The Health Care Lobby: Watch What They Do

A crisis that demands fundamental change. A president with a mandate to drive it. A Congress, controlled by Democrats, ready to act. Now comes the hard part - actually getting something real done.

These are salad days for Democratic lobbyists, because deep pocket interests - health insurance companies, Big Pharma, oil and gas and coal companies, the utilities and, of course, the banks - are buying them up to help harness the gale winds of change. Get ready to be dazzled - the strategies employed will reflect the imagination of Washington's most clever operators.

For example, the health care lobby has employed one basic theme in trying to stop health care: scare the hell out of Americans by decrying a "government takeover" of health care. But in the age of Obama, they want to be seen as part of the solution, not simply part of the problem.

So last week, the leading health care trade associations - -the lobbies for insurance companies, doctors, hospitals, drug companies, plus a union -- stood with the president to pledge dramatically to "do our part" to reduce the rate of soaring health care costs by 1.5% a year over the next decade, a promise that if fulfilled would save some $2 trillion from the cost of care. Not surprisingly, the president - eager to show that his efforts to give everyone a seat at the table were bearing fruit - was happy to hail that promise.

The lobbies got national coverage that their clients were for reform and would make a real contribution to it. This bolstered their argument that while regulation might be in order, we don't need a public plan like Medicare to provide a choice for businesses and individuals. Give us time to fulfill our promises (and for this reform moment to pass), they argue. If we fail, then consider a public plan (when the president may be less popular and the Congress more conservative). Word was Senator Grassley, a Republican Senator actually looking for bipartisan accord, thought that the argument made a lot of sense.

Outside the photo op, however, the reality was very different. A new report released today by Health Care for America Now, a leading citizens' coalition pushing for comprehensive health care reform, put the industry claims in sharp relief.

The HCAN report shows that after 400 mergers involving health insurers over the last 13 years, concentration has gone up in local markets across the country. The single largest provider of small group coverage (for small businesses, for example) controlled a median market share of 47% in 2008. The AMA says 94% of insurance markets in the US are highly concentrated.

The result, of course, is soaring prices - with premiums up, on average, more than 87% over the past six years. Profits at 10 of the country's largest publicly traded health insurance companies in 2007 rose from $2.4 to 12.9 billion (428%) from 2000 to 2007. The CEOs of these companies in 2007 alone collected an average compensation of $11.9 million each. Nice work if you can get it.

As then Senator Barack Obama said in September 2007, "These changes (mergers) were supposed to make the industry more efficient, but instead premiums have skyrocketed."

Insurers use their position to pass rising costs onto the insured. And, not surprisingly, Medicare does better. A recent study by University of California professor Jacob Hacker for the Institute for America's Future (which I co-direct) shows that from 1997 to 2006, private health insurance spending per enrollee grew at an annual rate of 7.3% while that of Medicare was at 4.6%, or more than one-third less.

The concentration of insurance markets and the lack of private competition provide compelling reasons for the Congress to establish a public plan like Medicare as an option for those seeking insurance. Give consumers a real choice. The public plan would provide both a benchmark for private plans and much needed competition in what are now perversely concentrated markets.

That certainly offers better hope for bringing down prices than the voluntary promises of the hospital, drug and insurance company lobbies, made without detailing how they would go about fulfilling those promises. (promises that many of them began to wiggle away from two days after the press conference when the TV lights were no longer on).

HCAN and other citizen groups are scrambling to counter the calumnies, claims and cash of the health insurance lobby - but of course, they can't match the industry's firepower. What they do have is the best moment for serious reform since the sixties when Johnson ushered Medicare into existence. And the possibility of rousing citizens to put their legislators on notice that they are paying attention, want real reform, and aren't going to be distracted by the health care lobby.

Comments

[elfNW]

I happen to be very worried about where health care reform is headed, and how it will all turn out in the end. Between the health insurance lobby dollars and influence, and the anticipated Republican attacks on any serious reform as a Democratic proposal to have the government “take over” everyone’s health care, it looks like the real rational and cost effective solution, a government run single payer plan, is already totally off the table.

Now Obama’s desire to reach across the political spectrum and try and build a consensus on major issues is like a breath of fresh air after eight years of a right wing ideologue in office, but in the end certain core principles should not be surrendered. There is a reason that the Democratic Party did so well in the last election. The public is ready for a real change in direction away from catering to big industry, the wealthy, and their lobbyists.

Depending on how any health care reform legislation looks in the end I may wind up wishing that if fails to pass. If it does not include an affordable government provided option for all then better to continue with our current system. The current system is bound to collapse in the end forcing a real reform. Anything else is just putting lipstick on the pig.

[GGuyleSmith]

With over 60% support for single payer in the polls, every sitting Congress person and Senator that won't support a bill including single payer could potentially face political extinction come the next election cycle. Any electable populist candidate on the right or left could use a combination of positive and attack ads to beat any incumbent who comes out against a single payer system.

Have you seen Rep. John Conyers' comments on YouTube?
http://www.youtube.com/watch?v=jVPt7j1jR4U

Go have a look and contact your Rep, Senator, and Obama now! Scare them into it. If they think they could lose an election over it, they drop the lobbyists like a hot rock.

[ntmessage]

Indeed!

Is not all of the tens of billions of dollars debate we are about to have on Health Care a fundamental root cause of the overall problem? None of this effort in lobbying or marketing dollars (which the media wants so they can remain in the tank) will end up getting to patients, doctors or nurses. Yet we are paying for it!

Health Care reform and getting all of the sales people out of the process, remove the massive amounts of marketing and administrators that just push paper only to deny coverage actually HELPS Doctors and Nurses of whom many feel that the industry is criminal in its current form.

For example, how many United Health Care ads (AARP in disguise) are on the news channels now, as well as those two-minute commercials for drugs you really do not need? They are trying to buy off the news media. And all the money is NOT going to patients is it?

In addition to the massive marketing dollars that never see the delivery of health acre, greedy middle players abound between the hands on delivery of health care to patients.

How did this get so amazingly inefficient and perverse?

Many are bankrupt due to Health Care and now this industry want to bankrupt the country. With the depression and Health Care inflation, we are on track to 20-25% of GDP. More than THREE TIMES what other nations pay and we get mediocre care as well.

Stop the insanity!

[progressiveconnie]

GOOD MORNING!!! MY FELLOW HOMO SAPIENS WHICH MEANS THE SPECIES WHO IS WISE.
Since the American people have been waiting for generations for a decent, efficient, humane, sane and fair health care plan for all Americans there is no doubt about it: IT IS TIME FOR IT TO HAPPEN!!!
Almost all the other countries on this planet cover all their citizens with a single payer health care plan because such a plan results in the most savings of tax payers dollars.
Here is how you get it to happen:
1 You pass a law that states that no federal employee can have a health care plan until all Americans have a health care plan since it is the American taxpayer that is paying for those federaL health care plans.
2 You totally eliminate those greedy, corrupt, barbaric, cruel and wasteful HMO'S and also that DRUG PLAN D SWINDLE BILL (AARP supported this swindle bill) and apply the l00 billion savings to all the presently uninsured Americans.
3 Anyone in the U.S. Congress who is taking HMO, INSURANCE CORPORATION OR PHARMACEUTICAL CAMPAIGN MONEY MUST STOP DOING SO and anyone in the U.S. Congress who refuses to support a single payer health care plan for all Americans will be working for the Robber Barons and getting paid for it and therefore must not be reelected.

[yulyyz]

For those interested, here are new and interesting posts on this subject:

http://www.open.salon.com/blog/kanuk/2009/05/21/lets_spread_the_risk_i_mean_health_care_not_flu

http://open.salon.com/blog/kanuk/2009/05/15/lets_compare_public_and_private_health_care_costs_eh

[Mixpixlix]

Well, start screaming and I don't mean on this board. Where is all the outrage! The media barely covered the explusion of Healthcare-now advocates for the committee hearing on healthcare.

Contact you local TV and newspapers, your civic and community organizations. TakeAction! What the heck happened to us. We're are the protests, the street marches, the calls to Congress.

I've done my part and have for 30 years. It's been a lonely vigil and I'm still without much company.

[BullMoose1]

I'm with you!

[verhaftik1]

Part II

Yet, there's plenty of evidence from socialized medicine that most preventative measures are better and much less expensive than this "after the fact" treatment we get in the US. For example, proprietary studies (those not released to the public) show that after 5 years on diabetes medicines, they are worthless. And, that simply losing 10+ pounds usually cures diabetes (DM II) altogether. Yet, in the U.S., people are urged to stay on drugs for decades while doctor's withhold, are oblivious to, or strongly downplay, the simple truth that weight loss alone is curative. Their MO is extreme profit, not efficacy or efficiency. Then again, it's the GOP's healthcare system, so no surprise there.

Also, healthcare does not want records digitized is because it gives them the excuse to rerun every test again, a set for every new practitioner the patient sees. And, it also manages to keep the billing costs per transaction artificially high. The farce of redundant testing is lost on the public because they don't know any better. It's time they educate themselves a bit and demand better. Yet how can they when the all healthcare professionals collude, leaving millions - except Congress, of course - to wallow in medical bankruptcy.

[verhaftik1]

Part III

It's really insulting that the current healthcare leaders are offering to reduce costs by 1.5% per year, when they could do that by digitizing billing or eliminating one useless test and/or prescription per patient. In fact, that 1.5% simply sounds like the cost savings they've already planned by digitizing insurance billing. A savings which won't impact profits. It's time to convene an independent panel of medical professionals - who won't try to protect their colleagues and who are truly pro-patient - who will advise Congress on the many tricks and suppressed (non-existent) research that has made for-profit healthcare such a bloated monster. (Exception: (plastic) surgeons.) No one finds it surreal that we are medically the most expensive, but still the sickest first world citizens on Earth....?

[verhaftik1]

You are not alone. I'm not sure why media downplays healthcare issues. Ignorance, boredom, a sense of futility?

I wish Americans would realize one thing: the US healthcare system is not about making people healthy. People in healthcare - MDs, nurses, nursing home staff, etc., for the most part view patients as a chore. Much like a plumber would view an overflowing toilet. However, if you are quite sick, at least they'll get their money's worth from you while you're there - by running tests, etc. If you are healthy/not sick, you're a waste of their time. (Hence, the required fee for just the visit. What a farce.)

The GOP will have us think this for-profit heath system is the best in the world. False. It is for-profit. Therefore, they will in no way help you or give you information on how to prevent your diseases, or fund research to help you be less sick as you age. They are simply waiting for your body to break down - and the faster the better.

Their appointments with you seek to maximize their profits, period. That's not a crime, that is good business, but what does that mean? That there is nobody, noone in government even, who does any meaningful research - million/bilion dollar research, like we see with cancer drugs - into wellness and nutrition, diabetes and cancer prevention (which is not the same as early treatment, early screening). And, that is how the AMA insists it stays.

[Alexander Hamilton]

On May 15, Alabama State Rep. Thomas Jackson (D-Thomasville) drafted a resolution condemning the entire scheme of health care "reform" emanating from the Obama Administration. Jackson, chair of the Agriculture Committee of the Alabama House of Representatives, and member of the Health Care Committee of the legislature, drafted his resolution for introduction into either a special session of the legislature, or the scheduled 2010 regular session. It is being circulated for discussion among legislators around the nation.

The resolution ( http://www.larouchepac.com/node/10324) is a blunt attack on the proposed policy coming out of Peter Orszag, Chairman of the Office of Management and Budget, Larry Summers, the chief economic advisor to the President, and President Obama himself, and likens the direction of the policy of cost-cutting and health care rationing to the very same policies that were implemented by Nazi Germany. Jackson condemns this entire approach and calls for repeal of the murderous HMO bill enacted by President Richard Nixon in 1973, and replacing it with a return to the Hill-Burton legislation that is still on the books as propounded by Alabama Senator Lister Hill and Ohio Senator Harold Burton in 1946.

Jackson also cites economist Lyndon LaRouche as the leading spokesman against the Obama administration plan.

[vanmungo]

WARNING TO ALL: This person repeatedly posts here touting the views of Lyndon LaRouche. These posts are intended as a recruiting tool to an organization widely regarded as a right-wing cult with alarming undercurrents of anti-Semitism and fascism. Please see the full report on LaRouche and criticisms of him from socialists and progressives:

http://en.wikipedia.org/wiki/Lyndon_LaRouche

There are many truly distinguished economic authorities, including two Nobel Prize winners--Paul Krugman and Joseph Stiglitz--who have written cogently about the virtues of a single payer system. One needn't peg one's arguments on the ideas of the shadowy ex-felon Lyndon LaRouche (jailed for bilking unsuspecting targets for contributions to his campaigns-­-"LaRouche was sentenced to 15 years' imprisonment in 1988 for conspiracy to commit mail fraud and tax code violations" (Wikipedia).

[blueken]

The health care industry promising to keep costs down, tomorrow, is like a drug addict saying he will quit.....t­omorrow. What a scam. If this flies we deserve whatever the fat cats do to us. I pray this country is sick of being scared into supporting things that are not in our best interest. For the record, the HMO part of health care was financed with our tax dollars. The hope was managed care would drive down health care. How did that work out? For twenty years the health care industry has been promising uniform billing for doctors, clinics and hospitals. Hows that working out? The health care industry tells people that a government health insurance would have to ration health care. What do you call "network doctors" and mandatory "referrals", and "life time maximums". This hypocritical insurance companies have been restricting our access to health care for years. What's the difference? At least with a single payer system, every body is in. I live in Mass, and we have a mandatory health insurance law. The numbers this year indicate that the subsidized health care of the poor has only had a very small, marginal affect on the budget. Why? Because before these un-insured people showed up at the ER and the state paid the bill. Now, they contribute something.

[veritasor]

private healthcare insurance = public misery insurance.

Only Single Payer healthcare like all other countries works!

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

[canuckgirl]

The reform of health care must start with investigating psychiatry which is a medical fraud.

Most psychiatrists use the book called "The Diagnostic and Statistical Manual of Mental Disorders" called the DSM IV.

There is no scientific proof nor test to prove that mental illness exists.

Paula J. Caplan wrote a book called "They Say You're Crazy - How the World's Most Powerful Psychiatrist Decide Who's Normal" . In her book "It's main focus is quite specifically
on the disingenuous and dishonest process of constructing the world's most influential handbook
of "mental disorders"­...."much of what is labeled "mental illness" would more appropriately be called
problems in living and some has been shown to result from such problems as dietary deficiencies or from food or environmental allergies"

Dr. Peter R. Breggin a psychiatrist in NY State wrote many books and has spoken out about psychiatry about the hazards of antidepressants and brain damaging electroshock. One of his books is called "Toxic Psychiatry" His website URL is: http://www.breggin.com

Ray Sandford of Minnesota has been forced to have 41 electroshock against his will. See his tragic story at the URL: http://www.mindfreedom.org/ray

The time has come for psychiatry to be investigated for its many atrocities being committed against
American citizens by the psychiatric industry like forced electroshock, forced medications, forced incarceration, sexual, mental and physical abuse.

more information:

http://www.ect.org
http://endofshock.com
http://capa.oise.utoronto.ca
http://psychrights.com
http://doctorsofdecption.com

[dsws]

We don't have the political wherewithal to get single payer. So, what's the compromise? Where should the line in the sand be?

[American In Chicago]

Good question dsws. My line in the sand is a public policy option, and one that remains funded enough and inclusive enough and administered well enough to force private plans to either reform to compete with it or be entirely replaced by it. The goal is universal healthcare, whatever form delivers it.

My line in the sand is thist be enacted by this congress. If not, here is one citizen that promises to do his part to expose representatives who voted against it and the lobbies that influenced them. Over this single issue, my vote and support is for the Democratic Party to either lose or retain.

[GGuyleSmith]

Sorry dsws, but I have to disagree with you: We have the political wherewithal because 60%+ of the American people want Single-Payer and they can scare their representatives into going against the health insurance lobby. With 60%+ support for single payer in all the polls, Obama could safely take this to the American people in a heartbeat and threaten every sitting Congress person and Senator that won't vote for a bill including single payer with political extinction come the next election cycle. Any electable populist candidate on the right or left could beat an incumbent against single payer. Single payer's time has come to America. It's time to call or email your Congress person, Senator, and the White House!

[vanmungo]

Borosage talks about endorsing a "public-option" plan that would give consumers a "choice" between private insurers and government insurance. But such a two-headed monster cannot work--and has not worked anywhere it's been tried.

Here's the reason: the whole point of single payer is to achieve cost efficiencies through risk pooling. With everyone in the same pool--young and old, sick and ill, rich and poor, all paying a modest tax rather than extortionate private premiums--the 80 percent who are healthy subsidize the 20 percent who are not. If that sick/older 20 percent are segregated into the government plan, the "public option" would be inherently more costly and therefore uncompetetive. It would thus have to charge premiums and impose deductibles, just like the private plans, in order to try to hold down these costs.

So what have you gained? Exactly nothing: no real cost efficiencies, and no universal coverage, since even a legal mandate to purchase coverage will not work for those who cannot afford it--this is what Massachusetts found out when they tried out this HMO boondoggle.

There's a final twist--the hybrid plan, by making the public option appear too costly, would discredit the idea of a publicly financed plan for another generation.

The hyrbrid plan is the classic lipstick on a pig scenario--it's amazing to see Borosage and HCAN falling for it.

[vanmungo]

I need to clarify one point I meant to make but had to delete because of the word limit: in a hybrid plan, the older/sicker 20 percent would end up in the public plan because the healthier, younger 80 percent--the more profitable cohort--would be aggressively marketed by the HMOs. Hence the public plan would be saddled with the sickest, oldest, and poorest, depriving it of the advantage of risk pooling that is the WHOLE POINT of single payer.

This public-option plan is the HMOs last-resort Trojan Horse to undermine single payer. In the hybrid propoal, the whole system would be gamed to make public insurance appear to be unsustainably costly and unworkable, thus burying the prospects of single payer for another generation.

DON'T FALL FOR THE PUBLIC OPTION. DEMAND SINGLE PAYER. Go to www.singlepayeraction.org, and join the fight for the only rational, humane, and workable solution to the health-care nightmare this country is living through.

[Luvial]

Patients have no place at the table with Obama in the White House. Lobbyists rule in Obamaland. Patients demand privacy of their medical records. Obama=Bush

[Northreader]

As a Canadian watching all this from a safe distance, I wonder about the Democrats, especially the so-called Blue Dog Democrats. Or anytime Senator Ben Nelson opens his mouth on the subject of health reform and the poor insurance companies. Do the Democrats need a threat of a more progressive party just to their left if they show signs of caving big time again? In Canada our version of the Democrats (the Liberal Party of Canada) is often kept honest by the New Democratic Party to their left. The NDP holds the provincial government here in Manitoba. But it wins by being fairly cautious and stealing votes from the Liberals. Watching the current discussion in the U.S., I find lots of good full debate on the internet (eg. Huffington Post and Tom Paine,.com­), even if the mainstream media is somewhat asleep or easily distracted on the sujbject.

[Jimmy1920]

It is not that complicated. The United States only graduates enough medical students to fill 80% of the internships and residencies in US hospitals.

The remaining 20% are filled by foreign medical students, who had received their training up to that point at their own government's expense.

So not only do we syphon of the best and brightest from other countries, we rely on foreign taxpayers to pay costs we are not willing to pay. Does that sound familiar.

All too frequently, they end up setting up practices in minority neighborhoods, where substandard Medicaid reimbursements make the delivery of quality care a challenge. Add to that mix the communication difficulties of different languages and cultures. And you have a recipe for what the policy makers call "health care disparitie­s."

The real question to ask is, if our system is that great, why aren't we sending our doctors to their countries - or other poor countries? For starters, our docs are so deep in debt, the banks wouldn't let them give up income producing time to promote American good will abroad.

Frankly, if we were to pass only one piece meal reform item, I would support free medical education for doctors. That way when they graduate, they will owe their debts to us, the taxpayers, and not to the banks.
http://thehealthcaremaze.wordpress.com

[Star2000dancer]

Well,I'm in so much pain with my back, I've had to barely move. I've got some of the strongest pain pills & they do'nt phase the pain. I need deep massage therapy, about 8 weeks of chiro, swimming & PT. No surgery, meds only until needed. But, I wo'nt get the therapy, only the pills. So, I sit in pain, & try to streatch a little so my torn musles do'nt shrink & wrap around the neverves even wors. Great healthcare we have here.


Never cure, pills & surgery only.

[minerva117]

Me. too. 10 years taking pills....d­on't wan't surgery. Work comp insurers want to argue over who is reponsible to pay for treatment, therefore, I get no treatment. Only pills...an­d yeah, sometimes they do very little for the pain.