Showing posts with label Insurance. Show all posts
Showing posts with label Insurance. Show all posts

Monday, November 22, 2010

My Apologies to Michael Moore and the Health Insurance Industry

Cover of "Sicko (Special Edition)"Cover of Sicko (Special Edition)

My Apologies to Michael Moore and the Health Insurance Industry

by Wendell Potter
In advance of my appearance with Michael Moore on Countdown with Keith Olbermann tonight on MSNBC (8 and 11 p.m. ET), I would like to offer an apology to both Moore and his arch enemy, the health insurance industry, which spent a lot of policyholder premiums in 2007 to attack his movie, Sicko.
I need to apologize to Moore for the role I played in the insurance industry's public relations attack campaign again him and Sicko, which was about the increasingly unfair and dysfunctional U.S. health care system. (I was head of corporate communications at one of the country's biggest insurance companies when I left my job in May 2008.) And I need to apologize to health insurers for failing to note in my new book, Deadly Spin, that the front group they used to attack Moore and Sicko -- Health Care America -- was originally a front group for drug companies. APCO Worldwide, the PR firm that operated the front group for insurers during the summer of 2007, was outraged -- outraged, I tell you -- that I wrote in the book that the raison d'ĂȘtre for Health Care America was to disseminate the insurance industry's talking points as part of a multi-pronged, fear-mongering campaign against Moore and his movie. An APCO executive told a reporter who had reviewed the book that I was guilty of one of the deceptive PR tactics I condemned: the selective disclosure of information to manipulate public opinion.

Which Industry Was Really Behind "Health Care America?"

Well, shucks. Ignorance is no defense, I know, but no one at APCO ever told me, even when I was on the insurance industry's side, that Health Care America's first benefactor was Big Pharma.
Here are the offending sentences, excerpted from the chapter entitled "The Campaign Against Sicko," in which I described a top-secret meeting of insurance company flacks -- including me -- where APCO and America's Health Insurance Plans (AHIP), the lobbying group for insurers, laid out the industry's strategy:
(AHIP's Mike) Tuffin and (APCO's Robert) Schooling said they had already begun recruiting conservative and free-market think tanks, including the American Enterprise Institute and the Galen Institute, as third-party allies. Those allies, they said, would be working aggressively to discredit Moore and his movie. They then mentioned an ally that most of us had never heard of, Health Care America. It had been created by AHIP and APCO for the sole purpose of attacking Moore and his contention that people in countries with government-run systems spent far less and got better care than people in the United States. The sole reason Health Care America exists, they said, was to talk about the shortcomings of government-run systems.
I learned a few days ago from Jack O'Dwyer, longtime watchdog of the PR profession and publisher of O'Dwyer's PR Daily, that an APCO executive told him I had failed to disclose that APCO had originally set up Health Care America in 2006 with money primarily from big drug companies. Big Pharma was worried at the time that drug makers would be Moore's main target in the movie. Thinking ahead, they feared that being vilified in Sicko would increase the odds that lawmakers would cast them as the chief villain when the health care reform debate got underway.
O'Dwyer blogged last Tuesday that, "Just about every known evil practice that PR has ever engaged in is described in 'Deadly Spin.' " He noted that I had mentioned APCO -- the second biggest firm in the O'Dwyer ranking, with $100.3 million in fees in 2009 -- several times in the book. APCO and AHIP must be paying a media monitoring service to alert them immediately when I am mentioned in the media, as they did for Michael Moore and Sicko three years ago. Within hours, APCO Senior Vice President William Pierce sent O'Dwyer an email to challenge my credibility because of my failure to disclose Health Care America's original incarnation. He's right --partially. I should have pointed out in the book that APCO repurposed Health Care America for the insurance industry and other special interests who were concerned that Sicko might lead to reforms that would threaten their profits, too. I would have disclosed it if I had known about it. Unlike PR people who practice the dark arts of PR, I had no intention of misleading anyone.

Now, Even More Info About "Health Care America"

After hearing from O'Dwyer, I discovered even more about Health Care America than I had recalled. I came across a couple of interesting articles and a press release from 2006 that Pierce had sent to the media. (He was listed as the organization's media contact, although he was an employee of APCO during the entire brief existence of Health Care America. If you called the number on the press release, you would have reached Pierce at his APCO office.) I also found Health Care America's federal tax returns for 2006 and 2007, which were helpful in understanding just how much of a front group it really was.
In a press release dated April 6, 2006, Pierce announced that Health Care America -- which he described as a non-partisan, non-profit organization --had "opened for business as a champion for common-sense solutions to improving our health care system without furthering government control."

The Old PR Dodge and Weave

In one of the hardest-working paragraphs of spin I've come across in a long time, the release went on to quote Sarah Berk, the outfit's executive director, as saying: "We will promote access, choice, innovation, quality and competition in the U.S. health care system. And we will highlight how government-controlled systems around the world limit payment choice, stifle innovation and force thousands to wait for health care services in the U.S."
(Note to Ms. Berk: Please make plans now to join me next July at the 11th annual Remote Area Medical Free Health Care Expedition at the Wise County, Virginia Fairgrounds. If you come early enough, you can help other volunteers scrub and sanitize the animal stalls where doctors and nurses treat the thousands of patients who wait for a year to get the care they need, but cannot afford in the United States of America. Be forewarned, however. The experience might force you to consider another line of work, as it did for me when I went to  Wise County in 2007. I knew then that my days as a spinmeister for the insurance industry were numbered.)
The release did not disclose that Ms. Berk had recently left the American Hospital Association where, according to a story in Roll Call, she was director of "grassroots" advocacy and federal relations. Roll Call also reported that she earlier had "worked on health issues" for former Sen. Rick Santorum (R-Pennsylvania).
So what were the common-sense solutions Health Care America promised to champion? Well, according to Roll Call, Ms. Berk "declined" to talk about them.   "We're not there yet," Roll Call quoted her as saying. "We're not here to get in the weeds on issues."
That was not the only declining she did that day. According to Roll Call, "Berk declined to name any specific companies or groups that were backing (Health Care America)." Oh, well.
Roll Call did disclose a tidbit that the Pierce's press release did not: "Health Care America is represented by public affairs firm APCO Worldwide and is currently leasing office space from APCO." One has to wonder how much space APCO's front group leased from APCO. Berk was identified as the only employee, although she was quoted in Roll Call as saying that she planned to hire at least one other person within three months.

Undisclosed Income Source, Mysterious Expenditures, Virtual Offices ...

According to the Form 990 Health Care America filed with the IRS for 2006, it took in $822,298.00 from undisclosed sources. Of that, $142,500 was paid out in compensation, presumably to Ms. Berk, and $9,000 was spent for "occupancy." Accounting and legal fees totaled nearly $47,000. By far the biggest expenditure -- $240,000 -- was for "consultant services."  One has to wonder how much of that went to APCO.
Health Care America's Form 990 for 2007 disclosed that Ms. Berk was even more handsomely rewarded for her work during the second and apparently final year of the organization's existence (I could not find a Form 990 for any subsequent year), one presumes because she apparently never got around to hiring anyone else and consequently had to work an average of 60 hours a week, or so she claimed. She was paid $197,917 in 2007. Legal and accounting fees skyrocketed to more than $80,000, and the amount spent for "occupancy" jumped to $15,870 in 2007.
One has to wonder who got that $15,870. In the 2006 Form 990, Ms. Berk listed her office address as 1455 Pennsylvania Avenue, N.W., Suite 400, Washington, D.C. 20004. That is not where APCO is located. In fact, that is the address of a "virtual office" at the Willard Office Building. Well, of course. How appropriate. Why would a front group need a real office?
The Web site for the virtual office at the Willard lists these amenities: a prime business address; a "live" receptionist; a lobby greeter, a business support center, a client drop-off/pick-up point; and mail forwarding, all for $125 a month. That's a heck of a deal for an "office" in the heart of arguably the most important city on the planet. Note, however, that you will have to pay extra to have your organization's name in the lobby directory and to actually use a real office or conference room. You can rent a real office for $10-$35 an hour, which for some reason reminds me of the fleabag motels I've heard about that rent rooms by the hour. Make no mistake, though, the Willard is no fleabag. Here's a fun fact, noted on the Web site for Suite 400:
The Willard Office Building is nestled between the famous Willard Intercontinental Hotel, where the term 'lobbyist' was coined, and the Occidental Restaurant, where D.C.'s power brokers negotiate deals over fabulous American fare."
Go ahead. Google the address. You'll find that oodles of organizations claim to occupy Suite 400. Let's hope that all those folks don't show up for work on the same day.

Operating Front Groups Isn't Criminal, Just Shameful

While the Forms 990 disclosed some interesting information, they didn't disclose the details that would be most helpful in determining who is really behind Health Care America. The government doesn't require such disclosure, even though front groups play a major role in persuading people to think the way the groups' financiers want them to think and to do what they want them to do, such as disrupting Congressional Democrats' town hall meetings. The ultimate goal, of course, is to influence public policy.
"Where's the felony Potter is saying took place?" Pierce asked O'Dwyer.
There was no felony (that I have personal knowledge of), and I never said that anyone at APCO had committed one. That's the problem. Setting up and operating front groups -- and not having to disclose who is behind them -- is shameful and, according to the code of ethics of the Public Relations Society of America, unethical. But it's perfectly legal.
So APCO, I've apologized for failing to disclose something I didn't know when I wrote Deadly Spin. Now it's your turn. How about you apologizing to the American people for the role you played in making it necessary for me to write the book in the first place.
P.S.: I just received a message from an APCO spokesperson who wrote to chastise me for writing that the insurance industry would "push Moore off the cliff" in a worst-case scenario. "You know there was never any suggestion to do anyone personal harm," she wrote. Yes, I knew that and I wrote that. She should read the book. Here's what I wrote on page 38 of the chapter about Sicko:
"Tuffin and Schooling wrapped up their presentation with a 'worse-case scenario' plan. If Sicko showed signs of being as influential in shaping public opinion on health care reform as An Inconvenient Truth had been in changing attitudes about climate change, then the industry would have to consider implementing a plan 'to push Moore off the cliff.' They didn't elaborate, and no one asked what they meant by that. We knew they didn't mean it literally--that a hit man would be sent to take Moore out. Rather, an all-out effort wuld be made to depict Moore as someone intent on destroying the free-market health care system and with it, the American way of life."
The APCO spokesperson denied the firm had done research on Moore's family and said APCO "did not attempt to suppress turnout for the movie." I'll let the PR plan, which I first discussed on Bill Moyers Journal in July 2009, speak for itself. Moyers' staff obtained copies of May 2007 and June 2007 versions of the PR plan developed by APCO and AHIP. To view the interview and PDF versions of the documents, click this link.
P.P.S: I also want to apologize to Moore for not disclosing until now that, while I was still working for the insurance industry, I traveled as an industry spy to his hometown of Bellaire, Michigan, to attend the official U.S. premiere of Sicko on June 16, 2007. Moore and I actually met that day, although he doesn't know it. (I didn't tell him who I was or who I worked for). The picture accompanying this blog, taken at a pre-screening reception by another movie-goer, shows me on Moore's left and my son, Alex, on his right. Alex, who has always been a big fan of Moore's, traveled with me on the reconnaissance mission. Moore even autographed a Sicko poster for Alex. It's quite a momento.
Wendell Potter is the Senior Fellow on Health Care for the Center for Media and Democracy in Madison, Wisconsin.
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Wednesday, September 29, 2010

What If Everyone Had Medicare?

Barack Obama signing the Patient Protection an...Image via Wikipedia
San Francisco Chronicle
September 24, 2010
What if everyone had Medicare?
By Henry Abrons

The Census Bureau released its annual report on income, poverty and health insurance coverage in the United States earlier this month, and it's no surprise to learn that we're in bad shape. The number of people living in poverty was 43.6 million (14.3 percent), up sharply from 2008, and real per capita income declined 1 percent.

Looking at health insurance, the situation is truly dire. There was a dramatic spike in the uninsured - 4.3 million more, to a record 50.7 million - in spite of the expansion of government health insurance rolls by nearly 6 million.

Those opposing government health insurance should ponder the fact that private health insurance coverage dropped to the lowest level since comparable data were first collected in 1987. On the other hand, those who look to the new health reform law - the Patient Protection and Affordable Care Act (PPACA) - for a solution should be deeply disturbed.

PPACA was not designed to provide universal coverage. In fact, if the new law works as planned, in 2019 there will still be 23 million uninsured. Yet the consequence of being uninsured can be lethal: Research published last year shows about 45,000 deaths annually can be linked to lack of coverage. That number is probably more than 50,000 today.

As Don McCanne, senior health policy fellow at Physicians for a National Health Program, has observed, PPACA is an underinsurance program. Employers, seeing little relief, will expand the present trend of shifting more insurance and health care costs onto employees.

Individuals buying plans in the new insurance exchanges (which won't start until 2014) will discover that subsidies are inadequate to avoid financial hardship. Inevitably, they will end up with underinsurance, spotty coverage and high deductibles.

And workers who are unemployed or without employment-based insurance will move into Medicaid (Medi-Cal in California), where providers are reimbursed at such low rates that many will not accept patients.

When Congress passed the new law last spring, it based its decision on a faulty assumption - namely, that the rest of the population will have sustainable private health insurance. But between 2008 and 2009, the number of people covered by private health insurance decreased from 201.0 million to 194.5 million, and the number covered by employment-based health insurance declined from 176.3 million to 169.7 million.

If this trend continues, as it's bound to do under current economic conditions, the ranks of the uninsured will expand and the new law will fall far short of the mark - either the cost will exceed projections, or coverage will be need to be reduced.

The Census Bureau report underscores the urgency of going beyond the Obama administration and swiftly implementing a more fundamental reform - a single-payer national health insurance program - improved Medicare for all.

Improved Medicare-for-all, by replacing our dysfunctional patchwork of private health insurers with a single, streamlined system of financing, would save about $400 billion annually in unnecessary paperwork and bureaucracy. That's enough to cover all of those now uninsured and to provide every person in the United States with quality, comprehensive coverage.

A single-payer plan would also furnish us with effective cost-control tools, like the ability to negotiate fees and purchase medications in bulk. It would permit patients to go to the doctor and hospital of their choice.

Short of a full national plan, some states, like ours, are eyeing a state-based single-payer model. The new health law allows states to experiment with different models of reform, but not until 2017. Congress should move that date forward. There is no time to waste.

(Henry Abrons, M.D., is a member of Physicians for a National Health Program-California - www.pnhpcalifornia.org.)



Comment:  Henry Abrons' message is certainly very familiar to supporters of an improved Medicare for all, but we have to keep repeating it over and over until more people start listening.
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Thursday, August 5, 2010

Study Shows Universal Health Benefits

BMC Health Services Research
August 4, 2010
The impact of universal National Health Insurance on population health: the experience of Taiwan
By Yue-Chune Lee, Yu-Tung Huang, Yi-Wen Tsai, Shiuh-Ming Huang, Ken N Kuo, Martin McKee and Ellen Nolte

Background

Taiwan established a system of universal National Health Insurance (NHI) in March, 1995. Today, the NHI covers more than 98% of Taiwan's population and enrollees enjoy almost free access to healthcare with small co-payment by most clinics and hospitals. Yet while this expansion of coverage will almost inevitably have improved access to health care, however, it cannot be assumed that it will necessarily have improved the health of the population. The aim of this study was to determine whether the introduction of National Health Insurance (NHI) in Taiwan in 1995 was associated with a change in deaths from causes amenable to health care.

Methods

Identification of discontinuities in trends in mortality considered amenable to health care and all other conditions (non-amenable mortality) using joinpoint regression analysis from 1981 to 2005.

Results

Deaths from amenable causes declined between 1981 and 1993 but slowed between 1993 and 1996. Once NHI was implemented, the decline accelerated significantly, falling at 5.83% per year between 1996 and 1999. In contrast, there was little change in non-amenable causes (0.64 percent per year between 1981 and 1999). The effect of NHI was highest among the young and old, and lowest among those of working age, consistent with changes in the pattern of coverage. (This result is consistent with our expectations as 77% of the working age population were already covered by the pre-existing social insurance; thus they were inevitably going to be affected less by the introduction of NHI.) NHI was associated with substantial reductions in deaths from circulatory disorders and, for men, infections, whilst an earlier upward trend in female cancer deaths was reversed.

Conclusions

NHI was associated in a reduction in deaths considered amenable to health care; particularly among those age groups least likely to have been insured previously.

Policy Implications

These findings have implications for other countries that do not have universal health insurance coverage. The implementation of NHI in Taiwan was associated with a sustained reduction in deaths from causes amenable to health care, which surpassed the underlying decline in other causes. It is reasonable to expect that the introduction of universal coverage elsewhere might also have beneficial effects.

Looking ahead, while the Taiwanese NHI has succeeded in terms of cost (3.4% of GDP), satisfaction (77.5% satisfied in 2007), low administrative cost (1.49%), and equitable financial burden, the system is not without problems. For example, as a publicly-managed program, it is difficult to insulate it from political interference, a factor that has contributed to a continuing financial deficit. Thus, the existing budget may be inadequate to sustain the current level of performance.


Full article (provisional):

United States has worst rate of amenable mortality:


Comment:  Taiwan's 1995 introduction of a single payer system of universal National Health Insurance provides us with a natural experiment on the impact of single payer reform on health outcomes. The results are dramatic. The rate in reductions of deaths due to disorders that are amenable to health care were nine times the reductions in deaths from non-amenable causes. Nine times!

The United States should be especially interested in these results since, in a study of nineteen industrialized nations, we have the worst rate of amenable mortality (link above). We have over 100,000 excess deaths per year due to disorders amenable to health care.

Will the Patient Protection and Affordable Care Act (PPACA) erase this blemish on our health care system? Most of our dysfunctional financing system will remain in place. Some will receive care under an expansion of Medicaid, but as a chronically underfunded program with insufficient numbers of willing providers, access problems are inevitable. Others will receive care under the private plans in the insurance exchanges, but financial barriers to access will remain because of the low actuarial values of the plans and inadequate subsidies. There is little reason to believe that the tweaks of PPACA will have much impact on amenable mortality.

After enacting a single payer system, Taiwan not only greatly reduced amenable mortality, but it was done at a fraction of our spending, with great patient satisfaction, with extremely low administrative costs, and with a financing system that is equitable. Maybe Taiwan needs to spend more, but just think of what we could have with the amount that we are already spending. Besides, saving 100,000 lives a year seems to be a worthy policy goal.
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Thursday, February 25, 2010

Opeyemi Column Issues Manifesto Re Health Care

Mary Baker Eddy Burial MonumentImage via Wikipedia

Opeyemi’s manifesto by Opeyemi Parham.

It’s time to walk away from the beat grinder, folks. I am speaking --truth to power, in relation to our health. The WHOLE of our health. Holistic health. Mind, body, and spirit.

They drew a line in the sand. In their reality, I stepped over it.

In Massachusetts, we are penalized each April if we have not purchased the mandatory health insurance legislated by our state. This is NOT universal health care, nor is it health care for all. It is a coercive attempt to monopolize “health” by forcing us into the jaws of Big Pharma and corporate medicine.

Feel like I may be overstating my case? Check out the stock market’s response, as the “public option” section of Obama’s version of comprehensive health coverage gets mangled and co-opted in Washington. The insurance companies stocks are rocketing up.

This year I said “no” to the entire mess, and I mean it.

In Massachusetts, I can say “no” to mandatory health insurance if I have a sincere religious belief that conflicts with purchasing insurance. Well, I do. I believe the system that would be forcing this upon me is EVIL I believe that this system not only has no interest in my health; it actually has an interest in making me, and keeping me, chronically ill.

In order to claim my religious exemption, I must show that I use no medical care. No doctors. No emergency rooms. No hospitals. I am sure that this caveat in the law was influenced by Massachusetts being the birthplace of Mary Baker Eddy’s Christian Science movement. And, I am also sure that the arrogance of the state that birthed Harvard medical school assumes that no one in their right mind would claim such an exemption.

I am not a Christian Scientist, but my spiritual views on health are closer to the fringe than to the mainstream, these days. I had a religious experience back in 2005, that led me to question my entire world view and belief system. Up to now, I held that experience sacred/secret because it is not wise for a conventionally trained M.D. to use the “s” word when speaking about health and healing.

Not the “s” word sex,; the “s” word SPIRIT.

My spiritual experience left me on the wrong side of that line in the sand, drawn by the Bigheads on Beacon Hill. When push comes to shove, if you ask me to use conventional meds as prescribed by my state’s legislature, or be banned from using them at all, I will choose the side of the ban.

THEY drew the line in the sand. In their reality, I am stepping over it.

In my reality, I am dancing into spiritual evolution:

I’m stepping into clarity…
I’m walkin’ in my Power
I’m dancin magic in my life
Every day and every hour
I’m choosin’ to be usin’ the things I got
To make this world so fine
‘Cuz I am one unique expression,
of the great divine…
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Tuesday, February 2, 2010

Minnesota Health Plan Touted

Single Payer Insurance is the way.Image by freestylee via Flickr

Published on Tuesday, February 2, 2010 by CommonDreams.org
Single Payer Solution for Obama

by MN Senator John Marty

"If anyone...has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know."
-- President Obama, State of the Union
January 27, 2010

An open letter in response to President Obama's State of the Union request for a better approach to health care reform:

Dear President Obama,

During your State of the Union address, you explained why you are fighting for health care reform, expressed frustration at the lack of success, and invited others to suggest a better approach.

I'm taking you up on that invitation and offer a bold suggestion:

Take a look at our Minnesota Health Plan -- a proposal that covers everyone, saves money, and creates a logical health care system to replace the dysfunctional non-system which currently exists. It is a proposal that would provide health care to everyone, not merely health insurance for many. Our MN Health Plan (mnhealthplan.org) could be readily adapted as a nation-wide plan. It would meet each of the five requirements you mentioned in your State of the Union request:

Bring Down Premiums. Most Americans would see a big reduction in premiums because the plan would be significantly cheaper than our current health care non-system. Because the premiums for the MHP would be based on ability to pay, everyone's premiums would be affordable. Some would pay more, but overall, costs would go down. Most people would save money, while getting the care they need and deserve. The total costs for the plan would be less than we now are paying for premiums, co-pays, deductibles, and taxes for medical programs.

Bring Down the Deficit. By keeping people healthier and by delivering quality health care efficiently, it would save hundreds of billions of dollars for the federal government, and even more for states. For example, by covering chemical dependency treatment and providing comprehensive mental health services, it would cut crime and human service costs (such as out-of-home placement of children), some of the biggest and fastest growing expenses facing state and local governments.

Cover the Uninsured. It would cover the uninsured and the under-insured. In fact it would cover everyone -- 100% of the public.

Strengthen Medicare for Seniors (and everyone else). It would cover prescription drugs -- with no "doughnut hole." It would cover long term care, in-home care, dental, eye care, physical therapy, and medical supplies -- it would cover all medical needs. And, they would have their choice of doctor, hospital, clinic, dentist -- complete freedom to choose their medical providers.

Stop Insurance Company Abuses. There would be no "pre-existing conditions" to worry about, no underwriting, no denials of coverage, no "out of network" problems. I like to use the analogy of police and fire protection. When you return home to find a burglary in process and call 911, the police dispatcher does not ask if you qualify. They do not ask if you have police insurance. They do not ask whether your policy covers home burglary. They don't ask if you have pre-existing conditions that would disqualify you. They don't waste time and money having you fill out forms so your insurance company can be billed. The police response does not depend on your insurance status. Everyone is treated equally. It's the American way. It is time to treat health care the same way.

As a 23 year member of the Minnesota Senate, let me comment briefly on the politics of this proposal:

The MHP is a single payer proposal. You have acknowledged that single payer is the only way to cover everyone. Seven years ago you said that single payer health care is "what I'd like to see. But... we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House." Now that we have taken back the White House and the Congress, it is time to act.

I recognize, as you do, that you do not have the votes to pass truly universal health care at this time. The insurance and pharmaceutical industries contribute so much to members of Congress -- they control the debate -- so health care for everyone isn't even on the table.

This, however, is your opportunity for leadership. If you propose and fight for health care for all, as FDR did with Social Security in 1935, the voters would respond. If you don't win this year, ask the American people to elect candidates who will stand with you. Make it the issue of the campaign: Health Care for All vs. Health Insurance for Some. Instead of losing Democratic members of Congress this year -- as Massachusetts illustrates -- you would gain votes and could actually pass the bill next year.

Dr. Martin Luther King stated, "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."

Almost a half century later, we still have not addressed the injustice in health care that Dr. King described as the most inhumane. Ignoring this injustice is immoral and it is economically unsustainable. People are hurting, some are literally dying, businesses are folding, and it is crushing our national economy.

Please, restore the Hope that you raised in all of us, bring back the inspiration that made the American people so excited by your inauguration. I urge you to step back, reconsider, introduce a health care plan that is truly universal, and fight for it.

Justice requires no less.

Respectfully,

John Marty
John Marty is a state Senator from Minnesota, who is currently a Democratic candidate for governor. John currently chairs the Minnesota Senate Health, Housing and Family Security Committee. He is author of the Minnesota Health Plan, a bold single-payer health plan that would cover all Minnesotans for all their medical needs, including mental health and chemical dependency. He has been successful in gaining the support of one-third of the state's legislature as co-authors.

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Saturday, December 26, 2009

Another Lump of Coal

Single-payer rallyImage by Public Citizen via Flickr

Healthcare Bill a Nightmare Before Christmas

by Billy Wharton
Call it the nightmare before Christmas or Santa's lump of healthcare coal. Either title captures the disastrous qualities of the healthcare reform bill passed by Senate on Thursday. After months of media coverage, a summer of wild town hall meetings and all the high-sounding rhetoric one could swallow, a 2,000 page monster has been birthed. Though President Barack Obama hailed the bill's passage by declaring, "This will be the most important piece of social legislation since Social Security passed in the 1930s," it carries few of the universal qualities or public control of the Social Security legislation. For all the political theater associated with the bill, remarkably little in the bigger picture of healthcare in America has changed - private health insurers still run the system, Washington politicians are still gathering in the campaign contributions and millions will still be left without health insurance.
Bad Gets Worse in the Senate
The Senate bill is even weaker than the already comprised piece of legislation passed by the House of Representatives. The number of uninsured capable of gaining insurance will be somewhere around 24 million. With private plans as the alternative, estimates are that more than $450 billion in tax-payer money will be transferred to private insurers in order to allow the uninsured to gain coverage. However, that coverage will be something akin to the lowest form of car insurance - you get by before the eyes of the state, but get into an accident and you will find yourself facing massive debt. Estimates are that the low-coverage plans would only cover 60% of costs. Even worse news comes for the more than 20 million people who will likely remain uninsured. They will now also have to forfeit 2% of their annual income because of it. A nightmarish scenario indeed - uninsured and penalized!
Smaller parts of the bill also promise negative outcomes. Medicare plans are still being trimmed by $43 billion. Democrats claim it is fat-cutting through the elimination of tax-payer subsidies to private insurers. Seniors fear the long-term impact of the cuts will result in reduced services, especially for quality of life issues such as the ability to participate in exercise programs for free. Reproductive rights also took a hit. While the Senate bill moves off the harsh language on abortion proposed by the Stupak amendment in the House bill, it still represents a serious reversal of reproductive rights on a national scale. If a female subscriber wishes to use her healthcare plan to pay for an abortion, she will have to pay into a separate fund connected to plan. Given the unexpectedness of most unwanted pregnancies, this measure practically eliminates the ability to use insurance to obtain an abortion. The Stupak amendment was defeated in
words, but its content seems certain to return in practice.
Finger-pointing Misses the Big Picture
Who is to blame for such a fiasco? Much progressive ink has been spilt in examining the days leading up the Christmas Eve coup. Joe Lieberman has been a particular target, and even Bernie Sanders has taken some grief for removing his single-payer amendment and, ultimately, voting yes on the bill. Yet this focus on the theatrics of the approval misses the larger structural dimensions of how this bill will become law. Sure, Lieberman converted his leverage as a fence-sitting Conservative into a further watering of bill and Sanders left the field without much of a fight, preferring a go-along-to-get-along approach in order to fight another day. Neither of these statements says much about how this bill came to be.
The real story of this bill is rooted in two moments. One came from the campaign trails of 2008, where massive sums of campaign contributions from health insurers and pharmaceutical companies tipped the balance of national and local elections throughout the country. Democrats drank deeply from this revenue stream and proved to be loyal servants to both the insurance industry and the pharmaceutical lobby. The contributions were targeted - committees that would be formulating the healthcare reform bill, such as the House Committee on Ways and Means, received an inordinate amount of funds. No wonder then, that when candidate Barack Obama declared a goal of "universal healthcare coverage," little rebuttal was heard from the normally vocal insurance lobby. The fix was in and it was insured by some $2 million dollars in donations to his campaign.
Just to insure that things went well for the healthcare lobby, an army of lobbyists was mobilized at a critical juncture in May 2009. The lobby spent a reported $2.3 million a day peddling influence. Such a massive expenditure of political and financial resources insured that the perspectives of private insurers were represented at every committee meeting and in the offices of every elected representative. The lobby was also buffered by the efforts of the right-wing Heritage Foundation, which successfully exported their free-market notion that "insurance exchanges" could cure the ills of rising healthcare costs. Soon everyone - from Barack Obama to Harry Reid and even Howard Dean in his statement opposing the bill - was parroting this line. This, despite the fact that nearly sixty years of private control, through free-market policies, over healthcare has created a national emergency in the cost and access to care. So much for learning from
history.
Single-Payer: Union Hall or Lobby Day?
There was some resistance to this process as single-payer proponents did their best to fight the good fight. Massively outgunned in the realm of financial resources, they turned to a campaign of civil disobedience that bore witness to the sheer hypocrisy of the proceedings. Democracy was not in motion in the House committees that formulated the bills, and doctors, healthcare activists and victims of private insurers rallied to express their dissent. For their trouble, these activists received stinging rebukes from some of the very same politicians they had championed as friends. Not only Sanders, but Representative John Conyers, the author of the single-payer bill HR 676, voted in favor of the watered-down reform proposal. Both yielded to expediency and provided a useful lesson in how power politics work in Washington, where you are only as good as your next campaign contribution or legislative horse-trade.
In the end, the movement in support of single-payer was too thin - not able to mobilize large numbers or exercise any influence on a political process saturated with corporate funds. Single-payer activists will have to return to running broad educational campaigns with an eye toward developing a movement with solid roots in working communities throughout the country. They may pick up some new allies from a labor movement that recoiled from unfettered support of the Democrats once the terms of the Senate bill were released. Now wonder then that the bill was swiftly forced through - popular support was rapidly dwindling. In the end, a painful lesson may have been learned - only the ungovernability of the people in motion can win single-payer. To accomplish this, the church congregation, the dinner table and the union hall are more potent weapons than cultivating "friends" in the Senate or House.
The Healthcare Scrooges
Like Scrooge before his revelation, the health insurance industry and their Democratic and Republican representatives have one-track minds - money, money, and money. Such a singular pursuit blinds one to the reality of the social suffering that the three ghosts introduced old Scrooge to. A day may come, perhaps even sometime soon, when the millions of sufferers wake up from this nightmare in order to assert the only quality that no socio-economic system can strip them of - their humanity. Then we might not be willing to offer our healthcare Scrooges the chance to reform themselves. It will be right to the political grave for the private insurers and their political lackeys in order to insure that healthcare becomes the birth-right of all the people. What a wonderful Christmas present that would be.
Billy Wharton is the editor of The Socialist and the Socialist WebZine. His articles have appeared in the Washington Post, Monthly Review Webzine, The Indypendent, CommonDreams.org and Links International Journal of Socialist Renewal.]
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Wednesday, October 28, 2009

Healthcare Hypocrites

Official photo of U.S. Senator {{w|Jim DeMint}}.Image via Wikipedia

Healthcare Hypocrites

by Jim Hightower

How do you spell "hypocrisy"?

Try this: "H-Y-P-O-C-O-N-G-R-E-S-S." The hypocongress consists of those Republicans and Blue Dog Democrats who have risen up on their hind legs in recent weeks to snarl and howl at any mention of a government role in meeting America's health care needs. "Socialism," they bark — we won't allow Barack Obama and the liberals to create a Washington-run, big-government intrusion into the hallowed private market. Sen. Jim DeMint, a South Carolina Republican, even pledged to fight so ferociously that the health care battle would be Obama's "Waterloo."

What a stand-up guy for free enterprise! What an ideologically correct appeal to laissez-faire principle! And, let me add, what a crock!

What these bellicose market-purists hope you don't discover is that they are closet socialists. As members of the congressional elite, they and their families are governmentally blessed with their very own gold-plated, taxpayer-financed, Washington-run health care system. And, they loooove it.

Theirs is such an effective system that not a single member of the hypocongress has been willing to give it up — even though they surely realize the political peril of being exposed as rank hypocrites for enjoying the very program they so adamantly reject for you.

Actually, they happily take a double dip in the soothing waters of public health care. First, they enroll their entire families in the Federal Employees Health Benefits Program — and you probably would, too, if it were available to you, for it's the Rolls Royce of health plans.

For example, while even the best employer-provided health policies offer only one or two types of coverage, FEHBP is a Chinese menu, offering dozens of coverage choices that allow its lucky members to assemble a plan that meets their unique needs. Members also need not worry about being denied coverage because of some pre-existing condition — once sworn into office, lawmakers and their families are immediately and fully insured, with total access to a national network of doctors and hospitals.

But here's the sweetest part of their Rolls Royce ride: up to 75 percent of the premiums are paid for by taxpayers, many of whom are lucky if they can afford to buy an old Yugo-level of health coverage in the vaunted private market.

Well, snaps the hypocongress crowd, even if FEHBP is essentially government-paid insurance, at least it's not socialized medicine, with doctors working for the government — so, technically, we're still pure.

Ah, that raises the second bit of secret socialism that lawmakers have mandated for themselves.

Right under the Capitol dome, conveniently situated between the Senate and House chamber, is the Office of the Attending Physician. Inside are more than a dozen navy doctors, nurses, medical technicians, pharmacists and other health professionals, all employed by the government solely to attend to a select clientele: the 535 members of Congress.

Let's say that, after giving a fiery speech on the floor assailing the evils of government-run health care, a lawmaker gets gaseous or has a tongue cramp. He or she can pop right into the OAP for — yes! — some government-run health care. No appointment needed, no pesky insurance forms to fill out, no co-pay — just care.

For this, members pay a flat fee of $503 a year. A year! You and I are taxed to cover the real costs of this elite service. And that's not the end of public health benefits for lawmakers — if they need a specialist, an operation, therapy, rehab or other pricey procedure, it's all free at the government's Walter Reed and Bethesda Naval hospitals.

If it's good enough for them, why not us? The public deserves what the Congress has, and any member who opposes extending it to us should automatically be stripped of their privileges.

For a model of integrity, they might look to Sen. Sherrod Brown, D-Ohio, and Rep. Steve Kagen, D-Wis. — both of whom have rejected taking congressional coverage until everyone in America has coverage of equal quality. I don't think the noisy naysayers are looking for integrity, however — not as long as they can get away with their abominable hypocrisy.

National radio commentator, writer, public speaker, and author of the book, Swim Against The Current: Even A Dead Fish Can Go With The Flow, Jim Hightower has spent three decades battling the Powers That Be on behalf of the Powers That Ought To Be - consumers, working families, environmentalists, small businesses, and just-plain-folks.

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Tuesday, September 29, 2009

Portrait of w:Dean BakerImage via Wikipedia

The Public Option Is Nothing To Fear

Republican opponents of a public option for US healthcare are defending the insurance industry, not conservative principles

by Dean Baker

Back in the good old days, the conservatives were the folks who favoured individual choice. Not any more. In the current healthcare debate, the top priority of the so-called conservatives is to deny people choice. They want to make sure that Americans do not have the option to buy into a Medicare-type public healthcare plan. These alleged conservatives have come up with a variety of arguments against allowing people the Medicare-type option, but the only one that makes sense is that they work for the insurance industry.

The argument against a Medicare-type option always begins with the assertion that the government can't do anything. This is a peculiar claim given the popularity of Medicare, but it also makes no sense as an argument against giving people a buy-in option. Suppose the government gives people the option to buy into its really bad plan. Everyone would just stick with the good private plans we have now, right?

The so-called conservatives then tell us that people will end up buying into the bad Medicare-type plan instead of the good private insurance options because the government will subsidise the Medicare-type plan. A little bit of arithmetic is sufficient to dismiss this argument.

How much money would be needed to get people to choose a bad healthcare plan rather than a good one? This would have to involve some serious subsidies. People are not going to sacrifice their health and the health of their families for another cup of coffee at Starbucks.

Suppose it took a subsidy of $1,000 a year to get people to choose the bad Medicare-type plan over the good private sector plans. With a non-Medicare population of more than 250 million, this would imply government subsidies of more than $250bn a year, if the Medicare-type plan was to fully replace private sector plans, as the so-called conservatives warn.

Is it really plausible that Congress will approve $250bn a year in subsidies ($2.5tn over a 10-year budget window) for a Medicare-type plan that everyone thinks is awful? Is there another altogether wasteful programmes that gets public subsidies even one-tenth of this size?

This one just doesn't pass the laugh test. If conservative politicians don't think they can prevent such an enormous waste of taxpayer dollars being perpetuated year after year for the indefinite future, they should probably consider another line of work.

In short, there is no genuine conservative argument against allowing people the option of buying into a Medicare-type plan. If the plan proves to be inferior to private insurance plans, as is often argued, then the consequences will be relatively minor. Some number of people who choose to sign up with this plan will find that they don't like it, and then will switch to a better alternative. In time, a bad public plan will soon flounder, since few people will buy into it. There may be some effort to provide subsidies to even a bad public plan, but it is not plausible that the subsidies could be large enough to displace private plans.

It is also clear that the opposition to a Medicare-type public plan does not stem from townhall-type mass opposition. A recent New York Times poll found that by an overwhelming majority, 65% to 26%, the public favours giving people this option. If there is a member of Congress that risks defeat by supporting a public plan, it is not because of their constituents' views.

The opposition to a Medicare-type option is not based on public sentiment or the fear that the plan will be bad. Rather the opposition is based on the fear that the plan will be good and that people will choose to buy into it. This will cost the insurance industry tens of billions of dollars in profit over the next decade and could mean the end of big paycheques for the industry's CEO's and other high-level executives.

But the people who oppose giving the public the opportunity to buy into a Medicare-type plan should not be called conservatives. Honest conservatives would have no objection to giving the public a choice. The people who oppose a Medicare-type plan are doing the bidding of the insurance industry - there is no conservative principle at stake. And we all know what Joe Wilson has to say about people like that.

Dean Baker is the co-director of the Center for Economic and Policy Research (CEPR). He is the author of The Conservative Nanny State: How the Wealthy Use the Government to Stay Rich and Get Richer ( www.conservativenannystate.org) and the more recently published Plunder and Blunder: The Rise and Fall of The Bubble Economy. He also has a blog, "Beat the Press," where he discusses the media's coverage of economic issues. You can find it at the American Prospect's web site.

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