Posts Tagged ‘medical insurance reform’

Don McCanne, MD: Consensus on the constitutionality of Medicare for all

October 12th, 2011

Some Common Ground for Legal Adversaries on Health Care

By Adam Liptak

The New York Times, September 29, 2011

The 2010 health care overhaul law has provoked an unprecedented clash between the federal government and 26 states, dividing them on fundamental questions about the very structure of the federal system. But the two sides share a surprising amount of common ground, too, starting with their agreement in briefs, filed on Wednesday, that the Supreme Court should resolve the clash in its current term.

Their briefs also reflect agreement on matters of substance. The two sides, along with the judges in the majority in the appeals court decision most likely to be reviewed by the justices, all said the dispute is about means rather than ends. There are other ways, they said, for Congress to achieve near-universal health coverage, some of them more expansive than what was enacted.

“Both sides agree that Congress has the constitutional power to enact a national health care system that raised taxes to support a single government agency that pays all medical bills, just like Medicare,” said Walter Dellinger, who served as acting solicitor general in the administration of President Bill Clinton and supports the law.

Randy E. Barnett, a lawyer for some of the plaintiffs who on Wednesday sought Supreme Court review, made essentially the same point. “What I’ve said from Day 1,” he said, “is that if Medicare is constitutional then Medicare-for-everyone is constitutional.”

http://www.nytimes.com/2011/09/30/us/health-care-adversaries-have-common-ground.html

Comment:

By Don McCanne, MD

The Affordable Care Act represents the most expensive model of reform and yet falls short on universality and affordability, and now it is being challenged as a violation of the Constitution. Why are we defending it when the least expensive model that actually would accomplish our goals has been declared by all parties to be compliant with the Constitution?

Fast tracking the decision is great. Once the legal issues are dispensed with, we can look at the mess we have left, reject it, and move on to enacting an improved Medicare for all.

Additional comment from Merrill Goozner:

What’s interesting about rising insurance premiums is that they are way out of line with the rise in costs, which was only around 4% last year in nominal dollars, which in inflation-adjusted dollars would be just a 2% increase. Both Medicare total expenditures and insurance total expenditures rose (which, after adjusting for inflation was the same rate as economic growth; GDP rose 2.6% in 2010). It was one of the lowest increases in decades, as health care’s share of the economy did not increase for the first time in many years.

So why the hike in premiums. A Goldman Sachs analyst quoted in the WSJ story earlier this week attributed the outsized premium increases to insurance
companies padding their bottom lines.

I blogged on it here: http://gooznews.com/?p=3215

Re-posted with permission from pnhp.org.

As many predicted, health insurance costs skyrocketing, insured Americans forgoing care

September 28th, 2011

by nyceve

As the debate played out during the contentious summer of 2009 before the passage of the Affordable Care Act, many were deeply concerned that the insurance industry would escalate its war against the American people. We feared and predicted even more egregious price gouging.

It seems all our fears were justified.

As we know, even insured Americans are delaying or forgoing needed and necessary healthcare because the high deductible junk insurance they have (which is all they can afford), requires huge out-of-pocket costs, making healthcare a luxury. And please keep in mind, we’re talking about people with insurance. Insured Americans are consuming less health not because they don’t need to see a doctor, but because they can’t afford to do so. This is what the insurers want, they collect our premiums, sell us high deductible insurance which we can’t even afford to use.

A new study just released by the Kaiser Family Foundation paints as grim a picture of the U.S. healthcare system and its unaffordability, as I have ever read. It is ghastly and our healthcare system is on the precipice of collapse.

After several years of relatively modest premium increases, annual premiums for employer-sponsored family health coverage increased to $15,073 this year, up 9 percent from last year, according to the Kaiser Family Foundation/Health Research & Educational Trust 2011 Employer Health Benefits Survey released today.  On average, workers pay $4,129 and employers pay $10,944 toward those annual premiums.
Premiums increased significantly faster than workers’ wages (2.1 percent) and general inflation (3.2 percent).  Since 2001, family premiums have increased 113 percent, compared with 34 percent for workers’ wages and 27 percent for inflation.

“This year’s nine percent increase in premiums is especially painful for workers and employers struggling through a weak recovery,” Kaiser President and CEO Drew Altman, Ph.D. said.

You should not be surprised at this terrible and deeply demoralizing state of affairs. There is little (or nothing) in the Affordable Care Act which requires insurers to make their junk products affordable. Even worse, despite paying a huge percentage of our dwindling income to buy insurance, Americans are paying for almost useless policies. I define a useless policy as one with high deductibles and high out-of-pocket costs.  As the economy continues to show little or no improvement, even workers with insurance are not getting the care they need to do all the costs they are expected to shoulder.

And to make a bad situation even more troubling, the added benefits, insurers are now required to provide due to the passage of the Affordable Care Act, are giving them the cover to raise rates to unconscionable levels and ‘blame’ the ACA.

Throughout this year, major health insurers have defended higher premiums — and higher profits — saying that their expenses would rise once the economy recovered and people believed they could again afford medical care. The struggling economy will probably keep suppressing demand for medical care, particularly as people pay a larger share of their own medical bills through higher deductibles and co-payments, according to benefits consultants and others. About three-quarters of workers now pay part of the bill when they go see a doctor, and nearly a third have a deductible of at least $1,000 if they have single coverage, up from just one in 10 in 2006, according Kaiser.

The Affordable Care Act was written without teeth or strong enforcement mechanisms, but that is old, sad news.  To be fair, the ACA allocates money to the states to police rate hikes, but it is powerless to stop them, and many believe this is really window dressing to give cover to the politicians and to make the very gullible American people think the government is trying to bring us some relief.

Every  day in America, 3,700 families file for bankruptcy caused by illness and medical bills, and that number is rising. This shameful situation happens in no other wealthy democracy. It would be a scandal anywhere else. Most medically bankrupt families were middle-class before they suffered financial setbacks. Roughly 60 percent of them had attended college; 20 percent of families included a military veteran or active-duty soldier.

Most astoundingly, 60 percent of the individuals whose illness led to bankruptcy had private, for-profit health insurance when they got sick. Don’t we buy health insurance to avoid financial ruin? High deductibles lead directly to bankruptcy and foreclosure. To make matters worse, they cause people to postpone needed care. All of which lead to higher insurance company profits.

You should be very, very scared to be an American citizen. I’m sorry to say this, it’s the truth.

Nyceve is a board member for California OneCare. Originally posted in the DailyKos.

PNHP: New Census Figures on Uninsured Show Urgent Need for National Health Care

September 14th, 2011

Number of uninsured climbs to highest figure since passage of Medicare, Medicaid
50 million uninsured shows urgency of enacting single-payer Medicare for all: national doctors group

Official estimates by the Census Bureau showing an increase of about 1 million in the number of Americans without health insurance in 2010 – to a 45-year high of 49.9 million persons, or 16.3 percent of the population, under the bureau’s revised calculation method – underscore the urgency of going beyond the Obama administration’s federal health law and swiftly implementing a single-payer, improved Medicare-for-all program, spokespersons for Physicians for a National Health Program said today.

Employment-based coverage continued to decline. The bureau said 55.3 percent of Americans were covered by employment-based plans in 2010, down from 56.1 percent in 2009. It was the eleventh consecutive year of decline, from 64.2 percent in 2000.

Read the rest of the article here.

Health Committee Chair’s Questionable Financial Gains From Insurance Industry Lobbyists

September 9th, 2011

When California Senate Health Committee Chair Ed Hernandez’s foot dragging earlier this year nearly killed the single payer bill, SB 810, outright, I wondered whether health insurance industry lobbyists had gotten to him. Hernandez, a Democrat, eventually voted to move SB 810 out of committee, but only after a massive amount of arm-twisting by universal healthcare advocates and a public dressing down by a Democratic Party activist at the state convention. However, weeks after the vote, SB 810 was still placed on ice, to be re-introduced in January.

Hernandez then complained about another popular bill, AB 52, that would have allowed state regulators to pre-approve insurance industry rate increases. He voted that one out of committee too, but said he wouldn’t support a final version unless changes were made. Under industry pressure, AB 52 soon died in the State Senate in late August. Well, turns out there may have been a reason for all of Hernandez’s hemming and hawing. According to an investigation by Think Progress, he’s been on the health lobbyists’ payroll:

State Sen. Ed Hernandez (D), the chair of the health committee, voted for AB 52 but told the press he could not support the bill in its current form. Hernandez’s income is boosted by about $69,000 a year in payments from Kaiser Health Plans, the state’s largest insurer (and one of AB 52′s most prominent opponents) in rent at an office building owned by Hernandez. The unusual arrangement might present a serious conflict of interest, but Hernandez’s spokesman told ThinkProgress that the rent payments began shortly before Hernandez entered the legislature, and that Kaiser maintains a community outreach center in the senator’s building. (emphasis is the author’s)

Hernandez’s spokesman can try to spin this stinky arrangement until he gets dizzy. It doesn’t matter that the rent payments were made before Hernandez became a state senator. What’s problematic is that Hernandez continued this financial relationship with Kaiser while still sitting on the state Senate Health Committee. At the very least, Hernandez should have recused himself from the vote on AB 52. It makes one wonder if there are any other little arrangements the senator has got going with his health lobbyist buddies? The stench of corruption here is just too great to ignore.  It’s no wonder that we, the people of California, and the United States can’t get the kind of legislation passed that will truly address the dire problems we face, which includes replacing a morally bankrupt and deadly healthcare system with one that provides high-quality and affordable care to all. Our democracy has been hijacked by unethical business interests funneling money to our so-called “representatives” by means that may be legal in this country, but elsewhere, such “arrangements” would be called by another name.

Sylvia@californiaonecare.org