Showing posts with label universal health care. Show all posts
Showing posts with label universal health care. Show all posts
"Reform": Nation’s Largest RN Organization Says Health Care Bill Cedes Too Much to Insurance Industry
Damning ress release from National Nurses United:
The 150,000 member National Nurses United, the nation’s largest union and professional organization of registered nurses in the U.S., today criticized the healthcare bill now advancing in the U.S. Senate saying it is deeply flawed and grants too much power to the giant insurers.
“It is tragic to see the promise from Washington this year for genuine, comprehensive reform ground down to a seriously flawed bill that could actually exacerbate the healthcare crisis and financial insecurity for American families, and that cedes far too much additional power to the tyranny of a callous insurance industry,” said NNU co-president Karen Higgins, RN.
NNU Co-president Deborah Burger, RN challenged arguments of legislation proponents that the bill should still be passed because of expanded coverage, new regulations on insurers, and the hope that it will be improved in the House-Senate conference committee or future years.
“Those wishful statements ignore the reality that much of the expanded coverage is based on forced purchase of private insurance without effective controls on industry pricing practices or real competition and gaping loopholes in the insurance reforms,” said Burger.
Further, said NNU Co-president Jean Ross, RN, “the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the healthcare industry lobbyists and the lessons of this year in which all the compromises have been made to the right.”
“Sadly, we have ended up with legislation that fails to meet the test of true healthcare reform, guaranteeing high quality, cost effective care for all Americans, and instead are further locking into place a system that entrenches the chokehold of the profit-making insurance giants on our health. If this bill passes, the industry will become more powerful and could be beyond the reach of reform for generations,” Higgins said.
NNU cited ten significant problems in the legislation, noting many of the same flaws also exist in the House version and are likely to remain in the bill that emerges from the House-Senate reconciliation process:1. The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.“Desperation to pass a bill, regardless of its flaws, has made the White House and Congress subject to the worst political extortion and new, crippling concessions every day,” Burger said.
2. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.
3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.
4. The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they’d pass the higher costs to their employees.
5. Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:* Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.6. Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California’s largest insurers have rejected more than one-fifth of all claims since 2002.
* Insurers are permitted to sell policies “across state lines”, exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.
* Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.
* Insurers may continue to rescind policies for “fraud or intentional misrepresentation” – the main pretext insurance companies now use to cancel coverage.
7. Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.
8. New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn’t want.
9. Reduced reproductive rights for women.
10. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.
“NNU and nurses will continue to work with the thousands of grassroots activists across the nation to campaign for the best reform, which would be to expand Medicare to cover everyone, the same type of system working more effectively in every other industrial country. The day of that reform will come,” said Ross. (December 21, 2009)
Health Care Reform: Howard Dean calls for a universally available public option -- like Medicare For All
By now, you've heard that Howard Dean has gone off the reservation.
Action: Sign the petition at Stand with Dr. Dean
If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers' monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.It looks like Dr. Dean is right and his critics wrong. As they could have done in the first place, the White House and the leadership should stand behind the House bill and, using reconciliation, push it through the Senate with a simple majority. The Republicans used to get a lot more done with 55 votes than the Democrats have been able to accomplish with 60. Time to get this done, but it needs to be done right.
Real health-care reform is supposed to eliminate discrimination based on preexisting conditions. But the legislation allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage. The bill was supposed to give Americans choices about what kind of system they wanted to enroll in. Instead, it fines Americans if they do not sign up with an insurance company, which may take up to 30 percent of your premium dollars and spend it on CEO salaries -- in the range of $20 million a year -- and on return on equity for the company's shareholders. Few Americans will see any benefit until 2014, by which time premiums are likely to have doubled. In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG.
Action: Sign the petition at Stand with Dr. Dean
The Good, the Bad, and the Ugly for Consumer Protection in the Senate Bill
Pre-emption of State Health Benefit Laws Is a Major Retreat; Insurance Rate Justification Shows Promise (press release)
Consumer Watchdog released a list today of the 10 key positive and negative consumer protection provisions of the U.S. Senate health reform bill, HR 3590, which passed an important procedural vote this weekend.
The group lauded the bill’s dramatic expansion of coverage for those currently without health insurance and subsidies to help consumers afford care, but called for amendments as the bill is debated next week.
Consumer Watchdog said that two provisions allowing for pre-emption of state laws by less protective federal standards amounted to a major step backwards in coverage and affordability. Provisions requiring insurance companies to justify their rates and providing grants to states to develop “prior approval” systems are promising, but need further development to protect Americans from price gouging by health insurers.
“The ‘bad’ and the ‘ugly’ of the Senate bill threaten to undermine the ‘good.’ In particular, provisions of the Senate bill that would pre-empt more protective state standards will result in insurance policies that do not provide needed services and treatments when patients get sick and need health care the most,” said Jerry Flanagan, Health Care Policy Director for Consumer Watchdog. “If the government is going to require all Americans to have health insurance, then the government has the duty to ensure coverage is affordable. Insurance rate justification and prior approval of rates are essential to achieve affordability. However, even some of the ‘good’ provisions of the bill need additional clarifications and fixes to ensure that consumers get the coverage they pay for when the health care reform bills become law.”
The List of 10 of Consumer Protections (details are below):
The Good:
Rate Increase Justification, State Grants for Prior Approval (page 37, § 2794). Insurance rate increase justification, and prior approval of those rates, are essential components of controlling the kind of double-digit health insurance rate increases that led U.S. Representative Crowley (D-NY), and U.S. Senators Durbin (D-IL) and Landrieu (D-LA), to spearhead a letter from 119 Members of Congress asking the health insurance industry to explain the unusually high increases predicted for 2010. Specifically, section 2794 of the Senate bill provides that:
Public Option (page 182, § 1323). The public insurance option is now called the "Community Health Insurance Option." Under the Senate bill:
Consumer Rebates if Insurer Overhead Exceeds 20-25% (Page 30, § 2718). Insurers will be required to provide annual rebates to consumers if the insurer's overhead costs (administration and profit) exceed 20% for coverage sold to employers and 25% for coverage sold to individuals. States may require lower overhead percentages. Rebates would equal the amount by which an insurer exceeds the overhead limit.
Recommendation: See 85% Administrative Cost Cap.
85% Administrative Cost Cap (Page 204, § 1331). Some analyses of the bill say that it requires private health insurance plans to spend at least 85% of premium revenue on medical costs. However, the placement of this language in the bill appears to apply the 85% requirement only to state “alternative programs” for low-income individuals.
Recommendation: The 85% so-called “medical loss ratio” should be applied to all insurers and all coverage. The required consumer rebates should be triggered if the insurer exceeds a 15% cap on administrative costs and profits, instead of the current limit in the bill of 20-25%.
Prohibition on Rescission. (page 16, § 2712). Under the U.S. Senate bill, health insurers are barred from retroactively canceling coverage after a patient gets sick, a practice known as “rescission,” unless the patient committed fraud or made an intentional misrepresentation of a material fact as “prohibited by the terms of the plan or coverage.”
Recommendation: The bill must clarify the grounds on which a rescission of coverage is justified, not leave it up to insurers to define in the fine print of their coverage contracts. For example, if an applicant’s health condition is not a factor in determining whether an individual or group is eligible for coverage under the bill’s Guaranteed Issue provisions, then failure to disclose such information cannot be grounds for rescission of the policy.
Guarantee Issue, Guaranteed Renewability, & Community Rating (page 82, § 2702; page 83, § 2703; page 83, § 2705). The bill bars a health insurer from refusing to sell coverage, refusing to renew coverage, or charging more for coverage due to a patient’s past health condition.
Recommendation: No change.
BAD
Individual mandate (page 320 § 1501). The bill requires every American, with some exceptions, to show proof of owning a health insurance policy or receiving health coverage from a public program. (For example, Medicaid or Medicare). Failure to do so will result in a fine of up to $750.
Recommendation: A mandatory purchase regime, particularly one without a true public option such as universal access to Medicare and without vigorous cost controls and guaranteed benefits, amounts only to a government-funded customer delivery system for the fragmented, wasteful private insurance market. The Senate should:
No matter what the premium price, strapped middle-class Americans who buy these plans will get horrible sticker shock on their deductibles and copays when they need to use the policy for anything beyond basic preventive care. Such costs deter families from seeking needed treatment for themselves and their children.
Recommendation: Bronze plan should provide benefits at 75% of actuarial value.
Employer “Fine” Shifts Burden of Health Care Costs to Individuals and Families (Page 348, § 1513). The bill requires employers with 50 or more employees to provide health coverage or pay a fine of $750 per employee each year. Those employers would only be required to pay a fine if any of its employees qualify for a subsidy to buy coverage on their own through the Exchange.
Recommendation: Health insurance for a family of four costs $13,375 each year. Allowing business owners to choose between paying for health coverage or paying a small fine will result in individuals and families bearing more of the cost burden. The Senate should amend the bill to require employers to pay a significant share of the cost of coverage in line with the requirements of the House of Representatives bill.
UGLY
Pre-emption of State Benefit Mandate Laws (Page 219, § 1333). Insurers may form “health care compacts” (page 219) and “Nationwide plans” (page 222) which would only be subject to the health benefit mandate laws and regulations of the State in which the plan was “written or issued.” Assuming that the proposed new national minimum benefit guidelines (page 102, § 1302) would apply to the compacts and Nationwide plans, the national minimums would become default rules because insurers would certainly choose to be regulated by the weakest state. As a result, millions of Americans could lose insurance coverage of important medical treatments and services such as AIDS/HIV testing, reconstructive surgery, home health care services, and child delivery and mastectomy minimum hospital stays.
Provisions in the bill allowing states to “opt-out” of permitting Nationwide plans and “opt-in” to interstate compacts offer little protection. The 1,000 health insurance lobbyists estimated to be working the federal health reform bill, and the industry’s unlimited capacity to buy votes with campaign contributions, would be marshaled to advance the insurers’ interest at the state level.
Click here to read Consumer Watchdog's analyses of the pre-emption provisions and the group’s letter to Senate Majority Leader Harry Reid.
Recommendation: States have traditionally been the laboratories of innovation in health care and insurance reform. States also have a greater ability to respond quickly to local needs. The Senate health reform bill should be modeled on existing federal health care laws which provide for a federal-state partnership rather than federal pre-emption of more protective state standards. Minimum federal standards should set a floor, not a ceiling, on state health care protections. In all cases, including Nationwide plans, heath care compacts, and Co-Ops, states must be free to impose their own required benefits and consumer protection laws if those benefits and laws are more protective than the laws of state where the policy was written or issued or the new federal guidelines.
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Consumer Watchdog is a nonpartisan consumer advocacy organization with offices in Washington, D.C. and Santa Monica, CA.
Consumer Watchdog released a list today of the 10 key positive and negative consumer protection provisions of the U.S. Senate health reform bill, HR 3590, which passed an important procedural vote this weekend.
The group lauded the bill’s dramatic expansion of coverage for those currently without health insurance and subsidies to help consumers afford care, but called for amendments as the bill is debated next week.
Consumer Watchdog said that two provisions allowing for pre-emption of state laws by less protective federal standards amounted to a major step backwards in coverage and affordability. Provisions requiring insurance companies to justify their rates and providing grants to states to develop “prior approval” systems are promising, but need further development to protect Americans from price gouging by health insurers.
“The ‘bad’ and the ‘ugly’ of the Senate bill threaten to undermine the ‘good.’ In particular, provisions of the Senate bill that would pre-empt more protective state standards will result in insurance policies that do not provide needed services and treatments when patients get sick and need health care the most,” said Jerry Flanagan, Health Care Policy Director for Consumer Watchdog. “If the government is going to require all Americans to have health insurance, then the government has the duty to ensure coverage is affordable. Insurance rate justification and prior approval of rates are essential to achieve affordability. However, even some of the ‘good’ provisions of the bill need additional clarifications and fixes to ensure that consumers get the coverage they pay for when the health care reform bills become law.”
The List of 10 of Consumer Protections (details are below):
The Good:
1. Rate review. Insurers must publicly justify “excessive” rate increases, and federal grants would encourage states to require full “prior approval” of such increases. (Needs strengthening of prior approval, definition of “excessive.”)The Bad:
2. Public Option. Bill retains an op-out public option and allows states to expand access to large employers.
3. Consumer rebates. Requires insurer rebates to consumers of administrative and overhead costs higher than 20% to 25%.
4. Minimum “loss ratio.” Insurers in some cases must assure that 85% of premiums are spent on medical care. (Should be expanded to all policies.)
5. Rescission ban. Insurers may not rescind policies except for “intentional misrepresentation” of material facts as determined by the coverage contract. (Needs much tighter definition.)
6. Guaranteed issue. Health insurance must be available to all, renewable for all, and rate differences, such as for age, are limited.
7. Mandate. Proof of insurance coverage is required of all Americans, while insurers are still largely free to charge what they want. (To keep insurers in check the bill needs a broader public option and mandatory rate approval to curb prices.)The Ugly:
8. Poor minimum coverage. Allowable minimum health plan, the “bronze” level, would cover only 60% of overall patient costs, including copays and deductibles. (Should be at least 75%.)
9. No employer requirement. Employers face only very weak fees for failing to even offer coverage. (Need more realistic requirements in House bill.)
10. Race to the bottom on state protections. State benefit requirements would be preempted by “nationwide plans” and multistate “compacts,” which would be ruled by laws of the weakest states; weaker federal requirements would become the norm. Coverage of AIDS/HIV testing, reconstructive surgery, home health care services, and child delivery and mastectomy minimum hospital stays and more would likely be lost. (States must retain freedom to require stronger coverage for all types of policies.)GOOD
Rate Increase Justification, State Grants for Prior Approval (page 37, § 2794). Insurance rate increase justification, and prior approval of those rates, are essential components of controlling the kind of double-digit health insurance rate increases that led U.S. Representative Crowley (D-NY), and U.S. Senators Durbin (D-IL) and Landrieu (D-LA), to spearhead a letter from 119 Members of Congress asking the health insurance industry to explain the unusually high increases predicted for 2010. Specifically, section 2794 of the Senate bill provides that:
(1) The Secretary of Health and Human Services, in conjunction with states, shall require health insurance companies to justify unreasonable premium increases prior to implementing them. Insurers are required to post the justifications on their websites.Recommendation: Consumer Watchdog, which pioneered the most successful insurance premium regulation law in the nation, Proposition 103, called on the Senate to adopt amendments reflecting key provisions of California’s landmark insurance reform law, including:
(2) The Secretary of Health and Human Services will provide $250 million in grants to assist states “in reviewing and, if appropriate under State law, approving premium increases for health insurance coverage...”
(3) Any state receiving a federal grant is required to make recommendations about whether particular health insurers should be excluded from participation in the Exchange “based on a pattern or practice of excessive or unjustified premium increases.”
• Mandatory justification of any rate increase (including premiums, deductibles, co-pays), not merely justifications of "unreasonable" premium increases.Click here to read about California’s landmark law to rein in gouging by property and casualty insurers.
• Increased amount of funding available for grants to assist states developing 'prior approval' systems. The U.S. House of Representatives bill provides $1 billion in such state grants.
• Mandatory prior approval, which means requiring insurers to seek permission from government regulators, in addition to justifying rate increases, before imposing the new rates. The language conditioning such prior approval on whether it is “appropriate under state law” should be deleted. In its place, states should be required to adopt Prop 103-styled prior approval in order to maximize saving and decrease insurance company waste and overhead. Since 1988, California’s Proposition 103 has saved drivers $62 billion while fostering a competitive and profitable insurance market.
• An intervenor system that provides consumers a forum to challenge unnecessary or excessive rate increases. Since 2003, Consumer Watchdog has saved the state’s consumers $1.7 billion by challenging unnecessary premium increases using the public intervention process.
Public Option (page 182, § 1323). The public insurance option is now called the "Community Health Insurance Option." Under the Senate bill:
(1) States may opt out entirely, but also may opt back in later.Recommendation: The Senate bill should make clear that any individual or employer can choose to buy coverage under the Community Health Option.
(2) The plans under this option, though offered through the state exchanges to individuals and small businesses, are federally administered by the Secretary of HHS.
(3) The public option benefit is limited to the "essential health benefits" described in the law, though states may offer additional benefits. In such cases, the state must fund said benefits.
(4) All enrollees in the public plan are treated as a nationwide single pool (not state by state).
(5) Plans are subject to state "consumer protection and solvency laws, with a federal minimum standard.
(6) States accepting the option shall form a "State Advisory Council" including patients and providers to provide recommendations to HHS on policies, public awareness and payment structures.
Consumer Rebates if Insurer Overhead Exceeds 20-25% (Page 30, § 2718). Insurers will be required to provide annual rebates to consumers if the insurer's overhead costs (administration and profit) exceed 20% for coverage sold to employers and 25% for coverage sold to individuals. States may require lower overhead percentages. Rebates would equal the amount by which an insurer exceeds the overhead limit.
Recommendation: See 85% Administrative Cost Cap.
85% Administrative Cost Cap (Page 204, § 1331). Some analyses of the bill say that it requires private health insurance plans to spend at least 85% of premium revenue on medical costs. However, the placement of this language in the bill appears to apply the 85% requirement only to state “alternative programs” for low-income individuals.
Recommendation: The 85% so-called “medical loss ratio” should be applied to all insurers and all coverage. The required consumer rebates should be triggered if the insurer exceeds a 15% cap on administrative costs and profits, instead of the current limit in the bill of 20-25%.
Prohibition on Rescission. (page 16, § 2712). Under the U.S. Senate bill, health insurers are barred from retroactively canceling coverage after a patient gets sick, a practice known as “rescission,” unless the patient committed fraud or made an intentional misrepresentation of a material fact as “prohibited by the terms of the plan or coverage.”
Recommendation: The bill must clarify the grounds on which a rescission of coverage is justified, not leave it up to insurers to define in the fine print of their coverage contracts. For example, if an applicant’s health condition is not a factor in determining whether an individual or group is eligible for coverage under the bill’s Guaranteed Issue provisions, then failure to disclose such information cannot be grounds for rescission of the policy.
Guarantee Issue, Guaranteed Renewability, & Community Rating (page 82, § 2702; page 83, § 2703; page 83, § 2705). The bill bars a health insurer from refusing to sell coverage, refusing to renew coverage, or charging more for coverage due to a patient’s past health condition.
Recommendation: No change.
BAD
Individual mandate (page 320 § 1501). The bill requires every American, with some exceptions, to show proof of owning a health insurance policy or receiving health coverage from a public program. (For example, Medicaid or Medicare). Failure to do so will result in a fine of up to $750.
Recommendation: A mandatory purchase regime, particularly one without a true public option such as universal access to Medicare and without vigorous cost controls and guaranteed benefits, amounts only to a government-funded customer delivery system for the fragmented, wasteful private insurance market. The Senate should:
- Adopt a “public option” to the private market that is open to all Americans.Low in Price, High in Cost -- 60% Actuarial Cap on Basic Coverage (page 112, § 1302(d)). The bill, responding to insurance industry lobbying, has lowered the overall value of the cheapest "bronze" plan to below that of almost any current employer-sponsored plan. The bronze plan has an actuarial value of 60%, 5% below the previous Senate plan, and 10% below the House plan. That means patients will have to pay, between premiums and out of pocket costs, 40% on average of their supposedly covered costs.
- Adopt a robust health insurance rate prior approval and rate justification system.
- Bar any new federal health care reforms from preempting state laws and regulations; they should follow the model of existing federal law, which promotes a state-federal partnership. (See “Ugly” below).
No matter what the premium price, strapped middle-class Americans who buy these plans will get horrible sticker shock on their deductibles and copays when they need to use the policy for anything beyond basic preventive care. Such costs deter families from seeking needed treatment for themselves and their children.
Recommendation: Bronze plan should provide benefits at 75% of actuarial value.
Employer “Fine” Shifts Burden of Health Care Costs to Individuals and Families (Page 348, § 1513). The bill requires employers with 50 or more employees to provide health coverage or pay a fine of $750 per employee each year. Those employers would only be required to pay a fine if any of its employees qualify for a subsidy to buy coverage on their own through the Exchange.
Recommendation: Health insurance for a family of four costs $13,375 each year. Allowing business owners to choose between paying for health coverage or paying a small fine will result in individuals and families bearing more of the cost burden. The Senate should amend the bill to require employers to pay a significant share of the cost of coverage in line with the requirements of the House of Representatives bill.
UGLY
Pre-emption of State Benefit Mandate Laws (Page 219, § 1333). Insurers may form “health care compacts” (page 219) and “Nationwide plans” (page 222) which would only be subject to the health benefit mandate laws and regulations of the State in which the plan was “written or issued.” Assuming that the proposed new national minimum benefit guidelines (page 102, § 1302) would apply to the compacts and Nationwide plans, the national minimums would become default rules because insurers would certainly choose to be regulated by the weakest state. As a result, millions of Americans could lose insurance coverage of important medical treatments and services such as AIDS/HIV testing, reconstructive surgery, home health care services, and child delivery and mastectomy minimum hospital stays.
Provisions in the bill allowing states to “opt-out” of permitting Nationwide plans and “opt-in” to interstate compacts offer little protection. The 1,000 health insurance lobbyists estimated to be working the federal health reform bill, and the industry’s unlimited capacity to buy votes with campaign contributions, would be marshaled to advance the insurers’ interest at the state level.
Click here to read Consumer Watchdog's analyses of the pre-emption provisions and the group’s letter to Senate Majority Leader Harry Reid.
Recommendation: States have traditionally been the laboratories of innovation in health care and insurance reform. States also have a greater ability to respond quickly to local needs. The Senate health reform bill should be modeled on existing federal health care laws which provide for a federal-state partnership rather than federal pre-emption of more protective state standards. Minimum federal standards should set a floor, not a ceiling, on state health care protections. In all cases, including Nationwide plans, heath care compacts, and Co-Ops, states must be free to impose their own required benefits and consumer protection laws if those benefits and laws are more protective than the laws of state where the policy was written or issued or the new federal guidelines.
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Consumer Watchdog is a nonpartisan consumer advocacy organization with offices in Washington, D.C. and Santa Monica, CA.
Health Care Reform: Not!
Here's a statement by Healthcare-NOW! summing up the prospects for affordable, universal health care:
See, also: Why I Voted "No" by Rep. Dennis Kucinich.
On Saturday, November 7, 2009, the House passed H.R. 3962, the Affordable Health Care for America Act, to much celebration by the Democratic party. Healthcare-NOW!'s view, however, is that the House bill is a gift to the insurance industry at the further expense of the people of this nation.Action: Donate to Healthcare-NOW!
The bill's advocates claim it will cover an additional 36 million people, subsidize the cost of insurance for families up to 400% above the poverty level, increase Medicaid coverage to 150% above the poverty level, close the Medicare donut hole by 2019, place a surcharge on individuals making more than $500,000 and couples making more than $1,000,000, will end rescissions and pre-existing conditions.
What the Democrats fail to mention is the bill leaves millions of people uninsured, allows medical bankruptcies to persist, criminalizes and fines the uninsured, increases the number of underinsured, does nothing to contain the sky rocketing costs, blocks women from their reproductive rights, transfers massive public funds to private insurance companies strengthening their control over care, protects pharmaceutical companies' superprofits at patient expense, fails to reclaim the 31% of waste in our system, expands Medicaid without regard to the state budget crises, discriminates based on immigration status and age, and sets up several levels of care covering less for those without the ability to pay. Those who have coverage will increasingly find care unaffordable and will go without. The whole system will inevitably fail from being fiscally unsustainable.
So is the House bill better than nothing?
"I don't think so," writes Marcia Angell, M.D. , former editor of the New England Journal of Medicine. "It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right."
Given that the bill does nothing to contain or reduce rising costs or end the private health insurance industry's dominance, we hoped that the Progressive Caucus would stand strong. But they did not. All but two of H.R. 676's cosponsors voted for H.R. 3962 -- Rep. Eric Massa [D-NY] and Rep. Kucinich [D-OH].
Rep. Massa stated, "At the highest level, this bill will enshrine in law the monopolistic powers of the private health insurance industry, period. There's really no other way to look at it."
Despite telling single-payer advocates that Congressman Weiner's single-payer amendment could not go to vote because it would open the floodgates for regressive amendments on abortion and immigrant access, the Democratic leadership allowed votes on both. Prior to the vote on H.R. 3962, the Stupak Amendment passed that will prevent women receiving tax subsidies from using their own money to purchase private insurance that covers abortion and in many cases will prevent low-income women from accessing abortion entirely.
"The House of Representatives has dealt the worst blow to women's fundamental right to self-determination in order to buy a few votes for reform of the profit-driven health insurance industry," writes Terry O'Neill, President of National Organization for Women. "We must protect the rights we fought for in Roe v. Wade. We cannot and will not support a health care bill that strips millions of women of their existing access to abortion."
Healthcare-NOW! fought to win a fair and open debate on healthcare reform including the merits of a single-payer system. This has not yet happened, but the advocacy for this system has greatly impacted the debate in meaningful ways.
We need to continue to build the grassroots movement for single-payer, not-for-profit, national healthcare. We look forward to much brain-storming at our upcoming national strategy conference in St. Louis this weekend, and the opportunity to move forward with renewed energy, creative ideas, and resolve.
Meanwhile, we have the opportunity NOW to continue to support the Sanders' Single-Payer Amendment to be introduced in the U.S. Senate, Congressman Kucinich's efforts to get the state single-payer amendment back in when the House and Senate bills are reconciled, and the efforts of the Mobilization for Health Care for All.
See, also: Why I Voted "No" by Rep. Dennis Kucinich.
Health Care Reform: Why I voted "no" - Rep. Dennis Kucinich
Dennis Kucinich Explains Why He Voted Against the Affordable Health Care for America Act
Congressman Kucinich has been one of the strongest voices for health care for all. With Rep. John Conyers, he introduced HR 676, the single-payer or Medicare-for-All bill, the proposal that had the widest support among Democrats in Congress until Pelosi and Obama pulled it "off the table" to make way for H.R. 3962, the Affordable Health Care for America Act, a.k.a., the Save-the-Insurance-Companies bill that passed Saturday. Thirty-six Democrats joined all but one Republican in voting "nay," Kucinich among them. On his website, he explains why:
Congressman Kucinich has been one of the strongest voices for health care for all. With Rep. John Conyers, he introduced HR 676, the single-payer or Medicare-for-All bill, the proposal that had the widest support among Democrats in Congress until Pelosi and Obama pulled it "off the table" to make way for H.R. 3962, the Affordable Health Care for America Act, a.k.a., the Save-the-Insurance-Companies bill that passed Saturday. Thirty-six Democrats joined all but one Republican in voting "nay," Kucinich among them. On his website, he explains why:
“We have been led to believe that we must make our health care choices only within the current structure of a predatory, for-profit insurance system which makes money not providing health care. We cannot fault the insurance companies for being what they are. But we can fault legislation in which the government incentivizes the perpetuation, indeed the strengthening, of the for-profit health insurance industry, the very source of the problem. When health insurance companies deny care or raise premiums, co-pays and deductibles they are simply trying to make a profit. That is our system.Why I Voted NO by Dennis Kucinich
“Clearly, the insurance companies are the problem, not the solution. They are driving up the cost of health care. Because their massive bureaucracy avoids payingbills so effectively, they force hospitals and doctors to hire their own bureaucracy to fight the insurance companies to avoid getting stuck with an unfair share of the bills. The result is that since 1970, the number of physicians has increased by less than 200% while the number of administrators has increased by 3000%. It is no wonder that 31 cents of every health care dollar goes to administrative costs, not toward providing care. Even those with insurance are at risk. The single biggest cause of bankruptcies in the U.S. is health insurance policies that do not cover you when you get sick.
“But instead of working toward the elimination of for-profit insurance, H.R. 3962 would put the government in the role of accelerating the privatization of health care. In H.R. 3962, the government is requiring at least 21 million Americans to buy private health insurance from the very industry that causes costs to be so high, which will result in at least $70 billion in new annual revenue, much of which is coming from taxpayers. This inevitably will lead to even more costs, more subsidies, and higher profits for insurance companies — a bailout under a blue cross.
“By incurring only a new requirement to cover pre-existing conditions, a weakened public option, and a few other important but limited concessions, the health insurance companies are getting quite a deal. The Center for American Progress’ blog, Think Progress, states 'since the President signaled that he is backing away from the public option, health insurance stocks have been on the rise.' Similarly, healthcare stocks rallied when Senator Max Baucus introduced a bill without a public option. Bloomberg reports that Curtis Lane, a prominent health industry investor, predicted a few weeks ago that 'money will start flowing in again' to health insurance stocks after passage of the legislation. Investors.com last month reported that pharmacy benefit managers share prices are hitting all-time highs, with the only industry worry that the Administration would reverse its decision not to negotiate Medicare Part D drug prices, leaving in place a Bush Administration policy.
“During the debate, when the interests of insurance companies would have been effectively challenged, that challenge was turned back. The 'robust public option' which would have offered a modicum of competition to a monopolistic industry was whittled down from an initial potential enrollment of 129 million Americans to 6 million. An amendment which would have protected the rights of states to pursue single-payer health care was stripped from the bill at the request of the Administration. Looking ahead, we cringe at the prospect of even greater favors for insurance companies.
“Recent rises in unemployment indicate a widening separation between the finance economy and the real economy. The finance economy considers the health of Wall Street, rising corporate profits, and banks’ hoarding of cash, much of it from taxpayers, as sign of an economic recovery. However in the real economy -- in which most Americans live -- the recession is not over. Rising unemployment, business failures, bankruptcies and foreclosures are still hammering Main Street.
“This health care bill continues the redistribution of wealth to Wall Street at the expense of America’s manufacturing and service economies which suffer from costs other countries do not have to bear, especially the cost of health care. America continues to stand out among all industrialized nations for its privatized health care system. As a result, we are less competitive in steel, automotive, aerospace and shipping while other countries subsidize their exports in these areas through socializing the cost of health care.
“Notwithstanding the fate of H.R. 3962, America will someday come to recognize the broad social and economic benefits of a not-for-profit, single-payer health care system, which is good for the American people and good for America’s businesses, with of course the notable exceptions being insurance and pharmaceuticals.”
Health Care Reform: Planned Parenthood Condemns Passage of Stupak/Pitts Amendment (Press Release)
Statement by Cecile Richards, President, Planned Parenthood Federation of America Condemning Passage of Stupak/Pitts Amendment
“Planned Parenthood condemns the adoption of the Stupak/Pitts amendment in HR 3962 this evening. This amendment is an unacceptable addition to the health care reform bill that, if enacted, would result in women losing health benefits they have today. Simply put, the Stupak/Pitts amendment would restrict women’s access to abortion coverage in the private health insurance market, undermining the ability of women to purchase private health plans that cover abortion, even if they pay for most of the premiums with their own money. This amendment reaches much further than the Hyde Amendment, which has prohibited public funding of abortion in most instances since 1977.
“Planned Parenthood serves three million women every year through its more than 850 affiliate health centers across the country and has worked tirelessly on behalf of those patients for affordable, quality health care. On behalf of the millions of women Planned Parenthood health centers serve, the Planned Parenthood Federation of America has no choice but to oppose HR 3962. The bill includes the Stupak/Pitts amendment that would leave women worse off after health care reform than they are today, violating President Obama’s promise to the American people that no one would be forced to lose her or his present coverage under health reform.
“The Stupak/Pitts amendment violates the spirit of health care reform, which is meant to guarantee quality, affordable health care coverage for all. In fact, this amendment would create a two-tiered system that would punish women, particularly those with low and middle incomes, the very people this bill is intended to assist. The majority of private health insurance plans currently offer abortion coverage, and the Stupak/Pitts amendment would result in the elimination of private abortion coverage in the ‘exchange,’ the new insurance market created under health care reform, as well as in the public option, if one is created.
“The Stupak/Pitts amendment would purportedly allow women who want comprehensive reproductive health care coverage to purchase a separate, single-service rider to cover abortion. But such abortion riders do not exist because women do not plan to have unintended pregnancies or medically complicated pregnancies that require ending the pregnancy. These so-called ‘abortion riders,’ which would be the only insurance policy through which abortion care could be covered in the ‘exchange,’ are discriminatory and illogical. Proposing a separate ‘abortion rider’ or ‘single-service plan’ is tantamount to banning abortion coverage since no insurance company would offer such a policy.
“It is extremely unfortunate that the United States Conference of Catholic Bishops and anti-choice opponents were able to hijack the health care reform bill in their dedicated attempt to ban all legal abortion In the United States. Most telling is the fact that the vast majority of members of the House who supported the Stupak/Pitts amendment in today’s vote do not support HR 3962, revealing their true motive, which is to kill the health care reform bill. These single-issue advocates simply used health care reform to advance their extreme, ideological agenda at the expense of tens of millions of women.
“Planned Parenthood applauds the members of Congress who stood up for women’s health and voted to oppose the Stupak/Pitts amendment. We will work with those members to rectify this travesty.
“As a health care provider, Planned Parenthood is committed to passing health care reform that will guarantee affordable, quality health care coverage for all, including access to comprehensive reproductive health care. In the coming weeks, Planned Parenthood will work with its allies in the Senate to ensure that the United States Conference of Catholic Bishops and those who oppose abortion do not once again hijack the legislative process in their ongoing campaign to make abortion illegal. Planned Parenthood will join forces with women and their families and health providers to ensure that health care reform does not take away benefits that most women with private health coverage have today. Together, women and their allies are going to make their voices heard, so that they do not become second-class citizens in a newly reformed health care system in the United States.”
“Planned Parenthood condemns the adoption of the Stupak/Pitts amendment in HR 3962 this evening. This amendment is an unacceptable addition to the health care reform bill that, if enacted, would result in women losing health benefits they have today. Simply put, the Stupak/Pitts amendment would restrict women’s access to abortion coverage in the private health insurance market, undermining the ability of women to purchase private health plans that cover abortion, even if they pay for most of the premiums with their own money. This amendment reaches much further than the Hyde Amendment, which has prohibited public funding of abortion in most instances since 1977.
“Planned Parenthood serves three million women every year through its more than 850 affiliate health centers across the country and has worked tirelessly on behalf of those patients for affordable, quality health care. On behalf of the millions of women Planned Parenthood health centers serve, the Planned Parenthood Federation of America has no choice but to oppose HR 3962. The bill includes the Stupak/Pitts amendment that would leave women worse off after health care reform than they are today, violating President Obama’s promise to the American people that no one would be forced to lose her or his present coverage under health reform.
“The Stupak/Pitts amendment violates the spirit of health care reform, which is meant to guarantee quality, affordable health care coverage for all. In fact, this amendment would create a two-tiered system that would punish women, particularly those with low and middle incomes, the very people this bill is intended to assist. The majority of private health insurance plans currently offer abortion coverage, and the Stupak/Pitts amendment would result in the elimination of private abortion coverage in the ‘exchange,’ the new insurance market created under health care reform, as well as in the public option, if one is created.
“The Stupak/Pitts amendment would purportedly allow women who want comprehensive reproductive health care coverage to purchase a separate, single-service rider to cover abortion. But such abortion riders do not exist because women do not plan to have unintended pregnancies or medically complicated pregnancies that require ending the pregnancy. These so-called ‘abortion riders,’ which would be the only insurance policy through which abortion care could be covered in the ‘exchange,’ are discriminatory and illogical. Proposing a separate ‘abortion rider’ or ‘single-service plan’ is tantamount to banning abortion coverage since no insurance company would offer such a policy.
“It is extremely unfortunate that the United States Conference of Catholic Bishops and anti-choice opponents were able to hijack the health care reform bill in their dedicated attempt to ban all legal abortion In the United States. Most telling is the fact that the vast majority of members of the House who supported the Stupak/Pitts amendment in today’s vote do not support HR 3962, revealing their true motive, which is to kill the health care reform bill. These single-issue advocates simply used health care reform to advance their extreme, ideological agenda at the expense of tens of millions of women.
“Planned Parenthood applauds the members of Congress who stood up for women’s health and voted to oppose the Stupak/Pitts amendment. We will work with those members to rectify this travesty.
“As a health care provider, Planned Parenthood is committed to passing health care reform that will guarantee affordable, quality health care coverage for all, including access to comprehensive reproductive health care. In the coming weeks, Planned Parenthood will work with its allies in the Senate to ensure that the United States Conference of Catholic Bishops and those who oppose abortion do not once again hijack the legislative process in their ongoing campaign to make abortion illegal. Planned Parenthood will join forces with women and their families and health providers to ensure that health care reform does not take away benefits that most women with private health coverage have today. Together, women and their allies are going to make their voices heard, so that they do not become second-class citizens in a newly reformed health care system in the United States.”
Health Care Reform: California Nurses on the canning of the single-payer in the House (Press Release)
CNA/NNOC Statement on the Withdrawal of the House Single Payer Amendment (California Nurses Association/National Nurses Organizing Committee)
"On the eve of what would have been the first national vote on single-payer legislation Rep. Anthony Weiner's single-payer/Medicare for all amendment was withdrawn Friday, November 6. The vote for Congressman Weiner's single-payer amendment would have allowed advocates to have their representatives on record as single-payer supporters. The announcement of the withdrawal of the amendment also followed an 11th hour decision by the House leadership to drop an amendment sponsored by Rep. Dennis Kucinich that had been in the bill since July to remove legal barriers for states that choose to enact single payer/Medicare for all state bills.
"The outcome on the Weiner and Kucinich amendments is the latest in year-long maneuvers by the Obama administration to take single payer off the table, to exclude single payer advocates from participation in the Congressional debate and White House healthcare forums, and to twist arms behind the scenes to block both the Kucinich and Weiner amendments.
"Regrettably, the administration and Congressional leadership efforts to silence the voices of advocates of the most comprehensive, most cost effective, most humane reform reinforced the extensive corporate lobbying of the insurance industry and its corporate allies. The private insurance industry alone has sent 3,000 lobbyists to Capitol Hill this year, spending $1.4 million dollars a day to shape reform that protects their profits and reinforces the broken, insurance-based healthcare system.
Only the remarkable, and persistent effort of our members and allies has kept the flame of the single payer/Medicare for all movement moving forward in Congress. And, we're not done.
"Our focus now turns to two remaining efforts for single-payer in this Congress. Sen. Bernie Sanders will introduce S 703 in coming weeks. In addition, Rep. Kucinich's amendment to allow states to more easily implement a single-payer system may be reinserted into the bill during the conference committee between the House and Senate.
"All of these efforts are crucial to building the movement for the best solution to our healthcare crisis - single-payer national healthcare.
"While the current bills will provide limited assistance for some, the inconvenient truth is they fall far short in effective controls on skyrocketing insurance, pharmaceutical and hospital costs, do little to stop insurance companies from denying needed medical care recommended by doctors, and provide little relief for Americans with employer-sponsored insurance worried about health security for themselves and their families.
"People are suffering – they die needlessly. The Democrats, who control the White House and Congress, bear the responsibility for changing that. Republicans cheerlead to deny care and humanity. The Democrats act as though they care and block the best solution. The heroes in this debate are the Medicare for all proponents who have stood by the American families.
"We will continue to press for guaranteed healthcare in Congress. Further, the outstanding state based campaigns for single payer bills in California, Pennsylvania, Maine, Illinois, and other states will continue.
"We concur with Healthcare-NOW, 'Let us not forget how far we have come. Either now or later, a single-payer national healthcare system must come to the table. We will keep building the movement to make that happen.'"
"On the eve of what would have been the first national vote on single-payer legislation Rep. Anthony Weiner's single-payer/Medicare for all amendment was withdrawn Friday, November 6. The vote for Congressman Weiner's single-payer amendment would have allowed advocates to have their representatives on record as single-payer supporters. The announcement of the withdrawal of the amendment also followed an 11th hour decision by the House leadership to drop an amendment sponsored by Rep. Dennis Kucinich that had been in the bill since July to remove legal barriers for states that choose to enact single payer/Medicare for all state bills.
"The outcome on the Weiner and Kucinich amendments is the latest in year-long maneuvers by the Obama administration to take single payer off the table, to exclude single payer advocates from participation in the Congressional debate and White House healthcare forums, and to twist arms behind the scenes to block both the Kucinich and Weiner amendments.
"Regrettably, the administration and Congressional leadership efforts to silence the voices of advocates of the most comprehensive, most cost effective, most humane reform reinforced the extensive corporate lobbying of the insurance industry and its corporate allies. The private insurance industry alone has sent 3,000 lobbyists to Capitol Hill this year, spending $1.4 million dollars a day to shape reform that protects their profits and reinforces the broken, insurance-based healthcare system.
Only the remarkable, and persistent effort of our members and allies has kept the flame of the single payer/Medicare for all movement moving forward in Congress. And, we're not done.
"Our focus now turns to two remaining efforts for single-payer in this Congress. Sen. Bernie Sanders will introduce S 703 in coming weeks. In addition, Rep. Kucinich's amendment to allow states to more easily implement a single-payer system may be reinserted into the bill during the conference committee between the House and Senate.
"All of these efforts are crucial to building the movement for the best solution to our healthcare crisis - single-payer national healthcare.
"While the current bills will provide limited assistance for some, the inconvenient truth is they fall far short in effective controls on skyrocketing insurance, pharmaceutical and hospital costs, do little to stop insurance companies from denying needed medical care recommended by doctors, and provide little relief for Americans with employer-sponsored insurance worried about health security for themselves and their families.
"People are suffering – they die needlessly. The Democrats, who control the White House and Congress, bear the responsibility for changing that. Republicans cheerlead to deny care and humanity. The Democrats act as though they care and block the best solution. The heroes in this debate are the Medicare for all proponents who have stood by the American families.
"We will continue to press for guaranteed healthcare in Congress. Further, the outstanding state based campaigns for single payer bills in California, Pennsylvania, Maine, Illinois, and other states will continue.
"We concur with Healthcare-NOW, 'Let us not forget how far we have come. Either now or later, a single-payer national healthcare system must come to the table. We will keep building the movement to make that happen.'"
Health Care Reform: House vote on Medicare For All cancelled
This has just been released by Healthcare-NOW!:
On the eve of what could have been the first vote on single-payer legislation in our nation's history, we have just learned that because of last minute developments, the vote and debate on Congressman Weiner's single-payer amendment will not happen.
Speaker Pelosi received a statement from Rep. Kucinich and Rep. Conyers, the co-authors of HR 676, that they do not think that this is the right time for a vote on national single-payer legislation. They made this statement despite the extensive mobilization in support of this vote across the country. In addition, Speaker Pelosi felt that offering a single-payer amendment would open the floodgates to amendments proposed to limit abortion funds, restrict immigrant access to healthcare, and other regressive legislation.
Let us remember that the potential vote on Congressman Weiner's single-payer amendment resulted from holding fast to our principles of universal, comprehensive healthcare with no financial barriers. These efforts have brought truth and clarity to a national debate on healthcare reform that has been polluted by the corporate influence over Congress. While the private insurance industry has sent 3,000 lobbyists to Capitol Hill this year, spending 1.4 million dollars a day to shape reform that protects their profits, our calls, faxes, and demonstrations have created the momentum to bring legislation based on HR 676 to the floor of the House and Senate.
The vote for Congressman Weiner's single-payer amendment would have allowed advocates to have their representatives on record as single-payer supporters.
But this legislative battle is not yet over. Our focus can now turn to two remaining efforts for single-payer in this Congress. Sen. Bernie Sanders will introduce S 703 in coming weeks, and we understand that he is considering editing it to be more like HR 676. We will have the opportunity again to see the first ever vote on single-payer in this Congress. In addition, Rep. Kucinich's amendment to allow states to more easily implement a single-payer system may be reinserted into the bill during the conference committee between the House and Senate.
All of these efforts are crucial to building the movement for the only solution to our healthcare crisis - single-payer national healthcare.
If this Congress passes inadequate legislation, there will no doubt be emboldened state movements in the coming years. We welcome them. But let us not forget the movement to push our federal legislators to meet the demands of the people, not roll that responsibility onto the states.
Healthcare-NOW! and the Leadership Conference for Guaranteed Health Care remains committed to a national, single-payer solution to the healthcare crisis.
Comprehensive, quality healthcare is a right that should be extended to every U.S. resident.
At this important time, let us not forget how far we have come. Either now or later, a single-payer national healthcare system must come to the table. We will keep building the movement to make that happen.
For healthcare justice, Healthcare-NOW!
Physicians for a National Health Program
Progressive Democrats of America
Public Citizen
Healthcare for All Texas
Western PA Coalition for Single Payer
Alliance for Democracy
Action: Donate to Healthcare-NOW!
On the eve of what could have been the first vote on single-payer legislation in our nation's history, we have just learned that because of last minute developments, the vote and debate on Congressman Weiner's single-payer amendment will not happen.
Speaker Pelosi received a statement from Rep. Kucinich and Rep. Conyers, the co-authors of HR 676, that they do not think that this is the right time for a vote on national single-payer legislation. They made this statement despite the extensive mobilization in support of this vote across the country. In addition, Speaker Pelosi felt that offering a single-payer amendment would open the floodgates to amendments proposed to limit abortion funds, restrict immigrant access to healthcare, and other regressive legislation.
Let us remember that the potential vote on Congressman Weiner's single-payer amendment resulted from holding fast to our principles of universal, comprehensive healthcare with no financial barriers. These efforts have brought truth and clarity to a national debate on healthcare reform that has been polluted by the corporate influence over Congress. While the private insurance industry has sent 3,000 lobbyists to Capitol Hill this year, spending 1.4 million dollars a day to shape reform that protects their profits, our calls, faxes, and demonstrations have created the momentum to bring legislation based on HR 676 to the floor of the House and Senate.
The vote for Congressman Weiner's single-payer amendment would have allowed advocates to have their representatives on record as single-payer supporters.
But this legislative battle is not yet over. Our focus can now turn to two remaining efforts for single-payer in this Congress. Sen. Bernie Sanders will introduce S 703 in coming weeks, and we understand that he is considering editing it to be more like HR 676. We will have the opportunity again to see the first ever vote on single-payer in this Congress. In addition, Rep. Kucinich's amendment to allow states to more easily implement a single-payer system may be reinserted into the bill during the conference committee between the House and Senate.
All of these efforts are crucial to building the movement for the only solution to our healthcare crisis - single-payer national healthcare.
If this Congress passes inadequate legislation, there will no doubt be emboldened state movements in the coming years. We welcome them. But let us not forget the movement to push our federal legislators to meet the demands of the people, not roll that responsibility onto the states.
Healthcare-NOW! and the Leadership Conference for Guaranteed Health Care remains committed to a national, single-payer solution to the healthcare crisis.
Comprehensive, quality healthcare is a right that should be extended to every U.S. resident.
At this important time, let us not forget how far we have come. Either now or later, a single-payer national healthcare system must come to the table. We will keep building the movement to make that happen.
For healthcare justice, Healthcare-NOW!
Physicians for a National Health Program
Progressive Democrats of America
Public Citizen
Healthcare for All Texas
Western PA Coalition for Single Payer
Alliance for Democracy
Action: Donate to Healthcare-NOW!
Health Care Reform: Lack of Insurance May Have Figured In Nearly 17,000 Childhood Deaths, Study Shows
Under the various proposals being considered by Congress, health care coverage is likely to be universal or nearly so. But will it be affordable? Unless the new system is single-payer, or at least includes a robust public option -- consumer option, as Speaker Pelosi is calling it now, it will not save money and the number of deaths will continue to be needlessly high.
This press release from the John Hopkins Children's Center (2009-10-29) provides background on the problem:
Lack of health insurance might have led or contributed to nearly 17,000 deaths among hospitalized children in the United States in the span of less than two decades, according to research led by the Johns Hopkins Children's Center.
According to the Johns Hopkins researchers, the study, published Oct. 29 in the Journal of Public Health, is one of the largest ever to look at the impact of insurance on the number of preventable deaths and the potential for saved lives among sick children in the United States.
Using more than 23 million hospital records from 37 states between 1988 and 2005, the Johns Hopkins investigators compared the risk of death in children with insurance and in those without. Other factors being equal, researchers found that uninsured children in the study were 60 percent more likely to die in the hospital than those with insurance. When comparing death rates by underlying disease, the uninsured appeared to have increased risk of dying independent regardless of their medical condition, the study found. The findings only capture deaths during hospitalization and do not reflect deaths after discharge from the hospital, nor do they count children who died without ever being hospitalized, the researchers say, which means the real death toll of non-insurance could be even higher.
"If you are a child without insurance, if you're seriously ill and end up in the hospital, you are 60 percent more likely to die than the sick child in the next room who has insurance," says lead investigator Fizan Abdullah, M.D., Ph.D., a pediatric surgeon at the Johns Hopkins Children's Center.
The researchers caution that the study looked at hospital records after the fact of death so they cannot directly establish cause and effect between health insurance and risk of dying. However because of the volume of records analyzed and because of the researchers' ability to identify and eliminate most factors that typically cloud such research, the analysis shows a powerful link between health insurance and risk of dying, they say.
"Can we say with absolute certainty that 17,000 children would have been saved if they had health insurance? Of course not," says co-investigator David Chang, Ph.D. M.P.H. M.B.A. "The point here is that a substantial number of children may be saved by health coverage."
"From a scientific perspective, we are confident in our finding that thousands of children likely did die because they lacked insurance or because of factors directly related to lack of insurance," he adds.
Given that more than 7 million American children in the United States remain uninsured amidst this nation's struggle with health-care reform, researchers say policymakers and, indeed, society as a whole should pay heed to their findings.would
"Thousands of children die needlessly each year because we lack a health system that provides them health insurance. This should not be," says co-investigator Peter Pronovost, M.D., Ph.D., director of Critical Care Medicine at Johns Hopkins and medical director of the Center for Innovations in Quality Patient Care. "In a country as wealthy as ours, the need to provide health insurance to the millions of children who lack it is a moral, not an economic issue," he adds.
In the study, 104,520 patients died (0.47 percent) out of 22.2 million insured hospitalized children, compared to 9, 468 (0.75 percent) who died among the 1.2 million uninsured ones. To find out what portion of these deaths would have been prevented by health insurance, researchers performed a statistical simulation by projecting the expected number of deaths for insured patients based on the severity of their medical conditions among other factors, and then applied this expected number of deaths to the uninsured group.
In the uninsured group, there were 3,535 more deaths than expected, not explained by disease severity or other factors. Going a step further and applying the excess number of deaths to the total number of pediatric hospitalizations in the United States (117 million) for the study period, the researchers found an excess of 16,787 deaths among the nearly six million uninsured children who ended up in the hospital during that time.
Other findings from the study:
More uninsured children were seen in hospitals in the Northeast and Midwest than in the South and West. However, hospitals from the Northeast had lower mortality rates than hospitals from the South, Midwest and West. Insured children on average incurred higher hospital charges than uninsured children, most likely explained by the fact that uninsured children tend to present to the hospital at more advanced stages of their disease, which in turn gives doctors less chance for intervention and treatment, especially in terminal cases, investigators say. Uninsured patients were more likely to seek treatment though the Emergency Room, rather than through a referral by a doctor, likely markers of more advanced disease stage and/or delays in seeking medical attention. Insurance status did not affect how long a child spent overall in the hospital.
The research was funded by the Robert Garrett Fund for the Treatment of Children.
Co-investigators in the study include Yiyi Zhang, M.H.S.; Thomas Lardaro, B.S.; Marissa Black; Paul Colombani, M.D.; Kristin Chrouser, M.D. M.P.H.
This press release from the John Hopkins Children's Center (2009-10-29) provides background on the problem:
Lack of health insurance might have led or contributed to nearly 17,000 deaths among hospitalized children in the United States in the span of less than two decades, according to research led by the Johns Hopkins Children's Center.
According to the Johns Hopkins researchers, the study, published Oct. 29 in the Journal of Public Health, is one of the largest ever to look at the impact of insurance on the number of preventable deaths and the potential for saved lives among sick children in the United States.
Using more than 23 million hospital records from 37 states between 1988 and 2005, the Johns Hopkins investigators compared the risk of death in children with insurance and in those without. Other factors being equal, researchers found that uninsured children in the study were 60 percent more likely to die in the hospital than those with insurance. When comparing death rates by underlying disease, the uninsured appeared to have increased risk of dying independent regardless of their medical condition, the study found. The findings only capture deaths during hospitalization and do not reflect deaths after discharge from the hospital, nor do they count children who died without ever being hospitalized, the researchers say, which means the real death toll of non-insurance could be even higher.
"If you are a child without insurance, if you're seriously ill and end up in the hospital, you are 60 percent more likely to die than the sick child in the next room who has insurance," says lead investigator Fizan Abdullah, M.D., Ph.D., a pediatric surgeon at the Johns Hopkins Children's Center.
The researchers caution that the study looked at hospital records after the fact of death so they cannot directly establish cause and effect between health insurance and risk of dying. However because of the volume of records analyzed and because of the researchers' ability to identify and eliminate most factors that typically cloud such research, the analysis shows a powerful link between health insurance and risk of dying, they say.
"Can we say with absolute certainty that 17,000 children would have been saved if they had health insurance? Of course not," says co-investigator David Chang, Ph.D. M.P.H. M.B.A. "The point here is that a substantial number of children may be saved by health coverage."
"From a scientific perspective, we are confident in our finding that thousands of children likely did die because they lacked insurance or because of factors directly related to lack of insurance," he adds.
Given that more than 7 million American children in the United States remain uninsured amidst this nation's struggle with health-care reform, researchers say policymakers and, indeed, society as a whole should pay heed to their findings.would
"Thousands of children die needlessly each year because we lack a health system that provides them health insurance. This should not be," says co-investigator Peter Pronovost, M.D., Ph.D., director of Critical Care Medicine at Johns Hopkins and medical director of the Center for Innovations in Quality Patient Care. "In a country as wealthy as ours, the need to provide health insurance to the millions of children who lack it is a moral, not an economic issue," he adds.
In the study, 104,520 patients died (0.47 percent) out of 22.2 million insured hospitalized children, compared to 9, 468 (0.75 percent) who died among the 1.2 million uninsured ones. To find out what portion of these deaths would have been prevented by health insurance, researchers performed a statistical simulation by projecting the expected number of deaths for insured patients based on the severity of their medical conditions among other factors, and then applied this expected number of deaths to the uninsured group.
In the uninsured group, there were 3,535 more deaths than expected, not explained by disease severity or other factors. Going a step further and applying the excess number of deaths to the total number of pediatric hospitalizations in the United States (117 million) for the study period, the researchers found an excess of 16,787 deaths among the nearly six million uninsured children who ended up in the hospital during that time.
Other findings from the study:
More uninsured children were seen in hospitals in the Northeast and Midwest than in the South and West. However, hospitals from the Northeast had lower mortality rates than hospitals from the South, Midwest and West. Insured children on average incurred higher hospital charges than uninsured children, most likely explained by the fact that uninsured children tend to present to the hospital at more advanced stages of their disease, which in turn gives doctors less chance for intervention and treatment, especially in terminal cases, investigators say. Uninsured patients were more likely to seek treatment though the Emergency Room, rather than through a referral by a doctor, likely markers of more advanced disease stage and/or delays in seeking medical attention. Insurance status did not affect how long a child spent overall in the hospital.
The research was funded by the Robert Garrett Fund for the Treatment of Children.
Co-investigators in the study include Yiyi Zhang, M.H.S.; Thomas Lardaro, B.S.; Marissa Black; Paul Colombani, M.D.; Kristin Chrouser, M.D. M.P.H.
Clip File: The inevitability of an American single-payer health system
"Amidst the ideological back and forth that is the health care reform debate of 2009, recent studies reveal a growing reality that each of us can easily understand, no matter what our ideological point of view.
"It will not be long until the private health insurance model will no longer work – for anybody.
"It’s got nothing to do with public options or single payer advocates just as it will have nothing to do with those prepared to defend America from socialism at all costs.
"The simple fact is that single-payer, government controlled health care is inevitable because the trajectory of the private health insurance system reveals that it is doomed to fail – and sooner than we might realize."
The rest of the story: The inevitability of an American single-payer health system by Rick Ungar (True/Slant 2009-10-20)
"It will not be long until the private health insurance model will no longer work – for anybody.
"It’s got nothing to do with public options or single payer advocates just as it will have nothing to do with those prepared to defend America from socialism at all costs.
"The simple fact is that single-payer, government controlled health care is inevitable because the trajectory of the private health insurance system reveals that it is doomed to fail – and sooner than we might realize."
The rest of the story: The inevitability of an American single-payer health system by Rick Ungar (True/Slant 2009-10-20)
Health Care: Public option endgame
I'm down with flu, but I wanted to make sure you saw this updating of the status of the public option:Take action: Contact your representatives in Congress to let them know you want a robust alternative to private health care insurance.
Visit msnbc.com for Breaking News, World News, and News about the Economy
Health Care: We Can Have Obama's Staggeringly Complex Plan to Save the Insurance Industry
Or we can have Medicare for All.
See: The Simple Solution to the Health Care Crisis: Medicare for All by Dave Lindorff (CounterPunch 2009-07-24)
Health Care Reform: What is to be done?
On last night's MSNBC Countdown, Keith Olbermann looked at the Senate health care reform bill, the prospects of the public option, Sen. Reid's leadership, and with Florida Democratic Rep. Alan Grayson the need for public action if reform is to succeed.
Here's former governor Howard Dean on the same subject:So what should the public do? Olbermann ends by quoting Frederick Douglas: "Agitate. Agitate. Agitate."
Visit msnbc.com for Breaking News, World News, and News about the Economy
Health Care: Rep. Alan Grayson keeps up the pressure for real health care reform
Speaking for the Democratic wing of the Democratic Party, Florida Democrat Alan Grayson reminds his colleagues of the life-and-death urgency of reforming health care insurance to make it universal, portable, affordable and cost-saving.
He appeared Friday on MSNBC's Countdown.
In an aside, as the White House and the Democratic House and Senate election committees begin their biennial search for Blue Dogs like Kirsten Gillibrand to run against progressives in the primaries, Grayson offers the reminder, too often ignored by party moderates, that "You can NOT beat a Republican by being one."
Grayson Watch:
Health Care: Something needs to be done about Alan Grayson (Impractical Proposals 2009-10-01)
Health Care: Democrat feeds the GOP a bitter pill (Impractical Proposals 2009-09-30)
The Fed: Geithner wants to let the foxes run the chicken coop (Impractical Proposals 2009-09-11)
He appeared Friday on MSNBC's Countdown.
In an aside, as the White House and the Democratic House and Senate election committees begin their biennial search for Blue Dogs like Kirsten Gillibrand to run against progressives in the primaries, Grayson offers the reminder, too often ignored by party moderates, that "You can NOT beat a Republican by being one."
Grayson Watch:
Health Care: Something needs to be done about Alan Grayson (Impractical Proposals 2009-10-01)
Health Care: Democrat feeds the GOP a bitter pill (Impractical Proposals 2009-09-30)
The Fed: Geithner wants to let the foxes run the chicken coop (Impractical Proposals 2009-09-11)
Health Care Reform: What's the difference between "the public option" and Medicare for All?
The opponents of reform have sown considerable confusion about the differences between single-payer health care -- Medicare for All -- and the various health care reform alternatives, including the so-called public option, being debated in the House and Senate. Here are some more resources to help clarify the difference:
Report Card for Single-Payer and “Public Option” (pdf)
More of the Same Is Not Health Care Reform, It’s a Placebo by Leonard Rodberg, PhD
Hold out for single payer by Nick Skala
Bait and switch: How the “public option” was sold by Kip Sullivan
The “Public Plan Option”: Myths and Facts
Health Policy Q & A with PNHP Co-founders Drs. David Himmelstein and Steffie Woolhandler (pdf)
Tell them why they’re wrong when they say single-payer is not politically viable! (pdf)
Dr. Len Rodberg, of Physicians for a National Health Program, made a great presentation on single-payer and the public option at a teach-in in New York City. Download Len Rodberg’s slide show (ppt)
And here's a rap kicker.
It's not over 'til it's over. Contact your representatives and let them know you want Medicare for All.
Sonameme further reading about the public option:
Trigger Happy (Time 2009-11-18)
One-Two Punch: Unemployed and Uninsured (Families USA 2009-10)
The House Public Plan: Yes, It's Worth It (The New Republic 2009-11-05)
Trigger Unhappy: What Experience Can Teach Us About Why We Should Not Delay the Implementation of Public Plan Choice by Timothy Stoltzfus Jost (Washington and Lee University)
Trigger Unhappy (The New Republic 2009-11-22)
Report Card for Single-Payer and “Public Option” (pdf)
More of the Same Is Not Health Care Reform, It’s a Placebo by Leonard Rodberg, PhD
Hold out for single payer by Nick Skala
Bait and switch: How the “public option” was sold by Kip Sullivan
The “Public Plan Option”: Myths and Facts
Health Policy Q & A with PNHP Co-founders Drs. David Himmelstein and Steffie Woolhandler (pdf)
Tell them why they’re wrong when they say single-payer is not politically viable! (pdf)
Dr. Len Rodberg, of Physicians for a National Health Program, made a great presentation on single-payer and the public option at a teach-in in New York City. Download Len Rodberg’s slide show (ppt)
And here's a rap kicker.
It's not over 'til it's over. Contact your representatives and let them know you want Medicare for All.
Sonameme further reading about the public option:
Trigger Happy (Time 2009-11-18)
One-Two Punch: Unemployed and Uninsured (Families USA 2009-10)
The House Public Plan: Yes, It's Worth It (The New Republic 2009-11-05)
Trigger Unhappy: What Experience Can Teach Us About Why We Should Not Delay the Implementation of Public Plan Choice by Timothy Stoltzfus Jost (Washington and Lee University)
Trigger Unhappy (The New Republic 2009-11-22)
Health Care Insurance Reform: To do it right will require raising revenues
In order to bring the cost of health insurance reform below the $900 billion limit imposed arbitrarily by the White House, the House of Representatives may have to cut government subsidies for low- and middle-class families unable to afford the mandated insurance. The amount of coverage that people will be required to buy may also have to be reduced. In other words, the mandated insurance would be less affordable and less effective than is called for now. If coverage is to be truly universal and affordable, finding new revenues makes more sense than raising the cost and lowering the coverage for those the legislation is intended to help. The House bill as it stands is about $1.2 trillion. Some House Democrats think a windfall profits tax on the revenue boost insurance companies will get from the bill would be only fair. Others want to raise taxes on people making more than $300,000 a year to help pay the bill's costs. Either is a better idea than cutting subsidies or limiting benefits.
Health Care Insurance Reform: 30 senators sign letter backing public option
"In the past, it's been House Democrats who've been most vocal in supporting the public option. Now, Senate Democrats are getting on the bandwagon.
"30 Democratic senators (really, 29 Democrats and one independent who caucuses with them, Vermont's Bernie Sanders) joined together on Thursday to send a letter to Senate Majority Leader Harry Reid in which they ask him 'for your leadership on ensuring that the merged health reform bill contains a public insurance option.'"
The rest of the story: 30 senators sign letter backing public option (Salon 2009-19-08)
"30 Democratic senators (really, 29 Democrats and one independent who caucuses with them, Vermont's Bernie Sanders) joined together on Thursday to send a letter to Senate Majority Leader Harry Reid in which they ask him 'for your leadership on ensuring that the merged health reform bill contains a public insurance option.'"
The rest of the story: 30 senators sign letter backing public option (Salon 2009-19-08)
Health Care: Other Options
Universal coverage, private competition and reduced deficits
"Re-read that headline. I am not making this up. A health care bill exists that would accomplish what the headline says.
"Moreover, it has been verified by the Congressional Budget Office (CBO), in a letter signed in May 2008 by the office's then-Director Peter R. Orszag, who now directs President Obama's Office of Management and Budget.
"It's called the Healthy Americans Act (the HAA). It has been fully vetted for years, written in legislative language, scored by the CBO and has substantial bipartisan support. [Here are] the two basic, simple concepts of the HAA:
"Re-read that headline. I am not making this up. A health care bill exists that would accomplish what the headline says.
"Moreover, it has been verified by the Congressional Budget Office (CBO), in a letter signed in May 2008 by the office's then-Director Peter R. Orszag, who now directs President Obama's Office of Management and Budget.
"It's called the Healthy Americans Act (the HAA). It has been fully vetted for years, written in legislative language, scored by the CBO and has substantial bipartisan support. [Here are] the two basic, simple concepts of the HAA:
"Universal coverage, attracting liberal support — i.e., all Americans are required to purchase health insurance just like auto drivers are required to purchase car insurance.The rest of the story: Universal coverage, private competition and reduced deficits by Lanny Davis Universal coverage, private competition and reduced deficits (The Hill 2009-10-05)
"More consumer choice and private-market competition, attracting conservative support — permitting everyone to purchase their own insurance policies in open, competitive 'state exchange' marketplaces, each of which must include the Blue Cross/Blue Shield 'Basic' policy, the lowest-tier option available to all federal employees and members of Congress or its functional equivalent."
Health Care: Fake reform is worse than no reform
It's time to draw a line in the sand on health care insurance reform. A bill that forces everyone to buy health insurance but doesn't include a mechanism to control prices can't fairly be called reform at all -- it's nothing more than a windfall for the parasitic insurance industry, and neither universality nor portability will make it palatable. The Democrats in the House who support HR676 should stick to their guns: Medicare for All.
Here's a bit of nostalgia from the 2008 campaign:
We don't have the luxury to be nostalgic, however. If the Democrats fail to pass Medicare for All -- or if, as seems likely, they pass legislation that requires people to buy health insurance they can't afford, voters will not be wrong to turn them out in 2010 and 2012. Contact your senators and representative. Tell them you demand affordable, universal health care. Say it like you mean it. It's now or never.
Further reading: The "public option" is not dead by Scott Galindez (truthout 2009-09-30)
HR 676 (Conyers) The United States National Health Insurance Act
S. 703 (Sanders) Bill to provide for health care for every American
Take action: Contact your congressional representatives
Here's a bit of nostalgia from the 2008 campaign:
We don't have the luxury to be nostalgic, however. If the Democrats fail to pass Medicare for All -- or if, as seems likely, they pass legislation that requires people to buy health insurance they can't afford, voters will not be wrong to turn them out in 2010 and 2012. Contact your senators and representative. Tell them you demand affordable, universal health care. Say it like you mean it. It's now or never.
Further reading: The "public option" is not dead by Scott Galindez (truthout 2009-09-30)
HR 676 (Conyers) The United States National Health Insurance Act
S. 703 (Sanders) Bill to provide for health care for every American
Take action: Contact your congressional representatives
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