Blue Mass Group

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Terminator in pursuit of Deval on healthcare

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It looks like the Terminator is in hot pursuit of Deval.  Important health care reform ? if it goes through without too much perversion ? is brewing in California. Should be interesting to see how closely the CA plan mirrors the MA plan, and how each of them fares with their very different state situations.

(from yesterday’s WSJ)

Mr. Schwarzenegger would force all Californians to buy insurance, while compelling insurers to accept all customers — even those with medical problems. Businesses that don’t offer coverage to employees would pay 4% of their payroll costs into a state fund to help subsidize those who can’t afford insurance?

?California wouldn’t be the first state to enact a plan aimed at ensuring coverage for all of its citizens; Massachusetts did that last year. But the Golden State has the largest number of uninsured residents of any state — about 6.8 million people, more than the entire population of Massachusetts — so overhauling its $200 billion health-care industry would be a milestone?

?The plan itself was plenty dramatic. Mr. Schwarzenegger aimed to cover every California resident, including undocumented immigrants, a touchy decision for a Republican. Businesses, except those with fewer than 10 employees, would be required to either provide insurance to workers or pay 4% of their payroll value into a state fund — a mandate known as “pay or play.” Every Californian would have to get health insurance, which would draw young, healthy people into the system?

?Fabian Núñez, the Democratic speaker of the state Assembly, says he wasn’t expecting such a comprehensive proposal. “I think the governor in some ways was further to the left” than Democratic leaders, says Mr. Núñez. Their plans weren’t aiming for universal coverage.

An important step, regardless of some Terminator silliness:

“I feel strongly that the people of California have sent me to Sacramento to tackle those big problems,” the Republican governor told voters at an elementary school here recently. “They have seen me on the screen to be the big action hero, so they know that I can be the big action hero also in Sacramento.”

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annem

I recommend the rigorous research and reporting of FTCR – details below.  Their ConsumerWatchdog.org website resources in general and in particular their site sections on Health Care are immensely valuable.

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2 FTCR Press Releases speak to the topic of this BMG post very directly with loads of substance rather than the WSJ snow job (pun intended) the original post cites. Stating “Terminator in hot pursuit of Deval on healthcare” indicates a severe knowledge deficit; the following info might be useful to begin to remedy that condition:

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NEWS RELEASE Apr 12, 2007
Mass. Promise of “Universal” Health Care Forgotten — Needed Care Would Be Unaffordable Under Insurance Mandate; State Analysis Finds Insurance Too Costly for Families, Older Consumers
(and this is just the beginning of why and how the MA Chapter 58 law is harmful and constitutes fake reform -AnnEM)

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and

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NEWS RELEASE, July 12, 2007
Analysis of Health Insurance Industry Contributions to CA Legislature and Governor Released;
Explains Why Premium Regulation Failed, Employee Mandate Passed Last Night

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Foundation for Taxpayer and Consumer Rights (FTCR)
NEWS RELEASE, July 12, 2007

CONTACT: Jerry Flanagan, (310) 392-0522 ext. 319, or Jamie Court, ext. 327

Analysis of Health Insurance Industry Contributions to CA Legislature and Governor Released; Explains Why Premium Regulation Failed, Employee Mandate Passed Last Night

Santa Monica, CA — The Foundation for Taxpayer and Consumer Rights (FTCR) released today an analysis of health insurance industry contributions to the California legislature which helps explain why the Senate Health Committee supported a proposal requiring employees to pay for private coverage but refused to pass a bill to regulate what insurers can charge for the policies.

Two of the largest recipients of health insurance contributions in the Senate, Leland Yee (D-San Francisco) and Gloria Negrete McLeod (D, Chino), refused to vote on the premium regulation measure though both were present at the time of the vote. Download the analysis of donations to all legislators and the governor at: http://www.consumerw…

Between 2001 and 2007:

– Yee received $58,867 from just the top five health insurers and their lobby associations, making him the second-largest recipient in the Senate and fifth-largest in the legislature.
– McLeod received $52,970, making her the the fourth-largest recipient in the Senate.

Among Senators voting “No” on the measure, Senator David Cox (R, Fair Oaks) was the top recipient of health insurance contributions in the Senate:

– Dave Cox (R): $68,700
– Abel Maldonado (R): $55,587
– Sam Aanestad (R): $16,500
– Mark Wyland (R): $10,250

Governor Schwarzenegger has received $578,000 from the top five health insurers and their lobbying since taking office. Assembly Speaker Fabian Nunez, the top recipient in the legislature, has received $134,000 since 2001 and Senator Don Perata received $30,500.

“The Governor and the Legislature can talk about forcing employers and employees to pay for coverage but its the insurance industry cash that’s preventing them from supporting proven regulation to lower industry overhead and profit and make premiums fair,” said Jerry Flanagan, health policy director of the Foundation for Taxpayer and Consumer Rights. “Such large donations to key committee members are not given out of the good of the insurance companies’ hearts. The defeat of AB 1554 is a large and welcome gift back to private insurers. Yee and McLeod’s deliberate abstentions and the practice of ‘non-voting’ is a plague on the Legislature, allowing legislators to evade responsibility for the defeat of bills that their constituents would strongly support.”

Committee chair Sheila Keuhl (D-Santa Monica), who strongly supported the regulation bill, received no contributions from insurers.

AB 1554 by Assemblymember Dave Jones (D- Sacramento) would have required health insurers to defend their overhead and profit while getting approval for premium increases. The legislation would have applied to health insurers the same standards applying to most other insurers under Prop 103. AB 1554 was granted reconsideration which means it could be voted on again by the Senate Committee before the end of the 2008 session.

The Committee supported AB 8 (Nunez/Perata) which would require workers to pay for part of their insurance, even while the committee refused to regulate how much they would pay. Employers’ contributions would be capped, but not employees’ out of pocket costs for both premiums and rising deductibles.

“Supporters of any health care reform should have voted for this bill as the foundation of reform,” said Flanagan. “Proposals by Gov. Arnold Schwarzenegger, Assembly Speaker Fabian Nunez, and Senator Don Perata will either require all Californians, or workers whose employers provide coverage through a state pool, to pay for health insurance. But they allow health insurers to charge whatever they choose. AB 1554 would have curbed both double-digit premium increases and benefit reductions.”

The vote also came as state regulators, under a narrow merger agreement, are investigating illegal transfer of $950 million in profit to Blue Cross’ parent company. AB 1554 would have extended such oversight to all insurers.

AB 1554 was similar to requirements in the auto insurance market that have saved drivers $23 billion since 1988. It would have controlled the type of administrative waste and profiteering that allowed Blue Cross of California to keep, as overhead and profit, 50% of every premium dollar collected from individual policyholders. Such individual policyholders would not be protected by either the Schwarzenegger proposal or the Nunez/Perata bill.

The five California companies (Kaiser, Blue Shield, Blue Cross, PacifiCare, and HealthNet), that control 80% of the HMO market, have recorded profit increases of $11.7 billion since 2002. Four of the companies transferred $4.1 billion in profit to out-of-state parent companies since 2002. The six largest HMOs spent $1.6 billion on marketing in 2006.

In total, Governor Schwarzenegger, members of the California legislature, and political parties received $3,395,896 from the top five health insurers and their lobbying associations since 2001.

– 30 –

FTCR is California’s leading public interest watchdog. For more information, visit us on the web at: http://www.ConsumerWatchdog.org

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If you made it this far in this comment you deserve this link  to a cool new music video “Pirates of the Health Care-Ibbean”

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state-of-grace

I appreciate your substantive response.  As far as my “severe knowledge deficit” is concerned, while I don’t pretend to have detailed familiarity with the specifics of every layer of Massachusetts or California’s healthcare regulations, I do have firsthand knowledge of the importance of having health insurance.  In my mid-twenties I elected to enroll in COBRA, although since I was young and very healthy I considered going without insurance for a while.  I experienced a severe sports injury that would have bankrupted me if I didn’t have that insurance, right when I was moving toward things like becoming a homeowner.  Since then, I’ve promised myself that I wouldn’t ever go without health insurance.  I’m fortunate in that I can afford to pay for insurance, and I feel strongly that we need to do more to make insurance and access to high quality healthcare more widely available.

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My point is that I’m thrilled that the concept of universal health insurance coverage, which would have been laughed at not that long ago, is being pushed forward in not one, but two states.  Remember the reception that Hillary Clinton’s ahead-of-her-time work on healthcare received in the early 90s?  I can’t imagine current reform efforts are perfect; I’m sure there is some form of influence from involved parties; I know more needs to be done to help the working poor be able to afford even discounted insurance; but I’m glad that more people are going to have health insurance than would if this “reform” wasn’t taking place.

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What would you propose be done differently?

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annem

Go see it and then we’ll talk about how great it is to have private health insurance… Our entire system is so very very broken that only fundamental reform will begin to fix it and prevent the obscene amount of preventable suffering and early death that occur. every. day. every. hour.

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Hillary-care WAS NOT ahead of her time.  Large numbers of people have been advocating for National Health Insurance since the 1940’s.  Ms. Clinton and the Prez caved to the insurance and big Pharma industries; folks that know her and Bill stated at the time that both Clinton’s believe that a Medicare For All approach, expanding and improving Medicare to cover all of us cradle to grave using a streamlined financing mechanism, is by far the most effective — both clinically and economically — type of universal healthcare reform.

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Follow the money trail, connect the dots, and watch the revolving door of where many politicians go when they leave office… The truth ain’t pretty but understanding it is essential to us achieving and sustaining universal healthcare or positive change on just about any other social issue.

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We’ve got to reclaim our democracy to get real universal healthcare, and settling for anything less merely serves as an obstacle to reaching these urgent goals. That might sound extreme but it’s not; it’s true.

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And when you go see SiCKO, please know that it’s the G-rated version of the horrid pain and suffering and early death caused by OUR U.S. healthcare system.

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I’ve worked as a nurse for 15 years, at Mass. General Hospital and in homes across Roxbury, Dorchester and the South End as a VNA nurse and I feel as though I perpetuate this harmful system by working within it – If you’re not part of the solution then you’re part of the problem…

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We can do SO MUCH BETTER THAN THIS (HB 1137-SB 703 in the state and HR 676 on the federal level); now is the time for the good people of Massachusetts to step up and carry this issue forward.

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Please visit these sites to learn more about state health justice work and to get involved:

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Alliance to Defend Healthcare
and
MassCare

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For national reform info:

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Healthcare-Now.org
and
SickoCure.org National Organizing Campaign

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Excellent background resources on the issue:

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StraightTalk from Campaign for America’s Future

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bean-in-the-burbs

Moore’s best, I think, and that comes from someone who enjoyed his other films.  The one criticism I would make is the same one I had for Fahrenheit 911 – Moore doesn’t issue a clear call to action.  Why doesn’t he include a list of 5 things at the end of the movie for people to go home and do?  The movie is powerful – I would think it could really channel some energy if he had done so. 

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I’ll check out the websites you cited. 

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annem

Re your question about why Moore didn’t issue a Call To Action in the film such as for passage of HR 676 (the federal Medicare for All bill), that’s a good question that I don’t know the answer to.

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Moore does support HR 676 to expand and improve Medicare for All.  And the “5 things you can do” list is right there on SickoCure.org (not an official Moore website).

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Maybe the answer has something to do with the Distribution Co. for the film, the Weinstein Brothers, or something like that.  I suppose only Michael Moore knows the true answer.

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I was in DC last month before SiCKO opened in theaters and sat in a congressional hearing room with many other nurses from around the country along with Michael Moore and many of the patients from the film SiCKO.  We were each there to help build the social and political movement that it will take to enact real universal healthcare in the U.S.

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Rep. John Conyers, the lead sponsor of HR 676 convened the hearing on the U.S. health care system crisis and his bill HR 676.

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Moore testified before congress and gave his support for HR 676.  He showed clips from the film and then the patients and family members from the film, and a nurse testified as well. 

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These congressional hearings are continuing and can be read about at MichaelMoore.com

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A final word of advice for all of us from the homepage of SickoCure.org (that brings Niki Tsongas to mind):

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blockquote>Beware of Phony Universal Coverage: Many political candidates say they support ?universal health care,? but usually this just means making more Americans insurance company customers. Real universal coverage means evicting insurance companies and establishing a national health program instead. 

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bean-in-the-burbs

I signed the website’s petition and wrote my Rep. John Tierney, who has yet to sign on.  But I’ve got to say, I’ve worked for the last decade for insurance companies. Despite Moore’s movie’s horror stories, the insurance companies aren’t all evil incarnate.  They’re businesses trying to sell a service at a profit to their customers.  It isn’t an easy business – in many types of insurance, the margins are narrow and the market is saturated and highly competitive.  There has been a lot of consolidation as smaller companies that can’t realize efficiencies of scale have been swallowed up by larger ones. Claims fraud is a real problem – and unfortunately medical providers are all too often among the fraudsters.  Fraud ran $40 million dollars a year at one large company where I worked. 

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Single-payer seems like the best solution, but how will medical professionals and hospitals be paid under such a model?  Doesn’t it make sense to leverage the business processes and information technology systems that insurance companies have already built to do this?  States hire the company I work for, for example, to administer their Medicare and Medicaid programs, rather than do it themselves.  We can offer systems that are more cost effective and efficient. 

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Our healthcare system clearly needs help – we can do so much better than we are today.  I’m interested in learning more and hope we’ll see some positive change with a new administration in Washington.

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