Wednesday morning, June 24th I left Boston on my way to Washington DC and after that Bethesda Maryland for a few days. In DC in the morning I was one of eight people from Massachusetts, who believe “Massachusetts is not the model”, to meet with some of the people that were going to be in the White House that evening for President Obama’s town hall meeting on national health reform which aired on ABC to talk about health reform in Massachusetts. I gave them my morning copy of the Globe I picked up at Logan and read on the way down. The front page story (above the fold) was about the projected cuts of $115 million from the state’s health care budget. The front page of the Metro section (again above the fold) was a story on the State Treasurer saying that the Massachusetts experiment in “health reform was too pricey.” In the afternoon I took the Metro to Bethesda to attend a conference of the Agency for Healthcare Research and Quality (AHRQ) to discuss the role of primary care practice based research networks in helping move the AHRQ agenda promoting and funding in the area of comparative effectiveness research, a necessary strategy in national health reform aimed at getting a better return on investment of the health care dollar in regard to efficacy and quality. That night I watched the President on ABC.
The next day, Thursday, I attended a rally organized by Health Care for America Now (HCAN) at the Capitol and was hyped by the overwhelming display of support for health reform from communities, organizations, and workers from across the country. I spent the day talking with legislators, staff and policymakers, including our own John McDonough who came out of a Senate committee mark up session to meet with us. Friday morning I attended the closing of the AHRQ conference in Bethesda and had an afternoon meeting with some officials in the Health Resources and Services Administration in Rockville. It was an exciting and validating few days with the positive buzz around health reform. There was but one degree of separation between me and the Senator, me and the President, and reform seemed all but assured.
A month later on Wednesday morning, July 22nd I’m in Boston on my way to work hearing on the morning news shows about the President’s press conference scheduled for that evening and how national health reform is in jeopardy of failing due to Republican opposition and some renegade Democrats. Republicans see it as the President’s Waterloo and the so called Democrats see it as too expensive. That evening President Obama made a powerful and compelling case for why we must succeed at national health reform. He articulated all the reasons. He outlined the consequences of inaction. The cost of health care is making the country less competitive in a global economy. As a nation we spend more on health care than any industrialized nation in the world that manifests in less health. Health reform is an essential strategy in the turnaround and revitalization of the economy. More and more Americans are losing their health insurance everyday, the result of job loss or unaffordable premiums. We cannot afford to wait … the time is now.
Massachusetts health reform has been at the center of the national discussion and debate and seemingly the preferred model for a national program and while it is not the model the Massachusetts experience provides valuable lessons worth learning.
Universal coverage is a valued principle and what we want in an equitable, quality health care system. However, without addressing escalating costs it is unaffordable in the short term and unsustainable over the long term. Health care costs in Massachusetts continue to rise faster than the national average and in the face of the current fiscal crisis the state cuts $115 million from Commonwealth Care, threatens the removal of 30,000 working, taxpaying, legal immigrants, and the largest safety net hospital is threatened with bankruptcy.
Cost containment and control has to be a priority in any model of reform as escalating health care costs threaten the bottom lines of businesses, the household budgets of families, and the viability of the US economy. High premiums from insurance companies result in enormous profits (surpluses in non-profit vernacular) as they pass on more to the consumer in co-pays, deductibles, and other out-of-pocket expenses. Several strategies may lead to cost containment such as price controls, strict hospital budgets, pay for performance, investments in prevention, even tort reform, and all should be tried.
A public option, yes a Government run heath plan, is essential as one other strategy for cost containment is “free market competition” and a public plan to compete with the private insurance industry is just what the people need. Despite the assertions of those that use the scare tactics about government run health care, we already have a government run plan and it must be unknown to them that Medicare consumers express the highest satisfaction rates of all consumers of health care in America.
Budget neutrality is a Washington term that requires health reform to pay for itself. The Massachusetts health reform principle of shared responsibility provides an important lesson. So a proposed tax increase on income of those more wealthy Americans after the dramatic cuts they enjoyed under the last administration seems fair. The offer of $80 billion from the pharmaceutical industry should be looked at, to see if we can get more. Increase “sin” taxes on alcohol and tobacco and impose “health risk” taxes on sugar sweetened beverages such as soda and energy drinks. Repeal deductions for medical expenses, and eliminate Medicare Advantage plans administered by insurance companies.
The American health care system is in crisis. All of the warning signs indicate its eminent collapse. They time to act is now before we find ourselves reacting like we did with the financial crisis. The time is here … Health Care for America NOW!
Elmer Freeman is Executive Director of the Center for Community Health Education Research and Service and Director of the Office of Urban Health Programs and Policy, Bouvé College of Health Sciences at Northeastern University
Oh, Elmer, get over yourself.
A public option will do very little if anything to save money and won’t help the many millions who can’t afford it. They will be dumped into the expanded Medicaid with all its disparties, including no doctors – not to mention no choice thereof or ability to keep the doctors they’ve been using, and, there’s estate recovery for the 55 and up crowd who will actually be getting a loan, not a health insurance policy.
Obama forgets this part when he talks about how his health care reform will be financed – on the backs of the lower-income people all the way around – can’t afford the insurance or the penalties, and if you sign on the dotted line, you just gave away the store.
Obama said all Americans would have choice between private and public. Obviously this is not true b/c the Tri-Committee bill also has expanded Medicaid, and contains subsidized plans which also discriminate in even more ways than Medicaid – just like in MA. So a large segment of the population won’t have choice. They will be forced under the thumb of the HMO profit-seekers along with having no choice of doctors, hospitals, etc.
Therefore, the law of the land will not be equitable for all. It will be just as it is in MA – based on ability to pay – you get what you can afford. If you can’t afford it you get penalized. If you can’t afford much, you get a pricey premium that you can’t afford to use. If the state needs to save money, they drop you, and the sad saga goes on while people like you tell the world what a success this is. Do you live with your head in the sand? Or are you one of those, “I’ve-got-mine people?”
Obamacare is the same broken system with everyone forced to buy the failed product, the insurers send us the bills, and Congress continues to pocket the bribes.
Uniquely American? Unfortunately it is because every other industrialized country does much better with a single-payer system. Obama and the 111th Congress should be ashamed to fly the stars and stripes next to this scheme.
Be sure to watch Bill Moyers at 9:00 EST July 24 – Marcia Angell and Trudy Lieberman and read Trudy’s series on the MA plan at http://www.cjr.org.
It never ceases to amaze me, the amount of energy that can go into a project just to avoid doing the right thing. The best, simplest, least costly, most effective thing we could do is expand what has been working so well for years, Medicare. You get sick, you get care, and the caregiver gets paid. Nothing could be simpler. But follow the money and you’ll find that the insurance industry wants just the opposite, and they’ve given congressmen $46 million to block it.
Elmer may look at these responses and say “Hewwo! Acme Pest Contwol? Well I have a pest I want contwolled.” Truth is, we are the people being extorted by the Massachusetts Mandate’s criminal redistribution of our hard earned dollars into insurance industry coffers by political shills and insurance lackeys often writing columns at this website. It’s just further evidence why we must have single payer; Myth: Taxes in Canada are extremely high, mostly because of national health care.
“In actuality, taxes are nearly equal on both sides of the border. Overall, Canada’s taxes are slightly higher than those in the U.S. However, Canadians are afforded many benefits for their tax dollars, even beyond health care (e.g., tax credits, family allowance, cheaper higher education), so the end result is a wash. At the end of the day, the average after-tax income of Canadian workers is equal to about 82 percent of their gross pay. In the U.S., that average is 81.9 percent.”
Read more here: http://www.denverpost.com/opinion/ci_12523427
The obsession with any health-insurance reform proposal being “budget-neutral” is the inevitable result of Obama’s decision that any health care “reform” must have the protection of the unconscionable waste and profits of the private-insurance pirates as its core principle.
But until some form of federal SINGLE PAYER, Medicare For All, not-for-profit system is enacted, both universal health insurance coverage and cost containment will be impossible to achieve.
To the private insurers, a policyholder suffering from a malady is not someone needing care but rather a cost. Thus, increased private profits from decreased costs mandate that people remain sick. Optimally, someone suffering from an illness will not be insured by a private insurer. If that person is a policyholder when the malady occurs, the private insurance company often will drop the policyholder with little or no notice.
The private insurers make no secret of this brutal practice, which they delicately call “recission.” Testifying before the U.S. House Subcommittee on Oversight and Investigations June 17, UnitedHealth, Assurant Health and Wellpoint executives all refused to discontinue using recission:
“WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period….
“[P]olicyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses….
“The executives — Richard A. Collins, chief executive of UnitedHealth’s Golden Rule Insurance Co.; Don Hamm, chief executive of Assurant Health and Brian Sassi, president of consumer business for WellPoint Inc., parent of Blue Cross of California — were courteous and matter-of-fact in their testimony.
“But they would not commit to limiting rescissions to only policyholders who intentionally lie or commit fraud to obtain coverage….”
Thus it is ridiculous even to discuss reaching universal coverage in an insurance environment dominated by private health insurers, because the private insurers’ prime directive is to maximizer profits, not provide health care.
Yet for months the Obama Administration, and the Democratic Party, have based every proposed “reform” on maintaining the control of our health care system by private insurers.
Further, every Democratic proposal emphasizes reducing health care by encouraging those private insurers to be even more ruthless in their cost-slashing which immediately will cause major reductions in health care for the vast majority of Americans.
As a sadly typical example of Obama’s destructive focus on making the denial of necessary health care his health “reform” cornerstone, the July 24 Wall Street Journal stated: “At a White House summit in March, Mr. Obama spoke 18 sentences about the need to cuts costs, and two about the uninsured.” (Source: “Obama’s Expert On Health-Care Costs Gets Political,” p. A1.)
This is horrible health policy and even worse politics. It prioritizes private profits over the public’s health, which badly will weaken our society and economy in the midst of the worst recession in eight decades.
Obama, the Democratic leadership, and the private health insurers are acting as if we are too unintelligent to understand the deep cuts in health coverage they all are planning for Americans. But we are watching very closely, as Obama’s softening poll numbers already have begun to reveal.
The only way out of this destructive spiral is for Congress and the Obama White House to cooperate in the creation of an adequately funded, high quality, single payer, Medicare For All, not-for-profit health care system.
sick of the lies posted. I agree 100% no 200% with this persons post. I watched the Moyers show. People should also watch the one with Wendell Potter, a former health insurance executive to get full rounded view of why the insurance corporations need to be taken out of the health care system, or should I say market. It’s clear to me that Obama and the congress have sold the American people out.
The question I have to ask is why? Why is this happening? Why can’t we get this right? What’s wrong with this country?
I’m going to learn French.
One thing is fore sure, if Obama models his health plan after Massachusetts mandate plan it is doomed to be a huge catastrophic failure. People can not afford this anymore. Forcing people to pay will drive them over the edge and it will be Obama’s fault. His legacy will be this bastard child of health care reform aimed at making CEO’s of insurance companies rich while also keeping wall street happy. The same BS is happening with Cap and Trade. This administration is looking like the are owned by Goldman Sachs and the other wall street firms.
Nice piece, Elmer. And you didn’t even include any of your own personal recent experiences with the health care system. Obviously, we have had a ‘public option’, Medicare, for many years, and with regard to administrative expense, it operates much more efficiently than any private health care plan. Expansion of an option along those lines should be a ‘no-brainer’. It was extremely unfortunate that the question about the Gates arrest, and the President’s ill-chosen response, came at the end of the whole discussion of health care reform. Of course that was the sound bite for the day, night, and ensuing days, with virtually no prime attention paid in the media to the content of his remarks on health care. Did you see Jon Stewart on The Daily Show that night? He showed the press conference, and then paused the tape, and said to Obama, “Now whatever you do, don’t let this woman here (pointing to her in the crowd) ask a question!” Then he ran the tape a bit, Obama calls on her, she asks the question, and Stewart paused the tape again, and said, “Now whatever you do, don’t answer the querstion!” He then ran the tape again, Obama answered the question, and Stewart smacked his forehead. Health Care for America Now!