Lewin Analysis of Hacker-EPI Health Plan: Good News for Obama and Clinton

Last week, the Economic Policy Institute released an important analysis of Jacob Hacker's Health Care for America (HCFA) plan by the respected health economics team at the Lewin Group. As you can read in the EPI press release, Lewin found that HCFA would cover everyone in America, while saving the US economy over a trillion dollars over the next decade. And the efficiencies achievable primarily through Hacker's public health insurance plan would save enough money that, after modest premiums from employers and individuals, the new system would cost the US government only $50 billion more than what we are paying now for a system that leaves millions uninsured or badly insured.

A year ago, just as EPI was publishing Hacker's HCFA plan, CAF had already gone to work, engaging everyone who would listen in public and private educational discussions about the Hacker-EPI approach -- including presidential candidates from both parties. After a year-long dialogue, we can see how Hacker's work has become the template for both Barack Obama's and Hillary Clinton's health care plans. And just as importantly, our allies in the labor movement, public interest and community action networks are coming together around basic health care principles that are based on Hacker's model for health care for all. More on this soon - here at this website and at the Take Back America conference March 17, 18 and 19.

Comments

[ThomH]

Even with policy subsidies going into the pockets of the insurance companies, this system can achieve the savings needed to cover the presently uninsured only by cutting into insurance company margins and profits, since it does not save any costs they incur now. So the insurance companies will do a Harry and Louise on it, and the right wing will, rightly, alas, tear it apart for its complexity and its intrusiveness.


But what if Barack or Hillary came to see the crazy quilt complexity, fiscal weakness and political vulnerability of any “universal healthcare system” that distorts itself to make a place for the insurance companies, and simply came out for HR 676, as Kucinich did?

It is too late for them to be ridiculed and blacked out as he was. They could make possible the impossible, give the voters what they want, be morally and fiscally responsible, and prove once and for all that they are not owned by the insurance companies.

As for the rest of us, we have to demand HR 676 from Congress. Contact your Representative to press for it.

[ThomH]

Ugh. Reading the press release is depressing. All this complexity just so the insurance companies can have “a place at the table”, as Obama put it.

“A range of private insurance plans” indeed.

Meaning that doctors and hospitals will be coping with at least as many different payers as they do now, and be filling out forms and telephoning to get prior approval to proceed with treatment. Employers will have to submit forms to prove that their private insurance “is at least as good as what the [HCA] plan offers.” Workers will have to fill in a form to prove to the government that they are covered with an approved plan or pay a regular premium. (How? What if they get behind? Debtor's prison?)

Non-workers will be required to fill in forms to enroll in the HCA program and pay premiums or prove that they are otherwise covered. Subsidies would be granted depending on work status and income, up to 400% of the poverty level. Eligibility will change with income and with the definition of poverty level, which means many will pop in an out of eligibility. (How will they know? What happens if they continue accepting the subsidy after moving out of eligibility? )

Forms. Forms. Forms. Approvals. Approvals. Denials. Denials. Appeals. More denials. More forms.

All in all, a sad alternative to Medicare for All, as would be provided under HR 676. NO FORMS. NO APPROVALS. NO DENIALS. NO BANKRUPTCIES. And of course, no insurance companies. Which is why it is “politically impossible”, even though it is fiscally sounder than the HCA Plan, and a clear majority of voters want it.

[foreffectivegovernment]

This is the problem with Healthcare in America along with the solution. Notice this was a Bi-partisan effort that got us here so don't expect it to get us out.

"Republican Ideas" is how managed Healthcare got started.

Transcript of taped conversation between President Richard Nixon and John D. Ehrlichman (1971) that led to the HMO act of 1973:

Ehrlichman: "Edgar Kaiser is running his Permanente deal for profit. And the reason that he can - the reason he can do it - I had Edgar Kaiser come in - talk to me about this and I went into it in some depth. All the incentives are toward less medical care, because -"
President Nixon: [Unclear.]
Ehrlichman: " the less care they give them, the more money they make."
President Nixon: "Fine." [Unclear.]

This is how it was foisted on the American people.
In the Senate, Kennedy, author of the HMO Act, also encouraged its passage: ``I have strongly advocated passage of legislation to assist the development of health maintenance organizations as a viable and competitive alternative to fee-for-service practice. This bill represents the first initiative by the Federal Government which attempts to come to grips directly with the problems of fragmentation and disorganization in the health care industry. I believe that the HMO is the best idea put forth so far for containing costs and improving the organization and the delivery of health-care services.''

This is how it became law.
On December 29, 1973, President Nixon signed the HMO Act of 1973 into law.

This is how to start to eliminate it.
http://www.hillaryclinton.com/feature/healthcareplan/

Then comes "Single Payer System" that should have been enacted in 1993. This is the answer to the problem but will never see the light of day.

http://www.house.gov/conyers/news_hr676.htm

[ThomH]

Obama and Clinton should each be asked: "Your health care plan keeps the insurance companies in the act, even increasing their revenues at the expense of the taxpayers. What value do the insurance companies contribute that justifies letting them keep almost one third of total healthcare insurance receipts?"

In the US, about two thirds of total health insurance receipts goes to treatment providers (hospitals, doctors), almost one third is kept by the insurance companies for their expenses and profits.

The truth is the insurance companies contribute almost no positive value in exchange for the 31% chunk they keep. Instead, they introduce uncertainty, inefficiency and confusion into the system, and increase administrative costs and hassles for treatment providers.

Single Payer insurance would end this waste and cover everyone for about the same total dollars we spend now.

A clear majority of voters wants a Single Payer System. If it "will never see the light of day", that is only because the insurance companies oppose it to protect their revenues and profits.

Congress could deliver Single Payer by passing HR 676. Find out if your Representative is signed up as a sponsor of HR 676, congratulate them if they are, and press them to do so if not.

The one thing politicians need even more than campaign funds is votes. Let them know that your vote depends on them supporting HR 676.

[Aaror]

I used to work on the doctor's side of that equation, and 31% is not all that is being spent on the insurance companies. The staff doctors have to hire to fill out forms, re-submit claims, and file appeals is probably 1/3rd of their costs. So the insurance companies probably account for 1/2 of what is spent on health care, in order to try to deny actual medical care.

[schatsie]

Exactly, they have taken away pensions, healthcare and then had the corporate tax rate cut and then offshored the jobs and then given them corporate welfare (Read Free Lunch) !!!

And then the Board of Directors have given them a great big pay raise for what????

We need to turn this country around now before all of our children and grandchildren are buried any further under the corporacracy greed...

[NABNYC]

When evaluating this and other proposals, we need to keep in mind that 30 years ago employers paid all the costs for the healthcare of employees and their families. Now few employers pay all the costs, and many employers provide no healthcare contribution whatsoever. Over that same time period, the top level in the business world has grown obscenely rich precisely because they have taken income and benefits away from working people.

The health care plans by Clinton and Obama are nothing to cheer about: every person is required to buy their own health insurance from an industry that raises premiums by double digits every year. The medical profession and drug companies also rape the public while providing inadequate care.

This is the same as pensions. 30 years ago all employers provided pensions for their workers. Today that's rare. So if Clinton or Obama "offer" to allow working people to save a few more dollars towards their own retirement, keep in mind that this is a huge loss to working people.

At the same time, 30 years ago a working family (with one full-time worker) could buy a home for 4 times gross. Today it is 10 to 12 times gross.

The wealthy and powerful have taken away most of what working people used to have. So when they throw a few crumbs our way, let's not get too excited, and let's not lose sight of the big picture: we need big changes, and that must start by radically changing the tax structure and cancelling the trade agreements.

Bring the jobs back here, make housing affordable, and provide universal healthcare and pensions for working people.