Healthcare for the Middle Class
| Tue Mar. 3, 2009 10:10 AM PST
David Corn just got back from a breakfast meeting hosted by Nancy Pelosi, who outlined the Democratic messaging strategy on healthcare reform:The "appeal" of this push, she said, will not be that 48 million people don't have health care insurance. "What is important to the bigger population," she explained, "is their own health care."
....The bottom line: the battle cry will not be, "Health care for all!" Instead, it will be "Better health care for you — and also the rest of us." Given how the Hillary Clinton-led crusade for health care reform flamed out terribly in the 1990s, this sort of tactical shift may be warranted. It may even be wise.
I'd go further than that. Even as far back as 1993, Bill Clinton understood that fear of change among the already insured was the key issue in building public support for national healthcare. Unfortunately, even though he got this, he still didn't emphasize it enough, and that's one of the reasons his plan failed.
Since then, however, this has become conventional wisdom. Like it or not, universal healthcare will never get passed on the grounds that it will help the 48 million Americans who are currently uninsured. It will only pass if the other 250 million Americans are assured over and over and over again that the new plan will be at least as good for them as what they have now. The tactical shift Pelosi is talking about isn't just wise, it's absolutely indispensable.
More importantly, however, both David and Ezra Klein report that Pelosi's real priority this year isn't healthcare at all. It's energy policy — specifically, getting a cap-and-trade bill passed. My sense from Obama's non-SOTU last week was that this was his priority as well, so it wouldn't surprise me at all if serious healthcare reform ended up getting pushed off until next year.
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Comments
The basic problem is that
Submitted by BR (not verified) on Tue Mar. 3, 2009 10:31 AM PST.
The basic problem is that the key reform that's needed is a reduction in coverage. Expensive hi-tech treatments that provide little to no benefit (and sometimes less benefit) than cheaper ones need to be ditched. This is an extremely hard sell to people who have been told that the problem with our health care is that too much of what consumers demand is denied by greedy HMOs. Even Moore's Sicko tried to imply that those with coverage don't get enough treatment. The exact opposite is the case. If we want to bring American health costs in line with every other civilized country - all of whom have better health outcomes than the US - this is what we need to do.
Basic Problem?
Submitted by MarkH on Tue Mar. 3, 2009 4:56 PM PST.
The basic problem is that the key reform that's needed is a reduction in coverage. Expensive hi-tech treatments that provide little to no benefit (and sometimes less benefit) than cheaper ones need to be ditched. This is an extremely hard sell to people who have been told that the problem with our health care is that too much of what consumers demand is denied by greedy HMOs.I agree, in part. We clearly don't need doctors and hospitals running endless wasteful tests or anything else we don't need. We also clearly need more health care providers to follow 'best practices' rather than letting insurance 'doctors' decide what we need (or don't need). The net effects could be better AND cheaper health care. Getting more people covered is more of a political fight and if it's done in conjunction with cheaper & better, then it'll go through. If we can find a way to make 'cheaper' more possible by covering more people, then we can really bundle them convincingly.
I go even further
Submitted by Wagster on Tue Mar. 3, 2009 10:42 AM PST.
Yes, self-interest will sell better than compassion. But we can also snag some of the rhetoric from the right and use it for our purposes. To wit: "Health Care reform is a personal responsibility issue. The uninsured are getting emergency room care for their maladies, not paying for it, and passing the cost on to the rest of us. Under reform, everyone will pay their way. No free lunches!" (Of course, you need mandates in the plan to be able to make this argument... which is why I sided with Hillary on this back in the campaign.)
Hey, whenever you get around
Submitted by Anonymous (not verified) on Tue Mar. 3, 2009 10:55 AM PST.
Hey, whenever you get around to it guys.
Just returned from a town meeting in a small town in Vermont.
The health insurance bill to cover the town's whopping five employees just went up $22,000, from $62,000 to $84,000. To cover FIVE employees (who make less than $250,000 collectively).
Great system we got going here.
Entrepreneurship
Submitted by Anonymous (not verified) on Tue Mar. 3, 2009 11:19 AM PST.
How many creative, energetic people in this country are stifled in dead-end jobs because their families need the insurance.?
Valid argument for reform, or no?
Entrepreneurship
Submitted by Anonymous (not verified) on Tue Mar. 3, 2009 11:24 AM PST.
How many creative, energetic people in this country are stifled in dead-end jobs because their families need the insurance.?
Valid argument for reform, or no?
In Europe drugs are free
Submitted by alan (not verified) on Tue Mar. 3, 2009 12:03 PM PST.
In the UK and France prescription drugs are free or cost pennies.
We need to broadcast this simple point far and wide and stick to that.
Free meds
Submitted by Caspian of the Lake on Wed Mar. 4, 2009 3:51 AM PST.
Uh, no Alan, they aren't free in the UK or in France or anywhere for that matter. They uh still cost a lot of money but the uh taxpayer has to pay for it. You might though consider moving over there and trying their system for a year or two before endorsing it for the US. Of course you'd have to find employment and their job creation isn't very good and is far behind the US. Yes, Alan, even in bad times like these the US economy still out performs your compatriots on the other side of the pond. Still, why not give it a try? If after a year or two of economy stifling taxes you still think a 'free system' is good, come back here and make a more ardent case for it
One thing though. Pray you don't get sick while you are there.
Not gonna happen
Submitted by rhinoman (not verified) on Tue Mar. 3, 2009 1:53 PM PST.
Politically, this tactic is a sure loser. Give it up. Find a way to cover the uninsured, but you can forget about bringing the middle class into a national health care system. They will not go for it.
Believe me. It's childishly easy to campaign against this. Just ask people if they want their health care supplied by the mployees at the town hall or DMV or state capitol, or their local school board. Then, you can imply that the national health system will end up like universal schooling - kind of crappy for everybody, except the rich, who opt out. Then, point out that at least you can sue an HMO. Good luck suing City Hall.
Sure, you say it'll be different. People won't believe you.
We need to deal with the uninsured. But - trust me on this - the middle class does not trust the government to run their health care.
Consider Japan's health care
Submitted by Babba (not verified) on Tue Mar. 3, 2009 4:26 PM PST.
Consider Japan's health care system where everyone still purchases insurance from private insurance companies but no one can be charged more than 8% of their income and cannot be denied insurance because of pre-existing conditions. Their system isn't perfect, but it's one that IMHO Americans might cotton too.
http://healthcare.change.org/blog/view/turning_japanese_we_could_do_a_lo...
System - NO; Reform Yes!
Submitted by MarkH on Tue Mar. 3, 2009 5:02 PM PST.
by rhinoman (not verified) on March 3, 2009 - 1:53pm. Politically, this tactic is a sure loser. Give it up. Find a way to cover the uninsured, but you can forget about bringing the middle class into a national health care system. They will not go for it.Sure, a 'national health care SYSTEM' isn't so popular and trying to implement one would be a nightmare. But, if government requires electronic records and 'best practices' health care and prevents insurance company intervention in care, then how exactly are people going to avoid benefitting from this 'national health care REFORM'? It would be like rebelling against standards for automobile tire safety. Nobody is going to rebel against a good thing that could save their life.
pelosi's real priority
Submitted by supersaurus (not verified) on Tue Mar. 3, 2009 2:43 PM PST.
what, she can't work on two things in a year? she doesn't have staff? she's just one lonely little speaker?
Going for cap and trade
Submitted by frannie (not verified) on Tue Mar. 3, 2009 5:15 PM PST.
Going for cap and trade first will be a colossal political and policy error. Cap and trade is a policy with literally no short term benefits. Even the long term benefits are, sadly, a huge gamble considering that what is politically doable is probably not nearly enough to address the problem. Talk about a huge waste of political capital.
This is the first real shot at health reform since Clinton. Just watch the Democrats throw it away again.
Why not do something that will actually improve people's lives? Even incremental changes (which is all we're likely to get in the end) will expand access and help people live longer better lives in the here and now. Global climate change will not be stopped by anything that has to go through the U.S. Congress.
Guaranteed coverage is a big attraction for the middle class
Submitted by Jasper on Tue Mar. 3, 2009 5:56 PM PST.
Since then, however, this has become conventional wisdom. Like it or not, universal healthcare will never get passed on the grounds that it will help the 48 million Americans who are currently uninsured. It will only pass if the other 250 million Americans are assured over and over and over again that the new plan will be at least as good for them as what they have now.
I agree, but there exists a perfectly powerful and effective way to pitch UHC to the millions of middle class folks (including 95% of Obama voters, I'm told) who are currently covered: passing federally guranteed UHC is the only way to make it literally legally impossible to lose your coverage. Middle class Americans are only one insurance-losing layoff and a medical crisis away from penury. I'd say that making America a country where you're guaranteed to always be covered counts as something that's "at least as good" as the status quo.
My sense from Obama's non-SOTU last week was that this was his priority as well, so it wouldn't surprise me at all if serious healthcare reform ended up getting pushed off until next year.
Maybe I'm naive, or insufficiently cynical, but I don't think the White House will refrain from introducing UHC legislation this year. It just doesn't make political sense. The Democrats can't count on a recovering economy to get them through the midterms -- conditions in November of 2010 will almost certainly be challenging for incumbents (hopefully that's not the case in November of 2012), so they'd best get at least one highly tangible "deliverable" enacted that will directly benefit voters. Trying to do this in 2010 -- an election year -- is really courting disaster. Moreover, the president cannot bank on his currently high favorability numbers surviving unblemished in 2010; far better to take on daunting challenges when you still possess the necessary political capital. Anyway, I'm pretty sure Obama, Orszag, Emanuel et al are aware of all of this, and will push their congressional colleagues to get something done in 2009. I'm not saying they'll succeed, mind you. But their chances are better if the legislative process at least begins some time before the year is through.
Healthcare for the 'rest of us'.
Submitted by Caspian of the Lake on Tue Mar. 3, 2009 6:23 PM PST.
Of the 48 million uninsured that Pelosi quotes, 15 to 20 million are aliens- legal or otherwise- that should never be insured at American Tax payer expense. 8 million of the balance are children that are covered by Schip programs. Actually 18 million now that the legislation to expand the program was passed a few weeks ago.
The best way to get expand healthcare cover NOW is to eliminate state mandates and allow insurance companies to offer national programs. We need a Geico or Safe Auto of health insurance. Why should a 21 year old be forced to buy the same policy as a 51 year old. We don't all drive Chevy's. Let the insurance companies compete on a national basis and we'll have more options at a lower cost.
Healthcare Reform for All
Submitted by Anonymous (not verified) on Tue Mar. 3, 2009 6:51 PM PST.
Health insurance companies play a major role in our current healthcare crisis. These companies make huge profits and their CEOs make millions, while the rest of us face skyrocketing healthcare costs, impossible bureaucracy, and life-threatening insurance denials.
HEALTH INSURANCE COMPANY PROFITS IN 2007:
1. UnitedHealth Group -- $ 4.654 BILLION. UnitedHealth Group owns Oxford, PacifiCare, IBA, AmeriChoice, Evercare, Ovations, MAMSI and Ingenix, a healthcare data company
2. WellPoint -- $ 3.345 BILLION. Wellpoint owns BLUES across the US, including Anthem Blue Cross Blue Shield, Blue Cross Blue Shield of Georgia, Blue Cross Blue Shield of Wisconsin, Empire HealthChoice Assurance, Healthy Alliance, and many others
3. Aetna Inc. -- $ 1.831 BILLION
4. CIGNA Corp -- $ 1.115 BILLION
5. Humana Inc. -- $ 834 million
6. Coventry Health Care -- $626 million. Coventry owns Altius, Carelink, Group Health Plan, HealthAmerica, OmniCare, WellPath, others
7. Health Net -- $ 194 million
The huge insurance company profits—BILLIONS EACH YEAR—could be used to provide quality healthcare for millions of people, and to pay physicians adequately for their work.
We need to get the insurance companies OUT of healthcare . The only solution is a NON-PROFIT SINGLE-PAYER HEALTHCARE SYSTEM – and the single payer should not be an insurance company or a group of insurance companies.
The solution? The United States National Health Insurance Act, H.R. 676. You can read about it here: http://www.healthcare-now.org/hr-676/
FOR MORE INFORMATION: http://www.insurancecompanyrules.org/learn_more/the_roster/ and http://www.pnhp.org/
Healthcare reform for all
Submitted by Caspian of the Lake on Wed Mar. 4, 2009 3:41 AM PST.
So your rebuttal to private national healthcare insurance is to take away the profits of the insurance companies and limit the compensation of their executives. Great. Won me over. But what about Apple? Shouldn't they share the love too and provide ipods for every kid or haven't you checked out their profits recently? And what about the NFL? All those kids getting their shoes muddy playing on real grass when the salaries of the players are so obscene for a short work year. There is so much need after all.
Really!
There is a huge difference...
Submitted by freelyb (not verified) on Wed Mar. 4, 2009 6:24 AM PST.
...between needs and wants. Americans' wants are way too many. Forget about non-essentials such as IPods and personal image paraphernalia. We will be better of without them. Needs, however, like health care, are a different thing.
Why We Need NON-Profit, Universal, Single-Payer Healthcare
Submitted by Anonymous (not verified) on Tue Mar. 3, 2009 6:54 PM PST.
WHO’S LOOKING AT THE COMPENSATION OF THE HEALTHCARE INSURANCE EXECUTIVES?
The health insurance companies have played a major role in our current healthcare crisis. They make huge profits and their CEOs make millions, while the rest of us are denied care.
ANNUAL COMPENSATION OF HEALTH INSURANCE COMPANY EXECUTIVES (2006 and 2007 figures):
• Ronald A. Williams, Chair/ CEO, Aetna Inc., $23,045,834
• H. Edward Hanway, Chair/ CEO, Cigna Corp, $30.16 million
• David B. Snow, Jr, Chair/ CEO, Medco Health, $21.76 million
• Michael B. MCallister, CEO, Humana Inc, $20.06 million
• Stephen J. Hemsley, CEO, UnitedHealth Group, $13,164,529
• Angela F. Braly, President/ CEO, Wellpoint, $9,094,771
• Dale B. Wolf, CEO, Coventry Health Care, $20.86 million
• Jay M. Gellert, President/ CEO, Health Net, $16.65 million
• William C. Van Faasen, Chairman, Blue Cross Blue Shield of Massachusetts, $3 million plus $16.4 million in retirement benefits
• Charlie Baker, President/ CEO, Harvard Pilgrim Health Care, $1.5 million
• James Roosevelt, Jr., CEO, Tufts Associated Health Plans, $1.3 million
• Cleve L. Killingsworth, President/CEO Blue Cross Blue Shield of Massachusetts, $3.6 million
• Raymond McCaskey, CEO, Health Care Service Corp (Blue Cross Blue Shield), $10.3 million
• Daniel P. McCartney, CEO, Healthcare Services Group, Inc, $ 1,061,513
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
• Daniel Loepp, CEO, Blue Cross Blue Shield of Michigan, $1,657,555
• Todd S. Farha, CEO, WellCare Health Plans, $5,270,825
• Michael F. Neidorff, CEO, Centene Corp, $8,750,751
This executive compensation could be used to provide quality healthcare for millions of Americans! We need to get the insurance companies and their lobbyists OUT of healthcare. NON-PROFIT, SINGLE-PAYER IS THE ONLY OPTION.
The solution? The United States National Health Insurance Act, H.R. 676. You can read about it here: http://www.healthcare-now.org/hr-676/
Single-Payer Healthcare -- A RIGHT for All!
Submitted by Jenny R. (not verified) on Tue Mar. 3, 2009 6:57 PM PST.
Martin Luther King said, "Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane."
Only a single-payer approach will end the inhumanity of our failed healthcare insurance system, where profits are more important than patients’ health.
Only a single-payer approach will end the current disgraceful practice of insurance companies refusing to pay for medical treatment, denying claims, and engaging in rampant price gouging that discourages patients from going to the doctor and has resulted in 50 million Americans without healthcare.
The solution? NON-PROFIT, UNIVERSAL, SINGLE-PAYER HEALTHCARE. It works well in many, many countries around the world.
HR 676, The United States National Health Insurance Act, would ensure that every American, regardless of income, employment status, or race, has access to quality, affordable health care services.
Ask your Representatives to co-sponsor HR676.
Tell Senator Baucus to put Single-Payer Reform on the table: http://www.change.org/ideas/294/view_action/sen_baucus_we_need_accurate_...
HEALTHCARE SHOULD BE A RIGHT, NOT A BUSINESS.
Is Senator Baucus working for the insurance lobby?
Submitted by Kevin Walsh (not verified) on Tue Mar. 3, 2009 7:01 PM PST.
Senate Finance Committee Chairman Max Baucus (D-MT), who ruled single-payer off the table before he even started considering healthcare reform, is now pressuring the Congressional Budget Office (CBO) to favorably judge his health plan as financially sound--even though it isn’t.
According to CongressDaily (2/25), Baucus, other lawmakers, and some special interest groups have not been particularly pleased with what they view as CBOs conservative scoring of some supposed cost-cutting efforts that are needed to help offset the enormous price tag of overhauling the healthcare system under the Baucus plan.
Baucus said if healthcare reform is to pass, the CBO needs to get ever more creative to find pathways to get the savings that we have to have (Edney, CongressDaily, 2/25).
Baucus told the head of CBO last Wednesday that the CBO will play a significant role in efforts to overhaul the U.S. healthcare system because the agencys cost assessments will make or break this enterprise. Experienced observers assert that this is Baucus way of pressuring the agency to come up with figures to justify the kind of healthcare reform Baucus wants.
The fact is, the CBO has issued a series of recent studies which have found that most savings claimed, in the effort to keep private-for-profit insurance companies in the mix, do not exist.
Alternatively, a single-payer system would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.
Tell Senator Baucus we need accurate numbers not creative figuring. Single-payer should be on the table and should be given a full and fair hearing by the Senate Finance Committee.
http://www.change.org/ideas/294/view_action/sen_baucus_we_need_accurate_...
Write to Senator Max Baucus here: http://baucus.senate.gov/contact/emailForm.cfm?subj=issue
Healthcare
Submitted by urban legend (not verified) on Tue Mar. 3, 2009 8:54 PM PST.
Why the hell can't we stick to the simple message that you -- you -- will never lose protection against financial devastation from a health problem? Right now, in addition to the 50 million who don't even have any, 200 or so million who may have employer-based health insurance are always at risk of losing it, and know it, because they are always at risk of losing the job. That is the main social problem that has only become worse over the past few decades. It is THE problem that requires a socialized solution; all other problems, including enormous costs arising from uncertainty of compensation faced by healthcare providers and businesses hesitating to hire employees whose cost is unpredictable, flow from that.
Socializing unusually high medical costs in any given year will allow consumers who now have employer-based insurance to have exactly what they have now, at approximately 40% less cost because the worst exposure is covered. The worst risk is subject to a ceiling and completely predictable. Now, private insurers, besides wasted cost of searching for and fighting over pre-existing conditions, have to cover the contingency of extraordinary cost. As private entities must charge a profit on it. Moreover, because their pool is smaller and their pockets aren't as deep as the Federal government's, they must build in more cost for the uncertainty they face. Providers must expend inordinate administrative time making sometimes difficult decisions whether to provide service or not, and must pad bills and charge high fiance charges to cover potential delinquencies and delayed payment.
Socializing catastrophic costs -- the core purpose of real insurance -- will totally change the game. Americans get that: politicians and pundits, including Democratic politicians and pundits with their hearts in the right place, do not. Once the problem is framed correctly, all rational bases for objection fall by the wayside.
health care reform
Submitted by Anonymous (not verified) on Wed Mar. 4, 2009 4:59 AM PST.
The major problem in the U.S is one of perspective. We approach healthcare from an individual perspective both in the way we view it now and in the way we are trying to reform it. Even the idea of coverage for "all" is an approach from an individual perspective.
The individual view sees healthcare as an itemized purchase in the marketplace, when in actuality most costs are an investment in a service that we pay one way or another. The only way to control total costs is to assess what the population needs and invest in those services for everyone. I'm talking about a system here. One that includes everyone, is publicly financed, and publicly accountable We don't have a healthcare system in the U.S.and until we put one in place, we will not solve the problems of cost or access.
urban legend is right
Submitted by waterfowl (not verified) on Wed Mar. 4, 2009 11:39 AM PST.
What we need is universal catastrophic health care insurance. The risk of crippling, impossible-to-pay health care expenses after a severe injury or pursuant to a debilitating illness really ought to be socialized. This is the sort of thing that can hit anyone at any time; it makes sense to pool the risk, and the bigger the pool the better.
It does not make sense to pool ordinary, ongoing health care expenses, any more than it make sense to fold gas purchases and oil changes into auto insurance. The only reason we do it now is that there are tax advantages to paying employees in health care rather than money.
The broken health care
Submitted by Thalia Y on Mon Apr. 20, 2009 12:17 AM PDT.
The broken health care system that leads to rising health care cost is giving the people a great deal with stress. What we need these days, is an affordable and quality health care. As we all know, when it talks about the health of our family members it should not be set aside. Of course, we don’t want to take the risk of losing one of our loved ones just because we’re not able to seek for medication to their illness. What we ask from the government is to fix the health care system because many people are already suffering from it’s effects. There are more than 47 million Americans that are uninsured and if the health care system will not be fix immediately, for sure, the record number will keep on rising. Anyway, Express Scripts is buying up WellPoint's pharmacy benefit unit NextRx. Express Scripts is a pharmacy benefit management company, as is NextRx, which manages the distribution of medicines and pharmacy practices of health insurers. Essentially, these are the folks you have to thank if you need payday loans for a script for simple penicillin or migraine meds. WellPoint won't be alone, as more health insurers are expected to divest their pharmacy benefit divisions in the face of a major health care overhaul. Pharmacy benefit companies have come under fire for withholding profits and benefits, and Express itself was the subject of several lawsuits. Let's hope this deal means less people needing online payday advances to get meds through Express Scripts.
Hmmm… Health Care for ALL Americans is Simple!
Submitted by jpinsatx on Thu May. 28, 2009 2:33 PM PDT.
Hmmm… Health Care for ALL Americans is Simple!
1) MERGE Medicare, Medicaid and CHIPS into one single "Income Based" system for children, poor and elderly citizens.
2) REQUIRE insurance companies to provide the same basic coverage for EVERY Uninsured citizen, regardless of health status, at affordable rates.
3) ALLOW insurance companies to "Profit" by offering additional benefits and options to those who qualify and are willing to pay the difference.
As for Funding…
1) Changing from an "Emergency Treatment" to a "Preventive Care" system will save local communities billions, maybe even trillions of taxpayer dollars!
2) Consolidating and utilizing existing systems will expedite the process and make administration more efficient and cost effective!
3) Small business will be able to compete globally and hire additional taxpaying employees!
4) Wealthy seniors will pay their fair share!
The Tremendous Burden on Future (Healthier) Generations will be Greatly Reduced!
Hmmm... www.jpinsatx.newsvine.com/
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