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Ethan Rome

By Ethan Rome
Executive Director, Health Care for America Now!

The Republican budget proposal released by House Budget Chairman Paul Ryan of Wisconsin would give millionaires and political campaign contributors huge tax breaks while punishing seniors and working families. Ryan’s extremist plan would decimate Medicare and Medicaid and terminate the Affordable Care Act, undermining the economic security of America’s struggling middle class.

The Republican plan isn’t based on the principle of shared sacrifice. There’s no fairness. The idea that we solve big problems in this country by working together and sharing the burden can’t be found. The super-rich and big corporations aren’t asked to pitch in. Instead the Republicans manipulate the tax code so the rich get even richer. This budget blueprint changes the rules and reshapes this country in a breathtakingly dangerous way.

The Republican budget attacks every single one of us. Health care programs that everyone in this country depends on would be eviscerated. For example, we all depend on Medicare and expect that it will be there for us. What happens if it is not? What will people really do? Many of us have friends and relatives who receive Medicaid benefits, including millions in nursing homes. What happens when states slash benefits and dump people from the program? And the new health care law, the Affordable Care Act, has already made a huge difference in the lives of millions in its first year – and ultimately will directly touch 200 million of us. Affordable health care we can count on is a key to economic security. (more…)

Ethan Rome

By Ethan Rome
Executive Director, Health Care for America Now!

In a week when the Republicans attacked Planned Parenthood, the freedom of workers to bargain for a better life, programs that help middle class families and a whole lot more, the one thing they didn’t challenge was the excessive profits of the health insurance industry.

In fact, they continued their relentless effort to undermine the Affordable Care Act, which will eliminate the worst of insurance company abuses (like arbitrary denials of our care) and put a check on out-of-control profits that fuel rising premiums that are crushing families and small businesses.

Yesterday Health Care for America Now released a report that shows that the big five insurers earned $11.7 billion in 2010 – a 51% increase since 2008 – as they cut the number of people insured by millions and reduced the share of premiums they spend on actual medical care. So they made more money by charging more and providing less. It’s a great business model if you can swing it – sell a product for higher and higher prices, offer less and then try to deny services to your paying customers when they actually need it. (more…)

David Cay Johnston

 By David Cay Johnston
Pulitzer Prize winning investigative journalist

Atop the front page of the  Sept. 23 New York Times  is a color photo of Georgia homes flooded up to their rafters, an image that illustrates how when it comes to insurance our Congress applies two standards, separate and unequal, one for property and a lesser one for people.

Unlike people without health insurance, homeowners have access to public option flood insurance. 

Even those who fail to take personal responsibility to buy insurance to protect their property can get benefits, thanks in good part to politicians who are leading opponents of public option healthcare.

Consider the example of  Trent Lott of Mississippi, who was that state’s senior senator when Hurricane Katrina hit in 2005, flooding his home looking out on the Gulf. Lott had not exercised personal responsibility by taking out flood insurance even though it was available from the federal government at low cost. He did have private insurance, but his insurer refused to pay much of the claim, saying it was not wind damage (which was covered by the policy), but water damage (which was excluded).
    
Weeks later Lott introduced Senate Bill 1936, which would have authorized retroactive flood insurance. The idea came from Representative Gene Taylor, a Democrat who represented the Mississippi Gulf Coast, which should remind us that when there is voter demand for reform, and campaign contributions are not the driving force, the parties have worked together.    

Lott’s bill would have let flood victims pay 10 years of flood insurance premiums after-the-fact plus a 5 percent late payment penalty. Since this storm was rated a once in 500 years occurrence, even 10 years of premiums would not come close to covering the real costs, meaning a taxpayer subsidy was built into the Lott bill.

Instead of being laughed at by his fellow Republicans for promoting socialism, the concept of retroactive relief was warmly embraced, although not the idea for retroactive insurance. Instead the government went with handouts.

(more…)

Robert Borosage

By Robert L. Borosage
Co-Director of the Campaign for America’s Future

We’re headed into the end game for health care reform. The president has put himself in the arena. The insurance lobby is unleashing the scare campaign. A strong bill will pass the House. But at this point, too many Senators are still standing in the way.

The reform includes a broad range of measures to extend and improve care and help curb rising costs, but the epicenter of the debate is over what is called the “public option.” Health care reform will mandate businesses provide insurance or pay into a general fund. Individuals will be responsible to get health insurance, with subsidies for those that can’t afford it. We’ll able to retain the insurance we have, or have the choice of a range of plans, including a public option, modeled after Medicare. A strong public option, competing with private insurance, is key to helping to get costs under control.

And costs must be brought under control. We now spend nearly 50% more on health care per capita than any other country, with mediocre results. We ration care by price, with some 47 million Americans uninsured. It costs the rest of us about $1000 a year to pay for the price of their care when they are forced finally to check themselves into emergency rooms.

Tell stories, not statistics, the pollsters tell us. But after adjusting for inflation, health care costs have soared by 58% since 2000; while wages for most Americans were stagnant or lost ground. As the auto companies showed, businesses increasingly can’t afford health care. Families find it unaffordable. Virtually the entire long term debt challenge facing the US government is from the projected rise of health care costs. Get health care costs under control, the US has no long term fiscal problem. Fail to get them under control, the costs will bankrupt the federal government, state governments, businesses that offer health care (and increasing numbers won’t) and families. Reform that gets costs under control is imperative. There is no choice.

A key to getting costs under control is the public plan. It can take advantage of its purchasing power to gain cost reductions. It can model best care practices. Private insurance — which in most localities translates into a couple of dominant providers that don’t compete on price — will be forced to measure up with greater efficiency, innovation, and cost savings techniques.

Yet the debate in the Senate has been fixated on how to weaken or abandon the public plan rather than strengthen it. Republicans, for the most part, have taken themselves out of the adult conversation. Like first generation robots, they endlessly repeat the exact same words crafted by Frank Luntz – “government takeover,” “no choice of doctor,” “bureaucrats not doctors prescribing medicine.” It’s frankly pathetic. We have no choice as a society but to figure out how to fix this – and Republican leaders have chosen simply to peddle lies and scare stories and absent themselves from any serious discussion.

A gaggle of Democratic Senators — led by Senator Baucus and the so-called “moderate” Senators — have publicly thrashed around for ways to weaken or gut the public option. Outside groups like the Third Way have provided guidelines for disemboweling it. Some have suggested putting it off until private insurance competition proves it can’t get costs under control — as if that hasn’t been proven over the last decades. Baucus suggested decentralized local “co-ops” would serve as the public option — an idea notable for being both unmanageable and ineffective. Even if a network of coops somehow arose to insure that people had an option, they wouldn’t have the clout to hold costs down and force private insurance to compete.

Others, remarkably, have detailed ways to deprive the public option of the power to lower costs. They call for a “level playing field” with private insurance. The public plan can’t be subsidized, can’t use its buying power to lower costs, can’t take advantage of lower administrative overhead.

This sounds silly. We face soaring health care costs that will literally cripple our future. Surely, no Senator concerned about the country would work to undermine the key idea that would help get a lid on costs. They wouldn’t, as Barack Obama warned, just “create a system where the insurance companies have more customers on Uncle Sam’s dime, but still fail to meet their responsibilities.” If you assume that, you would be wrong. They’ve done it repeatedly in the past.

For example, early in Bush’s first term, Republicans decided that passing a prescription drug benefit for seniors would help cement Karl Rove’s permanent majority. The benefit would help 41 million Americans with a soaring cost of care not yet covered by Medicare. It would also create massive new market for the drug companies. And, of course, Medicare could do what governments across the world do — use its buying power to lower the cost of the drugs.

Only, when Republicans passed the law — in the dead of night, twisting arms to get it done — it actually prohibited Medicare from negotiating a lower price for drugs. Don’t worry, they argued, competition would lower drug costs (even as they banned the import of cheaper drugs from Canada or Mexico).

Why? Well, using government muscle violated “free market” sensibilities. More importantly, the drug companies have one of the most powerful lobbies on Capitol Hill. Billy Tauzin, the chair of the key House committee ushering the bill through, left soon after to get a two million dollar a year job as a head of Big PhRMA, the drug company lobby. Tom Scully, the administration’s point person who helped secret the actual cost of the bill, was already negotiating his million dollar job as the debate was going on. In all, 15 congressional representatives, aides and administration officials involved in the debate left shortly thereafter to take jobs with the drug lobby. With a $9 billion increase in annual profits at stake, the drug industry got an amazing return on its investment.

Today, seniors pay 60% more for the same drugs than the price charged veterans becuse the Veteran’s Administration does negotiate lower prices.

Extreme? Not really. The health insurance companies decided they should be allowed to compete with Medicare in providing health insurance options to seniors. Seniors would get more choice; Medicare, the bureaucratic behemoth, would get agile competition. Win, win, they argued, calling the program “Medicare Advantage.”

Only the insurance companies couldn’t compete with Medicare straight up. So they demanded subsidies from the government to enable them to vie with the Medicare program they described as horrendously inefficient, unpopular and bureaucratic.

And they stand to pocket an estimated $177 billion in excess payments over 10 years to compete with Medicare – subsidies that Obama would sensibly cut to help pay for health care reform.

Money talks. Nine Republican Senators on the key Senate Finance Committee wrote President Obama to say they would oppose any reform with a public plan. The Center for Responsive Politics reports that the nine had had pocketed $17.7 million in contributions from insurance and health care interests over the course of their careers.. http://www.bio-medicine.org/medicine-news-1/Senators-Who-Signed-Letter-Opposing-Public-Health-Plan-Took–2417-7-Million-in-Campaign-Donations-from-Health-Care-and-Insurance-Industries-48233-1/

Not surprisingly, the 20 largest insurance and drug companies and their trade associations have pumped up their lobbying by 41% over last year — with reported spending over $75 million in the first quarter alone.

This is the corruption of crony capitalism; a compromised congress using taxpayer’s money to enrich entrenched interests. Only now, the cost of this in health care is not sustainable. Dramatic reform is vital or we all follow the auto companies and go belly up.

So if your Senator says he or she is opposed to a public option, or wants a weaker public option, or a non-profit co-op that isn’t big government, or prates about the “government takeover of health care,” about losing your choice of doctor, about bureaucrats not doctors prescribing medicine, don’t fall for it. Either he or she is either utterly clueless or more likely is representing the interests of the industry, not the voters.

This business as usual is no longer affordable or acceptable. We shouldn’t let cynicism lower our expectations. Soaring health care costs and the human tragedy of those without insurance can no longer be ignored. Reform can’t be postponed. It is a stunning disservice that Republicans have taken themselves out of serious discussion. And it is an open scandal that Senators are catering to the private insurance industry that has profited from the problem rather than helping to solve it. We must expect more and demand more from those given the privilege to represent us.

By Leo W. Gerard
International President

John McCain should not be traveling in a bus called the Straight Talk Express.
No, that equivocating multimillionaire who kowtows constantly to the wealthy should be riding in one of those private, gilded railroad cars.
That would be symbolically appropriate as well since he is trying to railroad the middle class on taxes.
He is actually proposing a brand new tax on the middle class.
This has gotten so little attention it is astounding. And frightening, frankly, as television reporters and commentators focus instead on inane incidents like the lipstick-on-pigs remark.
McCain intends to tax workers for the value of health insurance that they receive from their employers.
Really.
Although it’s not included in the description of his plan on his web site. It is, however, on the site of the Henry J. Kaiser Family Foundation, a non-profit organization that specializes in health policy.
I understand McCain neglecting to mention this new tax on the middle class. If I were proposing this shocking tax increase, one that will cost the average American worker an additional $110 a month in taxes out of the blue, I would conceal it as best I could too.

Taxing health insurance

So let me provide you with some clarity. This comes from the Kaiser Foundation evaluation of the McCain and Barack Obama health plans. It says McCain would “reform the tax code to eliminate the exclusion of the value of health insurance plans offered by employers from workers’ taxable income.”
The value of the typical plan provided by an employer to a family is $12,106, of which the employer pays $8,824, and the worker pays the remaining $3,282. The median household income is $44,389, which places most American families in the 15 percent income tax bracket.

McCain wants to add the employer’s cost — an additional $8,824 — to that middle class family’s income, then tax it. The hit to the average family is 15 percent of the McCain-added income — $1,323 more in income taxes.
This new tax would affect the 158 million Americans who are insured through their employer.
Right now you should be yelling, “What?” And demanding to know why you haven’t heard about this before. That is because the media keeps focusing on McCain’s proposed health care tax credits — $5,000 for families and $2,500 for individuals.

McCain certainly wants the attention to stay on those credits. It sounds so much better to be giving families tax credits than tax increases. But what you need to know about those tax credits is that they don’t go to you – they’re to be sent to the insurance companies. You never get actual money in your pocket. McCain says it right on his web site: “the money would be sent directly to the insurance provider.”
So if you choose to remain with your employer-based insurance, there’s no guarantee that you’ll ever see any benefit from that $5,000 payment. In addition, giving young healthy workers $2,500 to buy insurance on their own, where it won’t be taxed, will encourage them to leave employer-based plans, quickly raising the costs for everyone remaining and thus eliminating benefits of the tax credits. Finally, the tax credits rise only at the rate of inflation, not the vastly faster rate of medical costs, so, again, their value will quickly erode, according to several studies, including one released last week by health economists from Columbia, Harvard, Purdue and Michigan and published in the journal “Health Affairs.”
New tax

Still, somehow, no one mentions the new tax part of McCain’s plan!
Even the credits don’t sound so great after you hear the whole story.
John McCain wants to kill employer-provided health insurance. He wants every American to go out on his or her own and try to buy insurance. He says that on his site if you read between the doubletalk. He says, for example, “The key to health care reform is to restore control to the patients themselves.. . .Health care. . . should not be limited by where you work.”
Here’s the way the New York Times put it in an April 30 story, in which there was only straight talk: “Mr. McCain’s health care plan would shift the emphasis from insurance provided by employers to insurance bought by individuals.”
Since 2000, the percentage of employers offering health insurance has declined from 69 percent to 60 percent. Many more companies would dump their plans as soon as the federal government offered tax credits to individuals who bought their own. Corporations would disingenuously justify this abandonment the same way McCain does — by saying workers would get the advantage of carrying their individual plans from job to job as they move around the country.
They won’t mention the cost, however. To buy plans comparable to what workers now receive from employers, families are going to have to shell out a lot more money from their own pockets.
The math is simple. To buy the $12,106 plan with the $5,000 family tax credit, a worker is going to have to cough up an additional $3,824. (That is the $8,824 the employer previously paid toward the plan minus the $5,000 credit.)
That is, assuming, of course, that you can get coverage. Insurance companies are notorious for rejecting anyone with pre-existing conditions, including acne, being overweight and diabetes.

McCain wouldn’t qualify

John McCain himself would likely be unable to find an insurer on the private market since he’s had the most serious form of skin cancer, melanoma, more than once.
But he doesn’t have to worry because, as a U.S. senator, he’s covered by a government plan. And he’s certainly not proposing eliminating that!
McCain could resolve the exclusion problem by requiring insurance companies to accept people with pre-existing conditions. But he doesn’t. Instead, he suggests setting up a system in which states would become responsible making sure those people get insurance. He says he won’t shift the costs to the states, but what’s the chance of that? He’s establishing a pool of all of those rejected by insurance companies – thus those with the highest risk. And he’s telling the states to deal with the problem that creates.
Meanwhile, insurance companies would be left to profit big time by providing insurance for the young, the healthy and everyone who doesn’t have anything at all wrong with them. What a deal!
He claims this plan will increase competition and drive down prices – as if an individual worker, on his own, without any real knowledge of the system, has the negotiating power of a major corporation with full-time experts on its staff whose only function is to buy insurance for a pool of hundreds or thousands of workers.
While McCain is planning to increase your taxes if you’ve got insurance at work or to force you into the insurance market at a huge financial loss, he intends, at the same time, to cut taxes on corporations — you know, like those giant oil companies that just raked in the largest quarterly profits of any firm ever in the history of mankind. And he plans to permanently retain those income tax cuts his friend George W. Bush gave to the rich, because, of course, the wealthiest Americans, like McCain and Bush, need a break today.

Lying to American workers

In the meantime, McCain is traveling to states like Michigan, Ohio and Pennsylvania, hard hit by the economic devastation caused by eight years of Bush administration fiscal policy failures. At each stop, McCain is sucking up the middle class – as if his administration wouldn’t cost workers dearly.
He needs to stop lying to America’s workers.
In fact, maybe Mr. Straight-Talk-Express needs to slap on some lipstick. Because sometimes the truth is a bitch.