Democracy for Utah - Universal Healthcare

McCain is apparently happy with his government health insurance

Thu, 02 Oct 2008 13:56:27 -0600

[A]s a 72-year-old who's healthy enough to run for president, there's no evidence that McCain has ever experienced a day of dissatisfaction with his health care coverage. Indeed, as the husband of an heiress, McCain could easily have stepped out into the private market — the very market he wants all Americans to use — and bought another plan for him and his wife, so he wouldn't have to deal with the government system any longer. There's no evidence he did that, either.

McCain's problem is not simply that he's been on government health insurance his whole life. It's that, by all accounts and appearance, he's been quite satisfied with his coverage. His complaints are all of a general nature. "I've always been a free enterprise person" or "my opponent wants to create a health care bureaucracy." Never "I've been on Medicare for years now, and it's a house of horrors."

Ted Kennedy's final battle: healthcare for all

Tue, 26 Aug 2008 12:37:34 -0600

Ezra Klein:

The Kennedy tribute was touching, but it was Kennedy who was powerful. Walking out to chants of "Teddy, Teddy," Kennedy sounded strong and sharp. He's old now, and sick. He walks slowly and the mane has thinned. But he's still got that voice, that rumbling bass — as Harold said to me this morning, "the last voice in American politics." The words, as they've always been, were clear, and the message was simple. Broadly, it was this: Health care. Before he even mentioned Obama's name. Health care. After he spoke of the hope Obama brings. Health care.

In the last few weeks, I've spoken to a couple Kennedy aides who all told me the same thing: Health care. Kennedy has told them that this is his final crusade. Aides who work in other legislative areas have been told that their issue areas are going to almost dissolve, and they'll become something like support staff for the health team. Kennedy means to pass a bill. He means to muster the full force of his legislative talents, his sprawling staff, his longstanding relationships, and even the poignancy of his condition. It will be his legacy. It is his dream. Health care.

Inside an insurance industry denial machine

Tue, 05 Aug 2008 12:56:55 -0600

nyceve at Daily Kos:

The medical loss ratio refers to the percentage of dollars actually spent on medical care versus administrative costs or profit. The higher the ratio, the more money is being spent on actual delivery of care. Components of the medical loss ratio include payments to physicians, hospitals, pharmacists and other providers of health care.

For example, an unheard of medical loss ratio of 91 percent means that 91 cents out of every dollar goes to practitioners and providers. This never happens, of course. Most medical loss ratios are in the neighborhood of 80–81 percent.

The mission of the U.S. insurance industry is to keep this ratio as low as possible. The way they do this is with ruthless companies like TC3 Total Claims Capture and Control which I'm going to introduce you to today. When the medical loss ratio creeps up, which means too much money is being spent on our healthcare needs, the for-profit insurer turns to TC3 to bring costs (losses) down.

What happens if Democrats succeed with universal healthcare?

Wed, 23 Jul 2008 11:31:54 -0600

Kos tells the story of a woman he met in Austin who was convinced that elected officials can't do anything about problems like health care or the mortgage crisis:

[...] Well, I responded, what about health care, are you happy with your health care? She lit up, "I know no one who is happy with their health care!" and then segued into a rant about the disgraceful state of the health care system. Well, I responded, Democrats are working for universal healthcare, but Republicans have gotten in the way. But we'll be able to do it next year.

"Ain't no one who can fix that stuff," she sighed, slumping. That brief expression of fire and brimstone snuffed out in an instant. She was adamant that it was all hopeless. [...]

I had one last argument up my sleeve. Look, I get it, I told her, government hasn't given us many reasons to be confident of late. I can certainly empathize. But can we make a deal? If Democrats push through universal health care in the next four years, will you vote for Barack Obama in 2012?

She looked initially uncomfortable at the thought, but after a pause and a brief internal struggle, she softened and said, "Yeah, I will."

That, in a nutshell, is what Kristol and Ponnuru and Lowry and every conservative in this country fears the most.

Benefits of Taiwan's single-payer healthcare system

Tue, 17 Jun 2008 13:18:30 -0600

Congressional Quarterly looks at Taiwan's system of single-payer healthcare, which was put into place in 1995:

"In Taiwan, we have no waiting lists," says Hou [Sheng-Mou]. "In Taiwan, the doctor works on Saturday. They operate on Saturday afternoon." Moreover, the government does not tell its citizens where they must go for care, he said. Sophisticated information technology is a part of the health system. Each resident of the country carries a "smart card" to entitles them to health care.

"With the smart card you can go to any clinic at any time without an appointment," Hou said. And there is no "gatekeeper" denying access to specialists, a frequent complaint among Americans about U.S. managed care companies. [...]

The smart card also contributes to the quality and efficiency of the system by giving doctors a medical profile of the patient and by automating payment. When a provider swipes the card, the patient's medical history and medications show up on the computer screen and the government is billed for the provider's services.

Taiwan's single-payer system isn't perfect; for example, its expenditures are slightly above its revenues, and there is less money available for R&D than in the U.S. On the plus side, Taiwan's system has far lower administrative costs: 1.6% of healthcare spending vs. 15% (as a low estimate) in the U.S. Also, Taiwan insures all its citizens while spending only 6% of its GDP on healthcare, while we spend 16% of our GDP on healthcare and still have 47 million Americans without coverage.

Broken Healthcare System: Cherrypicking 257

Mon, 02 Jun 2008 10:25:26 -0600

Unless healthcare is universal, we'll continue to get egregious instances of cherrypicking by insurance companies. Who knew a Caesarian birth could render a mom un-insurable or forced to pay more for insurance (NYTimes)?

When the Golden Rule Insurance Co. rejected her application for health coverage last year, Peggy Robertson was mystified....said Mrs. Robertson, "I'm in perfect health." She was turned down because she had given birth by Caesarean section. Having the operation once increases the odds that it will be performed again, and if she became pregnant and needed another Caesarean, Golden Rule did not want to pay for it... With individual insurance, unlike the group coverage sponsored by employers, insurance companies in many states are free to pick and choose the people and conditions they cover, and base the price on a person's medical history. Sometimes, a past Caesarean means higher premiums.

As more and more people are self-employed or take jobs that offer no health insurance, millions more Americans will seek individual health coverage...where cherry-picking the healthiest and gouging or refusing the others is rampant.

Medical Debt in Salt Lake City

Tue, 20 May 2008 08:06:59 -0600

Thousands of low-income people in our capitol city are suffering because of medical debt. What can our elected officials do about this problem? Come to the SLC Main Library on Wednesday, May 28, at 6:30 pm to be informed about this. For more info, email Bill Tibbitts at bill@crossroads-u-c.org. The event is sponsored by the Anti-Hunger Action Committee, an organization for food pantry clients that works to get low-income folks involved in the political process.

John McCain, lifetime beneficiary of 'socialized medicine'

Wed, 07 May 2008 12:27:11 -0600

Ezra Klein:

As Sarah Arnquist has written, aside from his awful internment in a Vietnamese prison camp, it is hard to find a day in McCain's life when he was not sheltered by the government-run health care he now claims to loathe. Born the son of a Navy admiral, he was cared for by Navy physicians during his childhood. After graduating from high school, he enrolled in the United States Naval Academy, and the military's care continued until he retired from the service in 1981. In 1982, he won a seat in Congress, ushering him into the Federal Employee Health Benefits Program, and in 2001, he qualified for Medicare. When he says, "we have the highest quality of health care in the world in America," he is speaking as a man who has enjoyed a lifetime of government-run care.

But now John McCain is seeking the presidency as a Republican, and a healthy distaste for government-run health care is de rigueur. "I am convinced," said John McCain at Miami Children's Hospital, "that the wrong way to go is to turn over your lives to the government and hope it will all be fine. It won't." Spoken like a 71-year-old whose government health coverage has kept him healthy enough to run for the presidency.

Consumer-Driven Health Plans: Do They Work?

Wed, 30 Apr 2008 08:32:52 -0600

"Consumer-driven" health plans are favored by many Utah legislators & other conservatives as a market-based solution to rising healthcare costs. These plans typically combine high deductibles with a tax-advantaged health account that can be used to pay deductible and medical/dental expenses that are not covered.

The latest survey by the non-partisan Employee Benefit Research Institute found that

Six steps for healthcare reform in Utah

Fri, 25 Apr 2008 12:37:08 -0600

Here are two of Dr. Joseph Jarvis's six suggestions for bringing about true health-care reform in Utah (Salt Lake Tribune):

Perverse incentives: From the Wall Street Journal on April 5: "Research at Dartmouth Medical School suggests that if everyone in America went to the Mayo Clinic, our annual health-care bill would be 25 percent lower (more than $500 billion) and the average quality of care would improve. ... Of course, not everyone can get treatment at Mayo. ... But why [is] this example of efficient, high-quality care not being replicated all across the country? The answer is that high-quality, low-cost care is not financially rewarding. Indeed, the opposite is true. Hospitals and doctors can make more money providing inefficient, mediocre care."

Market-based health policy: If we are to eliminate the perverse incentives that lead to inefficient, mediocre care, we have to give up the cherished notion that health care is a commodity efficiently distributed by market forces. We do not principally fund health care through the private sector — 60 percent of revenues paying for health services come from taxpayers, making our citizens more taxed for health care than any people in the world. Beyond that, health care is not subject to market forces, such as a lowered price increasing demand. No one ever had an appendectomy because the price was right. The occurrence of illness and injury primarily determine demand for health services.

More privatization of healthcare equals higher costs

Tue, 08 Apr 2008 11:16:28 -0600

Paul Krugman says that "the power of competition" does not drive down healthcare costs:

For one thing, even if you buy the premise that competition would reduce health care costs, the idea that it could cut costs enough to make insurance affordable for Americans with a history of cancer or other major diseases is sheer fantasy.

Beyond that, there's no reason to believe in these alleged cost reductions. Insurance companies do try to hold down "medical losses" — the industry's term for what happens when an insurer actually ends up having to honor its promises by paying a client's medical bills. But they don't do this by promoting cost-effective medical care.

Instead, they hold down costs by only covering healthy people, screening out those who need coverage the most [...]. They also deny as many claims as possible, forcing doctors and hospitals to spend large sums fighting to get paid.

And the international evidence on health care costs is overwhelming: the United States has the most privatized system, with the most market competition — and it also has by far the highest health care costs in the world.

Friday news roundup

Fri, 28 Mar 2008 10:32:54 -0600

How government lowers healthcare costs (Jacob Hacker in the Washington Post)
How to debunk a mischaracterization of what your candidate said (Charles Krauthammer in the Washington Post, demonstrating that he can think rationally when defending Republicans)
Small currency outlets in Amsterdam refuse to take U.S. dollars (Reuters)
After a brief dip last week, Obama takes an 8-point lead over Clinton nationally (Gallup)

The strange structure of health insurance

Wed, 26 Mar 2008 10:55:48 -0600

Ezra Klein is busy transcribing a speech from Dr. Mark Smith, CEO of the California Health Care Foundation. Here's an excerpt:

It's a strange business you're in. What you are selling is four different things. Why do we want people to have health insurance? I always get some variant of four answers. 1) We want people to be protected against rare, unpredictable and uncontrollable catastrophic events. 2) We want people to be covered so they can have their preventive services paid for. They're not rare, they're not unpredictable. But if we have them put it on their Visa, they don't do it. So we prepay for it. 3) So you can get discounts, and don't have to pay rack rate at the doctor. But that's not insurance, it's market leverage. 4) So people who have chronic diseases don't have to pay for the cost of their care, transferring assets from the known healthy to the known unhealthy. Each of these is a socially useful function, but they operate very differently. Saying you need to protect assets from financial loss is a difficult proposition for someone who has no assets to protect. [...]

It's like trying to sell a car that's bundled together with car insurance and three dozen eggs every week and a trip to Bermuda when you turn 27. Those are kind of different things and people will be differentially inclined to buy them, but if they're bundled together you have a pretty dysfunctional product. That's part of why we have such difficulty in the public space agreeing on what is adequate insurance.

Democratic national healthcare plan would save $1.04 trillion

Thu, 21 Feb 2008 10:52:06 -0700

Ezra Klein examines the healthcare plan from political scientist Jakob Hacker that's the foundation of the Edwards, Obama, and Clinton healthcare plans:

The bottom line is that the Hacker structure covers just about everyone and saves huge amounts of money. At the start, bringing the changes to the [healthcare] system and the broad expansion of coverage to 46 million (or so) Americans means total federal spending increases by about $50 billion, but employer spending decreases by $10 billion, families save $22 billion, and states save about $20 billion. So it evens out.

But that's only on day one. Then, over time, the new system does quite a bit to cut costs through "restricting provider payment increases, negotiating deeper drug discounts, and simplified administration." The bottom line of the report is that "under these cost controls, total national health spending over the 2008 through 2017 period would be about $1.04 trillion less than under current law over that same period." That's $1.04 trillion in savings even with 47 million more Americans covered and far less economic insecurity for the rest of us. That's $1.04 trillion that can be spent on infrastructure, on schools, on homes and televisions and groceries and wars and iPhones and whatever else we decide to fund. And that's a big deal.

Republican doctor says HB133 protects health insurance profits

Tue, 19 Feb 2008 12:09:39 -0700

From Dr. Joseph Jarvis, a Republican who ran against now-Senator Scott McCoy (Salt Lake Tribume):

It is axiomatic that sustainable health-system reform, when (or if) it finally comes to Utah (or any part of the nation), will come only after arduous and divisive debate.

The reason is simple: Too much money is being made by too many corporations from the contributions from employers, philanthropists and taxpayers that are intended to care for the sick and the injured. [...]

Described in this section [of the bill] are a dozen different ways that the insurance industry is to be favored, including exemption from state health-insurance laws, creating minimum required coverage policies and bringing public employees into the private health insurance market.

Unquestionably, this bill was written by the insurance companies and for the insurance companies. I think the bill title should be "No Health Insurance Company Left Behind."

It is outrageous that Utah state government should be instructed to sustain a viable insurance market. Since when is government in charge of sustaining any market? How is it a market if government must sustain it?