'Tis the season to be jolly! That may be how the song
usually goes, but this year American families are singing a different tune.
As the economic recession deepens, companies around the
country are closing their doors or cutting back by laying off employees and millions
of Americans are losing their jobs, salaries, and health insurance.
The unemployment rate has jumped from
about 4.7 percent last December, when the recession began, to 6.7 percent
today. Economists estimated in a Kaiser Family Foundation report that each 1
percent gain in the unemployment rate adds 1 million people to the Medicaid and
State Children's Health Insurance Program.
This estimate means that about 2 million people have been
added to these state-run programs, putting added strain on state governments
that are already struggling to keep these programs alive.
In the spirit of the holidays, one gift that we can give to
our fellow Americans in 2009 is access to the State Children's Health Insurance
Programs (CHIP) and Medicaid. Unfortunately, without funding from the federal
government, these crucial programs may endure
budget cuts that result in millions of adults and children losing their health
care coverage. During such tough economic times, when even more people are
expected to lose their jobs and apply to these programs, we must ensure that
CHIP and Medicaid are well-funded and can continue to provide high-quality
health care to those in need.
By including funding for Medicaid and CHIP in the economic recovery
package in the New Year, Congress can help states by sharing the financial
burden of supporting these programs, while guaranteeing that those currently
enrolled will not lose their coverage.
Please take a look at our E-card and
let your friends know how important the gift of affordable health care is this holiday
season and in 2009.
Have a safe, happy, and healthy holiday. We will be closed
from December 24 through January 5, but we hope to see you in the New Year with
a renewed hope for high-quality, affordable health care for all.
Insurance companies would
never pocket extra money on the backs of Medicare beneficiaries. Or would they?
According to a report released by
the Government Accountability Office (GAO) last week, insurers that sell
private plans to Medicare beneficiaries made a whopping $601.79 in profits per
enrolleein 2006, a profit margin 65 percent higher
than anticipated. Actual spending on non-medical expenses, such as
administrative costs, was also substantially higher than projections, while
spending on the delivery of care fell short of expected levels.
Since 2003, when the Medicare
Modernization Act authorized substantial new funding for Medicare plans
operated by private insurers, known as Medicare Advantage plans, a debate on
whether these plans provide good value to both enrollees and taxpayers has been
raging. These data offer new fuel to the fire in this debate.
Proponents of private
Medicare plans have long argued that the "efficiency of the private market"
would save taxpayer money while increasing access to care for beneficiaries.
The GAO's report suggests that this assertion simply isn't true. Only 83
percent of Medicare Advantage plan revenues actually go to providing care. The remaining 17 percent of Medicare Advantage
revenues go toward administrative costs, overhead and profits. In contrast, traditional Medicare accumulates no profits from its revenues and spends a mere 2 percent on administrative costs.
Rather than increase
efficiency and access, Medicare Advantage has served to direct precious
taxpayer dollars away from Medicare beneficiaries and into the pockets of
insurers. Stronger oversight of the insurance industry is essential. When the
federal government purchases goods and services, we expect accountability.
Taxpayers and beneficiaries deserve to know that premium dollars are being
spent in a way that maximizes value and promotes efficiency.
Last week at a press
conference announcing Tom Daschle as the new Secretary of Health and Human
Services, a journalist asked President-Elect Obama how he intended to find
money to pay for health care reform legislation. In his answer, Obama indicated that
regulation of Medicare Advantage insurers would be a necessary way to save
money and improve quality.
We're
also going to examine programs that I'm not sure are giving us a good bang for
the buck. The Medicare Advantage program is one that I've already cited where
we're spending billions of dollars subsidizing insurance companies for a
program that doesn't appreciably improve the health of seniors under Medicare.
Some members of Congress have
also talked about enacting
"minimum medical loss standards," which would require health insurance
companies to spend a certain percentage of premium dollars on medical care (as
opposed to administrative costs or profits). Such standards would allow
insurers to retain reasonable profits, while ensuring that taxpayer dollars are
spent wisely.
Now that sounds like a deal
that is fair to insurers, taxpayers, and
beneficiaries.
In
theory, the Medicare program - which provides health coverage to people over 65
and those with disabilities - gives the same benefits to everyone
enrolled. But in practice, not everyone
receives the same outcomes. Communities
of color consistently have more difficulty getting care and tend to receive
lower quality care.
Earlier
this year, Congress took a few baby steps in addressing those disparities. In a new law that chiefly dealt with how doctors
are paid for treating Medicare patients, Congress included language to help
reduce the disparities in Medicare for people of color.
The
new law, the Medicare Improvements for Patients and Providers Act of 2008
(MIPPA), includes three key changes to address these differences.
Improved data collection (which helps identify what
disparities exist so the best solutions can be designed to address them);
Outreach to the previously uninsured (since
those who do not have insurance are often the sickest and tend to experience
barriers to enrolling in public programs); and
Care
that is culturally and linguistically appropriate (since providers
and patients have to be able to effectively communicate with one
another in order for good health care to be delivered and received).
As we move ahead to tackle broader health care reform, it's
important to remember that the entire population will continue to grow and
become more diverse.
MIPPA provides a good example of how health disparities can be woven into the
broader health care reform discussion. Although this
legislation wasn't specifically created to eliminate health disparities, it
recognizes that making the system work for everyone requires us to understand
why difference exist and allows us to seek appropriate solutions to address and
eliminate them.
In a sign that President-Elect Obama means business, former
Senate Minority Leader Tom Daschle (D-SD) was selected to fill the top spot at
the Department of Health and Human Services. This is good news. Very good news.
"The appointment of Senator Daschle as Secretary of the Health and Human
Services Department is the best news possible for those who want to achieve
meaningful health care reform," said Families USA's Ron Pollack.
In addition to leading HHS, Daschle will also serve as the health
"czar" - or White House point person who will report directly to the
President.
This is a
perfect role for Daschle. Although he was always been interested in health
care, in the last few years he's become a true wonk on the subject, publishing
a book called Critical: What We Can Do About the Health-Care Crisis. It
urges precisely the sorts of reforms President-Elect Obama and his
congressional allies are promoting right now.
Daschle's track-record as Senate Minority leader turned
health wonk gives him incisive knowledge of both the political environment and
the policy required to push legislation through Congress.
Speaking at Families USA's Health Action conference last
year, Daschle
said:
One of the biggest tactical
mistakes we've made, the opponents of health reform have defined the debate. As
a result, we've lived under a number of myths. Perhaps the biggest myth of all
is that the US
has the best health system in the world. So before the debate can begin, we
need to all understand the same basic facts. We need to understand how we got
here and where we need to go.
Incremental change in our
system is no longer a viable option. Instead we need comprehensive reform. In
growing numbers the American people are demanding that we do something. Our
goal should be to build what current and retired members of Congress have
today, and make that available for all Americans.
Daschle's commitment to health care, combined with his astute
understanding of the political climate, gives us reason to believe that health
care reform is not simply a campaign promise, but a likely reality in an Obama
administration.
Today, Senator Max Baucus, chair of the Senate Finance
Committee, revealed his long awaited white paper on
health care reform. According to the Senator,
...the
Call to Action has three equally important legs: (1) a policy that ensures
meaningful coverage and care to all Americans; (2) an insistence that any such
expansion be coupled with an emphasis on higher quality, greater value, and -
over time - less costly care; and (3) an absolute commitment to weed out waste,
eliminate overpayments, and design a sustainable financing system that works
for taxpayers as well as for the nation's recipients and providers of health
care.
Creating ahealth insurance "exchange," where individuals and small businesses
could compare and purchase plans - which would include a range of private
plans and a public plan option.
An expansion of Medicaid and SCHIP.
The plan would allow people between 55 and 64 to
"buy-in" to Medicare as a temporary transition provision until quality,
affordable insurance options are available through the exchange.
Support for the employer based model where
employers would be required to offer coverage to their employees, and
small businesses would receive a tax credit if they comply.
Senator Baucus, along with
Senator Kennedy, is expected to play a very important role, as Ezra Klein explains
here, in the road
to reform. Baucus chairs the Senate Finance Committee, which has broad
jurisdiction, overseeing health care reform, Social Security, unemployment
benefits, and taxes and trade. As chairman, it is up to Baucus to schedule
markups, hearings, and votes - and ultimately serves as the gatekeeper for
legislative action on, say, health care reform.
Having Baucus on board with such a comprehensive plan is
certainly encouraging. To quote Families USA's own Ron Pollack:
"The white paper
released today achieves a sound balance between public- and private-sector
approaches, and it blends good policy with a sound view of what is achievable.
"There has never
been a more auspicious opportunity to secure meaningful health care reform: The
President-Elect has made it a top priority; key congressional committee chairs
have made it their top priority; and the large and diverse health care interest
groups are working cooperatively to find common ground.
"As a result, we
have a unique opportunity to succeed this time in securing much-needed health care
reform."
We heard encouraging words from Michael Myers, staff director for the Senate
Health, Education, Labor, and Pensions (HELP) committee, chaired by Senator Ted
Kennedy, at Families USA's post-election health care briefing:
"With the Obama victory, the
question is no longer whether we'll pursue comprehensive healthcare reform, but
when and in what form."
Determined to see health care reform come to fruition, Senator
Kennedy has wasted no time in convening regular meetings with key stakeholders in
the hopes of introducing comprehensive legislation in early January. In an
op-ed in Sunday's Washington Post., Kennedy reiterated
the urgency for reform:
"...despite the current economic downturn, we must forge
ahead with this urgent priority. The system is broken. And it's no longer just
patients demanding change. Businesses, doctors and even many insurance
companies are demanding it as well."
The specifics of his reform proposal remain under wraps,
according to Kennedy's office, but Myers
suggested that it will look much like Obama's plan and the Senator will
pursue a "single bill" strategy.
Senator
Obama's proposal builds on our current system of health coverage, preserving
what works and strengthening aspects of the system that need improvement. Under
his plan, workers who are satisfied with their employer-based coverage would
keep it. A new National Health Insurance Exchange would enable individuals and
businesses to purchase health coverage that's as good as the coverage for
members of Congress and other federal employees. His proposal requires that all
children have insurance. It would also cap out-of-pocket expenses and regulate
insurance companies so that they can no longer cherry-pick the young and
healthy and deny coverage to people with pre-existing conditions.
Many observers are poised
to see reform finally happen. Having learned a thing or two from the last
reform efforts in 1993 led by President Clinton, and understanding that reform
is not inevitable, many stakeholders (who don't always see eye-to-eye) are
searching for common ground. In Congress, staff from three jurisdictional
committees -- Finance, Budget, and Health, Education, Labor and Pensions (HELP)
-- have met to form working groups to discuss coverage expansion, systems
reform, and financing. In addition, Senator Baucus, chair of the Finance
Committee, which must approve any legislation before it goes to the Senate
floor, is also committed
to reform:
"I made sure the finance committee
spent this year learning and preparing for action on a comprehensive overhaul
of the healthcare system, and I intend for us to move swiftly and decisively with
legislation in early 2009."
We'll hear more from Baucus this week when he releases his
white paper on health reform.
Posted by: Ron Pollack, Executive Director, Families USA on Nov 05, 2008
The election we witnessed yesterday was not simply historic - it was truly transformative.
Just 43 years ago, Congress passed, and President Lyndon Johnson signed, the Voting Rights Act. For decades, since the end of Reconstruction, voting for many in the states of the old Confederacy was an act of unmatched heroism. To vote was to lose a job - even the laborious job of chopping and picking cotton for a meager $3 a day. To vote was to have your house shot into in the dark of night. To vote was to risk, and for too many to lose, one's life.
The Voting Rights Act was borne out of the heroism of many. Most visibly, it was catapulted onto the national agenda by the hundreds of brave souls, led by John Lewis in March of 1965, who crossed the Edmund Pettus Bridge leaving Selma, Alabama east on Route 80 to march towards Montgomery. As they crossed the bridge, they were brutally assaulted by police and highway patrolmen on horseback. They were beaten but not defeated.
Dr. Martin Luther King re-started the march soon thereafter. Thousands marched with him, sleeping in the fields at night. Singing their defiance of then-Governor George Wallace, they chanted:
Wallace, you never can jail us all,
Wallace, segregation's going to fall!
And they made it triumphantly to Montgomery. At night, after the final speeches were over near the State Capitol, Viola Liuzzo - a then-unknown civil rights activist who participated in the march - was murdered.
In the first election in Mississippi after the Voting Rights Act, a number of brave heroes decided to run for local office: sheriff, county board of education, mayor, county supervisor. They knew they wouldn't win, but they were undaunted.
I remember in the all-black town of Mound Bayou, Mississippi - in the heart of the Mississippi Delta, in the poorest part of our nation - black leaders assembled in houses before the elections, not knowing what violence they would face. Some had guns and other weapons to protect themselves and their families; others, more schooled and adherent to Dr. King's admonitions of non-violence, simply brought their bodies and heroic determination to vote for the first time.
Now, only four-plus decades later, we have witnessed an election that no one could realistically have dreamed about during those dark and difficult days. President-Elect Barack Obama's triumph - more profoundly, the triumph of our nation - is, in no small part, the victory of so many people who risked all they had to work for a better day.
For those of us fortunate to see, and participate in, this transformative election, our work must continue and start anew. This election is an opportunity - an opportunity to bring fairness and decency and dignity for those who have yet to share our nation's bounty. It is only the achievement of such justice that will enable us to realize Dr. King's dream: "Free at last, free at last, thank God almighty, we're free at last."
If Senators McCain and Obama can agree on one thing,
it's that we need health reform. While the
plans have some commonalities, there are also significant differences.
According
to our recent 501 (c)4 report, Health Care and the
2008 Election: Comparing the Candidates'
Positions on Health Care, "Senator McCain offers a radical restructuring of
America's health care system" while "Senator Obama's proposal builds on our
current system of health coverage, preserving what works and strengthening
aspects of the system that need improvement."
For
example, McCain's proposal:
Seeks to move Americans from group coverage-especially the
employer-based coverage they have today-to individual coverage, so that each
individual has to negotiate directly with insurance companies over premium
prices and benefits. Senator McCain's proposal also includes tax code changes
that will weaken existing employer-based coverage.
Meanwhile,
Obama's proposal:
Allows workers to keep the group coverage they now have
through their jobs. Employers help 180 million workers and their dependents
obtain coverage today, and Senator Obama recognizes the importance of this
financial support. His proposal strengthens the employer or group-based
insurance system, rather than moving toward individual insurance, since groups
have more clout in bargaining for lower premiums and better benefits.
Senator Edward Kennedy returned to Washington on July 10, 2008 to cast an important vote and break GOP opposition to the Medicare bill that blocks cuts in doctor payments. The Senator, who is currently undergoing treatment for brain cancer, flew in from Boston for thevote.
"I return to the Senate today to keep a promise to our senior citizens," Senator Kennedy said in a statement released by his office, "and that's to protect Medicare. Win, lose or draw, I wasn't going to take the chance that my vote could make the difference."
Kennedy's support helped swing the Senate in the right direction for what ultimately would be a victory for the senior citizens of America. And in the end, the bill passed overwhelmingly, with 69 senators infavor of the legislation.
The bill voids a 10.6 percent cut in Medicare payments to doctors. The GOP had blocked the bill because it reduces subsidies to private Medicare plans – subsidies that generate profits for private insurance companies, but cost seniors and taxpayers billions of dollars.
We want to thank Senator Kennedy for his commitment to help ensure that every American has affordable, quality healthcare. Please join us in saying thanks and sending our best wishes to him click here.
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Category: Health Care Costs,Medicare,Children's Health,Underinsurance and Medical Debt,Uninsured Americans
