Archive for June, 2009

Mr. President: Listen to Your Doctor!

The (President’s) doctor orders Medicare for all.   He’s right.   If  conventional wisdom is correct, and a single payer system is not “on the table,” surely the President and reform leaders must at least insist on a public health insurance option.

If the goal  of health care reform is to provide coverage for all as cost-effectively as possible, a public health insurance plan MUST be included in any health care reform package.   We can’t afford to be scared again by dire warnings about Big Government.  Big Insurance costs a lot more than a public program and it helps people get health coverage a lot less.   Ask anyone who really knows about the public Medicare program and private Medicare plans. 

Support a true public health insurance option!  It’s best for people who need health care and most cost-effective for taxpayers.   Isn’t that what the President and his doctor ordered?

June 23, 2009 at 6:32 pm 1 comment

Medicare for All?

This morning I showed my brand spanking new Medicare card to my 27-year old uninsured son, Patrick.

He looked the card over carefully and said “I wish I had one of these.”

June 23, 2009 at 2:53 pm 1 comment

This, From 1993, Will We Be Fooled Again?

Health Reform Cartoon

June 22, 2009 at 4:22 pm Leave a comment

From the Desk of Judith Stein

A True Public Plan: The Only Affordable Way to Provide Health
Care Reform

Have you read Paul Krugman in today’s NY Times? As he asks, what is health care reform for, people or insurance companies? We were already bamboozled into giving Medicare to the insurance and pharmaceutical industries in 2003. To the tune of about $15 billion a year! Are we really going to be scared into doing that again? Write your Congress people. Write the President. Tell them to support a TRUE public health plan option. And tell your friends to tell their congresspeople and president too!
June 22, 2009
Health Care Showdown
America’s political scene has changed immensely since the last time a Democratic president tried to reform health care. So has the health care picture: with costs soaring and insurance dwindling, nobody can now say with a straight face that the U.S. health care system is O.K. And if surveys like the New York Times/CBS News poll released last weekend are any indication, voters are ready for major change.
The question now is whether we will nonetheless fail to get that change, because a handful of Democratic senators are still determined to party like it’s 1993.
And yes, I mean Democratic senators. The Republicans, with a few possible exceptions, have decided to do all they can to make the Obama administration a failure. Their role in the health care debate is purely that of spoilers who keep shouting the old slogans — Government-run health care! Socialism! Europe! — hoping that someone still cares.
The polls suggest that hardly anyone does. Voters, it seems, strongly favor a universal guarantee of coverage, and they mostly accept the idea that higher taxes may be needed to achieve that guarantee. What’s more, they overwhelmingly favor precisely the feature of Democratic plans that Republicans denounce most fiercely as “socialized medicine” — the creation of a public health insurance option that competes with private insurers.
Or to put it another way, in effect voters support the health care plan jointly released by three House committees last week, which relies on a combination of subsidies and regulation to achieve universal coverage, and introduces a public plan to compete with insurers and hold down costs.
Yet it remains all too possible that health care reform will fail, as it has so many times before.
I’m not that worried about the issue of costs. Yes, the Congressional Budget Office’s preliminary cost estimates for Senate plans were higher than expected, and caused considerable consternation last week. But the fundamental fact is that we can afford universal health insurance — even those high estimates were less than the $1.8 trillion cost of the Bush tax cuts. Furthermore, Democratic leaders know that they have to pass a health care bill for the sake of their own survival. One way or another, the numbers will be brought in line.
The real risk is that health care reform will be undermined by “centrist” Democratic senators who either prevent the passage of a bill or insist on watering down key elements of reform. I use scare quotes around “centrist,” by the way, because if the center means the position held by most Americans, the self-proclaimed centrists are in fact way out in right field.
What the balking Democrats seem most determined to do is to kill the public option, either by eliminating it or by carrying out a bait-and-switch, replacing a true public option with something meaningless. For the record, neither regional health cooperatives nor state-level public plans, both of which have been proposed as alternatives, would have the financial stability and bargaining power needed to bring down health care costs.
Whatever may be motivating these Democrats, they don’t seem able to explain their reasons in public.
Thus Senator Ben Nelson of Nebraska initially declared that the public option — which, remember, has overwhelming popular support — was a “deal-breaker.” Why? Because he didn’t think private insurers could compete: “At the end of the day, the public plan wins the day.” Um, isn’t the purpose of health care reform to protect American citizens, not insurance companies?
Mr. Nelson softened his stand after reform advocates began a public campaign targeting him for his position on the public option.
And Senator Kent Conrad of North Dakota offers a perfectly circular argument: we can’t have the public option, because if we do, health care reform won’t get the votes of senators like him. “In a 60-vote environment,” he says (implicitly rejecting the idea, embraced by President Obama, of bypassing the filibuster if necessary), “you’ve got to attract some Republicans as well as holding virtually all the Democrats together, and that, I don’t believe, is possible with a pure public option.”
Honestly, I don’t know what these Democrats are trying to achieve. Yes, some of the balking senators receive large campaign contributions from the medical-industrial complex — but who in politics doesn’t? If I had to guess, I’d say that what’s really going on is that relatively conservative Democrats still cling to the old dream of becoming kingmakers, of recreating the bipartisan center that used to run America.
But this fantasy can’t be allowed to stand in the way of giving America the health care reform it needs. This time, the alleged center must not hold.

June 22, 2009 at 2:08 pm Leave a comment

What’s Wrong With This Picture?

Congress Finds Tobacco Causes Serious Illness And Death. New England Journal Of Medicine Finds Health Insurance Industry Has Large Tobacco Stock Holdings.

The Family Smoking Prevention and Tobacco Act (H.R. 1256ENR) passed both houses of Congress and is awaiting the President’s signature. In that bill, Congress made the following findings:

  •  “Tobacco use is the foremost cause of premature death in America. It causes over 400,000 deaths in the United States each year, and approximately 8,600,000 Americans have chronic illnesses related to smoking.” H.R.1256 ENR §2(13)
  • “The use of tobacco products by the Nation’s children is a pediatric disease of considerable proportions that results in new generations of tobacco-dependent children and adults.” H.R.1256 ENR §2(1)
  • “A consensus exists that tobacco products are inherently dangerous and cause cancer, heart disease and other serious adverse health effects.” H.R.1256 ENR §2(2)
  • “Nicotine is an addictive drug.” H.R.1256ENR §2(3)
  • “Tobacco dependence is a chronic disease, one that typically requires repeated interventions to achieve long-term or permanent abstinence.” H.R. 1256 ENR §2(33)

So, why do health insurance companies, the very companies that Congress wants to run health care reform, have major holdings in tobacco companies?

A recent report in a letter to the New England Journal of Medicine (“Insurance-Industry Investments in Tobacco,” N Engl J Med 360:23, June 4, 2009, at 2483-2484) perhaps provides the answer:

“Insurance firms, like any business, are driven by profit and this fact compromises any health care plan that includes them…..Although investing in tobacco while selling life or health insurance may seem self-defeating, insurance firms have figured out ways to profit from both. Insurers exclude smokers from coverage, or more commonly, charge them higher premiums. Insurers profit … twice over.” (Id.)

According to this recent report, U.S. based Prudential Financial (which provides life and long-term disability insurance) owns tobacco holdings of $264.3 million; U.K. based Prudential (which provides health, life and long-term disability insurance) has a stake in tobacco totaling $1.38 billion; Standard Life (which offers health and life insurance) owns nearly $950 million of tobacco stock; Canada based Sun Life, which offers health, life, disability and long term care insurance owns just over $1 billion of tobacco stock. Northwest Mutual and MassMutual (both of which offer life, disability and long-term care insurance) respectively own more than $235 million and $585 million of tobacco stock. (Id.).

As the writers to the New England Journal of Medicine remarked, “[T]hese data are a reminder of the true priority of the insurance industry, which is making money, not ensuring health and well-being.” (Id.)

Are these really the companies we want running our new health care reform program?

June 17, 2009 at 7:55 pm Leave a comment

“Venting” About Single Payer Health Care

Dr. Walter Tsou, a former Commissioner of Health in Philadelphia and a public health physician, eloquently testified before Congress on Wednesday, June 10, 2009 about why a single payer health plan is necessary. Although the Washington Post saw fit to characterize his and other speakers’ thoughtful and reasonable opinions as “venting”, in fact Dr. Tsou made many excellent points. Among them were: 

  • The only affordable means to achieve quality health care for every American is through a “properly financed, single payer national health insurance program”;
  • Attempts to reconcile universal coverage with cost control are futile without a single payer plan;
  • Cost controls will mean that either taxpayers , physicians, hospitals or the private health insurance industry will have to ‘pay the piper’
  • The private health insurance industry, which has dominated health care for the past 50 years in a supposedly competitive marketplace, has proven unable to control costs, even while the quality of health care in the U.S. is “suboptimal” (the federal Agency for Healthcare Research and Quality’s term, not Dr. Tsou’s) and nearly 50 million people are uninsured
  • A single payer plan cuts costs by cutting insurance firms’ profits, streamlining the massive administrative apparatus that adds to the costs of hospitals and doctor’s offices, using bulk purchasing, negotiating fee schedules with physicians, and putting hospitals on predictable, global budgets
  • By entrusting health care to private health insurers, we have saddled the U.S. with an inefficient and exorbitantly expensive health care system that drives jobs overseas where health benefit costs are low, and discourages entrepreneurs from striking out on their own for fear of losing their health insurance coverage
  • The $19 billion dedicated to health information technology is doomed to failure because our health care system will remain too fragmented under any system but a single payer plan.

Medicare is a single payer system. It’s time that an “Improved and Enhanced Medicare for All” be seriously considered and adopted by Congress and President Obama. It is the best solution to our current health care mess.

The complete text of Dr. Tsou’s remarks can be found here.

June 17, 2009 at 3:22 pm 2 comments

From the Desk of Judith Stein…

Senator Baucus, chair of the Senate Finance Committee, indicated yesterday that, despite prior comments distancing health reform efforts from a public plan, such a plan would be included in Senate legislation.  Thank goodness. 

Finally, it appears that legislators are listening to the people – and to experts like Nobel Laureate economist Paul Krugman, who offers two important pieces of advice in today’s New York Times:

     “1) Don’t trust the insurance industry.
      2) Don’t trust the insurance industry.”

The insurance industry is finally suggesting that they can operate health plans more efficiently and economically.  They are even willing to accept more regulation. Why?  Because they fear a public health insurance plan.

For an industry that so enthusiastically supported “competition” and “choice” when the Medicare Part D-ebacle was pushed through Congress, they suddenly seem to want to limit choice to only private plans.

To paraphrase Mr. Krugman, how can we expect to fix a broken game if we’re just fielding the same sullied players?  Kind of makes you stop and think.

June 5, 2009 at 4:42 pm 3 comments

Mandating Health Insurance – Hmm: Sounds Good.

The President favors requiring everyone to have health insurance coverage (Washington Post, p. A4, June 4, 2009). That’s a good idea, but how do you get there from here? The conversation is confusing. Employer mandates, individual mandates, subsidies for employers, subsidies for the poor, healthcare exchanges, go figure! What about the CHIP program? And, where will Medicare and Medicaid be in the mix? With employer-based coverage being in a state of flux and the fragility of our economy, including rampant job loss, relying on employer-based coverage seems risky, to say the least. Then there are the many issues of deciding the nature and scope of services and benefits to include in mandatory health insurance packages and how to make sure that mandatory insurance actually yields health care.

The solution: A strong public program, available to everyone, that guarantees health care coverage for all. Hmm, maybe we can get there from here.

June 4, 2009 at 2:57 pm Leave a comment

Health Policy Expertise

We provide effective, innovative opportunities to impact federal Medicare and health care policies and legislation in order to advance fair access to Medicare and quality health care.

Judith A. Stein, Executive Director

Contact us by email
for a free consultation,
Or call at (202) 293-5760.
Se habla español
June 2009


%d bloggers like this: