RKMBs Forums .::Important::. Politics and Current Events A right to Health Care

Sen. Max Baucus on Wednesday brought out the much-awaited Finance Committee version of an American health-system remake — a landmark $856 billion, 10-year measure that starts a rough ride through Congress without visible Republican backing.

The bill by Baucus, chairman of the Finance Committee, would make major changes to the nation's $2.5 trillion health care system, including requiring all individuals to purchase health care or pay a fine, and language prohibiting insurance company practices like charging more to people with more serious health problems.

"This is a unique moment in history where we can finally reach an objective so many of us have sought for so long," Baucus said. "The Finance Committee has carefully worked through the details of health care reform to ensure this package works for patients, for health care providers and for our economy."

Consumers would be able to shop for and compare insurance plans in a new purchasing exchange. Medicaid would be expanded, and caps would be placed on patients' yearly health care costs. The plan would be paid for with $507 billion in cuts to government health programs and $349 billion in new taxes and fees, including a tax on high-end insurance plans and fees on insurance companies and medical device manufacturers.

The bill fails to fulfill President Barack Obama's aim of creating a new government-run insurance plan — or option — to compete with the private market. It proposes instead a system of nonprofit member-owned cooperatives, somewhat akin to electric co-ops that exist in many places around the country. That was one of many concessions meant to win over Republicans.

In other ways though, including its overall cost and payment mechanisms, the bill tracks closely with the priorities Obama laid out in his speech to Congress last week.

Baucus is still holding out hope for GOP support when his committee actually votes on the bill, probably as early as next week.

The measure represents the most moderate health care proposal in Congress so far, compared to legislation approved by three committees in the House and the Senate's health panel. Obama's top domestic priority is to revamp the health care system to provide coverage to nearly 50 million Americans who lack it and to rein in rising costs.

The bill includes provisions to keep illegal immigrants from obtaining health coverage through the new insurance exchanges — reflecting the White House's newly stringent stance on the issue after a Republican House member interrupted Obama's speech last week to accuse him of lying about it.

The bill also would prevent federal funds from being used to pay for abortions except in cases of rape, incest, or if the life of the mother would be endangered. It's all but certain that the Baucus provisions will not be the last word on either of those volatile issues.

The bill would set up a verification system to make sure people buying insurance in the exchanges are U.S. citizens or legal immigrants, using Social Security data and Homeland Security Department files. The bill would impose penalties for fraud and identity theft.

While only legal residents would be able to buy coverage through the exchanges, illegal immigrant parents would be able to get insurance for their U.S. born children.

The bill would prohibit abortion from being included in any minimum benefits package. However, plans in the exchange could offer unrestricted coverage for abortions, provided that no funds from government subsidies are used to pay for them. Women who want coverage for abortions would have to pay for it with their own money.

Wednesday's bill release follows months of negotiations among Baucus and five other Finance Committee senators dubbed the "Gang of Six" — Republicans Chuck Grassley of Iowa, Mike Enzi of Wyoming and Olympia Snowe of Maine, and Democrats Kent Conrad of North Dakota and Jeff Bingaman of New Mexico.

Enzi said he couldn't support the Baucus bill and preferred an incremental approach. "Let's start by focusing on the issues where we already have broad, bipartisan agreement," he said.

In the end, Democrats believe Snowe may be the only Republican to support the bill, though she wasn't ready to commit her support Tuesday night. "Hopefully at some point through the committee process we can reach an agreement," she said.

The bill drew quick criticism from Republican leaders.

"This partisan proposal cuts Medicare by nearly a half-trillion dollars, and puts massive new tax burdens on families and small businesses, to create yet another thousand-page, trillion-dollar government program," said Senate Minority Leader Mitch McConnell, R-Ky. "Only in Washington would anyone think that makes sense, especially in this economy."

Many liberals also have concerns. Some wanted Baucus to include a public option, while others fear that, in his effort to hold down the price of his bill, Baucus didn't do enough to make health coverage affordable to working-class Americans. Sen. Jay Rockefeller, D-W.Va., a member of the Finance Committee, said Tuesday that he couldn't support the bill in its current form.

Baucus' plan, released as a detailed 223-page summary, aims to make health insurance more affordable for self-employed people and those working for small companies, who now have the biggest problems in getting and keeping coverage.

People insured through large employers would not see major changes, but some of their health care benefits would be nicked to help pay for the cost of the plan. The Baucus proposal would limit to $2,000 a year the amount people can contribute to flexible spending accounts, which are used to cover copayments and deductibles not paid by their employers. That provision would raise $16.5 billion over 10 years.

Everyone covered through an employer would learn the full costs of their health benefits, which starting next year would be reported on employees' W-2 tax forms. Although family coverage averages about $13,000 a year most workers don't know how much their employer is paying.

Not carrying insurance could result in a steep fine, as much as $3,800 per family, or $950 for an individual. People who can't afford their premiums would be exempted from the fine.

The plan proposes a $6 billion annual fee on health insurance providers, which would recoup some of the profits the companies expect to make from millions of new taxpayer-subsidized customers.

Unlike the health care bill written by majority Democrats in the House, which permanently rolls back scheduled cuts in Medicare payments to doctors, the Baucus plan only suspends the reductions for one year. That trims more than $100 billion from the cost of the bill, but has already led to criticism from the American Medical Association.

The legislation makes no changes in medical malpractice laws. It does incorporate Obama's call for federal funds for state experiments on alternatives to malpractice lawsuits.

Democratic leaders are aiming for votes in the full House and Senate this fall.

wo of every three practicing physicians oppose the medical overhaul plan under consideration in Washington, and hundreds of thousands would think about shutting down their practices or retiring early if it were adopted, a new IBD/TIPP Poll has found.

The poll contradicts the claims of not only the White House, but also doctors' own lobby — the powerful American Medical Association — both of which suggest the medical profession is behind the proposed overhaul.

It also calls into question whether an overhaul is even doable; 72% of the doctors polled disagree with the administration's claim that the government can cover 47 million more people with better-quality care at lower cost.

The IBD/TIPP Poll was conducted by mail the past two weeks, with 1,376 practicing physicians chosen randomly throughout the country taking part. Responses are still coming in, and doctors' positions on related topics — including the impact of an overhaul on senior care, medical school applications and drug development — will be covered later in this series.

Major findings included:

• Two-thirds, or 65%, of doctors say they oppose the proposed government expansion plan. This contradicts the administration's claims that doctors are part of an "unprecedented coalition" supporting a medical overhaul.

It also differs with findings of a poll released Monday by National Public Radio that suggests a "majority of physicians want public and private insurance options," and clashes with media reports such as Tuesday's front-page story in the Los Angeles Times with the headline "Doctors Go For Obama's Reform."

Nowhere in the Times story does it say doctors as a whole back the overhaul. It says only that the AMA — the "association representing the nation's physicians" and what "many still regard as the country's premier lobbying force" — is "lobbying and advertising to win public support for President Obama's sweeping plan."

The AMA, in fact, represents approximately 18% of physicians and has been hit with a number of defections by members opposed to the AMA's support of Democrats' proposed health care overhaul.

• Four of nine doctors, or 45%, said they "would consider leaving their practice or taking an early retirement" if Congress passes the plan the Democratic majority and White House have in mind.

More than 800,000 doctors were practicing in 2006, the government says. Projecting the poll's finding onto that population, 360,000 doctors would consider quitting.

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• More than seven in 10 doctors, or 71% — the most lopsided response in the poll — answered "no" when asked if they believed "the government can cover 47 million more people and that it will cost less money and the quality of care will be better."

This response is consistent with critics who complain that the administration and congressional Democrats have yet to explain how, even with the current number of physicians and nurses, they can cover more people and lower the cost at the same time.

The only way, the critics contend, is by rationing care — giving it to some and denying it to others. That cuts against another claim by plan supporters — that care would be better.

IBD/TIPP's finding that many doctors could leave the business suggests that such rationing could be more severe than even critics believe. Rationing is one of the drawbacks associated with government plans in countries such as Canada and the U.K. Stories about growing waiting lists for badly needed care, horror stories of care gone wrong, babies born on sidewalks, and even people dying as a result of care delayed or denied are rife.

In this country, the number of doctors is already lagging population growth.

From 2003 to 2006, the number of active physicians in the U.S. grew by just 0.8% a year, adding a total of 25,700 doctors.

Recent population growth has been 1% a year. Patients, in short, are already being added faster than physicians, creating a medical bottleneck.

The great concern is that, with increased mandates, lower pay and less freedom to practice, doctors could abandon medicine in droves, as the IBD/TIPP Poll suggests. Under the proposed medical overhaul, an additional 47 million people would have to be cared for — an 18% increase in patient loads, without an equivalent increase in doctors. The actual effect could be somewhat less because a significant share of the uninsured already get care.

Even so, the government vows to cut hundreds of billions of dollars from health care spending to pay for reform, which would encourage a flight from the profession.

The U.S. today has just 2.4 physicians per 1,000 population — below the median of 3.1 for members of the Organization for Economic Cooperation and Development, the official club of wealthy nations.

Adding millions of patients to physicians' caseloads would threaten to overwhelm the system. Medical gatekeepers would have to deny care to large numbers of people. That means care would have to be rationed.

"It's like giving everyone free bus passes, but there are only two buses," Dr. Ted Epperly, president of the American Academy of Family Physicians, told the Associated Press.

Hope for a surge in new doctors may be misplaced. A recent study from the Association of American Medical Colleges found steadily declining enrollment in medical schools since 1980.

The study found that, just with current patient demand, the U.S. will have 159,000 fewer doctors than it needs by 2025. Unless corrected, that would make some sort of medical rationing or long waiting lists almost mandatory.

Experiments at the state level show that an overhaul isn't likely to change much.

On Monday came word from the Massachusetts Medical Society — a group representing physicians in a state that has implemented an overhaul similar to that under consideration in Washington — that doctor shortages remain a growing problem.

Its 2009 Physician Workforce Study found that:

• The primary care specialties of family medicine and internal medicine are in short supply for a fourth straight year.

• The percentage of primary care practices closed to new patients is the highest ever recorded.

• Seven of 18 specialties — dermatology, neurology, urology, vascular surgery and (for the first time) obstetrics-gynecology, in addition to family and internal medicine — are in short supply.

• Recruitment and retention of physicians remains difficult, especially at community hospitals and with primary care.

A key reason for the doctor shortages, according to the study, is a "lingering poor practice environment in the state."

In 2006, Massachusetts passed its medical overhaul — minus a public option — similar to what's being proposed on a national scale now. It hasn't worked as expected. Costs are higher, with insurance premiums rising 22% faster than in the U.S. as a whole.

"Health spending in Massachusetts is higher than the United States on average and is growing at a faster rate," according to a recent report from the Urban Institute.

Other states with government-run or mandated health insurance systems, including Maine, Tennessee and Hawaii, have been forced to cut back services and coverage.

This experience has been repeated in other countries where a form of nationalized care is common. In particular, many nationalized health systems seem to have trouble finding enough doctors to meet demand.

In Britain, a lack of practicing physicians means the country has had to import thousands of foreign doctors to care for patients in the National Health Service.

"A third of (British) primary care trusts are flying in (general practitioners) from as far away as Lithuania, Poland, Germany, Hungary, Italy and Switzerland" because of a doctor shortage, a recent story in the British Daily Mail noted.

British doctors, demoralized by long hours and burdensome rules, simply refuse to see patients at nights and weekends.

Likewise, Canadian physicians who have to deal with the stringent rules and income limits imposed by that country's national health plan have emigrated in droves to other countries, including the U.S.

views of the President’s health care proposal ... statistically unchanged in an NBC poll

So the numbers have improved for Obama.

NBC/WSJ: OBAMA HEALTH #S INCH UP
Posted: Tuesday, September 22, 2009 5:00 PM by Mark Murray
Filed Under: Polls
From NBC's Mark Murray
Here's another tease of our new NBC/WSJ poll: According to the poll, the president’s health-care numbers have slightly increased, although that increase remains within the margin of error. Thirty-nine percent believe Obama’s health-care plan is a good idea, which is up three points since August. Forty-one percent say it’s a bad idea.

In addition, 45% approve of Obama’s handling of health care, while 46% disapprove, which is up from his 41%-47% score last month. By comparison, just 21% approve of the Republican Party’s handling of the issue.

And who will get blamed if health care doesn't get passed this year? Per the poll, 10% say Obama, 16% say congressional Democrats, and 37% say congressional Republicans.

The poll was conducted Sept. 17-20 and has an overall margin of error of plus-minus 3.1%. The full poll comes out beginning at 6:30 pm ET.

WASHINGTON — President Barack Obama scored a big victory on Thursday as the Senate Finance Committee rejected a proposal to require pharmaceutical companies to give bigger discounts to Medicare on drugs dispensed to older Americans with low incomes.

The victory came at the expense of senators in Obama's own party who had championed the proposal. The vote, in effect, upheld a deal reached in June by the White House and the drug industry.

The proposal, an amendment by Sen. Bill Nelson, D-Fla., would have required drugmakers to provide Medicare with discounts in the form of rebates totaling more than $100 billion over 10 years.

Some of the money would have been used to close a gap in Medicare coverage of prescription drugs. In 2007, more than 8 million Medicare beneficiaries fell into the gap, known as the doughnut hole.

Three Democratic senators — Max Baucus of Montana, Thomas Carper of Delaware and Robert Menendez of New Jersey — joined all the Republicans on the panel in defeating the amendment by a vote of 13-10.

The committee plodded through the health care legislation for a third day, as lawmakers debated the proper role of government in securing insurance coverage for all Americans. With many amendments still to be offered, Sen. Kent Conrad, D-N.D., said it was highly unlikely that the panel could finish its work this week — the goal set by Baucus, the committee chairman.

Under the June agreement with the White House, drugmakers pledged $80 billion over 10 years to help "reform our troubled health care system." In the belief that their contribution was capped, drug companies have run ads in support of a health care overhaul.

The rebates proposed by Nelson would have more than doubled the amount of money to be given up by the industry.

Carper said the proposal to wring more rebate money out of the drug companies would "undermine our ability to pass comprehensive health care reform in this Congress," because the drug industry would have opposed the legislation if it included mandatory rebates.

In arguing against the proposal, Carper said, White House officials told him that "a deal is a deal," and he agreed.

Ken Johnson, senior vice president of the Pharmaceutical Research and Manufacturers of America, a trade group, said the Nelson proposal could have caused job losses in the drug industry.

"If our contribution to health care reform exceeds $80 billion, you reach a point where you risk sacrificing someone's job for someone else's health insurance," Johnson said.

Drugmakers already pay rebates on drugs dispensed to many Medicaid recipients. Nelson's proposal would have required them to pay similar rebates on drugs prescribed for another group: low-income older Americans eligible for both Medicaid and Medicare. The group includes people taking numerous prescriptions for multiple chronic illnesses, so they account for a large share of drug spending.

When Congress added a drug benefit to Medicare in 2003, about six million older Americans who had been receiving drug coverage through Medicaid were shifted into the new Medicare drug program.

House Democrats are considering an insurance tax to help pay for their health care overhaul plan, even though such a funding scheme is bitterly opposed by labor unions that are among the party's most loyal constituencies.

House Speaker Nancy Pelosi, D-Calif., said Friday a tax on high-cost health insurance plans is "under consideration" as Democrats search for consensus within their ranks before taking a bill to the House floor later this fall.

"We just have to see how much money we need for what," Pelosi said. "And if we're taking the bill down in cost, there are other provisions in the Senate bill that bend the (costs) curve that might be more palatable. We'll see."

Pelosi didn't specify what other provisions she might find more acceptable. An aide said that if the House does incorporate an insurance tax in its plan, it would probably be a more modest one than what Senate Finance Chairman Max Baucus, D-Mont., has proposed.

The House Democratic plan calls for raising income taxes on upper-income people to pay for covering the uninsured. Baucus has instead proposed a tax on high-cost insurance plans worth more than $8,000 for an individual policy and $21,000 for family coverage.

Proponents of the insurance tax, which President Barack Obama has endorsed, say it would help to lower health care costs by encouraging people to become more cost-conscious health care consumers.

Some of the high-cost plans are so expensive because they come with no co-payments or deductibles, and cover every dollar spent for health care. Not all of them provide such "Cadillac" benefits, however. Some are very expensive because they're sold to companies with older employees, or workers in high-risk occupations.

Unions say they've given up higher pay to secure better health care benefits that they're determined to hang on to. Insurers are likely to try to pass on the cost of the tax through higher premiums.

If House Democrats adopt the insurance tax, it may help them to reduce the income tax increase that they've proposed.

Paying for their plan is only one of several nettlesome issues House leaders are trying to hash out as they struggle to merge three committee-approved bills into a single piece of legislation. They hope to finish that process next week.

House Democrats are struggling with getting their 10-year, $1 trillion-plus bill down to the $900 billion price tag Obama prefers. Major cuts could be required, but Democrats want to protect the subsidies their plan offers to low-income Americans to help them buy coverage. Those subsidies are the most costly part of the bill.

Meanwhile, Baucus' Finance Committee adjourned Friday without coming close to finishing its health care bill, even though that had been his goal when he convened the session on Tuesday. Hundreds of amendments and contentious debates over issues large and small, often initiated by Republicans, slowed progress. The panel will resume work Tuesday. It's the last of five committees in Congress to act on health care legislation.

At their core, all the health overhaul bills are designed to expand health insurance coverage to millions of people who lack it, employing a new system of federal subsidies for lower-income individuals and families and establishing an insurance exchange in which coverage would have federally guaranteed benefits. Insurance companies would be prohibited from refusing to sell insurance based on an individual's health history, and limits would be imposed on higher premiums based on age.

Not yet determined is whether final legislation would contain any version of a new public plan to compete with private insurers and sign up middle-class workers and their families.

The Senate panel's bill does not include a government-run option and the conservative-leaning committee is preparing for a showdown on the issue next week.

Although all the House bills include some version of a public plan, there's no final decision on how it will be structured. House liberals are pushing for provider payment rates tied to Medicare rates but 5 percent higher, but moderates say those rates are too low and would hurt struggling hospitals and other providers. Moderates would give the Health and Human Services secretary the ability to negotiate rates instead.

Energy and Commerce Chairman Henry Waxman, D-Calif., said Friday that the Medicare rate structures saves about $85 billion more over 10 years than the negotiated rate structure.

"That means we have to come up with the money to do that," Waxman said.

A complicated dispute over how to address regional disparities in Medicare payment rates also continued to be a major sticking point for House Democrats.

Not all of them provide such "Cadillac" benefits, however. Some are very expensive because they're sold to companies with older employees, or workers in high-risk occupations.

Sen. John Ensign (R-Nev.) received a handwritten note Thursday from Joint Committee on Taxation Chief of Staff Tom Barthold confirming the penalty for failing to pay the up to $1,900 fee for not buying health insurance.

Violators could be charged with a misdemeanor and could face up to a year in jail or a $25,000 penalty, Barthold wrote on JCT letterhead. He signed it "Sincerely, Thomas A. Barthold."

Latest Lie: "Death Panels By Proxy"
Posted by Karen Tumulty Sunday, September 27, 2009 at 12:17 pm
18 Comments • Trackback (0) • Related Topics: Max Baucus, congress, health care, senate, death panels, death panels by proxy, fear-mongering
There they go again. Now that the "death panel" lie has snookered nearly half the country, the Washington Times is going for the other half in an editorial headlined "Death Panels By Proxy." Cue the scary music for this one:

The offending provision is on Pages 80-81 of the unamended Baucus bill, hidden amid a lot of similar legislative mumbo-jumbo about Medicare payments to doctors. The key sentence: "Beginning in 2015, payment would be reduced by five percent if an aggregation of the physician's resource use is at or above the 90th percentile of national utilization." Translated into plain English, it means that in any year in which a particular doctor's average per-patient Medicare costs are in the top 10 percent in the nation, the feds will cut the doctor's payments by 5 percent.

Forget results. This provision makes no account for the results of care, its quality or even its efficiency. It just says that if a doctor authorizes expensive care, no matter how successfully, the government will punish him by scrimping on what already is a low reimbursement rate for treating Medicare patients. The incentive, therefore, is for the doctor always to provide less care for his patients for fear of having his payments docked. And because no doctor will know who falls in the top 10 percent until year's end, or what total average costs will break the 10 percent threshold, the pressure will be intense to withhold care, and withhold care again, and then withhold it some more. Or at least to prescribe cheaper care, no matter how much less effective, in order to avoid the penalties.

My question: Has anyone at the Washington Times actually talked to a doctor lately? Under the current system, lots and lots of people are showing up at physicians' offices with no insurance at all. And do you know what these medical heroes are doing? By and large, they are treating them anyway. Doctors I have spoken to tell me that it is not at all unusual for them to be writing off 10%, or 20% or even more of the care they give because their patients simply can't afford to pay their bills.

So now, the Washington Times would like us to believe that these very same doctors will suddenly start cutting their patients off, sending them out to die, simply to earn a little more money.

Yes, this provision is designed to encourage doctors to think a little more about what kind of treatment is most effective, and to cut back on the waste and overtreatment that experts say account for 30 cents out of every dollar that is spent on medical care in this country. But to call these "death panels by proxy" is simply fear-mongering.

What's more, the Times is wrong when it suggests the Finance Committee bill puts no focus on quality. In fact, it gives doctors incentives they don't have now, especially in the management of the chronic illnesses that have been such a factor in driving up health costs. This from former Clinton Administration health adviser Chris Jennings (via Ezra Klein):

... I choose to focus on a couple of other diamonds in the rough. The first would be the funding for prioritization and development of quality measures linked to aggressive reimbursement incentives to physicians for reporting on these measures. (These measures, developed by health professionals, are used to promote best practices for some of the most expensive chronic diseases, such as heart disease, cancer and diabetes). I have concluded that we will never really change the way we deliver health care without the buy-in of the medical profession, which can only be secured if they develop and apply measures that can be used to empower practitioners and hold them accountable through comparative outcomes with/by their peers.

A second, and related issue, is a Finance Committee provision which gives CMS the authority to develop pilot programs to test methods of reimbursing providers for chronic disease management, (including collaborations with the states and the dual eligible program). Today, the easiest course of medical intervention is to prescribe treatment plans that deal with the effects of the disease, high cholesterol, high blood pressure, etc., rather than spending time with patients to help motivate them to take control of their health and manage their own diseases through lifestyle changes. Only when patients begin to understand that they must be the focal point of any intervention to constrain or even reverse the course of expensive chronic illness and, ultimately, produce savings, will we have made progress. The most creative part of this policy is to allow the pilots to be constructed in a fashion that waive strict budget neutrality requirements (because this has killed ideas in the past) AND allows them to expand nationally automatically (without any other legislative action) IF they can prove budget neutrality or better in the budget window. We all know that chronic illness is the primary contributor to our nation's health-care tab – preventing and managing it is one of the absolute keys in getting the ultimate job done.

Okay, not as sexy as "death panels by proxy." But it does have the virtue of actually being true.

Health insurance under the current system is not always the rock-solid guarantee you think you're paying for.

Especially, it turns out, when you don't fill everything out just right.

In Beaton's case, the insurance company opened an investigation after her visit to a dermatologist and just before her scheduled breast cancer surgery, forcing postponement of her operation almost on the eve of it. The earlier problems on her enrollment form were discovered and her coverage was canceled.

To some lawmakers, that's outrageous enough -- never mind the acne story.
...
In the spring of 2008, Beaton visited a dermatologist. "My face began to break out," she said. "All it was, truly, honestly, was pimples."

The doctor diagnosed mild rosacea, sometimes called adult acne, and seborrheic keratosis, a benign and common skin growth.

Beaton says the visit nevertheless raised a red flag because a notation in her records was misconstrued as meaning precancerous.

Beaton says she's convinced "the acne is what started everything," meaning the insurance company scrutiny. Because she'd had her insurance for months, the acne was not a pre-existing condition that could have imperiled her policy.

Whatever the case, her breast cancer diagnosis that quickly followed surely would have prompted a similar review of her files.

On the Friday before her cancer surgery, she was told her insurance company was opening the investigation and would not pay for her operation before that was concluded, she said. That suspended the surgery.

"They searched high and low for a reason to cancel me," she said.

The insurer retrieved records from a cardiologist pointing to her unreported heart condition. Then, in an Aug. 22, 2008, letter, the company listed four questions it said she answered inaccurately on her form and a fifth that was insufficiently addressed.

As a result, wrote the insurer, "your coverage is rescinded as of 12/04/07, the original effective date of your policy."
...

According to Evan Tracey, who heads a private data tracking company called the Campaign Media Analysis Group, about $47 million has been spent for ads favoring a health overhaul and $32 million has gone to opposing the effort. The rest has been spent on commercials that generally mention the issues.

The Senate Finance Committee approved an amendment to the healthcare bill Wednesday that would allow employers to charge workers with unhealthy lifestyles more for their insurance coverage.


The amendment would permits employers to adjust premiums as much as 50 percent according to the level of workers’ health habits, up from 20 percent now.


“Weight gain and unhealthy lifestyles that focus on smoking and lack of exercise have skyrocketed our healthcare costs," Sen. John Ensign, R-Nev., said in a statement cited by Politico news service.


Ensign, who sponsored the amendment along with and Sen. Tom Carper, D-Del., said, "These costs could be lowered by focusing on what makes us healthy — through weight loss programs, smoking cessation and preventive care. Voluntary employee participation in these areas should naturally be reflected in lower healthcare costs.”


Opponents, including the American Cancer Society and the American Heart Association, counter that the new rule may spur insurers and companies to keep basing coverage decisions on pre-existing conditions, even though the bill itself prohibits that.


A consortium of healthcare advocacy groups wrote in a letter: “While we appreciate the amendments’ intent to encourage healthy behaviors, we believe that allowing employers to vary premiums by up to 50 percent of the total cost of employee coverage could lead to discriminatory practices and make health coverage unfordable for those who need it the most.”


Sen. John Barrasso, a Wyoming Republican who is a doctor himself, says premium differences are important.


“Americans want simple, practical, affordable changes now. . . Changes that offer reductions in premiums for making healthy lifestyle choices,” he wrote in the Little Chicago Review.

Be careful what you wish for MEM, the butt sex will be next!

Oh, the establishment press will just loooooove this -- not.

From BigGovernment.com (HT Mark Levin over the airwaves this evening):

Beverly Gossage, Research Fellow for Show-Me Institute and founder of HSA Benefits Consulting wondered which insurance companies rejected the most claims. She found her answer in the AMA’s own 2008 National Health Insurer Report Card (fairly large PDF).

I'm curious. Was it Aetna? Humana?

A chart showing the major carriers and how Medicare compared to them in the study follows:



Well, well.

The Medicare denial rate found in the study was, on a weighted average basis, roughly 1.7 times that of all of the private carriers combined (99,025 divided by 2,447,216 is 4.05%; 6.85% divided by 4.05% =1.69).

You would think Medicare's sheer size might enable it to have smoother procedures with its providers that would enable it to turn down a lower percentage of claims. But no, this is the government we're talking about.

So who's the most "heartless" now? And why should Americans accept the idea of gradually being forced into a government-run system when, based on documented government experience, they will be more likely to see their claims denied?

And I didn't even get to the idea of refusals to treat in the first place, something that is present to some degree in virtually every state-run system, but is currently against the law in hospital emergency rooms in the U.S.

AP-AP Poll-Health Care
October 07, 2009 04:20 EDT

WASHINGTON (AP) -- A new poll suggests public opinion on health care legislation is now an even split and a solid gain for Democrats after September results showed 49 percent opposed.

The latest Associated Press-GfK poll has found that the opposition to Obama's health care remake dropped dramatically in just a matter of weeks. Still, Americans remain divided over the complex legislation.

The poll finds the public is now split 40-40. In September, only 34 percent of those polled supported the effort.

Anger about health care boiled over during August town hall meetings. People worried the government was trying to take over the system and would usher in higher costs, lower quality -- even rationing and euthanasia.

Robert Blendon, a Harvard professor who tracks public opinion on health care says this month's gain is "very significant."

Budget Office Says Senate Bill Will Trim Deficit
By JANET ADAMY and JONATHAN WEISMAN
The latest Senate health bill will cost $829 billion over a decade and slightly reduce the federal budget deficit, congressional budget crunchers said Wednesday, marking a major step forward for Democrats' plans to overhaul American health care.

The nonpartisan Congressional Budget Office found that the sweeping measure will cover 94% of nonelderly legal U.S. residents, up from about 83% currently. The bill will reduce the deficit by $81 billion over the 10-year period, owing to trims in Medicare spending and new taxes.

The widely awaited report paves the way for the Senate Finance Committee to approve its bill as soon as this week.

After appearing in peril in August, the health overhaul has cleared a series of hurdles in recent weeks that have given Democrats increased confidence they will pass a bill. Lobbyists on both sides of the issue have shifted their focus to what the bill will look like rather than questioning whether a measure can succeed.
...