Mitch McConnell and several GOP Senators wrote a letter to President Obama in opposition to a public health insurance option saying:

“Forcing free market plans to compete with these government-run programs would create an unlevel playing field and inevitably doom true competition,” the letter stated.

It is ironic that McConnell would claim that true competition would be doomed because true competition currently does not exist in the health care market. According to the American Medical Association, a single insurance company controls 50% or more of the market share in 64% of the nation's 313 health care markets. In 96% of the nation's markets, one health insurance company controlled at least 30% of that region's health care market.

Due to the lack of competition, there is little motive to control costs in order to compete - meaning that many folks simply can't afford health insurance. A recent study by Families USA showed that 1 out of 3 Americans under 65 (people over 65 automatically qualify for Medicare) lacked health care for some or all of 2007-2008. The biggest irony is that that of that group, 4 out of 5 were in a household with a full time worker and still could not afford health care. With so many Americans uninsured and health care costs causing someone to file for bankruptcy every 30 seconds, it's clear that there is not adequate competition for providing working families with quality, affordable health care.

Jacob Hacker recently released a proposal calling for a public health insurance option. A public health insurance plan would not only provide a quality, affordable guaranteed backup plan for all Americans, but would force the monopolistic insurance industry to provide better and cheaper plans. A public health insurance option would improve private health insurance plans by providing the competition necessary to spur the needed cost containment and quality improvements for all health insurance options. Furthermore we can afford to do it as Hacker points out that a public health insurance option could save the United States $65 billion dollars a year.

To read more about the public health insurance option visit here or read this excellent interview Jacob Hacker gave with Ezra Klein of the American Prospect here. In the meanwhile, call your Congressman and Senator and tell them to support the inclusion of a public health insurance option so that all Americans can have access to quality, affordable health care.

(also posted at Yinzer Solidarity)

This post is part of a series on Women and Health Reform.

African American women aren’t any more likely to get a cancer diagnosis than white women (in fact, incidence rates for some cancer types—like breast cancer—are considerably lower among African Americans) but they are more likely to die from it. According to a new report from the American Cancer Society, the cancer death rate for African American women is 16 percent higher than the rate for their white peers. This racial disparity reflects poorer survival due to later stage at diagnosis and less access to appropriate and timely treatment, with the authors concluding that this type of health inequity is the result of “social and economic disparities more than biological differences associated with race.”

The disparity in death rates among the two groups is even greater when you examine rates for specific cancers. Compared to white women, African American women are more than twice as likely to die from cancers of the stomach and cervix. They’re nearly 40 percent more likely to die from breast cancer—the most common cancer diagnosis for women of both races. These statistics might be a little less distressing if the disparity gaps were shrinking over time, but they are not. Over the past three decades, the gap in overall cancer death rates between African American and white women has barely budged; for colorectal and breast cancers it has actually grown.

Read more…

An editorial in last week’s New York Times called attention to problems in the field of home health care, noting that health paraprofessionals who provide direct care to the elderly and disabled (“direct-care workers”) represent one of the fastest-growing occupations in the country yet remain unprotected by basic labor standards.  As such, the home health field—whose workers the NYT piece describes as among the “lowest paid and most exploitable”—suffers from very low job retention, with annual turnover of 40-60 percent on average.

The challenges that direct-care workers face are familiar to us.  Ninety percent of these workers are women.  Moreover, direct-care workers provide the bulk of the long-term care received by the nation’s elderly and disabled, and women comprise 2/3 of all long-term care consumers.  Women are heavily represented on both the giving and receiving ends of this type of care, and disproportionately feel the negative effects of poor-quality jobs for direct-care workers.

Read more…

Yesterday, The Institute for America’s Future hosted a conference, “Thinking Big Forward: A Conference on America’s Future.” The keynote speaker was renowned economist, Paul Krugman. In his speech he talked about how for 30 years this country has been dominated by a political movement that believes that government is not the solution, but is the problem.

Thinking like this leads to decisions like classifying ketchup as a vegetable in school lunches in 1981. Much hay was made of that huge gesture of disregard for future of health of America’s children, but in the final analysis that type of thinking won. We still only spend $2.57 per lunch for children in public schools over twenty years later.

Krugman explained that what you lose when a society is dominated by this type of thinking is investment. We lost investment in the things that raise the quality of life and general health and welfare for everyone in America. However, this economic crisis offers an opportunity to reopen the discussion about investment in the future. We spent the 30 years short changing public investment and Krugman believes that “it’s about time to start moving that pendulum back in the other direction.”

The Institute for America’s Future released a report that outlines what types of investment we need to make, including significant investment in a health care infrastructure that will provide quality, affordable health care for all.

The U.S. House Ways and Means Committee has put out legislative language for their version of an economic stimulus. As expected, the health components include increased Medicaid matching funds for states, subsidies to help the unemployed pick up COBRA coverage, and investment in health information technology. All of these are appropriate given the economic crisis: They will provide help and coverage to people losing insurance because of the recession and they will quickly increase government spending to stimulate the economy. But what makes the provisions particularly promising is that they represent a "first round" of health reform.

For example, a big problem in getting medical providers to move towards electronic record-keeping–which cuts down on medical errors and improves efficiency–is that they don't want to shoulder the cost. Now government will be bearing a lot of that cost. The increased Medicaid match for states will help prevent many of them from making proposed cuts in public programs–which, needless to say, is counter-productive at a time when we're trying to expand coverage.

The most exciting proposal that acts as a "down payment" on health reform is the provision that will allow states to expand Medicaid, temporarily, for unemployed adults. Many people think our public coverage programs cover the poor, but the truth is that they only cover some of the poor. Medicaid largely covers low-income children and parents, and the "aged, blind, and disabled." But there are many adults who don't have a child at home, who are not eligible for any public program-even if they are under the poverty level, which is $10,400/year for an individual, $14,000 for a couple. Sometimes called "medically indigent adults," they are left to whatever their county decides to provide in terms of a safety-net service.

Read more…

"Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.”  —Dr. Martin Luther King Jr., 1966.

Towards the end of his life, Dr. King increasingly confronted the intersection of racial inequality and other forms of injustice, particularly economic inequality.  This intersection created a framework in which Dr. King’s lifelong pursuit of justice applied, quite directly, to the disparities in health care that were part of America in the late 1960s and remain with us today.  Notes from Dr. King’s staff and his organization, the Southern Christian Leadership Conference (SCLC), reveal that bringing attention to health care inequities was a goal not far from Dr. King’s mind.  In fact, Dr. King’s closest advisers considered staging a sit-in at a hospital in the D.C. area to make evident, in the words of one King advisor, the “thousands of people in our nation in need of medical services.”

Over forty years after Dr. King’s tragic death, America still has a long way to go when it comes to bridging inequalities in health care.  Disparities in health exist across the board.  In 2007, African Americans had a rate of new AIDS cases that was ten times higher than white Americans.  Inequalities between men and women also plague the system.  For example, a 2008 National Women’s Law Center report showed that women, on average, are charged higher premiums for health insurance on the individual market than their male counterparts. Even among women, Hispanic and Native American women were roughly three times as likely as white women to be uninsured in 2007.

Read more…

Imagine, for a moment, that you are sick with ovarian cancer. Thankfully, you have good health insurance, are receiving excellent treatment, and expect to pay no more than a $3,000 deductible for the care you receive out-of-network. But then, in the midst of your recovery, you start receiving bills from your doctors— to the tune of more than $80,000.

This, as reported by the NY Times this past Tuesday, is what happened to Mary Jerome – a professor at Columbia University. Her subsequent complaints to New York Attorney General Cuomo’s office helped spur an investigation of “the puzzling gap between a doctor’s bill and what the insurer says it will cover.”

The culprit, as it turns out, is the database system the health insurance industry uses to determine how much of a medical bill is paid by the insurance company when a patient uses an out-of-network doctor. What the investigation uncovered, although unsurprising to those who place little trust in the insurance industry, is truly disturbing.

Read more…

The Institute for America’s Future and renowned health care and economics expert, Jacob Hacker, released a report today called: “The Case for Public Plan Choice in National Health Reform.” The report explains how the public plan option levels the playing field to allow for access and affordability by reducing costs, without reducing the innovation that can come from the private market. The Key Findings (pdf) of the report state:

A health care system that contains costs and drives value must include a good public plan if the broad goals of reform—universal insurance and improved value—are to be achieved. Private insurance and public insurance have distinct strengths and weaknesses, and thus should be encouraged to compete side by side to attract enrollees on a level playing field that rewards plans that deliver better value and health to their enrollees. Public insurance has a better track record at reining in costs, while preserving access; it has pioneered key quality and payment innovations that have often set the standard for private plans; it is essential to set a standard against which private plans must compete to drive value and can be a source of stability for people. Private plans are a source of new benefit options, and continuing pressure for innovation in benefit design and care management strategies.

HCAN Campaign Director, Richard Kirsch, voiced his support for the report’s conclusion: “Creating a high quality, affordable public plan alternative to private insurance is absolutely essential to achieving comprehensive health care reform solutions that will work for all of us in 2009.” Rep. Pete Stark stated his strong support for the choice of a public plan and HCAN agrees that a health care solution that does not include a public plan would be a non-starter. President-elect Obama also talks about the choice of a public option as a critical part of his plan, saying again and again in his speeches that every American should have a choice of a public plan similar to the health care that every Member of Congress gets.

However, we have seen signs that there will be debate on this issue. Advocates of real health care reform need to make sure that this critical part of the solution is not bargained away in a misguided attempt to placate those who see health care reform as a business opportunity, not a matter of the health of our families and our neighbors. This would be a tragic mistake.

Many of you who have been following Congressional politics for some time now will remember that in recent years, “Mr. Hastert was an advocate of governing the House by a ‘majority of the majority’ – a standard he thought best served the interests of his Republican members and, by extension, the nation.” By that standard on the list of Congressional supporters for the HCAN Statement of Common Purpose, we have a ‘majority of the majority’ supporting the public plan choice. We hope this will allay the fears of anyone who believes that real change can’t happen, because, in fact, this train is already pulling out the station.

Here is a little sampling of all the great work that is going on in the field with the HCAN campaign.

First, Representative-elect Himes in Connecticut made a public commitment to the principles for health care reform from the HCAN Statement of Common Purpose. You can watch his moving statement on video here from Connecticut Citizen Action Group:

Then, I got these photos from Progress Ohio where they are gathering forces from the around the state to fight for health care in 2009.

Progress Ohio Meeting

And finally, from Denver, Colorado our partners at SEIU are organizing health care workers from around the country to participate in health care community discussions with the transition team. Watch the video from Dr. L. Toni Lewis, President CIR/SIEU:

Keep up the great work guys! This is how will achieve change that works.

As reported in a recent New York Times article, the health insurance company UnitedHealth has a brand-new product. The company is selling the right to buy an individual health policy with the company at some point down the road when you may need it. Yes, what we’re talking about here is insurance for insurance. This new offer is meant to “reassure” those who currently have insurance but are (rightly) concerned that they may lose their coverage in the future and then have insurers deny them coverage when they try to obtain it again for themselves.

But first, let’s give credit where credit is due. UnitedHealth, in offering this “guarantee of insurance,” reveals critical problems with our current health care system, especially with the individual market, a market that is particularly hostile towards women. Today, you or I could lose our health insurance if we lose our jobs, or if our employers stop offering coverage, and be left to purchase health insurance directly from insurance companies in the individual market. In the current economic situation in which thousands of jobs are being lost every day, this has already become a frightening reality for too many. And while laws require insurance companies to cover individuals who get insurance through their employers even if they have pre-existing conditions or poor health histories, there are few adequate protections that stop insurance companies from rejecting individuals who are looking to buy coverage on their own.

Read the rest of this post…