Alex Blaze

Health care reform week, not weak health care reform

Filed By Alex Blaze | June 21, 2009 4:00 PM | comments

Filed in: Living
Tags: Blanche Lincoln, Bob Dole, Congress, Democrats, Ezra Klein, health care reform, health insurance reform, Max Baucus, Nancy Pelosi, plan, public option, Republicans, rescinsion, stupek, tom daschle

As big of a week this was for LGBT policy, it was also an important, exciting, disappointing, and stressful week for health care reform. I have more on that after the jump, but for those people who don't follow the policy debates, at least watch this video. d-day is trying to get 10 million views on YouTube for it because it shows just how fucked up our health care is in this country.

They're discussing rescission triggers, or when health insurers look for an excuse to kick someone off their insurance rolls at the moment they need treatment for an expensive disease. They look for pre-existing conditions that have nothing to do with the disease at hand, misfiled paperwork, misspelled words, whatever, they just don't want to pay for that cancer treatment or coronary bypass. A House investigation estimates that major insurers have refused to pay about $300 million over the five-year period studied and found that employees were praised in performance reviews for cutting off coverage to people with expensive diseases.

At about 4:50 in, Rep. Stupak asks the insurance CEO's to stop the practice of rescinding people unless they could prove fraud, and they refuse. Duh - denying people coverage just when they get a life-threatening disease means that they can collect premiums for years and then not pay when they have to. Why would they stop that hustle?

It's another reason we need a public option, along with the high premiums of private insurance and the fact that they deny coverage to people who need health care the most. To repeat the going meme, health care reform without a public option won't change anything. Private insurers will find a way around premium caps and eligibility requirements, and if that's all they have to exchange for an individual mandate that requires everyone to purchase their product and subsidies that send tax money straight to their coffers, they'll be sitting pretty when this is over and America will have gotten screwed on an issue we can't afford to lose.

Anyway, the week started with a blow to health care reform: the Congressional Budget Office released a preliminary report on the cost of Senator Baucus's plan for health care subsidies, and it predicted it to be far more expensive than anyone would be willing to vote for in the Senate. It's not particularly relevant, though, because as Ezra Klein pointed out (link above), the numbers had little to do with the reality of Baucus's plan or health care generally. But the report was put to work to decrease the chance of health care reform, and this evening my father brought up this report citing it as a reason that a public option shouldn't be created (even though that wasn't even included in the CBO report), so it's working to sway the public.

Hopefully, it won't do too much. An NBC/WSJ poll released Wednesday showed that 76% of Americans agree that it's important to have a public option to compete alongside private insurers. Now, if we lived in a real democracy, it would be a done deal after the president won his election with a mandate after campaigning hard on health care. But in America, where many of our politicians are bought off by the health care industry, it's still uncertain.

Also on Wednesday, two people who should have no influence in the legislative process came out against the public option:

"While I feel very strongly that consumers should have the choice of a national, Medicare-like plan, my colleagues do not. . . But we were concerned that the ongoing health reform debate is beginning to show signs of fracture on the public plan issue, so in order to advance the process of developing bipartisan legislation and to move it forward, it's time to find consensus here," Daschle said.

"We've come too far and gained too much momentum for our efforts to fail over disagreements on one single issue," he said.

In a blow to President Obama and many of his Democratic allies in the health care fight, the plan recommends that there be no federal public option, but rather state or regional public-sponsored networks that would compete with private health plans, according to the summary released today by the Bipartisan Policy Center.

"If you want to stop this thing dead in its tracks, or dead on arrival, in my view you put the public plan in it," Dole said when asked whether there were any non-negotiables to deal with when drafting the bipartisan recommendations.

"I had a lot of trouble with [individual] mandates just as Tom had trouble with the public plan. ... But if we can't compromise, how do we expect anyone else, how are we going to get a bill passed," Dole said. "We weren't going let two or three issues derail our total effort."

Daschle has taken a lot of money from the health care industry over the years, but that "D" next to his name makes him a rabid liberal in the eyes of the media. The bipart-gasm that followed these two former statesmen opposing something 76% of Americans want was rather disgusting.

Because they're both wrong: the public option isn't just another aspect of health care reform. It's the enforcement mechanism for any reform. There will be no change unless the private industry's gatekeeper position on health care is reduced. And they know it, and that's why they oppose it. The private industry couldn't compete with a strong public option and maintain its lavish profit margins and CEO benefits. It would either have to change its ways or die out, most likely the former, because they would lose the stranglehold over the public they have because their product is something people die without.

By Thursday, the CBO numbers on the Baucus plan had taken effect and the Senate Finance Committee produced a reduced proposal for health care reform:

The numbers tell the story. In that plan, subsidies reached 400 percent of poverty. In this plan, they've been cut to 300 percent. In that plan, Medicaid eligibility was as high as 150 percent of the poverty line. In this plan, it's 133 percent for pregnant women and children, and 100 percent for childless adults. In that plan, the "gold" coverage was 93 percent of a person's estimated expenses, and "bronze" coverage was 68 percent. In this plan, those numbers are 90 percent and 65 percent, respectively. That means people with a low-cost plan might be covered for only 65 percent of what they're likely to need.

It just goes to show how any slip up can end up costing us big time. Ted Kennedy is in charge of getting a proposal for more comprehensive health care reform, so let's hope that stays on track.

But we can't just have the Baucus plan without reforms to the industry, since subsidies for health care will likely just cause private insurers to jack up prices so they can get the subsidy money as well as the money people are paying now for health care. It's like we'll be paying taxes to the industry as well as premiums. So this is a health care reform that they want, of course, but it shouldn't be what they end up getting.

Which brings us to Friday, when the House released its plan for health care reform that includes a strong public option. Here are the talking points from Nancy Pelosi's office (pdf):

Here are 12 ways health care reform will help you and your family.

LOWER COSTS

  • No more co-pays or deductibles for preventive care
  • An annual cap on your out-of-pocket expenses--no longer driving Americans to financial ruin
  • An end to rate increases based on pre-existing conditions, gender, or occupation
  • Group purchasing power of a national pool if you have to buy your own plan
  • Guaranteed, affordable oral health and vision care for kids

GREATER CHOICE

  • Keep your doctor and your plan if you like them
  • More plan choices, including a high-quality public health insurance option that would compete with private companies

STABILITY & PEACE OF MIND

  • An end to coverage denials for pre-existing conditions such as heart disease, diabetes, or cancer
  • Get the care you need with an end to lifetime limits
  • Job and life choices will no longer be based on health care coverage

HIGHER QUALITY

  • Doctors--not insurance companies--in charge of health care decisions
  • More family doctors and nurses entering the workforce, at better payment rates, helping guarantee your access to quality care

It's a good sign, but the biggest problem isn't the House, it's the Senate. Republicans are expected to vote against anything with a public option in it since it would prove that the government can solve people's problems when run competently and that's the opposite of their philosophy. There is a group of Democrats who have been bought off by the industry and are willing to sell us down the river to keep their gravy train going.

Anyway, we need to keep our eyes on the prize. If you want to help by calling your Senators and Representatives, slinkerwink has the necessary information. When all this is over, when the dust has settled, we're going to find out that we've been screwed, that we've passed historic legislation that will help tens of millions of people, or that nothing's changed. And if nothing changes, we will have wasted this opportunity.


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Robert Ganshorn Robert Ganshorn | June 22, 2009 12:41 AM

Excellent Alex.

Far beyond a mere GLBT issue. Truly an issue for everyone. It is rather refreshing to watch each side try to "out lawyer" the other.

"It would either have to change its ways or die out, most likely the former, because they would lose the stranglehold over the public they have because their product is something people die without".

I do not see the oppositions argument. They make the claim that "OMG, it will cost us a Trillion dollars over 10 years", but they won't say a thing about the Trillion dollars a year, in total costs, of Military spending. It would look as if some of our Congress would prefer people just die by whatever method they can think up! Just as long as their Corporate/Entity constituents aka large campaign contributors are making a profit.

tobyhannabill | June 22, 2009 1:03 AM

This is why I've become so involved in OFA (Organizing For America) and their upcoming day of service on June 27th. I will be posting this blog to my Facebook and asking all my friends to spread it as far as it will go.

Bob Roehr | June 22, 2009 1:58 PM

Even if single payer (what many hope to be the eventual outcome of public option) where to come to pass, it would only nibble at the core problesm of healthcare in this country. The main porblem is how medicine is too often practiced by doctors as Atul Gawande made clear in his piece in The New Yorker. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

Doctors are as much a part of the problem as the insurance industry. There are too many specialists, not enough GPs, and they are retiring faster than they can be replaced. The entire us health system is fucked up.