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Archive for July, 2009

Hoping for failure - this isn't a game

Posted on July 24th, 2009 by Jason Rosenbaum in Profits Before People

Health care costsRepublicans want to kill health care to score cheap political points. Senator DeMint wants to make it Obama's "Waterloo." Newt Gingrich agrees. And Senator Inhofe sees killing health care as the way Republicans can win back seats in Congress in 2010.

This is about politics for them. But this isn't a game.

The Center for American Progress details what will happen in this country if we don't pass health care reform. The numbers are stark:

This analysis shows that without health reform, average family premiums will grow to more than $22,000 by 2019, up from $13,100 today. In some states with higher-than-average premiums, family premiums will exceed $25,000 in 10 years. Of course, a family’s total health care costs will be even higher once co-payments and other out-of-pocket expenses are calculated into the total.

The numbers have been broken down state-by-state, which you can see on the chart at right.

So, Jim DeMint from South Carolina wants his constituents to pay more than $21,000 for health care per year to give Obama his "Waterloo." James Inhofe from from Oklahoma wants to force his constituents to pay over $20,000 per year to win back a few seats in Congress. And they both have health care paid for by you and me.

It's not just Republican Senators, or course. Rich media personalities like Rush Limbaugh, who makes more than $50 million per year, deny there is a health care crisis and hope for Obama to fail. Glenn Beck and Sean Hannity, fellow multi-millionaires, are pushing the same line, when they're not flipping out about Obama's birth certificate.

These people simply have no skin in the game. They think the health care fight is about politics as usual. It's not. Over 14,000 are losing their health care every day. People are dying. And the cost of doing nothing is staggering. In just three weeks, this is what happens in America without health reform:

This is about health care for people and lowering costs for you and me. This isn't about winning a few seats or scoring some points in the media. But obstructionists of all stripes (and it's not just the media or Republicans) are willing to slow down or kill health reform for politics. These kinds of power games are enough to make you sick.

Failure to Protect? Yep, That's the Individual Market We Know

Posted on July 24th, 2009 by Brigette Courtot, National Women's Law Center in From Our Partners

If you’re looking for more evidence that the individual health insurance market (that unwelcoming place where people buy coverage directly from insurance companies) is failing us in pretty much every way possible, add this new brief from the Commonwealth Fund to the pile. Aptly titled “Failure to Protect,” it uses findings from a 2007 survey to illustrate why the individual insurance market is anything but a reliable source for comprehensive and affordable health coverage. Consider these findings:

  • Most adults who shopped for coverage in the individual market found it very difficult or impossible to find a plan that fit their needs—they were either denied due to a preexisting health condition or were offered a plan that was too expensive or that didn’t cover the care they needed.  The majority (73%) never ended up buying a plan.
  • Adults who do purchase individual market plans spend considerably more on health care than those with employer-sponsored insurance (ESI); 51% of people with individual market coverage spent 10% of their income or more on out-of-pocket costs (all medical expenses, premiums, and prescription drugs), compared to 29% of those with ESI. Median spending for those with individual market coverage was more than twice that for people with ESI ($6,750 vs. $2,250).
  • Those with individual market plans also report higher rates of problems with their coverage (e.g. dollar or visit limits on covered services, or expensive medical bills that aren’t covered by their plan) and are more likely to avoid or delay needed care because of cost.

Read more…

Daily Health Care News - 7/24/09

Posted on July 24th, 2009 by Jason Rosenbaum in News Clips

NEWS

White House Official Links Health Care Plan to Fiscal Balance - New York Times

A comprehensive overhaul of the health care system, eliminating inefficiencies and wasteful practices, will be crucial in correcting the nation’s unsustainable fiscal excesses, the White House budget director said on Wednesday. The Obama administration is increasing its pressure on Congress to act before the August recess.

Obama says Senate's delay in health care bill 'OK' - Associated Press

President Barack Obama stepped up his us-against-them pitch for overhauling health care Thursday, saying the American people need it and must overcome resistance from opponents in Washington, whom he described vaguely as naysayers and skeptics.

White House sees healthcare bill by year's end - Reuters

WASHINGTON (Reuters) - Shrugging off delays in a divided Congress, President Barack Obama's administration on Friday said a sweeping healthcare overhaul would still be approved by year end to control costs and expand coverage.

McCaughey claims end-of-life counseling will be required for Medicare patients - Politifact

Republicans have found many reasons to oppose the Democrats' health care proposal, but this is one of the oddest.

Baucus: Removing Health Care Deadline Should Help Process - Roll Call

Senate Finance Chairman Max Baucus (D-Mont.) said Thursday evening that Majority Leader Harry Reid’s (D-Nev.) decision to not push for a full Senate vote on health care reform before the August recess makes it somewhat easier for the gang of six bipartisan negotiators on his committee to reach a deal.

A few more answers from our Senators: Gillibrand and Cantwell

Posted on July 23rd, 2009 by Jason Rosenbaum in Congress Watch

We've gotten a few more answers in on the four questions Democracy for America, Open Left, and Health Care for America Now have been asking Senators. Here's what we've been asking:

  • Do you support a public healthcare option as part of reform?
  • Do you support a public healthcare option that is ready on day one?
  • Do you support a public healthcare option that is national, available everywhere, and accountable to our government?
  • Do you support a public healthcare option that has the clout to establish rates with providers and big drug companies?

First up, Senator Gillibrand from New York. We have been waiting for an answer to question four from Senator Gillibrand, and in her interview with Howard Dean last week, we got it. Watch:

Gillibrand clearly endorses a Medicare-like public healthcare option in this video, and Medicare has the clout to establish rates with providers, so Senator Gillibrand is a yes for question four.

Senator Cantwell from Washington has also sent a letter back to a constituent, answering three out of four questions. Here is the relevent paragraph:

Let me be clear: a public option needs to be part of health care reform. I am pushing for a public option that will keep insurance companies honest by competing to drive down costs and improve quality nation-wide. This plan needs to be accountable to the people and must work to provide the best coverage for the best price.

She supports a national public option that can establish rates, thus providing the "best price" for health coverage.

We've also received an answer of "maybe" on all questions from Senator Begich of Alaska.

Let's keep those answers coming! Click here to email your Senators and ask them where they stand.

The updated chart of supporters and opposition is below.

House Health Reform Bill Produces a $6 Billion Surplus

Posted on July 23rd, 2009 by ICR Bloggers in From Insurance Company Rules

The Congressional Budget Office (CBO) has released its score of the House health care reform bill and opponents of health care reform are trying to use it to scuttle the bill’s success. The truth, however, is that without the Medicare physician payment fix, the House health reform bill is budget neutral and even produces a $6 billion surplus. We should applaud the House for tackling this long-term problem in Medicare’s fee structure, not punish it by falsely claiming its health care reform initiatives will add to the federal deficit.

Read more…

Why do Blue Dogs want you and me to pay three times more than they do for health care?

Posted on July 23rd, 2009 by Jason Rosenbaum in Profits Before People

The Blue Dog negotiating list for health reform has been floating around for days now. Here's the list:

–Effectively bend the cost curve
–Realign incentives to reward high quality, efficient health care; include value-based purchasing, value index, innovation center for Medicare and Medicaid, and other delivery system reforms
–Increase small business exemption and adjust for inflation
–Address end-of-life care
–Adjust the value and cost of subsidy levels
– Provide affordability credits on a sliding scale from 100-300 percent FPL

– Public option must negotiate rates with providers, provide greater clarity on opt out, compete on a level playing field, and be available as a fallback
–Establish consumer-driven, state-based co-ops
–Create state-based exchanges with a federal fallback
–Maintain current state-federal partnership with Medicaid, while implementing reforms that increase its value and effectiveness

I've emphasized the two in the middle, because those are the two we hear are highest on the Blue Dog list right now. They are also the ones that cut to the heart of health reform. In short, the Blue Dogs want to keep health care unaffordable for you and your family.

Right now, the House bill protects families up to 400% of the Federal Poverty Level (FPL). The Blue Dogs want to cut that back to 300%. That would cut millions of people out and leave them on their own, paying full price for health care.

What's full price?

The average family health care plan costs $12,680 per year, which comes out to $1,056 per month. For someone making 350% FPL, that's 16% of their income going to health care costs. Meanwhile, Blue Dogs - who get health care paid for by you and me through the Federal Employees Health Benefit Plan - pay an average of just $357 per month [pdf] for health care, or $4,284 per year. They pay three times less, and they make $174,000 per year.

That's just not fair, and more importantly, Blue Dogs want to weaken the main goal of health care reform - to make it truly affordable to families.

Instead of asking families to pay huge portions of their income for health care costs, they should agree with leaders in the House and ask those in our society who can most afford it - those families making over $350,000 per year - to chip in their fair share by starting to roll back the tax breaks the wealthy got under George Bush.

To do any less would be to deny the crisis going on Blue Dog districts, where health care is unaffordable and uninsurance rates are sky high. It would be a dereliction of duty, it would keep health care out of reach for millions of families, and it would be shockingly unfair.

The Media Pans President Obama's "Grown Up" Health Care Talk

Posted on July 23rd, 2009 by Jason Rosenbaum in Profits Before People

President Obama's press conference last night is getting mixed reviews from the media. The AP says Obama's "stepped-up public role comes as he faces rising criticism from Republicans, sliding public approval ratings and divisions within his party." The New York Times says the debate is "slipping away" from Obama. Politico says reform efforts are "flagging."

Is this what you saw last night?

Because I saw more of what Jon Cohn was seeing:

Tomorrow's headline will probably focus on the length of Obama's professorial answers, the small bits of news in his press conference, and the fact that he seemed genuinely pissed off about what happened to his friend, Henry Louis Gates, in Cambridge the other day. But the most striking thing to me was Obama's willingness–in that question about doctors and a few others–to speak candidly about his health plan, even if that meant giving openings to some of his critics.

Consider that Obama's mission tonight was actually very straightforward: to build support for health reform at a time when it is moving through Congress but, for the first time, running into serious obstacles. To accomplish this, Obama basically had two options at his disposal. He could reassure the public by minimizing the scope of change he was promoting or he could persuade the public by convincing them change, even extensive change, was actually necessary.

In the past, Obama has frequently emphasized the former approach. And at times tonight, he did it again–most clearly when he repeated his promise that people could keep their insurance if they liked it.

But Obama spent most of his time this evening explaining why things had to be different. He did this, first, by talking about the problems of the status quo. He talked about rising premiums, dwindling benefits, and growing costs that are strangling employers and government alike.

But it was later, when the discussion got into policy specifics, that Obama seemed determined to convince people that transformation was a good thing. Consider this question, which–again–focused on the importance of reducing unnecessary medical treatment:

When you describe health-care reform, you don't–understandably, you don't talk about the sacrifices that Americans might have to make. Do you think–do you accept the premise that other than some tax increases, on the wealthiest Americans, the American people are going to have to give anything up in order for this to happen?

Once again, Obama could have changed the subject or offered a bland denial. Once again, he did nothing of the sort.

They're going to have to give up paying for things that don't make them healthier. And I–speaking as an American, I think that's the kind of change you want.

Look, if right now hospitals and–and doctors aren't coordinating enough to have you just take one test when you come in because of an illness but instead have you take one test; then you go to another specialist, you take a second test, then you go to another specialist, you take a third test; and nobody's bothering to send the first test that you took–same test–to the next doctors, you're wasting money. You may not see it, because if you have health insurance right now, it's just being sent to the insurance company, but that's raising your premiums, it's raising everybody's premiums. And that money, one way or another, is coming out of your pocket, although we are also subsidizing some of that, because there are tax breaks for health care. So not only is it costing you money in terms of higher premiums, it's also costing you as a taxpayer.

Now, I want to change that. Every American should want to change that. Why would we want to pay for things that don't work, that aren't making us healthier? …

It will require, I think, patients to–as well as doctors, as well as hospitals–to be more discriminating consumers. But I think that's a good thing, because ultimately we can't afford this.

Telling doctors and patients they need to be more "discriminating" takes a little bravery, at least in this media environment. Critics are already warning about a government takeover of medicine.

Obama seems to be banking on the fact that Americans will see past such ridiculous charges–and, more important, that they will come around to the idea that, yeah, maybe we really do need to start cutting down on all that unnecessary medical care.

Is he right? I'm way too close to this subject to have the necessary perspective. (And since I was actually in the East Room tonight, I can't even speak to how it all played on television.)

All I know is that Obama wanted to speak to America like adults tonight–and make the case for the reforms he (quite rightly) believes are necessary. Time will tell whether that faith in the public's patience and judgment is well-placed.

The commenters on Firedoglake watching live with me seem to agree.

It's not surprising that the media only sees the horserace. The surprising thing is that the President seems to be making a bet that the American people can see through the smokescreen and realize our health care system is incredibly screwed up and needs fundamental change.

Time will tell if he's right, but I personally respect him for taking the risk.

Daily Health Care News - 7/23/09

Posted on July 23rd, 2009 by Jason Rosenbaum in News Clips

NEWS

Obama turns health care focus to families, voters - Associated Press

After weeks of urging lawmakers to embrace his health care agenda, President Barack Obama is taking his case back to the road Thursday as the public's qualms about the plan seem to be growing.

Obama Press Conference On Health Care: TEXT, VIDEO - Huffington Post

Below is the full text of the prepared remarks President Obama delivered during his press conference last night, along with updates from the subsequent Q&A. The full transcript can be read here. Scroll to the bottom to watch the full press conference.

Employers Are Far From Unified Against Overhaul - Washington Post

Even as the national business lobby ramps up its opposition to health-care reform, there are signs that employers around the country are divided on the issue, reducing the force of an opposition push.

Leader Of GOP Health Care “Solutions Group” Says GOP Won’t Offer Health Care Bill - Greg Sargent

National Dems think they’ve caught a prominent Republican in another major health care gaffe, and they say they’re planning on banging away at it all day today.

Kaiser Health Tracking Poll — July 2009 - Kaiser Family Foundation

The July Kaiser Health Tracking Poll finds a majority of the public remains supportive of taking action on health reform now, though there is some softening of support as criticisms and doubts seem to be registering.

Obama takes health care campaign to Cleveland - Associated Press

President Barack Obama is taking his campaign for health care reform to Cleveland today.

Sen. Bond Denounces Sen. DeMint's "Waterloo" Comment: "I Think He Was Way Off-Base" - Media Matters

Sen. Jim DeMint (R-SC) has drawn a lot of fire for his assertion that if Republicans derail President Obama's plans for health care reform, "it will be his Waterloo. It will break him." The White House has seized on the statement as evidence that Republicans are more interested in playing politics than improving the nation's health care system. And, while DeMint insists that the president's response "played right into my hands," some Republicans are trying to distance themselves from his inflammatory remarks.

The Insurance Industry Doesn't Need Protection

Posted on July 22nd, 2009 by Jason Rosenbaum in Profits Before People

What's often lost in the debate over the public option, competition, and insurance regulation is that the insurance industry is taking in record profits. Case-in-point, UnitedHealth's second quarter profit skyrocketed:

The Minnetonka, Minn.-based company said its profit more than doubled compared to the same quarter last year, when hefty legal charges weighed down earnings. UnitedHealth also said revenue rose 7 percent, as it saw strong growth in its public and senior health insurance.

Why the huge profits?

Revenue rose to $21.66 billion from $20.27 billion on increased premiums, which grew partly due to price increases. UnitedHealth is the largest commercial health insurer based on revenue.

We're in the middle of a recession. People are losing their jobs every day. And yet, UnitedHealth, which dominates the market in some areas, continues to raise prices so it can generate record profits.

And, clearly, that's all they care about: Profits and maximizing returns for their stockholders. Not health care, not you or me. It's all about money.

So, while the Chamber of Commerce hyperventilates about a public health insurance option, the insurance industry is doing just fine squeezing you and me for our hard-earned money. They can stand a little competition, because their CEOs really don't need another bonus.

The media: All setbacks, no progress

Posted on July 22nd, 2009 by Jason Rosenbaum in Profits Before People

This probably isn't surprising, but worth noting anyway:

In their health care reform coverage, media have repeatedly given considerably more attention to perceived setbacks to progressive reform efforts than to events that signal progress for those efforts. A Media Matters for America analysis of transcripts available in the Nexis database has found that broadcast and cable news featured almost twice as many segments mentioning the American Medical Association's (AMA's) reported opposition to a public insurance plan as segments mentioning the AMA's recent announcement that it supported the House Democrats' health care reform bill, which includes a public plan.

That finding is consistent with an earlier Media Matters study showing that the number of cable news segments in Nexis mentioning an initial Congressional Budget Office (CBO) analysis of an incomplete version of a Senate health committee draft bill was far greater than the number of segments mentioning a later CBO analysis. That later analysis showed that an updated version of the bill would cover more people for less than the earlier scoring had suggested. Media Matters has also documented a pattern in which media suggest that President Obama's reform effort is in serious jeopardy, despite events — including the AMA endorsement and revised CBO score — that indicate reform efforts have made substantial progress.

That's twice now that the media has failed to cover the upsides of health reform, preferring the downside. Of course, they're all out for ratings, so reporting the drama is probably better for the bottom line than reporting the progress. It just happens to be unbalanced.