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Tuesday, July 21, 2009

Suppose you were depraved and heartless. Suppose you were a boss somewhere in the health insurance industry. But I repeat myself.


Cartoon from here. This site. Apologies to Mark Twain, but then his statement is an open vessel. I doubt if alive today he'd dislike or dispute my preemption of his irony.

Some flotsom and jetsom on the Sea of Tranquility:

"UnitedHealth Group reports higher than expected earnings" Strib reports it today online, here.

The PHNP website, a resource for reason in the healthcare debate, sitemap here. Homepage, here.

Page Logo, headline, and randomized Featured Lead Quote from a PHNP article I opened about the history of universal payer effort in the US - "Little more than 1% of GDP assigned to health could cover it all.":



Then, from the history, this page, this quote:

After FDR died, Truman became president (1945-1953), and his tenure is characterized by the Cold War and Communism. The health care issue finally moved into the center arena of national politics and received the unreserved support of an American president. Though he served during some of the most virulent anti-Communist attacks and the early years of the Cold War, Truman fully supported national health insurance. But the opposition had acquired new strength. Compulsory health insurance became entangled in the Cold War and its opponents were able to make “socialized medicine” a symbolic issue in the growing crusade against Communist influence in America.

Truman’s plan for national health insurance in 1945 was different than FDR’s plan in 1938 because Truman was strongly committed to a single universal comprehensive health insurance plan. Whereas FDR’s 1938 program had a separate proposal for medical care of the needy, it was Truman who proposed a single egalitarian system that included all classes of society, not just the working class. He emphasized that this was not “socialized medicine.” He also dropped the funeral benefit that contributed to the defeat of national insurance in the Progressive Era. Congress had mixed reactions to Truman’s proposal. The chairman of the House Committee was an anti-union conservative and refused to hold hearings. Senior Republican Senator Taft declared, “I consider it socialism. It is to my mind the most socialistic measure this Congress has ever had before it.” Taft suggested that compulsory health insurance, like the Full Unemployment Act, came right out of the Soviet constitution and walked out of the hearings. The AMA, the American Hospital Association, the American Bar Association, and most of then nation’s press had no mixed feelings; they hated the plan. The AMA claimed it would make doctors slaves, even though Truman emphasized that doctors would be able to choose their method of payment.


For the post-WWII era, onward, this set the stage and defined the propaganda attack song faithfully and repeatedly trotted out by the opponents of decency in healthcare. The article continues, and Truman's position had its history. Read it all. The Shibboleth of The Vested Interests: "Socialized Medicine." Crap like that. Fear mongering. Current version, if this goes through bureaucrats will come between you and your doctor. As if the insurance folks are not bureaucratic. The sky will fall. Chicken Little is quite busy shouting it, and wants you to listen.

Again, that bureaucratic thing, for the truth see PNHP here, on the incremented cost of insurer mandated paper shuffling [and where have I seen that cartoon before]:

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 45.7 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

Under a single-payer system, all Americans would be covered for all medically necessary services, including: doctor, hospital, preventive, long-term care, mental health, reproductive health care, dental, vision, prescription drug and medical supply costs. Patients would regain free choice of doctor and hospital, and doctors would regain autonomy over patient care.

Physicians would be paid fee-for-service according to a negotiated formulary or receive salary from a hospital or nonprofit HMO / group practice. Hospitals would receive a global budget for operating expenses. Health facilities and expensive equipment purchases would be managed by regional health planning boards.


Sanity and ability to plan better would replace patchwork quilted healthcare. And that link that was quoted, here, ends by providing a wealth of additonal resource materials to better understand the situation.

Press release materials, here. MinnPost and Minn.Independent staffers pay heed.

Maureen Reed, as a physician, you can join other physicians if you have not already done so you can sign the "Open Letter to President Obama," here. And let us voters know, it would gain you good will in the district rank-and-file.

Al Franken, you have had staff around the state conduct listening sessions with the public. You KNOW what staff has to report back on feelings in the hustings about getting it done and doing it right. Go for it. We love you anyway Al, but we'll love you more if you speak loudly and effectively for us.

Here, July 17, know the score:

Yesterday we met with LAs and two Representatives. One of the Representatives came out of a committee that is marking up the House bill agreed with us that the main objective in the long run is to make health care a right, and that we need single payer reform, but he saw no way to get further than the current proposal now. In the committee, the Republicans were using delaying tactics, taking 5 minutes each for each of the 50 plus amendments, and making absurd statements.


The good people are talking, and we must hope they are being heard.



And they tell the truth:

Every other industrialized nation in the world provides universal health care to its citizens. Under the complicated, employer-based American system, average health care spending per person is double what Europeans spend - and many people still have no coverage. Over 70 percent of uninsured Americans are in families where at least one adult works full time.


Two additional items, Amy Goodman reprinted on the PNHP website; and an update on KOS, do not forget the name, "Nataline Sarkisyan," as representing how CIGNA feels and "cares."


Health Insurance Whistle-Blower Knows Where the Bodies Are Buried
By Amy Goodman - TruthDig.com - Posted Jul 14, 2009

Wendell Potter is the health insurance industry’s worst nightmare. He’s a whistle-blower. Potter, the former chief spokesperson for insurance giant CIGNA, recently testified before Congress, “I saw how they confuse their customers and dump the sick—all so they can satisfy their Wall Street investors.”

Potter was deeply involved in CIGNA and industrywide strategies for maintaining their profitable grip on U.S. health care. He told me: “The thing they fear most is a single-payer plan. They fear even the public insurance option being proposed; they’ll pull out all the stops they can to defeat that to try to scare people into thinking that embracing a public health insurance option would lead down the slippery slope toward socialism … putting a government bureaucrat between you and your doctor. They’ve used those talking points for years, and they’ve always worked.”

In 2007, CIGNA denied a California teenager, Nataline Sarkisyan, coverage for a liver transplant. Her family went to the media. The California Nurses Association joined in. Under mounting pressure, CIGNA finally granted coverage for the procedure. But it was too late. Two hours later, Nataline died.

While visiting family in Tennessee, Potter stopped at a “medical expedition” in Wise, Va. People drove hours for free care from temporary clinics set up in animal stalls at the local fairground. Potter told me that weeks later, flying on a CIGNA corporate jet with the CEO: “I realized that someone’s premiums were helping me to travel that way … paying for my lunch on gold-trimmed china. I thought about those men and women I had seen in Wise County … not having any idea [how] insurance executives lived.” He decided he couldn’t be an industry PR hack anymore.

Insurance executives and their Wall Street investors are addicted to massive profits and double-digit annual rate increases. To squeeze more profit, Potter says, if a person makes a major claim for coverage, the insurer will often scrutinize the person’s original application, looking for any error that would allow it to cancel the policy. Likewise, if a small company’s employees make too many claims, the insurer, Potter says, “very likely will jack up the rates so much that your employer has no alternative but to leave you and your co-workers without insurance.”

This week, as the House and Senate introduce their health care bills, Potter warns, “One thing to remember is that the health insurance industry has been anticipating this debate on health care for many years … they’ve been positioning themselves to get very close to influential members of Congress in both parties.” Montana Sen. Max Baucus chairs the Senate Finance Committee, key for health care reform. Potter went on, “[T]he insurance industry, the pharmaceutical industry and others in health care have donated … millions of dollars to his campaigns over the past few years. But aside from money, it’s relationships that count … the insurance industry has hired scores and scores of lobbyists, many of whom have worked for members of Congress, and some who are former members of Congress.”


[italics added] Then, comparing the situation to that of Ms. Sarkisyan, a KOS diarist, reports here, a teenager Nick Columbo, not with CIGNA this time but Pacificare, has been denied coverage for needed treatment for Ewing's Sarcoma [a form of bone cancer]. We in Minnesota can be proud, the KOS diarist indicating, "Who owns Pacificare? Who else? UnitedHealth."

Go to the thread. You can scan until you pick up the thread in the grey box,

Hospitals Rank UnitedHealth/PacficiCare "Worst" Insurance Company in Nation

The Minnetonka, Minn.-based insurer received an "unfavorable" opinion from 91% of the hospital executives who responded, while 8% gave it a "favorable" rating. United owns PacifiCare of California.

http://www.latimes.com/...


Read and think about how UnitedHealth makes its money. Read there the link over to reporting about the backdated options we here have already heard about. Read there about the California investigation into 100,000 claims-processing situations of Pacificare. And read the linked Bloomberg item about
"UnitedHealth/Pacificare Looking at 13% Growth,"
http://www.bloomberg.com/...

Recall the opening blurb: "UnitedHealth Group reports higher than expected earnings" Strib reports it today online, here.

Now, whether UnitedHealth is making unconscionable profit levels, as the KOS item suggests, or whether the extreme care needed in some cases is outside of normal insurance industry coverage standards - the fact in the case of both of these teenagers, Sarkisyan and Columbo, is that AS THE SYSTEM STANDS HEALTHCARE IS BEING RATIONED, QUITE CLEARLY SO, AND IT IS BEING DONE UNDER A BOTTOM-LINE PROFIT MOTIVE WHERE LESS PAID FOR CARE MEANS A FATTER BOTTOM LINE, and that would not be so in government single payer coverage AND the Potter indication of other games insurers play also would be nonexistant; so to whatever extent there might be cost-based "rationing" of coverage in a government-run program, the naked greed dimension of the insurance industry need not be a "rationing" impact on your child's or your neighbor's child's health provider's decision making (if the scumbags are put at bay under reform of the system the scumbags now own, operate, and love dearly).

Anytime you encounter a scare-mongering moron talking about single payer coverage carrying the threat of "rationing" of health care, remember the truth, no government rationing could be as bad as the rationing now done by profit-mongering insurance industry bureaucrats.

Don't be deluded by such industry-sponsored talk, which is designed exactly for the purpose of deluding, and for no other purpose.


###

Finally, if you've a mind to deny the truth and favor being lied to, or if you've no mind at all, believe this sophist of the status quo.






_____UPDATE_____
Dr. Don McCanne, opinion from PNHP, worth this addiitonal flag. On the Elmandorf budget testimony at Senate hearings, the GOP has seized upon that, and the answer is the federal budget can be juggled to shift more cost onto individuals and employers of varying sizes, to have to continue wrestling with big insurance, big HMOs, big Pharma. It's a way of screwing the little people who in droves voted Obama, and I believe the President is more principled than to do that.

But he must articulate that fact, and mobilize his Senate and House allies, and he and they must come to see single payer advantages, even if it increases the budget short term. Long term, it will allow, as Dr. McCanne said, "For those who are very concerned about future federal deficits, there is a solution. Simply remove health care costs from the federal budget. Projections of future budget spending have been shown to be fully sustainable if health care costs are left out. Then set up a separate budget for health care financed through an equitably-funded universal risk pool.

"President Obama has stated repeatedly that we must control health care costs as the first priority, and then we can cover everyone. The current proposals do neither. But with a single risk pool, and with the monopsony power of our own public administration we would be able to ensure health care value for absolutely everyone." [italics added]

The current situation, where consumers are fragmented into small pools or even individual bargaining powers, and the moneyed interests are concentrated against them, will change to "monopsony power" as McCanne notes. The greater concentration of market impact will be in the other direction. As with a water flow reversing, a logjam can be quickly washed away. Harmony and sunshine can prevail again. All that.

More directly - squeeze those who've been squeezing us and making it hurt.

Turn the tables. It's only fair. It's payback. Long overdue payback. Remember - Truman!

Truman, that long ago.

Truman wanted it done right.

That was over fifty years ago, and the vested interests have held sway that long, and before. Reform is overdue and delivering anything less than true reform would be unconscionable. That is not to say that less than true reform will not happen. Only if that's what our House and Senate and Presidency do to us, there's no word but unconscionable. Each and every one of them. Except Jim McDermott. His position has been and remains just.

________FURTHER UPDATE___________
A good friend emailed about twelve hours ago, this thought, paraphrased:

Do you want your health care decisions made for you by a for profit health care system or the government? I believe that the politicians have a government health care system now. Don't they? And they seem able to believe that they are healthy enought that way, to work well past a normal retirement age. So government run healthcare must be okay for them. Why would they then keep such a nice thing FROM us, instead of FOR us? It is not as if they feel themselves specially entitled, is it?


During the election Obama did say (then) his proposal was, "You could keep the coverage you have if you like it, or you can have the coverage I have." Some of the approval slippage might be because such a simple and fine sounding thing seems to now be "off the table." Somehow. Somebody's doing.

It's a hard argument to dispute. Both when Obama made it and as my friend put it.

I welcome any GOP or other status quo advocates to post a comment in rebuttal. Please. I would like to read the rebuttal Sen. McCain could not make and never cared to even try. Ditto Palin. What's happened? Who took the tremendous simplicity out of things? Why?

_______FURTHER UPDATE_______
My sister points out, we have government run healthcare now. For the oldest and sickest.

It makes sense to look at things that way. There is government coverage, NOW, for those the privately run system presently is first to exclude as more costly than they would get as a return in enrollment fees. They don't want the old folks. It goes along with their universal will to exclude preexistant conditions, (where the elderly have had time to accumulate a lot of those). It is the major reason or one major reason for age discrimination in business, under privateer coverage plans.

If the hardest to insure are being covered sensibly when the government runs things, the suggestion is that making them responsible for a universal population pool including all those healthy youngsters would be just dandy, for the government, as a way to average out costs of covering all to a substantially lower per capita cost figure than Medicare now can show.

So do it.

________FURTHER UPDATE______
As usual, Brad Freidman at BradBlog comes through with an excellent (guest) post on the healthcare situation, here. It is so excellent I will not quote or excerpt a single word. Either go to the item and read it or remain ignorant of what it says.

Canning, the guest op-ed author, earlier had written "Single Payer and the 'Democracy Deficit'," carried June 5 on BradBlog, here, as well as other outlets here and here. Amy Goodman at the Democracy Now site, here, has a July 17 healthcare related interview with Howard Dean, a physician as well as a Dem leadership person. It is something readers should look at, with this clear and explicit lead-in paragraph:

“I don’t give a damn about the health insurance people being in business or out of business. I want a system that works,” sayd Dean, physician, six-term Vermont governor, Democratic presidential candidate in 2004, and former chairman of the Democratic National Committee. We speak to Dean hours after the House Ways and Means Committee approved legislation to overhaul the nation’s healthcare system and expand insurance coverage. By a 23-to-18 vote, the committee backed key elements of President Obama’s blueprint for healthcare, including the creation of a new government health plan and requirements for employers to offer health insurance to workers or contribute to its cost. To help fund the changes to the healthcare system, the House committee also agreed to impose a surtax on families with incomes of more than $350,000 a year. Meanwhile, the conservative American Medical Association has just come out in support of the House bill, saying “the status quo is unacceptable.” Howard Dean’s solution embraces President Obama’s healthcare plan but argues that the reform bill is “not worth passing unless the American people have the choice of signing up for a public option—a real public option.”


Mainstream media is deathly silent on this life-and-death healthcare single-payer outlook; go figure who fuels their coffers, and why their silence prevails.

Or if I am wrong and there are good single-payer MSM items, please put links into a comment or an email to the 4crabgrass email address.

________FURTHER UPDATE_______
It was suggested I look at MPR. From recent Polinaut links, and follow-up, there is this one Mankato Free Press item and several MPR/NPR items, here, here, here, here and here, respectively.

Then for lies, sophistry, nonsense, shibboleths, and such, here and here. The Amphibian [Newt] even trotted out the Cold War scare term, "socialized medicine," he could not resist being what he is. As noted earlier McCollum indicated as Strib reported, that in the course of reform the Pawlenty talking point, Minnesota would be more penalized because its Medicare reimbursement rates are lower because the State's been effective in keeping costs low, is yet one of several side-issue things that can be fixed in the course of passing comprehensive reform. But, hey, keep your eyes on the prize. Side issue fix-ups are good and needed, but, eyes on the prize, please.

_______FURTHER UPDATE_______
Strib reports online,

UnitedHealth profit soars 155%

The challenges facing America's biggest health insurer range from the uncertain to the unknowable.

Despite a continued drop in commercial members in the recession, UnitedHealth reported Tuesday better-than-expected earnings for the second quarter because of lower administrative costs and strong growth in its public-sector businesses, Medicare and Medicaid.

For the quarter ended June 30, UnitedHealth said net earnings were $859 million -- a 154.9 percent increase from $337 million a year earlier, when earnings were dragged down by big lawsuit settlement costs.


If one of the stated goals of nationwide healthcare reform is to have lowering costs, isn't profit taken out by for-profit insurers like blood taken by a leech?

Unavailable for the health of the human being.