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

Maybe I'm off base on this one,but didn't Obama slam McCain for his idea to tax Health Benefits or something along those lines?

Maine Sen. Olympia Snowe says she would vote with fellow Republicans to block the Democratic health care overhaul if changes are not made to the version Majority Leader Harry Reid outlined this week.

Everyone knows that if you don't pay to maintain and repair your car, you limit its life. The same is true as human beings age. We need medical care to avoid becoming clunkers -- disabled, worn out, parked in wheelchairs or nursing homes.

For nearly a half century, Medicare has enabled seniors to get that care. But ObamaCare is about to change that, by limiting what doctors can provide their aging patients.

The Senate Finance Committee health bill released last week controls doctors by cutting their pay if they give older patients more care than the government deems appropriate. Section 3003(b) (p. 683) punishes doctors who land in the 90th percentile or above on what they provide for seniors on Medicare by withholding 5 percent of their compensation.

This withhold provision forces doctors to choose between treating their patients and avoiding government penalties. HMOs used the same cost-cutting device in the early '90s until it was deemed dangerous to patients and outlawed. Now, lawmakers want to use it against the most vulnerable patients, the elderly. This bill and four others under negotiation also would slash about $500 billion from future Medicare funding.

President Obama and his budget director, Peter Orszag, have told seniors not to worry, claiming that Medicare spending could be cut by as much as 30 percent without doing harm. They cite the Dartmouth Atlas of Healthcare 2008, which tries to prove patients who get less care -- fewer hospital days, doctors' visits and imaging tests -- have the same medical "outcomes" as patients who get more care. But read the fine print.

The Dartmouth authors arrived at their dubious conclusion by restricting their study to patients who died. They examined what Medicare paid to care for these chronically ill patients in their last two years. By definition, the outcomes were all the same: death. The Dartmouth study didn't consider patients who recovered, left the hospital and even resumed active lives. It would be important to know whether these patients survived because they received more care.

The journal Circulation addresses that question in its latest issue (Oct. 16) and disputes the Dartmouth conclusion. Examining patients with heart failure at six California teaching hospitals, doctors found that hospitals giving more care saved more lives. In hospitals that spent less, patients had a smaller chance of survival. That's the opposite of what Obama is claiming and Congress is proposing. The Senate Finance bill establishes a formula that penalizes hospitals for high "Medicare spending per beneficiary" (Section 2001, p. 643). That may save money, but the California study suggests it will cost lives.

When Medicare started in 1965, the law forbade the federal government from interfering in treatment decisions. Doctors decided what patients needed, and Medicare paid for each treatment on a fee-for-service basis. Though this protection from government interference has been whittled away a bit, doctors and patients in Medicare still decide what state-of-the-art medical care they want.

The results are huge improvements in longevity and seniors' quality of life. Life expectancy at age 65 has jumped from 79 years to 84, while disability has steadily declined. Seniors enjoy more active lives than their parents owing to hip and knee replacements, angioplasty and bypass surgery, according to James Lubitz and Ellen Kramarow of the National Center for Health Statistics (Health Affairs, Sept./Oct. 2007). Obama adviser Dr. David Cutler reports that the heart medications and procedures Medicare patients have received over the last 20 years have been a "wise investment" resulting in "excellent value" (Health Affairs, Jan./Feb. 2007).

Cuts in future Medicare funding -- what Obama calls "savings" -- will mean less help in coping with aging and possibly shorter lives. Do we really want to treat our seniors like clunkers?

In the health care debate, Democrats and their allies have gone after insurance companies as rapacious profiteers making "immoral" and "obscene" returns while "the bodies pile up."

But in pillorying insurers over profits, the critics are on shaky ground. Ledgers tell a different reality.

Health insurance profit margins typically run about 6 percent, give or take a point or two. That's anemic compared with other forms of insurance and a broad array of industries, even some beleaguered ones.

Profits barely exceeded 2 percent of revenues in the latest annual measure. This partly explains why the credit ratings of some of the largest insurers were downgraded to negative from stable heading into this year, as investors were warned of a stagnant if not shrinking market for private plans.

Insurers are an expedient target for leaders who want a government-run plan in the marketplace. Such a public option would force private insurers to trim profits and restrain premiums to compete, the argument goes. This would "keep insurance companies honest," says President Barack Obama.

The debate is loaded with intimations that insurers are less than straight, when they are not flatly accused of malfeasance.

The insurers may not have helped their case by commissioning a report that looked primarily at the elements of health care legislation that might drive consumer costs up while ignoring elements aimed at bringing costs down. Few in the debate seem interested in a true balance sheet.

A look at some claims, and the numbers:

THE CLAIMS

_"I'm very pleased that (Democratic leaders) will be talking, too, about the immoral profits being made by the insurance industry and how those profits have increased in the Bush years." House Speaker Nancy Pelosi, D-Calif., who also welcomed the attention being drawn to insurers' "obscene profits."

_"Keeping the status quo may be what the insurance industry wants. Their premiums have more than doubled in the last decade and their profits have skyrocketed." Maryland Rep. Chris Van Hollen, member of the Democratic leadership.

_"Health insurance companies are willing to let the bodies pile up as long as their profits are safe." A MoveOn.org ad.

THE NUMBERS:

Health insurers posted a 2.2 percent profit margin last year, placing them 35th of 53 industries on the Fortune 500 list. As is typical, other health sectors did much better — drugs and medical products and services were both in the top 10.

The railroads brought in a 12.6 percent profit margin. Leading the list: network and other communications equipment, at 20.4 percent.

HealthSpring, the best performer in the health insurance industry, posted 5.4 percent. That's a less profitable margin than was achieved by the makers of Tupperware, Clorox bleach and Molson and Coors beers.

The star among the health insurance companies did, however, nose out Jack in the Box restaurants, which only achieved a 4 percent margin.

UnitedHealth Group, reporting third quarter results last week, saw fortunes improve. It managed a 5 percent profit margin on an 8 percent growth in revenue.

Van Hollen is right that premiums have more than doubled in a decade, according to a Kaiser Family Foundation study that found a 131 percent increase.

But were the Bush years golden ones for health insurers?

Not judging by profit margins, profit growth or returns to shareholders. The industry's overall profits grew only 8.8 percent from 2003 to 2008, and its margins year to year, from 2005 forward, never cracked 8 percent.

The latest annual profit margins of a selection of products, services and industries: Tupperware Brands, 7.5 percent; Yahoo, 5.9 percent; Hershey, 6.1 percent; Clorox, 8.7 percent; Molson Coors Brewing, 8.1 percent; construction and farm machinery, 5 percent; Yum Brands (think KFC, Pizza Hut, Taco Bell), 8.5 percent.

Poll: support growing for public option
Posted by Foon Rhee, deputy national political editor October 27, 2009 02:48 PM
Public support for a public option in health care appears to be growing, according to a new poll.

The NBC/Wall Street Journal survey found that 48 percent support a government-run plan to compete with private insurers and 42 percent oppose it -- the strongest support ever in the survey. Last month, opinion was basically divided with 46 percent in favor and 48 percent against.

The new poll, conducted Thursday through Sunday, has a margin of error of plus or minus 4.4 percentage points.

The top Senate Democrat, Harry Reid of Nevada, revived the possibility of a public option being in the final bill by announcing Monday that he would include one in the version he plans to bring to the full Senate -- albeit with a big exception in that states would be able to opt out.
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... but you can't pick and choose when the polls mean something and when they don't.

That's why unlike some others here I don't post them as much as they do.

Poll: support growing for public option

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And one hour later...



and two hours later...



Nambla Zick. Broken.

boston.com

It seems the more the GOP lies about it the more people start liking the idea

U.S. Senate Democratic Leader Harry Reid doesn’t have the 60 votes he needs to win approval of a government-run health-insurance program.

Connecticut Senator Joseph Lieberman, an independent who organizes with the Democrats, said he will oppose the so-called public option. At least four Senate Democrats criticized the idea and won’t commit to backing their party, and the two Republicans who have signaled a willingness to support health- care legislation said they won’t vote for the program.

“The last thing that we want to do now is create another Washington-run health-insurance company,” Lieberman told reporters yesterday, saying the first priority should be protecting the Medicare insurance program for the elderly.

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The White House has signaled it would be willing to accept Snowe’s proposal for a trigger mechanism, and moderate Democrats such as Nelson have praised it. An alternative is to allow states to decide whether to set up a public option, an opt-in plan that has also drawn kudos from Nelson.

Lawmakers are trying to pass a bill that would cover tens of millions of uninsured Americans while curbing rising medical costs. Their proposals for new purchasing exchanges, subsidies and a requirement that all Americans have insurance represent the biggest changes to U.S. health care in four decades.

Reid has been melding legislation passed by the Senate health committee in July with an $829 billion plan approved by the finance panel on Oct. 13. The health panel included a public option; the finance committee rejected it.

He told reporters he expects to work with Lieberman and other lawmakers to resolve issues with the bill. “Joe Lieberman is the least of Harry Reid’s problems,” Reid said.

He also has other issues to address. Senator Evan Bayh, an Indiana Democrat, said he’s not sure he will vote to begin debate on the measure because of concerns about the deficit.

“Joe Lieberman is the least of Harry Reid’s problems,” Reid said.

Washington, Nov 4 - House Republican Leader John Boehner (R-OH) issued the following statement after the Congressional Budget Office (CBO) confirmed in a letter tonight that the Republican health care plan will lower health care premiums by up to 10 percent and reduce the deficit by $68 billion over 10 years without imposing tax increases on families and small businesses:

“When it comes to reforming health care, controlling skyrocketing costs is the American peoples’ top priority. Now CBO has confirmed that the Republican plan will lower health care costs for American families, and that’s good news for everyone struggling in today’s economy. The choice now could not be clearer: Speaker Pelosi’s plan raises costs. Our plan lowers them.

“Not only does the GOP plan lower health care costs, but it also increases access to quality care – including for those with pre-existing conditions – at a price our country can afford. The cost of the Speaker’s bill, now at $1.3 trillion and counting, is a debt that will be paid for by our kids and our grandkids. The American people deserve a better solution, and Republicans’ smart, fiscally-responsible plans give them exactly what they want.”

Democrats' Plan for Sick: Wait in line. Under the health care bills in Congress, those with pre-existing medical problems must wait 6 months for care

...The bill's endorsement by the doctors' and seniors' lobby groups -- in addition to support announced by the American Cancer Society Cancer Action Network -- helps counter mounting opposition among employer groups that are stepping up their advertising campaign against the bill.

The AARP has been pushing for a health overhaul for more than a year, but it had withheld a formal endorsement of any of the healthcare bills being developed by congressional Democrats. On Thursday, AARP Executive Vice President Nancy LeaMond said the group saw the House Democratic bill as the most promising proposal.

"We can say with confidence that it meets our priorities for protecting Medicare, providing more affordable insurance for 50- to 64-year-olds and reforming our healthcare system," she said at the group's Washington headquarters.

The group plans to promote the bill to its 40 million members and other Americans through publications, advertising and e-mails to its activists.

The AMA's endorsement had been thrown in question when Congress delayed action on a related measure that is the group's top priority -- a bill to cancel a scheduled cut in Medicare payment rates to doctors. But Democratic leaders said that issue would be addressed later this year.

In announcing the group's endorsement Thursday, AMA President J. James Rohack said, "The time to make health system reform a reality is now."

He added that the measure "is not the perfect bill . . . but it goes a long way toward expanding access to high-quality affordable health coverage for all Americans."

The AMA's support comes ahead of a crucial policymaking meeting of its House of Delegates in Houston that begins Saturday. The organization is being asked by some constituencies, at the eleventh hour, to back away from supporting healthcare reform.

"These bills go far beyond what is necessary to fix what is broken with our healthcare system, and they grant the federal government considerable new powers and authority, which could ultimately amount to a complete government takeover of healthcare, and which is anathema to doctors and patients," reads a resolution introduced by three associations of surgeons.

The AMA, which represents a quarter of a million physicians, thinks the House bill backs goals supported by the majority of its members because doctors will have a choice on whether to participate in a government-run insurance plan, the so-called public option. In addition, the AMA has said the rates paid to doctors under that plan are going to be better than those they receive from the Medicare health insurance program for the elderly, which is also key to the group's support.
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The American Medical Association's much-touted endorsement of the House health care reform bill has triggered a revolt among some members who want the endorsement withdrawn.

Some members are outraged that the group's trustees made the endorsement without the formal approval of the organization's House of Delegates.

On Monday, delegates will vote on a resolution offered by some members that, if approved, will withdraw the AMA’s endorsement of the bill.

President Obama cited the endorsement of the influential AMA, along with AARP's, in a surprise appearance Thursday in the White House briefing room as he attempted to beat back criticism that the bill would gut Medicare.

"They're endorsing this bill because they know it will strengthen Medicare, not jeopardize it," he told reporters. "They know it will protect the benefits our seniors receive, not cut them."

"So I want everyone to remember that the next time you hear the same tired arguments to the contrary from insurance companies and their lobbyists and remember this endorsement the next time you see a bunch of misleading ads on television," he added.

Speaker Nancy Pelosi's office tells THE WEEKLY STANDARD that the speaker will not allow the final language of the health care to be posted online for 72 hours before bringing the bill to a vote on the House floor, despite her September 24 statement that she was "absolutely" committed to doing so.

House members are still negotiating important issues in the bill--whether it will provide taxpayer-funding for abortions, for example. Pelosi is pushing for a Saturday House vote, and a number of big changes will be introduced, likely less than 24 hours before the vote takes place (if in fact it does). The Rules Committee hasn't yet released its resolution, or rule, that must be passed before the bill can move from committee to the floor. The rule will set the terms of debate and determine what amendments are in order.

It seems likely that the rule will allow very few, if any, up-or-down votes on amendments on the House floor. Rather, the rule will include a series of amendments that will all be adopted at once if the rule passes.

On September 24, Speaker Nancy Pelosi told THE WEEKLY STANDARD that she was "absolutely" committed to putting the text of the final House bill online for 72 hours before the House votes:

TWS: Madam Speaker, do you support the measure to put the final House bill online for 72 hours before it's voted on at the very end?

PELOSI: Absolutely. Without question.

But tonight, when asked if Speaker Pelosi will leave the bill online for 72 hours after we see what's in the rule, Pelosi spokesman Brendan Daly replied in an email: "No; [the] pledge was to have manager’s amendment online for 72 hours, and we will do that."

Apparently Pelosi's agreement to leave the "final" bill online "at the very end" of the process wasn't such a straightforward pledge.

Republicans are offering a step-by-step, common-sense approach to health care reform - an altogether better solution than the 2,032-page government takeover of health care being pushed through Congress by Speaker Nancy Pelosi, D-Calif.

We've introduced a bill to lower costs, and increased access to high-quality care - a bill the nonpartisan Congressional Budget Office has confirmed will lower premiums by up to 10 percent, without imposing tax increases on families and small businesses.

As Ohio and other states across the nation continue to struggle with joblessness, rising costs of living and skyrocketing health care costs, our plan offers real relief.

In fact, the House Ways and Means Committee has determined that under the Republican plan, premiums for families will be nearly $5,000 lower than the cheapest plan in the Democrats' government-run proposal.

Not only does the Republican plan lower health care costs, but it also expands access to quality care at a price our country can afford, and tackles the problems in our health care system that have contributed to the crisis we face today.

Specifically, our bill includes common-sense solutions to:

Guarantee that all Americans - regardless of pre-existing conditions and past illnesses - have access to the care they need at affordable prices by creating Universal Access Programs that expand and reform high-risk pools and reinsurance programs.

Encourage competition - which is key to lowering prices and increasing quality of care - by allowing Americans to shop for coverage from coast to coast and permitting Americans living in one state to purchase insurance in another.

Empower small businesses to pool together and offer health care at lower prices, just as corporations and labor unions do.

Reward innovation by providing incentive payments to states that reduce premiums and the number of uninsured.

Help end costly junk lawsuits that contribute to higher health care costs by increasing the number of tests and procedures that physicians sometimes order, not because they think it is good medicine, but because they are afraid of being sued.

These are just a few highlights of our bill.

To learn more about the responsible, common-sense solutions in the Republican plan and read the entire bill, visit http://www.gop.gov/solutions/healthcare" target="_new">healthcare.gop.gov.

Clearly, our bill offers a stark contrast to Pelosi's health care plan. Pelosi's bill represents bureaucracy designed to centralize health care decision-making in Washington at the expense of patients and doctors.

It will create dozens of boards, bureaus and commissions in charge of coming up with new regulations and red tape that will inevitably make health care in this country more expensive.

And despite costing $1.3 trillion, it will push billions more in costs over to already cash-strapped states like Ohio, where our governor is already struggling to fill an estimated $850 million state budget hole.

Enough is enough. Americans are fed up. The trillion-dollar "stimulus" isn't working. Unemployment is rising. The debt to be paid by our kids and grandkids is exploding.

As members of the House of Representatives prepare to take a vote on a health care bill as early as today, they must make a decision:

They can vote for Pelosi's bill that will raise premiums, increase taxes and cut Medicare benefits for seniors, or they can support the Republican plan that makes health care more affordable and accessible for our families.

The American people have made it clear where they stand. It is time for members of Congress to show they are listening.