Tag: Health Reform

Money Well Spent!

Today is the BIG health summit….you know that piece of political theater that will set the stage for health reform….just wanted to add a thought or two into the mix…..

There have been a massive amounts of accusations that health reform is being beaten by the lobbies that are spending lots of cash on our diligent Congresspeople…..and if you think that is a bit harsh then you need to drop the playstation and pay a little more attention to what will be effecting you in the future…..I know….not an easy thing to do when you are so close to the high score….but give it try….

For months we have been bombarded with the facts that the health insurance industry has a anti-trust exemption and can basically gouge the crap out of its consumers with NO fear of reprisal by the government….in other words they have a Free Ride to make all the money they can off the plight of those insured……

The good news was that the Dems were fed up with the insurance companies and would do all they could to change the anti-trust exemption……they were going to make them more responsive and accountable…..well, that was the plan…..but as usual Washington is just full of surprises……the Politico’s Patrick O’Connor is reporting:

In an upcoming House vote to repeal the long-standing antitrust protections for the insurance industry. To most members of Congress, it seems like a no-brainer: Why should insurers be exempted from antitrust laws, anyway.

But Democrats look like they’ll scale back the legislation to protect insurance companies that offer malpractice coverage to doctors and other health care providers, bowing to industry pressure in the latest concession of the health care fight.

Democratic aides in the House said the final bill likely won’t include controversial new restrictions on medical malpractice insurers. Its authors also appear inclined to strip new authority for the Federal Trade Commission because it sparked similar unease.The concessions illustrate just how hard it’s been for the president and his congressional allies to overhaul a single sector of such an enormous segment of the economy.

Just goes to show that the lobbyist money is well spent……the free ride continues and the plight of the insured remains bleak…..As I keep saying…NOTHING about the health reform proposal is reform….it is a tweaking….minor adjustments that have the appearance of success…..and the American people wait…….

What Obama Wants In Health Reform

Tomorrow will be the big meeting of the minds…the health summit between Obama, Dems and Repubs……let us hope that this will not be the circus that I fear it will be……unless these people strat talking to each other instead of the finbger pointing then this will be a huge waste of time and effort….anyway Obama has finally come out with what he will support and they are suppose to go from there…….he wants:

Insurers such as WellPoint Inc, UnitedHealth Group Inc and Aetna Inc overall face increased regulations and payment cuts.

* Insurance plans would face a new federal Health Insurance Rate Authority to help U.S. states review “unreasonable rate increases and other unfair practices of insurance plans.”

* Restrictions on companies that aim to protect consumers are expanded to add new protections, such as prohibiting all annual and lifetime limits, and ban pre-existing condition exclusions, among others.

* Private Medicare plans called Medicare Advantage would see payment changes that aim to compromise between the U.S. House of Representatives and Senate bills. Reimbursement rates for the plans, which can offer more benefits than traditional fee-for-service Medicare coverage at a higher cost, would set benchmark payments at a certain percentage of traditional Medicare and then phase them out.

* Medicare Advantage plans would also see payment adjustments for unjustified billing practices.

* One small positive for health insurance companies: The 10-year $67 billion in fees they would face would be delayed until 2014.

The brand-name pharmaceutical industry faces another $10 billion in fees over 10 years on top of its earlier agreement with the Senate Finance Committee to provide savings and rebates.

* The industry wide fees, to be parceled out among companies such as Pfizer Inc and Merck & Co Inc, will be used to eliminate a gap in Medicare’s prescription drug coverage known as the “doughnut hole.” That could help brand-name companies by getting patients to continue taking their medication rather than switching to a generic or stopping medication altogether.

* In a positive move for the companies, the fees will be delayed by one year until 2011.

Companies that make cheaper, generic versions of brand-name medicines would see an end to lucrative “pay-to-delay” settlements with brand-name drugmakers.

* Obama’s measure gives the U.S. Federal Trade Commission authority to address the settlements and makes it illegal to pay generic manufacturers

“to limit or forego research, development, marketing, manufacturing or sales of the generic drug.”

* Exemptions would only be allowed if the companies can show their settlement would “outweigh the anti-competitive effects of the agreement.”

Medical device makers such as Boston Scientific and Medtronic Inc maintained their earlier win of reducing their costs to $20 billion, down from $40 billion, and won a two-year delay until 2013.

* The industry wide fees were replaced with an excise tax that raises the same amount of revenue over 10 years.

I know a helluva list….but at least we now know exactly what Obama is looking for….read over the list….I do not see many areas for negotiation by the parties if they stick to the line they have held for a year or more…..The summit ought to be a kick in the butt for us political observers….the rest of the world will just tire of the news…and if you will look closely there is still NO elimination of the health industry’s anti-trust exemption….meaning they still control the prices and the screwing of the American people…..there is not tort reform, which will piss off the Repubs and there is nothing in it about ALL Americans….in other words looks a lot like the Senate version that has already passed….so what’s new?

More On GOP Health Alternatives

Okay, let’s beat this damn dead donkey one more f*cking time!

Bi-partisanship is the buzzword in Washington and now the Prez is trying to grasp the concept with his new health care summit with Repubs…..good luck with that……

I have been accused by some as a basher of the GOP and that I do not think that they do anything right….Personally, I do not agree with this assessment but then I may be biased…..

Below is the alternatives that was recently handed to the Prez at a Repub Leadership Conference…….my comments on the proposals are in italics:

Some key elements of Republicans’ alternative plan:

· Lowering health care premiums. The GOP plan will lower health care premiums for American families and small businesses, addressing Americans’ number-one priority for health care reform.  I think this proposals is sterling….but I would like more info on just how they plan to accomplish this…..

· Establishing Universal Access Programs to guarantee access to affordable care for those with pre-existing conditions. The GOP plan creates Universal Access Programs that expand and reform high-risk pools and reinsurance programs to guarantee that all Americans, regardless of pre-existing conditions or past illnesses, have access to affordable care – while lowering costs for all Americans.  this is yet another GREAT idea and it was also when proposed by the Dems…..

· Ending junk lawsuits. The GOP plan would help end costly junk lawsuits and curb defensive medicine by enacting medical liability reforms modeled after the successful state laws of California and Texas.  This is just a typical GOP answer….lawsuits account for about 1% of the cost of health care….do not believe this would do much to solve the problems of paying for health reform….this is inevitable for Repubs to propose…..the reason is that they need to placate the insurance industry for their monetary support….but if it will get them talking then by all means throw it in…..

· Prevents insurers from unjustly cancelling a policy or instituting annual of lifetime spending caps. The GOP plan prohibits an insurer from cancelling a policy unless a person commits fraud or conceals material facts about a health condition. It also prohibits insurance plans from instituting annual or lifetime spending limits. Another good idea…but it sounds like an out for insurance companies, atr least parts of it…..but worth a look….

· Encouraging Small Business Health Plans. The GOP plan gives small businesses the power to pool together and offer health care at lower prices, just as corporations and labor unions do. I have NO prob with this proposal, in fact sounds like a good idea…..

· Encouraging innovative state programs. The GOP plan rewards innovation by providing incentive payments to states that reduce premiums and the number of uninsured.  As long as this is used to benefit all the people of the states then I see NO prob here either….

· Allowing Americans to buy insurance across state lines. The GOP plan allows Americans to shop for coverage from coast to coast by allowing Americans living in one state to purchase insurance in another.  An EXCELLENT idea…….

· Codifying the Hyde Amendment. The GOP plan explicitly prohibits all federal funds, whether they are authorized funds or appropriated funds, from being used to pay for abortion. This one is just boring, but I guess if it is your main concern then why not…..

· Promoting healthier lifestyles. The GOP plan promotes prevention & wellness by giving employers greater flexibility to financially reward employees who adopt healthier lifestyles.  This one I have a prob with….but that is for a much larger post because this involves much more than eating….

· Enhancing Health Savings Accounts (HSAs). The GOP plan creates new incentives to save for future and long-term care needs by allowing qualified participants to use HSAs to pay premiums.  A CRAP proposal!  The recent economic meltdown should preclude anyone from considering this piece of crap!

There you have it….the Repubs alternatives and what I think of them…..if you took the time to read it then you will see that there is room for lots of bi-partisanship….the question to ask is why is there not?

One answer is the games politician play….instead of going before the American people and emphasizing their points and commonality of points, they would rather spend their time insulting, lying and  just plain throwing negativity around….there is common ground why cannot they just work from there and leave all the BS behind?

Personally, I would not vote for any of these dickheads….they show a serious lack of country first….both sides…..there is plenty within the Repub plan that has the potential to be bi-partisan and worthy of negotiation…..if this does not take place for whatever reason then the American people will see that it is NOT about them but rather the egos and  the idiocracy of Washington…….then it will be time to send these dinks a message to start acting on the people’s behalf or go home and service the wife/husband….because YOU ARE finished in Washington….

Dems: Try This!

With the election of Brown from Mass the super majority is dead and with that so is health reform…..may I suggest a direction for the Dems to try….one the whole “Big Bang” approach just plain sucked!

You guys are making this whole health thing more complicated than it has to be…just keep in mind K.I.S.S.!

That bazillion page health reform bill…scrape it!….absolutely NO one knows what is in the damn thing…..it is so large that it only aids the opposition in their track down the misinformation highway….throw the damn thing in the trash and try again…..

I have an idea….put together a bill that contains a reversal of the anti-trust exemption for the insurance companies, insert a provision for a national exchange so that insurance can be bought like car insurance and finally, eliminate the pre-existing condition thing……send this to the Congress and wait…..

Let the opposition take shots at it all they want and then go before the people and say that the Repubs are fighting against people having choice, want insurance companies to keep their antitrust exemption and that people are not important…..

Then go back to the Hill and dare Repubs to vote against it……..their political future would be bleak if they do…..it would be hard for them to justify why they are against the bill to the voter….now you have them by the short hairs!

All bills are a political chess game….it helps if the players know the moves……unfortunately, just being in opposition is not a good move……maybe then the Repubs would offer alternatives other than tort reform….

Simplest answers are usually the best answers…..what could it hurt?

Where Is Health Reform Headed?

Now that the weather in Washington has cooled off, (is that because the hot air from politicians is missing?), and all the heated rhetoric of health reform has been silenced by some moronic words uttered by yet another dipstick politician……but what does it look like the final product, if they manage that, will look like?

The public option is pretty much dead, it has one foot in the grave and the other on a banana peel, and that the senate bill maybe the final curtain call for health reform…..

Senior House Democrats have largely abandoned hopes of including a government-run insurance option in the final compromise health care bill taking shape, according to several officials, and are pushing for other measures to rein in private insurers.

They also want the final measure to include a House-passed proposal for a nationwide insurance exchange, to be regulated by the federal government, where consumers could shop for private coverage. The Senate bill calls for a state-based system of exchanges.

Additionally, House Democrats want to require insurers to spend a minimum amount of premium income on benefits, thereby limiting what is available for salaries, bonuses, advertising and other items. The House bill sets the floor at 85 percent; the Senate-passed measure lowers it to 80 percent for policies sold to small groups and individuals.

So it looks more and more like the exchange idea will prevail….but what the hell is it?

This is how people would buy insurance if they don’t have an employer that provides it. The structure is complicated, but these exchanges would basically be run by each state in conjunction with the federal government, and states would be allowed to create additional mechanisms for offering insurance to their residents. Traditional insurance companies would be allowed to compete for customers through the exchanges, provided they met a set of requirements set by the federal government. The least expensive plans would offer catastrophic coverage only, and not be available to everyone. There would be several other levels of coverage, priced more for each bump-up in benefits. The exchanges would go into effect in 2014. The House bill includes similar reforms, although there would be an additional health-insurance exchange at the national level. And the public health-insurance plan (not included in the Senate bill) would compete with private plans on each of the exchanges.The Senate bill proposes to create state-based exchanges, while the House bill would create one national exchange. Consumers who don’t get health insurance through their employer or a government insurance program would be eligible to shop on the exchange for plans. Low- and middle-income people who shop on the exchange would be eligible for government subsidies to help them buy their insurance plan.

Both the House and Senate bills would provide $5 billion to create a temporary insurance pool until an insurance exchange is up and running. Under the House bill, this program would be available to people who have a preexisting condition or have been uninsured for at least six months. Under the Senate bill, individuals would have to meet both requirements to be eligible. The House pool would open immediately and the Senate pool would open within 90 days of the bill’s enactment. Both pools would set limits on the premiums and cost-sharing that individuals would have to pay.

And there you have the newest piece of…………sorry had to find a word that would offend others…….work from the people who brought you the Patriot Act. About the only people that will benefit largely from this piece of….work….is the insurance industry…they will have mandated 30 million  new customers that they can screw over endlessly….sorry people but with this you will get the best health care that the industry wants to give….not what you need….are you proud of this yet?

Just Say No To Health Reform Bill

There are some on the Left that say NO to the proposed health reform bill and they do have reasons other than the trash that the Repubs try to throw at the public.

The primary problem with HR 3962 and the Senate proposals is that all of the changes they propose are made within a for-profit system. The House Bill strips the insurance companies of the right to deny coverage based on a pre-existing condition. Yet, it de-links the public option from Medicare reimbursement rates, thereby surrendering
pricing to the private sector. The Bill removes the anti-trust exemption enjoyed by private insurers. However, it simultaneously mandates that all Americans carry some form of health insurance, thereby herding millions into low-coverage high-fee private plans. Each step in a positive direction is coupled with a restructuring that will enrich private insurance companies and pharmaceutical makers.

The bills lost further reform credentials as Democrats cut last minute deals with Republicans.  Immigrants were removed from eligibility for the public option, abortions were written out of the proposal and Medicare funding was cut. The Medicare cuts are particularly cruel, since they will reduce an already compromised plan to bare bones coverage. Some of the cuts will limit private insurance profiteering, but others will slash necessary items such as exercise programs for seniors. Overall, these omissions signal that the reforms are not about providing comprehensive medical coverage, but about political expediency within the establishment political class. The next round of negotiations in the Senate is sure to produce even further regressive measures as campaign-donation driven legislators cut more deals.

The Left of the Dem Party was instrumental in the formation of the whole health reform issue and now with a vote coming soon to a Congressman near you….they are starting to show that they do NOT support a watered down bill just to get a win in the column….they want REAL health reform and not some pale imitation of it.

But the bill will go forward and most likely before the end of the year and yes, we will have a health reform bill for the president to sign….but willit be a good bill or just a bill to say they have a win……in my opinion, it will be anything but a good bill….it will be a win and that is the only good thing that can be said about the new health reform bill….

Personal Thought On Health Reform

We have all heard the figures being thrown around about the uninsured people in the US…there maybe a difference in the total number, but NO one can argue that the system is sound….well, with the exception of anyone making profit off the existing one…..and I have heard some on the Right saying that there is a need for health reform…..then why is it so abhorrent that there is the possibility for reform?

I understand the desire to keep the deficit down….or to keep the insurance profit margins….or to protect the free market….but……doing nothing as some have suggested is not a free market approach….why?  insurance companies are setting fees, services, etc and they have very little competition, if any…..

Think about this…we bailout a numerous amount of banks with NO control…they lost money we gave them money and now they are not it again….answer?…..we needed to get some skin in the bailout…if they took cash then we got 20-30% of their profits and we then could have used that to fund stuff like healthcare…after all they made enough on your money to pay huge bonuses to the boneheads that damn near destroyed the economic system….why not get something for out cash…the banks would not have given free money to ANYONE!

Sorry, that was a double comment or thought health care and banks….oops…my bad!

All I am saying is to those so concerned about the deficit and government spending, there was away to silence their concern but instead we give the guys a free ride to wealth without the consequences of bad judgment……

There is more……the latest polls show that the American people think the public option is a good idea, regardless of what is said by the pundits on the Hill.  We elected these guys and gals to do our bidding but that is not what is happening….take for instance this report by Reuters:

Health insurers, drugmakers and other companies expect U.S. Senate lawmakers to soften the blow from health reform legislation narrowly passed by the House of Representatives that calls for a greater government role in the industry.Pharmaceutical and insurance sector stocks were all in positive territory in line with the overall market on Monday, following the approval of the House bill late Saturday calling for a public insurance option and a government role in drug prices under Medicare.

Let me see, the Senate is where the industry has put their money to defeat health reform and it looks like it was money well spent….

Privatization Of Medicare Is Back!

Just when you thought it was safe from the perils of the conservative attack machine–the privatization of Medicare has reared its ugly head….just recently the GOP was attacking Dems for their proposals on Medicare and I was truly impressed that they would defend medicare,  a program they have been trying to destroy for decades….but as usual, it was just smoke and mirrors on the part of the Repubs….it was the same game they always play…..

Rep. Broun of Georgia has introduced a bill that will try and privatize Medicare, HR 3889…….thinkprogress.org is reporting on this issue:

In an attempt to reclaim the right’s rich tradition of opposing Medicare, Rep. Paul Broun (R-GA) has proposed legislation that would roll back the Medicare system and replace it with a system of vouchers that seniors could use to purchase private insurance:

U.S. Rep. Paul Broun introduced his own health care reform bill last week that would, among other things, privatize the Medicare insurance program for seniors.

Broun’s bill would replace government benefits with vouchers that could be spent on private insurance or put in tax-free medical savings accounts.

Oh My God they NEVER stop trying…do they?

Will it be this?  A whole new set of reforms that will help the insurance companies while screwing the consumer?  Not a chance…it is the SAME lame reforms they always try to pass to call it health reform….Do as little as possible, but make it look like a chore to get it done…..it is just that easy….

God forbid that they, the Repubs, try to resurrect the really lame idea of health savings accounts (HSA)!


Here It Is……The House Version!

You asked for it….now you got it!  The House version of the health reform bill has finally seen the light of day…it has just been announced….and now we can pick it apart…well, as soon as all the details are out……let the fun begin!

CNN has its report on the bill:

The bill — a combination of versions passed by three House committees — includes what is termed a “negotiated rate” public option. It will cost $894 billion over 10 years and extend insurance coverage to 36 million Americans, according to House Speaker Nancy Pelosi’s office.

The bill guarantees that 96 percent of Americans have coverage, Pelosi’s office said. The figure is based on an analysis by the nonpartisan Congressional Budget Office.

Under the House plan, health care providers would be allowed to negotiate reimbursement rates with the federal government, according to Democratic leadership aides.

Pelosi’s office said the bill would cut the federal deficit by roughly $30 billion over the next decade. The measure is financed largely through a combination of a tax surcharge on wealthy Americans and spending constraints in Medicare and Medicaid.

Medicare expenditures would be cut by 1.3 percent annually, Pelosi’s office said.

Under the House plan, health care providers would be allowed to negotiate reimbursement rates with the federal government, according to Democratic leadership aides.

Any bill passed by the House of Representatives will eventually have to be merged with legislation passed by the Senate. Both chambers would then have to pass a revised measure before sending it to President Obama to be signed into law.

You may have only thought that the “robust” public option was still alive…….

Are you ready for the fun?  The GOP already hates it….go figure and as more details are released the more of an overall picture we will have of the proposal.

I will begin……”negotiated rate” public option?  What happen to there would be a “robust” public option?  Negotiated rate does not sound robust to me.

Sorry, progressives….so far you guys are getting bumpkus of the stuff you wanted….the GOP ought to be thrilled….why?….they have succeeded in killing the possibility of ALL Americans getting adequate health care….that is a win….so far the Dems are losing…but as the pundits say…if Obama gets a bill to sign, then that would be a win….

And that is the stupidest thing I have ever heard……

More to follow…………….

What Are They Cheering About?

Sen Snowe moved, by her vote, the finance committee bill onto the next level of negotiations…..what are you fools cheering about?

Snowe’s vote did NOTHING to further the health bill reform other than moving it out of committee….what part of that is something to cheer?  It has NOTHING in it that would cover the uninsured other than some pale BS about competition, but the bill does not even do that….the bill is just exactly what the insurance companies wanted.  They retain their massive profits and in turn will have access toi millions more customers.  In simpler words, it is NOT reform at all, but rather something I said months ago…a TWEAK!

Snowe’s arguments summarized a growing consensus among Democrats on Capitol Hill – and Republicans no longer in office – that a flawed bill that starts to overhaul the system is better than no bill at all.

Her vote gives political cover to moderate Democrats, puts Republicans on the defensive and gives Senate leaders the latitude to find 60 votes to overcome a GOP filibuster, rather than force health care legislation through the Senate with a special partisan procedure.

If you are one of those, like many citizens and many doctors that wanted a public option to be part of any reform, then you have NOTHING to cheer.

The Senate Finance Committee bill

Who’s covered: An estimated 94 percent of Americans. Illegal immigrants would not receive benefits.

Cost: $829 billion over 10 years.

How it’s paid for: Fees on insurance companies, drugmakers, medical device manufacturers. Additional tax levied on insurance companies. Cuts to Medicare and Medicaid. A fee on employers whose workers receive government subsidies to help them pay premiums.

Individual mandate: Everyone must get coverage through an employer or on their own. Exemptions for economic hardship. The bill requires individuals and families to buy coverage if it costs no more than 8 percent of their income.

Employer mandate: Not required to offer coverage, but companies with more than 50 full-time workers would pay a fee if the government subsidizes employees’ coverage.

Insurance restrictions: No denial of coverage based on pre-existing conditions. No higher premiums allowed for pre-existing conditions or gender. Limits on higher premiums based on age and family size. Limits on allowable co-pays and deductibles.

Changes to Medicaid: Income eligibility levels standardized to 133 percent of poverty ($30,000 a year for a family of four) for all parents, children and pregnant women. Childless adults making up to 133 percent of poverty ($14,400 for an individual) would be eligible for the first time. The expansion would be delayed until 2014.

This is not something to cheer…this was just a political move to give cover to those Blue Dogs that want to be part of the conversation….
There is a distinct odor of compromise….TWEAKING not reforming…just what the insurance companies were hoping for…that is why they spend millions putting congress people in their pockets.
And then there was the threat of premium increases, the newest threat from the insurance companies….but think about that……if they get their way with the reforms they will have a free reign to do that anyway…..so that was BS from the word GO.  BTW, they have already said that the increases next year would be sizable.