Posted by: Peggy Denker on May 08, 2009
Near the end of the Wizard of Oz, the little dog Toto pulls
back the curtain and exposes a man behind the scenes who's pulling all the
strings. And so today, in Toto's memory, we bring you the latest contribution
from GOP spinmeister Frank Luntz.
Oregon Senator Jeff Merkeley says
this about Luntz:
Dr. Luntz, the man who developed language designed to
promote pre-emptive war in Iraq
and distract from the severity of global warming, is at it again - this time
with a messaging strategy designed to sink our historic opportunity for health
care reform.
And Politico's Mike Allen reminds us that
Luntz, the author of the
bestselling book "Words That Work: It's Not What You Say, It's What People
Hear," has been involved in creating much of the language Republican lawmakers
used from 1994 through 2004. . . . One of his coups was popularizing the phrase
"death tax" for "inheritance tax."
Reading the
Luntz memo - and you SHOULD read it - you won't know whether to yell or
laugh. On the one hand, he urges readers to pretend that private insurance
companies never, ever deny care to those in their plans:
Nothing will anger Americans more
than the chance that they will be denied the healthcare they need for
whatever reason. . . . So say it. "The
plan put forward by the Democrats will deny people treatments they need and
make them wait to get the treatments they are allowed to receive."
And, on the other hand, there's this remarkable pivot:
Make no mistake: the high cost of
healthcare is still public enemy number one. . . . You can't blame [the failure
of cost containment] on the lack of a private market; in case you missed it,
capitalism isn't exactly in vogue these days.
But you can and should blame
it on the waste, fraud, and abuse
that is rampant in anything and everything the government controls.
The New
Republic's Jonathan Cohn
offers a useful factual refutation of Luntz here
and here.
But now that we've seen the guy who is pulling the strings,
we have to conclude with two observations. First, if you needed any evidence of
how far we've come, how much the wind is at our back, read the Luntz memo: His
strongest advice is to acknowledge the crisis because people are so fed up,
they won't even listen to you if you try to minimize it. Although his goal is
stopping reform, Luntz's images and language mimic the way we all talk about
it.
Second, as wrong-headed and cynical as this memo is, do NOT
underestimate Frank Luntz. His language is already being echoed by the
opponents of reform and, as we've seen in the past, they're more inclined to
all sing in harmony, out of the same hymn book, than we are. We need to figure
out ways to expose the man behind the curtain and the ways he's trying to
deceive American voters into opposing the very thing they want.
Posted by: Ron Pollack, Executive Director of Families USA on May 05, 2009
Today, I had the privilege of speaking at the Senate Finance
Committee's Roundtable on Coverage Issues in Health Reform, and I wanted to
share some thoughts with you. For Americans, fundamentally reforming our
nation's health care system is of utmost urgency. More people are going
without health insurance, family budgets are tightening, and American
businesses are unable to keep up with rising health care costs. At the same time that the number of uninsured
is rising, people who have insurance are struggling
to afford rising premiums.
Families USA
has two core goals for health care reform: 1) that everyone who currently has
satisfactory health care coverage can keep that coverage, and 2) that those who
do not currently have health care coverage can get it. The most effective way
to achieve these goals and reform our health care system is to build on and
improve what currently works in our system.
We recommend an approach that will expand coverage as part
of health care reform that will especially help low income families: First, we
want to build upon and strengthen Medicaid. Medicaid now covers approximately
60 million people who can't otherwise afford health insurance, but it has holes
and it fails to protect many very vulnerable people. We want to fill those
holes and makes sure that more families
have access to care through Medicaid.
We also believe that middle class working families should
receive subsidies to buy coverage in a regulated, reformed insurance market or
"exchange." A public plan should be available to everyone in this exchange to
help level the playing field.
Finally, we believe that working families should receive
help with out-of-pocket health care costs, such as deductibles and copayments, which
are keeping millions of Americans from getting care.
These three recommendations are critical to making health
coverage affordable for those who today lack coverage or who are at risk of
losing their health coverage.
So you might be asking - why
Medicaid? Medicaid is specifically designed to serve low-income people and
people with disabilities - people who cannot afford needed health care on their
own. Medicaid guarantees comprehensive coverage to people with diverse health
care needs. In addition, it limits how much people can be charged out-of-pocket
for health care. Therefore, we think it is essential that the federal
government step-up and strengthen the Medicaid program for everyone below a certain
income.
Health care reform presents a tremendous opportunity to move
forward and provide quality, affordable health coverage to everyone in our
country-and to do so within the framework of our uniquely American system.
Families USA
believes that we can build on the best of what we have today.
Posted by: Ella Hushagen on May 04, 2009
Rick Scott, a wealthy entrepreneur and former head of the
world's largest hospital chain, has emerged as the most outspoken opponent of health
care reform. Proponents of reform
couldn't have dreamed up a better villain than Scott, a rich businessman with
ties to the health care industry. He founded and bankrolls Conservatives
for Patient Rights, a group that claims to speak on behalf of all Americans,
but which is really opposed to meaningful reform. Most recently, CPR launched a
controversial
ad campaign.
Scott's legacy as the hospital tycoon that built the
Columbia/HCA hospital chain is tainted by the fraud scandal that led to his
resignation. As the New York
Times reports,
Mr. Scott was ousted by his own board of directors in 1997 amid the
nation's biggest health care fraud scandal. The company's guilty plea and
payment of $1.7 billion to settle charges including the overbilling of state and federal health programs was taken as a
repudiation of Mr. Scott's relentless bottom-line approach.
Scott's tenure at Columbia/HCA before the fraud
investigation further damages the credibility of his attacks on health reform
and comparative effectiveness research. While he now cautions Americans that
the government wants to ration their care (presumably beyond the rationing we
already see with eroding coverage and high levels of uninsured), the Wonkroom
reports that under Scott's leadership, Columbia/HCA hospitals were squeezed for profits to the detriment of patients.
Scott's Conservatives for Patient Rights has hired the PR firm famous for its Swift Boat Veterans
for Truth ads. They'll need the best spin doctors in town to spread
fabrications like those contained in Scott's letter published in The
Hill recently.
Scott is working overtime to undermine health reform
legislation that has yet to be written, while putting nothing on the table for
Americans struggling with ever increasing health care costs. The guiding principles Scott proposes-"choice,
competition, accountability and personal responsibility"-sound an awful lot
like the White House's principles.
According to the New York
Times, even some of Scott's allies are distancing themselves, saying that he
is "counterproductive to their efforts for compromise."
Rick Scott is trying to tear down health reform before it
gains more momentum; advocates for change cannot let his big money ad buys
distract from the goal of comprehensive health care reform. SEIU has called on
CNN and FOX News to refuse to air CPR ads, which are "grossly misleading." Sign
the SEIU petition to
ask the networks to stop airing the less than truthful ads or write a letter to
the editor supporting universal health coverage instead of Scott's calls
for more of the same.
Posted by: Ella Hushagen on Apr 29, 2009
Last week, the White House released a report
pointing out that small business stands to gain a lot through health care
reform. Small businesses are the lifeblood of the American economy, but the
current health care system blocks their progress and innovation. The burden of
health care costs on small business has implications for all of us.
According to the report,
Half of
workers in small firms that do not offer health benefits are uninsured.... [Between
2000 and 2007] the percentage of small businesses offering coverage dropped
from 68% to 59%, while large firms held stable at 99%.
More and more hard-working Americans are joining the ranks
of the uninsured because their employers cannot afford to provide health
benefits. For workers who are lucky enough to retain their health benefits,
many have seen the quality of their coverage erode:
In the
past two years, more than half of small businesses that offered coverage
reported switching to plans with higher out-of-pocket costs in response to
rising premiums. Another third switched to a plan that covered fewer services.
These numbers are bad for small business and bad for the
economy as a whole. When employers can't provide quality health benefits, it
hurts their ability to retain good employees and to keep their workers healthy
and productive. And these dire statistics may discourage an entrepreneurial
employee of a large firm from starting his or her own business, or even joining
a start-up.
Small business leaders recognize this hindrance on their
growth and performance, and
Nearly
half of small business owners in a recent survey said that "making health care
more affordable" is the idea Washington should address first.
Many of the options being
discussed in Washington would be a big help to small business. These include
things like prohibiting insurance companies from discriminating against small
firms based on the health status of their employees, providing an insurance
purchasing pool businesses could use to cut down on administrative costs, offering
subsidies to low-wage workers to help them afford coverage, and offering
additional subsidies directly to some small businesses so they can afford to
offer coverage to their employees.
Posted by: Julia Eisman on Apr 28, 2009
In a surprise move that broke
in the Washington Post today, Pennsylvania Senator Arlen Specter has
decided to switch over to the Democratic Party. In a statement, Specter
said:
Since my election in 1980, as part
of the Reagan Big Tent, the Republican Party has moved far to the right. Last
year, more than 200,000 Republicans in Pennsylvania
changed their registration to become Democrats. I now find my political
philosophy more in line with Democrats than Republicans.
This is not just big news for Pennsylvania, but the nation as a whole
since it brings the total number of Democrats closer to 60 - which would be a filibuster-proof
majority if all Democrats vote along
party lines. But Democrats shouldn't get too excited. As Specter stated:
My change in party affiliation does
not mean that I will be a party-line voter any more for the Democrats that I
have been for the Republicans...I will not be an automatic 60th vote for cloture.
The
implications? "This really increases the likelihood that Senator Specter
will be a helpful ally in health care reform," said Ron Pollack, Executive
Director of Families USA. "It is unimaginable that he will run in the Pennsylvania Democratic
primary without making a huge effort to pass health care reform."
This could be
a game-changer for health care reform, but we'll have to wait and see how
things play out.
Posted by: Ella Hushagen on Apr 27, 2009
Americans are avoiding the doctor's office when they're
sick, and they're struggling to pay the medical bills they get when they can't
avoid seeking care any longer, according to a Kaiser Family Foundation poll
released last week. The survey data reveal that over the past year,
Six in ten say they have
taken ... steps to delay or skip care....
One in four Americans say someone in their household has
had trouble paying medical bills.
However, such
difficulties have not soured Americans on pursuing health care reform. In fact,
the poll showed that,
A majority of
Americans (59 percent) continue to say that economic challenges make it more important than ever to take on health
care reform now.
Support for the
idea of health reform is high, and it doesn't splinter when pollsters got into
some of its proposed components:
[Sixty-seven] percent of Americans are favorably disposed to a public health
insurance option.... [Seventy-one] percent say
they support the idea of "requiring employers to offer health insurance to
their workers or pay money into a government fund."
Americans are struggling in unforgiving
economic times, and rightly see health reform as crucial to recovery.
Posted by: Julia Eisman on Apr 24, 2009
Should health reform give people the option to buy a public
health insurance plan?
Our answer is "Yes."
That question - and answer - have generated a lot of
discussion on the Hill and a fair amount of ink in the media.
A public plan would be valuable for many reasons:
- It would create healthy competition and encourage the
private sector to play fair;
- It would offer consumers more good choice about which plan best suits their needs.
Not everyone agrees with us, including the private insurance
industry. They fear that competition with a public plan will drive them out of
business.
E.J. Dionne outlines some of the political and ideological
tug-of-war in a column in yesterday's Washington Post:
What if including a robust public
plan has the effect of dooming a bill that gets affordable health insurance to
everyone? Should public-plan advocates block any bill that doesn't contain
their idea, as originally conceived? Of course not.
Dionne recognizes we have a window of opportunity to make
real reform and points out some groups are placing an "emphasis on
creative compromise in place of creative obstruction."
Dionne cites an example of a partnership between Families
USA and PhRMA advocating that health reform include an expansion of
Medicaid, a limit to out-of-pocket costs, and significant subsidies to
help middle-income people purchase insurance. While not perfect, Medicaid is
uniquely suited to serving the needs of low-income and vulnerable Americans. We
must improve and expand Medicaid as a starting point for expanding coverage. It
is extremely helpful to have PhRMA send this message loud and clear to Members
of Congress.
Dionne makes an important point about creative
compromises and his column is a valuable one. One clarifying note: Dionne appears to suggest that expanding
Medicaid is a substitute for a
public health insurance plan option. That is not Families USA's
position. Expansion and improvements to Medicaid are a foundation for expanding
health insurance coverage. On top of that expansion, we support subsidies to
moderate income families to purchase coverage-with the choice of a public
health insurance plan.
Posted by: Ron Pollack, Executive Director of Families USA on Apr 24, 2009
Our goal is health care for all Americans. Currently, health
care is unaffordable for too many middle-income working families and the poor.
To achieve our goal, we need several key proposals that are
specifically designed to make coverage and care affordable:
1. For the poor, we need to expand the Medicaid safety net so it
truly covers low- income people and families. We propose to establish a
Medicare eligibility floor at 133% of
the Federal Poverty Level - an expansion to adults who earn income below
$14,000 per year, and families of four who earn less than $29,300. Today, in 43
states, adults who don't have dependent children are ineligible for safety net
protection-even if they are penniless.
For parents, the median income eligibility standard is a meager 67%
2. For people above the Medicaid eligibility levels, but who can't
afford premiums, we need substantial sliding-scale subsidies so premiums can be
affordable. This system, currently working in Massachusetts, has enabled the state to have
the lowest portion of its population uninsured of any state.
3. We also need further subsidies
so that a cap is established on out-of-pocket
health care costs, such as deductibles and copayments. This would ensure
that health care is truly affordable and would avoid medical-related
bankruptcies.
We have entered a partnership with PhRMA to campaign for
these essential elements. In the weeks and months ahead, we will launch a
multi-million dollar advertising campaign, in addition to grassroots and
lobbying efforts.
As Politico reported,
The partnership could significantly
reshape the debate over health care reform.... The proposal could bolster the chances
of expanding the Medicaid program, an option that Senate Finance Committee
Chairman Max Baucus (D-Mont.) and the committee's ranking Republican, Sen.
Chuck Grassley of Iowa,
are reportedly discussing.
If we win these three cornerstones, which are needed to make
health care affordable, we will go a long way toward the goal of ensuring
access to high-quality and affordable health care - and coverage - for all.
Posted by: Ella Hushagen on Apr 22, 2009
Whether you work for a small mom-and-pop shop or a large firm, your health coverage is a big deal.
Unfortunately, existing federal law doesn't treat your coverage at the mom-and-pop and the big business the same way. COBRA protections that allow workers to retain their health benefits by paying the full premium after leaving the job do not apply to businesses with fewer than 20 workers.
This major gap in legal rights for small business workers has always been problematic, but it's even more painful in a recession when many people are losing their jobs, and with them their health coverage. While COBRA premiums are generally costly, COBRA coverage may be the only available option for workers with less-than-perfect health. Furthermore, the economic recovery package that Congress passed in February gives a 65% COBRA premium subsidy to Americans who have been laid off, making the premiums far more affordable.
Families USA reported last week that, luckily, many states have so-called "mini-COBRA" laws on the books to extend the right to keep employer-group health coverage to workers in small businesses. And now, these laws are worth even more to terminated employees of small firms because they are eligible for the 65% COBRA premium subsidy if their state has a mini-COBRA law.
Many states have recognized the need to help newly-uninsured terminated workers from small businesses gain access to the federal COBRA subsidy. Families USA reports that since the economic recovery law was enacted, 23 states have taken action to enact or improve existing mini-COBRA protections. States have increased the length of time residents are entitled to mini-COBRA benefits; some have allowed laid off workers who declined mini-COBRA a second chance to sign up; and a few have required insurers to cover pre-existing conditions once people sign up for mini-COBRA regardless of gaps in health coverage.
While it is encouraging to see states working hard to prevent former employees of small firms from joining the ranks of the uninsured, there are still states that are letting these workers down. According to the report,
The following states do not have mini-COBRA laws, so workers losing jobs in small firms will not be able to continue the coverage they had at their jobs or get a subsidy to help pay the cost: Alabama, Alaska, Arizona, Delaware, Hawaii, Idaho, Indiana, Michigan, and Montana.
As the report's author, Cheryl Fish-Parcham, told reporters,
If someone has the misfortune to get seriously ill when they are laid off and uninsured, they may have a really hard time getting access to care, and they may be saddled with medical debt.
Ultimately, comprehensive health care reform is necessary to create a real safety net in difficult times, rather than the current patched-together protections that leave many consumers vulnerable.
Posted by: Angela Shubert on Apr 15, 2009
In the past few weeks you may have heard the word
"reconciliation" thrown around in the context of health care reform.
So what is this mouthful, and why does it keep coming up? In
short, reconciliation means that legislation cannot be blocked by a minority of
Senators. Under reconciliation, legislation only requires 51 votes to pass on
the Senate floor and it is
filibuster-proof. This is important because controversial legislation can
require 60 votes (a super-majority) to pass Congress, rather than a simple
majority, otherwise the minority can block it with a filibuster. Thus, reconciliation can be a tool to protect the majority's
legislation from a few in the minority.
Support for reconciliation is mixed. Some members of
Congress insist that using reconciliation for health reform would deny them
input into the bill; others fear that, without the option of reconciliation,
partisan opponents could derail reform. As Senator Max Baucus, chairman of
the Senate Finance Committee said, "The
real effort is to keep this bipartisan."
But if bipartisan support cannot be achieved, the
reconciliation option gives leverage to members of Congress who are committed
to ensuring that health reform passes this year.
Thing is, reconciliation must be written into the budget to
even be considered - and this year it was. Reconciliation instructions were
included in the House's budget, not in the Senate's budget. By doing this,
reconciliation is still left on the table as an option for passing legislation,
if it looks like a minority of opponents will use their filibuster power to
block reform. Ron Pollack, executive
director of Families USA, has said this is "the
best of both worlds": A bipartisan approach is the preferred route, but if
it fails, Democrats will be able to move forward and ensure comprehensive
health care reform becomes a reality this year.
Also coming out in favor: the New York Times editorial
board, which reminded
us that:
When the Republicans controlled
Congress they used the same expedited procedure
to ram through controversial measures, including the enormous tax cuts for the
wealthy that plunged the federal budget deep into deficit.
And,
It is a weapon that the Democrats would be foolish to
give up without evidence that Republicans will truly cooperate in fashioning
meaningful reform. Not one Republican in the House or the Senate voted for the
budget resolutions, and only three supported the stimulus bill.
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Category: Affordability,Health Care Costs,Medicaid,Medicare,Pre-Existing Conditions,Underinsurance and Medical Debt,Uninsured Americans
