Blog entry

What Would You Do If You Had Guaranteed Health Care?

Sara Robinson — Tue, 26 Aug 2008 18:56:05 -0400

This was the Campaign for America's Future's Big Afternoon at the Big Tent. CAF took over the Digg Stage (the entire upstairs floor of The Big Tent) for a series of four panels addressing some of the Big Questions we wrestle with here.

One of the highlights for me was Rep. Jan Schakowsky's presentation, which was part of the second hour's health care panel. She cited an avalanche of statistics describing what condition our condition is in (and I don't need to tell you: it's not good). Two in particular leaped out at me. One (which I knew) is that an American dies due to lack of health care access every 30 seconds. The second (which I did not know) is that Americans are being driven into bankruptcy by health care costs at exactly the same rate. Sixty thousand deaths, sixty thousand bankruptcies, every single year.

(Update: A perspicacious commenter points out that Schakowsky's math was a little off. Sixty thousand deaths (or bankruptcies) works out to about one every ten minutes. My bad for not working the numbers out myself before posting them.)

Schakowsky also said that health care hasn't been a hot-button political issue to date because the political conventional wisdom says that nobody's ever lost an election due to their health care position. That, she said, needs to change -- starting with John McCain, whose plan will make things far worse than they are now (as if such a thing were possible).

As an American living in Canada, my permanent resident card (the Canadian version of a green card) entitles me to the services of that country's health care system. I also still see doctors in the US, even though I'm no longer insured there. As a participant in both systems, I've written at some length here and here about the myths Americans tell each other about the Canadian system. Right now, I think there's one important question we could ask Americans that would focus this debate, and take the conversation to the next level. It's this:

What would you do with your life if you never had to worry about health care again?

It's a hard thing for most Americans to imagine -- but it's odd how your vision of the future changes once you stretch your mind and see what it might be like.

Would you start a business of your own?

Go back to school to upgrade your skills, or retrain for an entirely new career?

Tell your toxic boss where to stick it, and find a job with reasonable hours and nice people?

Spend a few years at home with your kids?

Join the Peace Corps?

Move to a town that you really love?

Save some money up, and retire early?

I should probably warn you: You may get good and angry once you start to take stock of the huge trade-offs you've made over the years just to hold onto your health insurance. You may be even more angry when you realize that nobody else in the industrialized world has had to make those choices.

I live in a country where nobody is tied to a job they hate, or forced to give up important life opportunities just to hang onto a health care plan that may or may not even come through for them when they need it. Nobody ever declares bankruptcy because they can't pay a medical bill, either: most Canadians find this as mind-blowing as Americans seem to find the "What would you do...?" question. Almost nobody dies because they can't get care (and when it does happen, it's a cause for national outrage).

Countries with universal coverage free up their citizens to take advantage of personal development opportunities that, in the long run, stimulate the economy and create a more skilled, traveled, educated, and fulfilled workforce. Americans, on the other hand, routinely stay chained to jobs they hate -- and are forced to pass up on chances to expand their horizons and their fortunes -- because they can't afford to jeopardize their health care coverage.

Our health care mess has reached a point where it jeopardizes not only our lives, but also our liberty, our property, and our ability to pursue happiness -- as well as the long-term strength of the economy as a whole.

We cannot abide more of the same. Let's make sure John McCain pays the ultimate political price for his indifference to this issue -- and that every other elected official hears, loud and clear, that health care is a right they ignore at their own peril.

In the meantime, indulge yourself in a little fantasy. What would you do with your life if you never had to worry about health care again? Tell us in the comments.

This Week In "Insurance Company Rules": Forced To Raise Funds For Sick Friends

Bill Scher — Fri, 22 Aug 2008 10:59:33 -0400

Insurance Company Rules were in full effect this week, from New Orleans to Pennsylvania to The Hamptons, as communities rallied to raise funds for ill friends.

AmeriCorps volunteer Mark Smith has a hospital bill of more than $90,000, after relocating to help rebuild New Orleans, then getting shot in the abdomen and arm trying to stop a car theft. But the New Orleans Times-Picayune reports that his insurance company will only pay one-ninth of his medical expenses.

Despite the insurance company rules, the Friends In Need Foundation has organized a benefit this Sunday at the Mid-City Lanes Rock 'n' Bowl (one of the coolest places on earth, by the way) to help raise money for Mark's care. More information here.

The Chamersburg (PA) Public Opinion reports on Kathleen Angotti's struggles recovering from Lyme disease after her insurance company refused to pay for continuing treatment. She's become severely debilitated and wracked with symptoms. Her family is now soliciting donations to cover their costs. The Public Opinion reports:

After the diagnosis, Kathleen was treated with antibiotics, but they didn't help her condition. A doctor in Staten Island, N.Y., who specialized in Lyme disease, tried a different antibiotic. But that didn't help, either.

A different tack was tried -- antibiotics administered intravenously through a "pic" line inserted into her arm each day. Kathleen's symptoms improved with the treatment, but her insurance company refused to continue to pay for it.

The line was removed and her condition deteriorated.

A month after she was taken off the IV, her memory worsened and her pain returned.

At 24, Kathleen can't walk far and uses a wheelchair for longer distances.

She hasn't been able to ride a horse in more than a year, her mother said, adding that Kathleen sleeps 18 to 20 hours a day. She has developed other health problems, including lupus, and she has a small tumor on her pituitary gland.

The tumor causes her to have seizures. Plans have been made to have the tumor surgically removed later this month.

Recent tests revealed she still has Lyme disease and she's also been diagnosed with Rocky Mountain spotted fever, which is also contracted from a tick bite.

The family is concerned about funds to pay for their stay in Washington, D.C., while Kathleen undergoes surgery for removal of the tumor on her pituitary gland.

Gas cards or checks may be sent to Michele Angotti at 2821 Woodstock Road, Chambersburg 17201.

Mega-tony East Hampton, NY is losing family doctor Robert Semlear. Because of insurance company rules, he can't afford to stay. The East Hampton Star reports:

“I can’t afford to stay,” he said last Thursday. “It’s a comment on the state of medicine today, and I’m not the only one having problems financially.”

...

“Insurance companies are denying claims. We’re rejected constantly,” Dr. Semlear said. “We spend hours of staff time and our own time to get authorization for tests, consults that they say are not medically necessary. Then why did we go to medical school?”

Often he suspects something is wrong and wants to order a test, but the insurance company says no, he said. “It’s not fair to the patient or the doctor. The H.M.O. C.E.O.s are raking in millions and the rest of the system is falling apart.”

And that's how Insurance Company Rules work.

This Week In "Insurance Company Rules"

Bill Scher — Fri, 08 Aug 2008 01:23:03 -0400

After the Health Care for America Now coalition unveiled it's brilliant "Insurance Company Rules" video (below) -- elegantly depicting how insurance companies regularly try to make up rules as they go along to deny people coverage and benefits -- I decided to start a new feature: This Week In Insurance Company Rules -- tracking the latest in insurance companies tricks and tactics to keep us unhealthy and uncovered.

This week, we start on a positive note: two stories where government actions denied attempts by insurance companies to lay down "insurance company rules."

The Syracuse Post-Standard reports that a single woman not only successfully challenged her insurance company in an appeal to the New York State insurance department, but her challenge forced the insurer to pay back 2,500 other women as well.

In 2004, an Ithaca woman filed a claim with her health insurance company for a $154 infertility treatment. The insurance company denied her claim, as they did for almost 2,500 other claims for the same treatment.

But the woman from Ithaca was sure the insurance company was wrong to deny her claim. She disputed their findings, but they continued to refuse. So she filed a complaint with the New York State Insurance Department.

Turns out she was right. Last month, the state Insurance Department fined the insurer, and ordered it to reimburse those 2,500 women who had been denied payment.

And in Tampa, the family of a teenage rape victim -- who is in long-term care recovering from a fractured forehead and several strokes from an attempted strangulation -- successfully prevented their insurance company from meddling with her treatment. From the Tampa Tribune:

The victim of a beating and rape three months ago at the Bloomingdale library, who remains in long-term rehabilitation, has gotten some help from the state.

The family of the 18-year-old woman received a letter from its insurance company saying she had to be moved from her current rehabilitation center to another. The family and the teen's doctors disputed the insurer's decision, and the state stepped in.

A Florida Department of Financial Services spokeswoman confirmed Friday that the department's consumer insurance advocate intervened in the case, ensuring that the long-term care will continue uninterrupted.

Jerri Franz, spokeswoman for the department, said the health insurance company that had covered medical costs for the teenager since the attack sent a letter to the family saying the teen would have to be moved to another facility for coverage to continue.

Franz said doctors and therapists disagreed with the plan to move the woman, and the state's advocate intervened.

"Her current doctors felt like it would interfere with her progress," Franz said, "and that she would not be able to overcome that. She would lose ground. So we made a call on family's behalf."

The state cannot force the insurance company to pay expenses, but the unnamed company agreed to allow the teenager to remain where she is, Franz said. "We are extremely pleased that she will be able to stay in her facility."

The Health Care for America Now principles -- which envision a system where private plans have to fairly compete with a public insurance option -- calls for "a watchdog role on all plans, to assure that risk is fairly spread among all health care payers and that insurers do not turn people away, raise rates or drop coverage based on a person’s health history or wrongly delay or deny care."

The above success stories show that government watchdogs are a critical part of the solution to end "insurance company rules" for good.

Crash the Insurance Lobby's Party

Isaiah J. Poole — Tue, 22 Jul 2008 11:57:25 -0400

The health insurance industry is launching a public relations and lobbying campaign today that is designed to convince people that they are on the side of reform even as they support a status-quo solution suspiciously similar to one pushed by Sen. John McCain and congressional conservatives. But a group of determined activists is making sure that people see through this smoke-and-mirrors show.

The event kicking off the effort by America's Health Insurance Plans is a public forum in Columbus, Ohio, at noon Tuesday with a group of uninsured people. Health Care for America Now, the coalition that recently formed to push a universal health care plan that curbs the dominance and excesses of health insurance companies, is signing up people to, as they unabashedly say, "crash their party."

Jason Rosenbaum wrote in HCAN's blog:

The idea that Americans can be satisfied with the current state of health care in America is silly. Americans aren't satisfied with rising prices, yet lower coverage. We aren't satisfied with the insurance industry's murder-by-spreadsheet. We need a public option for health insurance, and we need to make sure insurance industry practices that kill Americans are made illegal.

The health insurance lobby calls its new publicity effort "Campaign for an American Solution." It is as bald-faced in its advocacy of corporate-profits-first health care as it is blatant in its jingoism.

Earlier this month, AHIP released a statement detailing how it intended to position itself in the health care debate. It includes a proposal that would essentially allow the insurance industry to cherry-pick the healthiest 80 percent of the country to insure while the remaining 20 percent would be dumped into some sort of public high-risk pool. They also support the use of tax credits to help people buy private insurance policies. This mirrors the approaches advocated by President Bush and by Sen. John McCain, who has said that if he becomes president the hallmarks of his health care reform plan would include tax credits (that would cover far less than half the cost of a private insurance policy, if you can get one) and an ill-defined risk pool for people private companies did not want to insure.

This is how Dr. Don McCanne of Physicians for a National Health Program sees what the insurance industry wants:

So the insurance industry wants to sign up 100,000 individuals in its fan club to provide free marketing for the private insurance concept. In spite of criticisms, the industry has not changed its goals. They want taxpayers to provide coverage for those too expensive to insure — the 20 percent of people who are responsible for 80 percent of health care costs, but the industry is quite willing to offer guaranteed coverage to everyone else — the 80 percent of people who are quite healthy.

Rep. Pete Stark, D-Calif., released a statement saying that "America's Health Insurance Plans' new 'Campaign for an American Solution' rings as true as the tobacco industry's efforts to end smoking. There is nothing grassroots about it. It is designed, financed, and coordinated through their Washington trade association with the singular goal of protecting their profits."

He added that while he hopes that the insurance industry can contribute positively to the health care debate—and it does need to be brought to the table—"I tend to be cautious when the fox starts drawing up plans for a new henhouse."

What the nation cannot afford to see again is the insurance industry come up with the equivalent of the "Harry and Louise" ads of the 1990s, with the money-changers in the health care temple scaring the public away from principled solutions because their lucre is threatened. That is why wherever AHIP brings its so-called "American Solutions" dog-and-pony show in the next few weeks, show up and say: No more multimillion-dollar industry feel-good campaigns. We want real change in our health care system that leads to true universal care. And that means that you, insurers, will have to change, too.

Facts and talking points about health care reform are in our "Making Sense" alert on the progressive Health Care for America Now plan.

Netroots Priorities: Iraq, Energy, Health Care, Poverty

Isaiah J. Poole — Mon, 21 Jul 2008 12:08:26 -0400

Netroots Nations participants have four clear priorities for the next president: ending the war in Iraq, addressing the global warming crisis, obtaining health care for all and clsing the growing gap between the rich and poor, according to a straw poll done by Democracy Corps and the Campaign for America's Future.

The straw poll was conducted over two days of the Netroots Nations conference and was designed to get a sense of what the political activists at the conference thought were the most important issues for the country and for the next administration.

Some of the key results:

Of the list of concerns below, which one of these is your top concern at this time?

Energy and global warming	19%
The growing gap between the rich and the poor	17%
Loss of constitutional rights	15%
The war in Iraq	11%
Corruption and special interests running Washington	10%

Which of the concerns listed below is your next top concern?

The war in Iraq	17%
The growing gap between the rich and the poor	12%
Loss of constitutional rights	12%
Lack of affordable health care	10%
Energy and global warming	9%

Which one of these should be the top priority for the next administration?

The war in Iraq	23%
Energy and global warming	20%
Lack of affordable health care	15%
The growing gap between the rich and the poor	12%
Loss of constitutional rights	7%

Which should be the next highest priority for the administration?

Lack of affordable health care	17%
Energy and global warming	17%
The war in Iraq	16%
The growing gap between the rich and the poor	12%
Loss of constitutional rights	10%

Sixty-eight percent of those who participated in the poll said that "not too much" has been accomplished by Congress this year, and when asked whether the blame was with Democrats or with Republicans, 43 percent said that Republicans were to some degree more to blame, and 29 percent said both parties were equally responsible.

Also, 72 percent of the poll participants said that Sen. Barack Obama should select a vice-presidential candidate "politically similar to himself, reinforcing the dynamic nature of his candidacy and the urgent need for change, and keeping true to his liberal roots."

For some MSM interpretation of the straw poll results, check out the latest from the Washington Post: What Do the Netroots Want? Straw Poll Offers Answers.

Blogging To Health Care For All

Bill Scher — Sun, 20 Jul 2008 13:14:18 -0400

At Netroots Nation, I talked with Melinda Gibson of the Health Care for America Now coalition, soon after she debuted a new (and hilarious) video taking on the insurance companies in advance of an expected battle between the public interest and special interest.

Gibson discussed how partnering with blogs can dramatically improve the ability to counter misinformation from the insurance lobby compared with the health care debate of 1994.

And here's the new HCAN video, "Insurance Company Rules":

Conservatives Spooked By Health Care for America Now Coalition

Bill Scher — Mon, 14 Jul 2008 08:52:40 -0400

For the latest installment of The Week in Blog over at Bloggingheads.tv, the Heritage Foundation's Conn Carroll and I discussed the new Health Care for America Now coalition which Campaign for America's Future helped forge.

And Conn, speaking from the conservative think tank's offices, made an interesting admission. After detailing the size of the coalition and the amount of money the coalition is expected to spend to build support for guaranteeing quality, affordable health coverage for all, "There is fear in this building about that." Watch it below.

I asked Conn what conservatives have planned to respond to such an unprecedented progressive push, and he indicated that there isn't anything as of yet. For conservatives, "there's so many other things to worry about," said Conn.

This is no reason to be sanguine. The insurance industry certainly won't give up without a major fight. And the conservative movement has time to re-focus and re-group before Washington addresses comprehensive health insurance reform once a new Congress and president are elected.

But it is further evidence that the progressive movement is out in front of the health care issue in a fashion we did not see in the run-up to 1993-4 health care fight that led to defeat.

Predictable Punditry

Bill Scher — Wed, 09 Jul 2008 11:20:16 -0400

On Monday, I not only noted that Sen. John McCain's health care plan represents a bigger political risk than Sen. Barack Obama's, but also that the Beltway punditocracy would presume the opposite.

That didn't take long. Here's yesterday's Boston Globe analysis (Dateline: Washington):

Healthcare overhaul would be risky for a President Obama

...

The Democrats sense that the combination of skyrocketing costs, insufficient coverage, and a growing realization that healthcare obligations are making American companies less competitive may be enough to erase traditional fears of a government-sponsored overhaul.

Or maybe not.
...

The reality is more complicated. Most Americans are pleased with their health coverage, even as they acknowledge the flaws in the national system. Every previous attempt to revamp healthcare has begun with a political consensus that change is necessary and ended with a political consensus that change is too risky.

What this off-the-shelf analysis fails to tell its readers is the Obama plan is designed to avoid that specific political pitfall. Recognizing that many are "pleased with the health coverage," his plan stresses that if you like what you have, you can keep it. The reform is in providing more choices for those that don't like what they live.

In reality, it is McCain's plan that assumes this political risk. By imposing a new tax on health benefits you get from your employer, McCain's plan would disrupt the current health care arrangements for everybody in the workplace, even for those who are happy with their present insurance.

It is McCain that needs to make the argument to folks who are content that they should take a chance on a completely new system, not Obama. (As today's New York Times piece on McCain's plan says, "Mr. McCain’s proposal ... would be part of a market-based restructuring that is in many ways more fundamental than the universal coverage proposed by Mr. Obama.")

But since Obama's plan envisions a more direct role for our government -- providing a public insurance option that competes with private plans -- the Beltway pundit knee-jerk reaction always is, that's politically dicey. Never mind the polls that clearly show that the opposite is true.

It is at least hopeful that the NYT is looking closely at the McCain plan. Other media outlets should do the same, for both plans, so voters can judge the potential risks for themselves.

A Car Mechanic's Plea For A Health Care Fix

Isaiah J. Poole — Tue, 08 Jul 2008 16:53:11 -0400

For David White, a small business owner in Bar Harbor, Maine, the health care crisis is doubly personal.

For one thing, he was proud of being able to cover the full cost of health insurance premiums for his employees at MDI Imported car repair service. But in 2002—a year in which his company experienced a record profit and in which he considered giving his employees a generous raise—he instead had to lay off one of his employees for six months, reduce the amount of coverage he offered and increase costs. That was because the company’s health insurance premiums that year doubled, more than eating up the increased profits of his business.

“I was literally in tears laying this out to my men, and I am not fond of crying in front of my men” he said in a news conference Tuesday, where he was telling his story at the announcement of the Health Care for America Now! Coalition.

After that news conference, he revealed that his parents, both over 70, until recently held jobs — his father driving a school bus until a stroke left him unable to do so — just so they could have health coverage. His mother finally retired earlier this year, now that she is eligible for coverage as a retiree under the school system’s health plan. “I know many people in that same situation,” he added.

White’s personal experience galvanized him to action, which is why he was in Washington to appear at the Health Care for America Now! event at the National Press Club alongside representatives from labor and citizen activist groups.

Richard Kirsch, the director of the coalition, said that so far about 116 organizations have signed up in solidarity with the coalition’s principles, which include coverage for the nation’s 47 million uninsured, the ability to choose between well-regulated private plans and a public plan, equity in access and effective cost controls.

The central mission of the coalition is to build the kind of mass movement Kirsch said did not exist when then-first lady Hillary Clinton tackled health care reform in 1993, only to see the effort shot down in a fusillade of advertising and lobbying from the insurance and pharmaceutical industries.

Leaders of the coalition are vowing that that won’t allow that to happen this time, and they have pledged a $40 million effort over the coming months to set the stage for a reform effort in Congress and the White House in 2009.

“The people in this coalition represent the deepest single-issue coalition in modern American history,” said Jeff Blum, the executive director of USAction, who went on to call the health care reform movement “the human rights movement of our time, a movement that transcends race, class and geography.”

“Today we’ve got a message for our elected officials,” said Gerald McEntee, president of the American Federation of State, County and Municipal Employees. “If you put profits ahead of patients, get out of the way. Don’t tell us about reforms that lack a guarantee of coverage. Don’t tell us about taxing the health care benefit employees receive on the job. Don’t tell us that insurance company practices don’t need to be regulated. Don’t tell us that $10,000 deductibles are OK.”

Conservatives have courted business owners like White with promises of low taxation and deregulation, but health care is an area where progressives and the small business community can forge common ground. Leaving the insurance industry to its own devices certainly hasn't worked for small business; deregulation has actually saddled small business owners who want to provide good benefits for their employees with costs that they cannot reasonably bear.

When entrepreneurs and their workers look at the policies now being presented to them during the election season, they are seeing that the choice is between a practical plan for affordable, universal health care and a plan that conservatives call “choice” but is really individuals sweating it out on their own in a hostile private insurance market, with nothing but a meager tax credit that will cover only a fraction of their premiums.

One thing that the movement will need is more people like White to tell their stories—from business owners to seniors who work well past retirement age just so they can have adequate health insurance coverage. “There’s a role for government in this that only we—the backbone of America— can hold it to,” White said. “I’m here to say that we can’t afford not to.”

Where McCain's Change Is Bigger Than Obama's

Bill Scher — Mon, 07 Jul 2008 13:53:05 -0400

As Sens. John McCain and Barack Obama both plan to engage each other on the economy this week, this presents an opportunity for reporters and voters to focus on one of the biggest contrasts between them: health care. As Paul Krugman observes today, "[health insurnace] premiums surged again after 2000, imposing huge new burdens on business. It’s a good bet that this played an important role in weak job creation." Fixing our patchwork health insurance system would go a long way to getting our economy back on track.

In most areas of the campaign, Obama offers a change from the policies of the past eight years, and McCain offers a continuation.

But on health care, both offer change. In fact, McCain will change health care for more people than Obama.

All those people potentially affected will have determine if they want the kind of change McCain is offering.

How would McCain's plan change health care for more people? Because he wants to strip the underpinning of how the vast majority of people get their health insurance, through their employers. (Just under 60% of Americans get insurance from employers, down from when President Bush entered office as fewer businesses offered coverage and the number of uninsured Americans rose.)

Presently, you don't pay income taxes on the health benefits you get from your employer. McCain would end that policy, which would not only impose a new tax mainly on middle-class families, but also end a strong incentive for employers to offer health benefits at all, and move us all towards a "consumer-driven" health market.

There are arguments elsewhere on our site criticizing such a plan.

But putting aside the merits of the plan for the moment, it is politically relevant that McCain's strategy directly impacts the vast majority of people who have health insurance -- many of whom are content with what they have, even though the number of uninsured and underinsured Americans is rising.

In contrast, Obama's plan would create a public insurance option and set new standards for private insurance options so they will be, in his words, "at least as generous as the new public plan and meet the same standards for quality and efficiency." But anyone happy with their health insurance could simply keep it and would find their plan untouched.

Obama's change is more targeted, aiming to help the uninsured and underinsured without unnerving the happily insured.

McCain's change is total, a frontal attack on the entire system as it stands, trying to convince all Americans that they will be happier if most everyone is moved into a new market where you buy insurance out of pocket.

Because Obama's plan involves an active role for our government -- both in creating a public insurance option and serving as a "watchdog" on private plans -- most Beltway pundits would argue that Obama is taking the bigger political risk.

But nearly two-thirds of Americans believe "the federal government should guarantee health insurance for all Americans.”

There's hasn't been much polling about the specifics of McCain's plan. But as a general rule, the notion of losing something you currently like is always a troubling prospect.

It will take a particularly powerful argument from McCain to overcome that political hurdle, and convince those voters that his brand of health care change is the right change for them.