Nation’s Largest RN Organization Says Healthcare Bill Cedes Too Much to Insurance Industry
By National Nurses United
December 21, 2009
The 150,000 member National Nurses United, the nation’s largest union and professional organization of registered nurses in the U.S., today criticized the healthcare bill now advancing in the U.S. Senate saying it is deeply flawed and grants too much power to the giant insurers.
“It is tragic to see the promise from Washington this year for genuine, comprehensive reform ground down to a seriously flawed bill that could actually exacerbate the healthcare crisis and financial insecurity for American families, and that cedes far too much additional power to the tyranny of a callous insurance industry,” said NNU co-president Karen Higgins, RN.
NNU Co-president Deborah Burger, RN challenged arguments of legislation proponents that the bill should still be passed because of expanded coverage, new regulations on insurers, and the hope that it will be improved in the House-Senate conference committee or future years.
“Those wishful statements ignore the reality that much of the expanded coverage is based on forced purchase of private insurance without effective controls on industry pricing practices or real competition and gaping loopholes in the insurance reforms,” said Burger.
Further, said NNU Co-president Jean Ross, RN, “the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the healthcare industry lobbyists and the lessons of this year in which all the compromises have been made to the right.”
“Sadly, we have ended up with legislation that fails to meet the test of true healthcare reform, guaranteeing high quality, cost effective care for all Americans, and instead are further locking into place a system that entrenches the chokehold of the profit-making insurance giants on our health. If this bill passes, the industry will become more powerful and could be beyond the reach of reform for generations,” Higgins said.
NNU cited ten significant problems in the legislation, noting many of the same flaws also exist in the House version and are likely to remain in the bill that emerges from the House-Senate reconciliation process:
The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.
No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.
An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.
The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they’d pass the higher costs to their employees.
Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:
Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.
Insurers are permitted to sell policies “across state lines”, exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.
Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.
Insurers may continue to rescind policies for “fraud or intentional misrepresentation” – the main pretext insurance companies now use to cancel coverage.
Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California’s largest insurers have rejected more than one-fifth of all claims since 2002.
Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.
New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn’t want.
Reduced reproductive rights for women.
No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.
“Desperation to pass a bill, regardless of its flaws, has made the White House and Congress subject to the worst political extortion and new, crippling concessions every day,” Burger said.
“NNU and nurses will continue to work with the thousands of grassroots activists across the nation to campaign for the best reform, which would be to expand Medicare to cover everyone, the same type of system working more effectively in every other industrial country. The day of that reform will come,” said Ross.
Wednesday, December 23, 2009
Monday, December 21, 2009
United Health Care profits soar 155 percent on Medicare
United Health Care profits soar 155 percent on Medicare plans
By Jerry Mazza
Online Journal Associate Editor
Sep 25, 2009
United Health Care’s 155 percent profits on Medicare plans must be a company record, especially in a down economy, and an embarrassing fact, particularly as the concervatives on the Senate Finance Committee fight to preserve the present payment structure of United Health Care and its fellow private insurance companies.
Private insurance plans in Medicare cost up to 19 percent more than it would cost to care for the same people in the public Medicare program. But then, we know whose pockets the Republicans and Blue Dog Democrats are really stuffing.
And never mind, as the Medicare Rights Center points out, “Private plans came into the Medicare program with the claims that they could save taxpayers money.” Right and I’ve got a bridge in Brooklyn I can let you have for cheap. The fact is, “they [the Private Plans] cost between 12 percent and 19 percent more per person than the public Medicare program, amounting to $5 billion per year in over-fattened costs to taxpayers.”
I guess this must be the advantage in the Medicare Advantage plans, only it’s for United Health Care and friends not the USA and its taxpayers. In fact, as Families USA reported, “Overpayments to Medicare Advantage plans and those regional PPOs could easily cost more than $60 billion over the next 10 years . . .” Hey, piece of cake, right?
And as Families USA noted, “As part of the 2003 Medicare Modernization Act, Congress has substantially increased payments to Medicare Advantage plans. They’re overpaid in comparison to traditional Medicare.” Modernization, you understand, means privatization here, thanks to George Bush and now Barack Obama and Congress, God love them if she can.
For instance, in 2005, Medicare overpaid private plans by at least 7 percent per beneficiary. And you, Mr. and Mrs. Taxpayer, lost $2.7 billion in 2005 to private Medicare Advantage plans and their parent insurance companies. Then, in 2006, under a new payment formula [woo, woo], overpayments to plans were 11 percent per beneficiary (that is, after accounting for health care status). And now in 2009, up in the 19 percent range. Nothing like HMOs and PPOs saving us money.
See, they keep telling innocent seniors that they will suffer (even more) if they lose their Medicare Advantage plans. Don’t believe it, folks. Medicare Advantage plans can hurt people with Medicare. Two studies found that people could end up actually paying higher out-of-pocket costs in a private plan than in straight Medicare, or in one private plan over another. I mean, the minute you let those dogs in, they’re gonna bite you, not protect you.
A study by MedPac found that a share of Medicare private health plans have high cost-sharing for “nondiscretionary” services such as chemotherapy. Like say, looking at some of the costs for a 70-yer old male with advanced colon cancer, the study showed out-of-pocket charges of $7,100 for one plan, $6,500 for a second plan and $1,900 for a third plane. You’re rolling the dice for your life with all this razzle dazzle. So, buyer beware!
Another study, by the nonpartisan [could that be] Commonwealth Fund found that out-of-pocket costs for private health plan members vary widely not only by your plan benefit package but by your health status. The report says that costs for plan members in poor health are actually higher than public Medicare in 19 out of the 88 private Medicare Advantage (MA) plans looked at. “Despite the high payments, relative to fee-for-service [public Medicare] costs, that MA plans receive from Medicare to enrich enrollee benefits, these plans may not always be a good deal for sicker beneficiaries who use more health services.”
A little bit of backstory
Medicare, the federal health insurance program for people over the age of 65 and those with severe disabilities, contracts with private health insurance plans that compete with the public Medicare program for membership. So, you have a choice, and I would recommend staying away from the “Advantages.” You’re somewhat better off with the Medigap programs that simply fill in the holes, like co-pays, yearly deductibles, and allow you to go to whatever doctor you want to.
That said, according to the Kaiser Family foundation, here is a quick look at private plans in Medicare through 2006 . . .
“As the private market for health insurance has evolved, Medicare has been modified so that beneficiaries can elect to get their Medicare benefits through a qualified private plan rather than the traditional fee-for-service Medicare program. Authorized in 1982, the Medicare risk-contracting program provided for enrollment in health maintenance organizations (HMOs).
“In 1997, Congress expanded private plan authority to include preferred provider organizations (PPOs), provider-sponsored organizations (PSOs), and private fee-for-service (PFFS) plans as the Medicare risk-contracting program was absorbed into Medicare+Choice (M+C). The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) replaced M+C with the Medicare Advantage (MA) program in 2004, raising payment rates and making other changes in anticipation of the Medicare drug benefit in 2006.”
So you can see for yourself how the cats were let in the door under the guise of “modernization,” “improvement” and so on. Take note that the name changes for the private health plans went through as they contracted with Medicare. “Medicare risk-contracting program,” not so appetizing, became “Medicare+Choice,” tastier, to “Medicare Advantage.” Delicious! Now gimme some of that. I want my advantage.
Yeah, well, it’s time to put back the advantage where it belongs, in the hands of the folks with Medicare, not in the coffers of the fat cat insurance companies. Let Medicare plans compete if they want, say, even if we descend to a public option if or if . . . who knows . . . to rampant socialism . . . and a Single-Payer (America-Care as one writer proposed), if they dare. Yea! Though be prepared for some kind of goulash, with a little bit of this and little bit of that and a lot of it all for the private sector.
Jerry Mazza is a freelance writer living in New York City. Reach him at gvmaz@verizon.net. His new book, “State Of Shock: Poems from 9/11 on” is available at www.jerrymazza.com, Amazon or Barnesandnoble.com.
Copyright © 1998-2007 Online Journal
Email Online Journal Editor
By Jerry Mazza
Online Journal Associate Editor
Sep 25, 2009
United Health Care’s 155 percent profits on Medicare plans must be a company record, especially in a down economy, and an embarrassing fact, particularly as the concervatives on the Senate Finance Committee fight to preserve the present payment structure of United Health Care and its fellow private insurance companies.
Private insurance plans in Medicare cost up to 19 percent more than it would cost to care for the same people in the public Medicare program. But then, we know whose pockets the Republicans and Blue Dog Democrats are really stuffing.
And never mind, as the Medicare Rights Center points out, “Private plans came into the Medicare program with the claims that they could save taxpayers money.” Right and I’ve got a bridge in Brooklyn I can let you have for cheap. The fact is, “they [the Private Plans] cost between 12 percent and 19 percent more per person than the public Medicare program, amounting to $5 billion per year in over-fattened costs to taxpayers.”
I guess this must be the advantage in the Medicare Advantage plans, only it’s for United Health Care and friends not the USA and its taxpayers. In fact, as Families USA reported, “Overpayments to Medicare Advantage plans and those regional PPOs could easily cost more than $60 billion over the next 10 years . . .” Hey, piece of cake, right?
And as Families USA noted, “As part of the 2003 Medicare Modernization Act, Congress has substantially increased payments to Medicare Advantage plans. They’re overpaid in comparison to traditional Medicare.” Modernization, you understand, means privatization here, thanks to George Bush and now Barack Obama and Congress, God love them if she can.
For instance, in 2005, Medicare overpaid private plans by at least 7 percent per beneficiary. And you, Mr. and Mrs. Taxpayer, lost $2.7 billion in 2005 to private Medicare Advantage plans and their parent insurance companies. Then, in 2006, under a new payment formula [woo, woo], overpayments to plans were 11 percent per beneficiary (that is, after accounting for health care status). And now in 2009, up in the 19 percent range. Nothing like HMOs and PPOs saving us money.
See, they keep telling innocent seniors that they will suffer (even more) if they lose their Medicare Advantage plans. Don’t believe it, folks. Medicare Advantage plans can hurt people with Medicare. Two studies found that people could end up actually paying higher out-of-pocket costs in a private plan than in straight Medicare, or in one private plan over another. I mean, the minute you let those dogs in, they’re gonna bite you, not protect you.
A study by MedPac found that a share of Medicare private health plans have high cost-sharing for “nondiscretionary” services such as chemotherapy. Like say, looking at some of the costs for a 70-yer old male with advanced colon cancer, the study showed out-of-pocket charges of $7,100 for one plan, $6,500 for a second plan and $1,900 for a third plane. You’re rolling the dice for your life with all this razzle dazzle. So, buyer beware!
Another study, by the nonpartisan [could that be] Commonwealth Fund found that out-of-pocket costs for private health plan members vary widely not only by your plan benefit package but by your health status. The report says that costs for plan members in poor health are actually higher than public Medicare in 19 out of the 88 private Medicare Advantage (MA) plans looked at. “Despite the high payments, relative to fee-for-service [public Medicare] costs, that MA plans receive from Medicare to enrich enrollee benefits, these plans may not always be a good deal for sicker beneficiaries who use more health services.”
A little bit of backstory
Medicare, the federal health insurance program for people over the age of 65 and those with severe disabilities, contracts with private health insurance plans that compete with the public Medicare program for membership. So, you have a choice, and I would recommend staying away from the “Advantages.” You’re somewhat better off with the Medigap programs that simply fill in the holes, like co-pays, yearly deductibles, and allow you to go to whatever doctor you want to.
That said, according to the Kaiser Family foundation, here is a quick look at private plans in Medicare through 2006 . . .
“As the private market for health insurance has evolved, Medicare has been modified so that beneficiaries can elect to get their Medicare benefits through a qualified private plan rather than the traditional fee-for-service Medicare program. Authorized in 1982, the Medicare risk-contracting program provided for enrollment in health maintenance organizations (HMOs).
“In 1997, Congress expanded private plan authority to include preferred provider organizations (PPOs), provider-sponsored organizations (PSOs), and private fee-for-service (PFFS) plans as the Medicare risk-contracting program was absorbed into Medicare+Choice (M+C). The Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA) replaced M+C with the Medicare Advantage (MA) program in 2004, raising payment rates and making other changes in anticipation of the Medicare drug benefit in 2006.”
So you can see for yourself how the cats were let in the door under the guise of “modernization,” “improvement” and so on. Take note that the name changes for the private health plans went through as they contracted with Medicare. “Medicare risk-contracting program,” not so appetizing, became “Medicare+Choice,” tastier, to “Medicare Advantage.” Delicious! Now gimme some of that. I want my advantage.
Yeah, well, it’s time to put back the advantage where it belongs, in the hands of the folks with Medicare, not in the coffers of the fat cat insurance companies. Let Medicare plans compete if they want, say, even if we descend to a public option if or if . . . who knows . . . to rampant socialism . . . and a Single-Payer (America-Care as one writer proposed), if they dare. Yea! Though be prepared for some kind of goulash, with a little bit of this and little bit of that and a lot of it all for the private sector.
Jerry Mazza is a freelance writer living in New York City. Reach him at gvmaz@verizon.net. His new book, “State Of Shock: Poems from 9/11 on” is available at www.jerrymazza.com, Amazon or Barnesandnoble.com.
Copyright © 1998-2007 Online Journal
Email Online Journal Editor
Thursday, December 17, 2009
Rob from the POOR and Give to the RICH
View this video and then call or write your Senator IMMEDIATELY. The current health care bill in the Senate literally robs from the poor and gives to the rich.
http://www.msnbc.msn.com/id/3036677/#34455431
http://www.msnbc.msn.com/id/3036677/#34455431
Wednesday, December 16, 2009
Screwed AGAIN
Our President has done it again. In his lobbying the Senate for the passage of ANY watered down health care reform bill, the section allowing the importing of pharmaceuticals at much lower prices than what we currently pay has been stricken from the bill. Coupled with the removal of a public option to create competition for policy holders, corporate america is the big winner while WE THE PEOPLE are SCREWED AGAIN.
What a major disappointment. President Obama's ratings have dipped to 50% approval and declining in less than a year. This is reflective of how he has abandoned the people who got him elected. He raised hope during his campaign and as soon as he was elected he has caved on every important issue including bailing out wall street and the banks, the escalation of the War in Afghanistan, and Health Care Reform. He promised to end the wars and create REAL HEALTH CARE REFORM. He promised to create jobs. What we will end up with is a health care bill that benefits the insurance industry and pharmaceutical industry. more of our kids dying, while our leaders line their pockets with campaign contributions in exchange for protection.
This is all about the economics of politics. Our elected representatives are all supported by corporate america, and are only interested in maintaining their political power. The deals to protect Big Pharma and the Insurance Industry in exchange for political support is the DC norm. Line our pockets and SCREW THE PEOPLE--this is the real party line. This is the Executive and Legislative branches of our government. Only in politics is bribery and corruption legal.
What a major disappointment. President Obama's ratings have dipped to 50% approval and declining in less than a year. This is reflective of how he has abandoned the people who got him elected. He raised hope during his campaign and as soon as he was elected he has caved on every important issue including bailing out wall street and the banks, the escalation of the War in Afghanistan, and Health Care Reform. He promised to end the wars and create REAL HEALTH CARE REFORM. He promised to create jobs. What we will end up with is a health care bill that benefits the insurance industry and pharmaceutical industry. more of our kids dying, while our leaders line their pockets with campaign contributions in exchange for protection.
This is all about the economics of politics. Our elected representatives are all supported by corporate america, and are only interested in maintaining their political power. The deals to protect Big Pharma and the Insurance Industry in exchange for political support is the DC norm. Line our pockets and SCREW THE PEOPLE--this is the real party line. This is the Executive and Legislative branches of our government. Only in politics is bribery and corruption legal.
Thursday, December 10, 2009
Public Option is Dead
The public health insurance option died on Thursday, December 10, 2009, after a months-long battle with Senate parliamentary procedure. The time of death was recorded as 11:12 a.m. Eastern Standard Time.
Thank you United States Senate, House of Representatives, and President Obama for allowing special interest such as the insuance industry, pharmaceutical industry, and medical device industry to continue to control health care. These companies continue to excessively profit off the sick and injured. You couldn't have done anything worse for the health and well being of all Americans.
Thank you United States Senate, House of Representatives, and President Obama for allowing special interest such as the insuance industry, pharmaceutical industry, and medical device industry to continue to control health care. These companies continue to excessively profit off the sick and injured. You couldn't have done anything worse for the health and well being of all Americans.
Tuesday, December 8, 2009
MAJOR Disappointment for Health Care NOW
Harry Hamburg, AP
Senate Majority Leader Harry Reid, D-Nev., said Tuesday a "broad agreement" had been reached on the public health care option. He would not provide details, but several officials said the government-run option is being dropped.
In place of a government-run plan, originally designed as a way of forcing competition on private industry, officials said the Democrats had tentatively settled on a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage. Additionally, the tentative deal calls for Medicare to be opened to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the 65-and-over population.
The officials who described the details did so on condition of anonymity, saying they were not authorized to discuss them publicly. Despite their reluctance, some senators had talked openly earlier in the day about the progress of the negotiations.
The developments followed a vote on the Senate floor earlier in the day in which abortion opponents failed to inject tougher restrictions into sweeping health care bill, and Democratic leaders labored to make sure fallout from the issue didn't hamper the drive to enact legislation. The vote was 54-45.
Senate Majority Leader Harry Reid, D-Nev., said Tuesday a "broad agreement" had been reached on the public health care option. He would not provide details, but several officials said the government-run option is being dropped.
In place of a government-run plan, originally designed as a way of forcing competition on private industry, officials said the Democrats had tentatively settled on a private insurance arrangement to be supervised by the federal agency that oversees the system through which lawmakers purchase coverage. Additionally, the tentative deal calls for Medicare to be opened to uninsured Americans beginning at age 55, a significant expansion of the large government health care program that currently serves the 65-and-over population.
The officials who described the details did so on condition of anonymity, saying they were not authorized to discuss them publicly. Despite their reluctance, some senators had talked openly earlier in the day about the progress of the negotiations.
The developments followed a vote on the Senate floor earlier in the day in which abortion opponents failed to inject tougher restrictions into sweeping health care bill, and Democratic leaders labored to make sure fallout from the issue didn't hamper the drive to enact legislation. The vote was 54-45.
Friday, December 4, 2009
Aetna Forcing 600,000-Plus To Lose Coverage In Effort To Raise Profits
From the Huffington Post
Health insurance giant Aetna is planning to force up to 650,000 clients to
drop their coverage next year as it seeks to raise additional revenue to
meet profit expectations.
In a third-quarter earnings conference call in late October, officials at
Aetna announced that in an effort to improve on a less-than-anticipated
profit margin in 2009, they would be raising prices on their consumers in
2010. The insurance giant predicted that the company would subsequently lose
between 300,000 and 350,000 members next year from its national account as
well as another 300,000 from smaller group accounts.
"The pricing we put in place for 2009 turned out to not really be what we
needed to achieve the results and margins that we had historically been
delivering," said chairman and CEO Ron Williams. "We view 2010 as a
repositioning year, a year that does not fully reflect the earnings
potential of our business. Our pricing actions should have a noticeable
effect beginning in the first quarter of 2010, with additional financial
impact realized during the remaining three quarters of the year."
Aetna's decision to downsize the number of clients in favor of higher
premiums is, as one industry analyst told American Medical News, a "pretty
candid" admission. It also reflects the major concerns offered by health
care reform proponents and supporters of a public option for insurance
coverage, who insist that the private health insurance industry is too
consumed with the bottom line. A government-run plan would operate solely
off its members' premiums.
http://www.huffingtonpost.com/2009/12/04/aetna-forcing-600000-plus_n_380130.html
American Medical News, which first reported the
story, noted that this is not the first time the
insurance giant has cut the rolls in an effort to
boost profit margins. "As chronicled in a 2004
article in Health Affairs by health economist
James C. Robinson, MD, PhD, Aetna completely
overhauled its business between 2000 and 2003,
going from 21 million members in 1999 down to 13
million in 2003, but boosting its profit margin
from about 4% to higher than 7%."
Health insurance giant Aetna is planning to force up to 650,000 clients to
drop their coverage next year as it seeks to raise additional revenue to
meet profit expectations.
In a third-quarter earnings conference call in late October, officials at
Aetna announced that in an effort to improve on a less-than-anticipated
profit margin in 2009, they would be raising prices on their consumers in
2010. The insurance giant predicted that the company would subsequently lose
between 300,000 and 350,000 members next year from its national account as
well as another 300,000 from smaller group accounts.
"The pricing we put in place for 2009 turned out to not really be what we
needed to achieve the results and margins that we had historically been
delivering," said chairman and CEO Ron Williams. "We view 2010 as a
repositioning year, a year that does not fully reflect the earnings
potential of our business. Our pricing actions should have a noticeable
effect beginning in the first quarter of 2010, with additional financial
impact realized during the remaining three quarters of the year."
Aetna's decision to downsize the number of clients in favor of higher
premiums is, as one industry analyst told American Medical News, a "pretty
candid" admission. It also reflects the major concerns offered by health
care reform proponents and supporters of a public option for insurance
coverage, who insist that the private health insurance industry is too
consumed with the bottom line. A government-run plan would operate solely
off its members' premiums.
http://www.huffingtonpost.com/2009/12/04/aetna-forcing-600000-plus_n_380130.html
American Medical News, which first reported the
story, noted that this is not the first time the
insurance giant has cut the rolls in an effort to
boost profit margins. "As chronicled in a 2004
article in Health Affairs by health economist
James C. Robinson, MD, PhD, Aetna completely
overhauled its business between 2000 and 2003,
going from 21 million members in 1999 down to 13
million in 2003, but boosting its profit margin
from about 4% to higher than 7%."
Thursday, December 3, 2009
Get Involved! Demand Health Care NOW Senate debate
The health care bill has hit the Senate.
This week, the Senate began debate on the Patient Protection and Affordable Care Act. The debate in the Senate is expected to be a long and complicated process, carrying on for upwards of three weeks.
During the debate, health care reform opponents will resort to desperate measures to stop this legislation, using stall tactics and other procedural tricks like filibusters. It's up to people like you and me to make sure this bill keeps moving.
For the health and well-being of men, women, and children across the country, we need the Senate to pass this bill as soon as possible. Sign our petition asking Senators across the aisle to come together for all Americans.
Tell them not to filibuster health care reform:
http://www.standupforhealthcare.org/page/s/dontfilibuster
Since you are an important member of the Stand Up For Health Care community, we wanted to keep you up to date on the Patient Protection and Affordable Care Act as it currently stands before the Senate.
Our policy experts have reviewed the bill and have found that among many other improvements, this legislation will lower costs for small businesses and working families. The bill will also lower premiums, providing significant savings for lower- and middle-income Americans. A public option in the bill will provide more choice in coverage. And, most importantly to some, the bill will allow Americans to keep their current insurance if they are happy with it.
We believe the Patient Protection and Affordable Care Act will help millions of Americans—but it can only help us once it’s passed.
Stand up for health care today. Tell the Senate not to stall on health care reform:
http://www.standupforhealthcare.org/page/s/dontfilibuster
This week, the Senate began debate on the Patient Protection and Affordable Care Act. The debate in the Senate is expected to be a long and complicated process, carrying on for upwards of three weeks.
During the debate, health care reform opponents will resort to desperate measures to stop this legislation, using stall tactics and other procedural tricks like filibusters. It's up to people like you and me to make sure this bill keeps moving.
For the health and well-being of men, women, and children across the country, we need the Senate to pass this bill as soon as possible. Sign our petition asking Senators across the aisle to come together for all Americans.
Tell them not to filibuster health care reform:
http://www.standupforhealthcare.org/page/s/dontfilibuster
Since you are an important member of the Stand Up For Health Care community, we wanted to keep you up to date on the Patient Protection and Affordable Care Act as it currently stands before the Senate.
Our policy experts have reviewed the bill and have found that among many other improvements, this legislation will lower costs for small businesses and working families. The bill will also lower premiums, providing significant savings for lower- and middle-income Americans. A public option in the bill will provide more choice in coverage. And, most importantly to some, the bill will allow Americans to keep their current insurance if they are happy with it.
We believe the Patient Protection and Affordable Care Act will help millions of Americans—but it can only help us once it’s passed.
Stand up for health care today. Tell the Senate not to stall on health care reform:
http://www.standupforhealthcare.org/page/s/dontfilibuster
Wednesday, December 2, 2009
AARP Backs Senate Health Care Reform Bill
AARP backs Democrats in Senate health care fight
By DAVID ESPO, AP
With a Senate showdown looming, the politically potent AARP rode to the rescue of Democrats on Wednesday, supporting $460 billion in Medicare cuts to help pay for landmark health insurance legislation.
As Republicans pressed to restore the cuts, AARP said Democrats merely were recommending elimination of waste and inefficiency within the giant health care program for seniors.
"Most importantly, the legislation does not reduce any guaranteed Medicare benefits," A. Barry Rand, the AARP's CEO, said in a letter to senators.
Republicans, led by Sen. John McCain, said seniors would lose some of their add-on benefits that are part of coverage under private insurance Medicare. "Above all, we must not use Medicare as a piggy bank" to pay for other programs, the Arizona Republican said.
Democrats, sensitive to the charges, rallied behind an alternative proposal by Sen. Michael Bennet, D-Colo., saying the bill would cause no reduction in guaranteed Medicare benefits.
A vote was expected later Wednesday on the issue, one of two that have dominated early debate on health care legislation that President Barack Obama has urged Congress to enact.
Women's health care was the other. The two parties maneuvered for political advantage on that issue, as well, each backing a promise to provide new no-cost preventive procedures such as mammograms.
Overall, the legislation is designed to extend health care to millions who now lack it, prohibit insurance companies from denying coverage on the basis of pre-existing medical conditions and generally slow the rate of growth in medical spending overall.
Most Americans would be required to carry insurance. While employers would not be obliged to provide it, big companies would face penalties if they did not and their workers received federal subsidies to help defray their personal insurance costs.
At its core, the bill would create new marketplaces, called exchanges, where consumers could shop for insurance that met government guidelines. The bill includes hundreds of billions of dollars in federal subsidies to help lower and middle-income individuals and families afford insurance.
The House passed its version of health care legislation last month, and Senate Majority Leader Harry Reid, D-Nev., has vowed to clear a bill through his chamber by Christmas.
The early pace of debate has been exceedingly slow, and Democrats accused Republicans during the day of stalling.
"There's a lot of talk that if we have to be here until Christmas, we'll be here until Christmas," Sen. Tom Harkin, D-Iowa, said after a closed-door Democratic caucus meeting.
That seems unlikely.
Democrats command 60 seats, enough to end any delaying tactics if they are united. So far, they are not, and while debate unfolds on the Senate floor, Reid is working behind the scenes to resolve a small number of controversial issues.
Chief among them is a call by liberals for the government to sell insurance in competition with private industry. The legislation on the floor permits that, subject to approval from individual states. But an unknown number of moderate and conservative Democrats have demanded changes as the price for their support on the legislation.
AARP has played an influential role all year on health care, working with the Obama administration as well as Democratic leaders to help pass legislation.
The organization's Web site claims more than 40 million members in all 50 states, and describes AARP as "a nonprofit, nonpartisan membership organization that helps people 50 and over improve the quality of their lives."
Polls have shown the group enjoys a high degree of trust among seniors, a group that tends to vote in disproportionately high numbers, particularly in midterm elections. As a result, its endorsement is prized by both political parties.
When Republicans held power in Congress, AARP's decision to support a new prescription drug benefit under Medicare was a turning point in the drive to pass legislation.
Democrats were furious at the time. But now, in power, they have worked closely with the organization, and the political lines are reversed.
"Shame on AARP," McCain said earlier in the week as he pressed his case to restore the cuts Democrats wrote into their legislation. Sen. Lamar Alexander, R-Tenn., accused Democrats repeatedly of seeking to cut "Grandma's Medicare" and use the money to finance other programs.
McCain and others recited the proposed cuts in future payments during days of debate, including private-insurance Medicare, payments to hospitals, hospices, home health agencies and others.
But Rand, in his letter, wrote, "AARP believes that savings can be found in Medicare through smart, targeted changes aimed at improving health care delivery, eliminating waste and inefficiency, and aggressively weeding out fraud and abuse."
The biggest cuts are aimed at the Medicare Advantage program, in which private companies provide coverage. Studies show the government pays 14 percent more a year for each beneficiary covered in a private plan, compared with traditional Medicare.
Critics say that money goes into high executive salaries and profits for the firms. But supporters say the plans use the funds to provide extra benefits, sometimes including vision or dental coverage or gym memberships.
—
Associated Press writers Ricardo Alonso-Zaldivar and Erica Werner contributed to this report.
By DAVID ESPO, AP
With a Senate showdown looming, the politically potent AARP rode to the rescue of Democrats on Wednesday, supporting $460 billion in Medicare cuts to help pay for landmark health insurance legislation.
As Republicans pressed to restore the cuts, AARP said Democrats merely were recommending elimination of waste and inefficiency within the giant health care program for seniors.
"Most importantly, the legislation does not reduce any guaranteed Medicare benefits," A. Barry Rand, the AARP's CEO, said in a letter to senators.
Republicans, led by Sen. John McCain, said seniors would lose some of their add-on benefits that are part of coverage under private insurance Medicare. "Above all, we must not use Medicare as a piggy bank" to pay for other programs, the Arizona Republican said.
Democrats, sensitive to the charges, rallied behind an alternative proposal by Sen. Michael Bennet, D-Colo., saying the bill would cause no reduction in guaranteed Medicare benefits.
A vote was expected later Wednesday on the issue, one of two that have dominated early debate on health care legislation that President Barack Obama has urged Congress to enact.
Women's health care was the other. The two parties maneuvered for political advantage on that issue, as well, each backing a promise to provide new no-cost preventive procedures such as mammograms.
Overall, the legislation is designed to extend health care to millions who now lack it, prohibit insurance companies from denying coverage on the basis of pre-existing medical conditions and generally slow the rate of growth in medical spending overall.
Most Americans would be required to carry insurance. While employers would not be obliged to provide it, big companies would face penalties if they did not and their workers received federal subsidies to help defray their personal insurance costs.
At its core, the bill would create new marketplaces, called exchanges, where consumers could shop for insurance that met government guidelines. The bill includes hundreds of billions of dollars in federal subsidies to help lower and middle-income individuals and families afford insurance.
The House passed its version of health care legislation last month, and Senate Majority Leader Harry Reid, D-Nev., has vowed to clear a bill through his chamber by Christmas.
The early pace of debate has been exceedingly slow, and Democrats accused Republicans during the day of stalling.
"There's a lot of talk that if we have to be here until Christmas, we'll be here until Christmas," Sen. Tom Harkin, D-Iowa, said after a closed-door Democratic caucus meeting.
That seems unlikely.
Democrats command 60 seats, enough to end any delaying tactics if they are united. So far, they are not, and while debate unfolds on the Senate floor, Reid is working behind the scenes to resolve a small number of controversial issues.
Chief among them is a call by liberals for the government to sell insurance in competition with private industry. The legislation on the floor permits that, subject to approval from individual states. But an unknown number of moderate and conservative Democrats have demanded changes as the price for their support on the legislation.
AARP has played an influential role all year on health care, working with the Obama administration as well as Democratic leaders to help pass legislation.
The organization's Web site claims more than 40 million members in all 50 states, and describes AARP as "a nonprofit, nonpartisan membership organization that helps people 50 and over improve the quality of their lives."
Polls have shown the group enjoys a high degree of trust among seniors, a group that tends to vote in disproportionately high numbers, particularly in midterm elections. As a result, its endorsement is prized by both political parties.
When Republicans held power in Congress, AARP's decision to support a new prescription drug benefit under Medicare was a turning point in the drive to pass legislation.
Democrats were furious at the time. But now, in power, they have worked closely with the organization, and the political lines are reversed.
"Shame on AARP," McCain said earlier in the week as he pressed his case to restore the cuts Democrats wrote into their legislation. Sen. Lamar Alexander, R-Tenn., accused Democrats repeatedly of seeking to cut "Grandma's Medicare" and use the money to finance other programs.
McCain and others recited the proposed cuts in future payments during days of debate, including private-insurance Medicare, payments to hospitals, hospices, home health agencies and others.
But Rand, in his letter, wrote, "AARP believes that savings can be found in Medicare through smart, targeted changes aimed at improving health care delivery, eliminating waste and inefficiency, and aggressively weeding out fraud and abuse."
The biggest cuts are aimed at the Medicare Advantage program, in which private companies provide coverage. Studies show the government pays 14 percent more a year for each beneficiary covered in a private plan, compared with traditional Medicare.
Critics say that money goes into high executive salaries and profits for the firms. But supporters say the plans use the funds to provide extra benefits, sometimes including vision or dental coverage or gym memberships.
—
Associated Press writers Ricardo Alonso-Zaldivar and Erica Werner contributed to this report.
Saturday, November 21, 2009
Senate Votes to Bring Health Care Reform Bill to Floor
Posted: 11/21/09 With no votes to spare, Democratic senators moved health care reform past its first major hurdle Saturday night, with a party-line, 60-to-39 vote to begin consideration of the 2,000-plus page bill that Senate Majority Leader Harry Reid unveiled this week.
The fate of the measure came down to two moderate Democrats -- Blanche Lincoln of Arkansas and Mary Landrieu of Louisiana. Both women had withheld their support for debating the bill until the last hour, but announced in the afternoon that they would vote with Reid -- at least for now.
"My vote today should in no way be construed as an indication of how I might vote as this debate comes to an end," said Senator Landrieu. "After a thorough review, I have decided that there are enough significant reforms and safeguards in this bill to move forward, but more needs to be done."
Senator Lincoln echoed her colleague's skepticism, saying she would vote to move forward with the debate, but stressing that she wants changes to the legislation -- including striking the public option entirely -- before she would consent to vote for it on final passage. "I have concluded that it is more important to begin debate rather than simply dropping the issue and walk away," Lincoln said.
The bill that senators will begin debating after Thanksgiving combines proposals passed by the Senate Finance Committee and the Senate Committee Health, Education, Labor and Pensions Committee (HELP), and is designed to make health insurance more accessible and affordable. The Congressional Budget Office estimates the bill would expand coverage to 94 percent of Americans at a cost of $848 billion over the next 10 years.
In addition to imposing new regulations on insurance companies, the legislation would create health insurance exchanges, which would function as a marketplace of last resort where Americans could choose between private insurance, non-profit cooperative insurance, and a government-run public insurance option. While Democrats differed in their levels of enthusiasm for the bill, Republicans were unanimous in their opposition, describing Reid's proposal as everything from a spending binge to a Ponzi scheme.
Sen. Olympia Snowe of Maine, who voted for the Democrats' bill in the Senate Finance Committee, voted against debating it Saturday night. She objected to many of the the policies in the version of the bill that emerged from the Majority Leader's office, including the public option. Mostly, Snowe was critical of the closed-door, partisan process used by Reid to combine the two committee bills.
Sen. Mike Enzi (R-Wyo.), the top Republican on the Senate HELP Committee and the only accountant in the Senate, warned of the bill's potentially catastrophic effect on the federal budget deficit. "Perhaps the best way to qualify this bill is to say it keeps me up nights," Enzi said, summing it up in one word: "Disaster."
Other Republicans, such as Sen. Orrin Hatch of Utah objected to the bill's abortion provisions, which are weaker than the House-passed bill, as well as the bill's estimated cost of nearly $1 trillion to the taxpayers over the next decade. Missouri Republican Sen. Kit Bond said there were so many objectionable elements to the proposal that his colleagues had a hard time choosing which ones to go after first. "We're like a mosquito in a nudist colony," he said. "We have so many targets to attack in this bill we don't know which one to hit."
Democratic leaders defended their bill, with Reid saying of Sen. Mitch McConnell (R-Ky.), "The facts he is talking about do not exist, except in the minds of people who do not understand this bill." Several Democrats also invoked the late Sen. Ted Kennedy before casting their votes, including Kennedy's close friend Connectucut Sen. Chris Dodd, who said "there is no greater compliment we could give to Ted Kennedy than to pass this bill."
In the minutes before the vote, Sen. Max Baucus, a leader for the Democrats in health care reform, said to his fellow senators, "History is knocking on the door. Let's open it."
The fate of the measure came down to two moderate Democrats -- Blanche Lincoln of Arkansas and Mary Landrieu of Louisiana. Both women had withheld their support for debating the bill until the last hour, but announced in the afternoon that they would vote with Reid -- at least for now.
"My vote today should in no way be construed as an indication of how I might vote as this debate comes to an end," said Senator Landrieu. "After a thorough review, I have decided that there are enough significant reforms and safeguards in this bill to move forward, but more needs to be done."
Senator Lincoln echoed her colleague's skepticism, saying she would vote to move forward with the debate, but stressing that she wants changes to the legislation -- including striking the public option entirely -- before she would consent to vote for it on final passage. "I have concluded that it is more important to begin debate rather than simply dropping the issue and walk away," Lincoln said.
The bill that senators will begin debating after Thanksgiving combines proposals passed by the Senate Finance Committee and the Senate Committee Health, Education, Labor and Pensions Committee (HELP), and is designed to make health insurance more accessible and affordable. The Congressional Budget Office estimates the bill would expand coverage to 94 percent of Americans at a cost of $848 billion over the next 10 years.
In addition to imposing new regulations on insurance companies, the legislation would create health insurance exchanges, which would function as a marketplace of last resort where Americans could choose between private insurance, non-profit cooperative insurance, and a government-run public insurance option. While Democrats differed in their levels of enthusiasm for the bill, Republicans were unanimous in their opposition, describing Reid's proposal as everything from a spending binge to a Ponzi scheme.
Sen. Olympia Snowe of Maine, who voted for the Democrats' bill in the Senate Finance Committee, voted against debating it Saturday night. She objected to many of the the policies in the version of the bill that emerged from the Majority Leader's office, including the public option. Mostly, Snowe was critical of the closed-door, partisan process used by Reid to combine the two committee bills.
Sen. Mike Enzi (R-Wyo.), the top Republican on the Senate HELP Committee and the only accountant in the Senate, warned of the bill's potentially catastrophic effect on the federal budget deficit. "Perhaps the best way to qualify this bill is to say it keeps me up nights," Enzi said, summing it up in one word: "Disaster."
Other Republicans, such as Sen. Orrin Hatch of Utah objected to the bill's abortion provisions, which are weaker than the House-passed bill, as well as the bill's estimated cost of nearly $1 trillion to the taxpayers over the next decade. Missouri Republican Sen. Kit Bond said there were so many objectionable elements to the proposal that his colleagues had a hard time choosing which ones to go after first. "We're like a mosquito in a nudist colony," he said. "We have so many targets to attack in this bill we don't know which one to hit."
Democratic leaders defended their bill, with Reid saying of Sen. Mitch McConnell (R-Ky.), "The facts he is talking about do not exist, except in the minds of people who do not understand this bill." Several Democrats also invoked the late Sen. Ted Kennedy before casting their votes, including Kennedy's close friend Connectucut Sen. Chris Dodd, who said "there is no greater compliment we could give to Ted Kennedy than to pass this bill."
In the minutes before the vote, Sen. Max Baucus, a leader for the Democrats in health care reform, said to his fellow senators, "History is knocking on the door. Let's open it."
Friday, November 13, 2009
House Bill DOES NOT regulate insurance premiums resulting in big gains for corporations.
From Marcia Angell, MD Harvard University
The Health Care Reform Bill passed by the House enshrines and subsidizes the "takeover" by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn't regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers -- those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)
Insurers also won't have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an "option" at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it's been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.
If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?
First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers -- government and employers -- will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It's a shell game in which money is moved from one part of our fragmented system to another.
Here is my program for real reform:
Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it's a better program, because it ensures that everyone has access to a uniform package of benefits.
Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.
Recommendation #3: Medicare should monitor doctors' practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.
Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.
Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.
Is the House bill better than nothing? I don't think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
The Health Care Reform Bill passed by the House enshrines and subsidizes the "takeover" by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn't regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.
What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers -- those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65's will be more likely to go without insurance, even if they have to pay fines. That's OK with the industry, since these would be among their sickest customers. (Shouldn't age be considered a pre-existing condition?)
Insurers also won't have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an "option" at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it's been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.
If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?
First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers -- government and employers -- will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.
But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It's a shell game in which money is moved from one part of our fragmented system to another.
Here is my program for real reform:
Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it's a better program, because it ensures that everyone has access to a uniform package of benefits.
Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.
Recommendation #3: Medicare should monitor doctors' practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.
Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.
Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.
Is the House bill better than nothing? I don't think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.
Wednesday, November 11, 2009
Is there really any question that HEALTH CARE REFORM is NECESSARY?
Following is an article published by Associated Press discussing the unethical and immoral behavior of pharmaceutical company Pfizer. The people at Pfizer who conduct bogus research that is then used for marketing their drugs based on the "fudged" results should be criminally prosecuted. As stated in several blog posts, the insurance companies, the pharmaceutical companies, and the medical device companies should all be held accountable for the price fixing, price gauging, and unethical behavior exhibited by these companies executives, researchers, and other employees.
Review: Reporting on Pfizer drug studies fudged
By LINDA A. JOHNSON, Associated Press Writer – 1 min ago
Analysis of a dozen published studies testing possible new uses for a Pfizer
Inc. epilepsy drug found that reporting of the results was often fudged,
indicating the medicine worked better than internal company documents
showed.
According to the report, when a company-funded study's primary finding
wasn't favorable, that result was usually buried and something else positive
was highlighted, without disclosing the switch.
The documents used in the review were obtained by lawyers suing Pfizer for
refunds on prescriptions paid for by insurers and consumers. The lawyers,
who are seeking class action status for the cases, claim Pfizer concealed
evidence the epilepsy drug Neurontin didn't work for those unapproved uses,
including nerve pain, migraines and bipolar disorder.
One of the report's authors is an expert witness for the plaintiffs; another
has received fees from the lawyers.
Pfizer disputes the report's conclusions, saying the company never
"attempted to mislead the medical community about the effectiveness" of the
drug for certain uses.
"We believe the review suffers from significant bias, insufficient data,
poor methodology, and cannot pass the threshold of credible scientific
research," Pfizer said in a statement.
The report, by researchers at the University of California at San Francisco
and the Johns Hopkins Bloomberg School of Public Health, comes two months
after Pfizer was fined a record $2.3 billion — including an unprecedented
$1.2 billion criminal fine — for illegally marketing other blockbuster
drugs.
The report appears in Thursday's New England Journal of Medicine.
Dr. Sidney Wolfe, head of health research at consumer group Public Citizen,
called it the first comprehensive look "at studies in which a company and
people working for it so maliciously manipulated the data to make a drug
look more effective than it actually was."
"In every instance, the published article made the drug look better than it
would have," said Wolfe, a member of the Food and Drug Administration's drug
safety advisory committee. "This results in harm."
Review: Reporting on Pfizer drug studies fudged
By LINDA A. JOHNSON, Associated Press Writer – 1 min ago
Analysis of a dozen published studies testing possible new uses for a Pfizer
Inc. epilepsy drug found that reporting of the results was often fudged,
indicating the medicine worked better than internal company documents
showed.
According to the report, when a company-funded study's primary finding
wasn't favorable, that result was usually buried and something else positive
was highlighted, without disclosing the switch.
The documents used in the review were obtained by lawyers suing Pfizer for
refunds on prescriptions paid for by insurers and consumers. The lawyers,
who are seeking class action status for the cases, claim Pfizer concealed
evidence the epilepsy drug Neurontin didn't work for those unapproved uses,
including nerve pain, migraines and bipolar disorder.
One of the report's authors is an expert witness for the plaintiffs; another
has received fees from the lawyers.
Pfizer disputes the report's conclusions, saying the company never
"attempted to mislead the medical community about the effectiveness" of the
drug for certain uses.
"We believe the review suffers from significant bias, insufficient data,
poor methodology, and cannot pass the threshold of credible scientific
research," Pfizer said in a statement.
The report, by researchers at the University of California at San Francisco
and the Johns Hopkins Bloomberg School of Public Health, comes two months
after Pfizer was fined a record $2.3 billion — including an unprecedented
$1.2 billion criminal fine — for illegally marketing other blockbuster
drugs.
The report appears in Thursday's New England Journal of Medicine.
Dr. Sidney Wolfe, head of health research at consumer group Public Citizen,
called it the first comprehensive look "at studies in which a company and
people working for it so maliciously manipulated the data to make a drug
look more effective than it actually was."
"In every instance, the published article made the drug look better than it
would have," said Wolfe, a member of the Food and Drug Administration's drug
safety advisory committee. "This results in harm."
Saturday, November 7, 2009
HALF WAY THERE TO HEALTH CARE NOW!
House Narrowly Passes Historic Health Care Bill
Posted: 11/7/09Filed Under:House, Democrats, Republicans, Abortion, Health Care, The Capitolist, Congress, Deficit 1233 Comments + Join the discussion »TEXT SIZE:AAAPRINT SHARE The U.S. House of Representatives narrowly passed a massive overhaul of the American health care system Saturday night by a vote of 220 to 215. One Republican, Rep. Joseph Cao of Louisiana, crossed the aisle, while 39 Democrats joined the Republicans in opposing the measure.
House Speaker Nancy Pelosi called passage of the bill "an historic moment for our nation and for America's families," while Republicans warned that the bill will raise taxes, increase insurance premiums and make cuts to Medicare. An enormous round of applause broke out throughout the House chamber when the crucial 218th vote was cast to ensure the bill's passage.
The $1.3 trillion-dollar bill would require individuals to buy health insurance, and would also require medium and large businesses to provide it to their employees. Consumers would be able to buy their insurance on an exchange, which would include a public insurance option for people who do not have access to insurance through their jobs. Low- and middle-income families would receive government subsidies to purchase insurance, which would be be paid for through tax increases on individuals making more than $500,000 per year, as well as fees on medical providers. Finally, the bill would prohibit insurance companies from dropping or denying coverage based on pre-existing conditions or cost of care.
The day of the vote was punctuated by high drama, as the House gaveled into a rare weekend session with no indication of whether the Speaker had all 218 votes necessary to pass the bill. But a last- minute addition to the bill to appease pro-life Democrats, as well as a high-profile visit from President Obama to press Democratic members to vote for the measure, provided just enough momentum to pass it through the House with two votes to spare.
House Majority Leader Steny Hoyer began the debate by saying, "This is not a new idea, but it is an idea whose time has come." Hoyer said that the bill under consideration was not perfect, but was the result of "careful scrutiny, hard work, citizen input, and is the right response to this time of economic insecurity in which we find ourselves."
Pelosi added that the bill would also reduce drug costs for seniors, prevent insurance companies from charging women more than men for the same coverage, and would allow young adults to stay on their parents' insurance until their 27th birthdays. She also promised that the bill would add "not one dime to the deficit."
Republicans countered that the bill will in fact explode the deficit and give the federal government an out-sized and improper role in Americans' health care decisions. Rep. Joe Barton (R-Tx.) said, "I just don't think it's right that in the guise of helping Americans, we're telling Americans what they have to do."
Rep. Marsha Blackburn (R-Tenn.) said that the federal government is not capable of running many of the programs it is already responsible for, and should not be trusted with more responsibilities for Americans' health care: "We have talked to mothers who say, 'You can't even get the H1-N1 vaccine out there and you think you're going to handle the health care for my children?' " Manufacturers have not been able to supply enough of the vaccine because of the difficulty of producing it.
Rep. Phil Gingrey (R-Ga.) warned, "I have no doubt that although the American people may forget what was said here, they will never forget what was done here and who did it to them."
A crucial barrier to the bill was eliminated when the House passed an amendment by Rep. Bart Stupak (D-Mich.), a pro-life Democrat, by a vote of 240 to 192. Stupak's measure would prevent insurance companies from participating in the new government exchange if they also cover abortion. It would also require women enrolled in the exchange to purchase supplemental abortion insurance with private funds if they want to be covered for the service in the future.
Speaking on the House floor Saturday, Stupak called the existing House bill a "direct assault" on existing limits to federal funding for abortion, but pro-choice Democrats lined up in staunch opposition to his effort. Rep. Jan Schakowsky (D-Ill.) called Stupak's amendment "an insult to millions of American women," while Rep. Diana DeGette (D-Colo.) said, "To say that this amendment is a wolf in sheep's clothing would be the understatement of a lifetime. If enacted this will be the greatest restriction on a woman's right to choose in our careers."
Although Pelosi initially resisted the Stupak amendment, the congressman had garnered commitments from more than 40 fellow pro-life Democrats to derail the entire health reform effort without stricter apportion language in the bill. Despite Stupak's victory Saturday, opponents of his measure vowed to strip it from the final bill in the conference committee.
Before voting on final passage, the House defeated the Republicans' significantly smaller alternative health care reform proposal by a vote of 176 to 258, with one Republican, Rep. Tim Johnson, voting against it. The Congressional Budget Office estimated the measure would have cost $61 billion over ten years. It would have expanded high-risk insurance pools and would have revised and expanded the use of health savings accounts, but would not have changed insurance companies' policies of refusing coverage for pre-existing conditions.
Now that the House has passed its version of health care reform, all eyes will be on the Senate, where moderate Democrats have already balked at the Senate bill's cost and scope.
Because the Senate measure already differs significantly from the House bill on everything from the nature of the public option (the Senate lets states opt-out), to income taxes increases (only the House has them), yet another hurdle awaits in the conference committee, where the House and Senate versions will be combined before a final vote in both chambers.
In a statement late Saturday, President Barack Obama thanked the House for its work in passing health care reform and said he is "confident" the Senate will follow suit, adding, "I look forward to signing comprehensive health insurance reform into law by the end of the year."
Posted: 11/7/09Filed Under:House, Democrats, Republicans, Abortion, Health Care, The Capitolist, Congress, Deficit 1233 Comments + Join the discussion »TEXT SIZE:AAAPRINT SHARE The U.S. House of Representatives narrowly passed a massive overhaul of the American health care system Saturday night by a vote of 220 to 215. One Republican, Rep. Joseph Cao of Louisiana, crossed the aisle, while 39 Democrats joined the Republicans in opposing the measure.
House Speaker Nancy Pelosi called passage of the bill "an historic moment for our nation and for America's families," while Republicans warned that the bill will raise taxes, increase insurance premiums and make cuts to Medicare. An enormous round of applause broke out throughout the House chamber when the crucial 218th vote was cast to ensure the bill's passage.
The $1.3 trillion-dollar bill would require individuals to buy health insurance, and would also require medium and large businesses to provide it to their employees. Consumers would be able to buy their insurance on an exchange, which would include a public insurance option for people who do not have access to insurance through their jobs. Low- and middle-income families would receive government subsidies to purchase insurance, which would be be paid for through tax increases on individuals making more than $500,000 per year, as well as fees on medical providers. Finally, the bill would prohibit insurance companies from dropping or denying coverage based on pre-existing conditions or cost of care.
The day of the vote was punctuated by high drama, as the House gaveled into a rare weekend session with no indication of whether the Speaker had all 218 votes necessary to pass the bill. But a last- minute addition to the bill to appease pro-life Democrats, as well as a high-profile visit from President Obama to press Democratic members to vote for the measure, provided just enough momentum to pass it through the House with two votes to spare.
House Majority Leader Steny Hoyer began the debate by saying, "This is not a new idea, but it is an idea whose time has come." Hoyer said that the bill under consideration was not perfect, but was the result of "careful scrutiny, hard work, citizen input, and is the right response to this time of economic insecurity in which we find ourselves."
Pelosi added that the bill would also reduce drug costs for seniors, prevent insurance companies from charging women more than men for the same coverage, and would allow young adults to stay on their parents' insurance until their 27th birthdays. She also promised that the bill would add "not one dime to the deficit."
Republicans countered that the bill will in fact explode the deficit and give the federal government an out-sized and improper role in Americans' health care decisions. Rep. Joe Barton (R-Tx.) said, "I just don't think it's right that in the guise of helping Americans, we're telling Americans what they have to do."
Rep. Marsha Blackburn (R-Tenn.) said that the federal government is not capable of running many of the programs it is already responsible for, and should not be trusted with more responsibilities for Americans' health care: "We have talked to mothers who say, 'You can't even get the H1-N1 vaccine out there and you think you're going to handle the health care for my children?' " Manufacturers have not been able to supply enough of the vaccine because of the difficulty of producing it.
Rep. Phil Gingrey (R-Ga.) warned, "I have no doubt that although the American people may forget what was said here, they will never forget what was done here and who did it to them."
A crucial barrier to the bill was eliminated when the House passed an amendment by Rep. Bart Stupak (D-Mich.), a pro-life Democrat, by a vote of 240 to 192. Stupak's measure would prevent insurance companies from participating in the new government exchange if they also cover abortion. It would also require women enrolled in the exchange to purchase supplemental abortion insurance with private funds if they want to be covered for the service in the future.
Speaking on the House floor Saturday, Stupak called the existing House bill a "direct assault" on existing limits to federal funding for abortion, but pro-choice Democrats lined up in staunch opposition to his effort. Rep. Jan Schakowsky (D-Ill.) called Stupak's amendment "an insult to millions of American women," while Rep. Diana DeGette (D-Colo.) said, "To say that this amendment is a wolf in sheep's clothing would be the understatement of a lifetime. If enacted this will be the greatest restriction on a woman's right to choose in our careers."
Although Pelosi initially resisted the Stupak amendment, the congressman had garnered commitments from more than 40 fellow pro-life Democrats to derail the entire health reform effort without stricter apportion language in the bill. Despite Stupak's victory Saturday, opponents of his measure vowed to strip it from the final bill in the conference committee.
Before voting on final passage, the House defeated the Republicans' significantly smaller alternative health care reform proposal by a vote of 176 to 258, with one Republican, Rep. Tim Johnson, voting against it. The Congressional Budget Office estimated the measure would have cost $61 billion over ten years. It would have expanded high-risk insurance pools and would have revised and expanded the use of health savings accounts, but would not have changed insurance companies' policies of refusing coverage for pre-existing conditions.
Now that the House has passed its version of health care reform, all eyes will be on the Senate, where moderate Democrats have already balked at the Senate bill's cost and scope.
Because the Senate measure already differs significantly from the House bill on everything from the nature of the public option (the Senate lets states opt-out), to income taxes increases (only the House has them), yet another hurdle awaits in the conference committee, where the House and Senate versions will be combined before a final vote in both chambers.
In a statement late Saturday, President Barack Obama thanked the House for its work in passing health care reform and said he is "confident" the Senate will follow suit, adding, "I look forward to signing comprehensive health insurance reform into law by the end of the year."
Maybe LAST CHANCE for YOU to Make a Difference: Call your Congressperson NOW
Health Care NOW to be voted on in the House of Representatives. It is TIME to FIX our broken health care system. Let your Congressperson know how you feel. Call today.
WASHINGTON (Nov. 7) - President Barack Obama is traveling to Capitol Hill on Saturday to try to close the sale on his signature health care overhaul, facing a make-or-break vote in the House certain to be seen as a test of his presidency.
Obama scheduled a late-morning visit with House Democrats convening a rare Saturday session on legislation to remake the U.S. health care system, extending coverage to tens of millions now uninsured and banning insurance company practices such as denial of coverage based on pre-existing medical problems.
Late Friday, House Democrats cleared an abortion-related impasse blocking a vote and officials expressed optimism they had finally lined up the support needed to pass Obama's signature issue.
Under the arrangement, Democratic Reps. Bart Stupak of Michigan, Brad Ellsworth of Indiana and other abortion opponents were promised an opportunity to insert tougher restrictions into the legislation during debate on the House floor.
The leadership's hope is that no matter how that vote turns out, Democrats on both sides of the abortion divide will then unite to give the health care bill a majority over unanimous Republican opposition.
"We wish to maintain current law, which says no public funding for abortion," Stupak said. "We are not writing a new federal abortion policy."
Ellsworth added, "From day one, my goal has been to ensure federal tax dollars are not used to pay for abortions and to provide Americans with pro-life options on the exchange. And I am proud to be part of an effort to help make this goal a reality."
With Democrats' command of the necessary votes looking tenuous in the final hours, Obama threw the weight of his administration behind the effort to round up support. He and top administration officials worked the phones to pressure wavering lawmakers.
Rep. Jason Altmire, D-Pa., said he heard Friday from Obama, White House Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.
Their message: "This is a historic moment. You don't want to end up with nothing," said Altmire, who remained undecided.
Democratic leaders hoped to hold the vote Saturday evening, but Majority Leader Steny Hoyer said it could slip.
Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote. But all 177 Republicans were expected to vote "no," and Democratic leaders faced a series of complications trying to seal the needed votes for their complex and controversial legislation that would affect one-sixth of the economy and touch the lives of countless Americans.
In the GOP's weekly radio address, Mississippi Gov. Haley Barbour said Democrats should scrap their ambitious legislation and concentrate on modest health care changes that could find bipartisan support.
"The House Democrats' health care bill should be withdrawn and reworked," he said.
Tuesday's elections — in which Democrats lost two governors' races — sent a message that voters care about jobs, not growing the size of government, Barbour said.
The final hurdle for the Democrats was a controversy over federal funding for abortion, which simmered into Friday night with tensions running high as party leaders shuttled between meetings of anti-abortion and abortion rights lawmakers.
Federal law currently prohibits the use of federal funds to pay for abortions except in the case of rape, incest of situations in which the life of the mother is in danger. That left unresolved whether individuals would be permitted to use their own funds to buy insurance coverage for the procedure in the federally backed insurance exchange envisioned under the legislation.
Democrats have little room for error, with the prospect of the 2010 midterms looming large and a some of their own moderates already declaring their opposition.
The 10-year, $1.2 trillion House bill would create a new federally supervised insurance marketplace where the uninsured could purchase coverage.
Consumers would have the option of picking a government-run plan, the most hotly contested item in the legislation.
Associated Press writers David Espo and Ricardo Alonso-Zaldivar contributed to this report.
WASHINGTON (Nov. 7) - President Barack Obama is traveling to Capitol Hill on Saturday to try to close the sale on his signature health care overhaul, facing a make-or-break vote in the House certain to be seen as a test of his presidency.
Obama scheduled a late-morning visit with House Democrats convening a rare Saturday session on legislation to remake the U.S. health care system, extending coverage to tens of millions now uninsured and banning insurance company practices such as denial of coverage based on pre-existing medical problems.
Late Friday, House Democrats cleared an abortion-related impasse blocking a vote and officials expressed optimism they had finally lined up the support needed to pass Obama's signature issue.
Under the arrangement, Democratic Reps. Bart Stupak of Michigan, Brad Ellsworth of Indiana and other abortion opponents were promised an opportunity to insert tougher restrictions into the legislation during debate on the House floor.
The leadership's hope is that no matter how that vote turns out, Democrats on both sides of the abortion divide will then unite to give the health care bill a majority over unanimous Republican opposition.
"We wish to maintain current law, which says no public funding for abortion," Stupak said. "We are not writing a new federal abortion policy."
Ellsworth added, "From day one, my goal has been to ensure federal tax dollars are not used to pay for abortions and to provide Americans with pro-life options on the exchange. And I am proud to be part of an effort to help make this goal a reality."
With Democrats' command of the necessary votes looking tenuous in the final hours, Obama threw the weight of his administration behind the effort to round up support. He and top administration officials worked the phones to pressure wavering lawmakers.
Rep. Jason Altmire, D-Pa., said he heard Friday from Obama, White House Chief of Staff Rahm Emanuel, Health and Human Services Secretary Kathleen Sebelius and Education Secretary Arne Duncan.
Their message: "This is a historic moment. You don't want to end up with nothing," said Altmire, who remained undecided.
Democratic leaders hoped to hold the vote Saturday evening, but Majority Leader Steny Hoyer said it could slip.
Democrats hold 258 seats in the House and can afford 40 defections and still wind up with 218, a majority if all lawmakers vote. But all 177 Republicans were expected to vote "no," and Democratic leaders faced a series of complications trying to seal the needed votes for their complex and controversial legislation that would affect one-sixth of the economy and touch the lives of countless Americans.
In the GOP's weekly radio address, Mississippi Gov. Haley Barbour said Democrats should scrap their ambitious legislation and concentrate on modest health care changes that could find bipartisan support.
"The House Democrats' health care bill should be withdrawn and reworked," he said.
Tuesday's elections — in which Democrats lost two governors' races — sent a message that voters care about jobs, not growing the size of government, Barbour said.
The final hurdle for the Democrats was a controversy over federal funding for abortion, which simmered into Friday night with tensions running high as party leaders shuttled between meetings of anti-abortion and abortion rights lawmakers.
Federal law currently prohibits the use of federal funds to pay for abortions except in the case of rape, incest of situations in which the life of the mother is in danger. That left unresolved whether individuals would be permitted to use their own funds to buy insurance coverage for the procedure in the federally backed insurance exchange envisioned under the legislation.
Democrats have little room for error, with the prospect of the 2010 midterms looming large and a some of their own moderates already declaring their opposition.
The 10-year, $1.2 trillion House bill would create a new federally supervised insurance marketplace where the uninsured could purchase coverage.
Consumers would have the option of picking a government-run plan, the most hotly contested item in the legislation.
Associated Press writers David Espo and Ricardo Alonso-Zaldivar contributed to this report.
Tuesday, November 3, 2009
Cancer Treatment and Health Care Reform
From Barbara O’Brien
One argument you may hear against health care reform concerns cancer survival rates. The United States has higher cancer survivor rates than countries with national health care systems, we’re told. Doesn’t this mean we should keep what we’ve got and not change it?
Certainly cancer survival rates are a critical issue for people suffering from the deadly lung cancer mesothelioma. So let’s look at this claim and see if there is any substance to it.
First, it’s important to understand that “cancer survival rate” doesn’t mean the rate of people who are cured of a cancer. The cancer survival rate is the percentage of people who survive a certain type of cancer for a specific amount of time, usually five years after diagnosis.
For example, according to the Mayo Clinic, the survivor rate of prostate cancer in the United States is 98 percent. This means that 98 percent of men diagnosed with prostate cancer are still alive five years later. However, this statistic does not tell us whether the men who have survived for five years still have cancer or what number of them may die from it eventually.
Misunderstanding of the term “survivor rate” sometimes is exploited to make misleading claims. For example, in 2007 a pharmaceutical company promoting a drug used to treat colon cancer released statistics showing superior survival rates for its drug over other treatments. Some journalists who used this data in their reporting assumed it meant that the people who survived were cured of cancer, and they wrote that the drug “saved lives.” The drug did extend the lives of of patients, on average by a few months. However, the mortality rate for people who used this drug — meaning the rate of patients who died of the disease — was not improved.
But bloggers and editorial writers who oppose health care reform seized these stories about “saving lives,” noting that this wondrous drug was available in the United States for at least a year before it was in use in Great Britain. Further, Britain has lower cancer survival rates than the U.S. This proved, they said, the superiority of U.S. health care over “socialist” countries.
This is one way propagandists use data to argue that health care in the United States is superior to countries with government-funded health care systems. They selectively compare the most favorable data from the United States with data from the nations least successful at treating cancer. A favorite “comparison” country is Great Britain, whose underfunded National Health Service is struggling.
It is true that the United States compares very well in the area of cancer survival rates, but other countries with national health care systems have similar results.
For example, in 2008 the British medical journal Lancet Oncology published a widely hailed study comparing cancer survival rates in 31 countries. Called the CONCORD study, the researchers found that United States has the highest survival rates for breast and prostate cancer. However, Japan has the highest survival for colon and rectal cancers in men, and France has the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers. The differences in the survival data for these “best” countries is very small, and is possibly caused by discrepancies in reporting of data and not the treatment result itself.
And it should be noted that Japan, France, Canada and Australia all have government-funded national health care systems. So, there is no reason to assume that changing the way health care is funded in the U.S. would reduce the quality of cancer care.
—
One argument you may hear against health care reform concerns cancer survival rates. The United States has higher cancer survivor rates than countries with national health care systems, we’re told. Doesn’t this mean we should keep what we’ve got and not change it?
Certainly cancer survival rates are a critical issue for people suffering from the deadly lung cancer mesothelioma. So let’s look at this claim and see if there is any substance to it.
First, it’s important to understand that “cancer survival rate” doesn’t mean the rate of people who are cured of a cancer. The cancer survival rate is the percentage of people who survive a certain type of cancer for a specific amount of time, usually five years after diagnosis.
For example, according to the Mayo Clinic, the survivor rate of prostate cancer in the United States is 98 percent. This means that 98 percent of men diagnosed with prostate cancer are still alive five years later. However, this statistic does not tell us whether the men who have survived for five years still have cancer or what number of them may die from it eventually.
Misunderstanding of the term “survivor rate” sometimes is exploited to make misleading claims. For example, in 2007 a pharmaceutical company promoting a drug used to treat colon cancer released statistics showing superior survival rates for its drug over other treatments. Some journalists who used this data in their reporting assumed it meant that the people who survived were cured of cancer, and they wrote that the drug “saved lives.” The drug did extend the lives of of patients, on average by a few months. However, the mortality rate for people who used this drug — meaning the rate of patients who died of the disease — was not improved.
But bloggers and editorial writers who oppose health care reform seized these stories about “saving lives,” noting that this wondrous drug was available in the United States for at least a year before it was in use in Great Britain. Further, Britain has lower cancer survival rates than the U.S. This proved, they said, the superiority of U.S. health care over “socialist” countries.
This is one way propagandists use data to argue that health care in the United States is superior to countries with government-funded health care systems. They selectively compare the most favorable data from the United States with data from the nations least successful at treating cancer. A favorite “comparison” country is Great Britain, whose underfunded National Health Service is struggling.
It is true that the United States compares very well in the area of cancer survival rates, but other countries with national health care systems have similar results.
For example, in 2008 the British medical journal Lancet Oncology published a widely hailed study comparing cancer survival rates in 31 countries. Called the CONCORD study, the researchers found that United States has the highest survival rates for breast and prostate cancer. However, Japan has the highest survival for colon and rectal cancers in men, and France has the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers. The differences in the survival data for these “best” countries is very small, and is possibly caused by discrepancies in reporting of data and not the treatment result itself.
And it should be noted that Japan, France, Canada and Australia all have government-funded national health care systems. So, there is no reason to assume that changing the way health care is funded in the U.S. would reduce the quality of cancer care.
—
Saturday, October 31, 2009
Seventy-Two Year Old Patty Zeitlin Raps about HEALTH CARE NOW
Patty is a senior citizen who is mad as hell and won't take it anymore. View Patty's RAP on You Tube......LEARN and Enjoy
http://www.youtube.com/watch?v=lTjoHqurBUg
http://www.youtube.com/watch?v=lTjoHqurBUg
Thursday, October 29, 2009
Thank you Senator Harry Ried
For months, Senate Majority Leader Harry Reid has been under intense pressure to drop the public health insurance option.
But Reid defied insurance lobbyists, political pundits, and conservatives of both parties and announced that he's including a public option in the Senate floor bill.
I just added my name to a newspaper ad thanking Senator Reid, to show that thousands of Americans have got his back and are fired up to fight alongside him. You can participate as well.
The Senate's version of the Health Reform Bill includes a public option with negotiated provider rates. The result of the passage of this bill will be a resolving of the access to health care affecting millions of Americans, and the plummeting of health care costs due to competition. The bill is not perfect, but the Senate version is the best I have reviewed so far. If you would like to lend your name in supporting Senator Reid, go to the following link and sign on.
http://pol.moveon.org/thankreid/?r_by=17734-8124316-HYvJJwx&rc=confemail
But Reid defied insurance lobbyists, political pundits, and conservatives of both parties and announced that he's including a public option in the Senate floor bill.
I just added my name to a newspaper ad thanking Senator Reid, to show that thousands of Americans have got his back and are fired up to fight alongside him. You can participate as well.
The Senate's version of the Health Reform Bill includes a public option with negotiated provider rates. The result of the passage of this bill will be a resolving of the access to health care affecting millions of Americans, and the plummeting of health care costs due to competition. The bill is not perfect, but the Senate version is the best I have reviewed so far. If you would like to lend your name in supporting Senator Reid, go to the following link and sign on.
http://pol.moveon.org/thankreid/?r_by=17734-8124316-HYvJJwx&rc=confemail
Monday, October 26, 2009
Washington Post "New Life for the Public Option"
New life for the public option
The resurrection of the public option is the latest and one of the most surprising turns in the long battle over legislation to overhaul the nation's health-care system. Under assault for months, and declared on life support repeatedly in recent weeks, the provision for a public insurance option is unexpectedly alive as House and Senate leaders prepare to send their bills to the floor.
That doesn't mean it's a done deal. Whether it survives the final battles, and in what form, are still the unanswerable questions. Multiple versions of a public option are on the table. Liberal and moderate Democrats are still at odds and are drawing lines in the sand in hopes of exercising maximum influence on the outcome.
Senate Majority Leader Harry M. Reid (D-Nev.) and House Speaker Nancy Pelosi (D-Calif.) are still scratching for the votes to pass bills with a public option included. But by next week, both hope to have bills ready either for unveiling or to send to the Congressional Budget Office for analysis and scoring.
What encourages some of those who have followed this debate closely from the inside is the degree to which Democrats are in sight of a compromise on the public option and other remaining differences -- though many may have to accept some disappointment to get a bill to President Obama's desk.
What brought the public option back to life?
Conservative opposition nearly sank the public option over the summer. Many Republicans called it a government takeover of health care. Some conservatives see it as the first step toward a single-payer system (as do some liberals). At the height of the town hall and Tea Party activity, the White House appeared to be running for cover. Officials worried that the public option had become a proxy for more pervasive concerns about the amount of government intervention Obama was calling for in his economic and domestic policies.
Administration officials sent equivocating signals. White House Chief of Staff Rahm Emanuel, driven by a pragmatic desire to get a bill through Congress, appeared willing to sacrifice the public option, if necessary, to reach the larger goal. The president maintained that he still preferred to see a public option in the legislation, but he told one town hall audience that this was merely "a sliver" of the overall health-care debate. In other words, if it sank into obscurity, he wouldn't weep long over its disappearance.
The conservative opposition and the administration's apparent wobbliness prompted a counterattack by liberal advocates of the public option, who saw it as the holy grail of the debate. Few experts see it that way, and there are no doubt far more important provisions that would have a more direct effect on coverage, on how individuals are treated by their insurance companies and in controlling costs (still the weakest element of bills under consideration). But the grass-roots support had an effect.
When Congress returned to Washington in September, the debate's focus shifted to the dynamics of the Senate Finance Committee, where Chairman Max Baucus (D-Mont.) had labored for months to produce a bipartisan consensus. To that end, he joined several other Democrats in opposing two versions of a public option in the committee's bill, saying he saw no way to get 60 votes in the full Senate.
That seemed to spell the end for the public option. Baucus, however, managed to get one Republican, Sen. Olympia Snowe (Maine), to join with Democrats in approving the legislation. Snowe opposes a public option, but she has advocated the use of a trigger mechanism that would allow a government insurance plan if private competition proves inadequate. Snowe's future votes remain conditioned on what is in the final bill.
With virtually unanimous Republican opposition likely, Democrats reevaluated the politics of the public option. Two recent events contributed to their renewed push to include it. One was the insurance industry's decision to attack the legislation and issue a report warning of higher premiums. The report triggered a backlash among liberal Democrats, who decided to push even harder for a public option.
Then last week, new polls, one from The Washington Post and ABC News and the other from the Henry J. Kaiser Family Foundation, found clear majority support (57 percent) for a public option. The Post-ABC News poll showed support had risen five percentage points since August. The new numbers emboldened public-option supporters to press harder, even though the same polls continued to show the public divided over the overall shape of health-care legislation.
National polls are one thing. But getting the votes in the House and Senate is quite another. For red-state senators or House Democrats from marginal districts, perceptions of public opinion at home are another, which is why rounding up the votes for a bill with a public option remains a challenge.
Pelosi has long been a determined advocate for the public option. The most robust version, which would pay on the basis of Medicare rates, appears not to have enough votes to get through the House. As of this weekend, Pelosi's fallback appears to be a provision that pays on the basis of negotiated rates, still a relatively robust approach.
Reid is trying to attract 60 votes for a bill with a more qualified public option, one that would let states opt out of the system. Even if he is a few votes short, Reid is inclined to include the option in the bill that goes to the floor. Snowe's trigger mechanism may be the fallback position in the Senate if there aren't 60 votes for an opt-out plan.
On Friday, Pelosi signaled her receptivity to the opt-out approach as a possible compromise between the House and Senate, a sign that despite her advocacy for a robust public option she doesn't want to jeopardize reelection prospects for the moderate-conservative members of her caucus.
Much negotiating and posturing lie ahead. Obama told Senate leaders late last week he still sees value in trying to keep Snowe in the coalition. But liberal Democrats will be unhappy if the Senate bill includes her trigger mechanism rather than something stronger.
That will then test Democrats' cohesiveness, and Obama's leadership and persuasiveness. That battle could be weeks away. The fact that the House and Senate now appear likely to receive health-care bills with a public-option provision is surprise enough.
The resurrection of the public option is the latest and one of the most surprising turns in the long battle over legislation to overhaul the nation's health-care system. Under assault for months, and declared on life support repeatedly in recent weeks, the provision for a public insurance option is unexpectedly alive as House and Senate leaders prepare to send their bills to the floor.
That doesn't mean it's a done deal. Whether it survives the final battles, and in what form, are still the unanswerable questions. Multiple versions of a public option are on the table. Liberal and moderate Democrats are still at odds and are drawing lines in the sand in hopes of exercising maximum influence on the outcome.
Senate Majority Leader Harry M. Reid (D-Nev.) and House Speaker Nancy Pelosi (D-Calif.) are still scratching for the votes to pass bills with a public option included. But by next week, both hope to have bills ready either for unveiling or to send to the Congressional Budget Office for analysis and scoring.
What encourages some of those who have followed this debate closely from the inside is the degree to which Democrats are in sight of a compromise on the public option and other remaining differences -- though many may have to accept some disappointment to get a bill to President Obama's desk.
What brought the public option back to life?
Conservative opposition nearly sank the public option over the summer. Many Republicans called it a government takeover of health care. Some conservatives see it as the first step toward a single-payer system (as do some liberals). At the height of the town hall and Tea Party activity, the White House appeared to be running for cover. Officials worried that the public option had become a proxy for more pervasive concerns about the amount of government intervention Obama was calling for in his economic and domestic policies.
Administration officials sent equivocating signals. White House Chief of Staff Rahm Emanuel, driven by a pragmatic desire to get a bill through Congress, appeared willing to sacrifice the public option, if necessary, to reach the larger goal. The president maintained that he still preferred to see a public option in the legislation, but he told one town hall audience that this was merely "a sliver" of the overall health-care debate. In other words, if it sank into obscurity, he wouldn't weep long over its disappearance.
The conservative opposition and the administration's apparent wobbliness prompted a counterattack by liberal advocates of the public option, who saw it as the holy grail of the debate. Few experts see it that way, and there are no doubt far more important provisions that would have a more direct effect on coverage, on how individuals are treated by their insurance companies and in controlling costs (still the weakest element of bills under consideration). But the grass-roots support had an effect.
When Congress returned to Washington in September, the debate's focus shifted to the dynamics of the Senate Finance Committee, where Chairman Max Baucus (D-Mont.) had labored for months to produce a bipartisan consensus. To that end, he joined several other Democrats in opposing two versions of a public option in the committee's bill, saying he saw no way to get 60 votes in the full Senate.
That seemed to spell the end for the public option. Baucus, however, managed to get one Republican, Sen. Olympia Snowe (Maine), to join with Democrats in approving the legislation. Snowe opposes a public option, but she has advocated the use of a trigger mechanism that would allow a government insurance plan if private competition proves inadequate. Snowe's future votes remain conditioned on what is in the final bill.
With virtually unanimous Republican opposition likely, Democrats reevaluated the politics of the public option. Two recent events contributed to their renewed push to include it. One was the insurance industry's decision to attack the legislation and issue a report warning of higher premiums. The report triggered a backlash among liberal Democrats, who decided to push even harder for a public option.
Then last week, new polls, one from The Washington Post and ABC News and the other from the Henry J. Kaiser Family Foundation, found clear majority support (57 percent) for a public option. The Post-ABC News poll showed support had risen five percentage points since August. The new numbers emboldened public-option supporters to press harder, even though the same polls continued to show the public divided over the overall shape of health-care legislation.
National polls are one thing. But getting the votes in the House and Senate is quite another. For red-state senators or House Democrats from marginal districts, perceptions of public opinion at home are another, which is why rounding up the votes for a bill with a public option remains a challenge.
Pelosi has long been a determined advocate for the public option. The most robust version, which would pay on the basis of Medicare rates, appears not to have enough votes to get through the House. As of this weekend, Pelosi's fallback appears to be a provision that pays on the basis of negotiated rates, still a relatively robust approach.
Reid is trying to attract 60 votes for a bill with a more qualified public option, one that would let states opt out of the system. Even if he is a few votes short, Reid is inclined to include the option in the bill that goes to the floor. Snowe's trigger mechanism may be the fallback position in the Senate if there aren't 60 votes for an opt-out plan.
On Friday, Pelosi signaled her receptivity to the opt-out approach as a possible compromise between the House and Senate, a sign that despite her advocacy for a robust public option she doesn't want to jeopardize reelection prospects for the moderate-conservative members of her caucus.
Much negotiating and posturing lie ahead. Obama told Senate leaders late last week he still sees value in trying to keep Snowe in the coalition. But liberal Democrats will be unhappy if the Senate bill includes her trigger mechanism rather than something stronger.
That will then test Democrats' cohesiveness, and Obama's leadership and persuasiveness. That battle could be weeks away. The fact that the House and Senate now appear likely to receive health-care bills with a public-option provision is surprise enough.
Final Senate Bill to Have PUBLIC OPTION
Reid says health care bill to have public option By DAVID ESPO and ERICA WERNER, AP
posted: 18 MINUTES AGOcomments: 459PRINT|E-MAILMOREText SizeAAAWASHINGTON -
Majority Leader Harry Reid says health care legislation headed to the Senate floor will include an option for government-run insurance. Reid says states will have the prerogative of opting out of the program if they choose.
Reid noted that polls show widespread public support for giving the government a role in the overhauled health care system envisioned by President Barack Obama and his allies in Congress.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
2009-10-26 16:08:11
posted: 18 MINUTES AGOcomments: 459PRINT|E-MAILMOREText SizeAAAWASHINGTON -
Majority Leader Harry Reid says health care legislation headed to the Senate floor will include an option for government-run insurance. Reid says states will have the prerogative of opting out of the program if they choose.
Reid noted that polls show widespread public support for giving the government a role in the overhauled health care system envisioned by President Barack Obama and his allies in Congress.
Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
2009-10-26 16:08:11
Saturday, October 24, 2009
REAL HEALTH CARE REFORM NOT DEAD YET
Contact your Senators and Congressperson immediately. Let them know that the ONLY real health care reform MUST include a public option. Get involved, we can impact Health Care NOW. A Public Option will ensure access to health care and reduce costs through competition.
A Second Wind for the 'Public Option'
Posted: 10/24/09Filed Under:Nancy Pelosi, Health Care, Harry Reid 25 Comments + Join the discussion »TEXT SIZE:AAAPRINT SHARE To the surprise of many, the so-called "public option" - creating a gvoernment-backed insurance plan to compete with prviate insurers - is squarely back on the table after being considered dead by some, according to the Washington Post.
The Post says that Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi are trying to round up votes to pass the public option in some form. One of the reasons for its revival may have been a series of recent public opinion polls that showed a rise in support for the proposal.
A Second Wind for the 'Public Option'
Posted: 10/24/09Filed Under:Nancy Pelosi, Health Care, Harry Reid 25 Comments + Join the discussion »TEXT SIZE:AAAPRINT SHARE To the surprise of many, the so-called "public option" - creating a gvoernment-backed insurance plan to compete with prviate insurers - is squarely back on the table after being considered dead by some, according to the Washington Post.
The Post says that Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi are trying to round up votes to pass the public option in some form. One of the reasons for its revival may have been a series of recent public opinion polls that showed a rise in support for the proposal.
Friday, October 23, 2009
THIS SHOULD NEVER HAPPEN TO YOU
October 23, 2009
Last Friday we were notified that a patient of ours receiving a MRI had her insurance canceled by Blue Cross of California. Turns out that the MRI revealed cancer. The scan was performed in mid September, and the patient was notified of the cancellation last week retroactive to July 2009. This is NOT the first time Blue Cross has done this. You could be next!
This afternoon, Speaker Nancy Pelosi and other House leaders are making a decision on whether to include a public option in the House health care bill. Pelosi is leading the charge to put the public option in the bill, but she needs to be sure she has the votes to pass it on the House floor.
According to news reports last night, she's still 2 votes shy, so our participation is REQUIRED now.
Representative Henry Waxman is a key member of House leadership. Please call and urge him to stand with Speaker Pelosi and support the public health insurance option. A public option is the ONLY way to ensure Blue Cross and other companies won't treat you like they did our patient.
Here's where to call:
Representative Henry Waxman
Phone: 202-225-3976
Here are some points you might want to make when you call:
A public option is good fiscal policy. It will create competition and reduce health care costs. A new report from the Congressional Budget Office shows legislation with a public option is not just deficit neutral—it will help reduce the deficit.
Legislation with the public option will expand health coverage to 96% of Americans. The USA is the only industrialized country in the world without universal health care for their people.
The public option is widely popular—poll after poll shows strong support, including the latest poll released just this week by The Washington Post.
Health care legislation with the a public option would express the concern of all Americans for their fellow citizens. We do not live in an isolated environment. We need each other to promote our health and the health of our children. No United States Citizen should have to go bankrupt because they can't pay inflated medical bills. A public OPTION in the House of Representatives bill could be decided today.
Please call Rep. Waxman right away
Last Friday we were notified that a patient of ours receiving a MRI had her insurance canceled by Blue Cross of California. Turns out that the MRI revealed cancer. The scan was performed in mid September, and the patient was notified of the cancellation last week retroactive to July 2009. This is NOT the first time Blue Cross has done this. You could be next!
This afternoon, Speaker Nancy Pelosi and other House leaders are making a decision on whether to include a public option in the House health care bill. Pelosi is leading the charge to put the public option in the bill, but she needs to be sure she has the votes to pass it on the House floor.
According to news reports last night, she's still 2 votes shy, so our participation is REQUIRED now.
Representative Henry Waxman is a key member of House leadership. Please call and urge him to stand with Speaker Pelosi and support the public health insurance option. A public option is the ONLY way to ensure Blue Cross and other companies won't treat you like they did our patient.
Here's where to call:
Representative Henry Waxman
Phone: 202-225-3976
Here are some points you might want to make when you call:
A public option is good fiscal policy. It will create competition and reduce health care costs. A new report from the Congressional Budget Office shows legislation with a public option is not just deficit neutral—it will help reduce the deficit.
Legislation with the public option will expand health coverage to 96% of Americans. The USA is the only industrialized country in the world without universal health care for their people.
The public option is widely popular—poll after poll shows strong support, including the latest poll released just this week by The Washington Post.
Health care legislation with the a public option would express the concern of all Americans for their fellow citizens. We do not live in an isolated environment. We need each other to promote our health and the health of our children. No United States Citizen should have to go bankrupt because they can't pay inflated medical bills. A public OPTION in the House of Representatives bill could be decided today.
Please call Rep. Waxman right away
Thursday, October 22, 2009
The Time to act is NOW.......MAKE THE CALL
People from across the country are coming together to send a strong message to Congress: It’s time to deliver on health reform.
Join me in participating in a national call-in day to flood the capitol switchboard with calls in support of meaningful health reform.
Copy and Paste the link below to be connected automatically, or call 1-800-828-0498:
http://www.standupforhealthcare.org/timetodeliver
The facts are clear. The status quo is unsustainable. American families can no longer stand to shoulder the burden of rising health care costs.
It's time to put an end to insurance company abuses – it’s time to put people before profits. No American should suffer or go broke because they lack health insurance.
Please join us in sending a strong message to Congress that the time for health reform is now. We cannot afford to wait.
Join me in participating in a national call-in day to flood the capitol switchboard with calls in support of meaningful health reform.
Copy and Paste the link below to be connected automatically, or call 1-800-828-0498:
http://www.standupforhealthcare.org/timetodeliver
The facts are clear. The status quo is unsustainable. American families can no longer stand to shoulder the burden of rising health care costs.
It's time to put an end to insurance company abuses – it’s time to put people before profits. No American should suffer or go broke because they lack health insurance.
Please join us in sending a strong message to Congress that the time for health reform is now. We cannot afford to wait.
Monday, October 12, 2009
MORE ADVERTISING BS: MEDICARE TO GO BK IN 2017
Going Out OF Business?
A new ad goes too far when it says Medicare will be "bankrupt" in eight years.
October 7, 2009
Summary
A new health care ad from a conservative group claims that "Medicare will be bankrupt in eight years." That gives a false impression. The program does have huge financial problems, but there’s no reason to think it’s going out of business as the word "bankrupt" implies. And the issue isn’t new:
A government report the ad refers to says the trust fund for one part of Medicare – hospital insurance – won’t have enough money to pay all benefits in 2017. Medicare’s physician and drug benefits will "remain adequately financed," says the report.
Government projections have found that the hospital insurance trust fund would face a shortfall "almost from its inception," according to the Congressional Research Service. But in many cases politicians have found ways to extend it. In 1970, for instance, the trust fund was expected to be insolvent in 1972.
The ad also claims that "some want to pay for health care reform with $500 billion dollars in Medicare spending cuts." Actually, the House health care bill, to which this refers, proposes a net cut in spending of $219 billion over 10 years.
Analysis
The conservative group Americans for Prosperity has released a new 60-second ad through its Patients First project. The ad, which features a family doctor, Dr. Amy Siems, talking to viewers, recycles a few misleading talking points against health care legislation in Congress, but includes a new claim that is quite startling. Dr. Siems says that "Medicare will be bankrupt in eight years."
Bankrupt? Within a Decade?
Yikes. Quite a scary claim to make about a program that encompasses 16 percent of the federal budget and benefits 45 million Americans. But the word "bankrupt" is far too strong to accurately describe Medicare’s problems.
The AFP/Patients First ad points to a government report as the source of its claim, and that report does say Medicare’s "[p]rojected long run program costs are not sustainable," and that its problems are even more severe than those of Social Security. The report says further that the trust fund for one part of Medicare – hospital insurance – is projected to be insolvent in 2017, and calls that "an urgent concern." But that’s not the same thing as being "bankrupt," and it only applies to one of four distinct parts of the overall Medicare program. As the Social Security Administration explains:
Hospital insurance (Part A) pays for inpatient hospital services, skilled nursing facility care and hospice care.
Medical insurance (Part B) covers physician services and medical supplies not paid for by Part A.
Medicare Advantage (Part C) is an option to receive benefits through a private insurance company.
Part D is Medicare’s prescription drug coverage.
The ad refers to the Social Security and Medicare Boards of Trustees 2009 Annual Report, which indeed makes some dire predictions for Medicare Part A, the segment that’s in danger of running out of money. Part A relies primarily on payroll taxes and its trust fund, or reserves, to pay for benefits. Parts B and D, meanwhile, funded by general revenues and monthly premiums, "are both projected to remain adequately financed into the indefinite future," according to the report. (The trust fund for those segments, though, "will continue to require general revenue financing and charges on beneficiaries that grow substantially faster than the economy and beneficiary incomes over time.")
Funds for Part A will only be able to pay 81 percent of the projected spending in 2017, and less each year after that, according to the trustees’ estimates:
Trustees Report: The projected date of HI [Hospital Insurance]Trust Fund exhaustion is 2017, two years earlier than in last year’s report, when dedicated revenues would be sufficient to pay 81 percent of HI costs. Projected HI dedicated revenues fall short of outlays by rapidly increasing margins in all future years.
The report goes on to say that the HI trust fund "could be brought into actuarial balance over the next 75 years" by either significantly increasing the payroll tax which funds it, cutting spending by half, or a combination of those measures. "Larger changes would be required to make the program solvent beyond the 75-year horizon," the report says.
But warnings of depleting the HI trust fund aren’t new. In a 2008 report, the Congressional Research Service wrote that "almost from its inception, the HI trust fund has faced a projected shortfall. The insolvency date has been postponed a number of times, primarily due to legislative changes which had the effect of restraining growth in program spending." Indeed, a 1983 report from the Senate’s Special Committee on Aging forecasted that:
Senate Special Committee on Aging, 1983 report: Balances in the HI trust fund are projected to be exhausted during 1987. Though the HI balance was a substantial $18.7 billion at the end of 1981, borrowing by the old-age and survivors insurance trust fund (OASI) reduced the HI balance to $8.3 billion at the end of 1982. … This already low balance is projected to decline slowly through 1986 and rapidly in ensuing years, as outlays exceed income by a widening margin.
And that is hardly the only year in which a government report projected shortfalls just around the corner, as this table, re-created from a CRS report, makes clear:
We don’t mean to say that the projections about the future of the HI trust fund shouldn’t be taken seriously, or that Medicare in general isn’t facing long-term funding issues. But it’s not going to be “bankrupt in eight years.”
The Obama administration has commented on the trustees report several times. Health and Human Services Secretary Kathleen Sebelius called it “a wake up call for everyone who is concerned about Medicare and the health of our economy,” adding that “it’s yet another sign that we can’t wait for real, comprehensive health reform.” And the administration has put forth proposals that it says will extend the life of the trust fund by several years.
We can’t predict whether the Obama administration and Congress will find a way to save the HI trust fund yet again, but judging from the political past, it seems likely.
At the point where the hospital insurance trust fund is expected to run dry in 2017, the current payroll tax is estimated to cover only 81 percent of the projected outlays (compared to 88 percent this year), and less each year after that. In the past, scheduled depletions have been offset by a combination of increased taxes and other funding, as well as decreased payouts. The original HI tax rate was 0.35 percent in 1966 and increased steadily over the next three decades. It is now 1.45 percent on all covered earnings, and both the employee and the employer pay it. Hospitals, meanwhile, accept Medicare payments that are about 68 percent of what private insurance pays, according to the Lewin Group, and in July, hospitals agreed to cutting $155 billion in Medicare and Medicaid over 10 years, primarily through adjusting annual payment increases.
Other Claims
We’ve examined ads from Patients First and its parent group, Americans for Prosperity, before, and they’ve put forth the same straw man argument: that Congress wants a Canadian- or British-style health care system. As we’ve pointed out in several articles, that’s not what the legislation in Congress would set up. As evidence, the back-up for this ad includes a column in the Tucson Citizen that repeats falsehoods we’ve already debunked about the stimulus bill, which was passed in February.
The group’s support also includes several articles about patients in Canada waiting for specialist appointments, MRIs and even surgeries. It’s Dr. Siems’ opinion that this amounts to a “system that has already failed.” Others would disagree, such as a Canadian scientist quoted in a 2007 article that’s among the group’s back-up: " ‘Canada is not a medical utopia, as some would have you believe, or a disaster, as others claim,’ said Jack Tu, a senior scientist at the Toronto-based Institute for Clinical Evaluative Sciences and co-author of a recent study on waiting times. ‘Most people get care in a reasonable amount of time. What you hear about are the horror stories.’ "
But a debate on whether or not the system has “failed” north of our border is irrelevant. The health care legislation in Congress doesn’t amount to “forcing Americans” into such a system, anyway.
The doctor in the ad also says that "some want to pay for health care reform with $500 billion in Medicare spending cuts.” But that’s more than double the net amount the House legislation proposes to save from Medicare. It’s true that the House health care bill calls for getting $500 billion in savings out of Medicare, but its substantial increases in Medicare spending reduce the net amount cut from the program to $219 billion over 10 years, according to the Congressional Budget Office.
– by Justin Bank and Lori Robertson
Sources
“Financing Medicare: An Issue Brief.” The Kaiser Family Foundation. Jan 2008.
Medicare, SSA Publication No. 05-10043. Social Security Administration. Sep 2009.
Status of the Social Security and Medicare Programs. A Summary of the 2009 Annual Reports. Social Security and Medicare Boards of Trustees. 2009.
“Prospects for Medicare’s Hospital Insurance Trust Fund.” Special Committee on Aging, United States Senate. Mar 1983.
O’Sullivan, Jennifer. “Medicare: History of Part A Trust Fund Insolvency Projections.” Congressional Research Service. 28 Mar 2008.
Department of Health and Human Services. Sebelius Statement on New Medicare Trustees’ Report, news release. 12 May 2009.
WhiteHouse.gov. Paying for Health Care Reform, Medicare fact sheet. Accessed 7 Oct 2008.
Congressional Budget Office. Letter to Rep. Charles B. Rangel. 17 Jul 2009.
Davis, Henry L. “Is universal health care worth waiting for?” Buffalo News. 29 Jul 2007.
Posted by Justin Bank and Lori Robertson on Wednesday, October 7, 2009 at 5:45 pm
Filed under Articles · Tagged with Americans for Prosperity, medicare
A new ad goes too far when it says Medicare will be "bankrupt" in eight years.
October 7, 2009
Summary
A new health care ad from a conservative group claims that "Medicare will be bankrupt in eight years." That gives a false impression. The program does have huge financial problems, but there’s no reason to think it’s going out of business as the word "bankrupt" implies. And the issue isn’t new:
A government report the ad refers to says the trust fund for one part of Medicare – hospital insurance – won’t have enough money to pay all benefits in 2017. Medicare’s physician and drug benefits will "remain adequately financed," says the report.
Government projections have found that the hospital insurance trust fund would face a shortfall "almost from its inception," according to the Congressional Research Service. But in many cases politicians have found ways to extend it. In 1970, for instance, the trust fund was expected to be insolvent in 1972.
The ad also claims that "some want to pay for health care reform with $500 billion dollars in Medicare spending cuts." Actually, the House health care bill, to which this refers, proposes a net cut in spending of $219 billion over 10 years.
Analysis
The conservative group Americans for Prosperity has released a new 60-second ad through its Patients First project. The ad, which features a family doctor, Dr. Amy Siems, talking to viewers, recycles a few misleading talking points against health care legislation in Congress, but includes a new claim that is quite startling. Dr. Siems says that "Medicare will be bankrupt in eight years."
Bankrupt? Within a Decade?
Yikes. Quite a scary claim to make about a program that encompasses 16 percent of the federal budget and benefits 45 million Americans. But the word "bankrupt" is far too strong to accurately describe Medicare’s problems.
The AFP/Patients First ad points to a government report as the source of its claim, and that report does say Medicare’s "[p]rojected long run program costs are not sustainable," and that its problems are even more severe than those of Social Security. The report says further that the trust fund for one part of Medicare – hospital insurance – is projected to be insolvent in 2017, and calls that "an urgent concern." But that’s not the same thing as being "bankrupt," and it only applies to one of four distinct parts of the overall Medicare program. As the Social Security Administration explains:
Hospital insurance (Part A) pays for inpatient hospital services, skilled nursing facility care and hospice care.
Medical insurance (Part B) covers physician services and medical supplies not paid for by Part A.
Medicare Advantage (Part C) is an option to receive benefits through a private insurance company.
Part D is Medicare’s prescription drug coverage.
The ad refers to the Social Security and Medicare Boards of Trustees 2009 Annual Report, which indeed makes some dire predictions for Medicare Part A, the segment that’s in danger of running out of money. Part A relies primarily on payroll taxes and its trust fund, or reserves, to pay for benefits. Parts B and D, meanwhile, funded by general revenues and monthly premiums, "are both projected to remain adequately financed into the indefinite future," according to the report. (The trust fund for those segments, though, "will continue to require general revenue financing and charges on beneficiaries that grow substantially faster than the economy and beneficiary incomes over time.")
Funds for Part A will only be able to pay 81 percent of the projected spending in 2017, and less each year after that, according to the trustees’ estimates:
Trustees Report: The projected date of HI [Hospital Insurance]Trust Fund exhaustion is 2017, two years earlier than in last year’s report, when dedicated revenues would be sufficient to pay 81 percent of HI costs. Projected HI dedicated revenues fall short of outlays by rapidly increasing margins in all future years.
The report goes on to say that the HI trust fund "could be brought into actuarial balance over the next 75 years" by either significantly increasing the payroll tax which funds it, cutting spending by half, or a combination of those measures. "Larger changes would be required to make the program solvent beyond the 75-year horizon," the report says.
But warnings of depleting the HI trust fund aren’t new. In a 2008 report, the Congressional Research Service wrote that "almost from its inception, the HI trust fund has faced a projected shortfall. The insolvency date has been postponed a number of times, primarily due to legislative changes which had the effect of restraining growth in program spending." Indeed, a 1983 report from the Senate’s Special Committee on Aging forecasted that:
Senate Special Committee on Aging, 1983 report: Balances in the HI trust fund are projected to be exhausted during 1987. Though the HI balance was a substantial $18.7 billion at the end of 1981, borrowing by the old-age and survivors insurance trust fund (OASI) reduced the HI balance to $8.3 billion at the end of 1982. … This already low balance is projected to decline slowly through 1986 and rapidly in ensuing years, as outlays exceed income by a widening margin.
And that is hardly the only year in which a government report projected shortfalls just around the corner, as this table, re-created from a CRS report, makes clear:
We don’t mean to say that the projections about the future of the HI trust fund shouldn’t be taken seriously, or that Medicare in general isn’t facing long-term funding issues. But it’s not going to be “bankrupt in eight years.”
The Obama administration has commented on the trustees report several times. Health and Human Services Secretary Kathleen Sebelius called it “a wake up call for everyone who is concerned about Medicare and the health of our economy,” adding that “it’s yet another sign that we can’t wait for real, comprehensive health reform.” And the administration has put forth proposals that it says will extend the life of the trust fund by several years.
We can’t predict whether the Obama administration and Congress will find a way to save the HI trust fund yet again, but judging from the political past, it seems likely.
At the point where the hospital insurance trust fund is expected to run dry in 2017, the current payroll tax is estimated to cover only 81 percent of the projected outlays (compared to 88 percent this year), and less each year after that. In the past, scheduled depletions have been offset by a combination of increased taxes and other funding, as well as decreased payouts. The original HI tax rate was 0.35 percent in 1966 and increased steadily over the next three decades. It is now 1.45 percent on all covered earnings, and both the employee and the employer pay it. Hospitals, meanwhile, accept Medicare payments that are about 68 percent of what private insurance pays, according to the Lewin Group, and in July, hospitals agreed to cutting $155 billion in Medicare and Medicaid over 10 years, primarily through adjusting annual payment increases.
Other Claims
We’ve examined ads from Patients First and its parent group, Americans for Prosperity, before, and they’ve put forth the same straw man argument: that Congress wants a Canadian- or British-style health care system. As we’ve pointed out in several articles, that’s not what the legislation in Congress would set up. As evidence, the back-up for this ad includes a column in the Tucson Citizen that repeats falsehoods we’ve already debunked about the stimulus bill, which was passed in February.
The group’s support also includes several articles about patients in Canada waiting for specialist appointments, MRIs and even surgeries. It’s Dr. Siems’ opinion that this amounts to a “system that has already failed.” Others would disagree, such as a Canadian scientist quoted in a 2007 article that’s among the group’s back-up: " ‘Canada is not a medical utopia, as some would have you believe, or a disaster, as others claim,’ said Jack Tu, a senior scientist at the Toronto-based Institute for Clinical Evaluative Sciences and co-author of a recent study on waiting times. ‘Most people get care in a reasonable amount of time. What you hear about are the horror stories.’ "
But a debate on whether or not the system has “failed” north of our border is irrelevant. The health care legislation in Congress doesn’t amount to “forcing Americans” into such a system, anyway.
The doctor in the ad also says that "some want to pay for health care reform with $500 billion in Medicare spending cuts.” But that’s more than double the net amount the House legislation proposes to save from Medicare. It’s true that the House health care bill calls for getting $500 billion in savings out of Medicare, but its substantial increases in Medicare spending reduce the net amount cut from the program to $219 billion over 10 years, according to the Congressional Budget Office.
– by Justin Bank and Lori Robertson
Sources
“Financing Medicare: An Issue Brief.” The Kaiser Family Foundation. Jan 2008.
Medicare, SSA Publication No. 05-10043. Social Security Administration. Sep 2009.
Status of the Social Security and Medicare Programs. A Summary of the 2009 Annual Reports. Social Security and Medicare Boards of Trustees. 2009.
“Prospects for Medicare’s Hospital Insurance Trust Fund.” Special Committee on Aging, United States Senate. Mar 1983.
O’Sullivan, Jennifer. “Medicare: History of Part A Trust Fund Insolvency Projections.” Congressional Research Service. 28 Mar 2008.
Department of Health and Human Services. Sebelius Statement on New Medicare Trustees’ Report, news release. 12 May 2009.
WhiteHouse.gov. Paying for Health Care Reform, Medicare fact sheet. Accessed 7 Oct 2008.
Congressional Budget Office. Letter to Rep. Charles B. Rangel. 17 Jul 2009.
Davis, Henry L. “Is universal health care worth waiting for?” Buffalo News. 29 Jul 2007.
Posted by Justin Bank and Lori Robertson on Wednesday, October 7, 2009 at 5:45 pm
Filed under Articles · Tagged with Americans for Prosperity, medicare
Tuesday, September 29, 2009
Do you have the courage to take on the pharmaceutical companies, health insurance companies, medical device companies, your colleagues in the Senate?
Dear Senator Feinstein:
Thank you very much for responding to my email supporting health care reform.
For the record, I am a board certified medical psychologist and pain management specialist practicing in Los Angeles since 1972. I along with many of my colleagues (most on staff at Cedars Sinai, Brotman Medical Center, and Olympia Hospital) support health care reform.
More importantly we support insurance reform. It is admirable to pass legislation prohibiting insurance companies to deny coverage. However, that will not reduce the cost of care.
I have been practicing for 37 years and I believe the only cost cutting device is COMPETITION. If insurance companies had to compete with a public option, if providers had to compete for patients, the cost of health care would plummet.
Further, treating health care as a commodity like we do pork bellies and General Electric is flat out wrong. Corporations must make a profit. Health insurance companies make a profit from sick or injured people. There is somethng terribly and inherently wrong with this picture. Moreover, the profits by insurance companies are significantly increased by denying coverage or delaying treatment. These health insurance companies should be held accountable for the tens of thousands of people in the US who die each year for lack of coverage.
There are other changes that also need to take place to fix our broken health care system. Medicare rules MUST change. Using the CMS reimbursement as a base is fine, but the rule must allow for provider and patient to negotiate balances as opposed to forcing the provider to accept assignment. This will also result in cost containment because the patient will know prior to receiving health care what their out of pocket expense will be. Since providers will have to compete for patients, patients will benefit from this change in rules. The net effect of changing Medicare would be to put the health care decision making where it belongs; between provider and patient. Further, this change would put free enterprise back into medicine.
There must be changes in Tort law as well. Frivolous lawsuits should be disallowed with a mandate to the insurance companies to lower the premiums to providers.
The pharmaceutical and medical device companies also need reform. Two weeks ago we performed a neurostimulator implant surgery at our Los Angeles ambulatory surgery center. Our cost for the neurostimulator was $25,000. I would be willing to bet that the cost of manufacturing the device is less than $2500.
I can provide you with many examples and invoices from surgery equipment and supply vendors revealing the inflated and obscene charges from these companies. There is NO accountability and very little if any competition. These companies have been getting away with these outrageous charges since the early 1980's. Our elected representatives accept campaign contributions from all of these companies. I believe this is a major and significant reason why our health care system is broken.
As you well know, the drug companies are just as bad. Same drug, same manufacturer will sell for 10 times less in Canada or Mexico or any other country in the world than in the USA. The pharmaceutical and medical device companies drive the pricing in health care and it is time for you and your colleagues to STOP them. The only reason they get away with robbery is that we are the ONLY country in the industrialized world that does not have universal health care for their people.
You want to ensure access to health care to all of your constituents? You want to drive health care costs DOWN? You only need to look at the insurance industry, pharmaceutical industry, medical device industry and congress protecting them to make that happen. The solution is a lot simpler than you and your colleagues make it out to be.
Do you have the courage to take on the insurance companies? Pharmaceutical companies? Medical Device companies? You would make all Californians proud if you took them on.
I think it would be very beneficial for you to look at the New Zealand health care system. It is a combination of public and private health care that really works.
My colleagues and I are available to discuss any of these issues with you or your staff, and thank you for listening.
Howard Stanley Rubin, MP PhD
Chief Executive Officer
Museum Center Surgery Group, Inc.
Los Angeles, California
http://healthcarenow-doc.blogspot.com/
Thank you very much for responding to my email supporting health care reform.
For the record, I am a board certified medical psychologist and pain management specialist practicing in Los Angeles since 1972. I along with many of my colleagues (most on staff at Cedars Sinai, Brotman Medical Center, and Olympia Hospital) support health care reform.
More importantly we support insurance reform. It is admirable to pass legislation prohibiting insurance companies to deny coverage. However, that will not reduce the cost of care.
I have been practicing for 37 years and I believe the only cost cutting device is COMPETITION. If insurance companies had to compete with a public option, if providers had to compete for patients, the cost of health care would plummet.
Further, treating health care as a commodity like we do pork bellies and General Electric is flat out wrong. Corporations must make a profit. Health insurance companies make a profit from sick or injured people. There is somethng terribly and inherently wrong with this picture. Moreover, the profits by insurance companies are significantly increased by denying coverage or delaying treatment. These health insurance companies should be held accountable for the tens of thousands of people in the US who die each year for lack of coverage.
There are other changes that also need to take place to fix our broken health care system. Medicare rules MUST change. Using the CMS reimbursement as a base is fine, but the rule must allow for provider and patient to negotiate balances as opposed to forcing the provider to accept assignment. This will also result in cost containment because the patient will know prior to receiving health care what their out of pocket expense will be. Since providers will have to compete for patients, patients will benefit from this change in rules. The net effect of changing Medicare would be to put the health care decision making where it belongs; between provider and patient. Further, this change would put free enterprise back into medicine.
There must be changes in Tort law as well. Frivolous lawsuits should be disallowed with a mandate to the insurance companies to lower the premiums to providers.
The pharmaceutical and medical device companies also need reform. Two weeks ago we performed a neurostimulator implant surgery at our Los Angeles ambulatory surgery center. Our cost for the neurostimulator was $25,000. I would be willing to bet that the cost of manufacturing the device is less than $2500.
I can provide you with many examples and invoices from surgery equipment and supply vendors revealing the inflated and obscene charges from these companies. There is NO accountability and very little if any competition. These companies have been getting away with these outrageous charges since the early 1980's. Our elected representatives accept campaign contributions from all of these companies. I believe this is a major and significant reason why our health care system is broken.
As you well know, the drug companies are just as bad. Same drug, same manufacturer will sell for 10 times less in Canada or Mexico or any other country in the world than in the USA. The pharmaceutical and medical device companies drive the pricing in health care and it is time for you and your colleagues to STOP them. The only reason they get away with robbery is that we are the ONLY country in the industrialized world that does not have universal health care for their people.
You want to ensure access to health care to all of your constituents? You want to drive health care costs DOWN? You only need to look at the insurance industry, pharmaceutical industry, medical device industry and congress protecting them to make that happen. The solution is a lot simpler than you and your colleagues make it out to be.
Do you have the courage to take on the insurance companies? Pharmaceutical companies? Medical Device companies? You would make all Californians proud if you took them on.
I think it would be very beneficial for you to look at the New Zealand health care system. It is a combination of public and private health care that really works.
My colleagues and I are available to discuss any of these issues with you or your staff, and thank you for listening.
Howard Stanley Rubin, MP PhD
Chief Executive Officer
Museum Center Surgery Group, Inc.
Los Angeles, California
http://healthcarenow-doc.blogspot.com/
KAISER SURVEY FINDS INCREASED PUBLIC SUPPORT FOR HEALTH CARE AND INSURANCE REFORM
NEWS RELEASE
Tuesday, September 29, 2009
Public Support For Health Reform Increases in September, Reversing Summer Declines as Congress Takes Up Legislation
Survey Finds Support For New Proposals For Fees And Taxes on Insurance Companies to Help Pay For Overhaul
CONTACTS
Chris Lee(202) 347-5270CLee@kff.org
Rakesh Singh(650) 854-9400RSingh@kff.org
MENLO PARK, CA -- Public support for health reform ended its summer slide, reversed course and moved modestly upwards in September, according to the latest Kaiser Health Tracking Poll.
Fifty-seven percent of Americans now believe that tackling health care reform is more important than ever -- up from 53 percent in August. The proportion of Americans who think their families would be better off if health reform passes is up six percentage points (42% versus 36% in August), and the percentage who think that the country would be better off is up eight points (to 53% from 45% in August).
Despite the uptick, a substantial share of the public (47%) favors taking longer to work out a bipartisan approach to health reform, compared to 42 percent who would prefer to see Democrats move faster on their own. Meanwhile, the public continues to view the action in Washington with mixed feelings: The largest share (68%) said they were "hopeful" about reform, but 50% are "anxious" and 31% "angry."
"Opinion in the coming months is hard to predict, but as the focus shifted from the town halls and hot button issues to the President, the Congress and the core issues in the legislation that affect people the most, the summer downturn in support was largely erased," said Kaiser President and CEO Drew Altman.
Upswing in Support Driven by Changes Among Republicans and Independents
Republicans and political independents became markedly more pessimistic about health reform in August, but those viewpoints softened in September. While 49 percent of Republicans say their family would be worse off if health reform passes, this is down from 61 percent in August.
The percentage of independents saying they would be worse off fell from 36 percent in August to 26 percent this month.
Democrats remain overwhelmingly in favor of tackling health care now (77%), while most Republicans say we cannot afford to do so (63%) and independents are more evenly divided (51% in favor and 44% opposed).
Fifty-seven percent of the public -- including 56% of independents -- say the GOP is opposing reform plans more for political reasons than because they think reform will be bad for the country.
Majority Backing Seen for Taxing Expensive Health Plans and Imposing Fees on Insurers to Pay for Reform
Substantial majorities of Americans continue to say they back individual reform components designed to expand coverage, including an individual mandate (68%), an employer mandate (67%) and an expansion of state programs such as Medicaid and the Children’s Health Insurance Program (82%).
The component that draws among the strongest support across the political spectrum is requiring that health insurance companies cover anyone who applies, even if they are sick or have a pre-existing condition. Overall, 8 in 10 people support that idea, including 67 percent of Republicans, 80 percent of independents and 88 percent of Democrats.
When it comes to paying for reform, two ideas now under discussion among policymakers garner initial majority support. Fifty-seven percent of the public say they would support "having health insurance companies pay a fee based on how much business they have" and 59 percent would support "having health insurance companies pay a tax for offering very expensive policies." In both cases, Republicans are evenly divided while Democrats and political independents tilt in favor. The poll did not test arguments for and against the policies.
Messages Matter
People say they would be more likely to support a new reform proposal if they heard it would:
Improve health care for our children and grandchildren (77%);
Provide financial help to buy health insurance to those who need it (74%);
Help ensure the long-term financial health of Medicare (69%);
Fulfill a moral obligation by ensuring that people don’t have to go without needed health care just because they can’t afford it (68%); and
Mean that people with a history of illness would not be denied coverage and could get it at the same price as healthier people (65%).
Conversely, people say they would be less likely to support a new reform proposal if they heard that it would:
Limit choice of doctors (65%);
Reduce the quality of care provided to seniors under Medicare (63%);
Result in payment cuts that might make doctors less willing to take Medicare patients (62%);
Get the government too involved in your personal health care decisions (59%);
and Increase people’s insurance premiums or other out-of-pocket costs (57%).
Seniors Are Still Less Convinced Reform Will Benefit Them
Seniors are still less convinced than others that health reform will benefit them, but they too have become less pessimistic since August. The share of seniors who think their family would be better off if reform passes climbed 8 percentage points from August, from 23 percent to 31 percent. Twenty-eight percent thought they would be worse off, and 33 percent said it wouldn’t make a difference. Fifty-five percent of seniors said they were 'confused."
Some commentators believe that proposals to obtain savings in the Medicare program are driving opposition among seniors. The survey finds that a plurality of seniors (49%) opposed the idea of limiting future increases in Medicare provider payments as a way to help pay for health care reform. But a solid majority (59%) would back the same limits if they were framed as helping to "keep Medicare financially sound in the future."
"Some Medicare changes being discussed in the health reform debate can be seen as strengthening Medicare for the long-term or as harming it. Which of these messages breaks through could ultimately shape seniors’ reactions," said Mollyann Brodie, vice president for Public Opinion and Survey Research at the Kaiser Family Foundation.
Many Say News Coverage Has Focused on Politics and Controversy
Health reform is the top story out of Washington, with news organizations ramping up coverage in recent months. In assessing the job of the media, 50 percent of the public says news coverage of health reform "has been mostly about politics and controversies," while eight percent say it has been mostly about "how policy reforms might affect your own family." Thirty-seven percent view the coverage as a balance of the two.
Fifty-four percent of the public report that they had seen an ad in the last seven days that had to do with proposed changes in the health care system, up from 45 percent in August and 21 percent in June. The public says that these ads have come fairly evenly from proponents and opponents of reform.
Americans Continue to Struggle with Unaffordable Health Care While policymakers debate solutions, the problem of high health care costs remains. One third of Americans (33%) say they or someone in their household has had problems paying medical bills over the past year. That is up nine percentage points from August and represents the highest level this measure has reached in nearly a year.
A majority of Americans (56%) also say they have put off care over the last 12 months because of cost reasons, with many saying that they had relied on home remedies or over the counter drugs instead of seeing a doctor (44%), skipped dental care or other checkups (35%), or skipped a recommended medical test or treatment (28%).
Methodology
The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted September 11 through September 18, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 147 who had no landline telephone) were carried out in English and Spanish. The margin of sampling error for the total sample is plus or minus 3 percentage points. For results based on subgroups, the margin of sampling error is higher.
The full question wording, results, charts and a brief on the poll can be viewed online.
The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible information, research and analysis on health issues.
Tuesday, September 29, 2009
Public Support For Health Reform Increases in September, Reversing Summer Declines as Congress Takes Up Legislation
Survey Finds Support For New Proposals For Fees And Taxes on Insurance Companies to Help Pay For Overhaul
CONTACTS
Chris Lee(202) 347-5270CLee@kff.org
Rakesh Singh(650) 854-9400RSingh@kff.org
MENLO PARK, CA -- Public support for health reform ended its summer slide, reversed course and moved modestly upwards in September, according to the latest Kaiser Health Tracking Poll.
Fifty-seven percent of Americans now believe that tackling health care reform is more important than ever -- up from 53 percent in August. The proportion of Americans who think their families would be better off if health reform passes is up six percentage points (42% versus 36% in August), and the percentage who think that the country would be better off is up eight points (to 53% from 45% in August).
Despite the uptick, a substantial share of the public (47%) favors taking longer to work out a bipartisan approach to health reform, compared to 42 percent who would prefer to see Democrats move faster on their own. Meanwhile, the public continues to view the action in Washington with mixed feelings: The largest share (68%) said they were "hopeful" about reform, but 50% are "anxious" and 31% "angry."
"Opinion in the coming months is hard to predict, but as the focus shifted from the town halls and hot button issues to the President, the Congress and the core issues in the legislation that affect people the most, the summer downturn in support was largely erased," said Kaiser President and CEO Drew Altman.
Upswing in Support Driven by Changes Among Republicans and Independents
Republicans and political independents became markedly more pessimistic about health reform in August, but those viewpoints softened in September. While 49 percent of Republicans say their family would be worse off if health reform passes, this is down from 61 percent in August.
The percentage of independents saying they would be worse off fell from 36 percent in August to 26 percent this month.
Democrats remain overwhelmingly in favor of tackling health care now (77%), while most Republicans say we cannot afford to do so (63%) and independents are more evenly divided (51% in favor and 44% opposed).
Fifty-seven percent of the public -- including 56% of independents -- say the GOP is opposing reform plans more for political reasons than because they think reform will be bad for the country.
Majority Backing Seen for Taxing Expensive Health Plans and Imposing Fees on Insurers to Pay for Reform
Substantial majorities of Americans continue to say they back individual reform components designed to expand coverage, including an individual mandate (68%), an employer mandate (67%) and an expansion of state programs such as Medicaid and the Children’s Health Insurance Program (82%).
The component that draws among the strongest support across the political spectrum is requiring that health insurance companies cover anyone who applies, even if they are sick or have a pre-existing condition. Overall, 8 in 10 people support that idea, including 67 percent of Republicans, 80 percent of independents and 88 percent of Democrats.
When it comes to paying for reform, two ideas now under discussion among policymakers garner initial majority support. Fifty-seven percent of the public say they would support "having health insurance companies pay a fee based on how much business they have" and 59 percent would support "having health insurance companies pay a tax for offering very expensive policies." In both cases, Republicans are evenly divided while Democrats and political independents tilt in favor. The poll did not test arguments for and against the policies.
Messages Matter
People say they would be more likely to support a new reform proposal if they heard it would:
Improve health care for our children and grandchildren (77%);
Provide financial help to buy health insurance to those who need it (74%);
Help ensure the long-term financial health of Medicare (69%);
Fulfill a moral obligation by ensuring that people don’t have to go without needed health care just because they can’t afford it (68%); and
Mean that people with a history of illness would not be denied coverage and could get it at the same price as healthier people (65%).
Conversely, people say they would be less likely to support a new reform proposal if they heard that it would:
Limit choice of doctors (65%);
Reduce the quality of care provided to seniors under Medicare (63%);
Result in payment cuts that might make doctors less willing to take Medicare patients (62%);
Get the government too involved in your personal health care decisions (59%);
and Increase people’s insurance premiums or other out-of-pocket costs (57%).
Seniors Are Still Less Convinced Reform Will Benefit Them
Seniors are still less convinced than others that health reform will benefit them, but they too have become less pessimistic since August. The share of seniors who think their family would be better off if reform passes climbed 8 percentage points from August, from 23 percent to 31 percent. Twenty-eight percent thought they would be worse off, and 33 percent said it wouldn’t make a difference. Fifty-five percent of seniors said they were 'confused."
Some commentators believe that proposals to obtain savings in the Medicare program are driving opposition among seniors. The survey finds that a plurality of seniors (49%) opposed the idea of limiting future increases in Medicare provider payments as a way to help pay for health care reform. But a solid majority (59%) would back the same limits if they were framed as helping to "keep Medicare financially sound in the future."
"Some Medicare changes being discussed in the health reform debate can be seen as strengthening Medicare for the long-term or as harming it. Which of these messages breaks through could ultimately shape seniors’ reactions," said Mollyann Brodie, vice president for Public Opinion and Survey Research at the Kaiser Family Foundation.
Many Say News Coverage Has Focused on Politics and Controversy
Health reform is the top story out of Washington, with news organizations ramping up coverage in recent months. In assessing the job of the media, 50 percent of the public says news coverage of health reform "has been mostly about politics and controversies," while eight percent say it has been mostly about "how policy reforms might affect your own family." Thirty-seven percent view the coverage as a balance of the two.
Fifty-four percent of the public report that they had seen an ad in the last seven days that had to do with proposed changes in the health care system, up from 45 percent in August and 21 percent in June. The public says that these ads have come fairly evenly from proponents and opponents of reform.
Americans Continue to Struggle with Unaffordable Health Care While policymakers debate solutions, the problem of high health care costs remains. One third of Americans (33%) say they or someone in their household has had problems paying medical bills over the past year. That is up nine percentage points from August and represents the highest level this measure has reached in nearly a year.
A majority of Americans (56%) also say they have put off care over the last 12 months because of cost reasons, with many saying that they had relied on home remedies or over the counter drugs instead of seeing a doctor (44%), skipped dental care or other checkups (35%), or skipped a recommended medical test or treatment (28%).
Methodology
The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted September 11 through September 18, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (402, including 147 who had no landline telephone) were carried out in English and Spanish. The margin of sampling error for the total sample is plus or minus 3 percentage points. For results based on subgroups, the margin of sampling error is higher.
The full question wording, results, charts and a brief on the poll can be viewed online.
The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible information, research and analysis on health issues.
Friday, September 25, 2009
Called out on Miracles
I received this response to yesterday's Blog. Following are the criticism and my response. It would be great to hear from more of you. This issue effects ALL OF US.
There is one thing I'm having a hard time understanding about your (and many liberals' views)....you all want a 'public option' under the guise of increased competition to the insurance companies. But in the next sentence want a single payor system, which would ELIMINATE any competition. You guys should at least be honest and say that you want a public option as a means to eliminate the insurance companies.
Response
What I WANT and what is currently possible are two different things. If you read the blog again, you will find that I was answering a question about what a public option would look like based on my understanding of what is being considered by Congress. In this context, a public option would go a long way in driving costs down due to competition for policy holders and provider competition for patients.
I then addressed the issue of how health care is perceived and understood in the United States. UNFORTUNATELY, we view health care as a commodity or equity like we do pork bellies or General Electric. We are the only industrialized country in the world that views health care this way. In other words, health insurance corporations must profit at the expense of sick or injured people. They do this by denying or delaying treatment, or canceling policies AFTER the policy holder contracts a serious or catastrophic disease. There is something terribly wrong with that picture.
If our government created laws that did not allow profiteering off the sick or injured, health insurance companies would no longer exist. I think that not profiting from a human beings misery is a good thing. Universal health care in other countries is NON PROFIT, paid by tax dollars. That's right, tax dollars.
These countries have NO problem with taking care of their people, unlike us AMERICANS. I have heard so many people talk negatively about single payor system or even a public option because they don't want to pay for other peoples health care. Fact is we are all ready paying for other peoples health care. Those of us lucky enough to be employed pay taxes for Medicare. We are paying NOW for our health care later. We are paying NOW for those 65 or older, or who are disabled. That argument that "I shouldn't have to or don't want to pay for others health care" is shortsighted and WRONG. If this position is liberal, I am guilty.
I have some questions for those of you who actually believe that it is everyone for themselves.
If the US was attacked with biological weapons and you or a family member contracted a serious disease because of this attack; would you want to be obligated to obtain pre certification from your insurance company to be treated? Would you want to subject yourself to their scrutiny and review of your medical history? What if they determined that your policy was not valid because you forgot to document that you were treated for acne when you were a teenager so many years ago? What would you do if your insurance company denied your claim because they determined it was a pre existing condition? What if you had a $5000 deductible and didn't have the money? What if this disease prohibited you from earning a living and you didn't have your $50 co-pay?
My guess is that you wouldn't have any problem with this since your belief is that we should only have to take care of ourselves. I'm certain you would rather suffer in your illness than be treated for it.
There is one thing I'm having a hard time understanding about your (and many liberals' views)....you all want a 'public option' under the guise of increased competition to the insurance companies. But in the next sentence want a single payor system, which would ELIMINATE any competition. You guys should at least be honest and say that you want a public option as a means to eliminate the insurance companies.
Response
What I WANT and what is currently possible are two different things. If you read the blog again, you will find that I was answering a question about what a public option would look like based on my understanding of what is being considered by Congress. In this context, a public option would go a long way in driving costs down due to competition for policy holders and provider competition for patients.
I then addressed the issue of how health care is perceived and understood in the United States. UNFORTUNATELY, we view health care as a commodity or equity like we do pork bellies or General Electric. We are the only industrialized country in the world that views health care this way. In other words, health insurance corporations must profit at the expense of sick or injured people. They do this by denying or delaying treatment, or canceling policies AFTER the policy holder contracts a serious or catastrophic disease. There is something terribly wrong with that picture.
If our government created laws that did not allow profiteering off the sick or injured, health insurance companies would no longer exist. I think that not profiting from a human beings misery is a good thing. Universal health care in other countries is NON PROFIT, paid by tax dollars. That's right, tax dollars.
These countries have NO problem with taking care of their people, unlike us AMERICANS. I have heard so many people talk negatively about single payor system or even a public option because they don't want to pay for other peoples health care. Fact is we are all ready paying for other peoples health care. Those of us lucky enough to be employed pay taxes for Medicare. We are paying NOW for our health care later. We are paying NOW for those 65 or older, or who are disabled. That argument that "I shouldn't have to or don't want to pay for others health care" is shortsighted and WRONG. If this position is liberal, I am guilty.
I have some questions for those of you who actually believe that it is everyone for themselves.
If the US was attacked with biological weapons and you or a family member contracted a serious disease because of this attack; would you want to be obligated to obtain pre certification from your insurance company to be treated? Would you want to subject yourself to their scrutiny and review of your medical history? What if they determined that your policy was not valid because you forgot to document that you were treated for acne when you were a teenager so many years ago? What would you do if your insurance company denied your claim because they determined it was a pre existing condition? What if you had a $5000 deductible and didn't have the money? What if this disease prohibited you from earning a living and you didn't have your $50 co-pay?
My guess is that you wouldn't have any problem with this since your belief is that we should only have to take care of ourselves. I'm certain you would rather suffer in your illness than be treated for it.
Thursday, September 24, 2009
Do you believe in Miracles?
The following letter is in response to a question I was asked in regard to what a "public option" would be like. More specifically, I was asked if the public option was going to be like Medicare.
Sorry it has taken me so long to respond to your question. I have been very busy at the surgery center. My understanding is that the "public option" is one of several health insurance products that will be made available to individuals and small business that currently don't have or provide health insurance. The details have not been fully worked out, but I think the end product will be similar to Medicare in that the government will "outsource" the administration of the public plan to a third party as it currently does for Medicare. Hopefully, that will be the only similarity.
There will need to be some major changes in the current Medicare system to make a public option viable. I have outlined many of the necessary changes in previous posts on the Blog Health Care NOW. Specifically, reimbursement must be increased in order for providers to accept patients participating in the public option, and payroll decutions must be increased to pay for the public option.
One method of increasing reimbursement is to allow providers and their patients negotiate balances. I have suggested a two pronged approach where the current CMS reimbursement is increased 15--20% AND the difference between the providers fee and CMS reimbursement is negotiated with the patient PRIOR to the delivery of the health care service or procedure.
Further, an increase in the Medicare payroll deduction must also take place. This increase should be 10--15%. This increase pales in comparison to deductibles and co-payments currently in existence. This is doable since worker's and self employed people will have choices for their health insurance products and costs will decrease naturally with competition.
This is also true for the NON public plan options. Competition will drive the costs down because providers as well as insurance companies will be competing for patients and policy holders.
One other thing of note. Unfortunately, in the USA, health care is treated as a commodity. It shouldn't be, but it is. If this attitude were to change, private insurance companies would go out of the health care business which would be the best thing ever to happen in health care. It is the insurance industry along with the pharmaceutical companies and medical device companies that are raping the system. These are private companies that must be accountable to shareholders.
That means they MUST make money. This has been the case since the 1970s and at the expense of the patient and provider. Remove the necessity to make corporate profits off of health care and that money can be used to PROVIDE HEALTH CARE. Further, the costs would plummet since there would be NO health insurance premiums, no costly utilization review, no denial of health care, no delay of obtaining health care, no fighting for reimbursement, all of which costs billions. Further, denial often times ends in death, and delay ends up costing more than if treatment were authorized when requested. Remove all this nonsense, and we would all be healthier and health care costs would be significantly reduced.
Remember, health insurance companies DO NOT PROVIDE HEALTH CARE. They broker health care which is a nice way of saying they are pimps for executives and shareholders.
Tort reform should also drive down some of the cost and needs to be looked at carefully. There is not a lot of evidence showing that tort reform will reduce mal practice insurance premiums. Again, the insurance companies must make a profit and they will sell anything at the highest price they can get. No regulation is equal to highway robbery for the insurance industry. Only competition will drive down the costs of mal practice insurance.
The result of removing corporations from the health care system would be a single payor system in the USA. We are the only industrialized country in the world that does NOT have this for all of their citizens. Personally, I think that is shameful that people go bankrupt because one major illness cost them their life savings and assets in the wealthiest industrialized country in the world. This is ONLY because corporations must make a profit on health care.
Should be an interesting next couple of weeks. The senate finance committee should have legislation ready to present to the senate in a few days. I just hope our president has the balls to stand up to special interest, conservative democrats, and republicans on this issue.
Sorry it has taken me so long to respond to your question. I have been very busy at the surgery center. My understanding is that the "public option" is one of several health insurance products that will be made available to individuals and small business that currently don't have or provide health insurance. The details have not been fully worked out, but I think the end product will be similar to Medicare in that the government will "outsource" the administration of the public plan to a third party as it currently does for Medicare. Hopefully, that will be the only similarity.
There will need to be some major changes in the current Medicare system to make a public option viable. I have outlined many of the necessary changes in previous posts on the Blog Health Care NOW. Specifically, reimbursement must be increased in order for providers to accept patients participating in the public option, and payroll decutions must be increased to pay for the public option.
One method of increasing reimbursement is to allow providers and their patients negotiate balances. I have suggested a two pronged approach where the current CMS reimbursement is increased 15--20% AND the difference between the providers fee and CMS reimbursement is negotiated with the patient PRIOR to the delivery of the health care service or procedure.
Further, an increase in the Medicare payroll deduction must also take place. This increase should be 10--15%. This increase pales in comparison to deductibles and co-payments currently in existence. This is doable since worker's and self employed people will have choices for their health insurance products and costs will decrease naturally with competition.
This is also true for the NON public plan options. Competition will drive the costs down because providers as well as insurance companies will be competing for patients and policy holders.
One other thing of note. Unfortunately, in the USA, health care is treated as a commodity. It shouldn't be, but it is. If this attitude were to change, private insurance companies would go out of the health care business which would be the best thing ever to happen in health care. It is the insurance industry along with the pharmaceutical companies and medical device companies that are raping the system. These are private companies that must be accountable to shareholders.
That means they MUST make money. This has been the case since the 1970s and at the expense of the patient and provider. Remove the necessity to make corporate profits off of health care and that money can be used to PROVIDE HEALTH CARE. Further, the costs would plummet since there would be NO health insurance premiums, no costly utilization review, no denial of health care, no delay of obtaining health care, no fighting for reimbursement, all of which costs billions. Further, denial often times ends in death, and delay ends up costing more than if treatment were authorized when requested. Remove all this nonsense, and we would all be healthier and health care costs would be significantly reduced.
Remember, health insurance companies DO NOT PROVIDE HEALTH CARE. They broker health care which is a nice way of saying they are pimps for executives and shareholders.
Tort reform should also drive down some of the cost and needs to be looked at carefully. There is not a lot of evidence showing that tort reform will reduce mal practice insurance premiums. Again, the insurance companies must make a profit and they will sell anything at the highest price they can get. No regulation is equal to highway robbery for the insurance industry. Only competition will drive down the costs of mal practice insurance.
The result of removing corporations from the health care system would be a single payor system in the USA. We are the only industrialized country in the world that does NOT have this for all of their citizens. Personally, I think that is shameful that people go bankrupt because one major illness cost them their life savings and assets in the wealthiest industrialized country in the world. This is ONLY because corporations must make a profit on health care.
Should be an interesting next couple of weeks. The senate finance committee should have legislation ready to present to the senate in a few days. I just hope our president has the balls to stand up to special interest, conservative democrats, and republicans on this issue.
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