by Austin Frakt
The Incidental Economist Blog
October 5, 2009

A recent Business Week article summarized an argument against a public option that is based on the unfounded claims of cost shifting made by insurers and hospitals. In it Jane Sasseen and Catherine Arnst write

Proponents add that government competition would force private insurers to lower premiums, making coverage more affordable for all.

But the business community keeps cranking out studies undercutting such arguments. The insurance industry trade group, America’s Health Insurance Plans (AHIP), compared the lower reimbursement rates for health care paid by public programs vs. private payers. The group claimed the difference reflects cost shifting, which added an estimated $1,512 to the average premiums paid by a family of four. “The existence of the private sector allows that shift,” says Karen Ignagni, the head of AHIP. “If you clamp down on one side of a balloon, the other side just gets bigger.”

Ignagni’s balloon analogy is a false one, and AHIP’s cost shifting argument is faulty. It is based on a study that misapplies the term “cost shift” to price differentials.

Continue reading at: http://theincidentaleconomist.com/price-differentials-are-not-evidence-of-cost-shifting/

By Billy Zou
The Dartmouth
Monday, October 5, 2009

For those who have been living outside the U.S. or in a cave, two health care reform bills have been proposed to universalize the American health care system. One, H.R. 3200, proposes a public health insurance plan or “public option,” while the other, H.R. 676, would create a single-payer system that would cover all medically essential care.

The Senate rejected the public option plan last Tuesday, and the forecast is gloomy for proposals of bolder changes.

There’s been a lot of “debate” surrounding the reform. With all the news stories of inflammatory protests at town halls, I suspect that there’s something more than Godwin’s Law at work in political forums across the country.

It’s obvious that private insurance companies do not want a single-payer system that would marginalize their role to providing supplemental care, or a public option that would provide competition and potentially drive down premiums.

What I am interested in, however, is not the kaleidoscopic advantages that a universal public health insurance system would provide: reduced administrative costs, more patients seeking preventative measures — which save costs in the long run — and pharmaceutical research focused on developing drugs that reap the most social benefits rather than the largest profit, for example.

According to a report by the Organisation for Economic Co-operation and Development, one reason single-payer Canada spent $3,895 per capita on health care in 2007 while the U.S. spent $7,290 — with arguably inferior outcomes and 16 percent of the population uninsured — is Canada’s reduced administrative costs.

I am interested, on the other hand, in how seriously Americans take their Declaration of Independence, which states that they have certain inalienable rights, and that among them are “Life, Liberty and the pursuit of Happiness.”

If this is the case, isn’t government justified in — nay, obligated to — protect these rights?

The question then becomes whether health care is really a human right. There are those who argue that it is not, claiming that one only has the right to seek health care, not demand that others provide it. To them I say, is it not an American right to demand protection from foreign armies? Is it not a right to demand that our water be potable, our food edible and our media credible? (OK, not the last one.)

Food need not be a public good because it is inexpensive and easily obtained. This is not the case with some the most essential medical care, which may be very expensive and unaffordable to a large slice of the population.

To have a serious illness go untreated is to be deprived of the hope of pursuing happiness, if not at some point life (according to the American Journal of Public Health, 44,800 die in the U.S. each year simply from lack of coverage).

Indeed, according to an article on the science new web site, Science Daily, a global study on Satisfaction with Life conducted at the University of Leicester found that happiness correlated with health more strongly than any other measure.

The pragmatist in me realizes that a single-payer system isn’t happening in America any time soon.

Nevertheless, if the access to necessary health care is an inalienable right, then it is something that should not be handed out by private insurance companies that would prefer to turn away patients in order to maximize profit.

Instead, providing health care should be the responsibility of the government. The sole purpose of its existence is to protect the rights of those who have to live in this country.

By Colin Moynihan
New York Times
City Room Blog
September 29, 2009

Right-wing and antigovernment activists — a few of them wielding not only signs but even loaded firearms — have organized some of the angry protests surrounding the health care debate. But in Midtown Manhattan on Tuesday morning, a different sort of health care protest took place, led by left-leaning groups who accused insurers of greed and called for nationwide, single-payer health insurance.

The police said that 17 people were arrested after refusing to leave the lobby of an office building on Park Avenue where the insurance company Aetna has offices. They were charged with criminal trespass. In addition, the police said, three of those arrested were charged with obstructing governmental administration.

Organizers said it was the first step of a national campaign meant to publicize their views and challenge claims made by right-wing radio hosts and Republican officials.

“The myths about government death panels are pure hysteria,” an organizer, Mark Milano, said on Park Avenue. “The real death panels are people who are paid by insurance companies to deny health care to patients.”

About 50 people arrived at the building, at Park Avenue and 40th Street, at 10 a.m., participants said, and sent a representative to the Aetna offices upstairs to demand that the company agree to immediately approve “lifesaving” health care requests made by doctors. When that person was turned away, organizers said, 16 protesters entered the lobby of the building and sat on the floor.

Soon the police arrived and a senior officer used a bullhorn to inform those in the lobby that they were breaking the law and subject to arrest. By 10:45, officers could be seen removing the last of the demonstrators and ushering them into the back of police vans.

A spokeswoman for Aetna, Cynthia Michener, said that no protester visited the company’s office on Tuesday.

“Aetna has been actively engaged in health reform,” she wrote in an e-mail message. “When you put yourself out there like we have on this issue, you make yourself a target. But there is more agreement than disagreement on the need to get reform done. It is important we work together to make health care reform a reality this year.”

Ms. Michener added:

Broadly, Aetna ‘s goals are to get everyone covered, improve the quality of health outcomes and provide better value for each dollar spent on care. We’re committed to guaranteed coverage without regard to pre-existing conditions along with an individual requirement to get everyone in the system and subsidies for those who can’t afford it.

Outside, a crowd chanted “patients not profits” and said that large insurers routinely made decisions on what sorts of treatment to cover based more on cost than medical necessity.

“This is very much a dignified, nonviolent response to what some people call the howler movement that erupted in August,” said Katie Robbins, part of an advocacy group called Healthcare Now.

There has been a backlash from some quarters against Mr. Obama’s support for a public insurance plan that would compete with private insurers.

Ms. Robbins advocates on behalf of a bill before the House of Representatives that would, essentially, expand Medicare to cover all citizens. She said organizers from several groups across the country, with networks in 40 states, had been working together for about six weeks on a campaign they called Mobilization for Healthcare for All.

The groups have organized using a Web site and Twitter. So far, organizers said, 300 people have signed up to take part in additional protests using civil disobedience and aimed at insurance companies that are being planned for October, while legislators are expected to be working on health care issues.

“We’re going to be in Chicago next week and L.A. the week after that,” Ms. Robbins said. “We’re timing this around the legislative efforts of Congress.”

Video:

http://www.youtube.com/watch?v=gqP8bEyFRAo

http://cityroom.blogs.nytimes.com/2009/09/29/17-held-in-protest-outside-health-insurers-offices/

by Private Health Insurance Must Go!
September 30, 2009

19 citizens and health care providers arrested, launching national mobilization for health care for all

29 September 2009, New York, NY — Citizens and health care providers today staged a sit-in at the offices of Aetna, one of the nation’s largest health insurance companies, in New York City (99 Park Ave @40th. The action is part of a national mobilization to end health insurance abuses such as the denial of coverage for lifesaving treatments, and win support for the only real public option — Medicare for all, a single payer plan. The action was part of a Mobilization for Health Care for All campaign that includes actions in Chicago, Los Angeles, and other cities across the country.

The 19 participants, wearing T-shirts with slogans that read “Medicare for All” and chanting “patients, not profits!” linked arms and sat down in the lobby of the Aetna building, prompting Aetna employees to step around them on their way into their offices, where insurance claim reviewers are busy looking for ways to deny people the lifesaving treatment that they need. A crowd of supporters picketing outside the building held signs that said “Aetna is the real death panel,” and “Single payer now.”

Participants in the action demanded that the insurance company immediately approve all doctor-recommended lifesaving treatments in their files, stating that they would not leave until Aetna approved care. Aetna, however, refused to meet with their representative.

“Insurance companies are denying care to people who need it right and left, but that’s not how it should work. Health care is a right, not a privilege,” said Constancia ‘Dinky’ Romily, 68, just before getting arrested. Romily is a retired nurse and a resident of East Village, New York. “I’m putting myself on the line and getting arrested to end insurance abuse and win health care for all,” she says.

The sit-in is part of the Patients Not Profit campaign of the Mobilization for Health Care for All. The mobilization was launched by the organizations Prosperity Agenda, Health Care NOW!, and the Center for the Working Poor. Today’s action has been organized by the Private Health Insurance Must Go! coalition, a local New York organization.

“People are dying because these corporations put profits before patients, and the health care bill currently on the floor of Congress fails to address the real cause of the health care crisis — the insurance companies,” says Katie Robbins, an organizer with Healthcare-Now! “The only solution to our health care crisis is the real public option, Medicare for All, a single payer plan.”

Laurie Wen, 38, a Manhattan resident, is one of the everyday Americans who are fed up with the state of health care in our country, and was arrested today to stand up for the hundreds of Americans who are denied lifesaving care every day, and to call for the only solution for health care for all, Medicare for all. A friend of hers, she says, was recently denied by Aetna for coverage for a bone marrow transfusion to treat cancer for three months, setting his care back for three months.

“We will continue to stage these sit-ins as Congress debates legislation that expands the insurance company stranglehold over our health, our lives, and our government,” says Wen. “We need a better system to end insurance abuse and win health care for all.”

The Private Health Insurance Must Go! Coalition (PHIMGC) is a growing and diverse New York City-based non-partisan organization focused on education, legislative advocacy and direct action in the fight for single-payer healthcare reform and HR 676.