Comparison of House and Senate Versions of Health Reform Bill

BusinessWeek.com published this comparison of the House and Senate versions of the health insurance reform bill:

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The Senate Democratic bill (Patient Protection and Affordable Care Act):

WHO'S COVERED: About 94 percent of legal residents under age 65 -- compared with 83 percent now. Government subsidies to help buy coverage start in 2014. Of the remaining 24 million people under age 65 left uninsured, about one-third would be illegal immigrants.

COST: Coverage provisions cost $871 billion over 10 years.

HOW IT'S PAID FOR: Fees on insurance companies, drugmakers, medical device manufacturers. Medicare payroll tax increased to 2.35 percent on income over $200,000 a year for individuals, $250,000 for couples. A 10 percent sales tax on tanning salons, to be paid by the person soaking up the rays. Cuts to Medicare and Medicaid. Forty percent excise tax on insurance companies, keyed to premiums paid on health care plans costing more than $8,500 annually for individuals and $23,000 for families. Fees for employers whose workers receive government subsidies to help them pay premiums. Fines on people who fail to purchase coverage.

REQUIREMENTS FOR INDIVIDUALS: Almost everyone must get coverage through an employer, on their own or through a government plan. Exemptions for economic hardship. Those who are obligated to buy coverage and refuse to do so would pay a fine starting at $95 in 2014 and rising to $750.

REQUIREMENTS FOR EMPLOYERS: Not required to offer coverage, but companies with more than 50 employees would pay a fee of $750 per employee if the government ends up subsidizing employees' coverage.

SUBSIDIES: Tax credits for individuals and families likely making up to 400 percent of the federal poverty level, which computes to $88,200 for a family of four. Tax credits for small employers.

BENEFITS PACKAGE: All plans sold to individuals and small businesses would have to cover basic benefits. The government would set four levels of coverage. The least generous would pay an estimated 60 percent of health care costs per year; the most generous would cover an estimated 90 percent.

INSURANCE INDUSTRY RESTRICTIONS: Starting in 2014: 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. Starting upon enactment of legislation: children up to age 26 can stay on parents insurance; no lifetime limits on coverage.

GOVERNMENT-RUN PLAN: In place of a government-run insurance option, the estimated 26 million Americans purchasing coverage through new insurance exchanges would have the option of signing up for national plans overseen by the same office that manages health coverage for federal employees and members of Congress. Those plans would be privately owned, but one of them would have to be operated on a nonprofit basis, as many Blue Cross Blue Shield plans are now.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Self-employed people, uninsured individuals and small businesses could pick a plan offered through new state-based purchasing pools. Would generally encourage employees to keep work-provided coverage.

DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Drug companies contribute $80 billion over 10 years with the majority of the money used to limit the prescription coverage gap in Medicare.

CHANGES TO MEDICAID: Income eligibility levels likely to be standardized to 133 percent of poverty -- $29,327 a year for a family of four -- for parents, children and pregnant women. Federal government would pick up the full cost of the expansion during the first three years. States could negotiate with insurers to arrange coverage for people with incomes slightly higher than the cutoff for Medicaid.

LONG-TERM CARE: New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.

ANTITRUST: Maintains the health insurance industry's decades-old antitrust exemption.

ILLEGAL IMMIGRANTS: Would be barred from receiving government subsidies or using their own money to buy coverage offered by private companies in the exchanges.

ABORTION: The bill tries to maintain a strict separation between taxpayer funds and private premiums that would pay for abortion coverage. No health plan would be required to offer coverage for the procedure. In plans that do cover abortion, beneficiaries would have to pay for it separately, and those funds would have to be kept in a separate account from taxpayer money. Moreover, individual states would be able to prohibit abortion coverage in plans offered through the exchange, after passing specific legislation to that effect. Exceptions would be made for cases of rape, incest and danger to the life of the mother.

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The House bill (Affordable Health Care for America Act):

WHO'S COVERED: About 96 percent of legal residents under age 65 -- compared with 83 percent now. Government subsidies to help buy coverage start in 2013. About one-third of the remaining 18 million people under age 65 left uninsured would be illegal immigrants.

COST: The Congressional Budget Office says the bill's cost of expanding insurance coverage over 10 years is $1.055 trillion. The net cost is $894 billion, factoring in penalties on individuals and employers who don't comply with new requirements. That's under President Barack Obama's $900 billion goal. However, those figures leave out a variety of new costs in the bill, including increased prescription drug coverage for seniors under Medicare, so the measure may be around $1.2 trillion.

HOW IT'S PAID FOR: $460 billion over the next decade from new income taxes on single people making more than $500,000 a year and couples making more than $1 million. The original House bill taxed individuals making $280,000 a year and couples making more than $350,000, but the threshold was increased in response to lawmakers' concerns that the taxes would hit too many people and small businesses.
There are also more than $400 billion in cuts to Medicare and Medicaid; a new $20 billion fee on medical device makers; $13 billion from limiting contributions to flexible spending accounts; sizable penalties paid by individuals and employers who don't obtain coverage; and a mix of other corporate taxes and fees.

REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through a tax penalty of 2.5 percent of income. People can apply for hardship waivers if coverage is unaffordable.

REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payrolls under $500,000 annually are exempt -- a change from the original $250,000 level to accommodate concerns of moderate Democrats -- and the penalty is phased in for companies with payrolls between $500,000 and $750,000.
Small businesses -- those with 10 or fewer workers -- get tax credits to help them provide coverage.

SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level, or $88,000 for a family of four, would get sliding-scale subsidies to help them buy coverage. The subsidies would begin in 2013.

HOW YOU CHOOSE YOUR HEALTH INSURANCE: Beginning in 2013, through a new Health Insurance Exchange open to individuals and, initially, small employers. It could be expanded to large employers over time. States could opt to operate their own exchanges in place of the national exchange if they follow federal rules.

BENEFITS PACKAGE: A committee would recommend a so-called essential benefits package including preventive services. Out-of-pocket costs would be capped. The new benefit package would be the basic benefit package offered in the exchange.

INSURANCE INDUSTRY RESTRICTIONS: Starting in 2013, 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.

GOVERNMENT-RUN PLAN: A new public plan available through the insurance exchanges would be set up and run by the health and human services secretary. Democrats originally designed the plan to pay Medicare rates plus 5 percent to doctors. But the final version -- preferred by moderate lawmakers -- would let the HHS secretary negotiate rates with providers.

CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded to cover all individuals under age 65 with incomes up to 150 percent of the federal poverty level, which is $33,075 per year for a family of four. The federal government would pick up the full cost of the expansion in 2013 and 2014; thereafter the federal government would pay 91 percent and states would pay 9 percent.

DRUGS: Grants 12 years of market protection to high-tech drugs used to combat cancer, Parkinson's and other deadly diseases. Phases out the gap in Medicare prescription drug coverage by 2019. Requires the HHS secretary to negotiate drug prices on behalf of Medicare beneficiaries.

LONG-TERM CARE: New voluntary long-term care insurance program would provide a basic benefit designed to help seniors and disabled people avoid going into nursing homes.

ANTITRUST: Would strip the health insurance industry of a long-standing exemption from antitrust laws covering market allocation, price-fixing and bid rigging. The bill also would give the Federal Trade Commission authority to look into the health insurance industry at its own initiative.

ILLEGAL IMMIGRANTS: Would be barred from receiving government subsidies but permitted to use their own money to buy coverage offered by private companies in the exchange.

ABORTION: Private companies in the exchange could not offer plans covering abortion if those plans received federal subsidy money. Most plans in the exchange would be affected, because most consumers in the exchange would be using federal subsidy money to buy coverage. The new government plan could not offer abortion coverage. Insurance companies would be permitted to offer supplemental abortion coverage in separate plans that people could buy with their own money. Use of federal money for abortion coverage would be limited to cases of rape, incest or danger to the woman's life.

Scary New Health Care Tax = Small Tax on Cosmetic Surgery

Should Congress Tax Elective Cosmetic Procedures To Help Pay For Universal Health Care?

Now that Senator Landrieu and Congressman Cao have given their support to the health insurance reform initiative, let's talk about some of those BIG SCARY TAX INCREASES that have someone (read:. "insurance companies") splashing all kinds of silly misinformation all over TV and radio commercials.


For example, perhaps Cousin Sally was just diagnosed with leukiemia. But Sally is widowed and works two part time jobs to keep her kids in shoes and food, and neither of her low-wage jobs provides her with health insurance. On the other side of the tracks, Banker Joan has traded her youthful years to become a wealthy businesswoman, and wants to finally enjoy her single retirement. So she would like to get nice, natural looking  facelift and peruse the single life in her golden years. The Question:  Is it wrong for Congress to suggest that a small tax on Joan's fully elective, cosmetic procedure is in order to help Sally afford to get medical  insurance, which will help Sally work longer, and ensure that she is around and healthy enough to take care of her kids for as long as medically possible?

It's a question of priorities. Every special interest group in our nation has political action committee (PAC), and guess whose PAC is spending lots of money to tell you that this kind of taxing priority is wrong, wrong, wrong? If you guessed the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery (if you've misplaced your thesaurus, "aesthetic" translates as "pretty") then you are a winner! These are the doctors who are being paid (and have a personal financial stake) in telling you that Congress is trying to raise health care taxes - they just don't happen to mention that the tax is relatively small for each individual, and is only applied to non-medically required, purely aesthetic, elective cosmetic procedures.



These are the kinds of priorities that Congress is currently debating with a health insurance reform bill. What they are NOT debating is a "government takeover" of health care (remember, this is insurance reform, not doctor/patient reform; no matter what version of the bill passes, you will be able to keep your own doctor and your current insurance if you can afford and prefer it).



And since we're on the topic of priorities, let's discuss this proposed "cosmetic tax." What are the doctors who specialize in cosmetic procedures claiming is wrong with such a tax? Why, they say it is discriminatory. So apparently they're under the impression that people who can afford to pay out of pocket to have purely cosmetic procedures are some kind of protected class in our society...while apparently impoverished parents and children who suffer and die due to lack of insurance should be just swept aside as a national "oops, my bad."

Look, as a former policy specialist and an aging woman myself, do I think that this tax is likely to be primarily paid by women? Of course. Women are by far the largest consumers of elective cosmetic procedures (although men are gaining on us). But the key word here is "elective." If you really don't want to pay tax on a cosmetic procedure, don't get the procedure, or get it elsewhere (although you'll probably just end up paying for another nation's taxes if you do so). If you want the procedure enough to pay tax on it... well then you can probably afford your health insurance anyway. Consider yourself fortunate to be financially (and medically) stable in a time when millions of your fellow Americans are not.

Americans are by and large a compassionate, caring group of people. If 9/11 taught us nothing else, it taught us that when the shit really hits the fan, we as a nation want to be one community that cares for its own. So I really believe that once we learn who is truly in the business of trying to buy our votes - either with money, or with hyperbolic emotional half-truths and scare tactics, then we as a nation will do the right thing for our communities and our country. So keep an eye out, and remember to always ask the question: Who stands to benefit from this commercial, or that speech, or the other emotion-laded, fist-pounding diatribe? And once you find out who that beneficiary is, ask yourself whether they're really concerned with the best interests of you and your family, or simply with their own pocketbooks. Then you'll have an educated base from which you can confidently decide your own priorities.

Why the Pro-Life Movement Should Support Health Care Reform

Why the Pro-Life Movement Should Support Health Care Reform

Much has been made of Congressman Cao's recent cross-party vote to support the health care reform bill that was passed by the House of Representatives this week, but Cao has been on the side of our health ever since his election. In fact, as a recipient of his e-mail newsletter (you can sign up on his website), I have personally received no less than 5 messages in the last 2 months from his office directly related to health care issues in our community, including information about local health fairs, instructions on where LA residents can get H1N1 flu vaccines, his work to re-open Charity Hospital, and more. Critics can say what they will, but no one can deny that health issues have been a priority for Cao's office ever since his election.

So why is Congressman Cao so willing to take on an issue that has most Republican (and not a few Democrat) officials quaking in their political boots? There could be many reasons, but for my money, I'll say it's because he is unusually far-sighted for a congressman, especially one from our neck of the woods. Cao's priorities are far from hidden. He wants Charity Hospital re-opened. He wants Louisiana residents to have access to affordable health care. And he wants the Right To Life platform to put its money where its mouth is and take charge of the issue. And ultimately, that may prove to be his most notable battle.

Our Declaration of Independence states that we are endowed by our Creator with certain "unalienable" rights, including the right to life. Lawyers may argue that the Declaration, being a separate document from the Constitution, does not itself endow any rights upon U.S. citizens, and that therefore the failure to save a life when we have the ability to do so does not necessarily violate the legal principles of our nation. I disagree. In a nation where we have both the money and the technology to save hundreds of thousands, if not millions, of people who would otherwise die simply due to lack of health insurance, I believe that we have a moral and ethical, if not historical, obligation to provide that life-saving insurance - whatever the cost.

Indeed, if any political movement of our generation should be backing the call to reform health care, it is the "Right To Life" movement. It doesn't take a genius to see the connection between fighting to maintain the life of a fetus and fighting to maintain the life of a fellow citizen. Or have we reached some sad social benchmark where we care more for the life of a potential person than an actual one?

What Congressman Cao has done with his vote is not only support the right of our citizens to have access to effective, affordable medical care; he has also united the good intentions of the Right to Life movement with the stark realities of a nation which has failed to provide the most basic necessities to maintain the lives of  the citizens it already has. What the Health Care Reform movement may not have taken into account when it began is what the liberal voting base may have to give up in order to see successful reform enacted. Congressman Cao has very likely struck the first blow in a battle that could ultimately determine the way we as a nation proceed with both issues. Ultimately, it is possible that neither the Right to Life movement nor the Health Care Reform movement can come to fruition without the other. The question now is, what is the liberal voting base prepared to give up in order to see real health care reform enacted? And what is the conservative voting base willing to lay on the line in order to to advance the pro-life agenda? If we follow both arguments to their logical conclusion, it seems to me that they unfailingly end up in a place where we must either place the ultimate value on all lives, or none of them.

For those of you who are wondering, yes, my inner feminist is actively screaming bloody murder at the very thought of losing ground on the battle for women's rights, especially in a nation that has not even been able to pass an Equal Rights Amendment. Yet I cannot deny that my perspective on the matter of health care changed when I lost my own health insurance due to a chronic illness - just as my perspective on the matter of right to choice might change if our nation could ensure that any unwanted child born would, at the very least, have access to the basic health and medical care needed to ensure her or his healthiest possible life - no matter what. So if the Right to Life movement wants to gain votes, here is its best chance. Let the Right to Life advocates fight as hard for the lives of our fellow citizens now as they have for the lives of the unborn in the past, and - for the first time in my life - they might in return see my vote and my check headed in their own direction.

Why Insurance Companies Are Different, And Why They Need To Be Regulated More Than Your Job

Much has been made of “insurance companies’ right to make a profit” and “treating them like everyone else” lately. What this attitude fails to take into account is the series of massive favors that we, as a society, do for the health insurance industry. See, we are allowed to add regulations and requirements because we have exempted health insurance companies from the Federal Anti-Trust Act (the act that prevents an industry from having a monopoly on the entire market). Let’s say that again.

We have exempted health insurance companies from the Federal Anti-Trust Act. The McCarran-Ferguson Act of 1945, 15 U.S.C. § 1011, allows state law to regulate the business of insurance without federal government interference, though it does allow the Federal Government to pass laws specifically aimed at the insurance industry. It just exempts them from non-insurance-specific Federal Laws. Including anti-trust laws.

This is important because it means that we have not required health insurers to have competition or behave in a competitive manner. As such, “the market,” which everyone screams will save us from the horrible health care companies, has no bearing. “The market” requires competition. So it’s kind of like if we stopped regulating prices on energy companies completely. How much do you think you’d be paying for electricity if there weren’t rules about that sort of thing? See, that’s a trade-off. We give Entergy, or SoCal Edison, or whoever, a monopoly in a certain area. We then regulate their prices and what they supply to be sure they don’t take advantage. But we haven’t been doing enough of that in the United States in the health insurance arena.

Some facts about the anti-competitive nature of health care in America in 2008, according to the United States Government Accountability Office:

• The median market share of the largest carrier in the small group market was about 47 percent, with a range from about 21 percent in Arizona to about 96 percent in Alabama. In 31 of the 39 states supplying market share information, the top carrier had a market share of a third or more.

• The five largest carriers in the small group market, when combined, represented three quarters or more of the market in 34 of the 39 states supplying this information, and they represented 90 percent 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 five largest carriers.

• The median market share of all the BCBS carriers in the 38 states supplying this information was about 51 percent, with a range of less than 5 percent in Vermont and Wisconsin and more than 90 percent in Alabama and North Dakota.

This is unacceptable. A lack of competition coupled with a lack of regulation means higher costs to consumers and skyrocketing profits for companies. Which helps explain why 17.6 percent of our GDP is spent on health care, and why the average family health care plan has increased from $6,654 per year to $13,378 per year in the last decade. That’s over double, for those of you counting.

Nationally, the average premium for health insurance rose five times as much as median worker wages in the last ten years.

If health insurance companies want an exemption, they will live with regulation. If not, the numbers above show that they would already be under court order to split up if it weren’t for anti-trust exemptions. We should stop letting them be ungrateful, gluttonous children and show them what life is like for the rest of the businesses in this country. It’s cutthroat, it’s tough to scrape out a living, and it involves needing actual business acumen and sense.

Or, they can simply jump on board with reform and regulation. It seems like that would be in all of our best interests.

Why We Should Support Reform NOW

Why We Should Support Reform...NOW!

There are many reasons that our readers might want to support the health care and insurance reform efforts currently going on in congress. Some might support the bill because they cannot currently access health insurance due to a pre-exisiting condition or excessive cost. Others might want to use the public option to receive more affordable prescription medications. Some might simply believe, as we do, that the American economy would be improved by providing an affordable public insurance option for small business owners, contract or part-time employees, and those who are self-employed.

But there is one good reason to support the health care reform option as it exists now...because the longer the debate is drawn out, the less benefits we are likely to see. More than a few people are legitimately undecided about health care reform. They believe that reform is necessary, but are unsure how to go about it. But the real concern we have is in regards to those in congress and business who go out of their way to reject virtually any form of health care reform. Senators like David Vitter, who receive the majority of their campaign contributions from insurance and pharmaceutical companies, are putting the very nature of health care improvement at risk. Because the longer the debate continues, the more concessions will have to be made to satisfy those squeaky political wheels who benefit from resisting reform.

It is our belief that nothing is more powerful in America than an idea whose time has come, and like it or not, subsidized health insurance is that idea today. Make no mistake, some form of health care reform will be enacted. It will be enacted because it is an idea that has been effectively, if not perfectly, put into action in every other industrialized nation in the world. It will be enacted because it has received in President Obama the champion it previously lacked. It will be enacted because people like us - you and me - know that reform is key to the political and social future of our nation. And, perhaps most importantly, it will be enacted because Americans who have lived the alternative - who have lost loved ones or whose own lives are at risk without a public option - will never, can never stop lobbying for it. For millions of us, it is literally a matter of life and death.

But just to enact some health reform is not enough. Reform must be effective. It must provide affordable alternatives to Americans who currently have none. It must raise our designation as an ethical democracy in the world forum. And the longer we wait to support reform, the more we will have to give up to make it a reality.

If you have not already done so, please read about President Obama's plan. As it currently stands, it contains measures that would improve not only the status of those who are currently uninsured, but would also guarantee continued coverage to those who currently have insurance. It would be paid for up front, primarily by taxes that have already been collected, and it would not add a dime to the federal budget deficit. It is that rare but beautiful creature - a public policy that is designed to truly solve a problem. But the longer we wait, the more we hesitate, the more this plan will be torn apart by critics who will demand concessions that will mean less coverage, more cost, and ultimately could put enough holes in this plan to make it as ineffective as they already swear it to be. And then, as we all know, the terrorists win.

Don't let that happen. In all seriousness, this is about YOUR right to affordable health insurance. Congress will not win this battle for us.... they already have guaranteed health insurance for the rest of their lives. We don't. We have only each other. That is why we must each, individually, make our demands known. And the sooner we do that, the more our reform will look like this:

The President's Plan for Health Reform “It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will lower the cost of health care for our families, our businesses, and our government." – PRESIDENT BARACK OBAMA
If You Have Health Insurance, the President's Plan: Ends discrimination against people with pre-existing conditions. Limits premium discrimination based on gender and age. Prevents insurance companies from dropping coverage when people are sick and need it most. Caps out-of-pocket expenses so people don’t go broke when they get sick. Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money. Protects Medicare for seniors. Eliminates the “donut-hole” gap in coverage for prescription drugs.	If You Don’t Have Insurance, the President's Plan: Creates a new insurance marketplace — the Exchange — that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices. Provides new tax credits to help people buy insurance. Provides small businesses tax credits and affordable options for covering employees. Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice. Immediately offers new, low-cost coverage through a national “high risk” pool to protect people with preexisting conditions from financial ruin until the new Exchange is created.	For All Americans, the President's Plan: Won’t add a dime to the deficit and is paid for upfront. Requires additional cuts if savings are not realized. Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality. Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system. Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine. Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform.

Medical Debt #1 Cause of Bankruptcy In the U.S.

Are you concerned about the state of the U.S. economy? If you are, then consider the findings of a recent article in the American Journal of Medicine (among multiple other sources), which reports that medical debt is the #1 cause of bankruptcy in the U.S.

If you are like most Americans, you live one medical disaster away from poverty. What's worse, many of those who have unwillingly found themselves sunk in such debt had health insurance. The Washington Post points out that of those who were forced into bankruptcy by medical debt, nearly 80% had some health insurance coverage at the time of their illness, yet still reported an average medical debt of nearly $18,000. Meanwhile, Americans who did not have health insurance carried an average medical debt of over $26,000. What does all of this mean? As the health insurance system in the U.S. currently stands, you are more likely to fall to bankruptcy for medical debt than for any other reason - even IF you have health insurance!

Isn't it time we demanded more for our money?

Watch CBS News Videos Online

According to CBS News:

Health and Human Services Secretary Kathleen Sebelius pointed out on The Early Show Friday that many Americans who have health insurance have inadequate protection, and increasing out-of-pocket expenses are "crushing families and businesses."

"That’s why President Obama is so focused on health reform this year," she said, "lowering costs for those who have coverage already so that we can keep the coverage we have, keep the doctors we have, but also to provide some coverage and some payment for the millions of Americans -- close to 50 million -- who have no insurance coverage at all."

A Public Option Story: How "Socialized Medicine" Is Already Saving Lives In America

A Public Option Story:

How "Socialized Medicine" Is Already Saving Lives Right Here In the U.S.

Critics of health care reform seem eternally focused on the potential for problems, but rarely do we take the time to consider the possibility of the "best case scenario" where the public option is concerned. But we needn't tax our imaginations to see what a successful health policy would look like. Surprisingly, it seems that a successful public option already exists in America... for people with one specific diagnosis.

Jennifer Nix is the author of the article "I Love My Socialist Kidney," a first-hand look at how a government-sponsored "public option" for patients with end-stage renal disease has been saving lives for decades right here in the U.S... and how it saved hers.

The day after this country elected Barack Obama its 44th president, a doctor told me I'd inherited from my father a rare form of cystic kidney disease and that I was already in renal failure. Beyond the devastation I felt on hearing this news, and despite having health insurance, my greatest fear in those first, foggy days was one that haunts millions of Americans. I was more terrified of being dropped or denied treatment by my insurer over some minuscule technicality than I was of facing the disease.... A few weeks into my ordeal, however, I learned that my diagnosis qualified me for a little-known existing "public option," or government health insurance plan. The same program had saved my father's life, but I was frankly surprised to learn it still existed despite numerous legislative changes through the decades. Today, almost a year after my diagnosis and amid the disheartening acrimony and willful misinformation pervading our healthcare debate, I can bear witness to what constitutes "socialized medicine" in the United States....

By the 1960s, dialysis and transplantation were established as effective treatments for kidney failure, which could allow ESRD patients to live full and productive lives. With no funding for long-term, chronic dialysis, however, hospital committees decided who would live and die. These committees looked at age, complicating health concerns, psychological well-being and a patient's "social worth," but because the wealthy could afford to pay for their treatments outright, they were the most often treated, resulting in a class-driven mortality rate. The government "death panels" decried in the hyperbolic rhetoric of today's right-wing anti-healthcare reform fanatics may be imaginary, but in the 1960s and early '70s there really were death panels for ESRD patients....

Without the government stepping in to remedy a situation that the market and private business willfully ignored, both my father and I would most likely have died within a year of our diagnoses. I believe every American citizen deserves the same kind of health security. Even before I got sick, my father's story was the reason I became an activist myself during the Bush years, as I saw people's faith in government dwindling. It's why I fought so hard to get Obama elected, and why I'll be gravely disappointed if he gives in on the public option....

Click HERE to read the entire article.

 The author makes a strong point about the idea of "death panels," as the ultra neo-conservative rhetoric has labeled them. Although the myth of Social Security "death panels" in President O'bama's plan is patently false, the idea behind them is perhaps more based in reality than we would care to admit to ourselves.

Today, the specter of a "death panel" lingers over American families who receive a chronic or terminal medical diagnosis. For those who have health insurance, the stress of waiting and wondering whether their insurance will cover the high costs of treatment - or continue to cover them at all - has become in itself a part of the illness which much be treated. The same can be said for the millions of Americans who are lost somewhere in the (usually multi-year) process of applying for disability. In these situations, an insurance executive or an administrative law judge will literally make decisions of life and death - decisions which would be left in the hands of the patients and their own physicians if a public option for health insurance were available to these same patients.

So rather than pouring our national energy into figuring out ways that a policy of providing health insurance for everyone could go wrong, perhaps we have reached a point where we need to admit to ourselves that failing to provide such coverage has already cost us too much in terms of our economy, our national standing, and - most importantly - the lives of our own loved ones. Our lack of universal health coverage has already gone far wrong. It is up to us as citizens of "the world's wealthiest nation" to refuse to allow such a monumental failure of policy to continue. What we can do, as the moral and just society we want ourselves to be, we must do. What we can do to save one life, we can do to save many. We have seen the devastation caused by the lack of such a policy, and we can see how a successful policy can be run. Now it is up to us as Americans to make it work for everyone.

LA Senator David Vitter on Health Care/Health Insurance Reform

Louisiana Senator David Vitter On Health Care/Health Insurance Reform

Louisiana's Senator David Vitter (to label him "Republican" might be something of an understatement and/or a misnomer, depending on who you ask) is back in the news today regarding what seems to be a never-ending Washington prostitution ring scandal, but we're more interested in his stance on the state of health care in Louisiana. So we wrote to Senator Vitter about our support for reforms that would mean affordable health insurance for all Louisianans, and received in response his form letter on the issue (the same letter you would likely receive if you wrote to him on the issue). Senator Vitter's form response to the health care issue reads as follows (the only edit we made was to replace the name with an initial in the first line):

Dear Mrs. M.,             Thank you for contacting me in favor of a public health insurance plan.  I appreciate hearing from you on this important issue.              I understand many Americans are uninsured or underinsured, causing many individuals and families to not receive the proper care they need to stay healthy.  I am committed to finding ways to provide quality and affordable health insurance to all Americans, and I believe we can reform health care by allowing reimportation of safe, cheaper prescription drugs from Canada and by speeding the approval of generic drugs.  Also, I believe we should offer small businesses the ability to pool together, which would provide the same negotiating advantage as corporations, to get access to affordable health care for their employees.  And, providing refundable tax credits would make health care more affordable and accessible by empowering individuals and families with more buying power to pick the health care plan that best fits their needs.              I also want health care reform, but I am concerned that the America's Affordable Health Choices Act would actually limit choices, diminish quality, and do nothing to control costs.  The non-partisan Congressional Budget Office projected that this plan would cost more than $1 trillion over the next ten years and would still leave 34 million people uninsured.  Other independent studies show that 118 million Americans or 60 percent would lose their current coverage to be pushed on to the public plan.  I am concerned that the creation of a public plan would hinder Americans' access to the care they need and could result in long waiting lines for important surgeries and procedures.  I will continue working to make health care more affordable and accessible for Louisiana families as the Senate considers health care reform. Again, thank you for sharing your thoughts on this important issue.  Please do not hesitate to contact me again in the future about other issues important to you.

Sincerely, Senator David Vitter United States Senator

What we can discern from this letter:

1. Senator Vitter is aware that millions of Americans (and therefore presumably Louisianans) are currently uninsured or underinsured.
2. Senator Vitter supports the "reimportation" of prescription drugs from Canada. Apparently, he does not feel that the same drugs should simply be made more affordable to Americans in the first place. Why might this be? Perhaps we should consider that Vitter's top campaign contributors are from the "Health Industry" - and who has the money in the the health industry? Ah, that would be the insurance companies...followed closely by the pharmaceutical companies.
3. Senator Vitter believes that small companies should be able to pool together to seek insurance - which they already can. 
4. Senator Vitter wants to "solve" the problem of lack of insurance for millions of Americans by suggesting some kind of tax refund (although he doesn't seem want to suggest to anyone who hasn't written to him supporting health insurance reform). What's the biggest tax refund you have ever received? Would it come anywhere near paying for the cost of quality health insurance? We didn't think so.
   
5. Senator Vitter believes that the President's plan for health care reform is too expensive. So apparently, the senator has higher priorities for your tax dollars than to help you pay for your own health insurance. He would rather that money go... where? Oh, right. To his top campaign contributors - the health insurance industry.
6. Senator Vitter believes "independent" studies which seem to say that the plan would still leave millions without insurance, though how that is possible with a public option open to everyone, he doesn't explain. Nor does he provide you with a reference for these "studies," so I guess he just assumes that you wouldn't understand them anyway. We should just take his (and the insurance companies') word on it.
   
7. Senator Vitter seems to be under the impression that providing a public insurance option, affordable and open to anyone, would somehow cause a trend of people who are currently insured to lose their insurance, although he doesn't explain how or why this would be the case. In fact, he appears to be behind the times on this one, since Louisiana residents are already losing their health insurance at a faster rate than residents of any other state.

Health Statistics ; % Point Change in Uninsured (most recent) by state

VIEW DATA:  Totals	Definition     Source      Printable version
Bar Graph Map

Showing latest available data.

Rank   States  Amount  # 1   Delaware: 5.9   # 2   Mississippi: 5   # 3   Pennsylvania: 4.1   # 4   Rhode Island: 3.4   # 5   Tennessee: 3   # 6   New Jersey: 2.6   = 7   Utah: 2.1   = 7   Connecticut: 2.1   # 9   Missouri: 1.6   # 10   Michigan: 1.5   # 11   Vermont: 1.3   # 12   Wisconsin: 1.2   = 13   Minnesota: 1.1   = 13   Illinois: 1.1   = 13   Georgia: 1.1   # 16   North Carolina: 0.6   = 17   New Hampshire: 0.5   = 17   Arizona: 0.5   = 19   Colorado: 0.4   = 19   Oklahoma: 0.4   # 21   Nevada: 0.3   # 22   Montana: 0.2   # 23   North Dakota: -0.1   # 24   Massachusetts: -0.5   # 25   Maryland: -0.6   # 26   Iowa: -0.7   # 27   South Carolina: -0.8   # 28   Kentucky: -0.9   # 29   Oregon: -1.1   # 30   South Dakota: -1.2   # 31   Nebraska: -1.3   # 32   Texas: -1.4   # 33   Alabama: -2.1   # 34   Virginia: -2.2   = 35   Indiana: -2.3   = 35   Florida: -2.3   = 37   California: -2.4   = 37   District of Columbia: -2.4   # 39   New York: -2.5   = 40   Hawaii: -2.8   = 40   Ohio: -2.8   # 42   Maine: -3   # 43   West Virginia: -3.1   # 44   Washington: -3.3   # 45   Wyoming: -3.4   = 46   Kansas: -3.8   = 46   New Mexico: -3.8   # 48   Arkansas: -3.9   # 49   Alaska: -4.8   # 50   Idaho: -4.9   # 51   Louisiana: -7.2   Weighted average: -0.6

To summarize: Senator Vitter, who is self-admittedly perhaps not the foremost authority on "family values," knows that millions of us are uninsured. He knows that we cannot afford our prescription medications. But his campaign benefited more from the contributions of insurance and pharmaceutical companies than from any other industry. So, perhaps not coincidentally, he does not support health care reform as it is currently being debated, nor does he offer any more likely option. Senator Vitter would like, in short, to do absolutely nothing to help your family access affordable, quality medical care. He told us so himself.

Would you like to say something to Senator Vitter? Let your views be known (and let us know what he says)!  You can contact him via the internet, or through any of his offices:

Senator David Vitter:

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  Washington, D.C. Office

  516 Hart Senate Office Building
  Washington, DC 20510
  Main: (202) 224-4623
  Fax: (202) 228-5061
  
  
  
  
  
  
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  Central Louisiana Office

  2230 S. MacArthur Dr., Suite 4
  Alexandria, LA 71301
  Main: (318) 448-0169
  Fax: (318) 448-0189
  
  
  
  
  
  
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  Northeast Louisiana Office

  1217 N. 19th St.
  Monroe, LA 71201
  Main: (318) 325-8120
  Fax: (318) 325-9165
  
  
  
  
  
  
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  Northwest Louisiana Office

  920 Pierremont Road, Suite 113
  Shreveport, LA 71106
  Main: (318) 861-0437
  Fax: (318) 861-4865
  
  
  
  
  
  
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  Southeast Louisiana Office

  2800 Veterans Blvd., Suite 201
  Metairie, LA 70002
  Main: (504) 589-2753
  Fax: (504) 589-2607
  
  
  
  
  
  
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  Southwest Louisiana Office

  3221 Ryan St., Suite E
  Lake Charles, LA 70601
  Main: (337) 436-0453
  Fax: (337) 436-3163
  
  
  
  
  
  
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  Acadiana Office

  800 Lafayette St.
  Suite 1200
  Lafayette, LA 70501
  Main: 337-262-6898
  Fax: 337-262-6373
  
  
  
  
  
  
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  Baton Rouge Office

  858 Convention St.
  Baton Rouge, LA 70802
  Main: 225-383-0331
  Fax: 225-383-0952
  
  
  
  
  

Health Care Reform = Insurance Reform; The Difference Between Public/Private, and Profit/Non-Profit

Health Care Reform = Insurance Reform; 

The Difference Between Public/Private and Profit/Non-Profit

You may love your doctor, but do you love your insurance company?

Critics of "health care reform" like to film commercials showing home town doctors in white coats talking about how reform would be a problem for you. This is because critics would like you to associate them with your doctor's care. But the truth is that the reform issues that are currently being debated in congress focus on your insurance company's performance, not your doctor's care.

Why Private, Profit-Making Insurance Companies Will Never Put Your Health First:

Look at it this way. There is already someone between you and your doctor, whether those commercials show it or not. If you currently have health insurance, that someone is an insurance company executive, whose primary purpose is to make a profit off of your health care needs. As long as you are in good health, this is no problem for them. They charge a premium for covering you, because statistically it's a good risk for them...as long as you stay healthy. Of course, if your health should deteriorate for any reason, they'll re-think what they charge you and what they'll pay for - if they continue to cover you at all. And they'll do this for one simple reason; not because they're awful people, or they have no conscience, but because this is their job. As long as health care is only run as a for-profit industry, profits will always be the bottom line for insurance companies, even if it is at the expense of you or your family's health. 

Why Non-Profit Insurance Companies Aren't the Answer:

Some companies, such as Kaiser Permanenete,  have attempted to resolve this by creating non-profit insurance. Although the idea seemed solid, their track record in terms of improving quality of care has been poor. As someone who teaches classes in non-profit management, let me explain why this has been the case:

The label "non-profit" is often misunderstood. Non-profit status, also called 501(c)3 designation, is a designation that an agency makes primarily for tax reasons. The main difference between a non-profit and a for-profit corporation, as far as their interaction with the public, is that donations made to a non-profit can be tax-deductible. This is because any agency profits are required to be put back into the agency, rather than go to shareholders. For this reason, many charities choose to utilize the 501(c)3 status.

However, non-profit status does NOT necessarily mean that the agency is stable, well-funded, or provides any better quality service than a for-profit agency. Indeed, most non-profits are in a constant struggle to find and maintain funding. Non-profit insurance companies have a bit of a leg up, because they will charge you premiums and co-pays just like any for-profit insurer will. This helps them to maintain funding. But it does not guarantee that money will go into your care. Executives for large non-profit agencies, especially insurance agencies, can make just as outrageous salaries, bonuses, etc. as any other executive. That money is simply not considered to be a profit for the company. And running a non-profit insurance company is just as expensive as running a for-profit insurance company, so they still have to find a way to solicit business, pay for services, pay for salaries, etc. on top of the cost of doing business. The result has been that non-profit insurers have no better record of quality or consistency of care than any other insurance company.

How A Public Option Would Be Different:

A "public option," such as the one in President Obama's health care plan, means just that - it is an option that would belong entirely to the public. Essentially, the public - you and I - would replace the shareholders that  private agency would have. This means that anyone who wants to utilize the public option would be allowed to do so - because we, the public, are the providers. We are the insurers. Better yet, all of us can band together and work as one to bring the costs of health care down. This is how every insurer works - they use the collective power of all of their clients to bargain with health care vendors for better prices on materials, prescription medications, etc.

Imagine the bargaining power that we could wield as the entire public of the United States of America. The more people who select the plan, the better our bargaining power would be. And right now, with approximately 50 million people uninsured in the U.S., we already have a large bargaining base to begin with.

We could be larger than any insurance company could imagine. That's why insurance companies don't want this bill to pass. They simply don't know how to compete with us, if we all work together. They would have to improve their own performance and payment options to maintain competitiveness.

Of course, there will always be skeptics. Under the current plan, no one would have to leave his or her insurance company if they choose not to. Not everyone will sign up for the public option, so it is unlikely that other insurance companies would be driven out of business. More likely, they would have to bring down the cost of executive salaries, reduce their own profits, and provide better, more specialized care to maintain competitiveness...just like any other industry. At least, that's what has already happened in most other developed nations - all of which have some form of regulation on health insurance. But don't believe me. Go find yourself someone who is actually from one of these countries (don't rely on second-hand spin from ultra-conservative Americans), and ask if they would switch for the insurance system we have now. You might be surprised how fast they say "Not a chance."

How Can the Public Own An Insurance Organization?

We can be our own insurers, just the same as we own other businesses which are important to the stabilization of our nation's welfare. We own the postal service. We own interstate highways. We own libraries. Some are great, some need help. But everything the state (public) owns, it owns for one reason - we believe as a nation that it is too important to be left up to a few private companies.

And when it comes right down to it, what could be more important than your and your family's access to affordable health care, prescriptions, and medicine?

Protect Insurance Companies! (video spoof)

Thank you to FunnyOrDie.com for taking up the cause, and producing this video spoof of a PSA to protect the insurance companies against the threat of regulated health insurance!

Protect Insurance Companies PSA from Will Ferrell

Presenters: Will Ferrell, Jon Hamm, Olivia Wilde, Thomas Lennon, Donald Faison Linda Cardellini, Masi Oka, Ben Garant, Jordana Spiro, Drew Antzis, and Chad Carter