The return of Harry and Louise: the Insurance industry strikes back

First off thanks to the people who recommended my previous diary. But on the heels of that diary comes this new one based on the developments of the day. I have made my suspicion for the theater being conducted in Senate by Max Baucus pretty well known. Seemingly the notion is if a public option is kept on the table as a threat, the insurance industry will come crawling like little misbehaving puppies wanting to be disciplined, in this case be regulated. But with each passing day it is becoming increasing apparent that not only are they against strict regulation, but they are willing to kill the nascent public option plan to maintain their monopoly, profiting on people's sickness and misery.

Earlier this month Karen Ignani, President and CEO of America's Health Insurance Plans (AHIP), told this to Senator Schumer about the public option:

There are a significant amount of Capital requirements that we need to meet, Medicare would have failed the capital test right now and so that is a very significant dollar figure that would have to be imbued into this plan and I know you've thought about that. The third issue is the payment issue...it would take a very long time, for government to develop the infrastructure to negotiate with physicians. Government doesn't have networks, can't put together networks, the Disease Management program failed in traditional Medicare and we all know why--because there's no predictability with respect to who's coming through the doors to the physicians' offices, etc.

However on May 11, President Obama had a chat with the AHIP representatives and made this statement:

"These groups are voluntarily coming together to make an unprecedented commitment," Mr. Obama said. "Over the next 10 years, from 2010 to 2019, they are pledging to cut the rate of growth of national health care spending by 1.5 percentage points each year -- an amount that's equal to over $2 trillion."

Which was received by an immediate push-back by the insurance industry, that stated that they made no such commitment:

In the bulletin, Richard J. Pollack, the executive vice president of the hospital association, said: "The A.H.A. did not commit to support the `Obama health plan' or budget. No such reform plan exists at this time."

Moreover, Mr. Pollack wrote, "The groups did not support reducing the rate of health spending by 1.5 percentage points annually."

Even at this juncture, the Baucus panel, instead if aggressively moving on a public option, was more focused on leveling the playing field, diluting the bill and making concessions to the insurance industry. The Republicans who have always been and always will be against any form of public option and healthcare reform got energized by new talking points from FrankLuntz, the architect one might say of the 1993 health-care defeat. While Sen. Baucus was still dreaming of a broad bipartisan health-care reform (read another white wash), today we have this from the Washington Post:

One week after the nation's health insurance lobby pledged to President Obama to do what it can to constrain rising health costs, Blue Cross Blue Shield of North Carolina is putting the finishing touches on a public message campaign aimed at killing a key plank in Obama's reform platform.

As part of what it calls an "informational website," the company has hired an outside PR company to make a series of videos sounding the alarm about a government-sponsored health insurance option, known as the public plan. Obama has consistently maintained that a government-run plan, absent high-paid executives and the need for profits, could be a more affordable option for Americans who have trouble purchasing private insurance. The industry argues that creating a public insurance program will undermine the marketplace and eventually lead to a single-payer style system.

[One can view the story boards here]

Now for a little history of BCBS-NC, my insurance provider, which basically has the entire state in a testicular vise grip. The state of NC runs its public plan through BCBS-NC, except the company has grossly over-charged administrative costs and on a bad fiscal year, when the entire country is hurting economically, when state employees are either being laid-off or being forced to take a furlough, the state finds itself in debt to BCBS-NC for hundreds of millions of dollars:

BCBSNC's behavior has led to disaster in North Carolina. Recently, the State Health Plan "came in $137.6 million off its budget for fiscal year 2008, resulting in a $79.7 million loss." Part of the problem was that BCBSNC's administrative "expenses cost $200.1 million more than planned." Its administrative expenses "have never been audited"

And if that is not enough Media Matters has compiled some of the most egregious violations committed by BCBS-NC over the years.

So here we are once again, deja vu, the battle lines are drawn, the usual suspects have revealed themselves for what they really are and what they care about. Yet somehow the Democratic majority senate (yes we are 1 vote shy of filibuster proof majority) is so intent on playing nice and being bipartisan (or maybe getting their corporate sponsors' back) that they cannot get themselves to go forward with intent on a public plan, that instead of playing on level field (whatever that might mean) will actually use its size to negotiate lower drug prices, negotiate lower hospital costs, have lower administrative costs and overall force the private players to lower costs and increase benefits. But unfortunately, much like Robert Reich, I do not see this happening. If we do not get a public option that does all the above, we will still see a lot of celebration in Washington but it will be a defeat for all the people who want REAL health-care reform.

Tags: Healthcare, insurance industry (all tags)

Comments

26 Comments

Real health-care reform

is it still a pipe-dream?

by tarheel74 2009-05-19 11:11AM | 0 recs
The Insurance Industry's Brer Rabbit Strategy
It starts with a nice, but misleading idea.."All other things being equal, public, nonprofit insurance can be cheaper than for-profit insurance" Right? Wrong. Because Public insurance has to be fairer. The private insurance we all know is profitable and expensive, right? The catch is "if all other things are equal". The problem is they wont be equal.. They will be extremely unequal.. Of course, the insurance companies figured out long ago, they need to apply reverse psychology to get what they want. The trick is to play Brer Rabbit and the Briar Patch.. They cant let on that they want public option, to kill single payer... They can't let on that they know how and why it will die! They have to say the opposite. So they lie now about how the public option has an "unfair advantage" - The opposite, true reality is that there is actually a disadvantage that we hope public option bears, and the "disadvantage" is caused by the public option doing the right thing- now. That "right thing" is community rating. By accepting the sick.. they accept that the plan will have higher costs than the private plans. Their risk pool will be sicker. Thats Adverse selection.
by architek 2009-05-19 12:58PM | 0 recs
Re: the Insurance industry strikes back

Thanks for keeping us abreast of this issue.

The only affordable solution is single-payer health care, a system that replaces our inadequate capitalist for-profit system that is clearly a leftover form of social Darwinism.

by MainStreet 2009-05-20 06:59AM | 0 recs
Re: the Insurance industry strikes back

Except that when you really investigate similar plans in Great Britain and Canada you will find it is not the success that people are making it out to be. Single payer doesnt work without costs. Fact is we have the tools we need now to significantly lower costs and make healthcare more affordable for everyone. What we lack is the political will to do it. Healthcare IT alone will save billions, healthcare education at all levels teaching and reinforcing proper excercise and nutrition, more personal responsibility for our own behavior, an end to obscene litigation....read the documentation on all this from Brookings for example and you will understand and agree that we can do this without some massive public plan.

by BuckeyeBlogger 2009-05-20 03:33PM | 0 recs
Re: the Insurance industry strikes back

I have very close friends who work for the NHS in Britain. If you ask anyone there they will bitch and moan about how bad their system is but ask them if they want to trade the NHS for a totally privatized health care system like we have and you will witness the outrage. It might not be an imperfect system but it is far better than what we have here.

by tarheel74 2009-05-20 04:17PM | 0 recs
Re: the Insurance industry strikes back

I meant to say it might not be a perfect system.... anyway you get my point.

by tarheel74 2009-05-20 04:18PM | 0 recs
My Canadian friends take it for granted BUT

when I tell them how bad things are here, they would not trade it in a million years. Basically, it lets them not think about health care. Paying isn't an issue.

Their lives revolve around their lives, like Americans lives used to.

by architek 2009-05-21 11:24AM | 0 recs
Re: the Insurance industry strikes back

It's also a misdirection to speak of other countries without comparing them to the U.S. Without that comparison we are at lost to understand what the numbers mean.

by bruh3 2009-05-20 05:08PM | 0 recs
What the data says

http://www.openleft.com/diary/13404/the- public-option-and-the-grand-arc-of-ameri can-politics

http://www.oecd.org/dataoecd/46/2/389805 80.pdf

Health IT along will not solve the market based issues. Nor will regulation address it given American politics and business structures. Nor is any other country so reliant, regardless of structure, on private sector healthcare.

The most elegant way to address the issue is a market competitor who forces the rest of the market to compete against products that are cheaper and provide better healthcare. You can not regulate this.

It's interesting to debate this will people who say they are "conservative" when in fact the market based approach is the most conservative approach. It requires minimal policing to confirm that a business is able to compete against a public option or not because if they are not able to compete- they lose business. If they are able to compete, they do not.  Whereas we would have a higher cost of policing health insurance companies and more than that we would face attempts as we see now with other oligarchial powers to water down regulations and once hte regulations are in place to cut out the teeth of regulation while they think Americans are not looking.

There are other indicators as well- but the core point- we pay twice as much for half the quality. There is no argument for a lack of a public option here other than private healthcare companies do not want to competition. Any polician buying into this is not interested in the welfare of the American people.

by bruh3 2009-05-20 05:05PM | 0 recs
Re: What the data says

Oddly enough we have real traction on this issue now. Today the Republicans released their version of healthcare bill which borrows heavily from the Clinton plan except it does not address the issue of keeping costs down. Actually right now both the bills, Democrats and Republican is more focused on opening the insurance industry to everyone without addressing the core issue: how do you keep the costs down!

by tarheel74 2009-05-20 05:09PM | 0 recs
Re: What the data says

And I know people in Canada in particular who have coem to the US on numerous occassions becuase they couldnt get timely care there. One of who needed surgery and was goign to have to wait nearly 2 years. You show me anything the federal government does that is cost efficient and administratively efficient and I will sell you a bridge......The answer lies with private health insurers, with the government working to reduce costs and provide subsidy to those who cannot afford care.

by BuckeyeBlogger 2009-05-20 05:40PM | 0 recs
Re: What the data says

"You show me anything the federal government does that is cost efficient and administratively efficient"

The VA system.

As far the Canada thing goes one thing that people conveniently overlook is people in Canada have to wait not because of bureaucratic problems but because there is an acute shortage of doctors there. Even in this wonderful land of private insurance that you champion so much people have to wait over an year to get a physician appointment, even after you do get an appointment then becomes the tedious task of finding out if that physician is in your "network", whether the procedures and medicines recommended will be covered by your policy. Yes there are some Canadian rich people who are willing to pay hard cash for getting service, I would love to see how long they would have to wait if they actually had US insurance.
Your Canadian example is a oft-debunked urban legend, better luck next time.

by tarheel74 2009-05-20 06:16PM | 0 recs
Re: What the data says

I cant say I have ever heard of anyone who has health insurance in this country waiting a year for an appointment. Longest I have ever waited was for a routine physical, I couldnt get an appointment for 2 months.....would I trade healthcare systems, no. I prefer one with an abundance of trained, and qaulified physicians here in the US.

The notion that only wealthy people from Canada come here is absurd. The folks I knwo arent wealthy by any sense of the imagination. They needed care, got an appointment here within about 30 days. Do more than read statistics.....read real stories of people in Great Britain and Canada who put the truth to the lie in those statistics you like to cite.

by BuckeyeBlogger 2009-05-21 05:03AM | 0 recs
Re: What the data says

You are talking about stories that you read and I am talking from experience in working in the field. If you have not heard people waiting 1 year for an appointment then you are living in a make-believe world. Like I said I have friends who work now in the NHS and if the British system was such a nightmare you say I would have heard it. Is it perfect? No. But is it functioning better than ours, in that it covers every single citizen of the UK? Yes it does. We not only have a shortage of trained physicians, our access is less and our cost is more. But of course you would like to bandy anecdotes, but for every single anecdote you tell me I can give you 10 nightmarish stories of people dying for the lack of the very basic care in this country. Private health insurance has been a failure...no correction: A Disaster.

by tarheel74 2009-05-21 05:43AM | 0 recs
Re: What the data says

You notice that his trick is to never provide any comparsion. He just relies on anecdotes and half ass responses. He will mention where a numb er is higher for a certain country for a disease, but then he will not mention that across all diseases if you look at the numbers, our numbers are worse. I wish I could find this chart by Ezra Klein that was put out by some study on the subject of diseases. It's pretty bad. We are essentially paying more across diseases more than other countries (despite conservatives obsessions with taxes) but the results are far worse.  It's funny that he keeps harping on wait time. That's another example of how they use anecdote to b..s The wait time issue is for some diseases, while for other more serious diseases the wait time in the US can actually be higher than the countries he's mentioning for again  a much higher price tag, some people who are under insuranced and those without insurance altogether.

by bruh3 2009-05-21 08:56AM | 0 recs
Re: What the data says

Do you really want to trade  U.S. versus Canaddian horror stories? You will lose on that front. Badly. Beyond the anecdotes, you tell us again nothing in comparison what do you have to offer here. Without numerical comparison, your arguments are useless.

by bruh3 2009-05-20 07:04PM | 0 recs
Re: What the data says

Go look at the death rates from breats and prostate cancer in Great Britain, they are 2-3 times higher than in the US. Go online right now and do a search on care shortages and delays in GB. Go read how drugs are denied to patients, howe drugs are rationed, care rationed to meet targeted guidelines.

You talk abotu the fact that they have affordable care, well yes, but they pay nearly 61 percent of their income to the Government in taxes.....of course its affordable. An dif they never use it, they still give the government 2/3 of their money.

Start reading the facts and stop citing some crap stats about who has care and who is satisfied. Go read about cancer patients being denied surgery, about heart transplant patients having surgery cancelled because beds or doctors were not available, go read about the high rate of dental issues due to the fact that patients cant get quick access to dentists.....

The healthcare system you crave isnt the success you believe it to be. Fact is we can provide better private care insurance here in the US and we have ways to bring down the costs.

by BuckeyeBlogger 2009-05-21 05:12AM | 0 recs
Re: What the data says

On average Americans have significantly worse results across diseases. if you want to find one or another disease in a particular country upon which to lay your claim, you are going to lose badly when the across the board numbers are compared. I do not have time right now, but there are multiple charts about diseases. And as for your claims about taxes- that's again laughable. If taxes were going up at double the rate of inflation per year like health insurance does and there was no appreciable benefit from it- that may be something upon which you can lay your idealogical hat, but that's not the reality. The reality is that we are being killed with the cost that private sector is forcing on us whether it is healthcare or a number of other hyper inflationary costs produced by profit mongers in the private sector. YOu have yet to link to one source to prove any fo the the crap you are peddling. You aslo do not know what I crave so fuck off.

by bruh3 2009-05-21 08:50AM | 0 recs
Re: What the data says

Why do you find it necessary to become verbally abusive? Your last comment was really just a sign of someone who doesnt have confidence in what they say

by BuckeyeBlogger 2009-05-21 06:11PM | 0 recs
Re: What the data says

Why do you find it necessary to not respond to everyone with this comment who is basically saying that you are making stuff up? Notice below another poster says exactly the same thing as me. You don't respond to that poster why? My last comment is verbatim what the person below says. The fact you do not respond, but instead try to personalize it to me, tells me that you don't have a substantive response so you are going to try to personalize it.

by bruh3 2009-05-21 07:32PM | 0 recs
Re: What the data says

Here's how someone else just below me describes your comments here:

"Re: What the data says (2.00 / 1)

You're talking out of your ass."

Yet , interestingly enought you did not respond to it. Are you sock puppet who has talked to me int eh past?

by bruh3 2009-05-21 07:33PM | 0 recs
Re: What the data says

Well, I have a job, so my blogging is confined to first thing int the morning or at night. I simply didnt have time to respond other than to ask why you find it necessary you abusive language. You personalized it, not me.

by BuckeyeBlogger 2009-05-22 09:12AM | 0 recs
Re: What the data says

You're talking out of your ass.  You have to pick and choose 2 types of cancer out of thousands to find any where single payer systems perform less well than the US.  And even there, the numbers are misleading, because the rates you mention don't consider population compositional differences between the US and the UK.  Plus, in fact, in terms of overall cancer death rates, we're at the bottom of industrialized world.

I can tell you as a medical demographer and statistician who studies population health, the US ranks at the bottom of the developed world by the two most important indicators of health:  Infant mortality and Life expectancy.  Our values of these are just below Cuba.  Our costs, however, are 3 times per capita what any other developed country pays.

Now, you can find "horror stories" about people waiting for surgery or being denied medication, but the fact is THE SAME THING happens here.  Only, here, we ration care based on the ability to pay.  There, they ration it based on need and efficacy of treatment.  That is, people may be denied treatment if they don't need it or it won't help them.  Here, you can get anything you want if you have the money, whether you need it or not, and whether it will work or not.  Of course, that's only if your insurer agrees to it.  Don't even get ME started on denial of coverage horror stories here.  They're far worse than the crap anecdotes you're bringing up.

by slynch 2009-05-21 12:26PM | 0 recs
Re: What the data says

Conservatives are funny that way- always arriving once everyone else has moved on. They are for MLK now that the battles over racial bigotry against AAs is not considered mainstream. I imagine in 20 years if the public option becomes law they will have been for it sometime in 2029?

by bruh3 2009-05-20 07:06PM | 0 recs
ALL the horror stories I hear are from HERE

The horror stories are from the USA.

by architek 2009-05-21 11:25AM | 0 recs
Paul Krugman's challenge to Obama to TELL THETRUTH

" Which brings us back to Mr. Obama.

Back during the Democratic primary campaign, Mr. Obama argued that the Clintons had failed in their 1993 attempt to reform health care because they had been insufficiently inclusive. He promised instead to gather all the stakeholders, including the insurance companies, around a "big table." And that May 11 event was, of course, intended precisely to show this big-table strategy in action.

But what if interest groups showed up at the big table, then blocked reform? Back then, Mr. Obama assured voters that he would get tough: "If those insurance companies and drug companies start trying to run ads with Harry and Louise, I'll run my own ads as president. I'll get on television and say `Harry and Louise are lying.' "

The question now is whether he really meant it.

The medical-industrial complex has called the president's bluff. It polished its image by showing up at the big table and promising cooperation, then promptly went back to doing all it can to block real change. The insurers and the drug companies are, in effect, betting that Mr. Obama will be afraid to call them out on their duplicity.

It's up to Mr. Obama to prove them wrong."

by architek 2009-05-22 05:14PM | 0 recs

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