By Donna Smith
MichaelMoore.com, July 29, 2012
Has your insurance company called you recently to ask you to sign up for a wellness or disease management program? Has that same company told you it’s a free service to policyholders and promised you that they do not share the information with the departments and people who administer your benefits and claims? You – like me and millions of other Americans – are being scammed.
Follow the money, my friends, and do not believe for one minute that the same company that would deny medications, health treatments and care to you would suddenly have your best interests at heart. It’s the money. It’s always been the money.
As soon as the Patient Protection and Affordable Care Act (PPACA) was passed, we were all told that finally the insurance companies would have to spend more of the premium dollars they collect on actual health care. Look it up here for the nitty-gritty.
In short, The Kaiser Family Foundation writes, “The provision requires most insurance companies that cover individuals and small businesses to spend at least 80 percent of their premium dollars on health care (i.e. medical claims) and quality improvement, leaving no more than 20 percent for administration, marketing, and profit. Large group plans must spend at least 85 percent of premium dollars on health care. Insurers failing to meet these standards will have to pay rebates to consumers beginning later this year.”
And those rebate checks some policyholders are getting are also attributable to this provision of the Affordable Care Act. Sounds great, eh? What’s not to like about making the for-profit insurance companies spend more on actual health care or give us some money back?
What’s not to like is that never doubt for one instant that the for-profit insurance companies have found ways to subvert that well-intentioned – or at least well-scripted – nod to more accountability. Insurance companies like to make money – it is what they are for and what they are all about.
Health insurance is not health care. Health insurance is a financial product sold to you and to me to protect our health and our wealth which may well do neither thing. Health insurance companies do not exist to make you healthy but to make their stockholders wealthy. If you think otherwise, you are not understanding the fundamentals of corporate life or the laws governing what corporate CEOs are to do for their primary customers – their shareholders.
So, if required to provide more actual care that might reduce actual profits, what’s a good health insurance executive to do? Well, go to work changing what qualifies as actual health care under the new rules and then find ways to make even more money by providing that while denying more real health care services. And that’s exactly what is being done to you and to me.
Wellness and disease management programs now qualify under the ACA as part of what insurance companies can call “medical loss” for purposes of meeting the criteria required to be spent on health care. Having that nurse or other insurance company employee call you and me monthly and recount which medications we take and for what conditions and then set an appointment to do it again every month is considered spending on health care. That’s right.
Just last week, on the same day my insurance company, Aetna, was denying medications ordered by my doctor during the diagnostic and early care phases of my latest cancer journey, I was being absolutely dogged by the Aetna Connection folks (their wellness and disease management plan) wanting me to reconnect with the nurse who “needs” to engage with me on a monthly basis. Imagine, on one call I am begging Aetna to approve a medication needed to help me and relieve gut pain while on another call, I am telling the front person for Aetna Connection that I really don’t care about setting a new appointment with the wellness plan while Aetna is denying my care. I even told the caller I was groggy from the general anesthetic and that I couldn’t talk because of a sore throat from the intubation tube and that I hoped they’d call back another time when I could think more clearly, but she didn’t care. Like a collector of a very serious debt of some kind, she needed to get me assigned to a call date.
Imagine how many millions, if not billions, of dollars Aetna and every other insurer can now claim are being spent on health care through these programs. And imagine then how they will be actually able to deny real health care services when those millions spent on non-care figure into the totals they are required to spend on the new law.
We are screwed. At least I know I am. Aetna didn’t care for one moment if I got through this weekend in pain or was able to eat or rest comfortably. Aetna did care if I stayed in the Aetna Connection program. So, beware, fellow Americans. There is big money at stake in our health care system until it is changed to a more sane and honest system that values human life over cash. We need an improved and expanded Medicare for all for life system that cannot be gamed for profit.
Right now, we are still just part of the profit base for large health insurance companies and other health care corporations. We are not patients. Not yet. Follow the money.
Donna Smith, American SiCKO, is a national single-payer health care advocate and community organizer with the California Nurses Association/National Nurses Organizing Committee.
http://www.michaelmoore.com/words/mike-friends-blog/insurance-companies-gaming-system-dont-be-fooled
Republicans dismiss the uninsured, but what about the Democrats?
GOP Says Coverage For The Uninsured Is No Longer The Priority
By Julie Rovner
NPR, July 27, 2012
For decades, the primary goal of those who would fix the U.S. health system has been to help people without insurance get coverage. Now, it seems, all that may be changing. At least some top Republicans are trying to steer the health debate away from the problem of the uninsured.
Take this exchange between Fox News Sunday host Chris Wallace and Senate Minority Leader Mitch McConnell (R-Ky.) earlier this month, just after the Supreme Court upheld most of President Obama’s health law.
Wallace: “What specifically are you going to do to provide universal coverage to the 30 million people who are uninsured?”
McConnell: “That is not the issue. … The question is how can you go step by step to improve the American health care system? It is already the finest health care system in the world.”
But McConnell isn’t the only top Republican saying covering the uninsured should no longer be the top priority.
“Conservatives cannot allow themselves to be browbeaten by failing to provide the same coverage numbers as Obamacare,” Sen. Orrin Hatch, R-Utah, told a conference at the conservative American Enterprise Institute. “To be clear, it is a disgrace that so many American families go without health insurance coverage. But we cannot succumb to the pressure to argue on the left’s terms.”
“Every once in a while, the Republicans have rare moments of honesty. And so when they say that they don’t want to expand coverage, this is one of those rare moments,” says Ethan Rome, who runs Health Care for America Now, an advocacy group working to promote and defend the health care law.
“They look around and they see middle-class families and others in need, and what do they want to do? They want to give tax breaks to the super rich,” he says. “That’s who they are and what they do. And I think that’s why they’re starting to talk about how they don’t want to expand coverage. Because they at least want to be truthful about a couple of things. And those are the ways in which they want to abandon certain populations and be frank about it.”
Comment:
By Don McCanne, MD
So the Republicans contend that the problem of the uninsured “is not the issue,” but the Democrats have enacted a program that pretends to provide universal coverage when they are leaving 30 million uninsured. Who is being honest here?
Because the issue of national health insurance has been associated with liberal/progressive politicians, some have mistakenly assumed that Physicians for a National Health Program (PNHP) has aligned itself with the Democratic Party. This is a non sequitur.
PNHP is a 501(c)3 organization, and, as such, does not support any political candidate nor any political party.
More importantly, PNHP is a single issue organization, exclusively supporting a single payer national health program – an improved Medicare for all. Neither the Democratic Party nor the Republican Party supports single payer.
During the political season, it is tempting for single payer supporters to select a party that might be more open to single payer, and then to support candidates of that party in the election. But top down doesn’t work, as those who supported the Democrats can now see. The top rejected single payer.
We need a bottom up approach by joining together in coalitions, by educating the public, and by promoting grassroots efforts to bring a loud and clear single payer message to all would-be politicians, regardless of political affiliation. As individuals, we can support candidates that lead on the single payer issue, but as an organization, PNHP will lead on policy, not politics.
Happy birthday Medicare: Now, let's expand it to everyone
By William M. Fogarty Jr., M.D.
St. Louis Post-Dispatch, Letters, July 30, 2012
Today Medicare celebrates its 47th birthday. The system has served our elderly and disabled citizens well and could be a vehicle to serve all Americans. In a recent article published by the Commonwealth Fund, satisfaction with coverage, quality of care, access and out-of-pocket expenses was far greater for Medicare beneficiaries than those of the group or individual insurance markets. If Medicare were expanded to cover all Americans, some $400 billion now lost to administrative overhead and insurance company profits could be saved annually. Those savings could cover the 50 million people who lack coverage at present or the 25 million who will remain uncovered under the Patient Protection and Affordable Care Act.
As a physician who practiced under Medicare for 30 years and has been a beneficiary for 12 years, I can assure you that dealing with Medicare is far less stressful and wasteful of time and effort than any insurance company.
Efforts to turn Medicare over to private insurance companies are being made. Why would it make sense to convert an efficient system with high satisfaction to one with higher costs and lower performance? Medicare isn’t perfect, but with some improvements it could be made available to all at far lower cost and with significant improvements in quality and patient satisfaction.
Happy birthday, Medicare. I hope that all Americans will soon have the opportunity to choose “Medicare for all.”
Dr. William M. Fogarty Jr. is a member, member, Leadership Committee, Physicians for a National Health Program-St. Louis. He resides in Webster Groves, Mo.
Happy birthday Medicare: Now, let’s expand it to everyone
By William M. Fogarty Jr., M.D.
St. Louis Post-Dispatch, Letters, July 30, 2012
Today Medicare celebrates its 47th birthday. The system has served our elderly and disabled citizens well and could be a vehicle to serve all Americans. In a recent article published by the Commonwealth Fund, satisfaction with coverage, quality of care, access and out-of-pocket expenses was far greater for Medicare beneficiaries than those of the group or individual insurance markets. If Medicare were expanded to cover all Americans, some $400 billion now lost to administrative overhead and insurance company profits could be saved annually. Those savings could cover the 50 million people who lack coverage at present or the 25 million who will remain uncovered under the Patient Protection and Affordable Care Act.
As a physician who practiced under Medicare for 30 years and has been a beneficiary for 12 years, I can assure you that dealing with Medicare is far less stressful and wasteful of time and effort than any insurance company.
Efforts to turn Medicare over to private insurance companies are being made. Why would it make sense to convert an efficient system with high satisfaction to one with higher costs and lower performance? Medicare isn’t perfect, but with some improvements it could be made available to all at far lower cost and with significant improvements in quality and patient satisfaction.
Happy birthday, Medicare. I hope that all Americans will soon have the opportunity to choose “Medicare for all.”
Dr. William M. Fogarty Jr. is a member, member, Leadership Committee, Physicians for a National Health Program-St. Louis. He resides in Webster Groves, Mo.
Happy birthday to Medicare
By Margaret A. Nosek
Houston Chronicle, July 30, 2012
With all the commotion surrounding the Supreme Court and the Affordable Care Act (ACA), it would be easy to overlook an important birthday: Today is the 47th anniversary of Medicare, the public health insurance program that covers our nation’s seniors and people with severe disabilities.
It’s a birthday that deserves to be celebrated, including here in the Lone Star State. Medicare provides 48 million Americans — about 3 million of them in Texas — with reasonably good access to health care, thereby easing their suffering, prolonging their lives, and reducing financial pressures on them and their families. Before Medicare was enacted in 1965, most retired older people were at risk of financial ruin when they got sick. Medicare changed that picture, and our state and nation are much better for it.
The Medicare program is not perfect, of course. It has burdensome co-pays and deductibles, and its benefits could be better. But it remains immensely popular, and it’s not hard to figure out why. A new study in the journal Health Affairs found that “Medicare beneficiaries age 65 and older are more satisfied with their health insurance, have better access to care, and are less likely to have problems paying medical bills than working-age adults who get insurance through employers or purchase coverage on their own.”
Keep that in mind the next time you hear a politician or pundit argue that the Medicare program should be converted to a private voucher program, where seniors would get a flat amount to buy a health policy from a commercial insurance company. Such schemes are lucrative for the big private insurers but would be bad for most seniors, leaving them with inferior and progressively deteriorating coverage.
The pretext for privatizing Medicare is the claim that it is financially unsustainable. While it’s true the program faces big financial challenges, it’s more of a victim than a cause of skyrocketing health costs. Privatizing the program would only make matters worse as the insurers, notorious for their inability to control costs, would skim more premium dollars off the top.
Yes, there are some partial, short-term solutions. For example, Congress could tweak the payroll tax by a fraction of a percentage point to make Medicare’s reserves flush again. Or lawmakers could give Medicare the power to negotiate lower drug prices, something the ACA currently prohibits.
Ironically, the best way to save Medicare is to improve and expand it to cover everybody. By establishing an improved Medicare for all, a single-payer health-care financing system, we could recoup about $400 billion that is wasted each year on unnecessary, private-insurance-related profits, paperwork and bureaucracy. That’s enough money to provide health care to everyone in the U.S. with no co-pays or deductibles and without spending a penny more than we do now.
We would also acquire other cost-control tools like the market clout needed to negotiate lower prices for medical supplies, and the ability to set global budgets for hospitals.
This type of system would bring back free choice of doctor and hospital – the one thing everyone agrees is among the top goals of health-care reform.
Polls show an improved-Medicare-for-all approach enjoys the support of about two-thirds of the public and more than half of all physicians. Yet up to now, this commonsense solution has been blocked by private insurers, pharmaceutical companies and their allies in Congress.
On Medicare’s anniversary, what do you say we give them a run for their money? Tell your elected officials the ACA doesn’t go far enough. Cut the private insurers out of the picture. We need an improved and expanded Medicare for all.
Nosek is a professor in the Department of Physical Medicine and Rehabilitation at Baylor College of Medicine and president of Health Care for All Texas.
http://www.chron.com/opinion/outlook/article/Happy-birthday-to-Medicare-3741814.php
Improve Medicare to help address health care system
By Raymond Feierabend, M.D.
Bristol (Va.) Herald Courier, Letters, July 29, 2012
“There will always be a need” reads the headline of the recent Bristol Herald Courier article reporting that about 3,000 people were expected to seek medical and dental care at the Wise RAM [Remote Area Medical] event. In that report, Teresa Gardner, one of the organizers of the event, is quoted as saying “our success is really a failure on the health care system, that we see that many patients.”
In an important study just published in the journal Health Affairs, researchers from The Commonwealth Fund found that, compared with working-age adults who are insured through their employers or who purchase health insurance on their own, Medicare beneficiaries 1) are more satisfied with their health insurance, 2) have better access to medical care, and 3) are less likely to have difficulty paying their medical bills. In addition, those enrolled in traditional Medicare are more satisfied with their coverage than those enrolled in Medicare Advantage plans.
In a recent opinion piece published in the Des Moines Register, Jack Bernard, a (Republican) member of the Jasper County Georgia Board of Commissioners and the Jasper County Board of Health, tells his fellow Republicans that if they really want to abandon “Obamacare” they should embrace “Medicare for all.” After providing his cogent reasoning for why this makes most sense for the country, he argues that doing so would put Republicans in the vanguard of reform, and that not doing so is simply putting their heads in the sand.
Isn’t it time that we stop putting our collective heads in the sand? We need to look seriously at improving our current Medicare system and making it available to all Americans as the way to address our failed health care system.
Dr. Raymond Feierabend resides in Bristol.
Republicans dismiss the uninsured, but what about the Democrats?
GOP Says Coverage For The Uninsured Is No Longer The Priority
By Julie Rovner
NPR, July 27, 2012
For decades, the primary goal of those who would fix the U.S. health system has been to help people without insurance get coverage. Now, it seems, all that may be changing. At least some top Republicans are trying to steer the health debate away from the problem of the uninsured.
Take this exchange between Fox News Sunday host Chris Wallace and Senate Minority Leader Mitch McConnell (R-Ky.) earlier this month, just after the Supreme Court upheld most of President Obama’s health law.
Wallace: “What specifically are you going to do to provide universal coverage to the 30 million people who are uninsured?”
McConnell: “That is not the issue. … The question is how can you go step by step to improve the American health care system? It is already the finest health care system in the world.”
But McConnell isn’t the only top Republican saying covering the uninsured should no longer be the top priority.
“Conservatives cannot allow themselves to be browbeaten by failing to provide the same coverage numbers as Obamacare,” Sen. Orrin Hatch, R-Utah, told a conference at the conservative American Enterprise Institute. “To be clear, it is a disgrace that so many American families go without health insurance coverage. But we cannot succumb to the pressure to argue on the left’s terms.”
“Every once in a while, the Republicans have rare moments of honesty. And so when they say that they don’t want to expand coverage, this is one of those rare moments,” says Ethan Rome, who runs Health Care for America Now, an advocacy group working to promote and defend the health care law.
“They look around and they see middle-class families and others in need, and what do they want to do? They want to give tax breaks to the super rich,” he says. “That’s who they are and what they do. And I think that’s why they’re starting to talk about how they don’t want to expand coverage. Because they at least want to be truthful about a couple of things. And those are the ways in which they want to abandon certain populations and be frank about it.”
http://www.npr.org/blogs/health/2012/07/27/157439331/gop-says-coverage-for-the-uninsured-is-no-longer-the-priority
So the Republicans contend that the problem of the uninsured “is not the issue,” but the Democrats have enacted a program that pretends to provide universal coverage when they are leaving 30 million uninsured. Who is being honest here?
Because the issue of national health insurance has been associated with liberal/progressive politicians, some have mistakenly assumed that Physicians for a National Health Program (PNHP) has aligned itself with the Democratic Party. This is a non sequitur.
PNHP is a 501(c)3 organization, and, as such, does not support any political candidate nor any political party.
More importantly, PNHP is a single issue organization, exclusively supporting a single payer national health program – an improved Medicare for all. Neither the Democratic Party nor the Republican Party supports single payer.
During the political season, it is tempting for single payer supporters to select a party that might be more open to single payer, and then to support candidates of that party in the election. But top down doesn’t work, as those who supported the Democrats can now see. The top rejected single payer.
We need a bottom up approach by joining together in coalitions, by educating the public, and by promoting grassroots efforts to bring a loud and clear single payer message to all would-be politicians, regardless of political affiliation. As individuals, we can support candidates that lead on the single payer issue, but as an organization, PNHP will lead on policy, not politics.
Medicare’s birthday: Open letter to the president and leadership
It’s Our Economy, July 29, 2012
This Open Letter was published to honor Medicare’s 47th birthday. It comes on the heels of the Supreme Court upholding the Affordable Care Act and increasing threats to Medicaid and Medicare. The letter argues for the expansion of Medicare to all people in the United States and sees Medicare as the solution, not the problem.
Open Letter to the President and Leadership from Health Professionals, Lawyers and Advocates for Medicare for All
July 30, 2012
Dear Mr. President, Secretary Sebelius, Majority Leaders Reid and Cantor, Speaker Boehner and Minority Leaders McConnell and Pelosi,
We write to you on the occasion of Medicare’s 47th birthday to share our deep concern about increasing threats to both Medicare and Medicaid and to urge the immediate expansion of Medicare to everyone in the United States followed by its improvement. The implementation of the Affordable Care Act is not the solution; when it is fully implemented tens of millions will be left without insurance, tens of millions more will be left without adequate insurance and the cost of health care will continue to skyrocket. Forty-seven years of experience proves that Medicare is not the problem, but is the solution to the health care crisis in America.
For many of the most vulnerable among us, Medicare and Medicaid are their last protection from financial and medical catastrophe. Unfortunately, these vulnerable patients are not represented in health policy discussions. Instead, policy is dictated by special interests profiting from our health care system, not by those depending upon it to stay alive.
We call upon you to end the partisan and corporate influences that replace the best medical interests of our patients with the financial interests of those whose primary need and goal is to maximize profit, not to promote prevention and assure patient care.
Health care costs more in America than it does anywhere else in the world. Among the industrialized nations, we rank at or near the bottom on almost every measure of public health. Millions of us have limited or no access to health care, resulting in tens of thousands of unnecessary deaths and hundreds of thousands of family bankruptcies; these consequences are not found in other industrialized nations. Our country is heading in the wrong direction. We need immediate action.
We need a health care system that provides access to every one of us, no matter how sick, poor, old, or unemployed we may be. We need reduced costs. We need improved health for all people in the United States, not just the most fortunate.
The recent Supreme Court decision on the Affordable Care Act unhappily codifies into law an approach that fails to meet any of these health care needs:
• At its best, the ACA will leave 30 million Americans without health coverage. Another 40 million will be under-insured and therefore at risk for financial catastrophe or death when they get sick. Both numbers will increase as states opt out of the Medicaid expansion.
• With no restriction on prices charged by insurance companies, many people will find even the lowest tier policies unaffordable. Others will be unable to afford deductibles, and with that unable to afford necessary care. And still more will be bankrupted by out-of-pocket expenses when they get sick.
• As Medicare spending decreases, out of pocket expenses will rise. Patients will be compelled to defer health care until they are desperately ill, further eroding public health in America.
• The ACA will not slow the soaring costs of American health care. These costs exact a terrible toll on our economy. Small businesses struggle to survive if they choose to provide benefits to their employees. Large businesses cannot compete in international markets. Entrepreneurs refuse to start new businesses for fear their families will lack access to health care.
Instead of relieving our families and businesses from higher costs and diminishing access, the ACA entrenches the worst aspects of our health care system:
• Private health insurance companies are enshrined as the only portal through which most patients can access health care. We already know that because of the current system of more than a thousand insurance plans, the associated administrative waste consumes 31% of total health care spending. If this administrative loss were invested in health care, we could provide comprehensive care to every person with no additional funding.
• The ACA reduces Medicare costs by paying providers less, a tactic encouraging providers to avoid Medicare patients.
• The Supreme Court decision on the ACA allows states to cut Medicaid enrollment and services without penalty, leaving millions of Americans with inadequate or no access to care.
• The ACA encourages continuation of inhumane cost-shifting to patients in the form of compulsory purchase of expensive policies, higher deductibles, and higher co-pays.
• Millions of people will remain dependent upon employer-sponsored private insurance for health care access, continuing the pattern of labor-management negotiations becoming battlegrounds.
America needs cost-effective universal health care as exists in every other industrialized country. No other nation uses our unique private insurance system which penalizes the sick by charging them more, by reducing their benefits, or by denying care altogether. None allow private insurance companies to place profit over coverage. All of them encourage health care by reducing or eliminating deductibles and co-pays. And all of them provide better care to more people for less money than we do.
Instead of greater privatization of our health care system, we implore you to immediately extend Medicare, our cherished national public insurance, to every person in the United States and then work to improve it. Making Medicare universal would:
• Insure health care access to every American regardless of health, wealth, age, or employment.
• Create the opportunity to fund health care with progressive taxes designed to spare struggling families and small businesses.
• Reduce costs of health care by eliminating the extraordinary and unnecessary administrative waste generated by the private health insurance industry.
• Increase the financial health of our families by sparing them the specter of bankruptcy if any member should have a serious accident or illness.
• Eliminate labor-management disputes over health care benefits.
• Reduce fraud by using consistent forms throughout the country.
• Allow patients to choose their physicians, rather than having insurance companies choose for them.
Medicare needs improvement to provide these benefits. An improved Medicare program should:
• Include every person in the United States, giving them all equal access and benefits.
• Cover all necessary medical, dental, vision, mental health and long-term care with little or no patient cost-sharing.
• Negotiate fair prices for pharmaceuticals, medical devices and health services.
• Remove for-profit health facilities.
• Create an appointed board of patients and health professionals to determine benefits and payments based on need and evidence, not on politics.
• Assure guaranteed access to health care for all communities by defining global operating budgets for health facilities with separate capital budgets to facilitate better health planning.
America’s multi-decade experiment with market-driven care which emphasizes protection of for-profit industries has devastated our families, crippled our businesses, smothered our economy, and stolen our health. The ACA is a continuation of this experiment and medical ethics dictate that this experiment must be stopped.
We can no longer tolerate having the highest health care costs with the worst outcomes in the industrialized world. Our own publicly funded health care systems (Medicare and the Veterans Administration) can and do provide better care at lower cost to even the most vulnerable patients.
We cannot rely either on our private insurance industry or the ACA to remedy our crisis. We implore you to immediately protect, improve, and expand Medicare. Every person in the United States needs and deserves access to health care.
With concern,
Henry L. Abrons, MD, Berkeley, California; Pippa Abston, MD PhD, Huntsville, Alabama; Garrett Adams, MD, Louisville, Kentucky; Patch Adams, MD, Urbana, Illinois; Kris Alman, MD, Portland, Oregon; Paul Bigman, Business Representative, IATSE Local 15, AFL-CIO, Seattle, Washington; Mindy Blaski, MD, Seattle, Washington; Paul Blaski, Seattle, Washington; Philip Caper, MD, Brooklin, Maine; Claudia Chaufan, MD, San Francisco, California; Andy Coates, MD, Albany, NY, Mardge Cohen, MD, Boston, Massachusetts; Mary L. De Luca, MD, Albuquerque, New Mexico; Margaret Flowers, MD, Baltimore, Maryland; Elizabeth Frost, MD, Minneapolis, Minnesota; John Geyman, MD, Seattle, Washington; Leslie Hartley Gise, MD, Kula, Hawaii; Irene Gomez, Seattle, Washington; James S. Goodman, MD, Albuquerque, New Mexico; Jeoffry Gordon, MD, San Diego, California; Paul Gorman, MD, Portland, Oregon; Nancy Greep, MD, Los Angeles, California; Oliver Hall, JD, Washington, DC; Hedda L. Haning, MD, Charleston, West Virginia; Bruce Hector, MD, North Hills, California; David Himmelstein, MD, New York, New York; Paul Hochfeld, MD, Corvallis, Oregon; Michael Huntington, MD, Corvallis, Oregon; Dana Iorio, ARNP; Seattle, Washington; Joseph Q. Jarvis, MD, Salt Lake City, Utah; Jeffrey Kaplan, MD, Baltimore, Maryland; Stephen B. Kemble, MD, Honolulu, Hawaii; Jim Kratzer MD, MPH, Fresno, California; Don McCanne, MD, San Juan Capistrano; David McLanahan, MD, Seattle, Washington; George Martin, MD, Seattle, Washington; Samuel Metz, MD, Portland, Oregon; Russell Mokhiber, JD, Berkeley Springs, West Virginia; Kathleen Myers, DDS, Seattle, Washington; Eric Naumburg, MD, Columbia, Maryland; Clark Newhall, MD JD, Salt Lake City, Utah; Carol Paris, MD, Leonardtown, Maryland; George L. Pauk, MD, Phoenix, Arizona; Glenn Pearson, MD, Fort Collins, CO, Edward Pontius MD, Topsham, Maine Julie Keller Pease, MD, Brunswick, Maine; Ellen Punyon, Retired School Principal, Seattle, Washington; Richard Quint, MD, MPH, San Francisco, California; George Randt, MD, Cleveland,Ohio; Helen Redmond, LCSW, New York, New York; Katie Robbins, Mailman School of Public Health, MPH, Class of 2014, New York, New York; Cecile Rose, MD, MPH, Denver, Colorado; Johnathan Ross, MD, Toledo, Ohio; Rick Saling, CWA (for ID only), Seattle, Washington; Gordon Schiff, MD, Boston, Massachusetts; Ann Settgast, MD, Minneapolis, Minnesota; Elias Shaya, MD, Baltimore, Maryland; Diljeet Singh, MD, Chicago, Illinois; William Skeen, MD, Oakland, California; Paul Y. Song, MD, Santa Monica, California; Nancy Hewitt Spaeth, RN, Seattle, Washington James Squire, MD, Seattle, Washington; Karen Green Stone, Small Business Owner, Bloomington, Indiana; Rob Stone, MD, Bloomington, Indiana; Arthur J. Sutherland, III, MD, FACC, Memphis, Tennessee; Bruce Trigg, MD, Albuquerque, New Mexico; William Ulwelling, MD, Albuquerque, New Mexico; Robert Vinetz, MD, Los Angeles, California; John V. Walsh, MD, Cambridge, Massachusetts; Li-hsia Wang, MD, Berkeley, California; Daniel P. Wirt, MD, Houston, Texas; Steffie Woolhandler, MD, New York, New York; Kevin Zeese, JD, Baltimore, MD.
Is "repeal and replace" real policy, or just a sound bite?
The health-care 'repeal and replace' hoax
By Jack Bernard
The Charleston Gazette, July 25, 2012
Charleston, W.Va. — “Repeal and replace!” That is a very catchy slogan indeed. Of course, any objective observer knows that it has very little chance of happening, but it still makes for a great sound bite.
Since 2007, the Democrats have had to override Republican Senatorial filibusters 36O times, far more than ever before. This concerns me for two reasons. First, using the filibuster thwarts democracy and may be unconstitutional. Second, excessively employing the filibuster sets a precedent for others to follow when they are in the minority.
Let’s assume a very unlikely Republican sweep occurs in 2012. Romney wins, the House stays Republican and the Senate goes for the GOP with 51 or 52 Senators. Chances are still slim that repeal will take place due to the filibuster rule. Eight or nine Democrats would have to jump ship and vote with the Republicans, my party, to repeal the law before it really has a chance to be fully implemented in 2014.
Will Rogers once stated: “I do not belong to any organized political party, I am a Democrat.” But, to a growing degree, that party is showing more solidarity in support of its positions. Why? Because moderates in both parties have been run out of office. Getting liberal Democrats to support a Republican repeal effort is highly improbable unless a compelling case can be made that what replaces it will meet with clear public support.
What should most concern my party’s leaders about its proposals is that they are unlikely to ever generate much backing from the voters. People may not approve of the insurance mandate, but that does not mean that they want the Ryan alternative: Medicare turned into a voucher program, with the risk shifted from the federal government to senior citizens. Or, that states and their taxpayers are going to happily accept the Medicaid program being turned into a block grant whereby in the long-term they have to cut services or enrollment unless they raise state taxes.
On the policy wonk side, these efforts are laughable. No systemic changes are entailed. These proposals merely shift the burden from the federal government to the elderly and the states. They do little to constrain cost increases through changes in the delivery and financing of care, unless you count forcing poorer, sicker old people to refrain from getting needed care due to the expense being dumped in their laps.
No, our current proposals fall flat politically and technically. But, do not despair, fellow Republicans. There is a solution that will get enough votes to repeal and replace: Medicare for All, with built-in cost controls. That is a way out, say my GOP friends. Not so.
Obama stole a well-established Republican idea from the 1990s to come up with Obamacare (the Affordable Care Act), which is really just Romneycare recycled. We can do the same to the Democrats by adopting their program, Universal Medicare.
Forget promoting the “free market, more competition” model. It clearly does not work in health care for a variety of reasons, including lack of comparative data and the way health care decisions are made by third parties, including the very concept of insurance.
A study recently looked at our health system versus other developed nations. One key finding is that our prices are out of control, causing our per capita costs to be far greater than elsewhere. The best way to control prices is a single-payer system, like they have in Canada and much of Europe.
Financing Universal Medicare is more straightforward than under the ACA. It can be done through payroll taxes, as Medicare and Social Security are now, with the burden split between workers and employers. There would be no insurance premiums, so the additional expense would be minimal. Plus, Medicare administrative costs are 3 percent, rather than 30 percent for the private insurers. More on Medicare for All can be found at the web site of the highly respected advocacy group Physicians for A National Healthcare Program, pnhp.org.
The Republican path to majority party status is clear. We just have to think out of the box and act decisively.
(Bernard is a retired senior executive, formerly with for-profit health-care firms, who has worked on planning and cost containment issues with several hospitals in West Virginia. He is currently a small business mentor and a Republican County Commissioner in Jasper County, Ga.)
http://wvgazette.com/Opinion/OpEdCommentaries/201207250065
Comment:
By Don McCanne, MD
Although we seem to be locked in a highly partisan environment, Jack Bernard reminds us that mere sound bites, such as “repeal and replace,” get us nowhere if we do not back them up with sound policy. Since “repeal and replace” comes from his party (Republican) he is all the more credible when he delves into the policy implications of what that would really mean.
As the intensity of the political campaigns heat up, the sound bite on health reform has been simplified. Repeal and replace proved to be too complex because there is no clear replacement for the Affordable Care Act around which Republicans have coalesced.
In the recent past we have heard Republican proposals to voucherize Medicare (shifting risk to patients), block grant Medicaid (shifting risk to budget-constrained states), and sell private insurance across state lines (a race to the bottom in insurance benefits). Many Republican candidates have recognized that these measures are not popular, and in the absence of any other serious proposals on which they agree, they have reduced the sound bite to “repeal.”
Now where do they really stand on policy? The status quo was terrible, and the Affordable Care Act does have several beneficial features that are popular. Yet, even with the Affordable Care Act, we’ll hardly depart from the status quo since 30 million people will remain uninsured, and inadequate, low actuarial value plans will become the new standard. Do they really support repeal with a return to the status quo?
This is where Jack Bernard’s policy wonkery comes in. Maybe you can use partisan sound bites to get elected, but then once you are in charge, it is imperative that the severely dysfunctional health care financing system be replaced with one that actually works. So here the sound bite “replace” could be driving policy.
Many conservatives have said that we are going to end up with single payer anyway. Why is that? It’s that “improved Medicare for all,” a single payer system, is not simply a sound bite. It is a serious policy proposal that really would work for all of us.
Is “repeal and replace” real policy, or just a sound bite?
The health-care ‘repeal and replace’ hoax
By Jack Bernard
The Charleston Gazette, July 25, 2012
Charleston, W.Va. — “Repeal and replace!” That is a very catchy slogan indeed. Of course, any objective observer knows that it has very little chance of happening, but it still makes for a great sound bite.
Since 2007, the Democrats have had to override Republican Senatorial filibusters 36O times, far more than ever before. This concerns me for two reasons. First, using the filibuster thwarts democracy and may be unconstitutional. Second, excessively employing the filibuster sets a precedent for others to follow when they are in the minority.
Let’s assume a very unlikely Republican sweep occurs in 2012. Romney wins, the House stays Republican and the Senate goes for the GOP with 51 or 52 Senators. Chances are still slim that repeal will take place due to the filibuster rule. Eight or nine Democrats would have to jump ship and vote with the Republicans, my party, to repeal the law before it really has a chance to be fully implemented in 2014.
Will Rogers once stated: “I do not belong to any organized political party, I am a Democrat.” But, to a growing degree, that party is showing more solidarity in support of its positions. Why? Because moderates in both parties have been run out of office. Getting liberal Democrats to support a Republican repeal effort is highly improbable unless a compelling case can be made that what replaces it will meet with clear public support.
What should most concern my party’s leaders about its proposals is that they are unlikely to ever generate much backing from the voters. People may not approve of the insurance mandate, but that does not mean that they want the Ryan alternative: Medicare turned into a voucher program, with the risk shifted from the federal government to senior citizens. Or, that states and their taxpayers are going to happily accept the Medicaid program being turned into a block grant whereby in the long-term they have to cut services or enrollment unless they raise state taxes.
On the policy wonk side, these efforts are laughable. No systemic changes are entailed. These proposals merely shift the burden from the federal government to the elderly and the states. They do little to constrain cost increases through changes in the delivery and financing of care, unless you count forcing poorer, sicker old people to refrain from getting needed care due to the expense being dumped in their laps.
No, our current proposals fall flat politically and technically. But, do not despair, fellow Republicans. There is a solution that will get enough votes to repeal and replace: Medicare for All, with built-in cost controls. That is a way out, say my GOP friends. Not so.
Obama stole a well-established Republican idea from the 1990s to come up with Obamacare (the Affordable Care Act), which is really just Romneycare recycled. We can do the same to the Democrats by adopting their program, Universal Medicare.
Forget promoting the “free market, more competition” model. It clearly does not work in health care for a variety of reasons, including lack of comparative data and the way health care decisions are made by third parties, including the very concept of insurance.
A study recently looked at our health system versus other developed nations. One key finding is that our prices are out of control, causing our per capita costs to be far greater than elsewhere. The best way to control prices is a single-payer system, like they have in Canada and much of Europe.
Financing Universal Medicare is more straightforward than under the ACA. It can be done through payroll taxes, as Medicare and Social Security are now, with the burden split between workers and employers. There would be no insurance premiums, so the additional expense would be minimal. Plus, Medicare administrative costs are 3 percent, rather than 30 percent for the private insurers. More on Medicare for All can be found at the web site of the highly respected advocacy group Physicians for A National Healthcare Program, pnhp.org.
The Republican path to majority party status is clear. We just have to think out of the box and act decisively.
(Bernard is a retired senior executive, formerly with for-profit health-care firms, who has worked on planning and cost containment issues with several hospitals in West Virginia. He is currently a small business mentor and a Republican County Commissioner in Jasper County, Ga.)
http://wvgazette.com/Opinion/OpEdCommentaries/201207250065
Comment:
By Don McCanne, MD
Although we seem to be locked in a highly partisan environment, Jack Bernard reminds us that mere sound bites, such as “repeal and replace,” get us nowhere if we do not back them up with sound policy. Since “repeal and replace” comes from his party (Republican) he is all the more credible when he delves into the policy implications of what that would really mean.
As the intensity of the political campaigns heat up, the sound bite on health reform has been simplified. Repeal and replace proved to be too complex because there is no clear replacement for the Affordable Care Act around which Republicans have coalesced.
In the recent past we have heard Republican proposals to voucherize Medicare (shifting risk to patients), block grant Medicaid (shifting risk to budget-constrained states), and sell private insurance across state lines (a race to the bottom in insurance benefits). Many Republican candidates have recognized that these measures are not popular, and in the absence of any other serious proposals on which they agree, they have reduced the sound bite to “repeal.”
Now where do they really stand on policy? The status quo was terrible, and the Affordable Care Act does have several beneficial features that are popular. Yet, even with the Affordable Care Act, we’ll hardly depart from the status quo since 30 million people will remain uninsured, and inadequate, low actuarial value plans will become the new standard. Do they really support repeal with a return to the status quo?
This is where Jack Bernard’s policy wonkery comes in. Maybe you can use partisan sound bites to get elected, but then once you are in charge, it is imperative that the severely dysfunctional health care financing system be replaced with one that actually works. So here the sound bite “replace” could be driving policy.
Many conservatives have said that we are going to end up with single payer anyway. Why is that? It’s that “improved Medicare for all,” a single payer system, is not simply a sound bite. It is a serious policy proposal that really would work for all of us.
Presbyterians, TIAA-CREF hear call to divest from private health insurance firms
By Katie Robbins
Healthcare not Wealthcare, July 27, 2012
In the midst of a fierce debate on the national level around the Supreme Court’s decision to uphold the Affordable Care Act, the Divestment Campaign for Health Care made its official debut. Its stated mission: “to expose how the health insurance industry puts the need for profit above the needs of patients and to escalate public support for total removal of the private health insurance companies from our nation’s health care.”
Leading advocacy organizations dedicated to single-payer health care are committed to pursuing a divestment campaign from private health insurance companies in order to transform the treatment of health care as a commodity into a basic human right for all people in the U.S.
“We are responsible for our investments, and particularly as health care workers and patients, we see the immorality of the private health insurance companies as they deny payment for care in order to create huge profits for shareholders,” says Dr. Rob Stone of Bloomington, Ind., a leader in the effort. “Those who stand for a just and equitable health care system must recognize the corrupting force of the private health insurance industry on our political process that costs tens of thousands of lives every year in addition to being a huge financial drain.”
The Presbyterian Church (USA) became the first major institution to take steps towards divestment from private health insurance. On July 7, the church’s national assembly unanimously passed a resolution stating they will “evaluate the variance between church principles of universal access and affordability on the one hand and corporate objectives on the other. It will also assess the likelihood of significant change in corporate behavior.”
The resolution passed after moving testimony was delivered by Rev. Dr. Johanna W.H. van Wijk-Bos, the widow of the original author of the resolution, Rev. A. David Bos who passed away from a sudden case of pneumonia last year, stating before the committee:
“As he lay in the hospital, struggling with the oxygen mask provided to give his lungs the air they needed, he spoke haltingly what would be his last words on this earth: ‘How much will this cost?’ He died six days later. Three weeks after his death a representative from our health insurance company informed me in a telephone call that they rejected the claim to pay for my husband’s hospitalization and medical costs because of a ‘pre-existing condition.’”
Rev. Dr. van Wijk-Bos felt confident the work they had done would lead to full exposure of these corrupt companies because “corporate interests are incompatible with patient care.”
On the heels of this successful endorsement from the Presbyterian Church, activists gathered inside and outside the pension fund giant TIAA-CREF’s shareholder meeting in New York City to call attention to their holdings in private health insurance. Members of TIAA-CREF were shocked to learn that private health insurance companies are considered part of their socially responsible investment portfolio.
Sandy Fox, psychiatric social worker from Pittsburgh, received applause from the other attendees when she asked president and CEO Roger Ferguson Jr. about these holdings:
“How do you justify including health insurance companies – Cigna, Humana, Aetna, Coventry, and WellPoint – in CREF-Social Choice? Private health insurance companies add enormous cost but no value to health care. Furthermore, these companies violate 3 of the 5 social criteria for inclusion in the fund including:
1) NOT ‘devoted to human rights’;
2) NOT ‘dedicated to producing high-quality and safe products’; and
3) NOT ‘managed in an exemplary and ethical manner.’
…We come to you today to demand that you immediately divest from these ruthless companies.”
Shortly before the meeting, the Campaign launched a petition to TIAA-CREF calling for them to move their money out of private health insurance receiving nearly 2000 signers in just a few days.
The Divestment Campaign for Health Care calls upon all people of conscience to shed light on the duplicitous practices that continue in the private health insurance industry. As the Campaign’s mission statement says: “We have nothing to lose. Health insurance companies have everything to lose as their stock prices drop and their influence wanes. Go to your religious organization, your union, your pension plan, your 401(k) adviser, your university endowment, your city council, your friends and neighbors, and tell them it’s time to get the health insurers out!”
Katie Robbins is a divestment activist and member of Healthcare-NOW! NYC and Healthcare for the 99%.
Is "repeal and replace" real policy, or just a sound bite?
The health-care ‘repeal and replace’ hoax
By Jack Bernard
The Charleston Gazette, July 25, 2012
Charleston, W.Va. — “Repeal and replace!” That is a very catchy slogan indeed. Of course, any objective observer knows that it has very little chance of happening, but it still makes for a great sound bite.
Since 2007, the Democrats have had to override Republican Senatorial filibusters 36O times, far more than ever before. This concerns me for two reasons. First, using the filibuster thwarts democracy and may be unconstitutional. Second, excessively employing the filibuster sets a precedent for others to follow when they are in the minority.
Let’s assume a very unlikely Republican sweep occurs in 2012. Romney wins, the House stays Republican and the Senate goes for the GOP with 51 or 52 Senators. Chances are still slim that repeal will take place due to the filibuster rule. Eight or nine Democrats would have to jump ship and vote with the Republicans, my party, to repeal the law before it really has a chance to be fully implemented in 2014.
Will Rogers once stated: “I do not belong to any organized political party, I am a Democrat.” But, to a growing degree, that party is showing more solidarity in support of its positions. Why? Because moderates in both parties have been run out of office. Getting liberal Democrats to support a Republican repeal effort is highly improbable unless a compelling case can be made that what replaces it will meet with clear public support.
What should most concern my party’s leaders about its proposals is that they are unlikely to ever generate much backing from the voters. People may not approve of the insurance mandate, but that does not mean that they want the Ryan alternative: Medicare turned into a voucher program, with the risk shifted from the federal government to senior citizens. Or, that states and their taxpayers are going to happily accept the Medicaid program being turned into a block grant whereby in the long-term they have to cut services or enrollment unless they raise state taxes.
On the policy wonk side, these efforts are laughable. No systemic changes are entailed. These proposals merely shift the burden from the federal government to the elderly and the states. They do little to constrain cost increases through changes in the delivery and financing of care, unless you count forcing poorer, sicker old people to refrain from getting needed care due to the expense being dumped in their laps.
No, our current proposals fall flat politically and technically. But, do not despair, fellow Republicans. There is a solution that will get enough votes to repeal and replace: Medicare for All, with built-in cost controls. That is a way out, say my GOP friends. Not so.
Obama stole a well-established Republican idea from the 1990s to come up with Obamacare (the Affordable Care Act), which is really just Romneycare recycled. We can do the same to the Democrats by adopting their program, Universal Medicare.
Forget promoting the “free market, more competition” model. It clearly does not work in health care for a variety of reasons, including lack of comparative data and the way health care decisions are made by third parties, including the very concept of insurance.
A study recently looked at our health system versus other developed nations. One key finding is that our prices are out of control, causing our per capita costs to be far greater than elsewhere. The best way to control prices is a single-payer system, like they have in Canada and much of Europe.
Financing Universal Medicare is more straightforward than under the ACA. It can be done through payroll taxes, as Medicare and Social Security are now, with the burden split between workers and employers. There would be no insurance premiums, so the additional expense would be minimal. Plus, Medicare administrative costs are 3 percent, rather than 30 percent for the private insurers. More on Medicare for All can be found at the web site of the highly respected advocacy group Physicians for A National Healthcare Program, pnhp.org.
The Republican path to majority party status is clear. We just have to think out of the box and act decisively.
(Bernard is a retired senior executive, formerly with for-profit health-care firms, who has worked on planning and cost containment issues with several hospitals in West Virginia. He is currently a small business mentor and a Republican County Commissioner in Jasper County, Ga.)
http://wvgazette.com/Opinion/OpEdCommentaries/201207250065
Although we seem to be locked in a highly partisan environment, Jack Bernard reminds us that mere sound bites, such as “repeal and replace,” get us nowhere if we do not back them up with sound policy. Since “repeal and replace” comes from his party (Republican) he is all the more credible when he delves into the policy implications of what that would really mean.
As the intensity of the political campaigns heat up, the sound bite on health reform has been simplified. Repeal and replace proved to be too complex because there is no clear replacement for the Affordable Care Act around which Republicans have coalesced.
In the recent past we have heard Republican proposals to voucherize Medicare (shifting risk to patients), block grant Medicaid (shifting risk to budget-constrained states), and sell private insurance across state lines (a race to the bottom in insurance benefits). Many Republican candidates have recognized that these measures are not popular, and in the absence of any other serious proposals on which they agree, they have reduced the sound bite to “repeal.”
Now where do they really stand on policy? The status quo was terrible, and the Affordable Care Act does have several beneficial features that are popular. Yet, even with the Affordable Care Act, we’ll hardly depart from the status quo since 30 million people will remain uninsured, and inadequate, low actuarial value plans will become the new standard. Do they really support repeal with a return to the status quo?
This is where Jack Bernard’s policy wonkery comes in. Maybe you can use partisan sound bites to get elected, but then once you are in charge, it is imperative that the severely dysfunctional health care financing system be replaced with one that actually works. So here the sound bite “replace” could be driving policy.
Many conservatives have said that we are going to end up with single payer anyway. Why is that? It’s that “improved Medicare for all,” a single payer system, is not simply a sound bite. It is a serious policy proposal that really would work for all of us.