Archive for July, 2009

Medicare, We Hardly Know Ya

44 years ago Medicare was enacted into law.  All of today’s dire warnings about a public health option – socialism and government barring the doctor’s door – were made in opposition to Medicare.  Despite such opposition from “conservative,”  leaders, including Senator Bob Dole, Medicare passed. 

Before Medicare, 50% of  everyone 65 or older had NO health insurance. Now, as a result of Medicare, almost all older people are insured.  Medicare, which is national, government-run health insurance, succeeded in insuring older people where private insurance failed.  And, until the Bush Administration privatized Medicare with the extraordinarily subsidized private “Medicare Advantage” and Part D plans, Medicare was remarkably cost-effective too.  It’s private Medicare, not the traditional, public program, that’s bleeding taxpayers of billions of dollars. 

Medicare has been a success, fiscally and morally.  It took on the job of insuring health coverage and care to people that private insurance had abandoned.  Since 2003, on the other hand, private Medicare plans have cost us all tens of billions of dollars that went to support the private insurance industry, not to providing health care.  In addition, private Medicare plans have too often engaged in marketing abuses and restrictive coverage practices. 

As Paul Krugman recognizes in today’s New York Times, people with Medicare love it.  They do not want government to fool around with the traditional program.  Ironically,  these are sometimes the same people who worry that a public health care option will cause long waits for health care and government invasions into their private medical decisions. They, and their family members, (which accounts for pretty much all of us), forget that the traditional Medicare program is a  public health insurance option. 

Hello, America, meet Medicare:  Our 44 year-old public health insurance option that provides care to all its enrollees, anywhere in the country, and that has provided health and economic security for millions of older people, people with disabilities, and their families.

Happy anniversary, Medicare.  Thank you for showing us what a true public insurance program can offer.

July 31, 2009 at 6:38 pm 4 comments

There’s a Way to Pay For Health Care Reform – If There’s The Will

Congress should heed a new report from the Urban Institue if it is truly concerned about cost containment and the best way to pay for health care reform.  The Insitute recommends some adjustments to the way we deliver health care – increasing care coordination, improving chronic care and prevention, advancing electroninc medical records – and adjusting taxes. 

Not surprisingly, the report also concludes that a public option must be part of the mix if cost is really a concern.   In fact, the researchers found that including a public plan option in health reform would save between $224 to $400 billion.  

Once again, an independent study concludes that there IS a way to afford to provide health care for all Americans – if there’s the will.   Congress:  Read the report – and find the will. 

We need health care reform that is best for beneficiaries and most cost-effective for taxpayers.  We need a public option!

July 29, 2009 at 8:38 pm Leave a comment

The President on Health Care Reform: “It’s not about Me”

“This isn’t about me. I have great health insurance, and so does every Member of Congress. This debate is about the letters I read when I sit in the Oval Office every day, and the stories I hear at town hall meetings. This is about the woman in Colorado who paid $700 a month to her insurance company only to find out that they wouldn’t pay a dime for her cancer treatment ? who had to use up her retirement funds to save her own life. This is about the middle-class college graduate from Maryland whose health insurance expired when he changed jobs, and woke up from emergency surgery with $10,000 in debt. This is about every family, every business, and every taxpayer who continues to shoulder the burden of a problem that Washington has failed to solve for decades.”

– President Barack Obama, Press Conference, July 22, 2009

Health care reform is about the health of our country, both literally and figuratively.  It’s about the health of the people, and it’s about fiscal health. It’s about providing for people, not the insurance or pharmaceutical industries. And it’s about care, not just insurance. People aren’t cars, which might possibly have an accident. People get sick. Period. Not “might” get sick. Will. People need real health care, not just an insurance plan. The President knows this. Most of Congress knows this. So why are some fighting so vehemently against the truth?

 A Public Plan Will Work For You

Private insurers comprise a major for-profit industry. They serve their own interests and those of their stockholders before those of beneficiaries. First and foremost, insurers are in business to make a profit, not to take care of people. Their job is to calculate risks. Their goal is to maximize profits, which may conflict with providing health coverage. And they aren’t going to save the country money either, quite the contrary in fact. The cost of private Medicare has proven that.

Public coverage, on the other hand, saves taxpayers’ money. A recent study by the Commonwealth Fund, a non-partisan health policy research group, indicates that including a public health insurance option similar to Medicare in any proposed reform would save almost two TRILLION dollars more than any reform that does not include a public option.

We need real health care reform.  With a public option and a standard set of benefits across all private and public plans, everyone will be better able to access coverage they can understand, at a price taxpayers can afford.  It’s about our health and our quality of life. It’s about all of us.

July 23, 2009 at 10:13 pm 3 comments

Can Blue Dogs Learn New Tricks?

The Coalition of 52 conservative “Blue Dog” Democrats in the House of Representatives has emerged as a potential roadblock to passage of a health care reform bill in the House of Representatives. There are eight Blue Dogs on the Energy and Commerce Committee, the remaining House Committee with jurisdiction over health care to vote on the bill before it goes to the floor of the House for a vote.  Concerns raised by seven of the eight Blue Dogs about the health care bill have caused the Committee to delay its consideration of the pending legislation. What makes the Blue Dogs’ resistance so fascinating is not their politics, but rather their constituents.

In the 111th Congress there are 48 Congressional districts that were won by John McCain in the election but that are represented by a Democrat in the House.  Most of these districts are rural, blue collar areas.  Blue Dog Democrats represent most of them. On July 10th 2009 Gallup released their study of every Congressional district on “Health and Well Being”. One of the questions asked in this survey was whether citizens had health insurance.  The median uninsured population of all Congressional districts is 14.6%.  Of the 48 Districts won by McCain, 31 (roughly two-thirds) have numbers of uninsured well above the national median.

Take for example the districts of four Blue Dogs who are on the Energy and Commerce Committee: Charlie Melancon D-LA (21.9% Uninsured), Mike Ross D-AR (21.8% Uninsured), Bart Gordon D-TN (17.3% Uninsured) and Zachary Space D-OH (16.8% Uninsured). The House and Senate proposals are meant to assist these rural poor districts by directing the Institute of Medicine to study geographic inequities in Medicare reimbursement rates, and instructing the Health and Human Services Secretary to revise payment rates based on the findings. The bill even ensures that rural doctors are paid the same rate for their work as urban doctors. Yet, Health reform’s biggest obstacle might just be the representatives of those who need, and will benefit from, reform the most.

Can’t anyone teach these Blue Dogs new tricks?

July 22, 2009 at 4:37 pm 2 comments

Yes, Virginia, A Public Health Insurance Option Will Save Money and Provide Access To Good Care

Once again, probing, independent minds have concluded that a public health option will save money and provide stable access to health care.  A new Commonwealth Fund report finds “A public insurance plan can help drive new efficiencies in the system that will produce large cost reductions. Without a public plan, much of those potential savings will be lost,”

With a public option and a standard set of benefits across all private and public plans, everyone will be better able to access coverage they can understand, at a price taxpayers can afford. 

We get it. We need health care reform. We need a public option.  We don’t believe in fairy tales.  Tell Congress!

July 21, 2009 at 5:58 pm Leave a comment

From the Desk of Judith Stein

Health Care Reform:  If It’s Good it Won’t Be Easy

I have represented Medicare beneficiaries throughout Connecticut and the country for over 30 years. While there are surely gaps in Medicare coverage, and recent privatization efforts have threatened Medicare’s stability, Medicare has provided basic health insurance coverage, peace of mind, and enhanced economic security to hundreds of millions of older and disabled people, and their families. Finally, as a result of Senator Dodd’s leadership and the Senate HELP Committee’s bill, there is hope that younger uninsured people and their families will be benefited as older and disabled people have been under Medicare. The Senate HELP Committee bill, like all legislation, is a compromise; it is not perfect, but it is well worth supporting. I do so enthusiastically from three vantage points:

  1. As an advocate for fair access to health care and Medicare, and something of a Medicare historian, I particularly praise the Senate bill’s inclusion of mandated core benefits and a public health insurance option. Medicare teaches that this is the only way to truly provide fair access to comprehensible, secure, affordable health insurance and care. Anyone who truly knows Medicare and who looks objectively at the value and costs of the traditional program versus the private Medicare plans knows this is true.
  2. As a cancer survivor, I applaud this bill as it will bring access to health insurance and coverage to many who now go without by finally prohibiting insurance discrimination based on pre-existing conditions.
  3. As a small business “owner” (founder and executive director of a non-profit organization with 30 employees), I am grateful for the relief that this bill promises to employers, like my organization, that provide employee health insurance coverage. The cost of our good, but not “Cadillac” coverage, is a terrible strain on our budget and limits our ability to hire.

Thanks to the President, Senator Dodd and those on the Senate HELP Committee for pushing forward to provide health care coverage, and with it, access to care.  Please – keep it up.  Bring your Senate Finance Committee and House colleagues along.  This is not easy, but good things rarely are.

We need health care reform!

July 20, 2009 at 2:20 pm 1 comment

Beware of “Smoke and Mirrors” Savings

Hospitals Reach Deal with Administration, offering $155 billion in health savings.  (Washington Post, July 7, 2009)

The nation should be careful of healthcare savings that are more “smoke and mirrors” than actual savings through changed medical practices and efficiencies.  As the Washington Post article points out, “most of the savings – about $100 billion – would come through lower-than-expected Medicare and Medicaid payments to hospitals” and “$40 billion would be saved by slowly reducing what hospitals get to care for the uninsured.”  These savings, roughly $140 billion, represent on-going cost-containment efforts by the Centers for Medicare & Medicaid (CMS) and have little to do with any overall industry agreement to change its ways or to delve into a serious analysis of how its operations might be streamlined toward healthcare efficiencies.  The true smoke and mirrors aspect of the hospital industry’s agreement lies in their anticipation of a higher rate structure, under the administration’s yet-to-be-announced public plan, than is currently provided through Medicare.  It is hard to see what the public gets out of this “deal.”

July 8, 2009 at 1:44 pm Leave a comment

A Fourth of July Reflection on the Health Reform Debate

“Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity and that protection.”

President Obama might have spoken those words in recent weeks. Instead, President Truman spoke them over 65 years ago. With nearly 47 million Americans uninsured and millions more underinsured, most Americans are just one pink slip or accident away from financial disaster. The writing is on the wall, and the environment could not be more ready for health care reform.  Already this summer, the Congress has produced three different reform proposals:

  • The Senate Health, Education, Labor and Pensions (HELP) Committee released Sen. Kennedy’s (D-MA) draft proposal the “Affordable Health Choices Act” on June 9th. The “Affordable Health Choices Act” attempts to improve access to coverage by regulating insurers. The proposal expands Medicaid (to include families who earn up to 150% of the Federal Poverty Level) and SCHIP. The proposal is built upon establishing state-sponsored insurance Gateways (or exchanges) to help Americans find affordable coverage.  The current proposal would provide subsidies for buying health insurance through plans inside the Gateways to families with annual incomes as high as five times the poverty level. Senator Dodd (D-CT) announced on July 2nd that the HELP Committee bill will include a strong, national, public health plan option.
  • The House has also released a draft version of a Health Reform bill with their Tri-Committee Proposal. The current proposal would set up a new Health Insurance Exchange which would allow individuals and small employers to shop among private and public plans. The proposal also provides sliding scale affordability credits, expands Medicaid (to those earning 133% of the Federal Poverty Level) and caps out-of-pocket expenses.  Individuals will be responsible for having health insurance coverage, and employers will have the option of providing health insurance coverage for their workers or contributing funds on their behalf. Small businesses, with payrolls less than $250,000 per year, will be exempt from the employer responsibility requirement.
  • The Senate finance committee, chaired by Sen. Max Baucus (D-MT), will release its proposal imminently.

Just as we come together to barbecue or watch the fireworks on July 4th, those of us who believe in the promise of health care for all must also come together. This holiday is a time for us to reaffirm our will to fight the cynics who don’t believe in the essential promises of our land of opportunity and to renew the goal of health care for every American. Our representatives need to hear our voices! Please call your representative and message your members to act for this is our time to fight for our ideals. This week Families USA has published a toll free number that can be used to reach members of Congress. On July 7th and 8th you can call 1-866-210-3678 to connect to the Congressional Switchboard to speak to your representative. Help flood the switchboard.  Together we can achieve the reform that we are fighting for.

July 2, 2009 at 7:48 pm Leave a comment

Is Senator Lieberman Kidding?

I am appalled that Senator Lieberman has announced his opposition to a public plan in health care reform. Can he really believe a PUBLIC option can’t be afforded after our experience with Medicare and Medicare private plans! As Medicare has shown, private plans are what we can’t afford.   Study after study shows that Medicare, our only experience with a national health insurance, is spending about 14% more in private plans than it would pay for the same care in the traditional, public Medicare program.  The extra payments to private Medicare plans equal about $15 billion a year!  Come on – if we really are worrying about cost, a public plan is what we CAN afford. It’s private insurance that’s killing Medicare and that will bankrupt health care “reform”.

July 1, 2009 at 8:49 pm 1 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

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July 2009


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