Posts filed under ‘Health Care Reform’
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!
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?
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!
Beware of “Smoke and Mirrors” Savings
Hospitals Reach Deal with Administration, offering $155 billion in health savings. (Washington Post, July 7, 2009) http://www.washingtonpost.com/wp-dyn/content/article/2009/07/06/AR2009070604053.html?hpid=topnews.
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.”
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.
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”.
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?
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.”
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!
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June 22, 2009
OP-ED COLUMNIST
Health Care Showdown
By PAUL KRUGMAN
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.
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?
CMA Health Policy Blog 