may actually provide comprehensive benefits at a lower price and attract new beneficiaries. They fear it, because it would force them to compete with it. And for most Americans that would be a good thing.

We need a choice so we don't have to live with the rationed care and skyrocketing premiums we are forced to deal with now. And that means we need a public health insurance option, an alternative from the double-crossing insurance industry.

The right-wing attack on health care is coming into full view. Not surprisingly, they've settled on a tried and too-often true strategy: scare the @@#% out people. Health care reform will be defined as a "government-takeover."  The result of government-run health care will be long lines, waiting for treatment, not getting the treatment you need, not being able to choose your doctor or hospital. Health care reform is government rationing and Washington bureaucrats running the health care system.

While It started this winter with Rush Limbaugh's reaction to the health proposals in the Presidents Economic Recovery bill, the message was given a huge boost a few days ago when Republican message meister Frank Luntz briefed Republicans in the House on "The Language of Health Care 2009: The 10 Rules for Stopping the ‘Washington Takeover' of Healthcare."

Luntz's message is already being used by Republicans in the Senate and House. South Carolina Senator Jim DeMint published an article this week in which he said: "That's how a government take-over of your health care will try to get costs under control: cheap, outdated treatments, long waiting lists, and low-tech hospitals. It won't take long before families realize the true costs of such a plan aren't counted in dollars and sense."

Now Rick Scott, the disgraced former head of Columbia/HCA, is running ads on TV talking about people in England who have died because of government health care.

Will this message work? Not if we get our message out in response. The big problem with the Republican strategy to, as Luntz said, "kill what they're [Democrats] trying to do," is revealed in Luntz's memo:  "…because the American people blame the insurance companies more than almost anybody else for why health care is such a mess in this country right now."

Everyday people in America get their health care denied by insurance company bureaucrats, directed by insurance company CEOs who make millions of dollars a year, flying around in their corporate jets, paid for by hiking your premiums, denying you the care you need and coming in-between you and your doctor.
The American people know that. We have to remind them.

Take a look at this exchange between me and John Roberts, the host of CNN's American Morning, last week (you can also watch it here):

NEWS

North Carolina's Blue Cross Blue Shield Trying to Kill Key Plank of Obama Plan - Washington Post

One week after the nation's health insurance lobby pledged to President Obama to do what it can to constrain rising health costs, Blue Cross Blue Shield of North Carolina is putting the finishing touches on a public message campaign aimed at killing a key plank in Obama's reform platform.

Labor Groups Blast Senator on Health Benefits Tax - New York Times

They may not star Harry and Louise, the fictional couple who helped doom health care initiatives in the 1990s, but new health care advertisements from both ends of the spectrum signal the increasing attention focused on proposals under consideration on Capitol Hill.

U.S. workers paying more for healthcare: report - Reuters

Healthcare costs for Americans who get medical coverage through an employer hit a record $16,771 per family this year, and they are having to pay more themselves, a report released on Monday showed.

Wyden is winning over the GOP on healthcare - The Hill

Some of the biggest names in the Democratic Party have lined up to take the lead on healthcare reform, but the key to a bipartisan compromise may be the lesser-known Sen. Ron Wyden.

U.S. Says Wyeth Cheated Medicaid - Associated Press

The Justice Department on Monday accused Wyeth, the drug maker, of cheating Medicaid programs out of hundreds of millions of dollars by overcharging for a stomach acid drug.

According to new information obtained by the Washington Post:

One week after the nation's health insurance lobby pledged to President Obama to do what it can to constrain rising health costs, Blue Cross Blue Shield of North Carolina is putting the finishing touches on a public message campaign aimed at killing a key plank in Obama's reform platform.

As part of what it calls an "informational website," the company has hired an outside PR company to make a series of videos sounding the alarm about a government-sponsored health insurance option, known as the public plan. Obama has consistently maintained that a government-run plan, absent high-paid executives and the need for profits, could be a more affordable option for Americans who have trouble purchasing private insurance. The industry argues that creating a public insurance program will undermine the marketplace and eventually lead to a single-payer style system.

Somehow, this isn't surprising. On Friday, the health insurance industry showed how un-serious they were about really controlling costs by backing away from the promise they made to President Obama. And now, the same industry is planning on making videos (which could be turned into ads) to try and kill the public health insurance option, the only real way to control costs.

Check out the storyboards from their proposed ads [pdf]. The message is right out of the Frank Luntz playbook - scaring the public about the dangers of "government-run health care," and lying by omission about the fact that Obama's health care plan wouldn't force anyone to choose a public health insurance plan if they didn't want one.

Up until now, the disgraced CEO Rick Scott was the only one up on the air against Obama's health care reform plans. Not even Republicans had a coordinated message to attack health care, at least not until Frank Luntz came along. But now, it looks like the message carried by Harry and Louise might be returning, once again payed for by an insurance industry desperately looking for any way to protect their profits in the face of competition and reform.

They just can't get this story straight:

The six healthcare industry groups that promised President Obama they would find ways to reduce national healthcare spending by $2 trillion over 10 years reaffirmed their commitment to that goal Friday.

The organizations, representing healthcare companies and workers, reiterated that pledge in response to media reports suggesting they were backing away from it and from President Obama.

“Our organizations are currently engaged in an intensive process to develop proposals to reduce the rate of increase in future healthcare costs," the groups said in a joint statement Friday. “We look forward to offering cost-savings recommendations in the weeks ahead."

It's good to see the insurance industry along with the thers twisting in the wind a bit. And it really seems Obama has them right where he wants them. If they back down from their "historic" promise, they look like the liars they are. And if they keep their commitments, great. It means less profits for them and one step closer to health care we can afford.

But, this reversing of stories, now for the 2nd time, really does make them look untrustworthy. Not that they need the help.

NEWS

Health industry groups reaffirm $2T in savings - The Hill

The six healthcare industry groups that promised President Obama they would find ways to reduce national healthcare spending by $2 trillion over 10 years reaffirmed their commitment to that goal Friday.

The Machinery Behind Health-Care Reform - Washington Post

How an Industry Lobby Scored a Swift, Unexpected Victory by Channeling Billions to Electronic Records

Dems unclear where Baucus will side on health care reform - Politico

The fate of health care reform this year rests in the hands of a stoic Montana senator with a reputation for confounding his party and a zeal for bipartisanship that many in his caucus don’t share.

GOP, others gearing up for fight on health-care reform - The Montana Standard

While Democrats and their allies are pushing hard on health-care reform, their political opponents are gearing up for a fight — and it won't just be saying "no," says U.S. Rep. Denny Rehberg, R-Mont.

Blue Shield health insurance rescission case to go to trial - Los Angeles Times

For the first time, an Orange County jury will weigh whether the insurer wrongfully rescinded a California man's coverage.

Plouffe: Foes 'swiftboating' health care - Politico

Obama campaign adviser David Plouffe sent a fundraising appeal to supporters Saturday, calling for donations to stop the "swiftboating" of health care.

Medicaid is being used as an argument against the need to create a new, national public health insurance option. But Medicaid is not a good model for, nor an alternative to, the proposed new public health insurance plan. Medicaid varies too widely from state to state, its funding is unstable, its low provider payment rates lead to low provider participation, and its onerous application requirements keep many eligible people from enrolling. In addition, Medicaid has been largely handed over to private insurance companies, so it is no longer a truly public program.

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