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US Health Care System

Health Care Insurance Industry

Project: US Health Care System
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According to the US Census Bureau, between 2001 and 2004 the number of uninsured Americans increases by 5 million to 45.8 million, or 15.7 percent of the country’s total population. [US Department of Commerce, 8/2005, pp. 16-17 pdf file] The increase is blamed on a poor economy, budget cuts to the Medicaid program, and a more than 50 percent increase in insurance premiums. [Washington Post, 10/22/2004; Knight Ridder, 2/24/2005]

Category Tags: US Health Insurers, Medicaid

The National Academy of Sciences issues a report calling for universal health insurance coverage by 2010. “It is time for our nation to extend coverage to everyone,” the report says. “Universal insurance coverage is an important and achievable goal for the country.” The report was drafted by a panel of 15 experts and is the product of three years of work.
Sampling of report's conclusions -
bullet People without insurance receive about half the medical care of those who have it. Consequently, they are on average sicker and tend to die sooner.
bullet Roughly 18,000 people die each year because they do not have insurance.
bullet In 2001, only half of uninsured children in the US visited a physician during 2001, compared with three-quarters of privately insured children.
bullet In 2001, taxpayers spent roughly $30 billion in unreimbursed medical care for uninsured Americans.
bullet The poorer health and premature deaths of uninsured people cost taxpayers between $65 billion to $130 billion a year.
Reaction in US government - Republican Senate majority leader Bill Frist of Tennessee—whose family owns HCA Inc., the largest for-profit hospital chain in the US—expresses concern that “the report may not focus enough on the reasons why health care costs continue to rise and how to pay for any reform.” Democratic Senator Tom Daschle of South Dakota supports the call. “It’s doable,” he says. “It’s essential. This is, I believe, the single most important domestic issue facing our country.” Tommy G. Thompson, secretary of health and human services, tells reporters the proposal is “not realistic.” [Institute of Medicine, 2004; National Academies, 1/14/2004; New York Times, 1/15/2004]

Category Tags: Studies-Academic, US Health Insurers

A study conducted by the American Medical Association (AMA) finds that health insurance companies are becoming near-monopolies. Ninety-five percent of the 294 HMO/PPO metropolitan markets surveyed have a Herfindahl-Hirschman Index (HHI) above 1,800. The HHI is used to determine whether a company’s control of the market warrants antitrust concern. A market with a rating of 1,800 is considered by the Department of Justice to be “highly concentrated.” Sixty-five percent of the companies surveyed have a rating over 3,000. The concentration is apparently the product of a period of intense consolidation within the industry. According to the AMA, there were more than 400 mergers during the preceding ten years. [American Medical Association, 2006 pdf file; Associated Press, 4/18/2006] “Patients do not appear to be benefiting from the consolidation of health insurance markets,” says AMA board member Dr. J. James Rohack. “Health insurers are posting historically high profit margins, yet patient health insurance premiums continue to rise without an expansion of benefits.” [Consumer Affairs, 4/18/2006] The AMA has asked the Department of Justice to take up antitrust action. But the organization says that in spite of the extremely high market concentration, regulators seem uninterested. [Associated Press, 4/18/2006]

Entity Tags: US Department of Justice, J. James Rohack, American Medical Association

Category Tags: Studies-Academic, US Health Insurers

Wendell Potter, a senior health care executive with the insurance giant Cigna, visits a “health care exposition” in Wise, Virginia, not far from his home town. Potter is shocked at what he sees at the Wise County Fairgrounds. As he will later recall (see July 10, 2009), he assumed he would see booths set up for people to get their blood pressure checked and so forth. What he actually sees is doctors providing a range of care in livestock stalls and tents. Some patients are treated while lying on gurneys, under a rainy sky. “And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care,” he will later say. “People drove from South Carolina and Georgia and Kentucky, Tennessee—all over the region, because they knew that this was being done. A lot of them heard about it from word of mouth. There could have been people and probably were people that I had grown up with. They could have been people who grew up at the house down the road, in the house down the road from me. And that made it real to me.… It was absolutely stunning. It was like being hit by lightning. It was almost—what country am I in? I just—it just didn’t seem to be a possibility that I was in the United States. It was like a lightning bolt had hit me.” Potter will describe himself as “insulated” from the harsh reality of American health care before visiting the expo. “I had a great job. And I had a terrific office in a high-rise building in Philadelphia. I was insulated. I didn’t really see what was going on. I saw the data. I knew that 47 million people were uninsured, but I didn’t put faces with that number.… [W]hen you’re in the executive offices, when you’re getting prepared for a call with an analyst, in the financial medium, what you think about are the numbers. You don’t think about individual people. You think about the numbers, and whether or not you’re going to meet Wall Street’s expectations. That’s what you think about, at that level. And it helps to think that way. That’s why you—that enables you to stay there, if you don’t really think that you’re talking about and dealing with real human beings.” Potter finds it difficult to reconcile his executive lifestyle with relatives and neighbors being treated in livestock stalls. He will eventually resign his position with Cigna. [PBS, 7/10/2009]

Entity Tags: Wendell Potter, Cigna

Category Tags: US Health Insurers, History of US Health Care System, US Health Care Problems

Larry Niven.Larry Niven. [Source: Larry Niven]A group of science fiction writers calling themselves SIGMA is engaged in advising the Department of Homeland Security (DHS) on how to protect the nation. Undersecretary of Science and Technology Jay Cohen says he likes their unconventional thinking. Two of the approximately 24 members are right-wing libertarian authors Jerry Pournelle and Larry Niven, who have collaborated on a number of books as well as writing numerous novels and short stories on their own. One of Niven’s more controversial ideas is to help hospitals stem financial losses by spreading rumors in Spanish within the Latino community that emergency rooms are killing patients in order to harvest their organs for transplants. Niven believes the rumors would discourage Latinos from using the nation’s emergency rooms and thus ease the burden on hospitals. “The problem [of hospitals going broke] is hugely exaggerated by illegal aliens who aren’t going to pay for anything anyway,” Niven says. Pournelle asks, somewhat jokingly, “Do you know how politically incorrect you are?” Niven replies, “I know it may not be possible to use this solution, but it does work.” [National Defense Magazine, 2/28/2008] One blogger, apparently angered by Niven’s proposal, later writes that Niven’s idea comes from his “magical, mystical fictional universe where hospitals don’t have to treat rednecks who OD on meth, insurance companies aren’t inflating the cost of hospital care, under-regulated drug companies aren’t making massive profits, and uninsured children of hardworking parents don’t fall off skateboards.” [Mark Frauenfelder, 3/28/2008]

Entity Tags: US Department of Homeland Security, Jay Cohen, Jerry Pournelle, Larry Niven, SIGMA

Timeline Tags: Domestic Propaganda

Category Tags: Defense of corporate interests, US Health Insurers, US Health Care Problems

The Senate Finance Committee, chaired by Senator Max Baucus (D-MT), holds a series of hearings about health care reform, on April 21, May 5, and May 12. In all, 41 experts testify, but none of them advocate the so-called “single-payer” form of health care, a system which essentially has the government providing health care insurance instead of private insurers—“Medicare for all Americans,” as some characterize it. [Politico, 5/5/2009; Single Payer Action, 5/21/2009] The experts are from organizations like America’s Health Insurance Plans (AHIP), the health industry’s largest lobbying firm, and health insurers Blue Cross and Aetna. Some of the invited organizations employ former Baucus staff members. [Rolling Stone, 9/3/2009] Baucus says that single-payer is “off the table,” and will not be considered. [TPM Cafe, 5/5/2009]
Health Industry Heavy Donors to Baucus - The nonpartisan organization Consumer Watchdog has reported that Baucus, one of the Senate’s most important architects of Congressional health reform, has accepted more campaign contributions from the health insurance and pharmaceutical corporations than any other current Democratic member of the House or Senate. During the last two election cycles, he received $183,750 from health insurance companies and $229,020 from drug companies. [Single Payer Action, 5/21/2009]
Protesters Disrupt Hearings - Protesters disrupt the hearings by standing up and shouting criticisms of the committee over its failure to bring single-payer into the discussion. Eight protesters are led out of the hearing room and later arrested. At one point, Baucus asks for more police officers to enforce security. The protests are organized by Healthcare Now, Physicians for a National Health Program, and Single Payer Action, all of whom support a single-payer, government-run health care system. One protester calls the hearings nothing more than “political theater.” For his part, Baucus assures the audience, “I want you to know I care deeply about your views.” [Politico, 5/5/2009] The eight protesters spend around seven hours in jail. One, Dr. Margaret Flowers, later recalls: “It’s funny, the policemen were all telling us their horror stories about health care. One was telling us about his mother who was 62 and lost her job and was uninsured, waiting to get Medicare when she was 65.” The protesters are sentenced to six months’ probation. Baucus later admits that not allowing single-payer advocates to participate in the hearings was a mistake; he will eventually agree to meet with a group of those advocates (see June 3, 2009).
Single-Payer Never Considered - In September, Rolling Stone reporter Matt Taibbi will note that Baucus, like President Obama and other prominent Democrats, has supported single-payer insurance in theory, but asserts such a proposal would never get through Congress. Journalist Russell Mokhiber, who advocates for single-payer as a member of Single Payer Action, later says that the Obama administration and Congressional Democrats made an agreement with health industry leaders months before considering legislation for health care reform that single-payer would not be part of their proposals. In return, Mokhiber will say, they asked the industry not to oppose their reform efforts, a request that the industry has generally not honored. [Rolling Stone, 9/3/2009]

Entity Tags: Aetna, Healthcare Now, Consumer Watchdog, Barack Obama, America’s Health Insurance Plans, Single Payer Action, Blue Cross, Russell Mokhiber, Margaret Flowers, Matt Taibbi, Senate Finance Committee, Max Baucus, Obama administration, Physicians for a National Health Program

Timeline Tags: Domestic Propaganda

Category Tags: Obama Health Care Reform, US Health Insurers, Medicare

Wendell Potter (r) being interviewed by Bill Moyers (l).Wendell Potter (r) being interviewed by Bill Moyers (l). [Source: PR Watch (.org)]Former health care executive Wendell Potter, who left the insurance giant Cigna after fifteen years, appears on “Bill Moyers’ Journal.” He was formerly the head of corporate communications before he resigned his position, a post he calls “the ultimate PR job.” He says he was not forced to leave the company, and was extremely well compensated for his duties. He left after realizing that the health care industry is using underhanded and hurtful tactics to undermine the drive towards health care reform. He never went to his bosses with his observations because, he says, “for most of the time I was there, I felt that what we were doing was the right thing. And that I was playing on a team that was honorable. I just didn’t really get it all that much until toward the end of my tenure at Cigna.”
Health Care Expo Changed His Perceptions - In June 2007, Potter recalls, his perceptions were drastically changed by his visit to a health care exposition in Wise, Virginia (see June 2007).
Changing Plans - The industry shifted from selling primarily managed care plans, he says, to what they call “consumer-driven plans.” Despite the name, they are health care plans with high deductibles and limited coverage.
'Highlight Horror Stories' - Moyers shows Potter a copy of an “action plan” devised by America’s Health Insurance Plans (AHIP), the industry’s trade association. In large gold letters, the plan tells lobbyists and industry representatives to “Highlight horror stories of government-run systems.” Potter says that AHIP and other industry representatives try to paint government-run health care as socialism, and as inevitable failures. “The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them,” he says, “that if you even consider that, you’re heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern.” Moyers also notes that the AHIP plan targets the film Sicko, a 2007 documentary by leftist filmmaker Michael Moore that portrayed America’s health care industry in a dismal light. AHIP’s action plan is to “Position Sicko as a threat to Democrats’ larger agenda.” Potter says that was an effort to discredit the film by using lobbyists and AHIP staffers “to go onto Capitol Hill and say, ‘Look, you don’t want to believe this movie. You don’t want to talk about it. You don’t want to endorse it. And if you do, we can make things tough for you.’” If they did, AHIP would retaliate by running negative ads against the lawmakers in their home districts or other electoral punishments. AHIP focused strongly on the conservative Democratic Leadership Council. Another tactic, as delineated in the memo: “Message to Democratic insiders. Embracing Moore is one-way ticket back to minority party status.” Moyers says that AHIP attempted to “radicalize” Moore and portray him as an extremist who could not be believed. Many politicians used AHIP talking points in discussing Moore and his film. “So your plan worked,” Moyers observes. Potter agrees: “It worked beautifully.” The lesson that was lost from Moore’s film, Potter says, was that Americans “shouldn’t fear government involvement in our health care system. That there is an appropriate role for government, and it’s been proven in the countries that were in that movie.”
Conservative Counter-Strategy - Moyers then displays a memo from Republican strategist Frank Luntz, who in the spring of 2009 wrote a strategy memo for health care reform opponents. The memo reads in part: “First, you have to pretend to support it. Then use phrases like, ‘government takeover,’ ‘delayed care is denied care,’ ‘consequences of rationing,’ ‘bureaucrats, not doctors prescribing medicine.’” He then shows film clips of House Minority Leader John Boehner (R-OH), Senate Minority Leader Mitch McConnell (R-KY), Senator Jon Kyl (R-AZ), and others using Luntz’s talking points in discussions on the floors of Congress. Potter says that many conservatives—Democrats as well as Republicans—“are ideologically aligned with the industry. They want to believe that the free market system can and should work in this country, like it does in other industries. So they don’t understand from an insider’s perspective like I have, what that actually means, and the consequences of that to Americans. They parrot those comments, without really realizing what the real situation is.” He notes that Representative Zach Wamp (R-TN), who grew up very near Potter’s childhood home in Chattanooga, told reporters that half of America’s uninsured don’t want health care, they would rather “go naked and just take the chance of getting sick. They end up in the emergency room costing you and me a whole lot more money.” Potter notes that the word “naked” is an industry term for people who choose not to buy health insurance. He calls Wamp’s comment “ridiculous” and “an example of a member of Congress buying what the insurance industry is peddling.” Moyers cites conservative Democrat Max Baucus, the chairman of the Senate Finance Committee, as another politician central to the health care reform process who is heavily influenced by corporate lobbyists—two of whom used to work on his own Senate staff. Potter says: “[I]t does offend me, that the vested special interests, who are so profitable and so powerful, are able to influence public policy in the way that they have, and the way that they’ve done over the years. And the insurance industry has been one of the most successful, in beating back any kinds of legislation that would hinder or affect the profitability of the companies.”
Fierce Opposition to Public Option - The “public option,” the idea that the government would extend a non-profit, government-run health care alternative for citizens, is fiercely opposed by the health care industry. Potter says the reason why is “[t]he industry doesn’t want to have any competitor. In fact, over the course of the last few years, has been shrinking the number of competitors through a lot of acquisitions and mergers. So first of all, they don’t want any more competition period. They certainly don’t want it from a government plan that might be operating more efficiently than they are, that they operate.” Government programs such as Medicare and the Veterans Administration’s medical providers are far more efficient than private, for-profit health care providers, and the industry fears that having to compete with such a program will slash their profits. Medical companies will do whatever it takes to keep their profit margins—and shareholder returns—above a certain threshold. They will deny more claims, kick more people off their rolls, purge employer accounts, whatever it takes. Potter, evidently bemused, says, “You know, I’ve been around a long time. And I have to say, I just don’t get this. I just don’t understand how the corporations can oppose a plan that gives the unhealthy people a chance to be covered. And they don’t want to do it themselves.… I’m a capitalist as well. I think it’s a wonderful thing that companies can make a profit. But when you do it in such a way that you are creating a situation in which these companies are adding to the number of people who are uninsured and creating a problem of the underinsured then that’s when we have a problem with it, or at least I do.” A public option would help “keep [health care corporations] honest,” he says, and they would inevitably lose profits.
Predictions - Right now the industry is primarily involved in what Potter calls a “charm offensive,” where it is attempting to give the perception that it, too, is for health care reform. But once Congress begins putting out specific legislative language, the industry and its flacks will begin attacking specific provisions. Moyers says the upshot is for the industry to either “kill reform” or prevent lawmakers from agreeing on a bill, just like what happened in 1993-94 under the Clinton administration. No matter what they say—favoring the elimination of pre-existing condition restrictions, for example—the industry will adamantly oppose reform of any kind. “They don’t want a public plan,” Potter says. “They want all the uninsured to have to be enrolled in a private insurance plan. They want—they see those 50 million people as potentially 50 million new customers. So they’re in favor of that. They see this as a way to essentially lock them into the system, and ensure their profitability in the future. The strategy is as it was in 1993 and ‘94, to conduct this charm offensive on the surface. But behind the scenes, to use front groups and third-party advocates and ideological allies. And those on Capitol Hill who are aligned with them, philosophically, to do the dirty work. To demean and scare people about a government-run plan, try to make people not even remember that Medicare, their Medicare program, is a government-run plan that has operated a lot more efficiently.… [T]hey want to scare you into thinking that through the anecdotes they tell you, that any government-run system, particularly those in Canada, and UK, and France that the people are very unhappy. And that these people will have to wait in long lines to get care, or wait a long time to get care. I’d like to take them down to Wise County. I’d like the president to come down to Wise County, and see some real lines of Americans, standing in line to get their care. [PBS, 7/10/2009]

Entity Tags: John Boehner, Frank Luntz, Cigna, Bill Moyers, America’s Health Insurance Plans, Zach Wamp, Wendell Potter, US Veterans Administration, Senate Finance Committee, Michael Moore, Medicare, Max Baucus, Mitch McConnell, Jon Kyl, Clinton administration

Category Tags: US Health Insurers, Obama Health Care Reform, Medicare

Lewin Group logo.Lewin Group logo. [Source: WNY Media]The Republican National Committee plans to spend a million dollars in August on television ads opposing health care reform. One of the key elements of the ad campaign is a study released today by the Lewin Group that finds 119 million Americans would lose the coverage they currently have under the Obama administration’s health care reform proposal. MSNBC’s progressive talk show host Rachel Maddow airs video clips of Senators John Barrasso (R-WY) and Chuck Grassley (R-IA), Representatives John Boehner (R-OH), Tom Price (R-GA), Paul Ryan (R-WI), and former House Speaker Newt Gingrich (R-GA) all citing the Lewin study as evidence that health care reform is bad for Americans. The Lewin Group is a subsidiary of UnitedHealth Group, a health insurance provider. United Health operates a subsidiary called Ingenix, which in turn operates a consulting firm, the Lewin Group. Maddow notes that Republicans call the Lewin Group “nonpartisan and independent” when in fact it is a branch of a health care insurer. In January 2009, United Health agreed to pay $400 million to the State of New York after being charged with defrauding customers—manipulating data in order to shift medical expenses onto consumers. Former Vermont governor and Democratic National Committee chairman Howard Dean, himself a doctor, says the issue is “not… about Democrats versus Republicans. This is about the health insurance agency versus the American people.” [Ingenix, 7/27/2009; MSNBC, 7/28/2009]

Entity Tags: Republican National Committee, Tom Price, UnitedHealth Group, Rachel Maddow, Lewin Group, Obama administration, Paul Ryan, Ingenix, John Boehner, Howard Dean, MSNBC, Newt Gingrich, Charles Grassley, John Barrasso

Timeline Tags: Civil Liberties, Domestic Propaganda, 2010 Elections

Category Tags: HCA - Inflated Costs, US Health Insurers, Obama Health Care Reform

President Obama holds a “town hall” meeting on health care reform, sponsored by the American Association of Retired Persons (AARP). The meeting is conducted by telephone at AARP’s Washington headquarters, where a small studio audience and approximately 180,000 callers from around the country listen and take part.
Rumor Control - In his introduction, AARP CEO A. Barry Rand tells the participants: “There’s a lot of misinformation about health care reform—even on what AARP stands for, and what AARP supports. This town hall is part of our ongoing effort to debunk myths and provide accurate information.… I want to make it clear that AARP has not endorsed any particular bill or any of the bills being debated in Congress today. We continue to work with members of Congress on both sides of the aisle and with the administration to achieve what is right for health care reform.” AARP president Jennie Chin Hansen notes some of the most prevalent myths and misinformation about health care reform as expressed in previous AARP-sponsored town halls: “Like, will the government tell my doctor how to practice medicine?” For his part, Obama says: “Nobody’s trying to change what does work in the system. We are trying to change what doesn’t work in the system.” He reassures the participants that “Nobody is talking about cutting Medicare benefits. I just want to make that absolutely clear.… [W]e do want to eliminate some of the waste that is being paid for out of the Medicare trust fund that could be used more effectively to cover more people and strengthen the system.”
Opposition Profiting from Status Quo - Of the anti-reform opposition, Obama says: “I know there are folks who will oppose any kind of reform because they profit from the way the system is right now. They’ll run all sorts of ads that will make people scared.… Back when President Kennedy and then President Johnson were trying to pass Medicare, opponents claimed it was socialized medicine. When you look at the Medicare debate, it is almost exactly the same as the debate we’re having right now. Everybody who was in favor of the status quo was trying to scare the American people saying that government is going to take over your health care, you won’t be able to choose your own doctor, they’re going to ration care.… You know what? Medicare has been extraordinarily popular. It has worked. It has made people a lot healthier, given them security. And we can do the same this time.” If nothing is done to change the status quo, Obama says, the cost of health care coverage will rise dramatically. “Health care costs are going up much faster than inflation,” he says, “and your premiums will probably double again over the next 10 years.… We’re already seeing 14,000 people lose their health insurance every day. So the costs of doing nothing are trillions of dollars over the next couple of decades—trillions, not billions… without anybody getting any better care.” Controlling health care inflation will allow the government to stabilize the Medicare trust fund: “[N]ot only can we stabilize the Medicare trust fund, not only can we help save families money on their premiums, but we can actually afford to provide coverage to the people who currently don’t have health care.”
End-of-Life Rumors - One caller is concerned about rumors surrounding end-of-life care. “I have been told there is a clause in there that everyone that’s Medicare age will be visited and told to decide how they wish to die,” she says. “This bothers me greatly, and I’d like for you to promise me that this is not in this bill.” The host elaborates: “As I read the bill, it’s saying that Medicare will, for the first time, cover consultation about end-of-life care, and that they will not pay for such a consultation more than once every five years. This is being read as saying every five years you’ll be told how you can die.” Obama replies, “Well, that would be kind of morbid,” and reassures the caller that the rumors are not true, adding, “Nobody is going to be knocking on your door.” He explains that one proposal would have Medicare pay for consultations between doctor and patients about living wills, hospice care, and other information critical to end-of-life decisions. “The intent here is to simply make sure that you’ve got more information, and that Medicare will pay for it,” he says. “The problem right now is that most of us don’t give direction to our family members, so when we get really badly sick… the [doctors] are making decisions in consultation with your kids or your grandkids and nobody knows what you would have preferred.” Obama is refuting rumors that claim under his reform proposal, elderly Americans would be encouraged to die sooner (see July 16, 2009 and July 23, 2009).
Pre-Existing Conditions - Insurers will no longer be able to deny care to people with so-called “pre-existing conditions.” Obama reflects on his mother, who died of cancer: “She had to spend weeks fighting with insurance companies while she’s in the hospital bed, writing letters back and forth just to get coverage for insurance she’d already paid premiums on. And that happens all across the country. We’re going to put a stop to that.… We’re going to reform the insurance system so that they can’t just drop you if you get too sick. They won’t be able to drop you if you change jobs or lose your job.… We want clear, easy-to-understand, straightforward insurance that people can purchase.”
Keeping Existing Coverage - Obama reassures another caller that she will not have to drop the coverage she has. “Here’s a guarantee that I’ve made: If you have insurance that you like, then you’ll be able to keep that insurance. If you’ve got a doctor that you like, you’ll be able to keep your doctor. Nobody is going to say you’ve got to change your health care plan. This is not like Canada where suddenly we are dismantling the system and everybody’s signed up under some government program. If you’ve already got health care, the only thing we’re going to do for you is, we’re going to reform the insurance companies so that they can’t cheat you.… If you don’t have health insurance, we’re going to make it a little bit easier for you to be able to obtain health care.” Those dissatisfied with their coverage, or who have no coverage at all, would have a wider array of choices, including, perhaps, a government-run plan (the “public option”).
Rationing Health Care? - One caller asks, “Even if I decide when I’m 80 that I want a hip replacement, am I going to be able to get that?” Obama responds: “My interest is not in getting between you and your doctor—although keep in mind that right now insurance companies are often getting between you and your doctor. [Decisions] are being made by private insurance companies without any guidance as to whether [they] are good decisions to make people healthier or not. So we just want to provide some guidelines to Medicare, and by extension the private sector, about what [treatments] work and what doesn’t.… We don’t want to ration by dictating to somebody [that] we don’t think this senior should get a hip replacement. We do want to provide information to [you and your doctor about what] is going to be most helpful to you in dealing with your condition.” He gives the following analogy: “If you figure out a way to reduce your heating bill by insulating your windows… you’re still warm inside. [But] you’re not wasting all that energy and sending it in the form of higher bills to the electric or gas company. And that’s then money you can use to save for your retirement or help your kid go to college. Well, it’s the same principle within the health system.” Obama is refuting claims by health care opponents that the government intends to ration health care and deny elderly patients needed treatment (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 10, 2009, July 16, 2009, July 17, 2009, July 21, 2009, July 23, 2009, July 23, 2009, July 23, 2009, July 23-24, 2009, July 24, 2009, July 28, 2009, July 28, 2009, and July 28, 2009).
Reform Not 'Socialized Medicine' - Obama assures the participants that his vision of health care reform is not socialism under any guise. “A lot of people have heard this phrase ‘socialized medicine,’” he says. “And they say, ‘We don’t want government-run health care. We don’t want a Canadian-style plan.’ Nobody is talking about that. We’re saying, let’s give you a choice.” He recalls: “I got a letter from a woman the other day. She said, ‘I don’t want government-run health care. I don’t want socialized medicine. And don’t touch my Medicare.‘… I wanted to say, ‘That’s what Medicare is. It’s a government-run health care plan that people are very happy with.’”
Conclusion - Obama says he doesn’t expect a perfect health care system. “But we could be doing a lot better than we’re doing right now,” he says. “We shouldn’t have people who are working really hard every day without health care or with $8,000 deductibles—which means basically they don’t have health insurance unless they get in an accident or they get really sick. That just doesn’t make sense. So we’ve got to have the courage to be willing to change things.” After the town hall ends, AARP board chair Bonnie Cramer says she believes Obama “really made it very clear that Medicare beneficiaries will not see cuts in Medicare services.” By speaking directly to older Americans, Cramer says, “He put to rest a lot of their concerns.” [Slate, 7/28/2009; AARP Bulletin Today, 7/29/2009; McKnights, 7/29/2009]

Entity Tags: Medicare, Barack Obama, Bonnie Cramer, American Association of Retired Persons, A. Barry Rand, Jennie Chin Hansen

Timeline Tags: Domestic Propaganda, 2010 Elections

Category Tags: HCA - Inflated Costs, Obama Health Care Reform, US Health Insurers, Medicare

Jon Kyl (R-AZ), the Senate minority whip, says that the health care industry needs no further regulation or government intervention: “The health insurance industry is the most regulated or one of the most regulated industries in America. They don’t need to be kept honest by a competitor from the government.” Kyl is referring to the proposed “public option” in the Democrats’ pending health care reform legislation, which would provide a government-run alternative to private health care for millions of Americans. [MSNBC, 7/31/2009]

Entity Tags: Jon Kyl

Timeline Tags: Domestic Propaganda

Category Tags: Obama Health Care Reform, US Health Insurers

House Speaker Nancy Pelosi (D-CA) says of the corporate-led resistance to health care reform (see April 14, 2009, April 15, 2009, May 29, 2009, July 27, 2009, August 4, 2009, August 5, 2009, Before August 6, 2009, and August 6-7, 2009): “Insurance companies are out there in full force, carpet bombing, shock and awe against the public option. These are initiatives that are very important in this legislation, and they are to correct what the insurance companies have done to America and to the health of our people over the years.” Afterwards, Pelosi is equally blunt, telling reporters: “It is somewhat immoral what they are doing. Of course, they have been immoral all along how they have treated the people they insure. They are the villains in this. They have been part of the problem in a major way. The public has to know that.” [MSNBC, 7/31/2009]

Entity Tags: Nancy Pelosi

Timeline Tags: Domestic Propaganda, 2010 Elections

Category Tags: Obama Health Care Reform, US Health Insurers

The lobbying group America’s Health Insurance Plans (AHIP), funded by nearly 1,300 health care providers and other medical companies, urges its members’ employees to, in AHIP’s words, “GO TO TOWN MEETINGS WITH MEMBERS OF CONGRESS IN AUGUST TO CONFRONT THEM on House Democrats’ top recess message—that health reform legislation is ‘health insurance reform to hold insurance companies accountable’” (all caps from the source). AHIP plans on releasing negative television ads opposing the Obama administration’s health care reform proposals. According to AHIP spokesman Robert Zirkelbach: “The American people want Washington to focus on solutions, not the same old divisive political rhetoric that hasn’t worked in the past. Our industry has offered to completely transform how health insurance is provided today. We have stepped up to do our part to make health care reform a reality. That’s an INCONVENIENT FACT that some people have chosen to ignore. These attacks are politically motivated, and they ignore the significant commitment that our industry has made to the health reform process. WE’RE GOING TO BE VERY ACTIVE. We have people on the ground in more than 30 states. There are thousands of industry employees WHO HAVE NOW HAD THEIR INTEGRITY CALLED INTO QUESTION. They want to have their voices heard as part of this. We have contacted all of our member companies and encouraged them to get involved. August is a great time because of the face-to-face interaction with members.” [Campaign for an American Solution, 8/2/2009]

Entity Tags: Robert Zirkelbach, America’s Health Insurance Plans

Timeline Tags: Domestic Propaganda, 2010 Elections

Category Tags: Obama Health Care Reform, US Health Insurers

A protester at a health care forum wears a shirt from Anthem Blue Cross and Blue Shield, a prominent area health care provider.A protester at a health care forum wears a shirt from Anthem Blue Cross and Blue Shield, a prominent area health care provider. [Source: My Left Nutmeg (.com)]Representative Chris Murphy (D-CT) holds a forum in Simsbury, Connecticut, to discuss health care reform. Like many other forums in this and other states (see June 30, 2009, July 6, 2009, July 27, 2009, July 25, 2009, July 27, 2009, July 31, 2009, August 1, 2009, August 1, 2009, August 2, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 4, 2009, August 4, 2009, and August 5, 2009), Murphy’s meeting is disrupted by loud and angry protesters who oppose reforming health care. An African-American supporter of health care is accosted by one protester who, on camera, shouts: “You and your asinine friends say that we’re paid by big insurance—you’re paid by ACORN [a grassroots vote-registration organization] and our tax dollars. Yeah, that’s me, hello, get the f_ck out of my face and go back where you come from.” Another protester is caught on camera by a local blogger wearing an Anthem Blue Cross & Blue Shield shirt. [My Left Nutmeg, 8/5/2009; My Left Nutmeg, 8/6/2009] Anthem, like most corporations involved in health care, is opposed to reform of the health care industry. In recent days, it has asked to be allowed to raise rates on Connecticut members anywhere between 20 and 32 percent. Connecticut Attorney General Richard Blumenthal called the request “a rate increase that will be catastrophic, not only for our consumers but for our economy.” [Associated Press, 7/30/2009]

Entity Tags: Christopher Murphy, Anthem Blue Cross & Blue Shield, Richard Blumenthal

Timeline Tags: Domestic Propaganda

Category Tags: Obama Health Care Reform, US Health Insurers

MSNBC’s Rachel Maddow (l) interviews Frank Schaeffer (r).MSNBC’s Rachel Maddow (l) interviews Frank Schaeffer (r). [Source: Crooks and Liars (.com)]Frank Schaeffer, who with his late father Francis Schaeffer helped shape the social and religious conservatism that currently dominates much of American politics, writes what he calls an “inside scoop” on “why conservatives are rampaging town halls” to disrupt discussions of health care reform (see June 30, 2009, July 6, 2009, July 25, 2009, July 27, 2009, July 27, 2009, July 31, 2009, August 1, 2009, August 1, 2009, August 2, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 4, 2009, August 4, 2009, August 5, 2009, August 5, 2009, August 6, 2009, August 6, 2009, and August 6-8, 2009), and, ultimately, to deliberately foment political violence. Schaeffer was once a leader of the conservative evangelical movement who has now repudiated his former positions, and has written a book on the subject. [AlterNet (.org), 8/7/2009; MSNBC, 8/10/2009] Schaeffer’s father wrote a book, A Christian Manifesto, which compared pro-abortion policies to those of Adolf Hitler, and said that the use of force to roll back abortion law would be justified. Schaeffer himself has written a very different book, entitled Crazy for God: How I Grew Up as One of the Elects, Helped Found the Religious Right, and Lived to Take All or Almost All of It Back. [MSNBC, 6/1/2009]
Comparing Pro-Abortion Activists to Nazis - He tells MSNBC’s Rachel Maddow that his father used to compare pro-abortion activists to Nazis, and told his followers “that using violence or force to overthrow Nazi Germany would have been appropriate for Christians, including the assassination of [Adolf] Hitler.” It is a straight, short line, Schaeffer says, to go from the concept of justifiably assassinating Hitler to using violence against those who are compared to Nazis. “It’s really like playing Russian roulette,” he says. “You put a cartridge in the chamber, you spin, and once in a while it goes off. And we saw that happen with Dr. Tiller (see May 31, 2009). We’ve seen it happen numerous times in this country with the violence against political leaders, whether it’s Martin Luther King or whoever it might be. We have a history of being a well-armed, violent country.… There is a coded message here. And that is that you have a group of people who, like Rush Limbaugh (see July 21, 2009, July 27, 2009, July 28, 2009, August 3, 2009, August 4, 2009, August 6, 2009, and August 6, 2009) would rather see the president and the country fail, and their coded message to their own lunatic fringe is very simple—and that is go for broke. When you start comparing a democratically elected president, who is not only our first black president but a moderate progressive, to Adolf Hitler (see August 7, 2009), you have arrived at a point where you are literally leading—leaving a loaded gun on the table, saying the first person who wants to come along and use this, go ahead. Be our guest.” [MSNBC, 8/10/2009]
Conservative World View Shattered by Obama Election - In a separate op-ed, Schaeffer writes: “The Republican Old Guard are in the fix an atheist would be in if Jesus showed up and raised his mother from the dead: Their world view has just been shattered. Obama’s election has driven them over the edge.” Schaeffer says that when he worked with Dick Armey (R-TX), the former House Majority Leader and now lobbyist was “a decent guy, whatever his political views. How could he stoop so low as to be organizing what amounts to America’s Brown Shirts today?” He answers his own question: Armey, former House Speaker Newt Gingrich (R-GA), and others “can’t compute that their white man-led conservative revolution is dead. They can’t reconcile their idea of themselves with the fact that white men like them don’t run the country any more—and never will again. To them the black president is leading a column of the ‘other’ into their promised land. Gays, immigrants, blacks, progressives, even a female Hispanic appointed to the Supreme Court (see May 26, 2009)… for them this is the Apocalypse.… [N]ow all the the Republican gurus have left is what the defeated Germans of World War Two had: a scorched earth policy. If they can’t win then everyone must go down. Obama must fail! The country must fail!”
Using 70s-Era Anti-Abortion Protest Tactics - Schaeffer says conservative and industry lobbying firms orchestrating the anti-reform movement (see April 14, 2009, April 15, 2009, May 29, 2009, August 4, 2009, August 5, 2009, Before August 6, 2009, May 29, 2009, and August 6-7, 2009) are using the same tactics he and his father helped create for anti-abortion clinic protesters in the 1970s. He notes one lobbying organization, Armey’s FreedomWorks. “FreedomWorks represents a top-down, corporate-friendly approach that’s been the norm for conservative organizations for years,” Schaeffer writes. “How do I know this is the norm? Because I used to have strategy meetings with the late Jack Kemp (R-NY) and Dick Armey and the rest of the Republican gang about using their business ties to help finance the pro-life movement to defeat Democrats. I know this script. I helped write it. Democratic members of Congress are being harassed by angry, sign-carrying mobs and disruptive behavior at local town halls. It’s the tactic we used to follow abortion providers around their neighborhoods. ‘Protesters’ surrounded Rep. Tim Bishop (see June 22, 2009) and forced police officers to have to escort him to his car for safety. We used to do the same to Dr. Tiller… until someone killed him.” [AlterNet (.org), 8/7/2009]
Aware of Potential for Violence - In a previous interview with Maddow, Schaeffer expounded on this same topic. “[W]hat we did is we talked one game to the large public and we talked another game amongst ourselves,” he told Maddow. “And amongst ourselves, we were very radical.… I know that this is the case because of the fact that I was part of the movement, but also understood very well what we were doing back then was to attack the political issue when we talked to people like Ronald Reagan and the Bush family and Jack Kemp—the late Jack Kemp that we were very close to in all this. But on a private side, we also were egging people on to first pick at abortion clinics, then chain themselves to fences, then go to jail. We knew full well that in a country that had seen the assassination of Dr. Martin Luther King, two Kennedy brothers, and others, that what we were also doing was opening a gate here. And I think there’s no way to duck this. We live in a country in which guns are all over the place. We have plenty of people with a screw loose, plenty of people on the edge. It only takes one.” [MSNBC, 6/1/2009]
Using Lies to Obscure Facts, Disrupt Debate - The health care reform opponents are using what Schaeffer calls “[a] barrage of outright lies, wherein the Democrats are being accused of wanting to launch a massive euthanasia program against the elderly, free abortions for everyone, and ‘a government takeover’ of health care” to disrupt informed debate. Some protesters have escalated to physical violence and intimidation. Schaeffer says that just as in the 1970s, the protesters engaging in the physical violence are often “plants sent to disrupt public forums on the health care issue.… [M]uch of these protests are coordinated by public relations firms and lobbyists who have a stake in opposing President Obama’s reforms. There is no daylight between the Republican Party, the health care insurance industry, far-right leaders like Dick Armey, the legion of insurance lobbyists, and now, a small army of thugs.… No, I don’t believe that these people are about to take over the country. No, the sky is not falling. But the Republican Party is. It is now profoundly anti-American. The health insurance industry is run by very smart and very greedy people who have sunk to a new low. So has the Republican Party’s leadership that will not stand up and denounce the likes of Dick Armey for helping organize roving bands of thugs trying to strip the rest of us of the ability to be heard when it comes to the popular will on reforming health care.”
American Fascism - Schaeffer accuses the right of undermining American democracy and attempting to establish an almost-fascist control of society. “Here’s the emerging American version of the fascist’s formula,” he writes: “combine millions of dollars of lobbyists’ money with embittered troublemakers who have a small army of not terribly bright white angry people (collected over decades through pro-life mass mailing networks) at their beck and call, ever ready to believe any myth or lie circulated by the semi-literate and completely and routinely misinformed right wing—evangelical religious underground. Then put his little mob together with the insurance companies’ big bucks. That’s how it works—American Brown Shirts at the ready.” He notes that the murder of Tiller closed down his clinic, one of the few in the country that performed late-term abortions. So the murder of Tiller achieved the goal of the anti-abortion movement. “In this case a once-in-a-lifetime opportunity to save our economy from going bankrupt because of spiraling health care costs may be lost, not because of a better argument, but because of lies backed up by anti-democratic embittered thuggery. The motive? Revenge on America by the Old White Guys of the far right, and greed by the insurance industry.” Schaeffer concludes, “It’s time to give this garbage a name: insurance industry funded fascism.[AlterNet (.org), 8/7/2009]

Entity Tags: Frank Schaeffer, Francis Schaeffer, Newt Gingrich, Dick Armey, FreedomWorks, Tim Bishop, Rachel Maddow, Barack Obama

Timeline Tags: Domestic Propaganda, 2010 Elections

Category Tags: Obama Health Care Reform, US Health Insurers, Abortion controversy & violence

Former health insurance executive Wendell Potter (see July 10, 2009), who formerly headed the PR division at Cigna, says that the skyrocketing profits of health care corporations and their executives are directly driving the industry’s opposition to health care reform. According to filings with the Securities and Exchange Commission, the profits of the US’s 10 largest health insurance companies rose 428 percent between 2000 and 2007. In 2000, those 10 companies made a combined profit of $2.4 billion. In 2007, those numbers had risen to $12.9 billion. During that seven-year period, the number of Americans without health insurance rose 19 percent. The CEOs of those 10 firms made an average of $11.9 million in 2007 alone. MSNBC’s Rachel Maddow notes that the health insurance industry “bankrolled efforts to kill the last effort at health care reform” in 1994 (see Mid-January - February 4, 1994). In an interview with Maddow, Potter blames the insurance industry for much of the recent spate of “town hall” disruptions that have helped derail debate over health care reform (see June 30, 2009, July 6, 2009, July 25, 2009, July 27, 2009, July 27, 2009, July 31, 2009, August 1, 2009, August 1, 2009, August 2, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 3, 2009, August 4, 2009, August 4, 2009, August 5, 2009, August 5, 2009, August 6, 2009, August 6, 2009, August 6-8, 2009, August 8, 2009, and August 10, 2009) “and a lot of the deception that’s going on in terms of disinformation that many Americans apparently are believing.” Potter goes on to note that health insurance firms are making tremendous profits on the steady erosion of paid premiums going to fund medical claims. In 1993, the industry paid out roughly 95 percent of the premiums they took in to claims. In 2007, that number had dropped to 80 percent. Insurance firms also routinely “kick sick people off the rolls when they do get sick or when people get injured.… [A]nd also, they’re paying fewer claims.” The health insurance industry is dead set against the so-called “public option,” Potter says, for the simple reason that a publicly run alternative to private insurance would cost its members profits. [MSNBC, 8/11/2009]

Entity Tags: Wendell Potter, Rachel Maddow

Category Tags: Obama Health Care Reform, US Health Insurers

Hundreds wait in line for dental care at the Remote Area Medical clinic at The Forum.Hundreds wait in line for dental care at the Remote Area Medical clinic at The Forum. [Source: UPI / Jim Ruymen]The New York Times cites an eight-day health care event in Inglewood, California, as evidence of the overwhelming need for health care reform. Thousands of residents, who either lack any health insurance at all or are underinsured, line up every day outside The Forum, where the Los Angeles Lakers used to play professional basketball, to see a doctor, dentist, or nurse. The event serves 1,500 people per day; hundreds more are unable to get in to be seen. “It looked as if it was happening in an underdeveloped country, where villagers might assemble days in advance for care from a visiting medical mission,” the Times writes. “But it was happening in a major American metropolitan area. This vast, palpable need for help is a shameful indictment of our health care system—one that politicians opposed to reform insist is the world’s best.” The event is run by an organization called Remote Area Medical, originally formed to provide critical care to natives living in the Amazon basin. But the group realized that tremendous need exists within America itself, and began delivering free services in rural areas of the country. It has now expanded into urban areas. The first day, the group sees around 1,000 patients, and asks hundreds more to return the next day. By August 13, it has all available slots for the eight-day event committed. The Times writes: “The clinics are an inspiring example of what dedicated volunteers can do. But they are temporary events and come nowhere near to meeting the nation’s needs. Health care reforms under consideration in Congress could make big strides toward filling the gaps: by offering less costly insurance on new exchanges; by expanding Medicaid to cover more poor people and reaching out more vigorously to enroll them; by subsidizing coverage for low-income people; by helping increase the supply of primary care doctors; by requiring insurers to offer essential benefits and preventing them from denying coverage because of pre-existing conditions.… Americans deserve to know all of the facts, including that tens of millions of their neighbors and friends have no health insurance coverage at all or insurance that is grossly inadequate. If they still have doubts about why reform is so necessary, they should take another look at those lines in Inglewood.” [Guardian, 8/12/2009; New York Times, 8/15/2009; United Press International, 8/15/2009]

Entity Tags: New York Times, Remote Area Medical

Category Tags: Obama Health Care Reform, US Health Insurers, Medicaid

Wendell Potter, a former health insurance executive with CIGNA who has now become a whistleblower against the industry (see July 10, 2009 and August 10, 2009), says that the raucous and contentious protests at health care “town halls” are the result of what he calls “covert,” or “stealth” efforts by health insurance companies. Potter says he lacks the specifics for the current campaign, but he witnessed and actually took part in similar efforts in earlier years. This year’s efforts follow similar patterns to the ones he was familiar with, he says. “The industry is up to the same dirty tricks this year,” Potter says after meeting with House Rules Committee Chairwoman Louise Slaughter (D-NY), who supports the Democrats’ health care reform initiative. “When you hear someone complaining about traveling down a ‘slippery slope to socialism,’ some insurance flack, like I used to be, wrote that,” Potter says. He notes that during his 20 years in the industry, he watched—and participated in—the industry’s funneling money to large public firms who would create “Astroturf,” or fake grassroots, organizations (see April 14, 2009, April 15, 2009, May 29, 2009, July 27, 2009, August 4, 2009, August 5, 2009, Before August 6, 2009, August 6, 2009, August 6-7, 2009, and August 10, 2009) and use friendly conservative media voices. Slaughter says, “[T]he notion that this is going to be something devilish comes from the people who would lose money on it.” [The Hill, 8/12/2009]

Entity Tags: Wendell Potter, Louise Slaughter

Timeline Tags: Domestic Propaganda

Category Tags: Obama Health Care Reform, US Health Insurers

BlueCross BlueShield logo.BlueCross BlueShield logo. [Source: TopNews (.us)]Health insurers have mobilized tens of thousands of employees to fight against the Democrats’ health care reform initiative, according to reports by the Los Angeles Times and the Wall Street Journal. The insurance industry’s primary motive seems to be financial gain, according to the Times reporters. Many of the nation’s largest insurers, including UnitedHealth, have urged their employees to become involved in protesting health care reform, and provided advocacy “hot line” telephone numbers, printed “talking points,” sample “letters to the editor,” and other materials in almost every Congressional district throughout the nation. And many insurers, including BlueCross Blue Shield, have sponsored anti-reform television ads targeting conservative “Blue Dog” Democrats, many of whom are considered vulnerable to pressure from the industry. The insurance industry is paying for over 900 lobbyists, spending $35 million in the first half of 2009 lobbying Congress and the White House. AFL-CIO spokesman Gerald Shea says: “They have beaten us six ways to Sunday. Any time we want to make a small change to provide cost relief, they find a way to make it more profitable.” [Los Angeles Times, 8/24/2009; Wall Street Journal, 8/24/2009]
Jamming the 'Town Halls' - Insurers like UnitedHealth and others are sending their employees to “town hall” meetings to protest against reform. The Journal reports, “[T]he industry employees come armed with talking points about the need for bipartisan legislation and the unintended consequences of a government-run health plan to compete with private insurers.” But they are instructed not to become contentious and argumentative, according to a “Town Hall Tips” memo provided by the industry’s chief lobbying organization, America’s Health Insurance Plans (AHIP—see Before August 6, 2009). The memo warns those attending the meetings to expect criticism, and to stay calm. “It is important not to take the bait,” the memo cautions. AHIP president Karen Ignagni says the town hall meetings are an opportunity “to strongly push back against charges that we have very high profits. It’s very important that our men and women… calmly provide the facts and for members of Congress to hear what these people do every day.” Larry Loew, who works for the insurance administration firm Cornerstone Group, says he attended a recent town hall meeting hosted by Representative Alan Mollohan (D-WV) because “my whole industry is being threatened.” Loew claims he was not coached by AHIP, but admits to preparing for the meeting by gathering talking points from hospital and insurance company Web sites. AHIP spokesman Robert Zirkelbach says about 50,000 employees have been engaged in writing letters and making phone calls to politicians or attending town hall meetings. [Wall Street Journal, 8/24/2009]
'Hallelujah!' - One industry proposal that is gaining traction among some in Congress is the so-called “individual mandate,” which would require all citizens to buy some form of health insurance. That provision would guarantee insurers tens of millions of new customers—many of which would receive government subsidies to help pay the premiums. Robert Laszewski, a former health insurance executive who now heads the consulting firm Health Policy and Strategy Associates, says of the provision, “It’s a bonanza.” The industry’s reaction to early negotiations can, Laszewski says, be summed up in a single word: “Hallelujah!” Linda Blumberg, a health policy analyst at the nonpartisan Urban Institute, says, “The insurers are going to do quite well” with health care reform. “They are going to have this very stable pool, they’re going to have people getting subsidies to help them buy coverage, and… they will be paid the full costs of the benefits that they provide—plus their administrative costs.” Aetna’s chief executive, Ron Williams, says: “We have to get everyone into the insurance market. That is a huge, big deal [and] everyone has coalesced around that.” [Los Angeles Times, 8/24/2009; Wall Street Journal, 8/24/2009]
Battling the Public Option, - Insurers have fought most strongly against the so-called “public option,” which would create a government-run, non-profit alternative to private health insurance. Some polls are showing public support for the public option has declined, and stock prices for the insurance corporations have tracked upwards. Other insurance industry proposals are gaining ground. The Senate Finance Committee is considering a proposal to lower the proposed mandatory reimbursement rate for insurers to policyholders from 76 percent to 65 percent, and the industry is pressuring Congress to lower the limit that insurers must meet to cover a policyholder’s medical bills, leaving more of the money it gleans from premiums as profits. “These are a bad deal for consumers,” says J. Robert Hunter, a former Texas insurance commissioner who works with the Consumer Federation of America. Insurance companies would reap huge profits by providing less insurance “per premium dollar,” he says. Former Cigna executive Wendell Potter says, “It would be quite a windfall” for the insurance industry. [Los Angeles Times, 8/24/2009]

Entity Tags: Consumer Federation of America, UnitedHealth Group, Urban Institute, Wall Street Journal, BlueCross Blue Shield, Alan Mollohan, Senate Finance Committee, AFL-CIO, Aetna, America’s Health Insurance Plans, Wendell Potter, Robert Laszewski, Health Policy and Strategy Associates, Gerald Shea, Cornerstone Group, J. Robert Hunter, Robert Zirkelbach, Ron Williams, Linda Blumberg, Karen Ignagni, Larry Loew, Los Angeles Times

Category Tags: Obama Health Care Reform, US Health Care Problems, US Health Insurers

Health insurance corporations defend their use of “rescissions,” or denials of care due to what they term “pre-existing conditions” among their customers. Washington Post reporters interview Los Angeles businesswoman Sally Marrari, who in 2006 had her coverage canceled by Blue Cross & Blue Shield after the firm claimed she had withheld information from them about a back problem. Marrari was undergoing treatment for a thyroid disorder, a heart problem, and lupus. After her coverage was canceled, Marrari was diagnosed with pancreatic cancer, and quickly racked up over $200,000 in medical bills. She says she had no idea at the time that she had any back issues. She is currently suing the company, and is getting health care by trading office visits for work on her doctor’s 1969 Porsche at the garage she owns with her husband. Marrari’s tale is one of many cited by the Post as illustrative of the insurance industry’s unpopular practice. The Post writes, “Tales of cancellations have fueled outrage among regulators, analysts, doctors, and, not least, plaintiffs’ lawyers, who describe insurers as too eager to shed patients to widen profits.” Insurance company spokespersons claim to have little knowledge of just how and why particular patients are subjected to rescission, and Congressional investigators point to a patchwork of state laws and policies which lead to confusion. Since 2008, California’s five largest insurers have paid almost $19 million in fines for unfairly canceling policyholders’ insurance after those clients filed claims. One insurer, Health Net, has admitted to offering bonuses to employees for finding reasons to cancel policies. Gerald Kominski of the Center for Health Policy says: “This is probably the most egregious of examples of health insurers using their power and their resources to deny benefits to people who are most in need of care. It’s really a horrendous activity on the part of the insurers.” But insurers say the rescissions are necessary to combat fraud among policyholders. An Anthem Blue Cross spokeswoman says: “We do not rescind a policyholder’s coverage because someone on the policy gets sick. We have put in place a thorough process with multiple steps to ensure that we are as fair and as accurate as we can be in making these difficult decisions.” Blue Cross has been fined $11 million over the last two years by California state overseers, and required to reinstate dozens of canceled policies. Officials from three insurance companies recently told a House Energy and Commerce subcommittee they had saved $300 million by canceling about 20,000 policies over five years. [Washington Post, 9/8/2009]

Entity Tags: BlueCross Blue Shield, Anthem Blue Cross & Blue Shield, Sally Marrari, Gerald Kominski, Health Net

Category Tags: US Health Insurers, US Health Care Problems

The Pharmaceutical Research and Manufacturers of America (PhRMA) acknowledges it has funded a series of television advertisements in support of legislation primarily written by Max Baucus (D-MT), chairman of the Senate Finance Committee, to reform US health care. The television ads are part of an agreement between the Obama administration, Baucus, and PhRMA in June, where the organization agreed to various givebacks and discounts designed to reduce America’s pharmaceutical spending by $80 billion over 10 years. PhRMA then set aside $150 million for advertising to support health care legislation. More progressive House Democrats such as Henry Waxman (D-CA) are pushing for stiffer drug industry givebacks than covered in the deal. PhRMA is led by Billy Tauzin, a former Republican congressman. Until recently, the organization spent some $12 million on ads by an offshoot coalition called Americans for Stable Quality Care, and aired television ads such as “Eight Ways Reform Matters to You.” PhRMA’s new ads will specifically support the Baucus bill. Many are critical of the deal, with James Love of the progressive research group Knowledge Ecology charging, “Essentially what the US got was not $80 billion, but $150 million in Obama campaign contributions.” [New York Times, 9/12/2009] Investigative reporter Matt Taibbi agrees with Love, accusing the White House of colluding with Baucus and Tauzin’s PhRMA to orchestrate a “big bribe” in exchange for the Democrats’ dropping of drug-pricing reform in the Baucus bill. Taibbi writes that in June, White House chief of staff Rahm Emanuel met with representatives from PhRMA and drug companies such as Abbott Laboratories, Merck, and Pfizer to cut their deal. Tauzer later told reporters that the White House had “blessed” a plan involving the $150 million in return for the White House’s agreement to no longer back government negotiations for bulk-rate pharmaceuticals for Medicare, and to no longer support the importation of inexpensive drugs from Canada. Taibbi writes that the White House worked with Baucus and PhRMA to undercut Waxman’s attempts to give the government the ability to negotiate lower rates for Medicare drugs. PhRMA’s ads are being aired primarily in the districts of freshmen Democrats who are expected to face tough re-election campaigns, and in the districts of conservative “Blue Dog” Democrats, who have sided with Baucus, Obama, and PhRMA to oppose the Waxman provision in favor of PhRMA’s own provision, which would ban the government from negotiating lower rates for Medicare recipients. [True/Slant, 9/14/2009]

Entity Tags: James Love, Henry A. Waxman, Americans for Stable Quality Care, Abbott Laboratories, Rahm Emanuel, Pharmaceutical Research and Manufacturers of America, Senate Finance Committee, Obama administration, Medicare, Max Baucus, Matt Taibbi, Pfizer, Merck, W.J. (“Billy”) Tauzin

Category Tags: Marketing, Defense of corporate interests, US Health Insurers, Obama Health Care Reform, Medicare

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