NEWS

A merry Christmas; Senate eyes Dec. 24 vote on healthcare reform legislation - The Hill

The Senate is heading toward a Christmas Eve vote to pass landmark healthcare legislation, but instead of holiday cheer, Democrats and Republicans are digging in for trench warfare.

Liberal Revolt on Health Care Stings White House - New York Times

In the great health care debate of 2009, President Obama has cast himself as a cold-eyed pragmatist, willing to compromise in exchange for votes. Now ideology — an uprising on the Democratic left — is smacking the pragmatic president in the face.

Senate healthcare bill now relies on regulation - LA Times

Without a 'public option' to compete with private insurers, the government would instead police the industry. But do regulators have enough authority to make a difference?

A Race to Win One More Vote for Health Bill - New York Times

The White House and Senate Democratic leaders seem willing to give Senator Ben Nelson, Democrat of Nebraska, just about anything he wants to win his support of major health care legislation. Anything, that is, but the item at the top of Mr. Nelson’s wish-list: air-tight restrictions on insurance coverage for abortions.

President Obama's troops break ranks on health care - Politico

The foot soldiers of Barack Obama’s 2008 campaign, organized to go into action when key elements of his agenda are at stake, aren’t universally enthusiastic about fighting for the health care compromise now before the Senate.

Kaiser Health Tracking Poll — December 2009 - Kaiser Family Foundation

The December Kaiser Health Tracking Poll finds a dip on several measures of public opinion on health care reform. The number of Americans who say they personally will be better off if reform passes fell to 35 percent in December, down from 42 percent last month. Meanwhile, 27 percent say they will be worse off, and 32 percent said they don’t expect to see much of a difference. Similarly, 45 percent say the country would be better off if health care reform passes down from 54 percent in November.  This compares to 31 percent who say the country will be worse off and 17 percent who see no impact.  Public opinion in December looks more like it did in August, the last time this debate became so contentious.

N.C. voters steaming as Rep. Larry Kissell (D) turns against health-reform bill - Washington Post

To voters in this hard-luck town where stable factory jobs and the health care that came with them have long since disappeared, change looked good a year ago. Change came not only from President Obama, who narrowly won this swing state, but also from a mill worker-turned-high school civics teacher who had no political experience but ran on a promise to bring a progressive everyman's sensibility to Congress.

So screams the Business Insider.

If you need a guide to the health reform debate in Washington, take a look at health insurance company stocks. When the debate is going the right way - towards quality, affordable health care for everyone, towards getting people out from under the insurance industry's crushing monopoly - insurance company stocks take a dive. When the debate is moving against what America wants - towards more private industry, less insurance regulations, and the like - health care stocks soar.

Right now, they're soaring. The Indianapolis Star goes into more detail:

Shares of the Indianapolis-based health insurance giant surged to a 52-week high Thursday as the prospects for a new government-run "public option" health plan faded amid intense Senate debate. WellPoint rivals Cigna and UnitedHealth Group also hit 52-week highs.

It's a sign, more than one observer suggested, of victory for private health insurers, which strenuously fought the public option.

"Obviously, the market thinks WellPoint's a winner," said Daniel Evans, chief executive of Clarian Health, an Indianapolis-based hospital system. "If the public option is no longer on the table, then WellPoint is a winner because it's not threatened by a government competitor."

Wall Street is what has turned our nation's health care companies into profiteers. 16 years ago, before most of the insurance companies were publicly traded, they spent 95% of premium dollars on health care. That level is comparable to Medicare, which spends 97% of premium dollars on care. But once these companies went public and started trading on Wall Street, the relentless drive for profit drove down that percentage to where it sits today, at 81%.

Wall Street pressures directly caused insurance companies to deny more care. Wall Street accelerated the process by which insurance companies deny as much care as they can, which forces more people into bankruptcy (when they have to pay out of pocket for care their insurance company won't cover) and leaves millions uninsured (if you're bankrupt, it's hard to pay premiums). And being uninsured can be a death sentence.

The way Wall Street responds to the health care debate drives these companies. When insurance company stock prices catch fire as the public health insurance option is killed in the Senate, you can bet that these companies are watching and feel supported in their effort to kill any and all health reform that would hurt their bottom line.

Wall Street-run health care is the driving reason that if the insurance companies win, we lose.

Wall Street run health care is making huge profits right now. It's also making Americans sicker and sicker. A health care reform bill that does not take away Wall Street's power - one without a public option, one that doesn't mandate insurers spend 90% of their premiums on care, one without strict regulations on denying care or charging more to certain customers - will tacitly support the way the health care business works now, with Wall Street in charge.

The Senate bill, in too many ways, is the Wall Street bill. The House bill stands up to Wall Street. That's presents real problems for the American people, problems that must be fixed before this bill is sent to the President's desk.

NEWS

Reid Fights for 60th Vote on Health Bill - Wall Street Journal

Senate Majority Leader Harry Reid struggled to win over the last Democratic vote on health-overhaul legislation as uncertainty grew about whether the measure can be brought to a vote before Christmas.

The other Independent who could sink health care - CNN

There's been a ton of liberal  anger this week focused on Independent Sen. Joe Lieberman - who those on the left considered the main obstacle to the Democrats' efforts to pass a health care reform bill in the Senate by Christmas.

But now, an Independent senator from the progressive side of the Democrats' coalition could threaten passage of a reform bill.

Senate plan is called too empowering to health insurers - Washington Post

The Senate health-care bill could enable insurers to avoid some of the strongest consumer protections and benefit requirements adopted by state governments, Democratic lawmakers from Maine and California say.

SEIU Urges Changes In Senate Health Care Bill, Calls Out Obama - Huffington Post

A top labor leader urged Congress and the White House on Wednesday to make major improvements to the Senate health care legislation, suggesting that the labor community could not support the current incarnation.

How Joe Lieberman's 'no' helps President Obama - Politico

Sen. Joe Lieberman (I-Conn.) is taking a thrashing from his former Democratic colleagues and liberal activists for forcing a Medicare expansion out of the health bill.

But in the end, Lieberman may have done President Barack Obama one of the biggest favors in the health care debate.

Lieberman's Health Care Shift Gets Mixed Reviews - NPR

For a while this week, it looked like the opposition of Sen. Joe Lieberman, the Connecticut independent, could doom the Democrats' attempt at passing health care. That changed when Majority Leader Harry Reid gave in to Lieberman's demands on the Medicare buy-in program and the public option.

Sen. Coburn Promises "Several More" Stunts To Delay Health Care Reform - Media Matters

Sen. Tom Coburn (R-OK) tried to shut down the Senate today by demanding that a single-payer health care amendment introduced by Sen. Bernie Sanders (I-VT) be read in its entirety.  The amendment was 767 pages long.  After the clerks read for roughly 2.5 hours, Sanders withdrew the amendment calling it an "outrage" that Republicans would "bring the United States government to a halt."  Think Progress noted that, "at the pace it was proceeding, the reading of the bill would take 14.5 hours."

The insurance industry's allies - in this instance, the ultra-right wing Chamber of Commerce - seems to have run into some tough times. It looks like the only way they can get people to get involved with their anti-health care campaign is to offer free gift certificates to Hooters:

Online ads have popped up lately, telling readers that they can win a $150 Amex Gift Card for use at Hooters, if they complete a survey about other offers. One of those urges them to sign up for "free emails" from the Chamber of Commerce, which will explain "how to protect your family's future and bring common sense solutions to the health-care debate." In other words, getting involved with the Chamber's campaign against reform. These "incentivized ads" appear to be the favored new tactic of lobbying groups looking to generate the appearance of grassroots support for their positions.

This is of a piece with the astroturfing Blue Cross Blue Shield, AHIP, and the rest of the insurance industry is running, giving away fake "money" in popular online games like Mafia Wars and Farmville in exchange for sending anti-reform letters to Congress:

"Get Health Reform Right" has been caught offering Facebook users this "virtual currency" if they submit a form telling their Congressional representative "to get health reform right."

There's a lot of real fury out there right now about health reform. A ton of it is coming from the left. The right-wing, a handful of whom ironically showed up at the Senate yesterday for a "die-in," has to pay people to support their messages and get involved with their campaigns.

This tactic is one only the insurance industry, run by Wall Street businessmen, could endorse: If you can't get the people on your side for real, pay them to do it.

NEWS

Lieberman's Ties to Ex-Party Frayed by His Use of Swing Vote - Wall Street Journal

Sen. Joseph Lieberman's use of his swing vote to help quash a proposed expansion of Medicare marked the latest act in his deteriorating relationship with the Democratic Party.

Hospital, physician lobbyists fought Medicare buy-in plan - Washington Post

Four days before the Senate jettisoned the idea of expanding Medicare to younger Americans, a dozen Senate Democrats, including some of the chamber's most liberal members, dispatched a stern letter warning that the proposal would make it harder for elderly patients in parts of the country to find care.

Angry liberals: Why didn't Obama fight? - Politico

More than anything else in Barack Obama’s presidency so far, health reform has exposed a get-a-deal-at-any-cost side of Obama that infuriates his party’s progressives.

Obama Health Care Meeting Aims to Rally Senators - New York Times

As the battle over health care lurches toward a conclusion, President Obama is confronting an increasingly sharp divide on the Democratic left, with liberals in the Senate and the House split on a critical question: How much of what they want is enough?

What would happen if insurance companies had to spend more of your premiums on your health care? What if they couldn't give your money to their CEO as a bonus, or use it on misleading advertising campaigns fighting health care reform?

Specifically, what if insurers spent 90% or 95% of your money on your health care, instead of the 81% they spend now?

Well, according to a new report from the Main Street Alliance [pdf], they'd be able to give their customers between $54 or $94 billion in rebates on our premiums, depending on whether that level was 90% or 95%. That translates into hundreds of dollars per person covered by private insurance.

The amount private insurance spends on actual health care tells the story of the Wall Street takeover of the insurance industry, and points directly to why private insurance is so bad for our health:

Only 16 years ago, health insurance companies spent almost all of the premiums they collected to pay for actual health services. The leading insurers used 95 cents of every premium dollar on medical benefits, according to the consulting firm PricewaterhouseCoopers, a benchmark the industry referred to as a 95 percent “medical loss ratio.” That was in 1993, the year President Clinton proposed comprehensive health reform. Within 12 months the insurance industry had torpedoed the plan and reform was dead. Experts correctly forecast it would be many years before Washington tackled the issue again.

Ever since, health insurance executives have pursued mergers, acquisitions and initial public offerings that have turned the for-profit health insurance industry into a juggernaut. Wall street investors cheered as private, for-profit companies grew at a feverish pace. CEOs spent lavishly on sales and advertising to win market share away from home-grown non-profits that traditionally had low marketing costs. In response, non-profits had to behave more like for-profits, stepping up spending on sales and marketing and intensifying efforts to exclude the sick.

…

Along the way, health insurers’ medical loss ratios plummeted even as medical costs and premiums grew faster than overall inflation. By 2007 investor-owned health insurers had reduced spending on actual medical care to 81 percent of premiums collected, according to the analysis by PricewaterhouseCoopers, which often consults with the health insurance industry’s main trade group. The remaining 19 percent of premiums went to profits, marketing, executive salaries, administrative expenses, sales commissions, and the cost of weeding out sick people whose conditions might make them unprofitable to insure. Although the PricewaterhouseCoopers study gives an average for major investor owned insurance companies, other studies have found that in the individual and small group markets smaller insurers routinely have medical loss ratios that are much lower. A recent study of these markets found many as lowas 60 percent. By comparison, the public Medicare program has consistently had a benefit ratio greater than 97 percent since 1993.

The following chart neatly illustrates the problem:

Why has your health care gotten worse over the last decades since the insurance companies killed health care reform? Wall Street. Why have your premiums skyrocketed while they deny more of your care? Wall Street. Why are more Americans going bankrupt and dying every day because the insurance companies refuse to insure them? Wall Street.

Making sure the insurance companies spend at least 90% of your premiums on your health care is a start to fixing this problem. It'll at least curb Wall Street's influence over your health. Making insurers compete with a public health insurance option which, like Medicare, could spend 97% of its premiums on your health, would really fix this problem.

Of course, Joe Lieberman in the Senate is busy making sure the bill that body passes is as good for private insurance as possible. It'll be up to the House of Representatives and leadership in the Senate to make the bill better for us when it gets to conference.

NEWS

Lieberman Gets Ex-Party to Shift on Health Plan - New York Times

Just the thought of Joseph I. Lieberman makes some Democrats want to spit nails these days. But Mr. Lieberman, the Connecticut independent, is not the least troubled by his status as Capitol Hill’s master infuriator — and on Monday he showed how powerful that role can be at a time when Democrats cannot spare a single vote.

Biden: Lieberman wrong on health care - Fresnobee

Vice President Joe Biden says Connecticut Sen. Joe Lieberman is wrong to opposed a health care compromise in the Senate that would allow Americans as young as 55 to buy into the Medicare program.

Obama: 'Last chance' for health reform - Politico

In a provocative argument designed to rescue his foundering health-care plan, President Barack Obama will warn Senate Democrats in a White House meeting Tuesday that this is the "last chance" to pass comprehensive reform.

Obama’s Health Pitch Comes Backstage - Roll Call

President Barack Obama plans an intense but largely behind-the-scenes effort on health care reform legislation this week as the White House scrambles to help Senate Majority Leader Harry Reid (D-Nev.) push the bill toward passage.

Joe Lieberman says his objections to health reform are a "matter of conscience." One thing has become clear over the last 24 hours: When it comes to his conscience, he does a lot of flip-flopping. His changing positions on the Medicare buy-in is but the latest example.

When he was running for Vice-President and as recently as three months ago, he supported the Medicare buy-in idea he's now rejecting:

Meet Joe Lieberman, Medicare buy-in advocate. It's the winter of 2000, and Lieberman is pressing flesh and kissing babies in Bangor, Maine as the presidential election approaches. After holding a town hall meeting with voters at Bangor's opera house on Main Street, Lieberman, the Democratic vice presidential nominee, sits down with the local paper to discuss the upcoming election and his ticket's plan to improve the nation's health care system by allowing some younger Americans to "buy in" to the government run program.

…

It's not clear exactly when the Lieberman of 2000 turned into the Lieberman of Dec. 14, 2009, but it looks like it wasn't too long ago. In a Sept. 8, 2009 interview with the Connecticut Post, Lieberman outlined his opposition to a public option but suggested a way coverage could be expanded without one:

…By allowing citizens who are not eligible for Medicare or Medicaid to buy in for a rate below the private market, the government can extend coverage to more of those who are currently uninsured, he said.

To arrive at his position, Lieberman said he reached out to "every conceivable group" in the state, including residents, providers, doctors and hospitals.

Here's the video (h/t Greg Sargent):

And just last week, he said, "I don't know how anybody can decide until you see the actual language," before deciding without seeing the language yesterday:

CAVUTO: Which way you going to go on this?

LIEBERMAN: Good to be here. Well, the direct answer is, that Joe doesn’t know, because Joe doesn’t know what — nor do most other members of the Democratic Caucus — know what’s in the compromise proposals that came out of the group of 10 senators that Senator Reid sent to the Congressional Budget Office. [...]

The announcement, really, is that I don’t know how anybody can decide until you see the actual language of these compromise proposals. And, on the Medicare buy-in, I have increasing concerns, as I think a lot of other colleagues in the Democratic Caucus, including some of those who were not concerned about the public option.

There is no "matter of conscience" there. So why the flip-flop? Here's a few other things we know:

Joe Lieberman has taken $448,066 from the health insurance industry in the last 10 years, and he seems intent on giving his corporate paymasters everything they want.

We also know that Lieberman is holding up health care reform. That means that Lieberman will go to any length to make a political point against the left, even if it means killing his fellow Americans. As Ezra Klein over at the Washington Post wrote:

At this point, Lieberman seems primarily motivated by torturing liberals. That is to say, he seems willing to cause the deaths of hundreds of thousands of people in order to settle an old electoral score.

As has become clear, that is the depth that Lieberman will sink to. And there's no reason to believe he won't go lower.

NEWS

Lieberman Rules Out Voting for Health Bill - New York Times

In a surprise setback for Democratic leaders, Senator Joseph I. Lieberman, independent of Connecticut, said on Sunday that he would vote against the health care legislation in its current form.

Lieberman May Torpedo Health Care Reform - CBS

Senate Democrats who thought they had found a workable compromise on health care reform learned otherwise from independent Sen. Joe Lieberman over the weekend.

Rural leaders: Senate health care plan would help rural Nebraska - Grand Island Independent

With the Senate debating health care reform, Nebraska rural, farm and other organizations are urging lawmakers, including U.S. Sens. Ben Nelson and Mike Johanns of Nebraska, to pass a reform package that places an emphasis on the acute problems farmers and rural Americans face in accessing affordable, quality health insurance.

Medicare 'buy-in': A bargain or burden? - USA Today

Phil Tredway was intrigued when he heard the latest health insurance proposal making the rounds in Congress: letting people buy into Medicare starting at age 55.

The public health insurance option is treated in the media like an ideological sacred cow, something that must necessarily be sacrificed to moderates in order to pass health reform. The reality is, the public health insurance option would perform an essential function in the overall health care system.

The public health insurance option gives us the way to control insurance company costs and behavior. No other proposal would do this.

First, cost. The public option would put a lid on insurance company rate increases.

Even the CBO - a notoriously conservative outfit - has confirmed this fact. In their analysis of the House health care bill, they concluded that the public option would keep overall insurance premiums within the health insurance exchange down.

This would work in the way you'd expect - through competition.

Say I'm one of the over 50 million people who will get health care through the exchange under the House bill. When the exchange is finally open for business, I'll get to pick from any plan available. Likely, that will include plans from the for-profit insurance companies (one from Aetna, one from Unitedhealth, etc…), plans from the non-profits like Blue Cross Blue Shield, and the public health insurance option. Every one of those plans has to provide good benefits for me, so nobody can sell cheap but junky insurance in the exchange. And I'll receive a fixed subsidy to help offset the cost if I can't afford the plans.

So, let's say the insurance companies decide to do what they always do and price their plans sky-high. That means in the exchange, every plan will have a huge price tag except for the public health insurance option, which, having no profit motive and no executives to pay, has no reason to raise prices like the private insurance companies do. Which plan do you think I'm going to choose? Given I'm getting a fixed subsidy, the public option is going to be better for my wallet. And I also know the public option is looking out for my health, not for profit, so I don't have to be worried it will deny my care like the private insurance companies do.

Taken in aggregate, if the insurance companies keep raising their rates, all of the 50 million plus people in the exchange - 1/6th of America's population - will choose the public option, costing the private insurance companies a huge amount of business. So what will insurance companies do? They won't raise their rates. In fact, they'll keep their prices low to attract business. In indeed, this is exactly what the CBO said would happen.