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Rose Ann DeMoro

Rose Ann DeMoro

Posted: December 22, 2009 03:31 PM

An Inglorious End to the Promise of Reform

What's Your Reaction:

After all the fanfare and high expectations that accompanied the prospect of national health care reform at the outset of this year, the legislation is staggering to a particularly inglorious end.

At its heart, the single biggest weakness of the bill rapidly advancing in the Senate, which mirrors the central flaw of the House bill as well, is that it "cedes far too much power to the tyranny of a callous insurance industry," as Karen Higgins, RN, co-president of the 150,000-member newly created National Nurses United, the largest union and professional association of nurses in U.S. history, has said.

In a year when lobbyists, led by the health care industry, are poised to smash all records for influence peddling in Washington, we should not be surprised.

But the greater tragedy is that the current bill may lock into place a dysfunctional and inhumane system that threatens to move beyond the reach of more comprehensive reform for generations to come.

For those who counsel us to accept the steady stream of concessions to the obstructionists and the health care industry with the anticipation that the legislation will be improved in the House-Senate conference process, or in future years, the experience of this year suggests a very different outcome.

As Jean Ross, NNU co-president noted, "the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the health care industry lobbyists and the lessons of this year in which all the compromises have been made to the right."

Advocates of the current bill say it's most important feature is that it expands coverage to 30 million Americans. But their method for accomplishing what NNU Co-president Deborah Burger calls a "wishful statement" is an individual mandate forcing the uninsured to buy private insurance or be criminalized and subject to fines, in fact symbolizes the power of the insurance industry.

Individual mandate was the top priority of the insurance industry, which also succeeded in fending off meaningful restraints of its predatory pricing practices. The likely outcome is that far too many people will still face health care insecurity or medical bankruptcy due to ever rising out-of-pocket costs, or continue to skip needed medical care because of the high prices.

Indeed, discouraging provision of care as the preferred way to control costs, rather than rein in the pricing practices of the insurance and drug giants, is a central tenet of the insurance industry and conservative policy wonks.

That is also symbolized by the Senate bill's excise tax on comprehensive insurance, deceptively labeled as "Cadillac plans." In practice that tax will push employers to further reduce benefits for workers, and shift more costs to employees. Especially as more and more plans are subject to the tax every year due to the weak price controls on insurers in the legislation.

The Senate amendment exempting certain "high risk" occupations only serves to remind us of the inequity of the entire provision. Why are some protected, but others are not? It has not escaped notice that the targeted occupations are all male dominated -- mining, construction, police, and fire -- yet another gender imbalance in legislation that further erodes reproductive choice for women.

In exchange for lining up millions of new customers for the insurance giants, while failing to stop their price gouging or significantly cracking down on denials of claims they don't want to pay for, we're told that the legislation is historic for "ending" the worst industry abuses by banning exclusions of patients with pre-existing conditions and the shameful practice of dropping people when they become sick.

Yet both of those provisions are seriously marred by gaping loopholes for an industry which has perfected the art of adverse selection and gaming the system.

As the NNU has said in its statement on the bill, the loopholes include:

  • Provisions permitting insurers and companies to more than double charges to employees who fail "wellness" programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.
  • Permitting insurers to sell policies "across state lines", exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.
  • Allowing insurers to charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.
  • Insurers may continue to rescind policies for "fraud or intentional misrepresentation" - the main pretext insurance companies now use to cancel coverage.

The health care industry hardly needs the help. Within the last 35 years or - at least dating to the 1970s the Nixon administration's push for the HMO Act to stave off the 'threat' of a single payer system - we have witnessed the emergence of 'corporate giantism" in the health care sector:

  • The top five sectors have squandered more than2 trillion on mergers and acquisitions since 1993 with the end result that care is even less accessible and costs have skyrocketed.
  • The top ten pharmaceutical corporations reported nearly77 billion in profits last year
  • The top 19 HMOs made about17 billion in profits last year.
  • In California, the home of the managed care, just six insurers control more than two-thirds of the market. Overall, one or two companies dominate the top 94 metropolitan areas, severely limiting choice and competition

Helping these giant corporations become even bigger and more powerful is not a compromise with an eye to history or a step on the way to something greater; it is an historical blindness to the uniqueness of the current historical era and an ultimate surrender to corporate domination of our nation's health.

But nurses, who sustain the current flawed system and are highly motivated to continue to campaign for real change, are neither discouraged, nor giving up.

"NNU and nurses," said Ross, "will continue to work with the thousands of grassroots activists across the nation to campaign for the best reform, which would be to expand Medicare to cover everyone, the same type of system working more effectively in every other industrial country. The day of that reform will come."


Rose Ann DeMoro
is executive director of the National Nurses United.

 
After all the fanfare and high expectations that accompanied the prospect of national health care reform at the outset of this year, the legislation is staggering to a particularly inglorious end. At...
After all the fanfare and high expectations that accompanied the prospect of national health care reform at the outset of this year, the legislation is staggering to a particularly inglorious end. At...
 
 
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10:07 PM on 12/27/2009
You wanted reform and you put the wolves in charge of the hen house. Be careful what you ask for because you might get what you want, just not how you wanted it. We are about to be shook down by the hucksters in DC.
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HUFFPOST SUPER USER
tbone99
cruisin' duality
09:40 PM on 12/27/2009
When private insurers drop and deny people which they will , once they have the power and money , taxpayers can do nothing. Medicare and VA are open to scrutiny and have powerful taxpayer lobbying groups ( seniors and vets) constantly looking over their shoulder and keeping them on the up and up,

Private insurers will be immune to any taxpayer interference. They only answer to their investors to create more profits . They will have the max leverage to impose lesser quality health care standards on hospitals and demand decreased staffing , benefits and wages for workers, in order to get hospital costs to bare bones.
Many hospitals will have to close down, if they do not toe the line set by the insurers.

We have seen what the insurers are capable of ... How could the Dems possbly think these ruthless corporations could be the best stewards of our health?
09:32 PM on 12/27/2009
The major problem with trying to reform healthcare is that the people that we have entrusted to work for change are in fact agents for the corporations. The politicians receive significant funding for their campaigns from the very corporations they say need reform, be it healthcare, financial services or big pharma. The politicians say things to get elected but listen to their corporate puppet masters whenever significant change is brought up. The politicians know that the vast majority of americans want significant reform in the healthcare industry and are begging for relief from ever increasing insurance and out-of-pocket costs. So they pass a bill and pat each other on the back and speak about what a great historic piece of legislation has just been passed. In reality the benefit provisions do not take effect for a number of years so they can say wait it will have a positive effect once everything is in place, but in reality it guarantees massive profits for their bosses and by the time the ramifications of the legislation are known it has become the new norm, very crafty. If you look how quickly the politicians passed bailouts for the financial services industry with very little debate and no ramifications for the perpetrators, it becomes obvious to whom they serve.

It sure has to make you wonder what is next.
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HUFFPOST SUPER USER
nikto
06:49 PM on 12/27/2009
Please explain to me how this bill helps Democrats.

It looks like a pretty good crowbar for GOPers to clobber defenseless Dems with.

Just goes to show you that the best idea is to let the GOP act as the Republicans,
and NOT do their job FOR them, because they will clobber you for such atrocious misrule,
as THEY THEMSELVES would have imposed, but escaped accountability for due
to their complicit Corporate Media.

Now, the Dems get the worst of both worlds.

It's coming.
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
08:07 PM on 12/27/2009
I totally agree. This is a blunder and not a simple SNAFU.
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
05:33 PM on 12/27/2009
Excellent summary as to why this is a giveaway (or bailout) to the insurance companies. This corrupt system is entrenched by this legislation, actually enhanced, not "reformed" at all. I am disgusted.
11:25 AM on 12/27/2009
This says it all:

"Helping these giant corporations become even bigger and more powerful is not a compromise with an eye to history or a step on the way to something greater; it is an historical blindness to the uniqueness of the current historical era and an ultimate surrender to corporate domination of our nation's health."
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HUFFPOST COMMUNITY MODERATOR
writerjohnny
10:37 AM on 12/27/2009
Rose Ann DeMoro for PRESIDENT in 2012.
HUFFPOST SUPER USER
Austintatious
10:29 AM on 12/27/2009
Ah, a bit of truth, shining the light of day on this fraud that the Dems are perpetrating on the American people.

No, this is NOT a reform bill. Nowhere close. It's essentially welfare for big pharma and the health insurance corporations for decades to come, paid for on the backs of the middle class. Fits right in with Obama's welfare policies for the Wall Street execs, big banks and financial houses.

With this legislation, the Dems and this President are just ramming another huge lie down middle America's throat, doing it , sadly enough, with the help of those liberals and progressives still willing to buy into Obama's smoke and mirrors.

It is no surprise that the Repubs have determined to obstruct everything Obama. It is no surprise that the Dems are inept at governing and that, in the end, they act as the agents of big business. That was all quite predictable.

The only big surpise and, perhaps, it shouldn't be, is Obama's failure to fight for the people, as promised. Without that fight, the American middle class was bound to get the shaft, once again, and it's happening right now, this time with healthcare.

What the people are getting from Obama is the extension of Clinton's and Bush's trickle down economics to its extreme limits. The big question - just how badly can the middle class be squeezed before they decide they've had enough?
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jmpurser
See My micro-bio
10:39 AM on 12/27/2009
Agreed.
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
05:34 PM on 12/27/2009
It's a wonder Bu$h didn't propose this.
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HUFFPOST SUPER USER
tbone99
cruisin' duality
09:28 PM on 12/27/2009
he did - it was called Social Security privatization.
Essentially the exact same proposal , though with a different focus - retirement funds in place of health.But essentially a forced transfer of money from the taxpayer to private corporations,
03:35 AM on 12/27/2009
HCR squandered by lack of leadership from the President.
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HUFFPOST PUNDIT
jmpurser
See My micro-bio
10:21 AM on 12/27/2009
Oh he showed leadership when he quickly dove into the fray and killed single payer. He shows plenty of leadership whenever a corporate interest is involved.
12:19 AM on 12/27/2009
THE BIG TRAGEDY of the h.c. and ANY bill from Congress is the
CHRONIC SABOTAGE BY REPUBLICANS who work as corporate LOBBYISTS.
Repeat:
CHRONIC SABOTAGE BY REPUBLICANS who work as corporate LOBBYISTS.
CHRONIC SABOTAGE BY REPUBLICANS who work as corporate LOBBYISTS.
CHRONIC SABOTAGE BY REPUBLICANS who work as corporate LOBBYISTS.

REPUBLICANS: DETERMINED TO CRASH America's working and middle class.
12:42 AM on 12/27/2009
Darker, it's not only Republicans. Democrats, and Obama in particular, have aided the cause. Obama broke his campaign promises to have health care meetings in public and to televise them on C-SPAN. Instead, he met behind closed doors in secret with insurance company moguls. His approach, Dennis Kucinich has warned, "is the wrong way and is a sell-out to insurance companies." This article well documents many of the problems with the "reform" bill.
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Austintatious
09:40 AM on 12/27/2009
fflambeau's message is right on the money

darker's message is right, but it ignores the rest of the truth. The Dems are as bought and paid for by big business as the Repubs, and Obama didn't fight for the people, as promised.
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jmpurser
See My micro-bio
10:22 AM on 12/27/2009
You can blame the GOP all you want but the Democrats killed health care reform and delivered a corporate welfare bill.
02:27 PM on 12/24/2009
thats why we need Nurse for governor of California in 2010
maybe the nurses union could start an auxiliary
and we can all join
01:38 PM on 12/23/2009
Why is there such a dramatic 5 year wait for this plan to go into effect then?

Because Obama wants to get re-elected first.

Then you will find out that you will have to shell out literally $20,000 every single year to buy health insurance.

If you can't afford that, you will be punished with no health care plus you will be fined and possibly worse.

To qualify for aid, you will first have to liquidate all of your assets including your home and savings.

Finally, Obama and Emanuel now freely admit that this is the exact legislation that they wanted.
USBrit
And GOP Jesus said, I am come to help the rich.
02:59 AM on 12/25/2009
When I was last offered COBRA it would have cost me $18,000 per year for a family of four with no pre-existing conditions. I have no doubt the cost would right now be over $20,000 per year since insurance companies have been able to raise costs without complete abandon. The company offering me that wonderful COBRA package? BC/BS. And I'm guessing companies in the wonderful new insurance exchange will get the right to charge about the same amount. America, you have been hosed. You should have gotten Medicare for all and been done with it. Anything would be better than the economic disaster you have waiting for you as you stupidly continue to rely upon for profit organizations to show you any mercy in their drive to provide the best incomes possible for the few clowns running the insurance companies. In most modern countries medical care is a basic human right, with the exception of the country most owned by the corporations. They are picking clean the bones of the middle class. Oh well, corporations evidently don't need an American middle class, they only need an Asian middle class. I'd suggest everyone here learn Mandarin, you might be needing that.
01:14 PM on 12/23/2009
I am in total agreement with Ms. DeMoro and have nothing to add, except that I think that to permit AHIP and PHRMA to hold the uninsured hostage to pass schemes of monopoly, price fixing and institutionalized plutocratic graft is infamous. These are the very cartels who shaped this system and whose greed has created our cost problem. If this is who the Democrats are, then I don't want them.
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steel71
10:18 AM on 12/23/2009
Does this sound like a good deal? A family with a combined income of $ 88,000 or more, will pay have to pay $ 15,000 annually for government health care if their employer doesn't provide health care coverage. An employer that fails to provide health insurance for their employee will have to pay a $ 750 penalty (fine). single coverage will cost $ 5,800. There's a great incentive for employers to drop health care coverage and pay these small penalties. Everybody (unless they're very wealthy) will be stuck with government health care, and the middle class will be stuck with most of the bill. You would think that people would want government out of their lives but that isn't the case.

Insanity: doing the same thing over and over again and expecting different results.
Albert Einstein
07:42 PM on 12/23/2009
"government health care " - there is no "government health care" in this bill, and only a public option in the House's. You are misinformed.
"You would think that people would want government out of their lives but that isn't the case. " You're right, that is not the case, most Americans want a government that works to their benefit, rather than be tossed into the maws of the greedy in the marketplace.
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09:51 AM on 12/27/2009
It totally confounds me how Republicans are unable to get the corrupt connection BETWEEN government and big industry. They seem intent on remaining blind to the evils of the current free-market system. How can they not see that what we need is not less government, but better government? What kind of cognitive glitch is this? Someone help me understand the line of thinking here...
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HUFFPOST COMMUNITY MODERATOR
lisakaz2
Da ministero dell'interno di Snark.
08:10 PM on 12/27/2009
They' know full well it's not a free market. It's rigged for their cronies.
10:07 AM on 12/23/2009
Okay, so I hunkered down yesterday and read the bill. What I've gathered from it is not really change we need because it will drive insurance costs up, not down. Just my interpretation. I also don't agree with making people buy coverage or get taxed. If they don't have a job, what the heck are they supposed to buy insurance with?
USBrit
And GOP Jesus said, I am come to help the rich.
03:04 AM on 12/25/2009
The remaining equity in their houses. All part of the goal of driving the middle class into poverty so they will accept Chinese wage levels and learn to live with a lot less while the CxO class gets an ever increasing share of the country's GDP. Basically the same trend that has been followed ever since Reagan introduced us to voodoo economics. By the way, here is a good article on why trickle down economics is a load of bull.

http://arran.wordpress.com/2007/04/13/trickle-down-economics-the-4th-conservative-failure/