Why the Current Bills Don't Solve Our Health Care Crisis

Co-authored with Rose Ann DeMoro, executive director, California Nurses Association/National Nurses Organizing Committee

Now we know why they've stopped calling this health care reform, and started calling it insurance reform. The current bills advancing in Congress look more like rearranging the deck chairs on the insurance Titanic than actually ending our long health care nightmare.

Some laudable elements are in various versions of the bills, especially expanding Medicaid, cutting the private insurance-padding waste of Medicare Advantage, and limiting the ability of the insurance giants to ban and dump people who have been or who ever will be sick.

But, overall, the leading bills and the President's proposal are, like the dog that didn't bark, more notable for what is missing.

Here are 13 problems with the current health care bills (partial list):

1. No cost controls on insurance companies. The coming sharp increases in premiums, deductibles, co-pays, co-insurance, etc. will quickly outpace any projected protections from caps on out-of-pocket costs.

2. Insurance companies will continue to be able to use marketing techniques to cherry-pick healthier, less costly enrollees.

3. No restrictions on insurance denials of care that insurers don't want to pay for. In case you missed it, the California Nurses Association/National Nurses Organizing Committee uncovered data on the California Department of Managed Care website recently that found six of the biggest California insurers rejected, on annual average, more than one-fifth of all claims every year since 2002.

4. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas, where one or two companies dominate, severely limiting choice and competition.

5. A massive government bailout for the insurance industry through the combination of the individual mandate requiring everyone not covered to buy insurance, public subsidies which go for buying insurance, no regulation on what insurers can charge, and no restrictions on their ability to decide what claims to pay.

6. No controls on drug prices. The White House deal with Big Pharma, which won bipartisan approval in the Senate Finance Committee, opposes the use of government leverage to negotiate real cost controls on inflated drug prices.

7. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay.

8. Tax on comprehensive insurance plans. That will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of bare-bones, high-deductible plans, and lead to more self-rationing of care and medical bankruptcies.

9. Not universal. Some people will remain uncovered, including those exempted, and undocumented workers, denying them treatment, exposing everyone to communicable diseases and inflating health care costs.

10. No definition of covered benefits.

11. No protection for our public safety net. Public hospitals and clinics will continue to be under-funded and a dumping ground for those the private system doesn't want. Public monies going to hospitals serving low-income communities will be shifted to subsidies for private insurance.

12. Long delay in implementation. Many reforms don't go into effect until 2013.

13. Nothing changes in basic structure of the system; health care remains a privilege, not a right.

We may be slow learners, but the rest of the industrial world has figured it out: Universal, single-payer or national health care systems. That's the reason why all those other countries cover everyone, have better patient outcomes, cause no one to declare bankruptcy or lose their homes because of medical bills, and spend less than half per capita on health care than we do.

We could do it too, by reducing the starting age for Medicare from 65 to 0. There's still time to act.

Call on your Congress member to support the vote coming up on the House floor on the Anthony Weiner amendment to protect, expand and improve Medicare for All. Senators have the same opportunity in a vote on Senate bill 703, being offered as a floor amendment by Senator Bernie Sanders.

Democrats must also ensure that whatever bill passes includes a provision enabling states to set up their own single-payer systems. These votes are the true litmus tests of the Democrats' commitment to guaranteeing health care for all, and finally solving our health care crisis.

 

 

Comments

[Bodryn]

We do know that over 70% of Americans want single payer - if we can't get it, I guess we realize what that means: We do NOT live in a democracy. We have to face the facts, and they aren't pretty. America, I hardly recognize you anymore.

[Fastdrum]

Why don't we who elected Obama (for healthcare reform among other things) all chip in paying $10 a month each, for a fund to pay a lobbying firm (that outspends health industry lobbying) that lobbies politicians bribery included – let's fight fire with fire – Max Bachus got $150M to water down the bill, we pay him $200M to thicken it back up, dude will be richer than in his wildest dreams!! So we can out muscle the dozen or so corporations out there who want to rip us off when it comes to law-making­/reforming­.
The people's lobby!!

[snesich]

The Democrats are going to face "A Perfect Storm" if what finally emerges and gets signed by President Obama is a bill that forces us to buy the awful policies of the insurance companies, and allows them to operate exactly like they've been doing, with the slight change that they'll now have to accept everyone, regardless of health condition.

The insurance companies will just pass on that cost in higher premiums. They will continue to deny treatment and refuse to pay our claims and then dare us to challenge them in court, where they know that their sharp lawyer sharks will eat us alive.

The Democrats need to understand: "Health Care Reform" isn't just forcing us to buy policies from these companies; it has to be much, much more.

And it it's not, they should anticipate losing Congress in 2010 and the White House in 2012.

[fubar1491]

snesich--I agree with you 100% and we must, must have a public option to keep the private insurers from "price fixing". Also, I wonder if we can get a grass roots movement to have the floor debates on the health care bill(s) televised. The politicians have televised the Supreme Court Justice confirmation hearings, and others. This would give the American people an idea of how their representatives are representing them, and in addition, show how ridiculous some of these buffoons really are. I'm going to be talking it up whenever and wherever I can.

[Alabama John]

HEALTH OPTION ---- Bill 101

(1) As over 95% of illness is caused by a diet rich in fats, 50% fats being the average American diet, foods high in fats shall be taxed sufficient to repay the government for the damage it causes to our national economy.

(2) Healthcare paid by taxes shall be given to the poor, and to all with a blood test showing a low fats diet.

(3) Those with a blood test showing high levels of fats, they shall pay the medical expenses required to repair the damage caused by eating such unhealthy food.

----------­----------­----------­----------­----------­----------­----------­----------­----------­----------­-----

Note: In 30 years raised a family of five on a diet with 10% of calories fats, and not one penny on doctor bills. As a lifestyle educator everyone I helped had the same results.

DIET: For breakfast fresh fruit over oatmeal. For dinner a stew of beans, brown rice, vegetables, and salad

If you eat meat go low fats. No dairy products please.

[snesich]

No lunch? You might be right, buddy, from a strictly nutritional standpoint. But there has to be a balance between "All Fast Food All of the Time" and "For breakfast fresh fruit over oatmeal. For dinner a stew of beans, brown rice, vegetables, and salad."

If there were more cheap and convenient eateries offering beans, brown rice, veggies, salads, etc, a lot more of us would eat there. But burgers, fries and pizzas taste better to most people, cost a lot less, and are located everywhere---and open very late.

Nutrition is a big part of our health, no doubt. But Canadians, Europeans and Asians are eating those foods as well and they have much, much, much better health care delivery than we citizens of the USA.

[iblogleft]

I am ready to march on Washington to kill this bill and demand single payer, or a public profit option for everyone.

I am afraid if we help this bill forward, we will not get a robust insurance option to make insurance compete, and we will have mandated private insurance payments.

What do you folks think? Should we kill this bill if the President does not stand up for us and demand a robust public option? I think it may be time to threaten it, and ask the President to finally stand for something.

[emilyringstrom]

It's really not your president not standing up for your rights, but all the senators, governors, pundits, no-nothings like Palin and the likes of her, that has ruined your chances of having what you should be able to take for granted.
I think the current bill, is a better-tha­n-nothing-­kind-of-bi­ll, but will certainly not do much, to actually change what needs to be changed.
Sometimes people taking to the streets, and actually demanding change, is the only thing that works.Perhaps there needs to be a referendum of some sorts, and thus the American people would be able to decide for themselves, without special interests standing in the way of progress.

[mdlw]

At 32, I became disabled and filed for SSDI benefits. I went 2+/yrs without income/insurance after short term disability expired. SSA approved my claim and Medicare paid all medical expenses retroactive to onset of the disability. A while later, I tried unsuccessfully to return to work. Thirteen years later, I tried again but 8/mos later I quit and underwent surgery.

After surgery, I went back to work and later accepted a position at a large corporation. I worked there for 3+/yrs before I began having problems. I asked for an ergonomics workstation evaluation or a transfer. No transfer was available and no such evaluation provided. Problems continued to escalate until I finally underwent surgery. I returned to work but 4/mos later pain management provided no relief. My doctor took me off work permanently. After resigning, I pulled out 401k/pension plans monies. I filed for SSDI again, and began paying $396/mo Cobra. My monies ran out, I moved into my brother's home with family paying Cobra which I dropped 2/mos before its expiration. SSDI was approved after 19/mos; Medicare after 29/mos (not retroactive).

I became unable to work twice; without an income/insurance after short term disability expired twice; paid for long term disability twice, but denied such benefits twice. Luckily, my kids were grown the second time around. Laws written with loopholes protect corporations, not the intended beneficiary.

A single payer Medicare plan would have prevented the hardships I experienced.

[iblogleft]

I sincerely feel for you.

You almost have to have no arms, legs, teethe or nails to get SSDI these days, and it is horribly debilitating to those in need, and our society in general.

Many times the insurance people pay into, is only needed for short amounts of time, while they rehabilitate and adjust to illness, but our system creates disabilities that last lifetimes.

I am lucky enough to be disabled and not need benefits (that I payed into for 25 years) even though I am technically owed them. Millions are dying as we speak, simply because they lack the resources to hire the teams of lawyers and time required to receive the benefits they deserve. Too many people in need just give up, which puts huge burdens on the Medicaid system and states in general.

[nightwind928]

The new motto should be "GIVE ME HEALTH CARE OR GIVE ME DEATH"...because without proper health care that is the only real option for many of us at the grassroots level.

[Carl Caroli]

Bingo. The concept of health insurance in this day and age is preposterous, and we need to address it as health care to have a rational discussion. Insurance by definition, as in homeowners and auto, bank on the fact that most people wont have their house burn down or total their car, so they make a good profit over time and a broad base. With the cost of health care today, it's virtually guaranteed that all health insurance policy holders will grossly exceed their contributions at some point in time, and more often than not, sooner rather than later. We let insurance companies grow to broaden their geographic areas to spread risk and built monopolies which are now controlling our president and the rest of our so called elected officials with campaign contributions and lobbyists. Until we the people manage to have publicly funded elections, limit terms, and get the lobbyists out of Washington, we only elect those corporate America have chosen and funded. The problem is, we the people don't have a way to make that happen.

[GardenerNorCal]

No regulation on what insurers can charge, and no restrictions on their ability to decide what claims to pay.

No controls on drug prices. The White House deal with Big Pharma, which won bipartisan approval in the Senate Finance Committee, opposes the use of government leverage to negotiate real cost controls on inflated drug prices.

No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay.

No controls on drug prices. The White House deal with Big Pharma, which won bipartisan approval in the Senate Finance Committee, opposes the use of government leverage to negotiate real cost controls on inflated drug prices.

No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay.

Where exactly is the reform? The fact that I will be forced to shell out money for nothing?

[RRoadrunner]

What will the public option cost us?

I am an ardent supporter of the PO. After watching Michael Moore's new movie it made me wonder what will this really mean for us? We all know money talks in Washington and our voices are drowned out. I for one would like to know what is this going to cost the tax payer, who is going to be covered by the PO and who is going to benefit (besides the insurance industry and the pharmas) and by how much? When a politician says no one will be denied coverage, what do they mean and what will the premiums be? When they say coverage for all, who is the all. I hate to be cynical, but I am tired of being taken for a fool.

Micahel, as usual you are ahead of the herd.....

[GardenerNorCal]

Those are questions I ask. And when we don't even consider 12 million illegal aliens how can we pretend that we are even proposing providing care for all. And no one ever answers them.

[canarypapers]

For those genuinely wanting health care reform, rather than arguing back and forth on the blogs, follow the link Michael Moore provided in this article. Via this link, you can track down the names and contacts of your Representatives and Senators in Congress. Call them.

Call them and say this::::: I want you to cosponsor HR 676 and S. 703 and support the Weiner and Kucinich amendments for health reform.

If they ask you why, tell them that Medicare-for-all (from the cradle to the grave) is the only means to true universal health care. Period.

It's that simple. Debate is wonderful, but it does zilch toward urging our Representatives and Senators to do the right thing and vote on behalf of their constituents. As is, the insurance/pharma industries are winning this fight for no other reason than their millions speak more loudly than complacency and silence.

A voice is a tiny thing against such power, but enough voices do wield power. An absence of voice does nothing but aid and abet the cause of the insurance/pharma industries.Your choice for health care reform, thready as it is, begins and ends with that phone call to your Representa­tive/Senat­or.

[harleanc]

A Moveon.org member who organized a local healthcare rally told me that my state's senators report they only get 10 handwritten letters a month. A month! I have emailed or snail mailed them and my rep probably six times each on health care--the last missive from my sen. mentioned my previous missives. They must have a file on me alone. And when people complain to me about health care, I say, did you write your representatives? And they sheepishly say no, "But I'm glad you did."
Not good enough. EVERYONE can find the time to write a letter, just one, to each representative. There really are no excuses for letting someone else fight the battle for you.

[themainpoint]

As Michael pointed out in his best ever new film, the one thing that concerns the 1% who are busy greedily looting everything, is that the other 99% have votes. But as usual, the 1% is ten steps ahead and working on that, too. We've got to break down these monopolies that are forming:

From Commoncause.org:

Did you hear? Diebold is set to sell its voting machine division to Election Systems & Software – creating a company that would produce nearly THREE QUARTERS of our country's voting machine systems. (emphasis added b/c that is one company in control of 3/4 of the voting machines in the US!)

Please join us in calling on the Justice Department's Antitrust Division to investigate!

Tweet This Action!One company dominating the voting machine market means it will be more difficult for election officials to negotiate for voting systems on limited budgets, and raises serious concerns about reliability and election fraud issues.

Take action today!
http://www.commoncause.org/siteapps/advocacy/ActionItem.aspx?c=dkLNK1MQIwG&b=5459751

[Stephen-in-Seattle]

Voting machines can be tampered with.

Paper trail only vote casting is the only way to insure your vote is counted. Put these voting machine people out of business.

[themainpoint]

Absolutely agree. Just because the chad punch holes didn't work, was no excuse to put machines out there and get rid of paper ballots that each localilty counts. That's just throwing the baby out with the bathwater. Our entire voting history, we did just fine with local volunteers counting paper ballots. All we need to do is to get rid of the chad punch hole method (and now the machines) but keep the paper.

[jerabaub]

It is pathetic for some on the right to claim medicare is "broke".

The only reason medicare is running a deficit is because the amount of money the government deducts in fica taxes has not even remotely kept pace with the exponential rise in health care costs.

The fact that private health insurance premiums have risen so radically, and that these corporate interests have sloughed off onto their customers more and more of the costs of health care, is due partially to this exponential rise in health care costs.

Imagine how much we could have done on providing affordable health care for our own people had we not squandered over 2 trillion dollars on Iraq.

[baseline]

The bills so far make health care more complicated. We need something more simple like Single-payer Medicare For All.

[GardenerNorCal]

A national health care system. Each of us pays a certain percentage of income every year and we can walk into a clinic and hospital and not worry if we forgot to bring our purses or wallets, or sign a form saying we sign over our homes. Doctors and health care workers get paid a reasonable return and we no longer have to worry about constantly padding the pockets of insurance industry corporation.

[230AL]

Medicare for everyone.Let the others buy their cadillac plans.Take the insurance burden off employers.