Progress Now Action

A study published in Health Affairs (6-10-08) documents a sharp (60%) increase in numbers of underinsured between 2003-2007. Underinsurance rates nearly tripled among those with incomes above 200% of poverty. Consequently, 42 percent of U.S. adults were under- or uninsured in 2007, reporting high levels of access problems and financial stress.

Even among those with incomes over 400% of poverty, 15% are underinsured. The study indicates that the move toward greater consumer cost-sharing for minimum benefit insurance policies in recent years is pushing millions of insured non-elderly adults toward spending large shares of their incomes on health care. The clear impact is to increase the share of families at risk for medical debt and loss of savings for retirement, college, or other long-term needs.

Our current insurance system is working well only for the wealthy, who can afford high costs. Politicians' promises that "you can keep the insurance you have" also apply to the wealthy.  Read the Report

Following is a 650-word piece I wrote about the failure of profit-centered health care that has been picked up by several newspapers around the state.

                              Failure of U.S. profit-centered health insurance

Spending almost twice as much, the U.S. has worse health outcomes than other industrialized nations. Uniquely, U.S. health care is dependent on over 1200 for-profit health insurances, functioning as gatekeepers. Underwriting – the art of risk evaluation and avoidance – insures profits by covering the healthy and rejecting everyone else as a "pre-existing condition."

Profit is a perverse incentive for quality health care: imagine for-profit fire or police protection. "Market-driven" health care treats health as a commodity, to be negotiated like a car or a house. The free market has also spawned "designer hospitals," offering only the most profitable specialties, e.g., cardiac procedures, and eliminating less profitable services, e.g., emergency and mental health.

No reform proposal by current presidential candidates addresses the failure of the private health insurance industry, characterized principally by decreasing benefits and greater costs and risks shifted to consumers. In turn, more are subjected to underinsurance and unpaid medical bills – now the leading cause of personal bankruptcies. Premium increases of 87 percent over 6 years have outpaced both cost-of-living and median family income increases.

Incremental reform proposals demonstrate lack of political will – the same failure to confront corporate profit-taking by insurance and pharmaceutical industries that wrote Medicare prescription drug reform with billions of dollars of taxpayer subsidies and inflated profits to benefit their bottom lines.

Commercial health insurance is the 800-pound gorilla, responsible for over 25% of health care dollars siphoned to excessive administrative costs, lobbying, marketing, CEO salaries and profit-taking: $30 billion annual health insurance profits; $32 billion insurance underwriting and marketing costs (McKinsey Group, 2007).

Gaming the system for profit has given rise to the annual $20 billion business of "denial managment" – health insurance middlemen who search claims for excuses to delay, deny or renege on reimbursements.

Responding to double-digit premium increases, more employers are opting to move employees into underinsurance – high-deductible catastrophic plans. Simultaneously, the American Hospital Association reports that both family out-of-pocket health expenses and unpaid medical bills have risen approximately 60% over a decade – still more costs ultimately shifted to taxpayers and consumers.

Notably, more than 20 federal and state studies since 1990, including the 2007 Lewin Group evaluation in Colorado, have demonstrated that single-payer health insurance is the only reform model that can both save money and provide comprehensive health care benefits for all. Indeed, the single payer model is the only truly efficient, equitable, and sustainable financing system, enabling universal coverage by spreading risk across the entire population.

Contrary to assertions by the "free market" choir, only single payer insurance permits true choice of pubic and private providers; private insurance is limited to "in plan" doctors. Only single payer provides comprehensive benefits and protection against medical bankruptcy.

Rather than comprehensive health care reform, most current proposals revert to a Massachusetts-style nostrum, preserving insurance profits and requiring an individual mandate to purchase minimum-benefit insurance, subsidized by taxpayers as needed. It is a formula for continued inflationary consumer health costs and decreasing benefits.

National single payer bill, HR676, calls for a progressive 3 to 4 percent employer and employee payroll tax to replace all health deductibles and premiums. Full-coverage costs for a family of four earning $40,000 annually would drop to $110 a month, from recent levels of $273/month for employer-sponsored coverage, or $489/month for an individually-insured family (Kaiser Family Foundation, 2007).

A political class dependent on corporate money (and privy to 70 percent-taxpayer-subsidized health coverage) sidesteps meaningful reform. Nevertheless, polls by Pew and others have revealed increasing numbers – 54 to 65 percent of people – support a national single-payer health care plan. A recent survey reports that 59 percent of U.S. physicians now support national health care, up 10 percent from 2002.

A grassroots movement and political reforms, including publicly-financed campaigns, may be necessary to instill the political will for meaningful reform. We have everything to gain from quality-, saftey-centered universal single payer health care to replace U.S. dependence on profiteering health care gatekeepers.

I wasn't goofing off because it was a holiday weekend, I swear! JUST as I was patting myself on the back last Friday evening for being almost caught up, I noticed I was suddenly awfully congested in my chest. As though it had been booked for a tour by Bronchitis and the Wheezers, the atonal faux-accordion-pop group.

So I was mainly in bed from then until noon or so today. Thank goodness for my trusty laptop, which not only let me keep up virtually with the big world, but is warm and comforting to cuddle when you are sore from coughing.

Could have been worse, of course. In a funny co-incidence, as I was looking over the blogs I read on Wednesdays I found this article on Damn Interesting.com about The Heroes of SARS. It's an excellent overview of the epidemic from start to finish, showing how some things that are often politicized worked RIGHT for once. There's even a whistle-blower who got listened to! And not stomped on later!

By the way, if anyone is interested in ancient history, I did a write-up on my personal experiences and views of the State Assembly and Convention.

First part of Friday

Second part, Friday

Saturday

CheneyCare -- We taxpayers pay 70% of guaranteed coverage for VP Dick Cheney and 2 million federal legislators and employees. 
Link: Bill Moyers' Journal 5/9/08 -- California Nurses' campaign for "CheneyCare" for all.  Read transcript or view program: http://www.pbs.org/moyers/journal/05092008/transcript1.html


Video "Who the Health Cares?" gets straight to the point: Presidential candidates will not determine health care reform -- the ball is in the court of Congress. http://www.moblogic.tv/video/2008/04/30/who-the-health-cares/


For-Profit Health Insurance and Pharmaceutical Industries -- scary statistics

1) Melody Peterson's book "Our Daily Meds" reveals that the benefit of medicines marketed by pharmaceutical companies "has become secondary to how much it will bring shareholders in profit"...due to constant pressure by Wall Street for drug companies to exceed profits made the year before; Big Pharma employs 2 lobbyists for every Congress member.

2) Tests show that placebos often work as well as the drugs being marketed to the public.

3) 100,000 Americans die annually from taking prescribed drugs as prescribed (FDA reports).

4) U.S. experiences 75,000-100,000 preventable deaths annually, ranking 19 out of 19 nations. (Recent study, Ellen Nolte & Martin McKee, London School of Hygiene & Tropical Medicine) 

Please join Be the Change-USA & Health Care for All Colorado
for an exciting, engaging and fun event May 31

Are We All Really Covered? Closing the Gaps in Health Care
12 noon - 7:30 PM, Sat., May 31, 2008

First Plymouth Congregational Church
3501 S. Colorado Blvd. (Hampden and Colorado Blvd)
Englewood, CO

Registration: Full program: $35; Dinner & evening speakers: $25; Evening speakers only: $10. Discount for Seniors, students, veterans, BTC and HCAC members: $5

Special program features:
1-3 PM Providers and Patients Panel: "How did we get into this mess, and how can we get out?"

3-5 PM Presentations by CO elected officials and candidates: "Will Colorado begin to close the gap?"

5 PM Dinner "Legislative Grill" -- Members of Congress and candidates and representatives of Presidential campaigns: "Will Congress or our next President begin to close the gap?"

6 PM Evening Keynote speaker: Elizabeth Kucinich

More info: www.BTC-USA.org or www.healthcareforallcolorado.org or call Dick Barkey, 303-808-8504, or Eliza Carney, 970-416-0636
To register online: www.BTC-USA.org  

Senator Sandoval(D)(CHAIR and Senate sponsor for FAIR): 303-866-4862

Senator Romer (D): 303.866.4852

Senator Brophy (R): 303.866.6360

Senator Harvey (R): 303.866.4881

Senator Isgar (D): 303.866.4884

Senator Kopp (R): 303.866.2683

Senator Veiga (D): 303.866.4861

ProgressNow members have written over 800 emails to legislators in support of the Fair Accountable Insurance Rates ("FAIR") bill just since yesterday afternoon. You can contact your legislators using our simple online form at:

www.ProgressNowAction.org/FAIRSpeakout.

For more info on the FAIR bill, go to www.ProgressNowAction.org/FAIRFacts.

UPDATE: The FAIR bill has now passed the House, and it's on to the Senate. You can still use the link above to contact your Senator by email.

Rosemary Marshall,Chair (D)
(303) 866-2959
rosemary.marshall.house@state.co.us

Joe Rice, Vice Chair (D)
(303) 866-2953
joe.rice.house@state.co.us

Dorothy Butcher (D - Pueblo)
(303) 866-2968
dorothy.butcher.house@state.co.us

Morgan Carroll (D)
(303) 866-2909
morgan.carroll.house@state.co.us

Edward Casso (D)
(303) 866-2964
edward.casso.house@state.co.us

Cheri Jahn (D)
(303) 866-5522
cheri.jahn.house@state.co.us

John Soper (D)
(303) 866-2931
john.soper.house@state.co.us

David Balmer (R)
(303) 866-2935
david.balmer.house@state.co.us

Larry Liston (R)
(303) 866-2965

Victor Mitchell (R)
(303) 866-2946
victor.mitchell.house@state.co.us

Amy Stephens (R)
(303) 866-2924
amy.stephens.house@state.co.us

The U.S. spends on average twice as much on health care as other industrialized nations, and has overall worse outcomes. Paul Krugman’s & Robin Wells’ commentary ("The Health Care Crisis and What to Do About It," The New York Review of Books, 3/23/06) attributes the U.S. health care crisis to high dependence on fragmented, for–profit private insurances, hospitals and numerous middlemen that add health costs without adding value. Noting "the strange persistence, in the teeth of all available evidence, of the belief that the private sector can provide health insurance more efficiently than the government," Krugman and Wells remark that free-market ideology is "wholly inappropriate to health care issues." As many observe, health is not a commodity, like a car or house.

Factors of declining U.S. health care:

•      -Washington and the Bush administration are in thrall to insurance and drug industry lobbyists.
•      -The privatization-for-profit increases the fragmentation of U.S. health care, swelling the ranks of the uninsured.
•      -Commercial insurance has abandoned the principle of shared risk, shifting more risk to consumers, and has adopted the principle of adverse selection to guarantee profits for shareholders.
•      -Private insurances continue to skim over 20 percent of costs for profit and CEO salaries.

Employer-provided health coverage is unraveling, as U.S. health costs rise twice as high as inflation and 4 times faster than wages, prompting more employers to reduce/eliminate health coverage.

Medicaid rolls grow, as Medicaid picks up the slack from the unraveling system of employer-based insurance.

•      -Medicaid is particularly vulnerable as a means-tested program – its consituency is not politically powerful.
•      -Authors: "Funding for Medicaid depends on politicians' sense of decency, always a fragile foundation for policy."
•      -States fund an average 40 percent of Medicaid – unable to operate at a deficit, states are squeezed by growing Medicaid costs.
•      -Attempts to privatize Medicaid for profit – states like South Carolina are seeking federal waivers to offer recipients vouchers for purchase of private insurance – certain to be inadequate for many.

So-called ‘consumer-directed’ health plans requiring higher out-of-pocket medical expenses are not a cure.

•      -Health Savings Accounts (HSAs) serve as a tax break for the rich, but do nothing for the lower income.
•      -HSAs undermine employment-based health care, encouraging adverse selection – HSAs are attractive to healthier individuals, tempting them to opt out of company plans, leaving them less healthy individuals.

The authors cite a large body of evidence indicating that public insurance of the kind in many European countries achieves equal or better results at much lower cost.

Unfortunately, political will is lacking. Krugman and Wells call it "politically smarter" and "economically superior" to educate voters about the huge advantages of a single payer system, than to merely attempt to coopt the drug and insurance lobbies by writing them into compromise plans that they will likely oppose anyway. Alternatively, say the authors,"things will have to get much worse before reality can break through the combination of powerful interest groups and free-market ideology."

Everything speaks to the need to grow a grassroots movement in order to overcome the powerful insurance and pharmaceutical lobbies that write policy, as they did Medicare prescription drug reform, with billions of dollars of subsidies and inflated profits to enhance their bottom lines.

House Minority Leader Mike May and Rep. Morgan Carroll have privately exchanged terse words on the House floor this week over what May calls Carroll's "introduction of the politics of personal destruction into Colorado policy."

The bad blood between the lawmakers began to boil last week when Carroll sent out a news release claiming that industry lobbyists were hard at work trying to defeat her House Bill 1389, which would require insurance companies to justify rate increases to a state agency before they could take effect.

Carroll says Colorado's health insurance rates are seventh-highest in the country even though the state has one of the healthiest populations. She says rates are artificially high here because the state doesn't regulate increases.

Carroll attached a spreadsheet to her news release identifying lobbyists who were paid a combined $118,000 to speak for the insurance industry in January and February alone.

May said he really got angry when he learned Monday that the liberal group ProgressNow planned to "crash" a Republican press conference on GOP health care priorities.

The headline of the ProgressNow press release read: "ProgressNow Crashes Insurance Lobbyists/Lawmaker Press Conference: Upstages Insurance Lobby with signature of thousands of consumers who want accountability now."

Convinced that Carroll was behind the stunt, May confronted her. Carroll assured him she would not be in attendance, but would be available later by phone.

May took that to mean that Carroll had a hand in the protest and accused her of stooping to a brand of politics that had been kept out of the Capitol for years.

May complained to House Speaker Andrew Romanoff, D-Denver.

On Wednesday, Carroll approached May on the House floor and assured him she had not orchestrated the protest. Carroll said she had meant only to convey that she would be available to reporters by phone if they had questions about her bill.

May said he would take Carroll at her word but that his issues with her still stand.