Posts filed under 'Public vs. Private Health Coverage'

Thank you! 60 Senators Bring Us One Step Closer to Health Care Reform

True, the bill that passed the Senate is far from perfect. But, can you imagine what the opposition would be saying if the bill met our standards for true health care reform?  As it is, the brave Senators who led this battle have endangered their political careers. This includes Senator Chris Dodd (CT), senior Senator from the Center for Medicare Advocacy’s  home state. 

So we thank Senator Dodd and everyone who worked to get this good bill passed.  Here are some highlight’s from Families USA: Manager’s amendment: Providing more competition and affordable choices for Americans ; Manager’s amendment: Improving quality and controlling costs ; Manager’s amendment: Enhancing affordable choices for small businesses .

Get some rest, all!   Another big push to provide health care equity awaits us after we ring in 2010.

Add comment December 24, 2009

It Takes 2 To Tango: Senator Baucus Tells The Truth About (Not)Bipartisan Health Care Reform

Senate Floor Remarks of Senator Max Baucus  December 22, 2009

“Mr. President, it has been more than a month since the Majority Leader moved to proceed to the health care reform bill before us today.  At long last, the Senate is now in the final throes of passing this historic legislation.

From the beginning, this Senator has sought out what Abraham Lincoln called “the better angels of our nature.”  That’s the way that this Senator has always sought to legislate.

A year and a half ago, I convened a bipartisan retreat at the Library of Congress.  Half a year ago, I convened three bipartisan roundtables with health care experts.  Half a year ago, the Finance Committee conducted three bipartisan walk-throughs of the major concepts behind the bill before us today.

We went the extra mile.  I reached out to my good friend, the Ranking Republican Member of the Finance Committee.  I reached out to the ranking Republican Member of the Health Committee.  We sought to craft a bill that would appeal to the broad middle.  We sought to craft a bill that could win the support of Republicans and Democrats alike.

We met, a group of six of us, three Democrats and three Republicans.  We met more than 30 times.  We met for months.  No, we did not reach a formal agreement.  The Leadership on the other side of the aisle went to great lengths to stop us from doing so.

But even though we did not reach a formal agreement, we came very close to doing so.  The principles that we discussed are very much the principles upon which the Finance Committee built its bill.  The principles that we discussed are very much the principles reflected in the bill before us today.

From the debate that the Senate has conducted this past month, you would not know it.  During this debate, some on the other side of the aisle have mischaracterized the bill before us.  Some on the other side of the aisle have set about a systematic campaign to demonize this bill.  Through bare assertion alone, with the thinnest connection to fact, they have sought to vilify our work.  If one listened to their assertions alone, one would not recognize the bill before us.

And so, let me, quite simply, state the facts.

Some on the other side of the aisle assert that this bill is a Government takeover of health care.  The fact is that the nonpartisan Congressional Budget Office says that this bill would reduce the Government’s fiscal role in health care.  Just 3 days ago, CBO wrote, and I quote:“CBO expects that the proposal would generate a reduction in the federal budgetary commitment to health care during the decade following the 10-year budget window.”

Some on the other side of the aisle assert that this bill would add to our Nation’s burden of debt.  The fact is that the nonpartisan Congressional Budget Office says that this bill would reduce the deficit by $132 billion in the first 10 years and by between $650 billion and $1.3 trillion in the second 10 years.  The fact is that this is the most serious deficit reduction effort in more than a decade.

Some on the other side of the aisle assert that this bill would harm Medicare.  The fact is that Medicare’s independent Actuary says that this bill would extend the life of Medicare by 9 years.  The fact is that this is the most responsible effort to shore up Medicare in more than a decade.

Some on the other side of the aisle assert that this bill does not do enough to ensure the uninsured.  The fact is that the nonpartisan Congressional Budget Office says that this bill would extend access to health care to 31 million Americans who otherwise would have to go without.  The fact is that CBO says, and I quote: “the share of legal nonelderly residents with insurance coverage would rise from about 83 percent currently to about 94 percent.”

Nothing that Senators on the other side of the aisle have proposed would come close.  CBO estimated that the Republican substitute offered in the House of Representatives would have extended coverage to just 3 million people.  The fact is that CBO says of that plan, and I quote: “The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, roughly in line with the current share.”

I would cite the facts about the Republican substitute in the Senate.  But the fact is that there is no Republican substitute.

Some on the other side of the aisle assert that they simply prefer a more modest reform of health care.  The fact is that the Republicans controlled the Senate from 1995 to 2001 and from 2003 to 2006.  The fact is that before they took control, in 1994, 36 million Americans, 15.8 percent of non-elderly Americans were without health insurance coverage.  In the last year of their control, in 2006, nearly 47 million Americans, 17.8 percent of non-elderly Americans were without health insurance coverage.  The legacy of Republican control was 10 million more Americans uninsured.

Some on the other side of the aisle say that we are moving too fast.  The fact is that it was 1912 when former President Theodore Roosevelt first made national health insurance part of the Progressive Party’s campaign platform.  The fact is that people of good will have been working at this for nearly a century.

The fact is, health care reform for America is now within reach.  The fact is, the most serious effort to control health care costs is now within reach.  The fact is, life-saving health care coverage for 31 million Americans is now within reach.

Let us, at long last, grasp that result.  Let us, this time, not let this good thing slip through our hands.  And let us, at long last, enact health care reform for all.”

Add comment December 22, 2009

Yes, We Still Support Health Care Reform

We’ve decided, we can’t  afford to let the perfect interfere with the possibility of good health reform. There are millions of Americans waiting for insurance coverage and an economy waiting  for businesses to be relieved of health care’s extraordinary costs.  At best the Senate is likely to pass a bill that disappoints but, as of today, we support it.

As economist Paul Krugman says in today’s New York Times, “Pass the Bill, the current health care bill falls a long way short of ideal, but it is better than anything that seemed possible just a few years ago.”

So – today the Center for Medicare Advocacy sent the following letter to Senate health reform leaders:

Dear Senators Reid, Durbin, Dodd, and Baucus:

 The Center for Medicare Advocacy, Inc. is a national, non-profit organization that advocates on behalf of older people and people with disabilities to ensure access to health care.  We thank you for your efforts to enact health insurance reform. 

 The Patient Protection and Affordable Care Act will provide access to health insurance for millions of Americans, provide subsidies to those with limited incomes and resources, improve access to preventive services, and limit discrimination in the offering of health insurance.  Additionally, the bill protects the integrity of the Medicare program by reducing overpayments to Medicare Advantage plans and by promoting delivery system reforms to encourage high quality, coordinated health care.  The bill further assists people with limited means by extending eligibility for Medicaid for the under 65 population.

Overall, the Patient Protection and Affordable Care Act will move this country towards the goal of achieving universal access to health care.  We are pleased to support this legislation. 

Center for Medicare Advocacy, Inc.

1 comment December 18, 2009

The Connecticut-Based, Center for Medicare Advocacy, Joins the Washington Post in Applauding our Senior Senator, Chris Dodd, and Apologizes for the Actions of Joe Lieberman, our Junior Senator, to Bar Real Health Reform.

The essay below is from the 12/15/2009 Washington Post:

The heroes of health-care reform

Right on the heels of Joe Lieberman trying to kill the bill because it had a Medicare buy-in proposal, Howard Dean is exhorting Democrats to kill the bill because it doesn’t have a Medicare buy-in proposal. Sigh.

So let this serve as an encomium to Ron Wyden, Tom Harkin, Chuck Schumer, Sherrod Brown, Chris Dodd and Jay Rockefeller, among many others. All of these senators could have been the 60th vote. All of them had issues they believe in and worked for. Chris Dodd built and passed a bill. Sherrod Brown whipped up liberal support for the public option. Chuck Schumer spent countless hours devising compromises and searching for new paths forward. Ron Wyden spent years crafting the Healthy Americans Act, getting a CBO score, pulling together co-sponsors, speaking to activists and industry groups and other legislators. Jay Rockefeller has spent decades on this issue and wasn’t even invited into the Gang of Six process.

But you know what? They’re all still there. Because in the end, this isn’t about them, and though their states and their pet issues might benefit if they tried to make it about them, the process, and thus the result, would be endangered. I’ve said before that the remarkable thing isn’t that Joe Lieberman acts the way he does but that so few join him. The legislative process is given a bad name by the showboats and grandstanders, but the only reason it functions at all is because the vast majority of the participants keep their role in perspective.

If this bill passes, it will not be because Lieberman was pacified. It will be because senators such as Rockefeller, Wyden, Schumer, Harkin, Brown and Dodd swallowed their pride and their passion and allowed him to be pacified. They are the heroes here, and beneath it all, their quiet determination made them the key players.

Photo credit: By Jose Luis Magana/Associated Press

Add comment December 16, 2009

Private Medicare Plans Are Taking You to the Cleaners. Cut the Subsidies Now! And Don’t Repeat This Windfall in Health Care Reform.

New Report Highlights Medicare Advantage Insurers’ Higher Administrative Spending
Publications
Wednesday, 09 December 2009 11:51
Today Energy and Commerce Committee Chairman Henry A. Waxman and Oversight and Investigations Subcommittee Chairman Bart Stupak released a new report which found that 34 Medicare Advantage insurers expend significant sums on profits, marketing, and other corporate expenses.   Last year, the insurers spent an average of $1,450 per beneficiary on profits, marketing, and other corporate expenses, nearly ten times as much as traditional Medicare spent on administrative expenses per beneficiary.On average, Medicare Advantage insurers spent over 15% of premium revenue on profits, marketing, and other corporate expenses.  Two-thirds of the Medicare Advantage insurers surveyed by the Committee had a “medical loss ratio” – the percentage of premium revenues used to pay medical claims – below 85% during at least one of the four years examined.  In contrast, traditional Medicare spends 98% of its money on medical care.  If all Medicare Advantage plans had spent at least 85% of their premium dollars on medical care from 2005 to 2008, they would have spent an additional $3 billion on medical care for seniors.”Medicare plays a critically important role in insuring that millions of Americans receive the health care they need,” said Rep. Waxman.  “But as this report shows, Medicare Advantage insurers are squandering billions of dollars on overhead costs – in fact, they spend ten times the amount per beneficiary as traditional Medicare.  Our health care bill includes much needed reforms to the Medicare Advantage payment system.  There is no reason for Medicare to pay private insurers more than traditional Medicare pays in any community in the country.  That will insure that taxpayer dollars are spent wisely.”"Medicare Advantage was never intended to be a program for insurance companies to pad their corporate expense accounts,” said Rep. Stupak.  “Seniors pay Medicare Advantage premiums with the expectation that the money will be used to provide critical medical care – not pay for marketing campaigns and executive bonuses.  The disparity between the percentage of premiums used to pay medical claims in traditional Medicare and Medicare Advantage is unacceptable; our seniors deserve better.  This report is just the latest example of private insurance companies exploiting the Medicare Advantage system for their own gain.”At the request of Chairman Waxman and Subcommittee Chairman Stupak, the majority Committee staff analyzed premium revenues, medical claim payments, marketing costs, profits, and other data from 34 major Medicare Advantage insurers.

The report found:

  • From 2005 through 2008, the average Medicare Advantage insurer spent over 15% of premium revenue on profits, marketing, and other corporate expenses. Two-thirds of the Medicare Advantage insurers surveyed by the Committee had a medical loss ratio below 85% during at least one of the four years examined. Six of the insurers had medical loss ratios below 75% in one or more years. In comparison, traditional Medicare spends less than 1.5% on administrative expenses and over 98% on health care. In the aggregate, the Medicare Advantage insurers spent $1,450 per beneficiary in 2008 on profits, marketing, and other corporate expenses, nearly ten times as much as traditional Medicare spent on administrative expenses per beneficiary.
  • Requiring all Medicare Advantage insurers to have a medical loss ratio of 85% would provide billions of dollars in additional medical services to seniors. The total amount spent on profits, marketing, and other expenses by Medicare Advantage insurers over the last four years was $27 billion. The House health care reform bill requires Medicare Advantage plans to spend at least 85% of their total premium revenues on medical claims. If this threshold had been in effect from 2005 through 2008, the Medicare Advantage insurers would have spent an additional $3 billion on their beneficiaries’ medical care, enough to eliminate all copays for preventive care for all Medicare beneficiaries for ten years.
  • In 2007 and 2008, Medicare Advantage insurers with medical loss ratios lower than 85% paid their executives over $1.2 billion. In 2007, a company that had a medical loss ratio of 79% paid an executive over $35 million. The same company paid 16 more executives salaries and bonuses worth $1 million or more. Another company with a medical loss ratio of 79% paid more than $210 million in compensation to 260 executives.
  • Medicare Advantage insurers have spent millions on expensive retreats. In 2007, one company with a medical loss ratio of 83% spent $3.1 million for two events in Hawaii. In 2007, a company with a medical loss ratio of 84% spent $2.5 million on employees and agents at a retreat in San Jose del Cabo, Mexico and $1.4 million on an event in Rome, Italy. In 2008, a company with a medical loss ratio of 82% spent $1.5 million on a meeting in Edinburgh, Scotland and $1.8 million on a trip to Cancun, Mexico.

Add comment December 10, 2009

ANSWER to Pop Quiz! Who Said This? About What?

As a spokesman for the AMA, Ronald Reagan said this about the dangers of passing Medicare:  “… behind it will come other federal programs that will invade every area of freedom as we have known it in this country.  Until one day, as Norman Thomas said, we will awake to find that we have socialism.  And if you don’t do this and if I don’t do it, one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” 

Ronald Reagan, our beloved Republican president,  said this as a spokesman against Medicare.  Now Republicans laud Medicare, say they are its champion, but say that health care reform must not  pass as it will lead to socialism and the demise of Medicare.  There is little new under the sun! 

Tell your senators to vote for health care reform – with a public option.  Like Medicare it is desperately needed and, if passed, it too will become a beloved institution. 

Someone, someday, will thank you for fighting for it and will praise your senators’ votes.

Add comment November 30, 2009

Connecticut’s Senators, Health Care Reform, and Lessons From Medicare

The Center for Medicare Advocacy is incorporated and headquartered in Connecticut.  People from this state can be proud of the courage our senior senator, Chris Dodd, has shown in leading health care reform.  As a leader of the Senate’s efforts, Senator Dodd is once again speaking and fighting for real reform, to include a public option.  We urge our other Senator, Joe Lieberman, to review the true costs and principles involved in this historic opportunity to insure all Americans, and to vote along with Senator Dodd for real health care reform.

The Center has been representing people with Medicare since 1986. We know what we’re talking about when we talk about the benefits and costs of public health insurance. 

Medicare is public health insurance. It brought basic health coverage to older people in 1965, when 50% of people over 65 had NO insurance because the private market didn’t want to insure them. All the arguments being made now against health care reform and a “public option,” were also made against Medicare before it passed. Medicare was hardly bi-partisan legislation; it barely passed.

Now most everyone appreciates Medicare and the health and economic security it brings to older people and their families. We can only hope Congress, and both of our Connecticut senators, will vote courageously again, as those before them did to enact Medicare.  This time we call upon Congress to bring health and economic security to younger Americans by voting for health reform – with a public option.

Add comment November 20, 2009

Private Medicare Costs Too Much – THAT’S Why The Payments Should Be Cut

If Republicans and “conservative” Democrats really want to save money, help taxpayers, and serve Medicare beneficiaries, they will cut the wasteful subsidies to private Medicare plans. Private Medicare plans cost taxpayers about 14% more than would be needed to cover the same services in the traditional, public Medicare program. Private plans should be paid the same rate as original Medicare; we simply can’t afford otherwise. The subsidies to private “Medicare Advantage” plans cost taxpayers about $10 billion a year!

 

6 comments November 18, 2009

Private Medicare Plans – Bullies On The Playground?

Medicare “Advantage” private plans were created not-equal in 2003. Not equal to “regular Medicare” because the law gave private plans a windfall of about 14% more per covered beneficiary than is paid for the same coverage in regular Medicare. We have all  been paying for this – to the tune of about $10 billion a year!  So, if paying the private plans the same as the traditional program means they take their balls and go home, so be it. We simply can’t afford to pay for the kind of profit the private plans seem to insist they make at the expense of Medicare and taxpayers.

The Center for Medicare Advocacy has long been concerned about the extraordinary costs of private Medicare. The movement towards fragmenting and privatizing Medicare was advanced by the Medicare Act of 2003.The lessons from privatizing Medicare should be applied when developing health care reform: No matter how much some people may want to believe that the private market is always a more cost-effective model than a public program, it just isn’t so. Medicare proves the point.
• When Medicare private plans were paid 95% of what it costs to provide the same coverage in the public Medicare program, they left the program in droves. They couldn’t make enough profit. (“Medicare+Choice,” enacted in 1997 as part of the Balanced Budget Act of 1997.)
• Under the “Medicare Advantage” program, passed in 2003, private Medicare plans are paid about 14% more than the same coverage would cost in the traditional public Medicare program. And, not surprisingly, private insurance plans have flocked back into the system. The insurance industry is making a windfall from this system – at the expense of all Medicare beneficiaries, including the vast majority of beneficiaries who still choose “regular Medicare.” Taxpayers overpay too. (CBO, MedPAC, Commonwealth Fund.)
• The private Medicare plan program is bleeding the Medicare trust fund, reducing Medicare’s solvency by about 8 years.
If Congress passes a requirement that all Americans have health insurance, but does not provide for a public option, we will have been taken to the cleaners yet again. Private insurance will gain tens of millions of new customers and we taxpayers will all pay a much higher bill than is necessary. Medicare’s experience proves this.

Add comment November 16, 2009

Congratulations America: Healthcare Reform is Moving Forward

The Center for Medicare Advocacy is grateful to those who courageously voted for the Affordable Health Care for America Act, H.R. 3962. This legislation goes a long way towards ensuring for all Americans the peace of mind that was brought to older people and their families with the passage of Medicare in 1965.

Medicare itself is based on the notion of  a shared a public/private undertaking and of pooling resources for the common good.  In Medicare’s case, the common good is that of older people, people with disabilities and their families. The Affordable Health Care for America Act advances the common good to all Americans by expanding access to health care to America’s uninsured and by implementing private market insurance reforms.

Among other things, the legislation passed by the House of Representatives will:

  • Provide affordable health insurance options for those currently without coverage;
  • Provide a Public Insurance option to provide competition with private insurance and keep costs down for individuals and taxpayers;
  • Prevent insurance companies from denying coverage to those with pre-existing conditions;
  • Prevent insurance companies from dropping the coverage of those who get sick;
  • Prohibit insurance companies from having life-time limits on benefits;
  • Ensure that insurance companies offer real value for premiums paid;
  • Strengthen Medicare for the more than 44 million older people and people with disabilities who currently use the program and for future generations of beneficiaries;
  • Improve Medicare’s payment to doctors and thus ensure that Medicare beneficiaries can continue, as they do now, to see the doctor of their choice or find a doctor if they need one;
  • Require Medicare, as well as private insurance, to provide preventive benefits without application of cost-sharing;
  • Promote care coordination in Medicare – especially for those with multiple chronic conditions – through various pilot projects;
  • Improve access to Medicare-covered services for low-income beneficiaries by strengthening the programs that serve these individuals;
  • Lower drug costs for Medicare beneficiaries by closing the Medicare Part D “Donut Hole”  coverage gap
  • Lower drug costs for Medicare beneficiaries by allowing the government to negotiate for lower drug prices with pharmaceutical companies;
  • Provide benefits to help older people and people with disabilities live in their own homes and communities by establishing the Community Living Assistance Services and Supports (CLASS) program.

The Center for Medicare Advocacy applauds  President Obama, Speaker Pelosi and all members of the House of Representatives who have worked so hard to bring this legislation to life.   We urge the Senate to follow suit soon!

Add comment November 9, 2009

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