Today's joint statement by Sens. Max Baucus and Ted Kennedy promising to “seek common ground on health reform legislation” is, in essence, a declaration of war over inclusion of a public insurance plan to compete with private companies.
As chairmen of the two powerful committees shaping the legislation, Baucus (Finance) and Kennedy (Health, Education, Labor and Pensions) will be jousting over the core issue that the Obama Administration has been tap-dancing around but will eventually have to face head-on in what promises to be a serious test of the President's toughness and resolve.
After failing to get more than a glimmer of bipartisanship on the stimulus bill, the President up to now has been wooing both the health care establishment and its Republican mercenaries, but the public option (Medicare-for-all) is the deal-breaker he will eventually have to face.
Baucus' Finance Committee, to get Republican Chuck Grassley and his crew on board, has been bending over backward with compromises that would give lip-service to a public plan but "only if private insurance companies had not made meaningful, affordable coverage available to all Americans within several years."
Kennedy and 28 other senators are not buying that, insisting, as are large numbers of House Democrats, on a public plan in the bill that would be sent to Obama, who has said it is needed to “keep the private sector honest,” but thus far has signaled only his vaunted pragmatism if the eventual showdown materializes.
Today's statement is an attempt to put a Band-Aid over Senate differences, but health care reform is ready for the operating table and the Surgeon-in-Chief will have to decide soon about where and how deep to make the incision.
Showing posts with label Medicare-for-all. Show all posts
Showing posts with label Medicare-for-all. Show all posts
Saturday, May 30, 2009
Thursday, May 28, 2009
Ted Kennedy's Health Manifesto
For the coming political battle, the last Kennedy of his generation is sounding the trumpet for health care reform.
"Over the last year," he writes in a Boston Globe OpEd today, "I've seen our healthcare system up close. I've benefitted from the best of medicine, but I've also witnessed the frustration and outrage of patients and doctors alike as they face the challenges of a system that shortchanges millions of Americans."
In his manifesto, Kennedy hits all the notes of Obama's proposal for change and, albeit in a somewhat tentative way, for the highest of all. After promising more transparency in health insurance plans, negotiation for lower premiums and regulation to prevent denial of coverage for previously existing conditions, Kennedy writes:
"We're also hearing that some Americans want the choice of enrolling in a health insurance program backed by the government for the public good, not private profit--so that option will be available too."
That wording presages the crucial struggle to include a Medicare-for-all provision in the bill that would put pressure on private insurers to compete in the health care market instead of maximizing their profits.
Since his medical crisis last summer, Ted Kennedy has been fighting his own battle to survive. Now he clearly intends to leave a legacy that will give other Americans better odds in theirs.
"Change," he concludes, "is never easy, but the status quo is no longer acceptable to any except those who profit from the current broken healthcare system.
"We cannot afford to wait--or to fail. And we will do neither.
"And when successful reform takes hold, the American people will wonder what has taken us so long."
"Over the last year," he writes in a Boston Globe OpEd today, "I've seen our healthcare system up close. I've benefitted from the best of medicine, but I've also witnessed the frustration and outrage of patients and doctors alike as they face the challenges of a system that shortchanges millions of Americans."
In his manifesto, Kennedy hits all the notes of Obama's proposal for change and, albeit in a somewhat tentative way, for the highest of all. After promising more transparency in health insurance plans, negotiation for lower premiums and regulation to prevent denial of coverage for previously existing conditions, Kennedy writes:
"We're also hearing that some Americans want the choice of enrolling in a health insurance program backed by the government for the public good, not private profit--so that option will be available too."
That wording presages the crucial struggle to include a Medicare-for-all provision in the bill that would put pressure on private insurers to compete in the health care market instead of maximizing their profits.
Since his medical crisis last summer, Ted Kennedy has been fighting his own battle to survive. Now he clearly intends to leave a legacy that will give other Americans better odds in theirs.
"Change," he concludes, "is never easy, but the status quo is no longer acceptable to any except those who profit from the current broken healthcare system.
"We cannot afford to wait--or to fail. And we will do neither.
"And when successful reform takes hold, the American people will wonder what has taken us so long."
Wednesday, May 13, 2009
Exposed: HMO Torture Memo
As Dr. Scott Gottlieb, "a partner to a firm that invests in health-care companies," explains that the "surest way to intensify flaws in the delivery of health care is to extend a Medicare-like 'public option' into more corners of the private market," it seems only fair to balance the debate with a secret memo from the files of one of those enterprises in which the good doctor has such faith:
TO: Claims Prevention Department
FROM: President, HMO
Bills are being processed and paid without full use of our avoidance procedures. Such negligence impacts your company’s bottom line, let me review our guidelines:
1. Use the response “require more information from physician” to its full extent. Some providers fill in code numbers, diagnoses and dates of treatment. But who are these people? Can we trust them with the health of our insured not knowing when and where they went to medical school, how long they have been practicing, and whether they rent or own their Lexuses?
2. Handle phone queries properly. Quick answers deprive members of full participation in their care. For the persistent, employ your half-hour hold capability and, if that fails, tell them the computer is down and promise to call back. That will keep them close to their phones and away from doctors’ offices.
3. Don’t confuse claimants with data overload. Just indicate service is not covered because of a,b,c,d,z or some combination. Our forms make definitions of a,b,c,d,z easily comprehensible with the aid of a magnifying glass and legal dictionary.
4. Use “pre-existing condition” as a disqualification. If enrollees are treated for back pain or headaches, assume they had backs and heads before signing up. Are we to pay for problems that should have been treated in the past?
5. When all else fails, deny reimbursement with “This claim has been previously considered.” By the time the patient, physician, laboratory and hospital check with one another, no one will be sure who sent or received what. We should not pay twice or, better yet, once.
We will soon have new tools to aid in your work. A revised schedule of “customary fees” will reflect the global economy by factoring in provider charges of emerging nations. And our accountants are number-crunching the promising concept of a receding deductible.
Our new non-discriminatory policy of hiring applicants regardless of IQ, education or Attention Deficit Disorder will insure better performance in the future. Remember: A claim denied or delayed is a drop of lifeblood to the health of our organization.
Dr. Gottlieb and others may claim the memo is a hoax, but millions of Americans will testify that it understates the reality of what he glorifies as "inherently personal transactions between doctors and patients."
TO: Claims Prevention Department
FROM: President, HMO
Bills are being processed and paid without full use of our avoidance procedures. Such negligence impacts your company’s bottom line, let me review our guidelines:
1. Use the response “require more information from physician” to its full extent. Some providers fill in code numbers, diagnoses and dates of treatment. But who are these people? Can we trust them with the health of our insured not knowing when and where they went to medical school, how long they have been practicing, and whether they rent or own their Lexuses?
2. Handle phone queries properly. Quick answers deprive members of full participation in their care. For the persistent, employ your half-hour hold capability and, if that fails, tell them the computer is down and promise to call back. That will keep them close to their phones and away from doctors’ offices.
3. Don’t confuse claimants with data overload. Just indicate service is not covered because of a,b,c,d,z or some combination. Our forms make definitions of a,b,c,d,z easily comprehensible with the aid of a magnifying glass and legal dictionary.
4. Use “pre-existing condition” as a disqualification. If enrollees are treated for back pain or headaches, assume they had backs and heads before signing up. Are we to pay for problems that should have been treated in the past?
5. When all else fails, deny reimbursement with “This claim has been previously considered.” By the time the patient, physician, laboratory and hospital check with one another, no one will be sure who sent or received what. We should not pay twice or, better yet, once.
We will soon have new tools to aid in your work. A revised schedule of “customary fees” will reflect the global economy by factoring in provider charges of emerging nations. And our accountants are number-crunching the promising concept of a receding deductible.
Our new non-discriminatory policy of hiring applicants regardless of IQ, education or Attention Deficit Disorder will insure better performance in the future. Remember: A claim denied or delayed is a drop of lifeblood to the health of our organization.
Dr. Gottlieb and others may claim the memo is a hoax, but millions of Americans will testify that it understates the reality of what he glorifies as "inherently personal transactions between doctors and patients."
Monday, May 11, 2009
Life-and-Death Games
The health-care finals start in Washington today with the Obama home team hosting the all-stars who have made the American medical system one of the most expensive and least effective in the world.
The name of the game is cooperation as insurers, drug makers, hospitals et al come to the White House reportedly to announce "a voluntary plan to hold costs down, which health care industry officials involved in the effort say could save a family of four $2,500 a year in the fifth year, and a total of $2 trillion for the nation over 10 years. But there is no way of ensuring that the providers keep their promises, beyond publicizing their performance."
As a basketball fan, the President should recognize a fakeout when he sees one but, just in case, Paul Krugman has a head's up for him:
"What’s presumably going on here is that key interest groups have realized that health care reform is going to happen no matter what they do, and that aligning themselves with the Party of No will just deny them a seat at the table. (Republicans, after all, still denounce research into which medical procedures are effective and which are not as a dastardly plot to deprive Americans of their freedom to choose.)"
Behind all the trash talk this week will be the crucial contest over whether Congress will enact health-care reform that includes a government-sponsored option (Medicare-for-all) to give consumers a chance to buy care directly and pressure private insurers to improve what they offer.
Without that, they're just playing the same old games.
The name of the game is cooperation as insurers, drug makers, hospitals et al come to the White House reportedly to announce "a voluntary plan to hold costs down, which health care industry officials involved in the effort say could save a family of four $2,500 a year in the fifth year, and a total of $2 trillion for the nation over 10 years. But there is no way of ensuring that the providers keep their promises, beyond publicizing their performance."
As a basketball fan, the President should recognize a fakeout when he sees one but, just in case, Paul Krugman has a head's up for him:
"What’s presumably going on here is that key interest groups have realized that health care reform is going to happen no matter what they do, and that aligning themselves with the Party of No will just deny them a seat at the table. (Republicans, after all, still denounce research into which medical procedures are effective and which are not as a dastardly plot to deprive Americans of their freedom to choose.)"
Behind all the trash talk this week will be the crucial contest over whether Congress will enact health-care reform that includes a government-sponsored option (Medicare-for-all) to give consumers a chance to buy care directly and pressure private insurers to improve what they offer.
Without that, they're just playing the same old games.
Tuesday, April 21, 2009
Unbundling Health-Care Derivatives
With a goal of passing legislation by June, Congress is getting serious about health care reform, and advocates of change are more nervous about their allies than about lobbyists defending the current failed system.
"More than 70 House Democrats," the Washington Post reports, "recently warned party leaders that they will not support a broad health reform bill that does not offer consumers a government-sponsored policy, and two unions withdrew from a high-profile health coalition because it would not endorse a public plan."
Their action was prompted by suggestions that the Obama Administration may be willing to compromise on that aspect of providing universal coverage.
The health-care crisis, like the home-mortgage meltdown, has no simple solution but there are similarities in their origins--the greedy intervention of third parties to profit from what used to be transactions between buyers and sellers.
Like the derivatives that wrecked the housing market, profit-seeking insurers have created a convoluted system that siphons off one out of every three health-care dollars for themselves, giving Americans less care for more money than any place else in the developed world.
In reform legislation, it's crucial to include what has been called a Medicare-for-All option that would give consumers a chance to buy care directly and pressure private insurers to improve what they offer.
Without such a choice, health-care "reform" could turn out to be like Wall Street bailouts that shovel money to Citibank, Bank of America and AIG and leave all the decisions about spending it to their discretion.
"More than 70 House Democrats," the Washington Post reports, "recently warned party leaders that they will not support a broad health reform bill that does not offer consumers a government-sponsored policy, and two unions withdrew from a high-profile health coalition because it would not endorse a public plan."
Their action was prompted by suggestions that the Obama Administration may be willing to compromise on that aspect of providing universal coverage.
The health-care crisis, like the home-mortgage meltdown, has no simple solution but there are similarities in their origins--the greedy intervention of third parties to profit from what used to be transactions between buyers and sellers.
Like the derivatives that wrecked the housing market, profit-seeking insurers have created a convoluted system that siphons off one out of every three health-care dollars for themselves, giving Americans less care for more money than any place else in the developed world.
In reform legislation, it's crucial to include what has been called a Medicare-for-All option that would give consumers a chance to buy care directly and pressure private insurers to improve what they offer.
Without such a choice, health-care "reform" could turn out to be like Wall Street bailouts that shovel money to Citibank, Bank of America and AIG and leave all the decisions about spending it to their discretion.
Wednesday, April 08, 2009
Medicare-for-All Goes Mainstream
The health care reform that dares not speak its name edged out of the shadows yesterday with a New York Times editorial suggesting:
"A new public plan--to offer consumers greater choice, keep the private plans honest and, one can hope, restrain the relentless growth in health care premiums and underlying medical costs--seems worth trying.
"Any new public plan would constitute only part of a much broader effort to provide coverage for 46 million Americans who currently are uninsured and many more who may soon join their ranks. Other major parts under discussion include strengthening employer-provided coverage, expanding existing public programs such as Medicaid and creating a national health insurance exchange where individuals without employer coverage, small businesses and possibly others could buy policies at inexpensive group rates from qualified private plans and, we hope, from a new public plan as well."
This tiptoe approach to what has been called Medicare-for-All is symptomatic of the political minefields surrounding what experts consider the best solution to health-care reform--a single payer system, which has been gaining the support of doctors, nurses and unions since Rep. John Conyers introduced a bill in the House last year but is not part of the Obama Administration's "incremental" approach to reform the system.
In fact, the downfall of Tom Daschle, the President's first choice for health czar, derailed the faint hope that such a solution would be considered, since Daschle had written a book advocating just that.
Meanwhile, private insurer profits and "administrative costs" keep draining one out of every three dollars spent, making US health care one of the most expensive and least effective operations in the world.
Getting Medicare-for-All on the agenda to compete with that system would be a start toward sanity.
"A new public plan--to offer consumers greater choice, keep the private plans honest and, one can hope, restrain the relentless growth in health care premiums and underlying medical costs--seems worth trying.
"Any new public plan would constitute only part of a much broader effort to provide coverage for 46 million Americans who currently are uninsured and many more who may soon join their ranks. Other major parts under discussion include strengthening employer-provided coverage, expanding existing public programs such as Medicaid and creating a national health insurance exchange where individuals without employer coverage, small businesses and possibly others could buy policies at inexpensive group rates from qualified private plans and, we hope, from a new public plan as well."
This tiptoe approach to what has been called Medicare-for-All is symptomatic of the political minefields surrounding what experts consider the best solution to health-care reform--a single payer system, which has been gaining the support of doctors, nurses and unions since Rep. John Conyers introduced a bill in the House last year but is not part of the Obama Administration's "incremental" approach to reform the system.
In fact, the downfall of Tom Daschle, the President's first choice for health czar, derailed the faint hope that such a solution would be considered, since Daschle had written a book advocating just that.
Meanwhile, private insurer profits and "administrative costs" keep draining one out of every three dollars spent, making US health care one of the most expensive and least effective operations in the world.
Getting Medicare-for-All on the agenda to compete with that system would be a start toward sanity.
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