TW: I could post an anecdote a day on the ramifications of our lack of universal care. But this one seemed more real given its spontaneous nature. The theme rarely changes though. There are gaping holes in our health care system, those holes either result in folks not getting care or folks getting care with funding indirectly provided by taxpayers or privately insured folks. Much of the health care reform is about reducing the voids and formally funding them as opposed to the current system which hides the costs whilst leaving some folks floundering amidst the voids.
From Karen Tumulty at Time:
"...The Senate was holding a noon vote, and I was loitering near an elevator where I had a hunch (okay, a tip) that one Senator who had been eluding my interview requests might be appearing at any moment. The police there, as you might imagine, keep an eye on everything, and when they see you hanging around--even if you are a middle-aged woman with a press credential around your neck--they will politely ask you what you are up to. So it was yesterday, and when I told the uniformed officer the name of the Senator I was hoping to catch, he immediately guessed that I was working on a story on health care reform.
That's when the officer began to tell me about his own experiences as an emergency medical technician. Many was the time, he said, that a critically ill or injured person would try to stop him even as he was loading them into the ambulance. "I don't have insurance," they would say. "I can't afford this." Over and over again, he would tell them not to worry on that score, that the hospital would admit them anyway and ultimately add their bills to the growing amount of indigent care they provide.
The officer said he is mystified by all the talk he hears about how covering the uninsured would be too expensive for the government to take on. "Don't they know?" the officer said, gesturing to the Senators who were scurrying in and out of the elevator. "It's getting paid for. We are all paying for this. We are paying with our tax dollars[TW: and private insurance $]..."
http://swampland.blogs.time.com/2009/09/23/a-health-care-expert-speaks-up/
Showing posts with label Karen Tumulty. Show all posts
Showing posts with label Karen Tumulty. Show all posts
Thursday, September 24, 2009
Tuesday, September 8, 2009
Filling the Donut Hole: Recission
TW: Universal care is not about helping welfare recipients (they have Medicaid) it is about helping working class and middle class folks overcome the gaps in our current system.
From Karen Tumulty at Time:
" 'There's a depressing sameness to them, but these kinds of stories can't be told often enough. Today, the Washington Post has a front-page look at yet another:
"They said I never mentioned I had a back problem," said Marrari, 52, whose coverage with Blue Cross was abruptly canceled in 2006 after a thyroid disorder, fluid in the heart and lupus were diagnosed. That left the Los Angeles woman with $25,000 in medical bills and the stigma of the company's claim that she had committed fraud by not listing on a health questionnaire "preexisting conditions" Marrari said she did not know she had.
By the time she filed a lawsuit in 2008, she also got a diagnosis of pancreatic cancer and her debts had swelled beyond $200,000. She was able to see a specialist by trading office visits for work on the doctor's 1969 Porsche at the garage she owns with her husband.'
If you think these are rare cases or inadvertent errors on the part of the insurance companies, think again:
'In the past 18 months, California's five largest insurers paid almost $19 million in fines for marooning policyholders who had fallen ill. That includes a $1 million fine against Health Net, which admitted offering bonuses to employees for finding reasons to cancel policies, according to company documents released in court.' "
http://www.washingtonpost.com/wp-dyn/content/article/2009/09/07/AR2009090702455.html?hpid=topnews
From Karen Tumulty at Time:
" 'There's a depressing sameness to them, but these kinds of stories can't be told often enough. Today, the Washington Post has a front-page look at yet another:
"They said I never mentioned I had a back problem," said Marrari, 52, whose coverage with Blue Cross was abruptly canceled in 2006 after a thyroid disorder, fluid in the heart and lupus were diagnosed. That left the Los Angeles woman with $25,000 in medical bills and the stigma of the company's claim that she had committed fraud by not listing on a health questionnaire "preexisting conditions" Marrari said she did not know she had.
By the time she filed a lawsuit in 2008, she also got a diagnosis of pancreatic cancer and her debts had swelled beyond $200,000. She was able to see a specialist by trading office visits for work on the doctor's 1969 Porsche at the garage she owns with her husband.'
If you think these are rare cases or inadvertent errors on the part of the insurance companies, think again:
'In the past 18 months, California's five largest insurers paid almost $19 million in fines for marooning policyholders who had fallen ill. That includes a $1 million fine against Health Net, which admitted offering bonuses to employees for finding reasons to cancel policies, according to company documents released in court.' "
http://www.washingtonpost.com/wp-dyn/content/article/2009/09/07/AR2009090702455.html?hpid=topnews
Monday, July 13, 2009
Please Keep Abortion Out Of Health Care Reform
TW: This is an issue about which I had not thought at all. But I suspect it will become a real problem for health care reform (as if more were needed). Abortion funding- to include it or not. The solution I would think would be to let current funding parameters in place. Unfortunately it appears continuing the "status quo" will be technically challenging and I strongly suspect anti-choice interests will seek to use health care reform as a means by which to further restrict funding. I hate the abortion issue it is a cancer upon American society.
From Karen Tumulty at Time:
"Should government-subsidized health coverage pay for abortion procedures? For more than three decades, that question had seemed pretty much settled. The Hyde Amendment, passed by the House on Sept., 30, 1976, forbade Medicaid — a program for poor people, jointly administered by Washington and the states, which had, up till then, paid for about 300,000 abortions a year — from using any federal money to pay for the procedure. All but 17 states followed suit, banning use of their own funds as well; with a few modifications, the ban has stood up ever since.
The prospect of sweeping health reform, however, has reopened the issue. While current versions of the legislation do not address the abortion issue at all, late last month, 19 antiabortion Democrats in the House sent a letter to Speaker Nancy Pelosi, warning that they "cannot support any health-care-reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health-insurance plan."
...Indeed, the abortion question is just one of a myriad of tricky questions that will emerge from the fine print as the health debate moves forward. Democratic leaders say, for example, that they are already prepared to accede to Republican demands that illegal immigrants be excluded from the plan. But other issues, such as abortion, are going to be far more difficult to navigate.
If an explicit ban on abortion coverage were imposed, say sources involved in writing the legislation on Capitol Hill, it could have much further-reaching implications than the Hyde Amendment ever did. It could, in fact, have the effect of denying abortion coverage to women who now receive it under their private insurance plans. Nearly 90% of insurers cover abortion procedures, according to a 2002 survey by the Guttmacher Institute, a nonprofit organization whose statistics are relied upon by both sides of the abortion debate.
Under the legislation being worked on by three committees in the House, Americans earning up to 400% of the poverty level — $43,000 for an individual; $88,000 for a family of four — would be eligible for government subsidies to help them purchase coverage. But if the antiabortion legislators get their way, those subsidies would have a big string attached; they could not be used to purchase a policy that has abortion coverage. For many women, that would mean giving up a benefit they now have under their private insurance policies. And it would raise all sorts of other questions if insurers were allowed to discriminate among their customers based on whether or not they are using federal dollars to pay for their policies.
Abortion-rights advocacy groups are pushing back. On July 6, the National Women's Law Center (NWLC) released a poll of 1,000 likely voters conducted by the Mellman Group indicating that 71% favor including reproductive services such as birth control and abortion as part of health reform. The poll also found that 75% believe an independent commission should determine what medical services are covered among the basic benefits offered under health reform. (Congress is also considering giving that power to the Health and Human Services Secretary.) Said NWLC vice president Judy Waxman: "Congress should refrain from practicing medicine and instead let medical professionals determine what health-care services will be included in a benefits package."
http://www.time.com/time/politics/article/0,8599,1909178,00.html
From Karen Tumulty at Time:
"Should government-subsidized health coverage pay for abortion procedures? For more than three decades, that question had seemed pretty much settled. The Hyde Amendment, passed by the House on Sept., 30, 1976, forbade Medicaid — a program for poor people, jointly administered by Washington and the states, which had, up till then, paid for about 300,000 abortions a year — from using any federal money to pay for the procedure. All but 17 states followed suit, banning use of their own funds as well; with a few modifications, the ban has stood up ever since.
The prospect of sweeping health reform, however, has reopened the issue. While current versions of the legislation do not address the abortion issue at all, late last month, 19 antiabortion Democrats in the House sent a letter to Speaker Nancy Pelosi, warning that they "cannot support any health-care-reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health-insurance plan."
...Indeed, the abortion question is just one of a myriad of tricky questions that will emerge from the fine print as the health debate moves forward. Democratic leaders say, for example, that they are already prepared to accede to Republican demands that illegal immigrants be excluded from the plan. But other issues, such as abortion, are going to be far more difficult to navigate.
If an explicit ban on abortion coverage were imposed, say sources involved in writing the legislation on Capitol Hill, it could have much further-reaching implications than the Hyde Amendment ever did. It could, in fact, have the effect of denying abortion coverage to women who now receive it under their private insurance plans. Nearly 90% of insurers cover abortion procedures, according to a 2002 survey by the Guttmacher Institute, a nonprofit organization whose statistics are relied upon by both sides of the abortion debate.
Under the legislation being worked on by three committees in the House, Americans earning up to 400% of the poverty level — $43,000 for an individual; $88,000 for a family of four — would be eligible for government subsidies to help them purchase coverage. But if the antiabortion legislators get their way, those subsidies would have a big string attached; they could not be used to purchase a policy that has abortion coverage. For many women, that would mean giving up a benefit they now have under their private insurance policies. And it would raise all sorts of other questions if insurers were allowed to discriminate among their customers based on whether or not they are using federal dollars to pay for their policies.
Abortion-rights advocacy groups are pushing back. On July 6, the National Women's Law Center (NWLC) released a poll of 1,000 likely voters conducted by the Mellman Group indicating that 71% favor including reproductive services such as birth control and abortion as part of health reform. The poll also found that 75% believe an independent commission should determine what medical services are covered among the basic benefits offered under health reform. (Congress is also considering giving that power to the Health and Human Services Secretary.) Said NWLC vice president Judy Waxman: "Congress should refrain from practicing medicine and instead let medical professionals determine what health-care services will be included in a benefits package."
http://www.time.com/time/politics/article/0,8599,1909178,00.html
Thursday, June 4, 2009
So What Was Going Through Their Minds?
TW: Karen Tumulty at Time does a feature with Time photos called a "1,000 Words", today's was a really good one. Some of the comments even better, see link below.Thursday, May 28, 2009
Republicans Making Moves On Health Care Reform
TW: We appear to be on our way to some form of health care reform. The fiscal realities driven by demographics are becoming increasingly dire, a consensus that change is required is no longer very controversial. How to do so is of course debated but interestingly the Republicans and Dems are not that far apart. The recent proposal by a prominent group of Republican congressmen is a step in the right direction. Although their proposal much like the Dem's skirts the fundamental questions of cost containment.
They propose removing the tax exempt status of employer funded health benefits (not likely to happen) and uses that money to subsidize individual plans. Their plan would leave more folks uninsured than the Dem's plan (no mandated insurance) and seeks to use some privatization principles. We shall see...
From Karen Tumulty at Time:
"The last time this country undertook a serious debate over health-care reform, back when Hillary Clinton put together her proposal in 1993, the Republican strategy could have been summed up in three words: Just say no. This time around, however, the clamor for fundamental change of a system that covers too few and costs too much has grown to the point where the minority party knows that simple obstructionism is a dangerous route to take.
"The status quo is no longer acceptable," political strategist Frank Luntz wrote in a confidential memo to congressional Republicans earlier this month. "The overwhelming majority of Americans believe significant reform is needed — and they see Republicans (and the insurance companies) as the roadblock. If the dynamic becomes 'President Obama and congressional Democrats are on the side of reform and Republicans are against it' — which is exactly what Obama has already started to promote — the public will side with the Democrats and you will lose both the communication and the policy."
What kind of health-care reform would Republicans like to see? Four conservative GOP lawmakers — Senators Tom Coburn of Oklahoma and Richard Burr of North Carolina, along with Congressmen Paul Ryan of Wisconsin and Devin Nunes of California — introduced a proposal on May 19 that looks a lot like the one John McCain advanced during his presidential campaign as well as an idea George W. Bush advanced as President.
But it also includes the kind of rhetoric more generally associated with the Democrats. A 15-page summary of the bill begins: "It is time to publicly admit that the health-care system in America is broken. Costs are rising at an unacceptable rate — more than doubling over the last 10 years, which is nearly four times the rate of wage growth. Too many patients feel trapped by health-care decisions dictated by HMOs. Too many doctors are torn between practicing medicine and practicing insurance. And 47 million Americans worry what will happen to them or their children if they get sick."
The GOP plan would make the health benefits that companies provide their workers count as taxable income, and then use that money to provide tax credits with which individuals could purchase their own health coverage...it would provide new incentives for insurers to offer coverage to people who now have trouble buying it because they have pre-existing health conditions. It also puts more emphasis on preventive care and sets up "state exchanges" — similar to the one now operating in Massachusetts — in which individuals and families could comparison-shop for insurance plans.
However, that Republican bill does not purport to assure coverage to all — or even most — of the 47 million or so Americans who now lack it. It does not, for instance, impose a requirement that employers provide coverage to their workers or that individuals who do not get health benefits at work buy them on their own. The tax credits that it provides — $2,300 for individuals and $5,700 for families — fall well short of the average annual cost of a health policy, which is between $10,000 and $12,000 per family, says Robert Blendon, professor at Harvard.
Coburn, a practicing physician, disputes Blendon's analysis of his bill. "In the vast majority of cases, our credit will more than cover an employee's share of a health plan's cost, which is about a third of a plan's total cost, or $4,000," Coburn says...
...one thing seems clear: Republicans have figured out that, this time, the debate over health-care reform is not one they are going to win simply by saying no."
They propose removing the tax exempt status of employer funded health benefits (not likely to happen) and uses that money to subsidize individual plans. Their plan would leave more folks uninsured than the Dem's plan (no mandated insurance) and seeks to use some privatization principles. We shall see...
From Karen Tumulty at Time:
"The last time this country undertook a serious debate over health-care reform, back when Hillary Clinton put together her proposal in 1993, the Republican strategy could have been summed up in three words: Just say no. This time around, however, the clamor for fundamental change of a system that covers too few and costs too much has grown to the point where the minority party knows that simple obstructionism is a dangerous route to take.
"The status quo is no longer acceptable," political strategist Frank Luntz wrote in a confidential memo to congressional Republicans earlier this month. "The overwhelming majority of Americans believe significant reform is needed — and they see Republicans (and the insurance companies) as the roadblock. If the dynamic becomes 'President Obama and congressional Democrats are on the side of reform and Republicans are against it' — which is exactly what Obama has already started to promote — the public will side with the Democrats and you will lose both the communication and the policy."
What kind of health-care reform would Republicans like to see? Four conservative GOP lawmakers — Senators Tom Coburn of Oklahoma and Richard Burr of North Carolina, along with Congressmen Paul Ryan of Wisconsin and Devin Nunes of California — introduced a proposal on May 19 that looks a lot like the one John McCain advanced during his presidential campaign as well as an idea George W. Bush advanced as President.
But it also includes the kind of rhetoric more generally associated with the Democrats. A 15-page summary of the bill begins: "It is time to publicly admit that the health-care system in America is broken. Costs are rising at an unacceptable rate — more than doubling over the last 10 years, which is nearly four times the rate of wage growth. Too many patients feel trapped by health-care decisions dictated by HMOs. Too many doctors are torn between practicing medicine and practicing insurance. And 47 million Americans worry what will happen to them or their children if they get sick."
The GOP plan would make the health benefits that companies provide their workers count as taxable income, and then use that money to provide tax credits with which individuals could purchase their own health coverage...it would provide new incentives for insurers to offer coverage to people who now have trouble buying it because they have pre-existing health conditions. It also puts more emphasis on preventive care and sets up "state exchanges" — similar to the one now operating in Massachusetts — in which individuals and families could comparison-shop for insurance plans.
However, that Republican bill does not purport to assure coverage to all — or even most — of the 47 million or so Americans who now lack it. It does not, for instance, impose a requirement that employers provide coverage to their workers or that individuals who do not get health benefits at work buy them on their own. The tax credits that it provides — $2,300 for individuals and $5,700 for families — fall well short of the average annual cost of a health policy, which is between $10,000 and $12,000 per family, says Robert Blendon, professor at Harvard.
Coburn, a practicing physician, disputes Blendon's analysis of his bill. "In the vast majority of cases, our credit will more than cover an employee's share of a health plan's cost, which is about a third of a plan's total cost, or $4,000," Coburn says...
...one thing seems clear: Republicans have figured out that, this time, the debate over health-care reform is not one they are going to win simply by saying no."
Wednesday, May 6, 2009
Despair That Health Care Reform Will Ever Happen
TW: This re-cap by Time's Tumulty of a Republican consultant Frank Luntz' take on how to oppose Obama's health care reform initiative frames why Americans may understand partially at least that our system is broken and getting worse, but are absolutely not prepared to make the tough decisions to fix it.
Luntz realizes folks theoretically would like reform but then raises all of the standard objections with no solutions, suggesting a path that would result in retaining the status quo whereby Americans consume more and more health care at higher and higher prices. Luntz' strategy hits the usual hot buttons (the same ones that killed the 1994 Clinton effort) and could be summarized as:
"keep government out, have doctors and patients make all care decisions, prevent any rationing"
The above sounds great until you realize this does nothing to accomplish change or reform from the current system. Health care providers (in avoiding risk and pursuit of revenue) and patients (in avoiding any risk) will consume infinite health care. Luntz frames what likely could blunt the Democratic reform efforts. But where are his solutions? At some point our societal aversion to health care risk and the disconnect between users and payers must be addressed.
From Time:
"Politico's Mike Allen has this...look at the talking points that pollster/wordsmith Frank Luntz has crafted for the House Republicans, as they consider how to approach health care reform. Luntz warns them that public sentiment in favor of fixing the broken system is too strong for them to oppose it directly:
“The status quo is no longer acceptable. If the dynamic becomes ‘President Obama is on the side of reform and Republicans are against it,' then the battle is lost and every word in this document is useless...Republicans must be for the right kind of reform that protects the quality of healthcare for all Americans. And you must establish your support of reform early in your presentation.”
He says there are some arguments Republicans can make that would be "clear winners":
—“It could lead to the government setting standards of care, instead of doctors who really know what's best.”
—“It could lead to the government rationing care, making people stand in line and denying treatment like they do in other countries with national healthcare.”
-“President Obama wants to put the Washington bureaucrats in charge of healthcare. I want to put the medical professionals in charge, and I want patients as an equal partner.”
These could indeed be powerful arguments, as anyone who has watched previous battles over health care reform can tell you."
Luntz realizes folks theoretically would like reform but then raises all of the standard objections with no solutions, suggesting a path that would result in retaining the status quo whereby Americans consume more and more health care at higher and higher prices. Luntz' strategy hits the usual hot buttons (the same ones that killed the 1994 Clinton effort) and could be summarized as:
"keep government out, have doctors and patients make all care decisions, prevent any rationing"
The above sounds great until you realize this does nothing to accomplish change or reform from the current system. Health care providers (in avoiding risk and pursuit of revenue) and patients (in avoiding any risk) will consume infinite health care. Luntz frames what likely could blunt the Democratic reform efforts. But where are his solutions? At some point our societal aversion to health care risk and the disconnect between users and payers must be addressed.
From Time:
"Politico's Mike Allen has this...look at the talking points that pollster/wordsmith Frank Luntz has crafted for the House Republicans, as they consider how to approach health care reform. Luntz warns them that public sentiment in favor of fixing the broken system is too strong for them to oppose it directly:
“The status quo is no longer acceptable. If the dynamic becomes ‘President Obama is on the side of reform and Republicans are against it,' then the battle is lost and every word in this document is useless...Republicans must be for the right kind of reform that protects the quality of healthcare for all Americans. And you must establish your support of reform early in your presentation.”
He says there are some arguments Republicans can make that would be "clear winners":
—“It could lead to the government setting standards of care, instead of doctors who really know what's best.”
—“It could lead to the government rationing care, making people stand in line and denying treatment like they do in other countries with national healthcare.”
-“President Obama wants to put the Washington bureaucrats in charge of healthcare. I want to put the medical professionals in charge, and I want patients as an equal partner.”
These could indeed be powerful arguments, as anyone who has watched previous battles over health care reform can tell you."
Tuesday, January 27, 2009
Listening to Limbaugh Can Cause Blindness...
TW: I rarely mention Limbaugh (or say Coulter) because they are not journalists or even pundits merely entertainers who live for criticism. Obama made the error of mentioning the Puffy One Friday which I am sure sent Puffy into spasms of glee. But the Drudge/Puffy attack on Pelosi based on her comments Sunday on birth control funding is classic right-wing hack work. They strongly implied Pelosi was supporting population control as a cost savings measure. One would hope sane listeners would say to themselves why would Pelosi be for such a thing but somehow I fear that may not always be the case.
From Karen Tumulty at Time:
"...Like other portions of the stimulus bill, this measure [to which Pelosi referred] would not only aid states, but also provide preventative, cost-saving health care to help low-income women support their families and keep working. It focuses on access to recommended services and contraception to prevent unplanned pregnancies and promote maternal and infant health — not abortion. An upcoming Congressional Budget Office report estimates that this change would save $200 million over five years and $700 million over 10.
No one would be forcing states to pay for family planning services. States can now cover low-income women if they get a state waiver, but approval can take a long time. Despite these bureaucratic hassles, 27 states have already “obtained federal approval to extend Medicaid eligibility for family planning services to individuals who would otherwise not be eligible.” This bill would simply allow states to skip the administrative delays."
From Karen Tumulty at Time:
"...Like other portions of the stimulus bill, this measure [to which Pelosi referred] would not only aid states, but also provide preventative, cost-saving health care to help low-income women support their families and keep working. It focuses on access to recommended services and contraception to prevent unplanned pregnancies and promote maternal and infant health — not abortion. An upcoming Congressional Budget Office report estimates that this change would save $200 million over five years and $700 million over 10.
No one would be forcing states to pay for family planning services. States can now cover low-income women if they get a state waiver, but approval can take a long time. Despite these bureaucratic hassles, 27 states have already “obtained federal approval to extend Medicaid eligibility for family planning services to individuals who would otherwise not be eligible.” This bill would simply allow states to skip the administrative delays."
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