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.

Well, here we go again...time for another Secretary of Veterans Affairs to resign. This time we find that another arm of the George Bush mis-administration has made a dubious legal interpretation, trampled on the rights and benefits of veterans and is denying any wrong-doing.

You have to read the entire New York Times story to believe the depths of this tragic scenario.

http://www.nytimes.com/2008/06/13/washington/13vote.html?_r=1&th=&adxnnl=1&oref=slogin&emc=th&adxnnlx=1213380801-cdMfMk8+agmsFLoE3VAdHw

This is a bizarre and deplorable action on the part of the mis-administration of the current occupant of the White House.  Refusing to facilitate voter registriation is definately not prohibited by the Hatch Act.  It's really disappointing that former Senator Orrin Hatch (R-Utah) remains silent on this controversy.

Heads-up Colorado Springs and Northern Colorado. Beyond the fact that I've been working pretty hard for months to get this off the ground, it's just gonna be great!  This issue has been ignored (or at least danced around the edges) for too long.

 A Conversation with Rand Beers Tuesday, June 17th, 2008

Keeping Our Promises: Veterans, Soldiers and their Families 

Rand Beers, President and Founder of the National Security Network, former senior White House national security staffer and Vietnam-era Marine, will be the featured speaker at two town hall forums on issues facing the military community:  repeat deployments for members of the active-duty Armed Forces, Guard and Reserves, the needs of a growing new population of disabled veterans, and the burdens on military families.  Beers combines front-line experience (Rifle Company Commander in Vietnam and 10 years in the White House) with years of briefing our nation’s political leaders and, with the National Security Network, trains and advises candidates and advocates on how to address these issues in today’s political environment. A question and answer session will follow.

1:00 – 3:00pm

UCCS: The Upper Lodge

1420 Austin Bluffs Parkway

Colorado Springs, Colorado 80918 

6:30 – 8:30pm

Bill Reed Middle School

370 West 4th Street

Loveland, Colorado 80537 

RSVP: rkeenan@nsnetwork.org

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  

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.