Senators Jim Webb and Mark Warner are the two centrist Democratic senators of Virginia and their silence on the public option reflects it even though the majority of Virginia voters disapprove of such silence.  The disapproval ratings for Sens. Webb and Warner’s handling of health care is 52 and50 percent respectively according to a new poll conducted by Research 2000.

Virginia voters were asked the following:  

QUESTION: Would you favor or oppose the national government offering everyone the choice of buying into a government administered health insurance plan — something like the Medicare coverage that people 65 and older get — that would compete with private health insurance plans?

A whopping 61 percent of all Virginia voters want a public option in the health care reform bill.  Yet Sen. Mark Warner and Sen. Jim Webb have not given their support for the measure even though the approval rating for the public option is higher than the job approval rating of both Webb and Warner.  So one would think that it would be a no brainer for these two Virginia senators to push for the public option.  Not so much.  My question is WHY???  Please call or email Senators Warner and Webb  and ask them why they are not pushing for the public option when the majority of the Virginia voters want it.  Please be sure to press them to support including the public option in health reform through reconciliation.  If you see our post here you will notice that the two Virginia Senators have not voiced their position.

Senator Jim Webb:                       Phone: 202-224-4024      Toll Free Number:    1-866-507-1570   Email

Senator Mark Warner:                Phone: 202-224-2023       Toll Free Number:    1-877-676-2759   Email

Will someone please tell the Republican party that the Senate version of the Health Care Reform bill was passed on December 24, 2009.  Reconciliation is only being used to amend a bill that has already been passed by the Senate with a 60 vote supermajority.  So all of these end of the world proclamations by the right are hyperbolic, disengenious, falsehoods being perpetuated in the name of political strategy.  The GOP has made a calculated decision that it is better to scare its constuents about this bill in an effort to prevent its passage because Republican members realize that if  the health care reform does pass it will improve the health care market and Democrats will receive the benefit.  This will then dramatically interfere with its efforts to win back the House and Senate in 2010.

Pure politics.

The GOP was out in full force on the Sunday talk shows pushing the same stale talking points that they have been pushing for the last year.  This bill is too big, start over, increased premiums BLAH, BLAH, BLAH.  We caught the recently annointed GOP fiscal wonder boy Rep. Paul Ryan of Wisconsin on Fox News Sunday.  Below we have deconstructed his claim that premiums will rise as a result of the health care reform bill as done by the Congressional Budget Office and the President.

REP. PAUL RYAN (WI) Wisconsin claim of Fox News Sunday 02/28/10:  “No, it’s not true [that most Americans would be paying less in premiums].  The Congressional Budget Office says they will get higher premium increases 10 to 13 percent.  Private actuaries put those premium increases in the double digit to triple digit territory.  The Blue Cross plans are telling us you’re gonna see a massive spike in premiums for people…that’s the problem.  What we’re hearing coming out of Washington and the rhetoric doesn”t match the actual facts that are underneath this legislation.”

What the CBO actually said:

According to the nonpartisan CBO, for those in large group policies there would be no increase or a up to a 3% decrease in premiums.  For those in the individual market, premiums would increase 10% to 13% BECAUSE indivuals policy buyer would get better policies [actual coverage for routine procedures like mamograms, physicals, etc.] and over half of those in the individual market would get subsidies ‘that would reduce their costs well below the premiums that would be charged for such policies under current law.”  In other words, people would receive better value for their money or ACTUAL INSURANCE COVERAGE and not junk insurance that doesn’t even cover a annual physical.

Two days later after Congressman Ryan had time to think about a response:

REP. PAUL RYAN:  “Well if you had these…..if you had subsidies sure….but lets get this point clear, we’re not going to have more insurance competition under this new law we’re gonna have less insurance competition…that’s gonna increase prices and if you put more mandates on insurance as this does….this federalizes the regulation of health insurance…displacing states rights…that’s gonna make it more expensive.  So what this bill attempts to do is…yes  make health insurance much more expensive and then just have Washington subsidize more of it to try and limit people’s out of pocket cost..that’s a deficit nightmare its a cost nightmare.  And so you will be putting more cost on to the backs of taxpayers at the end of the day here.”

President Obama’s reponse to Congressman Ryan’s argument two days prior to him making it:

PRESIDENT OBAMA: When I was young, just got out of college, I had to buy auto insurance. I had a beat-up old car. And I won’t name the name of the insurance company, but there was a company — let’s call it Acme Insurance in Illinois. And I was paying my premiums every month. After about six months I got rear-ended and I called up Acme and said, I’d like to see if I can get my car repaired, and they laughed at me over the phone because really this was set up not to actually provide insurance; what it was set up was to meet the legal requirements. But it really wasn’t serious insurance.

Now, it’s one thing if you’ve got an old beat-up car that you can’t get fixed. It’s another thing if your kid is sick, or you’ve got breast cancer.

So the general idea has been here that we should set up some minimum standards within the exchange, that a plan that people are buying into, whether it’s a small business or an individual, should be at least solid enough that if your kid got sick, they’re actually going to be treated; that if something happened that you weren’t left with a huge bunch of out-of-pocket costs. It is true that you can always get cheaper insurance if it has really high deductibles or really high co-payments or doesn’t cover as many things. And so there has to be a balance that’s struck there. [SNIP]

More from the President:

Now, let me respond to your question. We could set up a system where food was probably cheaper than it is right now if we just eliminated meat inspectors and we eliminated any regulations in terms of how food is distributed and how it’s stored. I’ll bet in terms of drug prices, we would definitely reduce prescription drug prices if we didn’t have a drug administration that makes sure that we test the drugs so that they don’t kill us.

But we don’t do that. We make some decisions to protect consumers in every aspect of our lives. And we have bipartisan support for doing it, because what we don’t want is a situation in which suddenly people think they’re getting one thing and they’re getting something else — they’re harmed by a product. What Secretary Sebelius just referred to — which is not a Washington thing; in fact, state insurance standards in many states are higher than anything that’s done in Washington — is as a consequence of seeing consistent abuses by the insurance companies and people finding themselves helpless to deal with.

Just to go back to the original argument that Lamar and I had and we’ve now chased around for quite some time. Look, if I’m a self-employed person who right now can’t get coverage or can only buy the equivalent of Acme insurance that I had for my car — so I have some sort of high-deductible plan. It’s basically not health insurance; it’s house insurance. I’m going to — I’m buying that to protect me from some catastrophic situation; otherwise, I’m just paying out of pocket. I don’t go to the doctor. I don’t get preventive care. There are a whole bunch of things I just do without. But if I get hit by a truck, maybe I don’t go bankrupt. All right, so that’s what I’m purchasing right now.

What the Congressional Budget Office is saying is, is that if I now have the opportunity to actually buy a decent package inside the exchange that costs me about 10 to 13 percent more but is actually real insurance, then there are going to be a bunch of people who take advantage of that. So, yes, I’m paying 10 to 13 percent more, because instead of buying an apple, I’m getting an orange. They’re two different things.

Now, you can still — you still have an option of — no, no, let me finish. The way that this bill is structured uses a high-cost pool, a catastrophic pool, for people who can’t afford to buy that better insurance, but overall for a basic package — which, by the way, is a lot less generous than we give ourselves in Congress. So I’m amused when people say, let people have this not-so-good plan, let them have a high-deductible. But there would be a riot in Congress if we suddenly said, let’s have Congress have a high-deductible plan, because we all think it’s pretty important to provide coverage for our families. And the federal health insurance program has a minimum benefit that all of us take advantage of. And I haven’t seen any Republicans — or Democrats — in Congress suddenly say, “You know what, we should have more choices and not have to have this minimum benefit.”

So what we’re basically saying is we’re going to do the same thing for these other folks that we do for ourselves — on the taxpayers’ dime, by the way. [SNIP]

But again, the one difference, as I understand it, and the reason you’re not supporting the approach that we take, is what we say is there should be sort of a minimum baseline benefit, because if not, what ends up happening is you get a company set up in Nevada — let’s assume there were no rules there, there are no protections for the woman who’s got breast cancer; they go into New York, they offer pretty cheap insurance to everybody who’s healthy; they don’t offer the same insurance to people who aren’t so healthy or have preexisting conditions. They drain from New York all the healthy people who are getting cheaper rates, but now suddenly everybody left in New York who doesn’t qualify for that cheaper plan is in a pool that’s sicker, older, and their premiums go up.

So what we’ve said is, well, if we can set a baseline, then you can have interstate competition, but it’s not a race to the bottom; rather everybody has got some basic care. [SNIP]

NEXT?

The President exposed just how disconnected the Republican party is from the average American in the following exchange with Sen. John Barasso:

Obama: “Would you be satisfied if every member of Congress just had catastrophic care – you think we’d be better health care purchasers?”

Barrasso: “I think actually we would … We’d really focus on it. We’d have more, as you say, skin in the game. And especially if they had a savings account – a health savings account – they could put their money into that, and they’d be spending the money out of that.”

Obama: “Would you feel the same way if you were making $40,000. Or if that was your income? Because that’s the reality for a lot of folks.”

One of the better Congressmen on the hill Rep. Tom Perriello (VA – 5th) is responsible for has proposed the passage of a simple two page bill that would remove the antitrust exemption that allows health insurance companies to collude and prevent competitors from entering the the health insurance market.  UPDATE:  The bill passed with a vote of 406-19.  CONGRATULATIONS Rep. Tom Perriello and Rep. Betsy Markey who are co-sponsors of this great bipartisan effort. 

So the moral of this story.  Even though the latest SCOTUS decision allows corporations to donate unlimited amounts of money to defeat a candidate, Perriello and Markey are choosing the interest of their constituents and the nationover the health insurance industry by sponsoring this bill.  No other industry except Major League Baseball enjoys such a free pass from anti-competition laws.  Having this exemption allows the health insurance industry to charge exhorbitant premiums to its customers and get away with it by blocking and sabotaging start-up insurance companies that would provide competition and colluding with other health insurance companies to fix premium prices.  In essence, the industry is allowed to legally price fix so that the consumer does not have the option of purchasing insurance elsewhere because all of the health insurance companies are alligned.  It is also allowed to create monopolies within states thereby preventing consumer choice.  In any other industry this is illegal because it prevents competition within the marketplace.  Lack of competition ALWAYS translates to higher prices for the consumer and disasterous customer service because there is not incentive to take care of the customer when you’re the only game in town.

The operative language in Perriello’s bill is as follows:

“Nothing contained in this Act shall modify, impair, or supercede the operation of any of the antitrust laws with respect to the business of health insurance.” 

The bill will “restore the application of the Federal antitrust laws to the business of health insurance to protect competition and consumers.”   Call your House member Senate member and tell him/her to support and vote for a Senate equivalent of the House bill HR 4626 The Health Insurance Fair Competition Act that will repeal the health insurance antitrust exemption and help bring accountability and competition to the health insurance industry.  Write your House Senate member here.

Also, without repeal of the health insurance antitrust exemption the EXCHANGE/S being proposed in the current health care reform bill is/are pretty much useless.  The health insurance industry will still be able to price fix and collude within the EXCHANGE thereby setting premium prices among themselves and preventing consumers from receiving real choice and competition.

I apologize for the hiccup with the site in the last 36 hours.  Major issues with host company.  This post is actually a day late due to administrative difficulties.

An outline of the President’s health care plan:

From the White House Blog

The proposal will make health care more affordable, make health insurers more accountable, expand health coverage to all Americans, and make the health system sustainable, stabilizing family budgets, the Federal budget, and the economy: 

• It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today.  This helps over 31 million Americans afford health care who do not get it today – and makes coverage more affordable for many more. 
• It sets up a new competitive health insurance market giving tens of millions of Americans the exact same insurance choices that members of Congress will have.  
• It brings greater accountability to health care by laying out commonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of care.  
• It will end discrimination against Americans with pre-existing conditions.
• It puts our budget and economy on a more stable path by reducing the deficit by $100 billion over the next ten years – and about $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.

In this writers opin

The majority of Americans want a public option so why is the the Senate determined not to give the public what it wants?  Especially when it makes good fiscal sense, given the recent premium rate hikes of 39% CA and a proposed 54% in Michigan by Big Insurance, to do so?  Senators and House members should take note of Rep. Tom Perriello’s example.  Perriello is a Congressman in the very red fifth district in Virginia yet he voted his conscience when he voted in favor of including the public option in health care reform.  After doing so he stated that he is willing to lose an election in the name of  standing up for what he truly believes is best for his constituents and the nation.  The result?  At a time when many incumbents are retiring or are running a very weak reelection campaign Rep. Tom Perriello is tied or leading all the Republican candidates in his very red and conservative district.  As voters we want strong leaders who stand up for what they believe in and do not sway as a result of an election loss in a state thousands of miles away.  Voters do not vote for Democrats so that they will act like Republicans they vote for Republicans to be Republicans.  One Senator who should really take note of this is Sen. Blanche Lincoln of Arkansas.  When Arkansians want a Republican senator they will not reelect a pseudo Republican senator.  Therefore, pandering to the right does nothing more than expose such Senators as weak and willing to compromise their principles if it means getting reelected.  Think about it.

We need an effective method of cost control in the health care reform bill and requiring an 85 percent medical loss ratio is not enough because Big Insurance will develop a new way of defining medical care.  In other words, the insurance industry will find a way around the regulations similar to the way the credit card industry is doing to circumvent credit card company regulations.  The only effective method of cost control for Big Insurance is to provide a public option to compete with it head to head.

The Senators below have signed a letter to Leader Harry Reid requesting a vote on the public option through reconciliation:

Barbara Boxer (D-CA); Diane Feinstein (D-CA); Frank Lautenberg (D-NJ); Bar;bara Mikulski (D-MD); Jack Reed (D-RI); Bernie Sanders (I-VT); Chuck Schumer (D-NY) Jeanne Shaheen (D-NH); Tom Udall (D-NM); Michael Bennet (D-CO); Sherrod Brown (D-OH); Al Franken (D-MN); Kirsten Gillibrand (D-NY); John Kerry (D-MA); Patrick Leahy (D-VT); Jeff Merkley (D-OR); Sheldon Whitehouse (D-RI); Arlen Specter (D-PA); Sen. Tim Johnson (D-SD); Sen. Robert Menendez (D-NJ); Debbie Stabenow (D-MI); Sen. Daniel Inouye (D-HI); Dick Durbin (D-IL); Patty Murray (D-WA); Jeff Bingaman (D-NM); Amy Klobuchar (D-MN); Ben Cardin (D-MD); Ron Wyden (D-OR); Mark Udall (D-CO); Bob Casey (D-PA); Ted Kaufman (D-DE); Maria Cantwell (D-WA); Christopher Dodd (D-CT); Sen. Daniel Akaka (D-HI); Sen. Harry Reid(D- NV); Sen. Jon Tester (D-MT); Sen. Byron Dorgan (D-ND); Sen. Russell Feingold (D-WI); Sen. Carl Levin (D-MI); Sen. Bill Nelson (D-FL)

The following Senators have not yet signed the letter….please call them and tell them to support the public option through reconciliation.  Senate phone numbers and contact info.

Sen. Daniel Akaka HI
Sen. Max Baucus MT
Sen. Evan Bayh IN
Sen. Mark Begich AK
Sen. Jeff Bingaman NM
Sen. Robert Byrd WV
Sen. Maria Cantwell WA
Sen. Ben Cardin MD (Supporter)
Sen. Thomas Carper DE
Sen. Robert Casey PA
Sen. Kent Conrad ND
Sen. Christopher Dodd CT
Sen. Byron Dorgan ND
Sen. Richard Durbin IL
Sen. Russell Feingold WI (Supporter)
Sen. Kay Hagan NC
Sen. Tom Harkin IA
Sen. Daniel Inouye HI
Sen. Tim Johnson SD
Sen. Ted Kaufman DE
Sen. Amy Klobuchar MN (Supporter)
Sen. Herb Kohl WI
Sen. Mary Landrieu LA
Sen. Carl Levin MI (Supporter)
Sen. Blanche Lincoln AR
Sen. Claire McCaskill MO
Sen. Robert Menendez NJ  
Sen. Patty Murray WA
Sen. Bill Nelson FL
Sen. Ben Nelson NE
Sen. Mark Pryor AR
Sen. Harry Reid NV
Sen. John Rockefeller WV
Sen. Arlen Specter PA
Sen. Debbie Stabenow MI
Sen. Jon Tester MT
Sen. Mark Udall CO
Sen. Mark Warner VA
Sen. James Webb VA
Sen. Ron Wyden OR

Congressman Tom Perriello (VA-5th) and Betsy Markey (CO-4th) will propose legislation next week stripping the health insurance industry of its anti-trust exemption.  Bravo Rep. Perriello and Markey for your continued fight on behalf of the American people.  See excerpt of press release below.

The measure would end special treatment for the insurance industry that allows them to fix prices, collude with each other, and set their own markets without fear of being investigated. Removing this exemption has been a common priority of these two freshmen lawmakers, though they voted differently on the initial House health care reform bill.    

“It’s time for Washington to decide whether we stand with patients or profiteering, whether we believe in market competition or a collusion between politicians and insurance monopolies. It’s time to end the monopoly protections that Washington has protected for decades as prices skyrocketed. It’s time for a simple, clean bill – no carve-outs or special deals – that forces insurance companies to compete. It’s time to put patients and cost relief first,” said Rep. Perriello. “Americans deserve to know who stands with them against the price gouging of middle-class and working-class folks. Today, we do.”

“I’ve heard from tens of thousands of Coloradans across my district, and though people’s opinions may vary, the common message is clear: the current health care system is crushing our families and businesses,” said Rep. Markey. “Support for removing this unfair exemption cuts across party lines, and is a major piece of common ground that I’ve been working toward in our country’s health care debate. This is about bringing sorely-needed competition back into an industry that has for too long wielded monopoly control over hard-working American families.”

This is why we send people to Washington, DC to focus on our interest and not their re-election.

House Speaker Nancy Pelosi explains how to get stuff done when obstacles exist.  In this instance she is speaking of health care.

“You go through the gate. If the gate’s closed, you go over the fence. If the fence is too high, we’ll pole vault in. If that doesn’t work, we’ll parachute in. But we’re going to get health care reform passed for the American people.”

Though Sen. Harry Reid semed to think that Democrats had plenty of time to get health care reform passed before they lost the 60th vote in the Senate, he similarly thinks that they have time to get  health care reform passed with the 58 majority that Democrats currently enjoy.  It is this kind of thinking that is the reason health care reform has been dragged out for a year.  It is urgent that we get reform passed as soon as possible.  The House Speaker explains the path to making it happen:

“There is a path” to getting it done. It’s “majority rule” to fix the bill and to pass both and send to President Obama.

Its on you Harry.  Pass a House drafted reconciliation fix to the current Senate bill with a simple majority (making Leiberman, Nelson, Lincoln, Baucus, and Conrad irrelevant) and send it along with the Senate bill to the President for signatures.  Do not sqaunder this time away because soon Dems will be frozen in the full heat of midterm elections.

A recent poll conducted in several battleground states were freshman House members may be vulnerable in 2010 demonstrates that the consituents in such districts want more change.  Do you know what else they want??  A PUBLIC OPTION!!!!!!!  Are you listening House and Senate???  Research 2000 conducted telephone interviews with 2000  likely voters in swing districts in Virginia, Colorado, Florida, Michigan, North Carolina, New Mexico, and Ohio.  The result:  Democrats and Independents want a public option in this Health Care Reform bill.

Sen. Blanche Lincoln (D-AK) seems determined to make her reelection campaign as difficult as possible and alienating the majority of the Democratic party in the process.  Take a look at her lates regarding passing health care reform:

In a sign of how hard it is for Democrats to regroup on major health care legislation, two centrist Democratic senators said on Tuesday that they would oppose efforts to muscle through a bill using a procedural tactic called budget reconciliation.

Senator Blanche Lincoln, Democrat of Arkansas, who is in a tough race for re-election this year, said, “I am opposed to and will fight against any attempts to push through changes to the Senate health insurance reform legislation by using budget reconciliation tactics that would allow the Senate to pass a package of changes to our original bill with 51 votes.”

the Senate majority leader Harry Reid (D-NV) cannot lead all the Senate Democrats to the the promise land. Senate minority leader Mitch McConnell (R-KY) has managed to get every Republican Senator including Snowe and Collins (GOP moderates) to obstruct almost every single piece of legislation that the Democrats have proposed yet Senator Reid has not managed to obtain a similar result from Democratic senators. Lets take the health care bill for instance. Conservadems have managed to draw out the debate and negotiation process of health care reform to such an extent that it has resulted in the squandering of most of the valuable political capital that blew them into office with an super majority in 2008. We heard about how haaaaard Baucus worked to get Republicans on board only to find out later that the GOP had already agreed to act as a pact in opposing anything and everything put forward by the Democrats. Even after that the Conservadems Lincoln, Nelson, Conrad, and Landreiu continued to delay by opposing such popular aspects of the bill as the public option there was still a way to get the health care bill through in December.

Now we have an opportunity to pass health care reform by the House drafting an amendment bill  through reconciliation with all the changes negotiated by the House and Senate in December before Scott Brown won Massachusetts.  The reconciliation bill  can then be sent to the Senate were it will pass.  After the House reconciliation bill is passed through the Senate the House then passes the Senate HCR bill “as is.”   Both the Senate bill “as is” and the reconciliation bill is then sent to the President for his signature.  The President then signs the Senate bill first and then the amendment/reconciliation to the Senate bill in that order.  Health care reform ACCOMPLISHED!  Passed and fixed in a matter of minutes.  Senators and House members please follow David Plouffe’s advice and just GET IT DONE!

Rush Limbaugh has officially amazed me by his ability to turn the worst human suffering into an opportunity to make a buck.  His comments yesterday using the Haitian tragedy as an occasion to politicize a drastic situation and shock folks into tuning in to his radio show is reprehensible.  But it got me thinking, what wouldn’t Rush Limbaugh do for money.  For example, would Rush Limbaugh stage a fake health condition in the state where the President just happened to be spending the holidays in order to boost his ratings.  My answer:  Yes.

Think about it.  Limbaugh insisted on being taking out of the hotel in a private elevator out of sight of other guests.  Not long after getting to the hospital his handlers released a statement via his website stating that all updates on his condition would be posted on such site (increased web traffic…kaching, kaching).  Then it turns out that all the drama was for nothing and he was perfectly fine.  He then holds a press conference attempting to bash health care reform but fails miserably. First, because Hawaii mandates that all employers provide generous health care plans for every employee who works 20 hours or more per week.  Second, Hawaii consistently outperforms almost all other states in terms of health care access, quality, and costs.  Third, emergency hospital care is not health care.  Fourth, you’re the 400 million dollar man no one questions that you would receive quality health care.

But I digress.  All of these coincidences are just a wee bit too convenient especially when it comes to Limbaugh.  If it was a publicity stunt it was an unsuccessful one given that he was barely in the news for a day.  Perhaps the stunt would have worked better if the President had spent the holidays somewhere like Texas where tort reform has resulted in its ranking as one of the worst states for health care access, quality, and costs in the nation.  Chest pains in Texas may be a bit more believable.

There are serious negotiations going on between the White House and Nancy Pelosi concerning the health care reform bill and how to pay for it.  The White House prefers the excise tax on Cadillac health insurance plans while Nancy Pelosi and the House prefers a tax on the highest earning Americans.

[A]ides say she’s particularly steamed that the White House wants her to largely adopt the Senate bill in its entirety. And she’s particularly unhappy that the White House has thrown its weight behind the Senate bill’s chief funding mechanism: an excise tax on so-called “Cadillac” insurance policies, which she and many in her caucus have long believed violates President Obama’s pledge not to raise taxes on the middle class. According to one aide, that–not the public option–was likely the reason she ribbed Obama at her press conference yesterday, quipping, “there were a number of things he was for on the campaign trail.”

The House proposes paying for its bill by imposing a surtax on high-income Americans. And though there’s been speculation for months that the final reform package will include a combination of both sources of revenue, Pelosi, who’s already had to accept the demise of the public option, wants the excise tax gone.

After the sit down yesterday with House members,  President Obama agreed to strengthen the affordability portions of  the final version of the health care bill.

The Senate held the final vote needed to pass the health care bill or H.R. 3590.  The vote was 60 - 39 .  The total cost of the bill is $871 billion.  Democrats with Vice President Biden presiding over the Senate passed the bill along party lines as expected.  All Senators voted from their seats in the Senate.  There were a couple moments of levity when Sen. Reid of Nevada was asked for his vote Reid gave an exasperated gesture that indicated of course and the entire Senate broke into laughter as if there was a chance that the Leader would vote anything other than “Aye” or yes.  Also, Bernie Sanders of Vermont gave a very enthusiastic “AYE” sending the Senate into laughter a second time. 

Now they go to conference and hopefully this bill will be drastically improved.   Right now the bill does not make health insurance affordable and that needs major adjustmances that will hopefully be accomplished during reconciliation.  Three major points of contention: 1) public option 2) removal of the antitrust exemption enjoyed by the insurance industry 3) an immediate implementation date.

The insurance industry is already finding loopholes that it can exploit in the Senate health care reform bill.  First thing up:  Medical Loss Ratios or MLRs.  The MLR is the “loss” by insurance companies attributed to providing actual medical care to premium holders.  Imagine that, the insurance industry considers it a “loss” when it actually has to pay for the medical care that the premium holder receives.  You know when a policyholder uses the ”insurance” that he/she paid for.  What’s wrong with that picture.  The current MLR currently reported by some insurance companies can be as low as 60 percent which means that it only pays 60 percent of the policy holder’s premium for the medical care he/she receives.  So that equals 40 percent of your premium dollars is going to executive salaries and administrative cost.  Most insurance companies MLRs, at least those that share such info, are between 60 and 80 percent.  The proposed MLR in the Senate bill would raise the number from 80 to 85 percent.  Take a look at what was reported by Smart Money:

The Senate bill would impose a “medical loss ratio” of 80% to 85%, depending on the market segment, meaning insurers would have to spend 80 to 85 cents of each dollar they collect from plan members to provide health care. Carl McDonald, a health care analyst with Oppenheimer & Co., an investment bank, wrote in a note to clients Monday that the number was “workable” for insurers, especially if they can label certain items that count as corporate expenses for accounting purposes as health care for purposes of meeting the spending minimum.

Even though the MLR was put in to address the cost containment issue the insurance industry has already figured a way around it by recategorizing its administration expenses (executive salaries) as “medical care.”  Wendell Potter, former Cigna executive, reported that the insurance industry knows that it can manipulate the numbers simply by defining  administrative costs and categorizing certain expenses as medical care.  This is why Congress must include a provision in the bill that will prevent the insurance industry from implementing a work around the reform provision simply by giving such administrative expenses another name.  There must be transparency by the insurance industry with respect to expenses categorized as “medical care.”  The provision must have teeth by way of an enforcement mechanism.  Who is the regulatory body that will be in charge of this aspect of the health care reform bill.  There must be a heavy enforcement provision that explicitely defines what is “medical care.”  There must also be exclusions as to what is not considered “medical care.”

Smart Money also identifies why the insurance industry is so thrilled with this bill:

Insurer shares, in particular, are zooming. There are three reasons. First, stripped from the Senate bill is the so-called public option — a government health plan that threatened to undersell private insurers. Second, a proposed $6.7 billion industry tax is now likely to be phased in only gradually beginning in 2011, which should give health plans enough time to raise prices accordingly. Third, individuals will be required to purchase insurance — a fine deal for insurance sellers — although critics say the penalties for noncompliance are weak, suggesting many individuals will prefer to remain uninsured.

Further how does this prevent the insurance industry from increasing its profits and paying the 6.7 billion industry tax by raising premium rates.  The 6.7 billion tax should be another exclusion listed under what is not “medical care.”  The American people should not be punished for the sins of the insurance industry.  Providing the insurance industry with an incentive by allowing it to arbitrarily raise premium prices because it will receive 15 or 20 percent of a larger premium amount does not effectively address the continued rising cost of  premiums, e.g. health insurance. This needs to be fixed.  We NEED a PUBLIC OPTION!

Congressman John Conyers reminds the Senate how Congress works.

Without material changes, this legislation will be reform in name only.

snip

Lastly, I am troubled that some Senators believe that the House must accept the majority of the concessions embodied in this Senate bill. My message to the these Senators is this: Just as it took compromise to pass your bill last night, so now will it require additional compromise to successfully reconcile your legislation with the House. The Constitution established a bicameral legislature so that neither body would dominate the other.

Conyers complete statement:

“Last night’s vote in the Senate should be applauded for what it was: an affirmative statement by that body that comprehensive health care reform legislation should not be held captive any longer by a select few.” “As this legislation moves towards its constitutionally mandated reconciliation with the House of Representatives, I also want to make it clear that, in my mind, this bill does not adequately address many of the problems that plague our current system.  Without material changes, this legislation will be reform in name only.”

“In order to pass the House of Representatives, a final health care bill must provide universal affordability and competition to the American people.  Additionally, it should be financed by those with the ability to pay and not by working class Americans lucky enough to receive quality health coverage through their employers.”

“I supported the House bill because it included serious provisions aimed at helping individuals who currently cannot afford to purchase health care by providing subsidies and expanding Medicaid to 150 percent of the Federal Poverty Level.  The Senate bill passed last night does not ensure this same level of affordability; there are fewer subsidies and the expansion of Medicaid is not as extensive.”

“Similarly, I supported the House bill because I believe that it is immoral to continue to allow the private health insurance industry to operate without any real checks on its ability to charge unaffordable premiums and deny needed care.  That is why I believe competition, as provided through a national Medicare-like public health insurance option and the repeal of the industry’s antitrust exemption, is a necessary component of true reform.”

“The sole remaining ‘competition’ provision that remains in the Senate’s bill is woefully insufficient.  These multi-state non-profit plans run by the Office of Personnel Management will not be transparent; they will not have a built in network of doctors; they will not allow us to move away from the wasteful fee-for-service system that inflates costs; and they will not attract a risk pool big enough to create real savings and efficiencies for consumers.”

“The American people have already experienced private non-profit health insurance.  It hasn’t worked in the past and there’s no reason to think it’s the answer now.  Relying on private insurers to police other private insurers is like asking the fox to guard the hen house.”

“Additionally, the excise tax levied on certain “Cadillac”employer-based health care plans in the Senate legislation must be altered.  For years, many workers chose to forgo wage increases in exchange for helping their employers offer comprehensive health care plans.  The Senate’s efforts to tax these plans will hurt working families and they contradict the President’s pledge that individuals who like the health coverage they have will be able to keep it.  I strongly support the House’s approach to financing health care: an excise tax on the incomes of extremely wealthy Americans.”

“I look forward to working with the Senate and House Leadership to ensure that the final health care bill address these core principles of affordability, competition, and progressive financing.”

“Lastly, I am troubled that some Senators believe that the House must accept the majority of the concessions embodied in this Senate bill. My message to the these Senators is this: Just as it took compromise to pass your bill last night, so now will it require additional compromise to successfully reconcile your legislation with the House. The Constitution established a bicameral legislature so that neither body would dominate the other.

Lets listen to Sen. Obama:

OBAMA: Let’s break down what she really means by a mandate. What’s meant by a mandate is that the government is forcing people to buy health insurance and so she’s suggesting a parent is not going to buy health insurance for themselves if they can afford it. Now, my belief is that most parents will choose to get health care for themselves and we make it affordable.

Here’s the concern. If you haven’t made it affordable, how are you going to enforce a mandate. I mean, if a mandate was the solution, we can try that to solve homelessness by mandating everybody to buy a house. The reason they don’t buy a house is they don’t have the money. And so, our focus has been on reducing costs, making it available. I am confident if people have a chance to buy high-quality health care that is affordable, they will do so. That’s what our plan does and nobody disputes that.

Yes Mr. President that is correct.  Mandating Americans buy insurance as a way to solve the health care crisis does not make sense.  The reason that most folks don’t buy insurance is because they can’t afford it.  So is the reason that the Senate is mandating that Americans buy insurance because it can’t make insurance affordable?  And to your question Mr. President…if you have not made insurance affordable how are you going to enforce a mandate?

Wendell Potter, a former top executive at Cigna, says that the only winners in the Senate Health Care Reform bill are CEO’s and executives of the insurance industry.  So far two people that I trust, Dr. Howard Dean and Wendell Potter, says that the bill is not worth passing.  And attempting to discredit Dean who has been the biggest cheerleader in this fight misses the mark.  Dean and Potter have proven themselves trustworthy in the eyes of most supporters of health care reform and such supporters will not be persuaded to ignore their advice because Capitol Hill and the White House are upset that they are speaking truth to power instead of towing the party line.   The American people are not stupid.  We see for ourselves the ineffectiveness of this bill to reform.

Take a look of what prizes the insurance industry will receive if the bill as written is passed. 

Gets for Insurance company

• Repeal of Antitrust exemption language removed
• Inurance companies can sell insurance across state lines therefore allowing them to gravitate to states with weak consumer protection laws resulting in Americans paying higher premiums for less insurance
• Big Insurance can now charge older people four times the premiums of young people
• Consumers charged a premium rate of fifty percent more if he/she has a “preexisting condition” as defined by Big Insurance ie. high blood pressure, high cholesterol reading
• Annual limits alive and well and millions of Americans still risk bankruptcy if they hit the arbitrary health care limit set by Big Insurance
• A law that forces families, through an income tax hike, to pay 17 percent of their annual income for “noninsurance” that will enrich Big Insurance even more.  The number goes up to 22 percent if someone in the family is chronically ill.
• Big Insurance paid government subsidies to the tune of $450 billion over ten years for Americans who cannot afford the new tax or skyrocketing premium prices set by Big Insurance

Someone really needs to explain to me why this bill is a good idea as currently written.  Mr. President??  Please answer Dr. Dean’s question…is this more about getting votes to pass something than it is about reforming healthcare?  From the look of all the concessions made to Big Insurance it looks a whole lot like the former.

Health-care bill wouldn’t bring real reform  

Thursday, December 17, 2009

If I were a senator, I would not vote for the current health-care bill. Any measure that expands private insurers’ monopoly over health care and transfers millions of taxpayer dollars to private corporations is not real health-care reform. Real reform would insert competition into insurance markets, force insurers to cut unnecessary administrative expenses and spend health-care dollars caring for people. Real reform would significantly lower costs, improve the delivery of health care and give all Americans a meaningful choice of coverage. The current Senate bill accomplishes none of these.

Real health-care reform is supposed to eliminate discrimination based on preexisting conditions. But the legislation allows insurance companies to charge older Americans up to three times as much as younger Americans, pricing them out of coverage. The bill was supposed to give Americans choices about what kind of system they wanted to enroll in. Instead, it fines Americans if they do not sign up with an insurance company, which may take up to 30 percent of your premium dollars and spend it on CEO salaries — in the range of $20 million a year — and on return on equity for the company’s shareholders. Few Americans will see any benefit until 2014, by which time premiums are likely to have doubled. In short, the winners in this bill are insurance companies; the American taxpayer is about to be fleeced with a bailout in a situation that dwarfs even what happened at AIG.

From the very beginning of this debate, progressives have argued that a public option or a Medicare buy-in would restore competition and hold the private health insurance industry accountable. Progressives understood that a public plan would give Americans real choices about what kind of system they wanted to be in and how they wanted to spend their money. Yet Washington has decided, once again, that the American people cannot be trusted to choose for themselves. Your money goes to insurers, whether or not you want it to.

To be clear, I’m not giving up on health-care reform. The legislation does have some good points, such as expanding Medicaid and permanently increasing the federal government’s contribution to it. It invests critical dollars in public health, wellness and prevention programs; extends the life of the Medicare trust fund; and allows young Americans to stay on their parents’ health-care plans until they turn 27. Small businesses struggling with rising health-care costs will receive a tax credit, and primary-care physicians will see increases in their Medicare and Medicaid reimbursement rates.

Improvements can still be made in the Senate, and I hope that Senate Democrats will work on this bill as it moves to conference. If lawmakers are interested in ensuring that government affordability credits are spent on health-care benefits rather than insurers’ salaries, they need to require state-based exchanges, which act as prudent purchasers and select only the most efficient insurers. Sen. John Kerry (D-Mass.) offered this amendment during the Finance Committee markup, and Democrats should include it in the final legislation. A stripped-down version of the current bill that included these provisions would be worth passing.

In Washington, when major bills near final passage, an inside-the-Beltway mentality takes hold. Any bill becomes a victory. Clear thinking is thrown out the window for political calculus. In the heat of battle, decisions are being made that set an irreversible course for how future health reform is done. The result is legislation that has been crafted to get votes, not to reform health care.

I have worked for health-care reform all my political life. In my home state of Vermont, we have accomplished universal health care for children younger than 18 and real insurance reform — which not only bans discrimination against preexisting conditions but also prevents insurers from charging outrageous sums for policies as a way of keeping out high-risk people. I know health reform when I see it, and there isn’t much left in the Senate bill. I reluctantly conclude that, as it stands, this bill would do more harm than good to the future of America.

The writer is a former chairman of the Democratic National Committee and was governor of Vermont from 1991 to 2002.