Health Care

Deficit reduction: DOs and DON’Ts

Eric Lotke — Wed, 30 Sep 2009 18:02:51 -0700

The forum on American debt and deficit had it right. First, don’t panic. Don’t stop the stimulus spending or raise taxes with the economy still near the bottom.

The Center for American Progress and Center on Budget and Policy Priorities convened the forum. Guests included Paul Krugman (NYT), Robert Reischauer (Urban Institute, OMB), Senator Mark Warner (D-VA), and some all star academics.

I won’t attempt a blow-by-blow but some main themes emerged. First, a strong consensus on what NOT to do:

-- DON’T panic at the size of the deficit or worship at the feet of debt reduction.

-- DON’T stop the stimulus spending or raise taxes in the short term. We’re still in the depths of recession. Consumers aren’t spending and neither is business. The government needs to drive demand in the short run. If we quit now, we’ll likely tip back over the wrong side of the precipice.

These charts aren’t from the forum, but can help reduce the panic. America’s debt is high, but well within historical and international norms.

Source: OMB history, 1930-2008; CBO projections, 2009-11

Source: CIA

Those are DON’Ts from the forum. There were DOs as well:

-- DO worry about debt in the long term. Our progressive goals – education, health care, high speed rail, help for the needy – cost money. Negative budget numbers make it hard to reach our goals.

-- DO talk about more than just cuts.

Conservatives discuss the budget in terms of spending, and demand cuts. But there are other ways to shrink the deficit. Most obvious is to grow the economy, even if it takes stimulus or infrastructure spending to get there. That’s a different way to shrink the deficit as a percent of GDP.

-- DO go ahead and talk about raising revenues. “Raising revenues” is better language than “tax hikes,” and it opens more doors. Closing loopholes and corporate exemptions are also ways to raise revenue. We might give those Bush tax cuts some extra years during the recession, but ultimately we need to raise revenue. Don’t fall for the conservative framework of a one-side ledger, with spending-cuts as the only path to balance. The ledger has a revenue side as well; we can also level up.

-- DO link what we get with what it costs and where the money comes from. Nobody likes taxes. But people realize that schools and roads cost money. Package them all together.

Behind all of this lurk some political cautions. The ghost of Peter Orszag was often heard, reminding us that the budget problem is a health care problem. We need to fix health care (Medicare and Medicaid, not Social Security) to fix the budget.

Senator Warner recommended that Democrats find some spending cuts or new efficiencies to show good faith effort to control costs. They need to earn the taxpayers’ trust with their money.

Charlie Cook (Cook Political Report) warned that Democrats are likely to lose seats in the 2010 midterm elections, and will have more Senate seats than Republicans open or at risk in 2012. The American people are always suspicious of government, and nowadays they’re angry. They don’t trust government with their money.

Maybe the frustration comes from Republican failures after Hurricane Katrina, Bush bungling in Iraq or the current recession … but it’s the Democrats’ government now, and distrust is the Democrats’ problem. The current distrust jeopardizes long term progressive goals.

The conclusion: DON’T quit the stimulus yet; it’s too soon. But DO attend to the debt in the long run. It’s important both politically and financially to the progressive mission.

Electoral Support For The Public Option

Natasha Chart — Wed, 30 Sep 2009 15:09:31 -0700

Several recent polls have focused on national support for a public option, usually showing that support to be at levels that would translate to hefty electoral margins even greater than those the Democrats secured in 2008. However, we don't have a direct, but a representative democracy.

While the House has passed multiple health reform bills supporting national health care sentiment, the Senate has been especially resistant to including a public opinion in the final bill. In large part, this is likely the result of low-cost media markets in small states allowing corporations to disproportionately effect the outcome of their elections and often countermand even the will of the state's voters, whose contributions and lobbying efforts can be more easily, and cheaply, overwhelmed.

But to the extent that public opinion matters, and I would hope it does, it's harder to argue with its measure as expressed by actual vote totals than it is to argue with polls.

According to the 2008 census estimates, there are 304,059,724 people living in the United States and 131,257,328 voted in the 2008 election. This is the latest Senate whip count for the public option, a total of 50 Senators are now on the record as favoring the inclusion of a public option in the health care bill. So presuming that Vice President Biden will still vote for a health finance reform bill as per his campaign stance, and that none of the Senate Democrats will filibuster a bill that includes a public option (which none of them are known to be planning), there are now enough votes to pass health reform with a public option.

How does their support line up with their voting constituents and the general public? Inspired by Jed Lewison's breakdown of electoral support for the public option within the Finance Committee, I looked at 2008 census estimates and the US election atlas' 2008 results to put these numbers together:

Senator	State	Population	Senate Split	Total Pres Vote	% Obama	# Obama Votes	Last Senate (Re-)Election*
Boxer, Barbara	CA	-	-	-	-	-	6,955,728
Feinstein, Dianne	CA	36,756,666	N	13,577,265	60.94	8,274,473	5,076,289
Bennet, Michael	CO	-	-	-	-	-	(1,081,188)
Udall, Mark	CO	4,939,456	N	2,401,462	53.66	1,288,633	1,166,207
Dodd, Chris	CT	-	Y	1,646,793	60.59	997,773	945,347
Carper, Tom	DE	-	-	-	-	-	170,567
Kaufman, Ted	DE	873,092	N	412,616	61.91	255,459	(257,484)
Nelson, Bill	FL	-	Y	8,411,861	48.10	4,282,074	2,890,548
Akaka, Daniel	HI	-	-	-	-	-	210,330
Inouye, Daniel	HI	1,288,198	N	453,568	71.85	325,871	313,629
Harkin, Tom	IA	-	Y	1,537,123	53.93	828,940	941,665
Burris, Roland	IL	-	-	-	-	-	(3,598,277)
Durbin, Richard	IL	12,901,563	N	5,527,602	61.86	3,419,348	3,516,846
Kerry, John	MA	-	-	-	-	-	1,959,843
Kirk, Paul	MA	6,497,967	N	3,081,069	61.80	1,904,098	(1,500,738)
Cardin, Ben	MD	-	-	-	-	-	965,567
Mikulski, Barbara	MD	5,633,597	N	2,631,596	61.92	1,629,467	1,504,691
Levin, Carl	MI	-	-	-	-	-	3,033,550
Stabenow, Debbie	MI	10,003,422	N	5,010,194	57.33	2,872,579	2,151,278
Franken, Al	MN	-	-	-	-	-	1,212,629
Klobuchar, Amy	MN	5,220,393	N	2,910,369	54.06	1,573,354	1,278,849
McCaskill, Claire	MO	-	Y	2,928,450	49.24	1,441,911	1,055,255
Hagan, Kay	NC	-	Y	4,310,789	49.70	2,142,651	2,249,311
Dorgan, Byron	ND	-	Y	317,722	44.47	141,278	179,347
Shaheen, Jeanne	NH	-	Y	710,970	54.13	384,826	358,947
Lautenberg, Frank	NJ	-	-	-	-	-	1,951,218
Menendez, Robert	NJ	8,682,661	N	3,877,407	57.14	2,215,422	1,200,843
Bingaman, Jeff	NM	-	-	-	-	-	394,079
Udall, Tom	NM	1,984,356	N	830,158	56.91	472,422	505,128
Reid, Harry	NV	-	Y	967,848	55.15	533,736	490,232
Gillibrand, Kirsten	NY	-	-	-	-	-	(3,008,428)
Schumer, Chuck	NY	19,490,297	N	7,640,948	62.88	4,804,945	4,769,824
Brown, Sherrod	OH	-	Y	5,721,815	51.38	2,940,044	201,004
Merkley, Jeff	OR	-	-	-	-	-	864,392
Wyden, Ron	OR	3,790,060	N	1,827,864	56.75	1,037,291	1,128,728
Casey, Bob	PA	-	-	-	-	-	2,392,984
Specter, Arlen	PA	12,448,279	N	6,014,947	54.47	3,276,363	2,925,080
Reed, Jack	RI	-	-	-	-	-	320,644
Whitehouse, Sheldon	RI	1,050,788	N	471,766	62.86	296,571	205,274
Johnson, Tim	SD	-	Y	381,975	44.75	170,924	237,866
Warner, Mark	VA	-	-	-	-	-	2,187,613
Webb, Jim	VA	7,769,089	N	3,723,260	52.63	1,959,532	1,175,606
Leahy, Patrick	VT	-	-	-	-	-	212,850
Sanders, Bernie	VT	621,270	N	325,046	67.46	219,262	171,638
Cantwell, Maria	WA	-	-	-	-	-	1,184,659
Murray, Patty	WA	6,549,224	N	3,053,216	57.34	1,750,848	1,549,708
Feingold, Russ	WI	-	-	-	-	-	1,632,697
Kohl, Herb	WI	5,627,967	N	2,983,417	56.22	1,677,211	1,439,214
Byrd, Robert	WV	-	-	-	-	-	296,276
Rockefeller, Jay	WV	1,814,468	N	714,868	42.51	303,857	447,985
Totals	-	153,942,813	-	94,403,984	-	53,421,163	-

As you can see, of the 30 states these 50 Senators represent, 20 of them are represented by two Senators supporting the public option. Those 20 consensus states and their 40 Senators represent 153 million people, slightly over half the total US population.

Around 57 percent of voters in these 30 states voted for President Obama, who campaigned on a platform that included a public, not-for-profit, health coverage option. Of President Obama's 69,456,897 votes nationwide, voters in these 30 states accounted for 76 percent of his haul.

People voted for change in this election, and the party they chose has been campaigning nationally, and loudly, on a universal health coverage platform for several years. The Senate should give us what we voted for. It's the popular thing, and the right one.

* Election results in parentheses are listed for the immediate predecessor where the Senator is an appointee, all listed appointees replaced other members of the Democratic party.

Blocking Health Care Reform is Not a Winner for Grassley

Ella Humphry — Wed, 23 Sep 2009 11:14:36 -0700

Across the right wing blogosphere, conservatives are rubbing their hands with glee. They think the Republican strategy of blocking real health care reform is beginning to pay off. To quote Senator Jim DeMint, "If we are able to stop Obama on this, it will be his Waterloo. It will break him." For conservatives, failure is victory.

Their celebration is just a touch premature.

For one thing, they should be careful not to lose sight of their own. Senator Grassley, who at one time commanded strong bipartisan support in his home state of Iowa, is losing ground.

Amidst his high-profile role in the national debate over health care, his approval rating has declined to 57 percent according to the latest Selzer / Des Moines Register poll. On the face of it, this does not look too bad. However, it represents an 18-point decline since the start of the year.

More importantly, as the table below clearly illustrates, it seems he is really losing ground with Democrats. Independents' approval ratings have also dropped 11 points since April. The once-Republican state has changed markedly since Senator Grassley was first elected in 1980, it is split almost exactly evenly between Democrats (34%), Republicans (33%) and Independents (33%). The upshot is that Senator Grassley can’t afford to lose the support of his Democratic and Independent constituents.

Source: Nate Silver

It is little wonder then, according to New York Times, “Mr. Grassley, who often has been at the center of creating major legislation, instead mostly kept his head down on Tuesday, reading news clippings and his Kindle as the Senate Finance Committee began work on legislation to overhaul the health care system.”

Senator Grassley is rattled and so he should be.

Insurance Industry Plays The Victim, Admits To Rationing Care For Profit

Brian Dockstader — Fri, 28 Aug 2009 09:08:42 -0700

♫No one knows what it's like
      To be the bad man
      To be the sad man
      Behind blue eyes

      No one knows what it's like
      To be hated
      To be fated
      To telling only lies

The New York Times ran an article this morning that has been sparking some commentary in the blogosphere. In a piece that was essentially The Who's "Behind Blue Eyes" put to paper, we were presented with a sad tale of how we should feel sorry for the insurance industry, who are, in fact, the real victims of the health care debate.

I, for one, was wondering when someone would have the courage to stand up for the little guy, the Stephen Hemsley's of the world.

Most reactions to this piece focused less on the overall theme of playing the victim and more on the admission contained therein (emphasis mine):

"I believe we're getting the pushback because we are standing up for what we believe in," said Cheryl Tidwell, 45, Humana's director of commercial sales training. "We believe there's a better way to control costs by controlling utilization and getting people involved in their health care."

Now we know they aren't talking about controlling costs to the customer, since health insurance premiums have skyrocketed far above the pace of inflation, the vast majority of personal bankruptcies in this country now come as a result of medical costs, and since it isn't unheard of for an insurance company CEO to pull in $819,363 every single day of the year, or to be sitting on over $744 million in stock options, or to retire with a $73 million golden parachute. The insurance industry also spares no expense in throwing hundreds of millions of dollars into their lobbying blitzkrieg against health insurance reform. Suffice to say, these "savings" aren't being passed on to consumers.

So they are controlling their costs, to maximize their profit. And how do they admit to controlling costs? By "controlling utilization". What does that mean exactly? Well we know what "control" means. It means they, the insurance company, makes decisions. It means the insurance company has the power, all the control.

So what about "utilization"? The utilization of what exactly? Well there are two types of "utilization" that the insurance industry likes to control, because controlling them just so happens to keep their costs down, and their profits plump:

Insurance Utilization: This is the type of "utilization barrier" that effects nearly 50 million Americans. The premise is that if you can't afford to give the insurance industry their pound of flesh, or if you are sick enough that the insurance industry doesn't make a big enough profit in treating you, you don't get insurance, period. This keeps their costs down. Your costs? Who cares? All that matters is that insurance companies don't have to let you "utilize" their product--health insurance.

Treatment Utilization: You can't go to this hospital, you have to go to this one in your "network". You can't get this treatment because it isn't listed on the approved list from your insurance company. Woah, you are really sick, are you sure you never had headaches before? Ever? Do any of those sound familiar? This is where the insurance industry controls which treatments you get to utilize, if any at all, based on their cost-benefit analysis. If it doesn't benefit their bottom line, they don't sign on the dotted line. And then you don't get your treatment. By controlling the "utilization" of treatment, they are making all the decisions. And they are right, it does keep costs down: their costs. (Oh, did I mention that the CEO of insurance industry giant CIGNA "earned" over $120 million in compensation in the last five years alone?)

So that, in a nutshell, is what the euphemism "controlling utilization" actually means. And they control utilization constantly. Millions of Americans are denied coverage for specific illnesses or treatments every year, and millions more are denied any coverage at all.

The funny part is that when these very same people make up horror stories about what will supposedly happen if we even get the option of choosing public health insurance, they call this exact same thing RATIONING.

Get it? When the private insurance industry refuses to cover you, or makes decisions about what treatments they will and will not allow you to receive, that is called "controlling utilization" (and that happens in the real world, every day). Yet when the government will supposedly pull the plug on grandma, even though she is already on (and would continue to be on) Medicare, and is most certainly not being forced into death now nor would she ever be, that is called rationing care (and socialism, Nazi eugenics, death panels, and I'm sure about every other thing liars can dream up to spoon-feed gullible people--oh, and this rationing is only happening in fantasy land).

So that was the little gem buried in the NYT puff piece about what a hard knock life it is for the insurance industry--they admitted that they ration care, right now, and have been for as long as they've been doing business.

But perhaps my favorite part of the column is where they really get out the violins for employees of these insurance companies, to get us to see that they aren't monsters, or in their words, "We are human beings, too." It is really fit to be in the Merchant of Venice (daydream sequence begin):

Hath not a[n insurance industry employee] eyes? Hath not a[n insurance industry employee] hands, organs, dimensions, senses, affections, passions; fed with the same food, hurt with the same weapons, subject to the same diseases, heal'd by the same means, warm'd and cool'd by the same winter and summer as a [human] is? If you prick us, do we not bleed? If you tickle us, do we not laugh? If you poison us, do we not die? And if you wrong us, shall we not revenge? If we are like you in the rest, we will resemble you in that.

*Tear* Beautiful. I hope they do a remake of Evita next.

But of course this is all a straw man, because this anger at insurance industry greed isn't directed at the employees of these mega corporations, who are by all accounts just trying to make a living by doing what they are told. They are, after all, just doing their jobs. It isn't their fault that their job is to decline people coverage to save the company money. That is the one and only goal of a corporation, is it not? They are accountable to their investors, their shareholders, and no one else.

That is the bottom line--The corporation is a beast designed for a single purpose: to make profit and make people (investors) rich. And these employees, the ones being humanized so beautifully in this NYT column, are just cogs in the wheel, and if they refused to do it some other person (faceless bureaucrat, to use the hypocritical language of the conservatives) would fill their spot in an instant. And to their credit, many former employees of the insurance industry, haunted by the things there were made to do in the name of profit, have come forward and spoken out against insurance industry practices, like Dr. Linda Peeno in this ad from American's United for Change:

So no, it isn't about the little people, it is about the entire beast. Has anyone suggested that these people, the employees themselves, are evil? Do reformists think that these people, or even the executives in charge, get up in the morning with the goal of killing people and ruining lives? Of course not. They do what they do best: maximize profit, at all costs. The human lives destroyed are just collateral damage. Some of them, mostly those at the very top, are very much okay with this, and defend it vigorously. Others are haunted and find that they can't bring themselves to keep doing it.

This isn't about them, it is about an industry that is indeed evil, if not in intention, undeniably in effect. Just because a corporation is made up of people, are we not allowed to blame the whole?

That is the funny thing about the concept of "corporate personhood"-- corporations have long fought to enjoy all the rights and benefits of being treated as a living, breathing person, but without any of the costs, like mortality, and now, apparently, blame.

Progressives: Dumb It Down!

Brian Dockstader — Thu, 27 Aug 2009 09:18:23 -0700

I just came across this great video while sailing the intertubes (h/t tunesmith @ Daily Kos) and I think it needs to be seen by as many people as possible. It does a wonderful job of really simplifying the health care debate down to its most basic and important parts.

The odd part about the health care "debate" is that the most basic and common sense things we should be talking about are what are almost completely absent. This is why it has been so frustrating that we have had to struggle for decades against misinformation, fearmongering, and spurious claims of "socialism" and evil "government takeover", which have largely prevented us from making any progress on the issue (aside from Medicare and a few other important programs that have been implemented--and look, the country is better off for it, and we still aren't communists!), when we have the facts (and common sense) on our side.

Part of the problem is that smears are, by their very nature, simple things. They aren't complex, they don't have the burden of being based on any truth, logic or any other rational substantiation. And they are shocking. The more outrageous (and false) a smear is, the more it catches your attention. And many Americans seem to have lost the part of their brains which triggers being skeptical of things that sound too outrageous to be true ("Obama is trying to kill my grandma?? That sounds reasonable, go on...").

Progressives have thus far been impotent against these smears because the truth is, by its very nature, nuanced. This world is not simple, data can be hard to conceptualize, complex relationships can take a lot of knowledge to fully understand. It takes more words to tell the truth than to lie, and it takes even more words to set the record straight after a lie has already been told.

(Think of trying to explain how a car moves to a Pilgrim. A horse ~~industry lobbyist~~ dealer might warn customers that the car is moved by witches under the direction of Lucifer himself. A knowledgeable engineer from the future would try to explain how an internal combustion engine works. Who do you think would win? Simplicity trumps truth every time.)

And since all too many Americans have the attention spans of gerbils and don't seek out (or perhaps actively avoid) accurate information and a real understanding of these complex issues, all of our rational, intelligent, fact-based arguments in favor of health insurance reform (or any course of action) and against the lies are simply lost in the muddle. Conservatives know this, and that is why they know they can make up any ridiculous claim and have it eaten up by a large number of gullible people. It works, it really does.

So what progressives need to do is to essentially dumb it down. We need to bring it down to their level of simplicity, while not sacrificing any of the truth. And I think that is what this video does. It does a great job of explaining a complex issue, with cartoons and a lot of common sense. This is the level almost all Americans can understand, at least if they are at all open to understanding. Before anyone jumps into the health care debate, I think they need to start with this as a primer.

Please watch, learn, enjoy, and for the love of god share it with everyone you know and maybe, just maybe, we can get back to a rational discussion of the challenge in front of us, without suffering ridiculous stories of "death panels" and "death books" and socialism taking over the country. Let's be adults, but let's first learn like children.

Who's Paying to Kill Health Reform?

Sarah Shive — Mon, 24 Aug 2009 13:23:51 -0700

In watching town hall after town hall, many of us have looked at attendees frantically spouting nonsense about "death panels" and comparing the public health insurance option to Hitler and wondered, "where do they get these people?"

Inspired by John Boehner and friends, Campaign for America's Future brings you...

Click image to see large version

Health Care Decision: Who Does Government Help?

Dave Johnson — Mon, 17 Aug 2009 08:56:54 -0700

The health care debate is bringing America's division out into the open: Is America going to work for the benefit of its people or for the few who benefit from concentrated ownership of large corporations? Who is our economy FOR, anyway?

The argument over health care comes down to a clear choice: will the government provide a public choice that offers good health coverage to citizens for a low cost, or instead leave only a private system where the government promotes and subsidizes insurance companies (and their CEOs)?

The "public option" is an attempt to offer a choice between private insurance that is about maximizing profit for a few and a system designed to maximize benefits for the many. That is the difference between private companies and government. Government is We, the People banding together to empower and protect each other. Private companies are about systems that get money from people and try to deliver back as little as possible in return. The private system can work very well to incentivize innovation in consumer and other products. But health care delivery is not a "product" it is a human need and profit has no place in a health care delivery system.

Think about it, the perfected private company just taps into everyone's bank accounts and puts the money into the company's coffers, and that's it. Nothing has to be delivered in return. This is not unlike what AOL's business model became -- they just kept sucking out of your account long after you started trying to cancel the service!

Many health insurance companies apparently try to operate like this. You pay and pay, and then when you need the insurance to cover your medical expenses they find ways to get out of providing the service you had been paying for.

But government is We, the People taking care of each other. In a democracy everyone should have equal access to essential services. It must be delivered by the entity concerned with maximizing benefits to the people and that is government. Then public option is essential.

Toyota Plant: The Competition Is With Canada (and Mexico)

Marcy Wheeler — Fri, 31 Jul 2009 07:30:06 -0700

I've been meaning to cover the likely closure of the joint Toyota-GM plant in Fremont, Calif., for some time. But this comment from DiFi is worth a post in itself.

Sen. Dianne Feinstein, D-Calif., led a delegation of state lawmakers who said Thursday that they were exploring the use of stimulus funds among other moves to keep Toyota in California.

"But one of the things California has to come to grips with is that the competition here is Kentucky and Mississippi, and you have this high cost-of-doing-business problem," said Feinstein, who phoned Gov. Arnold Schwarzenegger to talk about Nummi.

The NUMMI (New United Motor Manufacturing Inc) plant was opened as a joint venture between Toyota and GM in 1984. Back then it was a shiny new-fangled plant-—the future of auto assembly in the United States. It's also, notably, Toyota's only unionized American plant. GM has pulled out of the partnership as part of its bankruptcy, which has led Toyota to consider closing the plant altogether. DiFi and the rest of California's politicos are scrambling to save the 4,700 high-paid union jobs.

And, apparently, DiFi has created a myth for herself that she is competing with (just) Kentucky and Mississippi for these jobs.

To the extent that California is now putting together a set of incentives to convince Toyota to stay—a model pioneered by Southern states—she is correct. And to the extent that Toyota might move the Corolla and Tacoma production to their currently vacant Mississippi plant (which was originally slated to assemble the Prius), she is correct that she's competing against MS.

But the more likely location for the production currently done in Fremont is, for the Tacoma, Mexico and, for the Corolla, Canada—where factories that already produce those models are currently running below capacity.

In addition, Toyota has plenty of unused production capacity in North America—including factories in Mexico and Canada that make the Tacoma and the Corolla, said George Peterson, president of Tustin consulting firm AutoPacific.

[snip]

Toyota's sales in the U.S. are down almost 38% this year as the auto industry suffers its worst slump in decades. As a result, the automaker has excess production capacity at its North American auto plants, which can produce more than 400,000 vehicles a year.

In the first six months of this year, the assembly line making the Vibe and the Corolla rolled out only 76,000 vehicles, a 25% decline from a year earlier, while the line making the Tacoma saw an 83% drop in production, according to the Automotive News Data Center. The plant was unprofitable last year, Michels said.

The distinction is critically important because DiFi's fiction that Kentucky and Mississippi are the problem pretends that the problem here is just wage costs (and, though she doesn't say it, union labor).

But if Toyota's moving these jobs to Mexico and, especially, Canada, then it's not just hourly wage costs that are the problem. It's health care.

You'll recall that Toyota made precisely this calculation a few years back, when it decided to site a new RAV-4 factory in Canada because it wanted better education levels than were available in the South, but it also wanted the government health care available in Canada.

We are—as we speak—about to lose another 5,000 middle class jobs in this country because our health care system sucks. And DiFi is doing little more than wringing her hands and trying to use stimulus funds rather that fixing the root problem.

(Cross-posted from emptywheel)

Why is Arkansas Rep. Mike Ross Blocking Health Care Reform?

Sarah Shive — Thu, 23 Jul 2009 13:31:10 -0700

Rep. Mike Ross, a Blue Dog Democrat and obstructionist hailing from the 4th District of Arkansas, is leading a coalition of Blue Dogs to attempt to derail the House health care bill by keeping it from leaving the House Energy & Commerce Committee. So far, committee chairman Rep. Henry Waxman has had to cancel mark-up of the health care bill for two days straight because of Rep. Ross’s obstructionism. According to Rep. Ross, he doesn’t want to kill the health care bill, he’s just concerned about costs.

The reality is that the health care industry was the single largest contributor to his campaign in 2008, with individuals and PACs collectively throwing in $261,000. Ross, a former pharmacist, also received over $100,000 in dividends last year from the pharmacy he used to own.

Rep. Ross says he’s on his constituents’ side, but as he holds up health care reform, his constituents are some of the hardest hit. Almost 22 percent of his constituents have no health insurance. Twenty percent live in poverty. Almost 30 percent are people of color, who experience significant disparities when it comes to health and access to health care. His economically depressed hometown of Prescott, Ark., which he now represents, is suffering immensely, as many residents are unable to afford health insurance and a floundering economy makes it even more difficult for employers to provide health insurance for their employees. The situation is further exacerbated by the fact that Arkansas residents have seen their health insurance premiums balloon 66% between 2000 and 2007.

The districts of Rep. Ross and his Blue Dog cohorts have been among the hardest hit by the health care crisis. It’s time for them to get down to business making the changes we need, not holding legislation hostage so they can “negotiate.”

Thank you to the Institute for Southern Studies for compiling the research.

Health Care's Private Bureaucrats

Seth Extein — Thu, 23 Jul 2009 13:00:38 -0700

Republicans like House Minority Leader John Boehner continually inject fear-mongering into the health care debate by saying the current reform bill would “put bureaucrats in charge of medical decisions rather than patients and doctors.”

If the idea of a middle-man getting in the way of you and your doctor scares you, you should be very afraid of the way private health insurance works today.

Private health insurance is a business, and businesses make profits by cutting costs. When you have a chronic illness, you are a big cost on the balance sheet of your insurance provider.

Meet chronic-cost and general-drag-on-company-profits Maureen Kurtek:

Kurtek was denied a medically necessary treatment, one that her doctors had given her six times previously, for 53 days while her new insurance company’s “bureaucrats” determined whether she should get it or not. In the meantime, the delay brought her to the brink of death, and her health and quality of life were damaged forever.

Industry whistleblower Wendell Potter testified in front of the Senate Committee on Commerce, Science and Transportation about how endemic this denial of care is within the industry.

Companies will use a tactic called rescission, where they find loopholes within your policy to deny care and take away your coverage right when you need it the most, or suddenly jack up premiums to “purge” you from the plan. An investigation by the Energy and Commerce committee found that three insurers “canceled the coverage of roughly 20,000 people in a five-year period, allowing the companies to avoid paying $300 million in claims.”

Aetna even spent $20 million in premiums to create a high-tech computer system dedicated to cutting the sickest and costliest from the rolls.

There is no use in asking or expecting the insurance companies to play nicer. They are under tremendous pressure from Wall Street investors to keep their costs at specific rates, or else quarterly projections go sour and stock prices tumble.

Right now there is a middle-man standing between patients and doctors, and that middle-man has billions in profits to worry about along with the well-being of any one patient.

Congress has to set new rules for the industry. The America’s Affordable Health Choices Act would end the deadly practice of rescissions and establish new consumer protections against abusive insurance practices. There will also be a clear, guaranteed list of benefits.

This health care debate is not just about the 47 million (and growing) Americans without health insurance. It’s about insurance actually meaning something, and getting the care you paid to make sure would be there for you.