Posts from — August 2009

Q: What type of health insurance do members of Congress receive? Is it a single-payer, government-run system?

A: Members of Congress are covered by private insurance under the same system that covers all federal workers.

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A notorious analysis of the House health care bill contains 48 claims. Twenty-six of them are false and the rest mostly misleading. Only four are true. [FactCheck.org]

Summary

Our inbox has been overrun with messages asking us to weigh in on a mammoth list of claims about the House health care bill. The chain e-mail purports to give “a few highlights” from the first half of the bill, but the list of 48 assertions is filled with falsehoods, exaggerations and misinterpretations. We examined each of the e-mail’s claims, finding 26 of them to be false and 18 to be misleading, only partly true or half true. Only four are accurate. A few of our “highlights”:

• The e-mail claims that page 30 of the bill says that “a government committee will decide what treatments … you get,” but that page refers to a “private-public advisory committee” that would “recommend” what minimum benefits would be included in basic, enhanced and premium insurance plans.
• The e-mail says that “non-US citizens, illegal or not, will be provided with free healthcare services” but points to a provision that prohibits discrimination in health care based on “personal characteristics.” Another provision explicity forbids “federal payment for undocumented aliens.”
• It says “[g]overnment will restrict enrollment of SPECIAL NEEDS individuals.” This provision isn’t about children with learning disabilities; instead, it pertains to restricted enrollment in “special needs” plans, a category of Medicare Advantage plans. Enrollment is already restricted. The bill extends the ability to do that.
• It claims that a section about “Community-based Home Medical Services” means “more payoffs for ACORN.” ACORN does not provide medical home services. The e-mail interprets any reference to the word “community” to be some kind of payoff for ACORN. That’s nonsense.

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FactCheck says it is a mix of false, true and misleading claims. [FactCheck.org]

The Republican National Committee this week posted a “Health Care Bill of Rights for Seniors,” which RNC Chairman Michael Steele and others have taken to the airwaves to publicize. It contains a number of claims we’ve seen and criticized before, but also contains one new one that has some truth to it, and another fresh one that has very little.

• The RNC says that cuts proposed by Democrats “threaten millions of seniors with being forced from their current Medicare Advantage plans.” That’s certainly possible. Ratcheting down payments to the private insurance plans in Medicare Advantage would likely cause them to reduce benefits or even withdraw from the market. That might force an unknown number of beneficiaries to find new plans or go back to the traditional system, which still covers 78 percent of the Medicare population.
  (Update, Aug. 31: At least 3 million of the more than 10 million Medicare Advantage beneficiaries would likely go back to traditional Medicare, one independent expert says.)
• Another new wrinkle in the RNC’s “Bill of Rights” is a claim that Democrats have proposed raising TRICARE insurance costs for retired military and their families. This one is false. It was actually the Bush administration that most recently proposed changes in TRICARE, which the hospital industry said would cost hospitals $458 million in its first year.

The RNC “Bill of Rights” document also recycles claims that Democrats are proposing $500 million in Medicare cuts without mentioning that much of that is offset by proposed Medicare increases. It falsely says that a comparative effectiveness research panel set up earlier this year could limit care based on a patient’s age, when in fact the law expressly prohibits the council from issuing such mandates. And the RNC implies, wrongly, that seniors who meet with their doctors to discuss end-of-life care could have their treatment cut off involuntarily. In fact, these discussions would be voluntary and any directives limiting treatment would have to come from the patient.

Please click the link above to read the entire FactCheck analysis.

Chuck Grassley, the main Senate Republican negotiator, has taken over $2.9 million from health and insurance interests that oppose reform. He’s also said he won’t support a public option because it would beat private insurance in the marketplace!

Wendell Potter cringes when opponents suggests that a “government takeover” of health care will be a milestone on the road to “socialized medicine.” He’s embarrassed that opponents are using a playbook that he helped devise, Nicholas Kristof, two time Pulitzer winning columnist of the New York Times, wrote. [Salt Lake Tribune]

“Over the years I helped craft this messaging and deliver it,” Potter noted.

Potter was a former executive of CIGNA. The “for profit” insurance industry is obsessed with sustaining the company’s stock price — which means paying fewer medical bills.

One way to pay fewer medical bills is to deny requests for expensive procedures.

A second way is “rescission” — seizing upon a technicality to cancel the policy of someone who has been paying premiums and finally gets cancer or some other expensive disease.

A congressional investigation into rescission found that three insurers, including Blue Cross of California, used this technique to cancel more than 20,000 policies over five years, saving the companies $300 million in claims.

Potter notes that a third tactic is for insurers to raise premiums for a small business astronomically after an employee is found to have an illness that will be very expensive to treat. That forces the business to drop coverage for all its employees or go elsewhere.

The insurers are open to one kind of reform — universal coverage through mandates and subsidies, so as to give them more customers and more profits. But they don’t want the reforms that will most help patients, such as a public insurance option, enforced competition and tighter regulation.

Potter argues that much tougher regulation is essential. He also believes that a robust public option is an essential part of any health reform, to compete with for-profit insurers and keep them honest.

Potter ought to know if anyone does. The program he helped develop for the insurance companies that a “government takeover” of health care will be a milestone on the road to “socialized medicine” is working, judging from the Town Hall Meeting held in Pahrump yesterday.

Actually, those that oppose the single-payer solution seem to fail to realize that they will remain at the mercy of the for-profit insurance industry if reformation fails. The propaganda war against health care systematic reform is succeeding, for lots of reasons.

It appears that Congress is determined to allow the private insurance industry to continue. Understandable when one considers the amount of money contributes to those Senators and Congressmen/women. Members of Congress, seemingly most, are not interested in protecting Americans from the scourge of for-profit insurance company practices.

Last Sunday I attended the Pahrump Town Hall Meeting at the Pahrump Nugget. Over 200 people attended, 50 of whom arose and spoke about the current health care system, the formation of that system being considered in Congress, or their personal experiences with the health care system.

Senators Harry Reid and John Ensign were invited to attend along with Congressman Dean Heller. Likewise invited were Congresswomen Shelly Berkley and Dina Titus though neither represents Pahrump. None attended or sent a representative. Only two of them even acknowledged their invitations.

Five chairs were set in front of the audience with their pictures appended to represent the Nevada’s Congressional Delegation.

A number of cameras recorded the event.

Dan Schinhofen, my fellow columnist in this newspaper, put the affair together. His idea, and a good one I thought, was to video the event and send copies of the video to each member of the Congressional Delegation. Since none of the Delegation had held their own Town Hall Meeting in Pahrump, or anywhere else in Nye County, residents of Pahrump was afforded no opportunity to discuss health care reform with any of their elected representatives in Congress. To his credit, Dan is seeing that the Delegation will hear from Pahrump whether they like it or not.

I doubt they will like it.

The reaction of the audience upon learning none of the elected Congressional members would attend or be represented by a member of their staff was negative. It was as though the audience felt they were being ignored. I could not escape the feeling that members of the audience can be expected to reciprocate by ignoring the Delegation on their next election day.

Having watched other Town Hall Meetings across the nation on TV I was not sure what to expect from the Pahrump audience. I was billed as being the Progressive liberal, Dan as the Conservative–opposite bookends of the political spectrum. And we are. We both were co-hosts of the event.

Though the event was not a political rally I could not help but scan the audience to see if I could identify any Democrats. Out of the 200+, I saw eight I could recognize.

The audience was well behaved. No banner waving, no orchestrated demonstrations. No AR15’s or handguns in view. As each spoke their allotted two minutes, the audience quietly and respectfully listened to each.

I saw the entire event as a classic example of grassroots democracy in action. The audience was attentive and engaged. I commend them for that.

The comments were a wide-ranging smorgasbord of views held by those that spoke. It displayed the intensity and seriousness with which they viewed the state of the current health care system and of their views of proposed reforms.

One man told of an experience with his wife who experienced cardiac emergency. He took her to Desert View hospital, learned there was no cardiologist to attend her. She had to be taken by helicopter to Desert Springs hospital in Las Vegas. He related the helicopter transport cost $16-18,000 and her stay at the Las Vegas cost another $26,000.

Two others shared their experiences in Canada’s health care system with ill loved ones in which they were told to take them home to die peacefully.

Distrust of government seemed to me to be the common theme throughout the audience. Fear of “socialized medicine,” intercession of government bureaucrats between patients and their doctors, inability of government to conduct any program successfully.

Only two of the number of bills wending their way through Congress were mentioned–HR 3200 and HR 676. Several speakers would refer to “the bill” without identifying which bill they were speaking. One of the problems, it seems to me to be prevalent, is that there has yet to be a single bill to arise for the public to address. There are several more, each from multiple Senate and House Committees. For example, the S 703 bill was not mentioned Sunday.

Until all the pending bills are digested into a single bill, it is almost impossible to evaluate the impact of health care reform.

The final item I would like to mention here is about the influence of special interest money on Congress’ treatment of healthcare reform.

I am nagged by the thought that perhaps one of the reasons, if not the reason, none of the Nevada Congressional Delegation appeared is that the actual constituents of the delegation is the health care insurance companies who feed so much money to members of Congress. Congress seems to be controlled and directed by those corporate interests, rather than ordinary citizens such as attended the Pahrump Town Hall Meeting. Perhaps that 200+ were forgotten the day after election.

Update: September 3, 2009. The Pahrump Valley Times stories about the Town Hall Meeting. Emotions vivid at health care forum and Obama proposal compared with Canadian health system.

It is Sunday morning, August 30, 2009. This afternoon between 3:00 to 5:00 p.m. there will be a “Town Hall Meeting” at the Pahrump Nugget about healthcare reform. I have been invited to attend as a “moderator.” The event has been sponsored and put together by Dan Schinhofen.

Dan is a columnist with the Pahrump Mirror, a weekly newspaper. So am I. Dan also has a weekly local TV talk show on Channel 30 on Fridays. I was his guest on the show last Friday.

I asked him how he was going to conduct the program this afternoon. He explained that those attending  the meeting will be provided an opportunity to come forward to the front of the room, five at a time, and address the Nevada Congressional Delegation with their view of healthcare reform. Each will have two minutes to make their statement. Then five more, until everyone has had their chance to speak up.

Dan and I will also be permitted to make a two-minute statement, just like everyone else.

The event will be video taped and the tape sent to the Nevada Delegation: Senators Harry Reid, John Ensign and Representatives Dean Heller, Dina Titus and Shelley Berkley.

The idea is to provide residents of Pahrump their opportunity to speak directly to those members of Congress.

Not a bad idea I thought. There is no other way I know of that residents of Pahrump can provide their input to Congress, unless they want to write.

So, being confined to two minutes to make my contribution I have been working on my “speech.” Here is my pitch:

Good afternoon to the Nevada Congressional Delegation.

It is regretful you cannot be here in Pahrump in person. But considering the acrimonious Town Hall Meetings being experienced in the nation your absence is understandable.

Here is my understanding of the facts with which we are faced:

The U.S. spends $7,129 per capita, twice as much as the other industrialized nations on health care.

Other industrialized nations have higher life expectancies, lower infant mortality and immunization rates.

Other nations provide comprehensive coverage to their entire populations, while the U.S. leaves 45.7 million completely uninsured and millions more inadequately covered. That 45.7 million is more people than the entire population of Canada.

The reason we spend more and get less than the rest of the world is because of our “for-profit insurance” system. Private insurers waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as profits and executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the multiple insurance bureaucracies. The cost consumes one-third (31 %) of money paid in premiums to the for-profit insurance companies. That leaves only 69 cents to pay medical claims.

Medical professionals in the group called “Physicians for a National Health Program” state that:

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under the single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would have free choice of doctor and hospital, and doctors would have autonomy over patient care.

Physicians would be paid a fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private for profit insurers replaced by non-profit insurers and recapturing their administrative waste. I understand that modest taxes would replace insurance premiums and out-of-pocket payments currently paid by individuals and business. That costs would be controlled through negotiated fees, global budgeting and bulk purchasing.

The current health care system by for profit insurance companies does not work. For profit insurers  systematically “dump” their customers who they find are not profitable. They deny payment of medical claims on grounds of “pre-existing medical conditions” or for surgeries they can classify as “experimental.” Failing that they hike the premium payments beyond the reach of ordinary people or small businesses.

UnitedHealth, Aetna, Wellpoint, and CIGNA have accumulated corporate control of virtually all of the healthcare industry in the nation and have eliminated savings from competition. They constitute a monopoly. They also exercise far too much control over members of Congress.

I urge Congress to pass HR 676 and establish comprehensive non-profit insurance coverage for all American citizens.

I’m looking forward to hearing what the others who attend the meeting will have to say. I’m also curious about how many Democrats will show up and speak. Will anyone from the Nye County Democratic Central Committee appear and speak on behalf of the Democratic Party. Same curiosity exists for those of the Republican persuasion.

I’ll know in a few hours.

Dean Heller, R-Nev., told some 70 members of Carson City’s Rotary Club Tuesday he has voted against all the stimulus projects, including the Cash for Clunkers program, because they will run up the national debt but won’t work. [See Heller’s voting record and campaign financing information here.]

“The more government gets involved in our economy, the more the free market struggles,” he said.

But one member of the group at the Carson Nugget took offense when Heller asked how many in the room had taken advantage of Cash for Clunkers. A man raised his hand, prompting Heller to say: “Congratulations. Everybody else in the room paid for your car.”

The man headed for the door, telling Heller: “I have better things to do than be insulted by a man who hasn’t learned anything. I’ll never vote for you again.” [Read more →]

In today’s Las Vegas Sun, Lisa Mascaro reported that Senator Harry Reid held a private meeting of health care providers in Las Vegas last Tuesday. Reid is quoted as saying:

“We have a problem in America and it’s called the private insurance industry.”

Reid also spoke about the antitrust exemptions health insurance companies have enjoyed for decades as part of the problem with the industry.

Having been blogging about the private health insurance industry for weeks now I thought “La de da—no fooling.” [Read more →]

Insurance Exec Turned Whistleblower Wendell Potter Speaks Out Against Healthcare Industry.

Amy Goodman of Democracy Now interviewed Wendell Potter, former Vice President of Cigna. (Click the Democracy Now link to see the video) As the debate over healthcare reform intensifies on Capitol Hill, we spend the hour with a former top insurance executive who’s now exposing the industry’s dirty secrets. Wendell Potter once served as the head of corporate communications at CIGNA, one of the nation’s largest health insurance companies. We speak to Potter about his own transformation from industry mouthpiece to whistleblower, the healthcare industry’s extensive PR and lobbying machine, the campaign to discredit Michael Moore’s film Sicko, and the insurance industry’s most pressing task: the fight against a public option, let alone a single-payer system. [Read more →]