http://www.opednews.com/articles/The-False-Health-Debate-S-by-thepen-100227-884.html
February 27, 2010
By thepen
By the time you read the next couple paragraphs the veil will be lifted from your eyes and you will finally understand what is really going on with the health care "debate", which up to this point has been a total fraud on the American people.
On the one hand we have the Republicans. They are for privatization, deregulation and the "free market", all deceptive synonyms for giving all power to, and putting us totally at the mercy of, the corporations. In the Republican world view, we will be forced to buy corporate medical insurance if we can afford it, and simply die if we cannot (or if they cheat us out of our coverage).
On the other hand we have the Democrats. They serve the SAME corporate contributors. But where the Republicans would force us to buy corporate medical "care" by direness of necessity, the Democrats would do it by force of LAW. Hence, they are pushing for a forcible mandate for everyone to buy insurance from an artificial "market" with no options OTHER than corporate insurance. And when the system goes bust from the overhead, and can no longer provide coverage because of unconstrained corporate greed, again people will simply die.
It is a false and ultimately meaningless choice. It is like giving a condemned person a choice of the method of their execution.
But one thing is certain. If the Democrats perversely persist in this it spells the END of the Democratic party. They will be wiped out in the next couple elections and there will be nothing left of them. And if you care whether that happens or not, YOU must tell them that. Because not telling them will not keep it from happening. The only thing that can stop it is if THEY finally understand that they are no longer fooling you.
Action Page: http://www.peaceteam.net/action/pnum1034.php
This action page has the subject line, "A Forcible Mandate For Corporate Medical Insurance Means The END Of Your Political Career." It will send faxes for you just by submitting the form, you do not need a fax machine of your own.
For those who might find our assertions melodramatic now, consider the source. On September 13 of last year (over 5 months ago), for those of you who were on our list then and remember, just after President Obama's speech to the nation and to Congress on health care, we put out an alert entitled "Obama's New Improved Leech Therapy". Here is a link to the original article, right here on OpEdNews.com
http://www.opednews.com/articles/2/Obama-s-New-Improved-Lee-by-thepen-090913-493.html
As stalwart progressives, it was clear to us from that speech, and we warned, that Obama had NO intention of letting a "public option" of any kind survive in the end. We told you that the so-called public option was never intended to be anything but a bait and switch to get gullible people of insufficient conviction and determination to give up working for true single payer.
To say that many were skeptical about our warnings is an understatement. And we have the shockingly vicious and insulting and foul mouthed hate mail from some of those no longer on our list to prove it, accusing us of being racist and all manner of other utterly irrational and ignorant lunacy, something we would have thought fellow progressives were not prone to. Speaking the truth is tough and sometimes thankless work.
But everything we warned about has now come to pass word for word.
Indeed, it is clear to all by now the degree to which Obama is fighting AGAINST any alternative to a complete corporate takeover of health care. First they told us that we could not have anything even remotely in the ball park of single payer because we did not have 60 votes. And yet, even as they are gearing up to force through the most despised bill in American political history by some parliamentary trick that only needs 51 votes, suddenly they can't even muster THAT many for a real alternative.
President Obama was happy to selectively discuss today the various isolated selling point proposals that poll well. But these are just the most thin of sugar coatings on the most gigantic bitter pill the American people have ever been asked to swallow. Try polling the forced mandate and see what those numbers are if you dare look. And if they try to force it down our throats as is, the political careers of any of those who vote for it are FINISHED, in which case we will all suffer the more.
If YOU speak out in sufficient numbers we can stop this from happening. If not, it will all transpire just as we have warned . . . again. Those are the stakes. Just so we are clear.
Action Page: http://www.peaceteam.net/action/pnum1034.php
The above are the regular action pages, for Facebook use this link:
[Facebook] Action Page: http://apps.facebook.com/fb_voices/action.php?qnum=pnum1034
And this is the Twitter reply for this action
@cxs #p1034
Please take action NOW, so we can win all victories that are supposed to be ours, and forward this alert as widely as possible.
If you would like to get alerts like these, you can do so at http://www.millionfaxmarch.com/in.htm
Saturday, February 27, 2010
Saturday, February 20, 2010
Donors Reward Dems Who Pushed Public Option
http://www.huffingtonpost.com/2010/02/05/donors-reward-dems-who-pu_n_449859.html
February 5, 2010 by Huffington Post
Donors Reward Dems Who Pushed Public Option
by Ryan Grim
Liberal bloggers have quietly raised nearly $90,000 in the past few days to reward three freshman House Democrats for organizing an effort to put the public health insurance option back into the Senate health care debate.
The three representatives -- Alan Grayson (Fla.), Chellie Pingree (Maine), and Jared Polis (Colo.) and -- have so far received more than $20,000 each, with the rest going to Howard Dean's Democracy for America group and the Progressive Change Campaign Committee (PCCC), which organized the campaign and set up website to raise funds.The three representatives -- Chellie Pingree (Maine), Jared Polis (Colo.) and Alan Grayson (Fla.) -- have so far received more than $20,000 each, with the rest going to Howard Dean's Democracy for America group and the Progressive Change Campaign Committee (PCCC), which organized the campaign and set up this website.
"It was easy to raise money for [the three members] because they did exactly what voters consistently say they want Democrats to do," said PCCC co-founder Stephanie Taylor. "They fought for bigger change instead of smaller change, and by fighting for the public option they showed they were willing to directly challenge corporate power on behalf of everyday people."
Grayson delivered a petition with tens of thousands of names to Senate Majority Leader Harry Reid (D-Nev.) calling on him to re-insert the public option if he planned to make changes to the Senate bill using the majority-rule process known as budget reconciliation.
Pingree and Polis, meanwhile, circulated a letter calling on Reid to do the same. Some Democrats privately worried at the time that the letter would garner fewer than the 65 signatures that an earlier demand letter had pulled in and indicate fading support.
Instead, 117 members signed the letter, thanks in part to thousands of calls generated by PCCC, DFA and Credo Action to Democratic offices, urging them to sign. The action is an example of the kind of inside-outside coordination that progressives in Congress rarely engage in.
Still, it likely won't be enough to sway the Senate, Speaker Nancy Pelosi (D-Calif.) said on a conference call with bloggers this week. Instead, she said, the Senate is most likely going to conform to the deal that was struck between the White House, the Senate and the House before the Senate Democratic caucus lost its 60th vote.
"They have to do what they have to do to get whatever they need to move the process along," Pelosi said. "I totally respect the process that they are going forward with and I also respect my members' enthusiasm for initiatives that we felt strongly about in the House bill. I don't know that that enthusiasm was shared across the board in all three elements of the negotiation."
The enthusiasm for the freshman effort does show, at least, that there is a reward -- beyond public support -- for Democrats who push policies favored by the progressive base.
"The $60,000 we raised in 24 hours for these Healthcare Heroes is an example of how the Democratic base rewards bold leadership and those willing to fight for a public option," said DFA's political director Charles Chamberlain. "It's time for Washington insiders to wake up to the fact that following Joe Lieberman's lead will depress the Democratic base in 2010 and result in big losses, while following the lead of these Healthcare Heroes will fire up Obama voters who still want real change."
© 2010 Huffington Post
February 5, 2010 by Huffington Post
Donors Reward Dems Who Pushed Public Option
by Ryan Grim
Liberal bloggers have quietly raised nearly $90,000 in the past few days to reward three freshman House Democrats for organizing an effort to put the public health insurance option back into the Senate health care debate.
The three representatives -- Alan Grayson (Fla.), Chellie Pingree (Maine), and Jared Polis (Colo.) and -- have so far received more than $20,000 each, with the rest going to Howard Dean's Democracy for America group and the Progressive Change Campaign Committee (PCCC), which organized the campaign and set up website to raise funds.The three representatives -- Chellie Pingree (Maine), Jared Polis (Colo.) and Alan Grayson (Fla.) -- have so far received more than $20,000 each, with the rest going to Howard Dean's Democracy for America group and the Progressive Change Campaign Committee (PCCC), which organized the campaign and set up this website.
"It was easy to raise money for [the three members] because they did exactly what voters consistently say they want Democrats to do," said PCCC co-founder Stephanie Taylor. "They fought for bigger change instead of smaller change, and by fighting for the public option they showed they were willing to directly challenge corporate power on behalf of everyday people."
Grayson delivered a petition with tens of thousands of names to Senate Majority Leader Harry Reid (D-Nev.) calling on him to re-insert the public option if he planned to make changes to the Senate bill using the majority-rule process known as budget reconciliation.
Pingree and Polis, meanwhile, circulated a letter calling on Reid to do the same. Some Democrats privately worried at the time that the letter would garner fewer than the 65 signatures that an earlier demand letter had pulled in and indicate fading support.
Instead, 117 members signed the letter, thanks in part to thousands of calls generated by PCCC, DFA and Credo Action to Democratic offices, urging them to sign. The action is an example of the kind of inside-outside coordination that progressives in Congress rarely engage in.
Still, it likely won't be enough to sway the Senate, Speaker Nancy Pelosi (D-Calif.) said on a conference call with bloggers this week. Instead, she said, the Senate is most likely going to conform to the deal that was struck between the White House, the Senate and the House before the Senate Democratic caucus lost its 60th vote.
"They have to do what they have to do to get whatever they need to move the process along," Pelosi said. "I totally respect the process that they are going forward with and I also respect my members' enthusiasm for initiatives that we felt strongly about in the House bill. I don't know that that enthusiasm was shared across the board in all three elements of the negotiation."
The enthusiasm for the freshman effort does show, at least, that there is a reward -- beyond public support -- for Democrats who push policies favored by the progressive base.
"The $60,000 we raised in 24 hours for these Healthcare Heroes is an example of how the Democratic base rewards bold leadership and those willing to fight for a public option," said DFA's political director Charles Chamberlain. "It's time for Washington insiders to wake up to the fact that following Joe Lieberman's lead will depress the Democratic base in 2010 and result in big losses, while following the lead of these Healthcare Heroes will fire up Obama voters who still want real change."
© 2010 Huffington Post
Thursday, February 18, 2010
Greed Trophy Goes to Health Insurance Companies
http://www.commondreams.org/print/52897
February 17, 2010 by Creators Syndicate
Greed Trophy up for Grabs
by Creators Syndicate
by Jim Hightower
By gollies, the top executives of health insurance corporations are not giving up without a fight! To paraphrase every high school football coach who ever lived, "When the going gets ugly, the ugly get going."
During the past several months, the Barons of Wall Street had established themselves as the vilest and most reviled corporate team in the land. They've been lavishing bonuses on themselves even as their firms continue to benefit from government bailout measures and even as ordinary Americans continue to struggle with the economic collapse caused by the bankers' arrogance and avarice. Wall Streeters were widely considered a shoo-in to take the coveted Corporate Greedhead Trophy this year — but, holy cow, what a comeback bid we're now seeing from the Giants of Insurance!
Let's recap their amazing charge: Last week, the news broke that America's five largest health insurance companies (United Health, Wellpoint, Aetna, Humana and Cigna) had scored record profits in 2009, totaling $12.2 billion. This was a stunning 56 percent hike over the previous year, a drive made all the more impressive by the fact that these gains came during the worst economic downturn since the Great Depression.
As American families struggled financially last year, Team Insurance was able to boot 2.7 million more people out of their private health plans, leaving those folks in the corporate dust. In an even slicker, hidden-ball play, three of the five giants cut the proportion of premiums they spent on their customers' medical care, shifting those premium dollars into corporate salaries, profits and administrative overhead. Even Wall Street's Barons had to shake their heads in disbelief and marvel at the audacity of that play.
By the way, buried in that increase for the insurers' administrative overhead was a little statistic that often gets overlooked: lobbying expenses. The Big Five spent $16.8 million last year to lobby against comprehensive reform of our health care system.
The recession-time surge in insurance profits, the shedding of older and sicker customers, the lateral of more premium dollars into things like executive pay — these maneuvers alone would've moved health insurance up in the top tier of ugly industries. But then the industry ratcheted up its game another notch. One of Wellpoint's subsidiaries heaved a "Hail Mary" pass that shocked everyone and catapulted insurance into a serious contender for the Greedhead Trophy.
In the same week that Wellpoint acknowledged that its 2009 profits were up by $2.3 billion over the previous year (a 91 percent increase), its Anthem Blue Cross subsidiary in California caused a sensation by seeking to raise the premiums on its customers' policies by as much as 39 percent this year.
As befits a true Greedhead striver, Wellpoint neatly stiffed critics by asserting that this price hike was necessitated by the general increase in America's health care costs — never mind that the corporation's rise in premiums is actually 10 times more than the rise in the overall cost of health care. What a move!
However, whether Wellpoint's daring California score will be allowed is in question, for there was a flag on the play. State insurance zebras are questioning the legitimacy of the increase, causing a company executive to argue heatedly that while tens of thousands of customers would indeed be socked with a 39 percent jump in their premiums, the average rate increase would be a mere 25 percent, so the play should be OK.
Come on, sports fans, ya gotta give 'em some style points just for trying to get away with that.
Still, can the upstart Insurance Giants hope to out-ugly the more-sophisticated Wall Street Barons? The great thing about Corporate America is that competition is always fierce for the national greedhead title, and insurance is now in the running. As sportscasters can tell you: Only time will tell, it's not over 'til it's over, tomorrow's another day, winners never quit/quitters never win, wait'll next year, and it's deja vu all over again.
February 17, 2010 by Creators Syndicate
Greed Trophy up for Grabs
by Creators Syndicate
by Jim Hightower
By gollies, the top executives of health insurance corporations are not giving up without a fight! To paraphrase every high school football coach who ever lived, "When the going gets ugly, the ugly get going."
During the past several months, the Barons of Wall Street had established themselves as the vilest and most reviled corporate team in the land. They've been lavishing bonuses on themselves even as their firms continue to benefit from government bailout measures and even as ordinary Americans continue to struggle with the economic collapse caused by the bankers' arrogance and avarice. Wall Streeters were widely considered a shoo-in to take the coveted Corporate Greedhead Trophy this year — but, holy cow, what a comeback bid we're now seeing from the Giants of Insurance!
Let's recap their amazing charge: Last week, the news broke that America's five largest health insurance companies (United Health, Wellpoint, Aetna, Humana and Cigna) had scored record profits in 2009, totaling $12.2 billion. This was a stunning 56 percent hike over the previous year, a drive made all the more impressive by the fact that these gains came during the worst economic downturn since the Great Depression.
As American families struggled financially last year, Team Insurance was able to boot 2.7 million more people out of their private health plans, leaving those folks in the corporate dust. In an even slicker, hidden-ball play, three of the five giants cut the proportion of premiums they spent on their customers' medical care, shifting those premium dollars into corporate salaries, profits and administrative overhead. Even Wall Street's Barons had to shake their heads in disbelief and marvel at the audacity of that play.
By the way, buried in that increase for the insurers' administrative overhead was a little statistic that often gets overlooked: lobbying expenses. The Big Five spent $16.8 million last year to lobby against comprehensive reform of our health care system.
The recession-time surge in insurance profits, the shedding of older and sicker customers, the lateral of more premium dollars into things like executive pay — these maneuvers alone would've moved health insurance up in the top tier of ugly industries. But then the industry ratcheted up its game another notch. One of Wellpoint's subsidiaries heaved a "Hail Mary" pass that shocked everyone and catapulted insurance into a serious contender for the Greedhead Trophy.
In the same week that Wellpoint acknowledged that its 2009 profits were up by $2.3 billion over the previous year (a 91 percent increase), its Anthem Blue Cross subsidiary in California caused a sensation by seeking to raise the premiums on its customers' policies by as much as 39 percent this year.
As befits a true Greedhead striver, Wellpoint neatly stiffed critics by asserting that this price hike was necessitated by the general increase in America's health care costs — never mind that the corporation's rise in premiums is actually 10 times more than the rise in the overall cost of health care. What a move!
However, whether Wellpoint's daring California score will be allowed is in question, for there was a flag on the play. State insurance zebras are questioning the legitimacy of the increase, causing a company executive to argue heatedly that while tens of thousands of customers would indeed be socked with a 39 percent jump in their premiums, the average rate increase would be a mere 25 percent, so the play should be OK.
Come on, sports fans, ya gotta give 'em some style points just for trying to get away with that.
Still, can the upstart Insurance Giants hope to out-ugly the more-sophisticated Wall Street Barons? The great thing about Corporate America is that competition is always fierce for the national greedhead title, and insurance is now in the running. As sportscasters can tell you: Only time will tell, it's not over 'til it's over, tomorrow's another day, winners never quit/quitters never win, wait'll next year, and it's deja vu all over again.
Medicaid is Failing, and Nothing Short of Health-Care Reform Can Fix It
The evil puppet masters want the poor children to die! Otherwise, they'd do more to save them including funding more medicaid. There's plenty of money for the bankers but none for the children...
By Naomi Freundlich, Health Beat
February 5, 2010
http://www.alternet.org/story/145540/
Health-care reform may be stalled in Congress, but you need only look to the overburdened Medicaid program to find evidence of the continued toll the current economic crisis is taking on Americans' ability to afford and access medical care.
At the same time that states are experiencing huge budget deficits, more and more of their residents are unemployed; more and more are joining the ranks of the uninsured and clamoring for Medicaid benefits. The result: Even with emergency federal infusions of funding, state safety nets are being stretched dangerously thin.
On December 1, for example, Tennessee closed enrollment in CoverKids, the state program that provides health coverage to uninsured lower-income children. Despite Gov. Phil Bredesen's promise in 2006 to provide health benefits for "every kid in Tennessee," this year coverage is frozen at 49,000 children; leaving Tennessee's other 150,000 uninsured kids without benefits.
According to Michele Johnson, an attorney with the Tennessee Justice Center, "Tennessee is the last state in the nation that can afford to neglect the health of its children. Infant mortality in Tennessee is worse than in many developing countries, and the rate of infant deaths in Memphis is the worst of any city in America…A state this unhealthy for kids should be striving hard to improve children's health coverage. Instead, Tennessee has just become an island of neglect, in terms of the health of its children."
Tennessee is not alone in limiting health coverage for some of its most vulnerable citizens. In Arizona, Gov. Jan Brewer, struggling with a $1.4 billion deficit this fiscal year (and a projected shortfall of $3.2 billion in fiscal 2011), ordered the state to stop enrolling children in KidsCare, that state's CHIP program that provides coverage for 47,000 children. Brewer has also introduced a ballot measure that would roll back a 10-year-old expansion of Arizona's Medicaid program, resulting in 310,500 -- more than 4 percent of all Arizonans -- losing their coverage.
Meanwhile, Medicaid in Arizona has seen enrollment increase 18 percent from a year ago, while facing the prospect of more than $200 million in cuts for the next fiscal year.
A report by Families USA states that in the current economic climate, more than 1 million people are at risk of completely losing health coverage in Medicaid and CHIP because of cuts that have been enacted or are under consideration in just eight states -- including Arizona, California and Florida. Some 39 states are planning to cut or freeze provider reimbursement rates in 2010 and 15 states have announced benefit cuts and increased cost-sharing; actions that ultimately reduce access to care. According to Kathleen Sebelius, Health and Human Services Secretary, "Every state in the country is looking at a huge gap."
According to the National Association of State Medicaid Directors, states will face a $140 billion budget shortfall in FY 2011. Meanwhile, the group also found that total Medicaid spending increased by an average of 7.9 percent in 2009 as more people became eligible for coverage.
This year, an infusion of $87 billion from the federal government's American Recovery and Reinvestment Act prevented some of the most draconian cuts in state Medicaid programs. This funding is scheduled to expire at various points this year and early in 2011, but the White House announced today that President Obama's budget will include a $25 billion extension of the Medicaid funding program -- giving the states another six months to help keep their programs solvent.
That's good news for the short term. This emergency life-line for Medicaid faces little opposition, even from states like Arkansas, North Carolina and Utah whose legislators fought hard against the program's expansion under health care reform. (Ironically, those same states -- with highest numbers of uninsured and lowest projected cost of Medicaid expansion -- stand to gain the most from reform.)
According to the Wall Street Journal , "Some states were so confident Congress would pass a health bill that they included the extra Medicaid funds in their state budgets." Without this stop-gap measure, they'd be scrambling to find ways to make up for the shortfall." From WSJ:
California Gov. Arnold Schwarzenegger called the health bill a "trough of bribes, deals and loopholes" in his Jan. 6 State of the State address. Two days later, he included a $1.2 billion increase in federal funding for the state's version of Medicaid, called Medi-Cal, in his budget proposal for the 2010-11 fiscal year. That figure was based on funding in the House bill.
Faced with a glum economic outlook, states of both the red and blue variety increasingly see bolstering Medicaid as an important issue. With the nation's unemployment rate at 10 percent, more Americans have lost their employer-provided insurance coverage. As insurance premiums continue to increase, more small businesses will drop coverage for their employees. These newly jobless, along with people who have pre-existing medical conditions, the chronically ill, and of course, old people who have maxed out their savings paying for long-term care, will desperately need coverage. In the absence of health reform, their only option is to apply for existing Medicaid benefits.
Of course, the House and Senate versions of health-care reform would do far more to help permanently shore up Medicaid finances, as well as expand coverage to 15 million of the nation's uninsured -- including childless adults who aren't eligible for benefits in most states. Under the House bill, individuals with incomes up to 150 percent of the federal poverty level, or $16,245, would be eligible for Medicaid. Under the Senate bill, eligibility would reach 133 percent of poverty, or $14,404 for individuals.
Medicaid expansion is an important feature of health care reform -- despite the need to rejigger some financing mechanisms to be fairer to states like New York that already provide generous benefits to residents. (And we need to get rid of the Nebraska pay-off that secured Senator Ben Nelson's vote on the Senate bill.)
Depending on short-term financial fixes is only a stop-gap measure. Without reform, Medicaid will remain a deeply inequitable and financially unstable program. In past years, for example, individual states have responded to budget concerns by increasing cost-sharing fees, instituting more frequent re-enrollment procedures or requiring new identification documents -- all with the ultimate goal of reducing their Medicaid rolls. States vary significantly in how much their Medicaid programs pay providers and in optional benefits like dental care, mental health services and smoking cessation programs.
These inequities are harshest in coverage of low-income parents. Some 34 states limit Medicaid eligibility to less than 100 percent of the government's official poverty line; and 17 of these states limit eligibility to less than 50 percent of poverty line. More than half of all states do not provide coverage for childless adults, no matter their income levels. Of the states that do, most provide coverage that is far more limited than standard Medicaid benefits.
For working parents, the inequities are equally stark, according to the New York Times:
Existing Medicaid coverage varies widely. Arkansas, for example, extends Medicaid to working parents who earn up to 17 percent of the federal poverty level, and Alabama offers coverage for those making up to 24 percent of that level. Minnesota covers working parents making up to 215 percent of the federal poverty level, and New York, up to 150 percent. New York also covers childless adults up to 65 making up to 100 percent of the federal poverty level.
In the end, the $25 billion that the administration wants to provide for Medicaid will help staunch the bleeding in state programs for a short while. But as Jocelyn Guyer, co-director of Georgetown University's Center for Children and Families writes on her center's blog, "If reform fails, we not only lose a valuable chance to stabilize and strengthen these programs, but face the prospect of states cutting back on Medicaid when fiscal relief runs out at the end of this year. We could see more states try to solve their state fiscal problems, in part, by putting uninsured children on waiting lists for coverage, as already has occurred in Tennessee and Arizona."
This short-term fix, although welcome, does not make for intelligent health policy. It might prevent some vulnerable Americans from losing their benefits today. But it won't make a dent in covering the 46 million Americans who continue to remain uninsured. And it is certainly no substitute for comprehensive health reform.
Naomi Freundlich is the associate editor of HealthBeat.
By Naomi Freundlich, Health Beat
February 5, 2010
http://www.alternet.org/story/145540/
Health-care reform may be stalled in Congress, but you need only look to the overburdened Medicaid program to find evidence of the continued toll the current economic crisis is taking on Americans' ability to afford and access medical care.
At the same time that states are experiencing huge budget deficits, more and more of their residents are unemployed; more and more are joining the ranks of the uninsured and clamoring for Medicaid benefits. The result: Even with emergency federal infusions of funding, state safety nets are being stretched dangerously thin.
On December 1, for example, Tennessee closed enrollment in CoverKids, the state program that provides health coverage to uninsured lower-income children. Despite Gov. Phil Bredesen's promise in 2006 to provide health benefits for "every kid in Tennessee," this year coverage is frozen at 49,000 children; leaving Tennessee's other 150,000 uninsured kids without benefits.
According to Michele Johnson, an attorney with the Tennessee Justice Center, "Tennessee is the last state in the nation that can afford to neglect the health of its children. Infant mortality in Tennessee is worse than in many developing countries, and the rate of infant deaths in Memphis is the worst of any city in America…A state this unhealthy for kids should be striving hard to improve children's health coverage. Instead, Tennessee has just become an island of neglect, in terms of the health of its children."
Tennessee is not alone in limiting health coverage for some of its most vulnerable citizens. In Arizona, Gov. Jan Brewer, struggling with a $1.4 billion deficit this fiscal year (and a projected shortfall of $3.2 billion in fiscal 2011), ordered the state to stop enrolling children in KidsCare, that state's CHIP program that provides coverage for 47,000 children. Brewer has also introduced a ballot measure that would roll back a 10-year-old expansion of Arizona's Medicaid program, resulting in 310,500 -- more than 4 percent of all Arizonans -- losing their coverage.
Meanwhile, Medicaid in Arizona has seen enrollment increase 18 percent from a year ago, while facing the prospect of more than $200 million in cuts for the next fiscal year.
A report by Families USA states that in the current economic climate, more than 1 million people are at risk of completely losing health coverage in Medicaid and CHIP because of cuts that have been enacted or are under consideration in just eight states -- including Arizona, California and Florida. Some 39 states are planning to cut or freeze provider reimbursement rates in 2010 and 15 states have announced benefit cuts and increased cost-sharing; actions that ultimately reduce access to care. According to Kathleen Sebelius, Health and Human Services Secretary, "Every state in the country is looking at a huge gap."
According to the National Association of State Medicaid Directors, states will face a $140 billion budget shortfall in FY 2011. Meanwhile, the group also found that total Medicaid spending increased by an average of 7.9 percent in 2009 as more people became eligible for coverage.
This year, an infusion of $87 billion from the federal government's American Recovery and Reinvestment Act prevented some of the most draconian cuts in state Medicaid programs. This funding is scheduled to expire at various points this year and early in 2011, but the White House announced today that President Obama's budget will include a $25 billion extension of the Medicaid funding program -- giving the states another six months to help keep their programs solvent.
That's good news for the short term. This emergency life-line for Medicaid faces little opposition, even from states like Arkansas, North Carolina and Utah whose legislators fought hard against the program's expansion under health care reform. (Ironically, those same states -- with highest numbers of uninsured and lowest projected cost of Medicaid expansion -- stand to gain the most from reform.)
According to the Wall Street Journal , "Some states were so confident Congress would pass a health bill that they included the extra Medicaid funds in their state budgets." Without this stop-gap measure, they'd be scrambling to find ways to make up for the shortfall." From WSJ:
California Gov. Arnold Schwarzenegger called the health bill a "trough of bribes, deals and loopholes" in his Jan. 6 State of the State address. Two days later, he included a $1.2 billion increase in federal funding for the state's version of Medicaid, called Medi-Cal, in his budget proposal for the 2010-11 fiscal year. That figure was based on funding in the House bill.
Faced with a glum economic outlook, states of both the red and blue variety increasingly see bolstering Medicaid as an important issue. With the nation's unemployment rate at 10 percent, more Americans have lost their employer-provided insurance coverage. As insurance premiums continue to increase, more small businesses will drop coverage for their employees. These newly jobless, along with people who have pre-existing medical conditions, the chronically ill, and of course, old people who have maxed out their savings paying for long-term care, will desperately need coverage. In the absence of health reform, their only option is to apply for existing Medicaid benefits.
Of course, the House and Senate versions of health-care reform would do far more to help permanently shore up Medicaid finances, as well as expand coverage to 15 million of the nation's uninsured -- including childless adults who aren't eligible for benefits in most states. Under the House bill, individuals with incomes up to 150 percent of the federal poverty level, or $16,245, would be eligible for Medicaid. Under the Senate bill, eligibility would reach 133 percent of poverty, or $14,404 for individuals.
Medicaid expansion is an important feature of health care reform -- despite the need to rejigger some financing mechanisms to be fairer to states like New York that already provide generous benefits to residents. (And we need to get rid of the Nebraska pay-off that secured Senator Ben Nelson's vote on the Senate bill.)
Depending on short-term financial fixes is only a stop-gap measure. Without reform, Medicaid will remain a deeply inequitable and financially unstable program. In past years, for example, individual states have responded to budget concerns by increasing cost-sharing fees, instituting more frequent re-enrollment procedures or requiring new identification documents -- all with the ultimate goal of reducing their Medicaid rolls. States vary significantly in how much their Medicaid programs pay providers and in optional benefits like dental care, mental health services and smoking cessation programs.
These inequities are harshest in coverage of low-income parents. Some 34 states limit Medicaid eligibility to less than 100 percent of the government's official poverty line; and 17 of these states limit eligibility to less than 50 percent of poverty line. More than half of all states do not provide coverage for childless adults, no matter their income levels. Of the states that do, most provide coverage that is far more limited than standard Medicaid benefits.
For working parents, the inequities are equally stark, according to the New York Times:
Existing Medicaid coverage varies widely. Arkansas, for example, extends Medicaid to working parents who earn up to 17 percent of the federal poverty level, and Alabama offers coverage for those making up to 24 percent of that level. Minnesota covers working parents making up to 215 percent of the federal poverty level, and New York, up to 150 percent. New York also covers childless adults up to 65 making up to 100 percent of the federal poverty level.
In the end, the $25 billion that the administration wants to provide for Medicaid will help staunch the bleeding in state programs for a short while. But as Jocelyn Guyer, co-director of Georgetown University's Center for Children and Families writes on her center's blog, "If reform fails, we not only lose a valuable chance to stabilize and strengthen these programs, but face the prospect of states cutting back on Medicaid when fiscal relief runs out at the end of this year. We could see more states try to solve their state fiscal problems, in part, by putting uninsured children on waiting lists for coverage, as already has occurred in Tennessee and Arizona."
This short-term fix, although welcome, does not make for intelligent health policy. It might prevent some vulnerable Americans from losing their benefits today. But it won't make a dent in covering the 46 million Americans who continue to remain uninsured. And it is certainly no substitute for comprehensive health reform.
Naomi Freundlich is the associate editor of HealthBeat.
Wednesday, February 17, 2010
Here Comes Single-Payer Healthcare in Another State
http://www.opednews.com/articles/Here-Comes-Single-Payer-He-by-David-Swanson-100217-52.html
February 17, 2010
By David Swanson
A bill to create single-payer healthcare in California has passed that state's senate for the third time now. Californians just need to persuade a governor to sign it. Single-payer healthcare bills are advancing in Pennsylvania, Ohio, Minnesota, Massachusetts, and a growing list of states, including New Mexico, where State Senator Jerry Ortiz y Pino, a long-time supporter of single-payer healthcare, is running for Lieutenant Governor.
Now North Carolina house candidate Marcus Brandon has pledged to introduce a bill to create single-payer healthcare in that state. Brandon, whom I know and like and who worked for Congressman Dennis Kucinich's 2008 presidential campaign, is a candidate in North Carolina House District 60. That's near Greensboro, where I can just picture Marcus sitting at a lunch counter and refusing to be provoked.
Brandon has promised that if he is elected, the first piece of legislation he will introduce will be the "North Carolina Healthcare Act" which will provide universal single-payer healthcare to every citizen of the state.
Brandon says that he remains a supporter of national single-payer healthcare and will continue lobbying for passage of HR 676, Congressman John Conyers' bill:
"The HR 676 fight is definitely not over, but we must now strategically shift the focus to the state level. When other states see that we can cut the cost of healthcare, streamline our medical industry, and still provide universal coverage to all North Carolinians, then all of the sudden, single-payer health care doesn't look so bad."
Brandon argues that a single-payer system could save over $1.5 billion per year in reduced bureaucracy in the state of North Carolina alone. And he speaks confidently about making this happen:
"North Carolina is poised to be the first state to adopt single-payer, once I am able to introduce it. North Carolinians are ready for real solutions to healthcare. North Carolina has the third highest healthcare cost of any state, while it sags at 37th in average income. This is a disparity that most North Carolinians feel when they have to think about healthcare. Every day, as I am knocking on doors to talk to voters, I hear stories of people who cannot afford insurance and become victims of this for-profit industry."
Brandon says his bill is similar to other states' initiatives such as the "Minnesota Health Act" or the "California Universal Healthcare Act." Brandon points to these two bills as excellent examples of how a single payer healthcare system could be both fiscally sound and provide full coverage.
Brandon served in 2007 and 2008 as Dennis Kucinich's National Finance Director and Deputy Campaign Manager. He says that Kucinich inspired him:
"Dennis urged me to run for office so we could build a state-by-state grassroots movement for single payer and other progressive issues. My campaign for the North Carolina House is an extension of the work I did with Dennis Kucinich."
While Kucinich has struggled unsuccessfully thus far to pass federal legislation facilitating the state creation of single-payer healthcare systems, states are pressign ahead and will deal with lawsuits from "health" corporations when and if they arise.
Marcus Brandon's website is at
http://www.marcusbrandon.com
He has a primary on May 4th. Those who want a real healthcare system in this country would be wise to pour money into his campaign and those of other state leaders across the country.
Alternatively we could keep putting all our eggs in the basket of fantasies about the United States Senate getting its act together.
February 17, 2010
By David Swanson
A bill to create single-payer healthcare in California has passed that state's senate for the third time now. Californians just need to persuade a governor to sign it. Single-payer healthcare bills are advancing in Pennsylvania, Ohio, Minnesota, Massachusetts, and a growing list of states, including New Mexico, where State Senator Jerry Ortiz y Pino, a long-time supporter of single-payer healthcare, is running for Lieutenant Governor.
Now North Carolina house candidate Marcus Brandon has pledged to introduce a bill to create single-payer healthcare in that state. Brandon, whom I know and like and who worked for Congressman Dennis Kucinich's 2008 presidential campaign, is a candidate in North Carolina House District 60. That's near Greensboro, where I can just picture Marcus sitting at a lunch counter and refusing to be provoked.
Brandon has promised that if he is elected, the first piece of legislation he will introduce will be the "North Carolina Healthcare Act" which will provide universal single-payer healthcare to every citizen of the state.
Brandon says that he remains a supporter of national single-payer healthcare and will continue lobbying for passage of HR 676, Congressman John Conyers' bill:
"The HR 676 fight is definitely not over, but we must now strategically shift the focus to the state level. When other states see that we can cut the cost of healthcare, streamline our medical industry, and still provide universal coverage to all North Carolinians, then all of the sudden, single-payer health care doesn't look so bad."
Brandon argues that a single-payer system could save over $1.5 billion per year in reduced bureaucracy in the state of North Carolina alone. And he speaks confidently about making this happen:
"North Carolina is poised to be the first state to adopt single-payer, once I am able to introduce it. North Carolinians are ready for real solutions to healthcare. North Carolina has the third highest healthcare cost of any state, while it sags at 37th in average income. This is a disparity that most North Carolinians feel when they have to think about healthcare. Every day, as I am knocking on doors to talk to voters, I hear stories of people who cannot afford insurance and become victims of this for-profit industry."
Brandon says his bill is similar to other states' initiatives such as the "Minnesota Health Act" or the "California Universal Healthcare Act." Brandon points to these two bills as excellent examples of how a single payer healthcare system could be both fiscally sound and provide full coverage.
Brandon served in 2007 and 2008 as Dennis Kucinich's National Finance Director and Deputy Campaign Manager. He says that Kucinich inspired him:
"Dennis urged me to run for office so we could build a state-by-state grassroots movement for single payer and other progressive issues. My campaign for the North Carolina House is an extension of the work I did with Dennis Kucinich."
While Kucinich has struggled unsuccessfully thus far to pass federal legislation facilitating the state creation of single-payer healthcare systems, states are pressign ahead and will deal with lawsuits from "health" corporations when and if they arise.
Marcus Brandon's website is at
http://www.marcusbrandon.com
He has a primary on May 4th. Those who want a real healthcare system in this country would be wise to pour money into his campaign and those of other state leaders across the country.
Alternatively we could keep putting all our eggs in the basket of fantasies about the United States Senate getting its act together.
Tuesday, February 16, 2010
Pharma Giant Gets Cozy With Congress, Spends $100 Million in Advertising to Cash in on Health Reform
By Paul Blumenthal, Sunlight Foundation
February 16, 2010
http://www.alternet.org/story/145685/
More than a million spectators gathered before the Capitol on a frosty January afternoon to witness the inauguration of Barack Obama, who promised in his campaign to change Washington’s mercenary culture of lobbyists, special interest influence and backroom deals. But within a few months of being sworn in, the President and his top aides were sitting down with leaders from the pharmaceutical industry to hash out a deal that they thought would make health care reform possible.
Over the following months, pharmaceutical industry lobbyists and executives met with top White House aides dozens of times to hammer out a deal that would secure industry support for the administration’s health care reform agenda in exchange for the White House abandoning key elements of the president’s promises to reform the pharmaceutical industry. They flooded Congress with campaign contributions, and hired dozens of former Capitol Hill insiders to push their case. How they did it—pieced together from news accounts, disclosure forms including lobbying reports and Federal Election Commission records, White House visitor logs and the schedule Sen. Max Baucus releases voluntarily—is a testament to how ingrained the grip of special interests remains in Washington.
In the 2008 campaign, Obama declared his intention to include all stakeholders as he sought to reform the nation’s health care system, but also supported key Democratic health reform policies. Among these were several that targeted the pharmaceutical industry: Allowing re-importation of drugs from first world countries with lower drug prices and providing Medicare with negotiating authority over prescription drug prices in the recently enacted Part D program. These weren’t just promises, Obama had already voted for both of them as a senator in 2007. (Roll Call Vote 132 and Roll Call Vote 150.)
Set to carry out this agenda were two Capitol Hill veterans, schooled in the monied Washington culture, chief of staff Rahm Emanuel and deputy chief of staff Jim Messina. Emanuel was a former fundraiser, Clinton administration official, investment banker and member of the Democratic leadership in Congress. Messina was the former campaign manager and chief of staff to the powerful Senate Finance Committee chairman Max Baucus. Both were known for their unparalleled legislative abilities.
Because of Obama’s decision to develop a plan operating through the legislative process, members of Congress also played key roles. Early on, the pharmaceutical companies were told to deal directly with Senate Finance Committee chairman Max Baucus. Baucus would be the vehicle for the deal worked out behind the scenes by the White House and PhRMA.
Central to this effort was PhRMA president, CEO and top lobbyist Billy Tauzin, a longtime Democratic member of Congress who switched party affiliations after Republicans gained control of Congress in 1994. By switching parties Tauzin was able to maintain his influence and even rose to be Chairman of the House Committee on Energy & Commerce. Tauzin became the poster child of Washington’s mercenary culture. He crafted a bill to provide prescription drug access to Medicare recipients, one that provided major concessions to the pharmaceutical industry. Medicare would not be able to negotiate for lower prescription drug costs and reimportation of drugs from first world countries would not be allowed. A few months after the bill passed, Tauzin announced that he was retiring from Congress and would be taking a job helming PhRMA for a salary of $2 million.
Tauzin’s job change became fodder for a campaign ad that then presidential candidate Barack Obama ran in the spring of 2008 simply titled “Billy.” It featured the candidate, sleeves rolled up, talking to a salon of gasping Americans about the ways of Washington. “The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee, who pushed the law through, went to work for the pharmaceutical industry making $2 million a year.” The screen fades to black to inform the viewer that, “Barack Obama is the only candidate who refuses Washington lobbyist money,” while the candidate continues his lecture, “Imagine that. That’s an example of the same old game playing in Washington. You know, I don’t want to learn how to play the game better, I want to put an end to the game playing.”
Aiding PhRMA in their outreach to Congress would be a squadron of lobbyists to push their health care reform priorities. Over the course of 2009, the drug industry trade group spent over $28 million on in house and hired lobbyists. Aside from PhRMA’s massive in-house lobbying operation, the trade group hired 48 outside lobbying firms. The total number of lobbyists working for PhRMA in 2009 reached 165. Some 137 of those 165 lobbyists representing PhRMA were former employees of either the legislative or executive branches. Of these dozens were former congressional staffers including two former chiefs of staff to Max Baucus.
According to data compiled by the Center for Responsive Politics, drug makers contributed huge sums to congressional campaign committees during the same period—from January to the end of October (4th quarter numbers are still being totaled), industry political action committees, employees and their family members flooded lawmakers with over $8 million. Those contributions tilted heavily to Democrats over Republicans by a 57 to 42 percent margin—the first time in any election cycle going back to 1990, the first year that the Center for Responsive Politics began tracking industry giving, that Democrats were so favored. Given their majorities on Capitol Hill, and the new President’s intention to reform America’s health care system, the new tilt was perhaps not surprising.
***
On March 5, the White House held a meeting with major health care industry leaders to try to bring them to the table and see what could be done to gain their support. In attendance were Billy Tauzin, president, CEO and top lobbyist for PhRMA, Pfizer CEO Jeff Kindler, America’s Health Care Plans (AHIP) Chairman Karen Ignani, Tom Donohue of the Chamber of Commerce and Robert Wood Johnson Foundations’ Risa Lavizzo-Mourey. A day before the White House meeting Tauzin appeared on CNBC touting health care reform and promising to work closely with the Obama administration. In the interview he touted it as an “optimistic plan”, acknowledging that the industry did have a few problems but was glad to have a chance to discuss these. Some were caught dumb-founded by this apparent change of heart on behalf of an industry long adverse to health care reforms.
On April 15, Jim Messina and Jon Selib, chief of staff to Senate Finance Committee chairman Max Baucus, convened a meeting at the headquarters of the Democratic Senatorial Campaign Committee (DSCC) with leaders of organized labor and health care groups, including PhRMA. At the meeting, the groups decided to form two nonprofit entities to promote reform efforts, Healthy Economy Now and Americans for Stable Quality Care, that would be almost entirely funded by PhRMA. The two groups spent $24 million on their advertising campaigns; the contract to produce and place ads went to White House Senior Advisor David Axelrod’s former firm, AKPD, which owed Axelrod $2 million.
In the next month, CEO’s from pharmaceutical companies would meet with Baucus and administration officials at least four times. These talks preceded a major public event at the White House, one critical to its strategy to promote health care reform. On May 11, PhRMA and other trade industry groups pledged cost cutting measures to the White House that would save, they claimed, upwards of $2 trillion over the next decade. President Obama announced the deal in the State Dining Room, flanked by leaders of the various trade groups; the administration followed up with a media blitz in the press and on the White House Web site.
The next day, Healthy Economy Now’s PhRMA funded ad campaign ran their first advertisement in support of the health care reform process calling for the government to finally “fix” the nation’s health care cost problems. While many elements of the $2 trillion cost cutting pledge fell apart, the drug industry remained committed to the process in the hopes that they could ultimately win out and defeat the provisions they most feared in closed-door meetings with the White House.
The first occurred on June 2. White House visitor logs show PhRMA’s top executives, including Tauzin, and industry CEOs met with Sarah Fenn from the White House Office of Health Care Reform. On the same day, the publicly available schedule of Senator Max Baucus shows Tauzin and the same industry CEOs met the Senate Finance Committee chairman. What ultimately resulted from these coordinated meetings would be revealed by Baucus on June 20.
In a press release featuring a statement by Tauzin, Baucus revealed that the pharmaceutical industry had accepted $80 billion in cost cutting measures to be included in the Senate Finance Committee version of the bill. According to news reports, Baucus initially proposed $100 billion in cost cutting measures, but the executives and lobbyists meeting on June 2 were able to win the lower figure.
The terms of the initial cost-cutting deal included $30 billion go directly towards closing the “donut hole” in Medicare prescription drug coverage. The “donut hole” is a term for the gap in coverage that occurs within the Medicare prescription drug coverage. For those purchasing prescription drugs through the Medicare program coverage cuts off at $2,700 spent and does not pick back up again until $6,154 is spent by the participant. The amount proposed in the deal, 50 percent coverage for drugs within the coverage gap, however, would not completely close the “donut hole.”
In Baucus’ press release, Tauzin is quoted as saying, “This is a once-in-a-lifetime opportunity and, working together, we can make this hope for a better tomorrow a reality today.” This “once-in-a-lifetime” opportunity also extended to the pharmaceutical industry’s ability to blunt the long-term Democratic agenda of lowering prescription drug prices through Medicare negotiations, re-importation and quicker release of generics onto the market. After making such a grand statement of support through cost cutting proposals it was time for the pharmaceutical industry to finally force the White House and Democrats to take certain chips off the table.
Baucus proceeded with a plan to convene a bipartisan group in an effort to craft the bill desired by the White House. These participants included Democrats Kent Conrad and Jeff Bingaman and Republicans Chuck Grassley, Mike Enzi and Olympia Snowe. Baucus’ decision and the need to solidify deals with groups like the pharmaceutical industry – which were reliant on Baucus producing a bill – slowed down the legislative process making it impossible for Congress to meet the White House’s announced August recess deadline for passing health care reform.
Soon after, PhRMA’s big guns and industry lobbyists paid the White House another visit on July 7 and this time met with Rahm Emanuel and Jim Messina (Baucus’ chief of staff Jon Selib is also listed in White House visitor logs for this meeting). In August, The Huffington Post’s Ryan Grim reported on an internal memo that was drafted at that meeting that outlined the policies that would not be allowed into any final version of health care reform. These included Medicare prescription drug negotiations, drug re-importation, and the lowering of prices for drugs available through Medicare Part D and Part B. The deal would be $80 billion in cost cutting and absolutely no more.
***
While the $80 billion deal was cut with Baucus’ committee, other congressional committees continued to mark-up their own versions of health care reform without the knowledge that the White House was relying on Baucus to produce the final product. In the House of Representatives, the House Energy & Commerce Committee leveled a direct threat to the $80 billion deal. Energy & Commerce Chair Henry Waxman sought to include all of the provisions that PhRMA had gotten the White House and Baucus to cut out of the reform bill. These included drug reimportation, Medicare negotiating power and speedier release of generics to the market. According to previous analysis of the measures proposed by the committee, these measures would have totaled hundreds of billions in cost cuts, far exceeding the $80 billion cap agreed to by the White House, Baucus and PhRMA.
The cost cutting measures passed in the Energy & Commerce bill spooked the board of PhRMA, which included all of the CEOs involved in the deal-cutting meetings with the White House and Baucus. The board pressured Tauzin to go public with the deal to ensure that the White House would recognize it and not renege. On August 4, the Los Angeles Times, in an exclusive report, featured quotes from Tauzin claiming that a deal between the White House and PhRMA existed and that, as Tauzin put it, “The White House blessed it.” Tom Hamburger wrote in the article, “For his part, Tauzin said he had not only received the White House pledge to forswear Medicare drug price bargaining, but also a separate promise not to pursue another proposal Obama supported during the campaign: importing cheaper drugs from Canada or Europe.”
The White House’s Jim Messina later confirmed Tauzin’s claim, stating, “The president encouraged this approach … He wanted to bring all the parties to the table to discuss health insurance reform.”
Democratic lawmakers were furious. Rep. Raul Grijalva, chairman of the Progressive Caucus, asked, “Are industry groups going to be the ones at the table who get the first big piece of the pie and we just fight over the crust?”
***
On September 7, Baucus’ bill made a private circulation on the Hill; pharmaceutical industry cost-cutting did not exceed $80 billion. Five days later, the New York Times reported that PhRMA planned to spend up to $150 million in an advertising blitz in support of Baucus’ bill. The Times noted that the ad spending “…would be a follow-up to the deal that drug makers struck in June with Mr. Baucus and the White House.” On September 16, Baucus released the full text of his legislation to the public.
The White House, PhRMA and Baucus still had to fight a few battles to keep the deal intact. The key amendment targeting the PhRMA deal in committee mark-up came from Sen. Bill Nelson from Florida, which has one of the largest Medicare participant populations in the nation. The pull of constituent needs clearly put Bill Nelson into a position to push for further cost cutting in Medicare prescription drug pricing. His target: closing the “donut hole” completely.
Nelson claimed that his amendment would generate $106 billion in revenue, or from PhRMA’s perspective increase their cost-cutting to $186 billion. That would be unacceptable to PhRMA, to Baucus, to the White House and to the pharmaceutical industry who had made the deal. Other Senate Democrats, Tom Carper and Robert Menendez voted with Republicans and Baucus on the committee to defeat the amendment. It is little surprise the Carper’s Delaware is home to AstraZeneca and Menendez’ New Jersey is home to Merck and Bristol-Myers-Squibb, all of which lobbied for the $80 billion cap.
Senate Majority Leader Harry Reid introduced the final bill, with the cap in place, on November 19. Debate began on Dec. 3, and with it come one more attempt by members to change the terms of the deal. Senator Byron Dorgan introduced an amendment that would allow for drug re-importation, but as the date for voting drew near, the Federal Drug Administration (FDA) released a letter objecting to the proposal that echoed pharmaceutical industry talking points: “…as currently written, the resulting structure would be logistically challenging to implement and resource intensive. In addition, there are significant safety concerns.” Dorgan’s amendment was defeated with numerous Democrats previously in support of reimportation switching to “no” votes.
On Christmas Eve, the bill passed the Senate with the PhRMA deal fully intact.
***
New Year’s Eve passed with no further action on health care reform. Public opinion regarding the health care reform bill had been slipping throughout 2009. It reached a fulcrum in the special election to replace the deceased senator Ted Kennedy in Massachusetts on January 19, 2010. Newly minted senator Scott Brown campaigned that he would be the senator to provide Republicans with the votes to filibuster the final health care reform bill. Democrats ran for cover. Despite having the largest majorities of any party since the 1970s, Democrats put the brakes on their agenda, particularly health care reform.
In the end, the pharmaceutical industry’s support for health care reform would be left up in the air. After spending $100 million in advertising in support of legislation that Tauzin and key executives hoped would be a windfall for the pharmaceutical industry, the legislative process had flat-lined. In February, the board of PhRMA, split over the deal cut by Tauzin, pushed Tauzin to resign his post.
In an interview with Diane Sawyer, President Obama owed up to failures in the process of passing health care reform, “[T]he health care debate as it unfolded legitimately raised concerns not just among my opponents, but also amongst supporters that we just don’t know what’s going on … And it’s an ugly process and it looks like there are a bunch of back room deals.”
Paul Blumenthal is the Senior Writer at the Sunlight Foundation.
February 16, 2010
http://www.alternet.org/story/145685/
More than a million spectators gathered before the Capitol on a frosty January afternoon to witness the inauguration of Barack Obama, who promised in his campaign to change Washington’s mercenary culture of lobbyists, special interest influence and backroom deals. But within a few months of being sworn in, the President and his top aides were sitting down with leaders from the pharmaceutical industry to hash out a deal that they thought would make health care reform possible.
Over the following months, pharmaceutical industry lobbyists and executives met with top White House aides dozens of times to hammer out a deal that would secure industry support for the administration’s health care reform agenda in exchange for the White House abandoning key elements of the president’s promises to reform the pharmaceutical industry. They flooded Congress with campaign contributions, and hired dozens of former Capitol Hill insiders to push their case. How they did it—pieced together from news accounts, disclosure forms including lobbying reports and Federal Election Commission records, White House visitor logs and the schedule Sen. Max Baucus releases voluntarily—is a testament to how ingrained the grip of special interests remains in Washington.
In the 2008 campaign, Obama declared his intention to include all stakeholders as he sought to reform the nation’s health care system, but also supported key Democratic health reform policies. Among these were several that targeted the pharmaceutical industry: Allowing re-importation of drugs from first world countries with lower drug prices and providing Medicare with negotiating authority over prescription drug prices in the recently enacted Part D program. These weren’t just promises, Obama had already voted for both of them as a senator in 2007. (Roll Call Vote 132 and Roll Call Vote 150.)
Set to carry out this agenda were two Capitol Hill veterans, schooled in the monied Washington culture, chief of staff Rahm Emanuel and deputy chief of staff Jim Messina. Emanuel was a former fundraiser, Clinton administration official, investment banker and member of the Democratic leadership in Congress. Messina was the former campaign manager and chief of staff to the powerful Senate Finance Committee chairman Max Baucus. Both were known for their unparalleled legislative abilities.
Because of Obama’s decision to develop a plan operating through the legislative process, members of Congress also played key roles. Early on, the pharmaceutical companies were told to deal directly with Senate Finance Committee chairman Max Baucus. Baucus would be the vehicle for the deal worked out behind the scenes by the White House and PhRMA.
Central to this effort was PhRMA president, CEO and top lobbyist Billy Tauzin, a longtime Democratic member of Congress who switched party affiliations after Republicans gained control of Congress in 1994. By switching parties Tauzin was able to maintain his influence and even rose to be Chairman of the House Committee on Energy & Commerce. Tauzin became the poster child of Washington’s mercenary culture. He crafted a bill to provide prescription drug access to Medicare recipients, one that provided major concessions to the pharmaceutical industry. Medicare would not be able to negotiate for lower prescription drug costs and reimportation of drugs from first world countries would not be allowed. A few months after the bill passed, Tauzin announced that he was retiring from Congress and would be taking a job helming PhRMA for a salary of $2 million.
Tauzin’s job change became fodder for a campaign ad that then presidential candidate Barack Obama ran in the spring of 2008 simply titled “Billy.” It featured the candidate, sleeves rolled up, talking to a salon of gasping Americans about the ways of Washington. “The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee, who pushed the law through, went to work for the pharmaceutical industry making $2 million a year.” The screen fades to black to inform the viewer that, “Barack Obama is the only candidate who refuses Washington lobbyist money,” while the candidate continues his lecture, “Imagine that. That’s an example of the same old game playing in Washington. You know, I don’t want to learn how to play the game better, I want to put an end to the game playing.”
Aiding PhRMA in their outreach to Congress would be a squadron of lobbyists to push their health care reform priorities. Over the course of 2009, the drug industry trade group spent over $28 million on in house and hired lobbyists. Aside from PhRMA’s massive in-house lobbying operation, the trade group hired 48 outside lobbying firms. The total number of lobbyists working for PhRMA in 2009 reached 165. Some 137 of those 165 lobbyists representing PhRMA were former employees of either the legislative or executive branches. Of these dozens were former congressional staffers including two former chiefs of staff to Max Baucus.
According to data compiled by the Center for Responsive Politics, drug makers contributed huge sums to congressional campaign committees during the same period—from January to the end of October (4th quarter numbers are still being totaled), industry political action committees, employees and their family members flooded lawmakers with over $8 million. Those contributions tilted heavily to Democrats over Republicans by a 57 to 42 percent margin—the first time in any election cycle going back to 1990, the first year that the Center for Responsive Politics began tracking industry giving, that Democrats were so favored. Given their majorities on Capitol Hill, and the new President’s intention to reform America’s health care system, the new tilt was perhaps not surprising.
***
On March 5, the White House held a meeting with major health care industry leaders to try to bring them to the table and see what could be done to gain their support. In attendance were Billy Tauzin, president, CEO and top lobbyist for PhRMA, Pfizer CEO Jeff Kindler, America’s Health Care Plans (AHIP) Chairman Karen Ignani, Tom Donohue of the Chamber of Commerce and Robert Wood Johnson Foundations’ Risa Lavizzo-Mourey. A day before the White House meeting Tauzin appeared on CNBC touting health care reform and promising to work closely with the Obama administration. In the interview he touted it as an “optimistic plan”, acknowledging that the industry did have a few problems but was glad to have a chance to discuss these. Some were caught dumb-founded by this apparent change of heart on behalf of an industry long adverse to health care reforms.
On April 15, Jim Messina and Jon Selib, chief of staff to Senate Finance Committee chairman Max Baucus, convened a meeting at the headquarters of the Democratic Senatorial Campaign Committee (DSCC) with leaders of organized labor and health care groups, including PhRMA. At the meeting, the groups decided to form two nonprofit entities to promote reform efforts, Healthy Economy Now and Americans for Stable Quality Care, that would be almost entirely funded by PhRMA. The two groups spent $24 million on their advertising campaigns; the contract to produce and place ads went to White House Senior Advisor David Axelrod’s former firm, AKPD, which owed Axelrod $2 million.
In the next month, CEO’s from pharmaceutical companies would meet with Baucus and administration officials at least four times. These talks preceded a major public event at the White House, one critical to its strategy to promote health care reform. On May 11, PhRMA and other trade industry groups pledged cost cutting measures to the White House that would save, they claimed, upwards of $2 trillion over the next decade. President Obama announced the deal in the State Dining Room, flanked by leaders of the various trade groups; the administration followed up with a media blitz in the press and on the White House Web site.
The next day, Healthy Economy Now’s PhRMA funded ad campaign ran their first advertisement in support of the health care reform process calling for the government to finally “fix” the nation’s health care cost problems. While many elements of the $2 trillion cost cutting pledge fell apart, the drug industry remained committed to the process in the hopes that they could ultimately win out and defeat the provisions they most feared in closed-door meetings with the White House.
The first occurred on June 2. White House visitor logs show PhRMA’s top executives, including Tauzin, and industry CEOs met with Sarah Fenn from the White House Office of Health Care Reform. On the same day, the publicly available schedule of Senator Max Baucus shows Tauzin and the same industry CEOs met the Senate Finance Committee chairman. What ultimately resulted from these coordinated meetings would be revealed by Baucus on June 20.
In a press release featuring a statement by Tauzin, Baucus revealed that the pharmaceutical industry had accepted $80 billion in cost cutting measures to be included in the Senate Finance Committee version of the bill. According to news reports, Baucus initially proposed $100 billion in cost cutting measures, but the executives and lobbyists meeting on June 2 were able to win the lower figure.
The terms of the initial cost-cutting deal included $30 billion go directly towards closing the “donut hole” in Medicare prescription drug coverage. The “donut hole” is a term for the gap in coverage that occurs within the Medicare prescription drug coverage. For those purchasing prescription drugs through the Medicare program coverage cuts off at $2,700 spent and does not pick back up again until $6,154 is spent by the participant. The amount proposed in the deal, 50 percent coverage for drugs within the coverage gap, however, would not completely close the “donut hole.”
In Baucus’ press release, Tauzin is quoted as saying, “This is a once-in-a-lifetime opportunity and, working together, we can make this hope for a better tomorrow a reality today.” This “once-in-a-lifetime” opportunity also extended to the pharmaceutical industry’s ability to blunt the long-term Democratic agenda of lowering prescription drug prices through Medicare negotiations, re-importation and quicker release of generics onto the market. After making such a grand statement of support through cost cutting proposals it was time for the pharmaceutical industry to finally force the White House and Democrats to take certain chips off the table.
Baucus proceeded with a plan to convene a bipartisan group in an effort to craft the bill desired by the White House. These participants included Democrats Kent Conrad and Jeff Bingaman and Republicans Chuck Grassley, Mike Enzi and Olympia Snowe. Baucus’ decision and the need to solidify deals with groups like the pharmaceutical industry – which were reliant on Baucus producing a bill – slowed down the legislative process making it impossible for Congress to meet the White House’s announced August recess deadline for passing health care reform.
Soon after, PhRMA’s big guns and industry lobbyists paid the White House another visit on July 7 and this time met with Rahm Emanuel and Jim Messina (Baucus’ chief of staff Jon Selib is also listed in White House visitor logs for this meeting). In August, The Huffington Post’s Ryan Grim reported on an internal memo that was drafted at that meeting that outlined the policies that would not be allowed into any final version of health care reform. These included Medicare prescription drug negotiations, drug re-importation, and the lowering of prices for drugs available through Medicare Part D and Part B. The deal would be $80 billion in cost cutting and absolutely no more.
***
While the $80 billion deal was cut with Baucus’ committee, other congressional committees continued to mark-up their own versions of health care reform without the knowledge that the White House was relying on Baucus to produce the final product. In the House of Representatives, the House Energy & Commerce Committee leveled a direct threat to the $80 billion deal. Energy & Commerce Chair Henry Waxman sought to include all of the provisions that PhRMA had gotten the White House and Baucus to cut out of the reform bill. These included drug reimportation, Medicare negotiating power and speedier release of generics to the market. According to previous analysis of the measures proposed by the committee, these measures would have totaled hundreds of billions in cost cuts, far exceeding the $80 billion cap agreed to by the White House, Baucus and PhRMA.
The cost cutting measures passed in the Energy & Commerce bill spooked the board of PhRMA, which included all of the CEOs involved in the deal-cutting meetings with the White House and Baucus. The board pressured Tauzin to go public with the deal to ensure that the White House would recognize it and not renege. On August 4, the Los Angeles Times, in an exclusive report, featured quotes from Tauzin claiming that a deal between the White House and PhRMA existed and that, as Tauzin put it, “The White House blessed it.” Tom Hamburger wrote in the article, “For his part, Tauzin said he had not only received the White House pledge to forswear Medicare drug price bargaining, but also a separate promise not to pursue another proposal Obama supported during the campaign: importing cheaper drugs from Canada or Europe.”
The White House’s Jim Messina later confirmed Tauzin’s claim, stating, “The president encouraged this approach … He wanted to bring all the parties to the table to discuss health insurance reform.”
Democratic lawmakers were furious. Rep. Raul Grijalva, chairman of the Progressive Caucus, asked, “Are industry groups going to be the ones at the table who get the first big piece of the pie and we just fight over the crust?”
***
On September 7, Baucus’ bill made a private circulation on the Hill; pharmaceutical industry cost-cutting did not exceed $80 billion. Five days later, the New York Times reported that PhRMA planned to spend up to $150 million in an advertising blitz in support of Baucus’ bill. The Times noted that the ad spending “…would be a follow-up to the deal that drug makers struck in June with Mr. Baucus and the White House.” On September 16, Baucus released the full text of his legislation to the public.
The White House, PhRMA and Baucus still had to fight a few battles to keep the deal intact. The key amendment targeting the PhRMA deal in committee mark-up came from Sen. Bill Nelson from Florida, which has one of the largest Medicare participant populations in the nation. The pull of constituent needs clearly put Bill Nelson into a position to push for further cost cutting in Medicare prescription drug pricing. His target: closing the “donut hole” completely.
Nelson claimed that his amendment would generate $106 billion in revenue, or from PhRMA’s perspective increase their cost-cutting to $186 billion. That would be unacceptable to PhRMA, to Baucus, to the White House and to the pharmaceutical industry who had made the deal. Other Senate Democrats, Tom Carper and Robert Menendez voted with Republicans and Baucus on the committee to defeat the amendment. It is little surprise the Carper’s Delaware is home to AstraZeneca and Menendez’ New Jersey is home to Merck and Bristol-Myers-Squibb, all of which lobbied for the $80 billion cap.
Senate Majority Leader Harry Reid introduced the final bill, with the cap in place, on November 19. Debate began on Dec. 3, and with it come one more attempt by members to change the terms of the deal. Senator Byron Dorgan introduced an amendment that would allow for drug re-importation, but as the date for voting drew near, the Federal Drug Administration (FDA) released a letter objecting to the proposal that echoed pharmaceutical industry talking points: “…as currently written, the resulting structure would be logistically challenging to implement and resource intensive. In addition, there are significant safety concerns.” Dorgan’s amendment was defeated with numerous Democrats previously in support of reimportation switching to “no” votes.
On Christmas Eve, the bill passed the Senate with the PhRMA deal fully intact.
***
New Year’s Eve passed with no further action on health care reform. Public opinion regarding the health care reform bill had been slipping throughout 2009. It reached a fulcrum in the special election to replace the deceased senator Ted Kennedy in Massachusetts on January 19, 2010. Newly minted senator Scott Brown campaigned that he would be the senator to provide Republicans with the votes to filibuster the final health care reform bill. Democrats ran for cover. Despite having the largest majorities of any party since the 1970s, Democrats put the brakes on their agenda, particularly health care reform.
In the end, the pharmaceutical industry’s support for health care reform would be left up in the air. After spending $100 million in advertising in support of legislation that Tauzin and key executives hoped would be a windfall for the pharmaceutical industry, the legislative process had flat-lined. In February, the board of PhRMA, split over the deal cut by Tauzin, pushed Tauzin to resign his post.
In an interview with Diane Sawyer, President Obama owed up to failures in the process of passing health care reform, “[T]he health care debate as it unfolded legitimately raised concerns not just among my opponents, but also amongst supporters that we just don’t know what’s going on … And it’s an ugly process and it looks like there are a bunch of back room deals.”
Paul Blumenthal is the Senior Writer at the Sunlight Foundation.
Friday, February 12, 2010
Top Five Health Insurers Posted 56 Percent Profit Gains in 2009
By John Byrne, Raw Story
February 12, 2010
http://www.alternet.org/story/145655/
If no health care overhaul passes Congress, health insurers may be in for a windfall -- and one far larger that most Americans probably realize.
According to a study by a pro-health reform group published Thursday, the nation's largest five health insurance companies posted a 56 percent gain in 2009 profits over 2008. The insurers including Wellpoint, UnitedHealth, Cigna, Aetna and Humana, which cover the majority of Americans with insurance.
The insurers' hefty profit gains came even as 2.7 million more Americans lost their insurance coverage due to the declining economy.
A lobbyist for American's Health Insurance Plans, the trade group that represents insurers in Washington, D.C., attributed the gain in 2009 profits to a poor performance in 2008. In 2008, insurers were forced to write down their stock holdings because of the US market's declines. Insurance companies keep a great deal of money in the markets, earning interest from the time between premiums are paid and the time when health providers are paid.
"It is disingenuous to look at the profits at one company today compared to where it was in the depth of a recession," Robert Zirkelbach, a spokesman for America's Health Insurance Plans, told the Cleveland Plain Dealer.
The insurer profit study was prepared by the liberal-leaning group Healthcare for America Now, an organization bankrolled by labor unions, which typically take strong positions in favor of Democratic policies, while historically being highly critical of Republicans.
"Insurers will - perversely - try and blame the economy for their record-breaking fortunes, saying employers have been shedding jobs and therefor dropping insurance coverage, leading to a decrease in customers," a press release for Health Care for America Now said. "And they're certainly right in the sense that less jobs equals less employer-based health coverage, but that obscures the fact that employers have been steadily dropping health coverage for more employees for 15 years - even during good times - because the insurance industry's prices keep skyrocketing much faster than inflation."
"None of the excuses can explain away the basic reality that insurers make more money when they insure less people. They can pay their CEOs more ("administrative costs" rose this year) when they can charge the healthy exorbitant prices and drop or deny these loyal customers when they become sick and therefore expensive," the release added.
Notably, the study also found that insurers spent less money on medical care as a percentage of their premiums from customers. Salaries, administrative expenses and profits made up more of the insurer's expenses in 2009.
Wellpoints Anthem Blue Cross California created a stir earlier this week by announcing that they will raise premiums on individuals by 39 percent in 2010. The increase was so high it drew a rebuke from the Obama Administration. Wellpoint defended the increase, saying the decline in customers had increased the percentage of sick patients under their care, thus warranting a higher charge to consumers. Wellpoint also pointed out that their California division actually lost money in 2009.
Yet, the company posted a profit of $4.7 billion for the year. That put them at a higher profit margin (7.3 percent) than any of the other top five American insurers.
Wellpoint's CEO also recently said they are considering paying a dividend to their investors -- a sign of their profitability -- which might further rankle insurance company critics.
Insurance companies typically average a profit margin closer to four percent, with about 80-85 percent of premiums spent on reimbursing patients' medical expenses. The remainer goes to administrative costs, salaries and marketing. Under a bill under consideration in the Senate, medical "loss benefit ratios" would be set at 80-85 percent, meaning insurers would face little pressure to trim administrative costs relative to medical care.
Other highly profitable insurers in 2009 included Humana, which saw a profit yield of 7.1 percent.
Despite record 2009 profits, insurers are under increasing pressure to deliver gains for investors, as the pool of insured Americans continues to fall. Insurance companies that make much of their money from businesses' healthcare plans have seen declining rolls amid an economy roiled by a nearly 10 percent unemployment rate.
Some analysts have also said that the failure of the health insurance reform package could damage insurance companies in the long run, because subsidies from the federal government would have likely insured 30 million new customers.
Health Care for America Now's study also highlighted the following statistics:
* The five largest insurance firms firms made $12.2 billion, an increase of $4.4 billion, or 56 percent, from 2008.
* Four out of the five companies saw earnings increases, with CIGNA’s profits jumping 346 percent.
* The companies provided private insurance coverage to 2.7 million fewer people than the year before.
* Four out of the five companies insured fewer people through private coverage. UnitedHealth alone insured 1.7 million fewer people through employer-based or individual coverage.
* All but one of the five companies increased the number of people they covered through public insurance programs (Medicaid, CHIP and Medicare). UnitedHealth added 680,000 people in public plans.
* The proportion of premium dollars spent on health care expenses went down for three of the five firms, with higher proportions going to administrative expenses and profits.
John Byrne is editor of Raw Story.
February 12, 2010
http://www.alternet.org/story/145655/
If no health care overhaul passes Congress, health insurers may be in for a windfall -- and one far larger that most Americans probably realize.
According to a study by a pro-health reform group published Thursday, the nation's largest five health insurance companies posted a 56 percent gain in 2009 profits over 2008. The insurers including Wellpoint, UnitedHealth, Cigna, Aetna and Humana, which cover the majority of Americans with insurance.
The insurers' hefty profit gains came even as 2.7 million more Americans lost their insurance coverage due to the declining economy.
A lobbyist for American's Health Insurance Plans, the trade group that represents insurers in Washington, D.C., attributed the gain in 2009 profits to a poor performance in 2008. In 2008, insurers were forced to write down their stock holdings because of the US market's declines. Insurance companies keep a great deal of money in the markets, earning interest from the time between premiums are paid and the time when health providers are paid.
"It is disingenuous to look at the profits at one company today compared to where it was in the depth of a recession," Robert Zirkelbach, a spokesman for America's Health Insurance Plans, told the Cleveland Plain Dealer.
The insurer profit study was prepared by the liberal-leaning group Healthcare for America Now, an organization bankrolled by labor unions, which typically take strong positions in favor of Democratic policies, while historically being highly critical of Republicans.
"Insurers will - perversely - try and blame the economy for their record-breaking fortunes, saying employers have been shedding jobs and therefor dropping insurance coverage, leading to a decrease in customers," a press release for Health Care for America Now said. "And they're certainly right in the sense that less jobs equals less employer-based health coverage, but that obscures the fact that employers have been steadily dropping health coverage for more employees for 15 years - even during good times - because the insurance industry's prices keep skyrocketing much faster than inflation."
"None of the excuses can explain away the basic reality that insurers make more money when they insure less people. They can pay their CEOs more ("administrative costs" rose this year) when they can charge the healthy exorbitant prices and drop or deny these loyal customers when they become sick and therefore expensive," the release added.
Notably, the study also found that insurers spent less money on medical care as a percentage of their premiums from customers. Salaries, administrative expenses and profits made up more of the insurer's expenses in 2009.
Wellpoints Anthem Blue Cross California created a stir earlier this week by announcing that they will raise premiums on individuals by 39 percent in 2010. The increase was so high it drew a rebuke from the Obama Administration. Wellpoint defended the increase, saying the decline in customers had increased the percentage of sick patients under their care, thus warranting a higher charge to consumers. Wellpoint also pointed out that their California division actually lost money in 2009.
Yet, the company posted a profit of $4.7 billion for the year. That put them at a higher profit margin (7.3 percent) than any of the other top five American insurers.
Wellpoint's CEO also recently said they are considering paying a dividend to their investors -- a sign of their profitability -- which might further rankle insurance company critics.
Insurance companies typically average a profit margin closer to four percent, with about 80-85 percent of premiums spent on reimbursing patients' medical expenses. The remainer goes to administrative costs, salaries and marketing. Under a bill under consideration in the Senate, medical "loss benefit ratios" would be set at 80-85 percent, meaning insurers would face little pressure to trim administrative costs relative to medical care.
Other highly profitable insurers in 2009 included Humana, which saw a profit yield of 7.1 percent.
Despite record 2009 profits, insurers are under increasing pressure to deliver gains for investors, as the pool of insured Americans continues to fall. Insurance companies that make much of their money from businesses' healthcare plans have seen declining rolls amid an economy roiled by a nearly 10 percent unemployment rate.
Some analysts have also said that the failure of the health insurance reform package could damage insurance companies in the long run, because subsidies from the federal government would have likely insured 30 million new customers.
Health Care for America Now's study also highlighted the following statistics:
* The five largest insurance firms firms made $12.2 billion, an increase of $4.4 billion, or 56 percent, from 2008.
* Four out of the five companies saw earnings increases, with CIGNA’s profits jumping 346 percent.
* The companies provided private insurance coverage to 2.7 million fewer people than the year before.
* Four out of the five companies insured fewer people through private coverage. UnitedHealth alone insured 1.7 million fewer people through employer-based or individual coverage.
* All but one of the five companies increased the number of people they covered through public insurance programs (Medicaid, CHIP and Medicare). UnitedHealth added 680,000 people in public plans.
* The proportion of premium dollars spent on health care expenses went down for three of the five firms, with higher proportions going to administrative expenses and profits.
John Byrne is editor of Raw Story.
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