Marilyn Clement

Posted by on Tuesday, Aug 4, 2009

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

Marilyn Clement’s Speech at Celebration Held in Her Honor

June 7, 2009

Closing comments of Marilyn Clement’s last speech:

Keep it up! We’re going to win single payer!

Video of speech (10 minutes):
http://www.healthcare-now.org/marilyn-clements-speech-at-celebration-held-in-her-honor/

Healthcare-NOW!
http://www.healthcare-now.org/

Marilyn never gave up, though she left us yesterday, August 3, 2009.

QOTD: A Canadian doctor diagnoses U.S. health care

Posted by on Monday, Aug 3, 2009

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

A Canadian doctor diagnoses U.S. healthcare

By Michael M. Rachlis
Los Angeles Times
August 3, 2009

Universal health insurance is on the American policy agenda for the fifth time since World War II. In the 1960s, the U.S. chose public coverage for only the elderly and the very poor, while Canada opted for a universal program for hospitals and physicians’ services. As a policy analyst, I know there are lessons to be learned from studying the effect of different approaches in similar jurisdictions. But, as a Canadian with lots of American friends and relatives, I am saddened that Americans seem incapable of learning them.

The U.S.’ and Canada’s different health insurance decisions make up the world’s largest health policy experiment. And the results?

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.

Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons.

However, according to the New York-based Commonwealth Fund, both the American and the Canadian systems fare badly in these areas.

On closer examination, most of these problems have little to do with public insurance or even overall resources.

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality.

U.S. health policy would be miles ahead if policymakers could learn these lessons. But they seem less interested in Canada’s, or any other nation’s, experience than ever. Why?

American democracy runs on money.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our “socialized” system doesn’t let us choose our own doctors. In fact, Canadians have free choice of physicians. It’s Americans these days who are restricted to “in-plan” doctors.

Unfortunately, many Americans won’t get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

(Michael M. Rachlis is a physician, health policy analyst and author in Toronto.)

http://www.latimes.com/news/opinion/la-oe-rachlis3-2009aug03,0,538126.story

August will be the month of sound bites on health care reform.

One of these sound bites is “unfair competition.” It is really a silly argument designed to suppress even the most feeble of reform efforts.

But the really unfair competition this month will be between those who can explain the relatively complex health policies that can benefit everyone (except those who are wasting our resources), and those who have at their command the very effective tool of simple sound bites. These sound bites relieve the listener of any responsibility to try to understand these complex issues.

Should the dialogue on reform move into discussions of effective health policies, the opponents will be ready with their sound bite diversions, including those based on the caricature of the Canadian experience suggesting that their government takeover of health care has caused Canadians to flee to the United States should they need health care – a lie supposedly “proven” by rare, bizarre anecdotes.

When the distortions and lies about Canada are brought up, interrupt (they do) with the response that Canada has a health care financing system that includes everyone and keeps health care affordable.

The United States needs the same. We need to include everyone in a system that is affordable. The problem for single payer advocates is that the program that the administration is trying to sell us will leave five percent of us out and make affordability even worse.

The real tragedy is that this war on health care financing reform will be settled by sound bites. On that war, the bad guys always win.

News from Tampa Bay

Posted by on Monday, Aug 3, 2009

From Greg M. Silver, MD (Clearwater, FL)

Lots of activity in the Tampa Bay region. As the battle heats up, I have appeared on WEDU-TV, our local PBS affiliate, for a Special Roundtable presentation on Health Care Reform on 7/17, as well as the “Kathy Fountain Show” on WTVT 13 our local Fox affiliate on 7/29. Yesterday, I was interviewed on WTAN radio in Clearwater for a program focusing on reform efforts. I am also scheduled for another discussion at the University of South Florida in September. More to come as soon as I can take a breath!

(Video links below)

Last night as the House Energy and Commerce Committee completed its markup of HR 3200, the House health reform bill, Chairman Henry Waxman interrupted Representative Anthony Weiner of New York to say that House Speaker Nancy Pelosi had promised that single payer legislation, HR 676, The United States National Health Care Act would come before the entire House of Representatives. Chairman Waxman:

The Speaker has said that she will allow this to be brought up on the House floor, and debated, and voted on.

Representative Anthony Weiner (NY-9, Brooklyn/Queens) had placed an amendment before the Energy and Commerce Committee that would have replaced the text of HR 3200 with the text of HR 676, the United States National Health Care Act. He was joined by fellow Energy and Commerce committee members Peter Welch (VT, Vermont), Mike Doyle (PA-14, Pittsburgh), Tammy Baldwin, (WI-2, Madison), Jan Schakowsky (IL-9, Chicago), Bobby L. Rush (IL-1, Chicago), Eliot L. Engel (NY-17, Rockland/Westchester).

Chairman Waxman asked for the single payer amendment to be withdrawn from committee debate in exchange for a debate and vote on the House floor. Representative Weiner hailed this victory in a brief statement:

Single-payer is a better plan and now it is on center stage. Americans have a clear choice. Their Member of Congress will have a simpler, less expensive and smarter bill to choose. I am thrilled that the Speaker is giving us that choice.

On the Mouth of the Potomac blog, NY Daily News Washington Bureau journalist Michael McAuliff reported:

The Brooklyn-Queens Rep. looked a little surprised when Chairman Henry Waxman said Pelosi would allow that vote, and made Waxman repeat the deal to be sure it was clear and on the record. It’s an especially big deal for advocates of a single health care system — who see it as cheaper and simpler than the complicated measure being drawn up — because they have been complaining that they have not even been able to get an airing of their position.

And having the vote of the floor of the House will force members to declare a position, and bring much more attention to the idea.

Reporting for The Hill Mike Soraghan wrote:

Legislation creating a single-payer system would be expected to lose, but would allow liberal members to record their support for the proposal. It will also be a tough vote for some Democrats who will be wary of upsetting the liberal base.

Many liberal lawmakers feel that the controversial “public option” that would compete with private insurers is a compromise from single-payer.

Single payer advocates should not be surprised by this turn of events. Chairman Waxman himself was a co-sponsor of HR 676 in the 109th Congress. Speaker Pelosi has also supported single payer in the past. Only this spring, at an event sponsored by the Christian Science Monitor, the Speaker told the audience:

… over and over again, we hear single payer, single payer, single payer. Well, it’s not going to be a single payer. …

Just one day before the Energy and Commerce Committee meeting, on July 30th, over one thousand single payer supporters swarmed through the halls of Congress to celebrate Medicare’s 44th birthday. Congresspeople and staff told us over and over again that back home grassroots clamor for single payer continues to build. In other words, across the nation, representatives have had the same experiences as the Speaker of the House.

Anthony Weiner’s initiative has created a new opening for us to educate our colleagues, our patients, our elected representatives, indeed everyone, about the need for a single payer program of national health insurance. A strong single payer vote in the House will mark a turning point in history.

As we accumulate momentum, we find steady support and fresh creativity for our great cause. What a wonderful time to join Physicians for a National Health Program. We need your voice!

**************
Video links:

The full Weiner amendment discussion at the Energy and Commerce Committee can be viewed here. Look at the bottom on the screen. The session is 6 hours 5 minutes and 38 seconds long. The Weiner piece begins at 3 hours 15 minutes and 40 seconds and ends at 3:32:53.

Representative Weiner introduces the single payer amendment at the Energy and Commerce Committee.

Representative Tammy Baldwin (Madison, Wisconsin) speaks for single payer at Energy and Commerce Committee

Representative Eliot Engel (Westchester/Rockland, New York) speaks for single payer at Energy and Commerce Committee.

Chairman Waxman interrupts Representative Weiner to ask that the amendment be withdrawn because Speaker Pelosi has promised to allow single payer before the entire House of Representatives.

As the debate over health care reform becomes all-out warfare between parties and within the Democratic party, Congress will adjourn shortly for its August recess with many of the key questions unresolved.  However, the bill as shaped by two or three House committees (H. R. 3200, America’s Affordable Health Choices Act) gives a point of departure to consider the most that we might expect out of such a bill.

As described in our last three posts, this bill calls for both an individual and employer mandate as well as a small public option to be available to the uninsured and employees of small employers through a national insurance exchange.  Individuals would be subsidized by the government to offset their premium and out-of-pocket costs.  People with household incomes up to 400 percent of the federal poverty level (FPL) would be eligible for subsidies.  Tax credits would also be provided to small employers with fewer than 25 full-time workers, covering up to 50 percent of their premium costs.  These new subsidies, of course, are in addition to the many subsidies the government already provides to individuals and employers through long-standing tax-exemptions of  insurance costs.  H.R. 3200 also calls for expansion of Medicaid for all individuals with incomes up to 133 percent of the FPL (about $14,000 for an individual and $88,200 for a family of four).

The CBO projects the cost of H. R. 3200 to be about $1 trillion over 10 years, not including the increased costs of Medicaid, for which it lacks jurisdiction to score.  “Conservative” projections estimate that the bill will increase the U. S. budget deficit by $239 billion in 2019.  Governors have already weighed in against the increased costs of Medicaid expansion, pleading for an increased federal role in paying for it, and political opposition to the bill’s inflationary trends seems certain to spread beyond the Republicans and Blue Dog Democrats to others.  As the debate intensifies, we can expect that eligibility for subsidies will be tightened up.

Returning to the affordability of health insurance, the supposed reason for reform legislation, there is an obvious disconnect from the impacts of a deepening recession.  Much of the population, including the broad middle class, are in increasingly dire straits in their ability to pay for necessary health care.  Average annual health care costs for a family of four are now $16,771, including insurance premiums, deductibles and other out-of-pocket costs.  For a family of four with an income of $88,200 (four times the FPL and much more than the median U. S. median income), these average costs exceed 19 percent of family income, well above the 10 percent considered by the Commonwealth Fund as a hardship level.

We have to remember that the costs of health insurance often have little to do with the total costs of health care for individuals and families.  For those with significant health problems, their costs will be much higher.  And although the current proposals in Congress call for annual limits on out-of-pocket spending ($5,000 for individuals and $10,000 for families), insurance premiums and out-of-network charges are not counted against these limits.

This bad situation is getting worse. The unemployment rate is poised to soon rise above 10 percent, and the broader unemployment rate is already more than 20 percent in a number of states.  Tax revenues have fallen precipitously in many states, and 16 states are now paying for unemployment insurance in borrowed funds.  Draconian cuts are being made in safety net programs all across the country.

So it seems certain that federal payments for subsidies will far exceed any projections that are now being discussed. There are at least 100 million Americans less than 65 years of age with incomes below 400 percent of FPL.  If eligibility for federal subsidies is set at that level, the CBO projects that their cost will be about $773 billion between 2013 and 2019. Concerning Medicaid expansion, the CBO has also estimated that extending Medicaid to an additional group of Americans with incomes for a family of four up to $33,000 a year would cost about $500 billion over 10 years.

We can be sure that the Senate will restrict subsidies below these levels and that any final health care reform bill, if ever enacted, will further exacerbate the problems Americans face in paying for health care.  And to boot, federal law would mandate them to purchase health insurance, under penalty of fine, and an underinsurance product at that.  A working draft of the “actuarial value” of insurance coverage in the Senate Finance Committee last month stated that a policy of “bronze” or “silver” value would cover 65 and 73 percent of total health care costs, respectively — undercoverage by any standard.  A family of four with an income at 300 percent of FPL would pay 15 percent of their income on health care. So we would end up with a mandate for inadequate coverage which much of the population, as well as taxpayers, cannot afford.

The strong conservative challenge that is building against H. R. 3200 is largely due to its deficit-busting certainty as well as its increase in entitlement to health care without credible cost containment requirements.  As a progressive advocate of real health care reform, I can only agree with these concerns.  What is likely to emerge from Congress on health care reform this year, if anything, will not be real reform and will only add to our problems.

Although still very much under-recognized and fought against by the medical industrial complex and complicit corporate media, there is only one solution to cost containment of our runaway market-based health care system.   H. R. 676, coupled with a private delivery system, is a paygo alternative that assures universal coverage of necessary health care for all Americans.  It would save up to $400 billion a year and provide a structure within which to put in place other cost-saving efficiencies.

The private health insurance industry is an impediment to reform, not part of the solution.  It has survived to this time only through generous subsidies from the government, whether in the employer-based or individual markets or privatized Medicare and Medicaid programs.  Until we recognize this, all of our incremental approaches to build on our multi-payer system will be of no avail.

Adapted from Do Not Resuscitate: Why The Health Insurance Industry Is Dying, and How We Must Replace It, and The Cancer Generation: Baby Boomers Facing a Perfect Storm, with permission from the publisher, Common Courage Press.  Order link
1,096 words

John Geyman, M.D. is the author of The Cancer Generation and Do Not Resuscitate: Why the Health Insurance Industry is Dying, and How We Must Replace It, 2008 by John Geyman. With permission of the publisher, Common Courage Press

Buy John Geyman’s Books at: http://www.commoncouragepress.com

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From Jeoffry Gordon, M.D., M.P.H. (San Diego, CA)

We had a good Medicare birthday rally on July 30th.

Next week is busy for me.
Sunday: Single payer presentation at Mission Hills United Church of Christ.
Tuesday: Medical Grand Rounds on Single Payer Reform at Sharp Coronado Hospital
Wednesday: I will represent PNHP and single payer on local PBS affiliate KPBS’s “These Days” show (you can get a podcast) which is presenting a four day series on problems with the health care and reform proposals.

From Wendy Ring, M.D., M.P.H. (Bayside, CA)

A group of us have been performing The Sound of Moolah, a show about health reform and why we need single payer, around southern Oregon and Northern CA recruiting new single payer activists wherever we go. There have been several newspaper articles and radio interviews.

From David A. Cimino, M.D. (St. Petersburg, FL)

I have had two letters to the editor published in the St. Petersburg Times in the past 4 months. The most recent was on July 22 and was a push for a Single Payer System. Tomorrow July 31 I have been asked to appear on a local news program on Channel 13 WTVT Fox News at 12:30 PM to discuss health care reform. I again will push for a Single Payer System as the only way to achieve affordable, quality health care for all. I am a semi-retired general pediatrician and for the past 20 years limited my practice to adolescents.

From Cynthia Haq, M.D. (Madison, WI)

Dr. Cindy Haq on Wisconsin Public Radio:
http://www.wpr.org/hereonearth/archive_090722k.cfm

Health Care Reform Rally 7/25/09 in Madison in Memory of Lindy Farley, MD

http://www.youtube.com/watch?v=TOc-2wwQYKk

Dr Jeff Patterson at the Farmer’s Market in Madison 6/28/09

http://www.youtube.com/watch?v=QaMU4-IYESc

Dr Gene Farley at the Farmer’s Market in Madison 6/28/09

http://www.youtube.com/watch?v=KeUjrW-UMZs

Farmer’s Market Madison 6/28/09
http://www.channel3000.com/health/19884995/detail.html

Poisoning thought with words

Posted by on Friday, Jul 31, 2009

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

“American Values” — A Smoke Screen in the Debate on Health Care Reform

By Allan S. Brett, M.D.
The New England Journal of Medicine
July 29, 2009

Amid all the rhetoric about health care reform, one claim has emerged as a trump card designed to preserve the current patchwork of private and public insurance and to stop discussion of a government-sponsored single-payer system in its tracks: the claim that single-payer health care — a Canadian-style Medicare-for-all system — is antithetical to “American values.” The idea that American values dictate a particular approach to health care reform is often stated explicitly, and it is implicit in the generalization that “Americans want” a particular system. The underlying premise is that an identifiable set of American values point incontrovertibly to a health care system anchored by the private insurance industry. Remarkably, this premise has received very little scrutiny.

Americans have been misled by the rhetoric about choice. In contrast with the single-payer option, a system with multiple private insurers would continue to restrict one dimension of choice (selection of physicians) and perpetuate a choice most people would consider irrational (wasteful spending on administrative overhead).

A closely related rhetorical device — the idea that Americans or American values are “unique” — also deserves attention… What is relevant is whether a solution works, not whether it is unique. Indeed, the aspect of the current U.S. system that is truly unique among developed countries is its failure to cover everyone — hardly something to brag about.

Policymakers debating health care reform should stop hiding behind the smoke screen of “American values.” Discussions dominated by references to uniquely American individualism, uniquely American solutions, or narrowly defined conceptions of choice tell us more about the political and economic interests of the discussants than about the interests of the Americans they claim to represent. In an increasingly diverse country that has a widening gap between rich and poor, a more promising approach is to start with the questions that matter to everyone: Will the system care for us when we’re sick and help prevent illness when we’re well? Will we have access to medical care throughout our lives without risking financial ruin? Will we be able to navigate the system easily, without jumping through unnecessary hoops or encountering excessive red tape? Will health care spending be managed wisely? Health care reformers owe Americans a system that best addresses these questions — not one that merely pays lip service to ill-defined “American values.”

http://healthcarereform.nejm.org/?p=1245

Click on the link above now. At the bottom of this article you will find another link to the full PDF version (2 pages). Download it now. It will be a very important resource during the August recess when tens of millions of dollars will be spent to keep our thought processes suppressed by the poisonous rhetoric of carefully-crafted nice words – a process that has permeated our national dialogue on health reform. It is ideas, not words, that count.

BREAKING NEWS: Speaker Pelosi promises floor vote on single payer

Posted by on Friday, Jul 31, 2009

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

Liberals will get single-payer vote on House floor

By Mike Soraghan
The Hill
July 31, 2009

Seeking to dampen liberal anger about deals cut with centrists, Energy and Commerce Committee Chairman Henry Waxman (D-Calif.) said House leaders have agreed to allow a floor vote on a government-run, single-payer system.

“A lot of members on our committee want a vote on that,” said Waxman said in an interview. “I believe their wishes will be accommodated.”

Rep. Anthony Weiner (D-N.Y.) offered a single-payer amendment in the Energy and Commerce Committee on Friday, but withdrew it after Waxman said House Speaker Nancy Pelosi (D-Calif.) had promised a floor vote.

http://thehill.com/leading-the-news/liberals-will-get-single-payer-vote-on-house-floor-2009-07-31.html

The Weiner single payer amendment:
http://energycommerce.house.gov/Press_111/20090731/hr3200_weiner_1.pdf

Call out the troops. We have work to do!

President Obama's hardship waivers

Posted by on Thursday, Jul 30, 2009

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

TIME’s Exclusive Interview with President Obama

By Karen Tumulty
TIME
July 29, 2009

Karen Tumulty: But some things have changed. I mean, for instance you were very much against an individual mandate. Could you describe how your thinking has evolved on this issue…

President Obama: I feel pretty good that I’ve been pretty consistent on this. The individual mandate is probably the one area where I basically changed my mind. The more deeply I got into the issue, the more I felt that the dangers of adverse selection justified us creating a system that shares responsibility, as long as we were actually making health insurance affordable and there was a hardship waiver for those who, even with generous subsidies, couldn’t afford it. And that remains my position.

Karen Tumulty: What about — you mentioned that subsidies have to be there. What’s — you’re hearing now — 300% [that the government would provide assistance to people earning up to 300% of poverty]. Is that enough? Is that really –

President Obama: Until I actually see the numbers, I don’t want to give a definitive answer on that. I do think that if we can figure out what is a fair, appropriate percentage of your income that you’re paying on health care, and peg it — peg subsidies so that it’s meeting that test, potentially with some regional variation then we’ll get it right. And I think that the committees are working on that. That’s the kind of detail that we had anticipated working through in conference. If it turns out that Congress just can’t get there and that’s the holdup, then we’ll give a very definitive idea of where we need to go on it.

http://www.time.com/time/politics/article/0,8599,1913410-1,00.html

Detail? Figuring out how to make insurance affordable if it is to protect families from the financial burden of the $16,771 already being spent on average for health care? 300 percent of poverty? 400 percent of poverty?

Play with the numbers all you want. Using the model of reform selected by the President and Congress automatically limits the total subsidies to an amount that will not increase the deficit in the federal budget. Even if the majority of employers continue to displace wage or salary increases in exchange for health benefits, the number of hardship waivers issued will have to be much larger than most are projecting. If employers finally bail out, the majority of us would require hardship waivers.

You don’t believe me? Do the numbers, starting with the amount of money they propose to spend on subsidies.

Steve Burd's magic elixir

Posted by on Wednesday, Jul 29, 2009

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website.

How Safeway Is Cutting Health-Care Costs: Market-based solutions can reduce the national health-care bill by 40%

By Steven A. Burd, CEO of Safeway Inc.
The Wall Street Journal
June 12, 2009

As with most employers, Safeway’s employees pay a portion of their own health care through premiums, co-pays and deductibles. The big difference between Safeway and most employers is that we have pronounced differences in premiums that reflect each covered member’s behaviors. Our plan utilizes a provision in the 1996 Health Insurance Portability and Accountability Act that permits employers to differentiate premiums based on behaviors. Currently we are focused on tobacco usage, healthy weight, blood pressure and cholesterol levels.

Safeway’s Healthy Measures program is completely voluntary and currently covers 74% of the insured nonunion work force. Employees are tested for the four measures cited above and receive premium discounts off a “base level” premium for each test they pass. Data is collected by outside parties and not shared with company management. If they pass all four tests, annual premiums are reduced $780 for individuals and $1,560 for families.

During this four-year period, we have kept our per capita health-care costs flat (that includes both the employee and the employer portion), while most American companies’ costs have increased 38% over the same four years.

While comprehensive health-care reform needs to address a number of other key issues, we believe that personal responsibility and financial incentives are the path to a healthier America. By our calculation, if the nation had adopted our approach in 2005, the nation’s direct health-care bill would be $550 billion less than it is today.

http://online.wsj.com/article/SB124476804026308603.html

And…

Preventive health plan may prevent cost increases

By Victoria Colliver
San Francisco Chronicle
February 11, 2007

Safeway chief executive Steve Burd has turned into an evangelist of sorts, spreading the lower-cost, better-health gospel to other business executives around the country.

Starting in January 2006, Safeway began offering a new plan to its 30,000 nonunion employees.

The plan, administered by Cigna Corp., is the lowest-premium option for nonunion employees, but it comes with a high deductible. To encourage enrollment, Safeway offered the plan last year for 22 to 30 percent less than what employees were paying for Cigna’s preferred provider organization option.

The company said its program focuses more on rewards for good behavior than penalties for bad. For example, smokers who agreed to fill out the questionnaire and try to quit smoking saw no increase in their 2007 premiums.

Virtually all the savings generated in the program’s first year came from changing the plan design, Burd said. But even if the company manages to keep spending flat, Burd noted, Safeway will remain ahead of the trend.

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/02/11/BUG02O20R81.DTL

And…

Mr. Burd Goes to Washington

By Kimberley A. Strassel
The Wall Street Journal
June 19, 2009

Mr. Burd explains that the “cure for today’s ills is simply removing the obstacles to a free health-care market.”

The Safeway plan has two main parts that work in tandem. The first involves giving employees a financial stake in the system. Safeway demolished the traditional PPOs and HMOs that encourage consumers to be cavalier about costs. The company deposits $1,000 each year into a “health reimbursement account,” which workers can use to pay for care. The next $1,000 in expenses is the employee’s responsibility. After that, employees pay 20% of costs up to a $4,000 maximum.

The second part of Safeway’s plan… Safeway’s “Healthy Measures” program, which is voluntary. Employees are tested for smoking, weight, blood pressure and cholesterol. Every area they “pass” results in a reduction in their premium, of as much as $1,560 for a family, a year.

When I ask Mr. Burd what he hopes to accomplish here, he is blunt that one goal is to prevent a “public option” that would only “piggyback on the experience of Medicare.” It’s a “Trojan Horse” that will steer people to government and ultimately squeeze out innovative programs like his.

He’s also working to ensure that any health-care bill contains provisions that would replicate or encourage Safeway’s success. That includes changing current law so that he can offer even steeper premium discounts for good behavior.

http://online.wsj.com/article/SB124536722522229323.html

And…

Just Rewards? Healthy Workers Might Get Bigger Insurance Breaks

By Mary Agnes Carey
Kaiser Health News
July 28, 2009

The discounts are being pushed by Steve Burd, the chief executive officer of Safeway Inc., who has met with several lawmakers on Capitol Hill and says that rewarding healthy behavior has helped keep his firm’s health care costs flat while other companies’ have skyrocketed.

Health care overhaul legislation passed by the Senate Health, Education, Labor and Pensions Committee would allow employers to increase those discounts to 30 percent and up to 50 percent if the secretaries of Labor, Health and Human Services and Treasury agree. A House proposal would allow employers to charge workers who participate in wellness programs 50 percent less than workers who don’t.

“If you give one person a discount, someone else is going to end up paying more,” said Paul Cotton, senior legislative representative, federal affairs, at AARP, one of more than 60 groups that’s fighting the provision. “So the people who aren’t able to change their behavior or participate in the program will end up paying more. Our fear is that premiums will become unaffordable for people who can’t change their behavior.”

By Safeway’s calculations, “if the nation had adopted our approach in 2005, the nation’s direct health-care bill would be $550 billion less than it is today,” Burd wrote in a June 12 op-ed in the Wall Street Journal. Critics of Burd’s data have said (that) has not been independently verified. A Safeway spokeswoman acknowledged that there has been no independent analysis, but “we were able to see savings clearly and immediately the first year we implemented the program.”

http://www.kaiserhealthnews.org/Stories/2009/July/28/Prevention.aspx

Safeway’s Steve Burd has been making the rounds in Washington and elsewhere claiming that his program would reduce our national health care bill by $550 billion, even though there is absolutely no verification of that.

So what is his program? It has two parts: 1) changing from traditional coverage to a high deductible plan with 20 percent coinsurance, and 2) premium reductions for better health.

Changing to consumer-directed high-deductible plans, with coinsurance replacing copays, reduces the amount that Safeway pays for its health benefit programs, but it does so by shifting more costs to the employees in out-of-pocket expenses, and by reducing the amount of health care received, no matter how beneficial. Since most health care spending is not subject to the negative impact of deductibles, the impact on our total national health spending would be negligible. So where is the $550 billion savings?

Reducing premiums for healthier employees automatically results in higher premiums for employees with health problems who are in the same risk pool. Hypertension, hypercholesterolemia, and a higher body mass index are problems that are much more complex than simple lifestyle choices. Health insurance is already unaffordable for the majority of us, and pushing premiums higher for those who have have greater health care needs is unsound policy, assuming that our goal is affordable health care for everyone.

Even if financial incentives were capable of reversing hypertension, hypercholesterolemia, and obesity, it would take many years – decades – to see a benefit in the form of lower national health care spending. Steve Burd’s claim that he has dramatically reduced costs in just a couple of years by shifting more out-of-pocket expenses to the less healthy employees is a crock!

Let’s say it like it is. When Steve Burd says that his program would save the nation $550 billion, he is lying. And he needs to be called on it.

His primary goal is to convince Congress that it needs to block the public option. The Senate Finance Committee decided this week that the reform bill will exclude the public option. Score one for Burd.

His other goal is to take care of his lower-cost healthy employees while punishing those with health care problems. Both the Senate HELP bill and the House Tri-Committee bill would shift even more of the premiums from the healthy to those with health problems than has Burd with his Safeway program. Score two for Burd!

It’s seems like a waste of time to even talk about Burd’s dishonest bull. But we have to, because Congress is converting his bull into our policy. At the same time, Congress is pushing aside the policies that would enable all of us to have affordable access to health care.

I only wish my anger were more contagious. The nation needs a massive epidemic of anger right now.

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