The Wonk Room

It’s Time To End Discrimination In Health Insurance»

Insurance companies will seize on anything to increase insurance premiums, and gender is no exception. An article in today’s New York Times points out that insurance companies rate-up individual insurance policies for women, forcing us to pay much more than men for identical coverage.

Since the individual market offers a raw deal to those who actually use care, women — who use maternity care and are more likely to have certain chronic diseases — may have a harder time finding affordable coverage than their male counterparts. A 30-year-old woman pays “31 percent more than a man of the same age in Denver or Chicago” and in Iowa, “a 30-year-old woman pays $49 a month more than a man of the same age.”

But Senator John McCain refuses to end this discrimination. McCain’s plan would make it even easier for insurers to cherry-pick the healthiest individuals who use the least amount of care. When asked why he didn’t support leveling the playing field and preventing insurance companies from covering only the healthiest and cheapest Americans, McCain replied that insurance companies should be able to decide who they cover and what they charge:

Q: Why not level the playing field, prevent insurance companies from cherry picking and let them compete on a level playing field?

MCCAIN: Because then I think then we would be mandating what the free enterprise sytem does and that would be, obviously, something I would not approve of.

Watch the ad from Health Care For America Now!:

I have often argued that buying health insurance is not the same as purchasing a refrigerator or a microwave. Health insurance is not another consumer good for which everyone pays the same price. Sick people are more expensive to insure than healthy people, the old accrue more cost than the young. For this reason, Senator John McCain’s belief in the dysfunctional and discriminatory individual market is fundamentally at odds with the point of health insurance, which requires that we share risks and pool costs.

Insurance companies should not be allowed to use a woman’s ability to become pregnant as an excuse to charge women more for health insurance. Unfortunately, by deregulating the individual market, Senator McCain would give insurance companies a free pass to continue charging women more for their health care.

Elizabeth Edwards On High Administrative Costs»

On Monday, during a discussion about health care policy, CAPAF Senior Fellow Elizabeth Edwards underscored the burden of administrative costs on the health system:

I ran into a woman who had worked in a hospital in Vancouver and she had moved to Boston. I met her in one of the New Hampshire primaries. And she said she worked in the accounting office in the hospital, and went to a hospital in Boston to get a job. Same number of beds in the hospitals. She got a job. She had worked in an accounting office with 6 people, she now worked in an accounting office with 600 people. Your health insurance dollars are being used to pay those 600 people. It is not an efficient use of our money.

Watch it:

Reducing administrative costs should be an important part of any serious cost-containment strategy. Unfortunately, Sen. John McCain’s reliance on the individual market would bolster the health bureaucracy and further grow the size of accounting offices.

That’s because marketing, medical underwriting, rescission, and increased paperwork for individuals leads insurance companies in the individual market to spend 29 percent of premium dollars on administrative costs, more than double the average amount in the group market.

As McCain adviser and individual market-proponent Douglas Holtz-Eakin admitted, employer based coverage “is way better” than a comparable plan in the individual market because the latter charges more for identical coverage. In fact, according to a study published in Health Affairs, higher administrative costs, along with other factors, increase the cost of an individual plan by an estimated $2,000.

So McCain’s push to get more Americans into the individual market, will have you paying more for less. As Peter Harbage points out, “shifting coverage from the group coverage market to the individual insurance market could generate as much as $20 billion in new administrative costs—which represents an increase of more than 20 percent in 2007 dollars.”

Keating: Only Radicals Support ‘Needle Exchanges’»

Today, acting as a surrogate for the McCain campaign, former Gov. Frank Keating (R-OK) linked Sen. Barack Obama’s (D-IL) support for needle exchange programs to Bill Ayers:

But on the Ayers side, it does suggest character and judgment…Barack Obama…voted for needle exchanges, voted against making it a felony for a gang member to go back to gang activity while on probation. I mean these are reckless, extreme, anti-law enforcement, leftist positions. And the American public, I think, needs to know about them because it shows a lot about somebody’s value system and character.

Watch it:

Keating is suggesting that Obama’s support for needle exchange programs and his other so-called “reckless, extreme, anti-law enforcement, leftist positions” explain the senator’s alleged sympathy for Bill Ayers.

But if terrorist sympathizers and “radicals” are the only supporters of needle exchange programs, then we may have a lot more sleeper cells than we thought.

Currently, 28 states and Washington D.C.– including Keating’s home state of Oklahoma — “provide free sterile syringes in exchange for used syringes to reduce transmission of bloodborne pathogens among injection-drug users.” In 1998, “then Secretary of HHS Donna Shalala certified that based on extensive scientific research, needle exchange programs are an effective component of a comprehensive strategy to reduce HIV transmission and do not encourage the use of illegal drugs.”

Studies reviewed by the National Institute of Health Consensus Panel on HIV Prevention concluded that needle exchanges lead to reductions “in risk behavior as high as 80%” and are economically cost effective. “The cost per HIV infection prevented by SEPs has been calculated at $4,000 to $12,000, considerably less than the estimated $190,000 medical costs of treating a person infected with HIV,” the studies found.

Moreover, “the American Medical Association, the American Bar Association, the American Public Health Association, and the National Conference of Mayors” and 66 percent of Americans support needle-exchange programs.

Palin Claims McCain’s Health Care Plan Is ‘Budget Neutral,’ Which Means It’s A Middle-Class Tax Hike»

There is a contradiction in the way John McCain has been selling his health care plan: either it busts the budget, or it raises taxes on middle-class families. It has to do one or the other.

Lately, John McCain’s campaign has been going around saying he won’t raise taxes on middle class families.

But last night Governor Palin twice insisted that John McCain’s health care plan is ‘budget neutral’ too:

He’s proposing a $5,000 tax credit for families so that they can get out there and they can purchase their own health care coverage. That’s a smart thing to do. That’s budget neutral. That doesn’t cost the government anything…But a $5,000 health care credit through our income tax that’s budget neutral. That’s going to help.

Watch it:

By insisting that his health care plan is ‘budget neutral’ Palin is implying that John McCain raises taxes on middle-class families. If it doesn’t raise taxes, it’s not ‘budget neutral.’

Here’s how it works:

Giving every family a $5,000 tax credit costs $3.6 trillion over ten years, according to the McCain campaign. McCain wants to pay for it by taxing employer health benefits as income.

If he makes families pay both payroll and income taxes on their benefits, the Joint Committee on Taxation projects McCain can raise the $3.6 trillion, making the proposal ‘budget neutral.’

If he subjects benefits only to income taxes, as the McCain campaign now claims they would, the Tax Policy Center showed that he would fall $1.3 trillion short in paying for his plan. Under any definition that’s not ‘budget neutral.’

The ONLY way to make McCain’s plan ‘budget neutral,’ as Palin insists it is, is to repeal the entire exclusion for health care from both income and payroll taxes. And if this is what he does, then he raises taxes on the typical family making $60,000 by $1,100 by 2013.

In either case families would see their taxes go up eventually because the tax credit grows by the rate of inflation (around 2%/year) and the current exemption grows with the rate of health care costs (close to 7%/year). But if both payroll and income taxes are imposed on benefits, McCain’s tax increase would be much larger much sooner, and would fall most heavily on the middle class.

Senator McCain and Governor Palin are trying to have their cake and eat it too.

Palin References Reagan’s Opposition To Medicare»

Matt Yglesias notes that during yesterday’s vice presidential debate, Gov. Sarah Palin (R-AK) quoted a 1961 advocacy ad by Ronald Reagan. In the ad, Reagan urges his listeners to oppose the growing menace of socialized medicine and argues that Medicare legislation will lead to national socialism:

PALIN: We’re going to find ourselves spending our sunset years telling our children and our children’s children about a time in America, back in the day, when men and women were free.

REAGAN: One of these days, you and I, are going to spend our sunset years telling our children and our children’s children what it once was like in America, when men were free.

Watch Palin’s remarks and Reagan’s quote in context:

Reagan’s rhetoric is eerily similar to McCain’s argument against comprehensive health care reform. During the 1960s, conservatives regularly claimed that Medicare would destroy the doctor-patient relationship, interject government into every-day decisions and undermine personal freedoms. Forty-seven years later, Maverick McCain is making the same argument.

Reagan was wrong then as McCain is wrong now.

Chet Edwards: McCain’s Veterans Access Card ‘Would Be Devastating’ To Veterans Health Care»

Yesterday, ThinkProgress interviewed Rep. Chet Edwards (D-TX) about Sen. John McCain’s (R-AZ) proposal to “give veterans the option to use a simple plastic card to receive timely and accessible care” outside of the VA health system.

Edwards noted that “virtually every major veterans organization in our country opposes” McCain’s Veterans Access Card Plan, and that even the new VA secretary called the plan “dangerous”:

It sounds good on the surface, but the reality is it would undermine the expertise, the credibility and the resources that we we have at our veterans hospital, where a vet knows he or she is going to be treated with special care or attention.

Watch it:

According to a report published by AMVETS, Disabled American Veterans, Paralyzed Veterans of America, and the Veterans of Foreign Wars, contracting out health care for rural veterans on a broad scale would undermine the existing VA system, “a system of immense value to veterans”:

- “The VA’s specialized health-care programs…would suffer irreparable impact by the loss of veterans from those programs.”

- “The VA’s medical and prosthetic research program…would lose focus and purpose were service-connected and other enrolled veterans no longer present in VA health care.”

- If veterans turned to private practice, “they would lose the many safeguards built into the VA system through its patient safety program, evidence-based medicine, electronic medical records and bar code medication administration,” resulting in “lower quality of care for those who deserve it most.”

“If you look at John McCain’s record on veteran’s issues, it’s a failed one. Not according to me, but according to some of the most respected veterans organizations in America…If his record had prevailed, veterans would have poorer health care and fewer benefits than they have today,” Edwards said.

Palin Praises Union Health Benefits»

Yesterday, in an effort to portray herself as “an everyday working class American,” Gov. Sarah Palin (R-AK) revealed that her family struggled to find health insurance “until Todd and I both landed a couple of good union jobs“:

But yeah, there’s been a lot of times that Todd and I have had to figure out how we were going to pay for health insurance. We’ve gone through periods of our life here with paying out of pocket for health coverage until Todd and I both landed a couple of good union jobs. Early on in our marriage, we didn’t have health insurance, and we had to either make the choice of paying out of pocket for catastrophic coverage or just crossing our fingers, hoping that nobody would get hurt, nobody would get sick. So I know what Americans are going through there.

Listen:

Sen. John McCain’s (R-AZ) strong anti-union sentiment aside, “Palin is right to credit her and her husband’s ‘good union jobs’ with securing her family health insurance coverage.” Union workers “receive more generous health benefits than nonunionized workers,” contribute a significantly lower percentage of the premium than those in firms without any union workers, and are significantly more likely to receive health insurance.

Consider the following data from the 2008 Kaiser Survey of Employer-Sponsored Health Benefits:

Unfortunately,McCain’s health care plan, would throw 20 million Americans out of employer-sponsored coverage, leave 18 million Americans without health insurance by 2013, and increase “out of pocket” costs across the board. If Palin believes that she knows “what Americans are going through” because she was once uninsured, she will have many more Americans to sympathize with under the McCain-Palin health care plan.

Note to CBS News: Yes, McCain’s Health Care Plan Raises Taxes»

Our guest bloggers are James Kvaal and Ben Furnas, senior fellow and research associate at the Center for American Progress Action Fund.

CBS News took a look at whether John McCain’s health care plan would raise taxes on millions of American families the other night. Watch it:

Here’s what we think is important.

First, the McCain plan will eventually result on higher taxes on most households with health insurance through their jobs.  That’s because the McCain tax credit will grow only with inflation. Current tax benefits grow with premiums, which increase three or four times faster than inflation.

Second, the McCain plan will result in higher taxes for some households right away.  Families with higher incomes and more expensive insurance plans are most likely to get hit by higher taxes.

Third, the full impact of the McCain plan is difficult to calculate because the McCain campaign is trying to have it both ways on a critical question at the heart of his health care plan: whether it imposes payroll taxes (as well as income taxes) on health benefits.

As originally announced, McCain seemed to impose both income and payroll taxes on health benefits.  That would mean that typical middle-class families would pay higher taxes within a year or two.

Now the McCain campaign is apparently saying that they will impose only income taxes on health benefits.  If that’s right, then – as CBS reports – most families will see tax cuts in initially.  However, because the credit would still quickly fall behind premiums, the plan would still increase taxes on most families eventually.  Moreover, McCain’s would cost an additional $1.3 trillion — a massive cost which the McCain campaign has not acknowledged.

Making families pay more for their health care is not some accidental quirk due to the details of the McCain plan.  It is a key part of the conservative ideology to shift costs onto families, which they believe will reduce wasteful health care spending.  But it is more likely to leave families struggling with higher and higher health care costs and forced to skip care they need.

CBS ‘Fact-Check’ On McCain’s Health Care Tax Contains Two Factual Errors»

CBS recently ran a “fact-check” on the claim that John McCain would raise taxes on workers’ health insurance. Watch it here:

Though we disagree with the conclusions of the piece (and will be addressing these disagreements in a future post), we first want to point out two factual errors.

–First: Thirty seconds in, the chyron reads “FACT: Employer health benefits for 16 million Americans will be taxed.” This, we believe, is a typo. There are around 160 million Americans who currently receive their health benefits through work, and, under McCain, all of them will pay taxes on their health benefits.

–Second: The announcer, at around forty-five seconds in, says that “McCain does want to tax the health insurance benefits that 60 million Americans now buy through their employer.” Again, the correct number is 160 million.

Check back soon for a more thorough critique of CBS’s conclusion.

Maverick Hypocrisy: McCain Condemns ‘One-Size-Fits-All’ Health Care Reform»

In an answer to a questionnaire about health care policy, Sen. John McCain (R-AZ) condemned “one-size-fits-all” health care reform:

I believe that all Americans should have access to quality and affordable health care of their choice, including keeping their current coverage. We can build a health care system that is more responsive to our needs and is delivered to more people at lower cost and higher quality. The “solution” isn’t a one-size-fits-all-big government takeover of health care.

We “can build a health care system that is more responsive to our needs” — but McCain’s health care plan doesn’t even come close. Under McCain’s proposal, the sick and the not-yet sick, the poor and the wealthy would all receive a one-size-fits-all tax credit, regardless of their health history or income status.

Warren Buffet would collect the same $5,000 as his secretary. A chronically ill older patient, who requires more care or more expensive care, would obtain the same amount for health care as a younger and healthier American.

In fact, senior McCain adviser Douglas Holtz-Eakin regularly brags about the “equalizing effects” of McCain’s reforms:

This is actually not a plan that relies on the individual market, it relies on the traditional source of health insurance, which is employers. And it would buttress that by taking the traditional subsidy, that exclusion from tax, for private health insurance and spreading it more fairly. Instead of only getting it in the employer market, you would get it regardless of your source of insurance. And you get the same amount whether you’re rich or poor, $5,000 for every working family.

Watch it:

Only a real maverick can get away with both condemning and promoting “one-size-fits-all” reforms.

GOP Ignores America’s ‘Health Care Crisis’ During Convention»

During a town hall event last month, Sen. John McCain (R-AZ) declared that the American health care system was “in crisis” and lamented that “if it were not for the energy crisis, we’d be talking a lot more about health care issues”:

There is a health care crisis in America. We would be, if it were not for the energy crisis, we’d be talking a lot more about health care issues. And we have to reform health care in America. And we have to make insurance available and affordable for all Americans. [New Mexico Town Hall, August 20, 2008]

Watch it:

And despite skyrocketing health care costs and millions of uninsured and under-insured Americans, almost all of the prominent speakers at the Republican National Convention ignored the “health care crisis.”

Gov. Sarah Palin (R-AK), Gov. Mike Huckabee (R-AR), Mayor Rudy Giuliani (R-NY), and Sen. Fred Thompson (R-TN) never addressed health care. Gov. Mitt Romney (R-MA) only discussed “health insurance” in passing.

On Tuesday, Huckabee, a long-time advocate of wellness and fitness, “said his health care remarks were cut for time restrictions.”

GOP Platform Undermines Professional Medical Standards On ‘Conscience Clauses’»

The medical ‘conscience clause’ in the Republican Party’s 2008 platform undermines the precious balance between provider and patient rights and, like three other federal statutes, may allow medical professionals to withhold medical information from patients:

No healthcare professional, doctor, nurse, or pharmacist — should ever be required to perform, provide for, or refer for a healthcare service against their conscience for any reason.

And while professional medical organizations and most in the medical profession “endorse a provider’s right to step away, or ‘withdraw,’ from providing a health care service that violates his or her moral or religious beliefs,” they also believe that “there must be limits to this right in order to ensure that patients receive the information, services and dignity to which they are entitled.”

- “The physician may not discontinue treatment of a patient as long as further treatment is medically indicated, without giving the patient reasonable assistance and sufficient opportunity to make alternative arrangements for care.” —World Medical Association, Declaration on the Rights of the Patient

- “The patient’s right of self-decision can be effectively exercised only if the patient possesses enough information to enable an intelligent choice….The physician has an ethical obligation to help the patient make choices from among the therapeutic alternatives consistent with good medical practice.” —American Medical Association, position statement on informed consent

- “Where a particular treatment, intervention, activity, or practice is morally objectionable to the nurse….the nurse is justified in refusing to participate on moral grounds….The nurse is obliged to provide for the patient’s safety, to avoid patient abandonment, and to withdraw only when assured that alternative sources of nursing care are available to the patient.”—American Nurses Association, Code of Ethics

A survey of physicians published in the New England Journal of Medicine found that most “believe that physicians are obligated to present all options (86%) and to refer the patient to another clinician who does not object to the requested procedure (71%).”

As Adam Sonfield of the Guttmacher Institute points out, “professional standards” — not rigid ideology — should “remind everyone that responsibility to the patient must always be the top priority and that a right to withdraw must never be turned into a right to obstruct.

Palin’s Conservative Ideology Is An Obstacle To Real Health Care Reform»

Despite Sen. John McCain’s (R-AZ) claim that Gov. Sarah Palin (R-AK) “will help me reform Washington,” Palin’s adherence to a rigid conservative ideology that treats health care like any other commodity will only drive-up health care costs.

While governor Palin led an effort to repeal Certificate of Need laws, (CON) — “a regulatory process that requires certain health care providers to obtain state approval before offering certain new or expanded service.” As the National Council of State Legislatures points out, “the basic assumption underlying CON regulation is that excess capacity (in the form of facility overbuilding) directly results in health care price inflation“:

When a hospital cannot fill its beds, fixed costs must be met through higher charges for the beds that are used. Bigger institutions have bigger costs, so CON supporters say it makes sense to limit facilities to building only enough capacity to meet actual needs.

Palin argued that CON programs have failed to “lower costs for the consumer“:

But after much consideration, we believe that the program has not accomplished what it set out ultimately to do more than 30 years ago — lower costs for the consumer. It is time to end Alaska’s program in its present form. Doing so will not only reduce the cost of health care, it will also improve the access to health care, allow more competition and improve quality of care for patients.

But as Joe Padula points out over at Managed Care Matters, Palin has “no clue what she’s talking about.” In fact, a study of the health care costs of the big three automakers concluded that “CON states have lower health care costs than non-CON states“:

Like many conservatives, Palin assumes that increasing the number of hospital beds will lower health care costs. But “health care is not like any other good or service.” Indeed, “competition in health care is very different from other types of products and services,” — “the more supply there is, the higher costs are.”

McCain And Palin: Promoting Failed Consumer-Driven Health Care»

In choosing Gov. Sarah Palin (R-AK) as his running mate, Sen. John McCain (R-AZ) has found someone who shares his vision of a radically different health care system which shifts the financial incentive and risk from the insurance company to the patient.

While McCain seeks to do-away with consumer protections, deregulate the insurance industry, drive Americans into scantier coverage, and inevitably phase-out the current employer-based system, Palin has similarly called for “flexibility in government regulation that allow competition in health care.”

As governor, Palin sought to push for greater commodification of health care by establishing the Alaska Health Care Strategies Planning Council and, after introducing a transparency act, promised to build “on the work they have done.”

Palin’s council promoted consumer-driven health care. Here are some highlights from the report:

- Increase the place of consumerism in health care purchasing by giving people control over their health care dollar…

- Reduce potential for financial impact from catastrophic loss by supporting new and innovative approaches to insurance for individuals, which would be consumer-owned, portable, and purchased with pre-tax dollar

- With respect to lowering costs, insurance that is portable and consumer-owned plays a central role, and requires much more discussion at the state level.

- Consumerism is an essential component of bringing rationality to the health insurance structure in Alaska…insurance must be consumer-owned, market-responsive and portable;

But ironically, consumers are often dissatisfied with “consumer-owned” plans. Thirty-three to 42% “of people in consumer-driven health plans are extremely or very satisfied with their health plans, compared to 63 percent of those with traditional plans” and Americans in such plans are twice as likely to report delaying or avoiding care and about three times as likely to report paying a large fraction of their income on health costs as those in comprehensive insurance.

What’s more, “enrollees in consumer-driven health plans appear to be significantly healthier than others. As sicker workers stay in traditional plans, the cost of such plans will go up, causing such plans to become unaffordable for workers and employers. This erodes group purchasing power, leading to even higher prices, and possibly more uninsured Americans. It could also undermine Medicare as it expands there.”

Unfortunately, in treating health care like any other consumer good, both McCain and Palin are placing ideology ahead of improving access and expanding health care coverage. Since “health care is ultimately about preserving life and delaying death,” “buying health care may not be the same as buying an iPod” — McCain and Palin should take note.

Will McCain Still Consider Raising Taxes On Tobacco?»

During his appearance at the Livestrong Presidential Forum in July, Sen. John McCain (R-AZ), who had supported a $1.10-per-pack tax hike in 1998, refused to consider increasing the tax on cigarettes because he believed that some of the funds were diverted away from tobacco control programs:

MCCAIN: I don’t think I would, [raise the federal tax on tobacco] because I don’t think the money is being spent on the state taxes right now. […]

ZAHN: So is there any circumstance that could be proven to you, if there was a direct correlation between taxes going up and the use of tobacco going down?

MCCAIN: It would have to be proven and frankly the constitution of this Congress, they couldn’t prove it to me, because I don’t believe them. I don’t… And by the way, I’m not for raising anybody’s taxes. I think, right now with these economic problems we have, lower taxes is what we need

Watch it:

A new study has proven just that. According to new research, despite some diversion of funding, California’s anti-tobacco program — which “was funded with a constant tax of $0.05 per pack” — yielded a 50-to-1 return, saved $86 billion in personal health care costs, and “prevented 3.6 billion–yes, billion with a “b”–packs of cigarettes from being smoked in 15 years.”

So will McCain raise taxes to save money and reduce tobacco consumption or stick by his ideologically-driven ‘no new taxes’ pledge?

Census Data: The Importance Of Public Heath Care Programs»

The decrease in the number of uninsured — from 47 million to 45.7 million — underscores the importance of public health care programs. As Len Nichols of the New Health Dialogue Blog rightly notes:

…a weakened economy and rising health care costs have led fewer Americans to buy private insurance and more Americans to turn to the government for safety net coverage. Let’s keep in mind, however, that the numbers released today are for 2007, before the economy really took a turn for the worse. Therefore, we can expect the reduction in private coverage enrollment and increased dependence on Medicaid to be magnified in 2008. This path places increasing strain on local, state, and federal governments who are already grappling with tough budgetary constraints.

Indeed, while conservatives continue to fear-monger and misrepresent public health programs as “inefficient rationed care,” “government run” or “controlled,” Americans are turning to them in greater numbers.

According to the new census data, in 2007 the percentage of people with private coverage dropped from 67.9% to 67.5%, while the number of Americans with government-provided health coverage increased from 27.0% to 27.8%. The number of children with private insurance also fell by 0.4%, and 1.2% more children received coverage through public programs.

This greater availability of care is the result of state, not federal, progress. President Bush’s refusal to adequately fund SCHIP and expand public health programs has forced state governments to pick up the slack. While the economy tempers prospects “for further progress,” “state efforts to expand Medicaid and SCHIP during 2007 reached a level not seen since the late 1990s.”

During 2007, “governors in 34 states offered plans to reduce the number of uninsured children, parents, adults, aged and disabled in their state through Medicaid expansions, SCHIP expansions…market-based approaches.”

The Kaiser Foundation offers this chart:

In fact, according to the new data, Massachusetts health reform — which has insured 439,000 new residents and cut the number of uninsured nearly in half — is responsible “for 24% of the decline nationally in the number of uninsured.”Last week, the Robert Wood Johnson Foundation released a report that underlined the important role public health programs like SCHIP and Medicaid play in providing health care to children. As the CEO of foundation pointed out, “programs like SCHIP are a true lifeline for vulnerable children. Hard-working parents need these programs, and their children benefit greatly because of them.”

Yesterday’s census numbers suggest that public health programs are a “lifeline” for all Americans who cannot afford private coverage.

Health Care Leaders Meet in Denver»

The following post is a dispatch from Peter Harbage, a Senior Fellow at the Center for American Progress Action Fund. Peter is attending the Democratic National Convention in Denver, Colorado.

Some of America’s greatest health care leaders gathered in Denver, today, to call for national health reform. Called “Winning Health Care Reform in 2009,” the event is sponsored by Families USA and SEIU.

The crowd was fired-up as the event kicked off with Ron Pollack, long-time health care warrior and head of Families USA, talked about the need for health reform. He lead off talking about how the slight dip in the number of uninsured reported by the Census Bureau just yesterday highlights how much ground we have lost since 2000. Pollack pointed out that today there are more uninsured in the US than the combined population in 24 states.

Pollack also featured the new Harry and Louise (www.harryandlouisereturn.com ) ad. The transformation of Harry and Louise from icons of the battle against the Clinton health reform effort to symbols in support of health reform in 2008 shows how bad the health reform has become. The website features a video where the actors talk about their personal experience with the broken health care system.

Andy Stern, President of SEIU International, followed Pollack by pumping up the crowd as only a labor leader can. He focused on one top message: Get health care done in the first 100 days of the Obama administration.

Rep. Hilda Solis (D-CA), kicked off the speakers talking about the fight for the SCHIP reauthorization last year, which was twice vetoed by President Bush.

Then came Rep. John Dingell (D-MI), Chairman of the House Ways and Means Committee, whose father lead the fight in support of health reform under President Truman. Dingell, who has lead the fight in the House of Representative for as long as anyone, said that he is “Ready to work his heart out,” for health reform under President Obama.

Gov. Kathleen Sebelius (D-KS) focused on the moral and financial urgency for health reform. She talked about the ‘hidden tax’ in health care where those with insurance already pay for care from the uninsured in a way that is hidden. The point: all of us already pay for the uninsured, and we all need to pull together to fix the broken system.

Stay tuned for more updates from the “Winning Health Care Reform in 2009″ event!

McCain’s Contradictory Rhetoric On Home Health Care»

Yesterday, in an answer to a question about providing affordable care to Americans with disabilities, Sen. John McCain (R-AZ) said he would “encourage home health care as opposed to institutional care”:

And we need to have policies that encourage home health care as opposed to institutionalized care. And we need to treat people on an outcome basis, that don’t pay for every test or every procedure, every visit to the doctor; but treat them for a period of time and then pay that provider.

McCain’s answer may have surprised disability advocates. Just last month, during a Town Hall event in Denver, McCain expressed strong opposition to the Community Choice Act, which would make more home care available to people on Medicaid.

After the audience member asking the question explained that the act — which has a total of 113 co-sponsors in the House and 21 in the Senate– “would end the institutional bias and allow people with disabilities to chose where we would live and receive services,” McCain expressed no support for home-based care and instead insisted that he “will not” support the act “because I don’t think that it’s the right kind of legislation.”

Watch both answers:

During the event in Denver in July, McCain implied that he had discussed the act with advocates in April. But by June, McCain seemed to have forgotten about the legislation. When an audience member asked the senator “would you support the Community Choice Act, Senate Bill 799,” McCain said, “I’m not sure which — I don’t know bills by their numbers” and instead touted his support for the Americans with Disabilities Act, which did nothing to promote home care.

Families USA: NFIB Now Supports Expanding Public Health Programs»

During a conference call promoting the new Harry and Louise ads, Ron Pollack, the Executive Director of Families USA, revealed that the National Federation of Independent Business — a group which strongly opposed President Clinton’s health reform effort but now promotes changing “the status quo” — supports expanding public health programs:

In the conversation I had with Todd [Stottlemyer]….when I talked about…the problems with private health programs and their failure to meet people who in no doubt need support… I said to him that that it was a top priority for Families USA in terms of seeing change…[to expand public health programs]… He was not aware of that…[I told him] we are going to push really hard for that and he said he would support it.

Stottlemyer’s endorsement of an expansion of public health programs is a significant development and a welcome reversal from the group’s insistence that “Americans should receive their health insurance and healthcare through the private sector.”

Read more about the importance of public programs here.

Harry and Louise Tip Their Hand: ‘Friend’ Would Not Get Coverage Under McCain’s Plan»

Our guest blogger is Adam Jentleson, the Communications and Outreach Director for the Hyde Park Project at the Center for American Progress Action Fund.

In their new ad, Harry and Louise – older and more mature than they were in 1993 – seem to go to great pains to stay neutral and avoid favoring either candidate’s position on health care. But despite their efforts to stay neutral, their new ad reveals one of the glaring flaws in John McCain’s radical health care plan.

In the ad, Harry mentions a friend who was recently diagnosed with cancer, but doesn’t have insurance. Under McCain’s plan, this “friend” would find it extremely difficult, even impossible, to get coverage.

Watch it:

Because his employer doesn’t cover him, the friend Harry describes has to shop for health care on the individual market, where he is at the mercy of the insurance companies. Under McCain’s plan, he would stay there, but he would have even less leverage to negotiate a fair deal for himself than he does now – because McCain’s plan would de-regulate the individual market, and give the insurance companies even greater leeway to deny people coverage or hike up their premiums even more.

Under McCain’s plan, the only option for Harry and Louise’s friend would be a high-risk pool – but in practice, high-risk pools have proven woefully ineffective at meeting the needs of people with cancer and other Americans in desperate need of care.

The friend in this ad may be fictional, but his crisis is not. In fact, there are 56 million Americans with chronic conditions who would be at risk of losing their coverage under McCain’s plan, and finding themselves in the exact same situation. Those 56 million Americans are very real – and so is the crisis they could face under John McCain’s health care plan.

Harry And Louise Flip Flop On Health Care»

Harry and Louise are back, but this time they’re saying that “the status quo is no longer an option.”

Fifteen years after falsely suggesting that President Clinton’s efforts to reform the health care system would undermine existing coverage and leave health care decisions in the hands of government bureaucrats, Harry and Louise — now “older and wiser” — are demanding that the next president “bring everyone to the table and make [health reform] happen.”

Watch both the 1993 and 2008 ads:

Former opponents of Clinton’s health reform locked arms with the plan’s proponents to finance the new ads, which will run on CNN, MSNBC, and Comedy Central during the Democrat and Republican conventions.

The effort is co-sponsored by the Cancer Action Network, American Hospital Association, The Catholic Health Association, Families USA, and the National Federation of Independent Business and is also supported by America’s Health Insurance Plans, the insurance industry front group behind the original advertisements.

AHIP President and CEO Karen Ignagni openly admitted her organization’s change of heart at the unveiling of the new ad and promised to “strongly support the coalition’s activity”:

This is a very different time [than 1993] and we are making a strong commitment…to work collaboratively [with this group].

What’s On The Table? McCain Adviser Pledges To Trim Health Benefits»

In an exchange with the Dallas Morning News, McCain health policy adviser John Goodman admitted that McCain’s plan to give families $5,000 to buy health insurance would drive Americans into scantier coverage:

The tax credit “would not subsidize bells and whistles [marriage counseling, acupuncture, etc.] as the current system does,” Mr. Goodman said in an e-mail.

Goodman’s comments echo the McCain campaign’s false ‘caviar health care’ argument — which compares “Americans’ use of the health care system to shoppers who indiscriminately buy caviar while someone else foots the bill” — and fundamentally misrepresent the causes of rising health care costs.

Despite the campaign’s insistence that an over-reliance on “marriage counseling” and “acupuncture” is driving-up health care costs, the fact remains that 80 percent of the health care costs “are incurred by the sickest twenty percent of Americans, those whose doctors order expensive treatments for difficult diseases such as cancer” — “acupuncture” or “marriage counseling” are rarely prescribed.

In fact, with family insurance premiums exceeding $12,000, it’s unclear which services Goodman would be willing to trim to get to $5,000. Which half should go? Wellness and prevention programs? Cancer screening and testing? Maternity care?

But with McCain, “everything is on the table.”

McCain Embraces Government-Run Health Care… But Only For Veterans»

After bitterly deriding so-called government-run health care on the campaign trail, Sen. John McCain (R-AZ) today vehemently defended the concept in a speech before the Veterans of Foreign Wars National Convention:

I will make sure that Congress funds the VA health care budget in a sufficient, timely, and predictable manner…I believe the VA should always be there to provide top-quality care for our veterans. And I believe that the VA should continue to provide broad-spectrum health care to eligible veterans, in addition to specialized care in areas such as spinal injuries, prosthetics, and blindness — services in which the VA sets the standard in medical care. […]

They will not signal privatization of the VA. And they will not replace any scheduled expansion of the VA network — including those facilities designed to serve veterans living in rural and remote areas.

And while McCain’s warm embrace of the popular government health care program may have pleased the VFW — which opposes the senator’s Veterans Health Access Card proposal — his comments likely surprised audiences across America, to whom McCain delivered a different message.

In fact, throughout the campaign and in numerous Town Hall events, McCain has consistently claimed that government involvement in health care sacrifices “the most essential value of American lives– freedom”:

- We’ve got to have incentives for people to make their own decisions about their own health care. Families should be making the decisions and not government. [Town Hall in Denver, 7/7/2008]

- We’ve had hours and hours of discussion on health care, but to sum it up, I want the families to make the choices on health care in America, and not the government. Thank you. [NALEAO Conference, 6/28/2008]

- I offer a genuinely conservative vision for health care reform, which preserves the most essential value of American lives — freedom…In health care, we believe in enhancing the freedom of individuals to receive necessary and desired care. We do not believe in coercion and the use of state power to mandate care, coverage or costs. [Des Moines, 10/11/2007]

Unfortunately, McCain, who has himself benefited from government-funded health services, is trying to have it both ways on health care.