Tag Archives: Health Care Reform

Responses to questions on health care reform

First, thanks for all the feedback on my prior blog with powerpoint on health care reform. Below I’ve tried to address some of the remaining issues that have arisen.  I am more committed than ever to REAL reform and this this ongoing conversation is critical to that end. Our health care system is broken. Worse yet, it is destroying businesses and individuals. It must be fixed now! I’m not convinced we yet have THE answer. I am convinced ongoing dialogue is critical to getting us there. Special thanks for my friend Chris Purk for constantly challenging me. Much of the response below was culled from an ongoing conversation we are having on facebook! Please join in! A great source for discussion on the health care needs of our nation, check out the nonpartisan National Coalition on Health Care at: http://nchc.org.


Premise #1:

If this health care bill isn’t the answer, our representative MUST craft one that IS! The power of special interests and lobbyists in the realm of health care reform have stopped the process of real reform for decades. We have been trying to take small steps for a very long time. PPOs, HMOs, managed care have all been stop gap efforts to control costs and increase the quality of care. They haven’t done so.

Premise #2:

There is simply no incentive for insurance companies, pharmaceutical companies, or health care providers to lower rates. It’s in their best interests to keep the run away price increases going. Bottom line: They make more money this way!

Premise #3:

Any cost estimates on either side: that health care reform won’t cost a thing OR that it will cost trillions are flawed. NO ONE can anticipate the contingencies that will ACTUALLY lower costs. The capitalist model says if you increase competition, costs will drop. That’s what a public option would do.

Premise #4:

This issue is NOT just about the un and underinsured. Health care costs are hurting EVERYONE!  We are already paying for the un and underinsured. They go to emergency rooms sicker and take longer to regain health (if they do at all) than those with insurance. They are less likely to get standard preventative care than those with insurance. They pay all they can and we (taxpayers) shoulder the rest. Insurance and preventative care are BETTER options than emergency room visits. Emergency rooms visits, the most expensive health care in the country, should not be the first line of health care for anyone.

BUT, the current health care system is NOT hurting only the un or underinsured. It’s hurting everyone – BUSINESSES that can’t afford to pay premiums are cutting benefits to employees and many are cutting insurance benefits all together or anticipate significantly reducing them in the near future. Business leaders are arguing that the single biggest factor in reduced R&D and their inability to expand the workforce are health benefits. We can’t get jobs for people if employers can’t afford to hire them.

EMPLOYEES are paying higher health care premiums and finding themselves with less coverage. People can’t afford to change jobs due to the fact that they may not be able to get insurance coverage, especially if someone in the family has a chronic or preexisting condition. People are losing their homes to cover medical costs; a large percentage of both personal bankruptcies and home foreclosures are linked to health care costs. And all this for a health care system that is ranked 37th in the world!

My personal “out-of-pocket” costs for health insurance doubled for next year, my co-pays on everything increased at least 20% and more medications are not covered at all. Fortunately except for my daughter’s issues with migraines, we don’t need any medications on an ongoing basis. As you know my daughter has been having problems with migraines. My COPAY for 10 migraine tablets (which she could use up in 5 days) was $90 last week. This is nothing compared to the costs of medications many pay for chronic conditions. On a related note, I don’t know if you’re aware of this or not, but the very same drugs that cost so much here cost much less in other parts of the world. We subsidize American pharmaceutical companies to sell drugs overseas by paying more for medications here at home. We attach taxes on international pharmaceuticals so they don’t compete with American makers here in the U.S. hurting the American taxpayer all the way around for the benefit of big business.

I’m LOVING the content ideas many of you have discussed. A number of them are part of the current discussion including not being able to drop people who get sick or refuse to insure them when they have preexisting conditions. None of them, at this point, will reduce costs by increasing competition.  The system is broken! We need to fix it now before it permanently sinks our entire economy! Those we elected to represent us need to get the job done. It’s time!

Help with conversations on health care reform

Last week I was at the National Communication Association Convention in Chicago. As I rode the shuttle from one location to another, I overheard a gentleman pontificating about the “fact” that the overwhelming majority of Americans oppose health care reform. He continued in this vein the whole trip back. I sat there, struggling with myself.  One side of me said “It’s been a long day…This guy isn’t going to listen anyway… If he’s going to blatantly make up statistics that are totally contrary to the findings of actual polls with actual people, there’s no room for discussion….They’re not talking to you anyway and it would be rude to interrupt.”  The other side of me was saying “Seriously, if you don’t challenging these uninformed blowhards at every opportunity, people will accept what they say with such confidence even if it IS blatantly inaccurate”….”You’ve got the stats, call him on this!…. “Seriously, speak up!!!!!”  The tired side won out.

However, that means that you, dear readers, who may have found yourself in similar circumstances and chose not to speak might benefit from the attached powerpoint.  Tammy Allen, Lynn Stephan and I developed this for The Group in Wichita and thought we might share it here. Let us know what you think. Agree…. disagree…. whatever you think.  For us the critical issue is that we engage….which I regret to say I did NOT on the bus ride in Chicago.  

Health care reform and the role of insurance companies “why we NEED a public option”!

I wrote my first speech about the need for health care reform and the contributions insurance companies were making to skyrocketing medical costs when I was a freshman in college.  Very little has changed in the 3 decades since.  … Except in the negative direction.

What I’m sure about:

1)  I am sure that relying on big insurance companies to monitor themselves hasn’t worked in decades and that our health care costs have continued to skyrocket. In the last decade alone the increase in health care costs has been – 119% which is 3 times as fast as wages and 4 times as fast as inflation (Kaiser Family Foundation, 2009).

2) I am sure that these increases is unsustainable and hurt American families. In 2007, nearly 2/3 of personal bankruptcies were linked to medical expenses; 80% were people with insurance (Journal of American Medical Assn., 2007).  1,500,000 American families lose their homes each year due to medical costs (Health Matrix, 2008).  In 2008, about 57 million Americans were in families that had problems paying medical bills, and nearly three-quarters had health insurance coverage (National Coalition on Health Care, 2009).

3) I am sure that these increases are unsustainable and hurt American businesses. The current system decreases American manufacturers’ competitiveness. We spend: $2.38 per worker /per hour for health care costs   vs.$0.96 per worker /per hour for US trading partners (Heritage Foundation, 2008). While some would say the problem is that we pay benefits that are too high to labor union workers, this misses the point! Passing on the costs to workers hurts workers (see numbers above) and does NOTHING to make the cost of health care sustainable. The problem isn’t workers, it’s that COSTS ARE TOO HIGH!  Health care costs are the fastest-growing business expense in the U.S. (National Coalition on Health Care, 2009). They drag down earnings and wages, slow job growth,  and decrease dollars available for research and development.

4) I am sure that shifting the burden of health care insurance and health care costs to American families is NOT the answer (see #2 above). For those firms providing coverage, nearly 3/4ths of those surveyed (73 percent) say they are struggling to continue to provide coverage due to high insurance costs (Small Business Majority, 2009). In the Hewitt Associates 10th annual health care report, results of surveys with 343 executives “found that over half (52%) of employers believe the economic downturn will affect their health care programs in 2010. In addition, 19 percent of these employers are planning to move away from directly sponsoring health care benefits in the next 3 to 5 years, which is almost 4 times as many who reported this in 2008” (National Coalition on Health Care, 2009).

5) I am sure that increased competition is critical. From where I sit the provision of health insurance in many states looks a lot like a monopoly and one that rapidly is growing.

In 2007,  the American Medical Association reported that a single insurance carrier controlled at least 30% of the insurance market in more than 95% of insurance markets.  For 15 of the 44 states reporting, the top two insurance providers controlled 75% or more of the market. Twenty-two more states have 50%  to 74% of the market controlled by the top two insurance companies. For a breakdown of the percentage of the market is controlled by the top 2 insurance providers in the 50 states and the District of Columbia, see  Health Care for America Now, available at http://hcfan.3cdn.net/dadd15782e627e5b75_g9m6isltl.pdf

A look at the Government Accountability Office report on Small Group Health Insurance Carriers by State released in February, 2009 comparing 2002, 2005 and 2008 results illustrates how the dominance of a few insurance companies is growing:

In 2008,

•   The median market share of the largest carrier in the small group market was about 47%, with a range from about 21% in Arizona to about 96% in Alabama. In 31 of the 39 states supplying market share information, the top carrier had a market share of a 1/3rd – 33% or more.
•   The five largest carriers in the small group market, when combined, represented 3/4ths – 75% or more of the market in 34 of the 39 states supplying this information, and they represented 90% or more in 23 of these states.
•   Thirty-six of the 44 states supplying information on the top carrier identified a Blue Cross and Blue Shield (BCBS) carrier as the largest carrier, and in all but 1 of the remaining 8 states, a BCBS carrier was among the 5 largest carriers.
•   The median market share of all the BCBS carriers in the 38 states supplying this information was about 51%, with a range of less than 5% in Vermont and Wisconsin and more than 90% in Alabama and North Dakota.

In comparing what states reported in 2008 to what they previously reported to GAO in 2005 and 2002, they found:
•   The median market share of the largest small group carrier has increased to about 47% in 2008 from the 43% reported in 2005 and the 33%  in 2002. Twenty-four of the 29 states providing information in both 2002 and 2008 saw increases in the market share of the top carrier that ranged from about 2 to 39 percentage points. In contrast, the top carriers in 5 states lost market share with decreases ranging from about 1 to 16 percentage points.
•   The number of states with a combined market share of the 5 largest carriers of 75% or more has also increased since 2002. The combined market share of the five largest small group carriers represented 75% or more of the market in 34 of 39 states, compared to 26 of 34 states reported in 2005 and 19 of 34 states reported in 2002.

The full report can be found at: http://www.gao.gov/new.items/d09363r.pdf

6) I am sure that it’s time we stand up to insurance companies who DO NOT have our best interests at heart – as evidenced by CEO compensation packages. Below from the Seton Hall University School of Law, Health Law and Policy Program website http://www.healthreformwatch.com/2009/05/20/health-insurance-ceos-total-compensation-in-2008/ are the total compensations for CEOs of insurance companies for 2007 & 2008.  Following is a “humorous” analysis of just how much money this is!

“Perhaps a slight bit of context is in order, however: it has struck me that Aetna’s Ronald Williams received $24,300,112 last year. That’s $467,309.85 per week. That’s a house. Maybe not a house that Mr. Williams would live in, but a house nonetheless. The man makes a house a week. And interestingly enough, if Mr. Williams were to eschew the purchase of a house on any given week and instead look to deposit the money in a bank– in order to remain FDIC insured (up to $250,000)– he would actually need to open more than one account–every week. Lest we lament the fate of the other CEOs on the list, in 2008 Ms. Braly had to get by on $189,311.76 per week, and Mr. Hemsley had to somehow manage on $62,327.73 per week (but perhaps he was able to save a little from last year when he made $253,164.02 per week).  May 20, 2009 by Michael Ricciardelli Health Reform Watch weblog Seton Hall University.”

Ins. Co. & CEO With 2007 Total CEO Compensation

  • Aetna Ronald A. Williams: $23,045,834
  • Cigna H. Edward Hanway: $25,839,777
  • Coventry Dale B. Wolf : $14,869,823
  • Health Net Jay M. Gellert: $3,686,230
  • Humana Michael McCallister: $10,312,557
  • U.Health Grp Stephen J. Hemsley: $13,164,529
  • WellPoint Angela Braly (2007): $9,094,271
    L. Glasscock (2006): $23,886,169

Ins. Co. & CEO With 2008 Total CEO Compensation

7) I am sure that a public option that will offer competition to private insurance companies, and if properly formed, will help bring the cost of health care insurance down.

The following video by Robert Reich (Secretary of Labor in the Clinton administration, Professor at UC Berkeley outlines succinctly the points that it’s not too late to get a public option and that insurance companies want it to fail.


8 ) I am sure that it is up to us, the American people, to hold our Congressional leaders accountable and to demand that this decades old problem be addressed, that a workable solution be found, before we permanently damage the economic viability of families and business nationwide. Phone, tweet, blog, email, write your Congressional representatives and demand that they get the job done on health care reform.

Health care should be a right, not a privilege!

Dear Senator Reid – GET A GRIP!

As a long time Nevadan and recent transplant to Kansas, I would like to express the sincere and deep displeasure of myself and many Americans with the sorry state of the U.S. Congress. For the first time in a long time democrats have the majority, have the capacity to make real change to benefit the American people, and have failed to show the leadership necessary to carry that change through. Unfortunately, historically this has been too often the case.

The opposition utilizes clear, concise (often blatantly erroneous if not flagrantly false) statements to support their positions. The democratic response is to pretend these are reasonable claims and to try to answer them – illegal immigrants covered under the reform plans, euthanizing your granny, the list seems endless. What the democratic leadership and the democratic members of Congress NEED to do is state clearly what they stand for and work for real, quality, necessary change, not chase phantoms designed to distract, dissemble and disable quality initiatives.

The democratic desire to compromise on basic principles is flawed and futile as evidenced by the Senate’s inability to support a public option in health care reform. The American people gave President Obama a clear mandate by both electing him and giving both houses democratic majorities. The American people in poll after poll have told you they want a public option in health care reform. You are squandering that mandate to the disadvantage of the American people. You are not acting in the best interests of the American people.

Get it right, Senator Reid. You are wasting the capacity you have as Senate Majority Leader and it is the American people who will ultimately pay for this.