Impeding changes to our Health Care system

[TheMercenary]

Health interest groups get fuzzy financing
Firms accused of ‘money laundering their PR’; unions contribute millions

The compressed time frame gives outside groups one more chance to attempt to derail the legislation or influence it to their advantage. But in many cases, it is hard to tell where their money is coming from.

The Institute for Liberty, for example, was a one-man conservative interest group with a Virginia post office box and less than $25,000 in revenue in 2008. Now, the organization has a Web site, a downtown Washington office and a $1 million advocacy campaign opposing President Obama's health-care plans.

Andrew Langer, the group's president, said the organization receives no funding from health-care firms but declined to provide details. "This year has been really serendipitous for us," he said. "But we don't talk about specific donors."

The biggest spenders in the health-care debate are well-known Washington veterans with clear constituencies, including the U.S. Chamber of Commerce, which is representing corporate titans who are against reform, and a well-organized network of labor organizations pushing for the legislation. Health Care for America Now, for example, is a consortium of unions and liberal groups that expects to spend $42 million on its wide-ranging pro-reform campaign.

But outside such established interest groups is a significant but more elusive collection of organizations, many of them particularly energized in opposition to Democratic health-care reform efforts. Most are organized as nonprofits, meaning they do not have to reveal many financial details beyond basic revenue and expenses. Some are bankrolled by charitable foundations with a political bent or by industries with a financial stake in the debate; nearly all use names that seem designed to obscure their origins.

'Money laundering their PR'
The Partnership to Improve Patient Care, for example, headed by former congressman Tony Coelho (D-Calif.), was formed by the drug industry in November 2008 to lobby against binding government effectiveness studies, which could be used to determine what insurance companies must cover. The American Council on Science and Health is an industry-friendly group whose board member Betsy McCaughey helped set off the "death panels" frenzy last year.

"It's sort of like money-laundering their PR," said Lisa Graves, executive director of the Center for Media and Democracy, a liberal-leaning group that runs a Web site called PRWatch.org. "A lot of these groups are heavily funded by corporations and then don't reveal it. They try to imply that they are funded primarily by individuals, but that's clearly not the case."

The Center for Medicine in the Public Interest (CMPI) is a New York-based think tank headed by Peter Pitts, a former Food and Drug Administration official who appears frequently on newscasts condemning Democratic health-care proposals. CMPI is an offshoot of the San Francisco-based Pacific Research Institute, which has received foundation grants over the years from Philip Morris, Pfizer and the Pharmaceutical Research and Manufacturers of America, according to public records.

While serving as president of CMPI, Pitts also works as the global health-care chief at Porter Novelli, a New York public relations firm whose clients include Johnson & Johnson, GlaxoSmithKline, Wyeth and Pfizer. He acknowledges that CMPI also receives money from the pharmaceutical industry, which is supporting reform legislation in exchange for a White House promise to limit cuts.

Pitts said he sees no conflict between his two roles, saying the jobs "are completely separate." Tax filings show that Pitts earned a $250,000 salary from CMPI in 2007, when he also headed another firm's global health-care practice.

"We support health-care reform, we just want to do it appropriately," Pitts said of CMPI. "Sometimes it puts us in the same camp as pharmaceutical companies; sometimes it doesn't."

continues
http://www.msnbc.msn.com/id/34742993...shington_post/

[SamIam]

Here are two tidbits I gleaned while perusing the Center on Budget and Policy Priorities’ site.

http://www.cbpp.org/cms/index.cfm?fa=view&id=2996

The first addresses the concern that insurance companies will simply charge higher premiums if forced to cover people with pre-existing conditions

Expending health reform legislation would create a system of health insurance marketplaces, called exchanges, that would offer a range of competing private health insurance plans to individuals who lack access to employer-sponsored insurance as well as to small businesses. Plans would not be allowed to turn people away, charge higher rates because of their health status, or deny coverage for pre-existing conditions. Plans would have to meet certain minimum benefit standards, including a limit on the maximum out-of-pocket charges that an enrollee would have to pay in any year. Low-income people would receive a tax credit that would allow them to purchase a plan at an affordable price and cost-sharing subsidies to hold down their out-of-pocket costs.

The second mentions a benefit that some high income households may not have considered. The higher payroll tax will not only cover certain seniors, but, also those with disabilities. From personal experience I can tell you that getting assistance for dealing with many disabilities is like pulling an elephant’s teeth.

Increasing the Medicare payroll tax on high-wage earners would represent a sound and well-targeted way of paying for health reform. It would also improve the solvency of Medicare’s Hospital Insurance (HI) trust fund and thereby strengthen this critical program, which provides health coverage for 46 million seniors and persons with disabilities.

[SamIam]

OK, this is anecdotal, but it makes me mad as hell, and it shows what's wrong with our medical system yet one more time.

I have two wonderful friends in their late 50's. They are far from wealthy, but they were getting by. Jobs are hard to get in this rural, end of the world part of Colorado. The husband, "Joe," managed to land work with the forest service but he ends up getting laid off every winter for a few months - he does get unemployment from them. He also works odd jobs where he can. His wife, "Judy" was a prep cook at a restaurant here in town. They help other peope all they can, even though their budget is limited and their home is just a small trailer.

Well, Judy just got diagnosed with emphysema. Since Joe is only seasonal at the Forest Service, it doesn't give him health insurance. Judy had limited insurance at her job, but she had to quit because she must now use a portable oxygen tank and can't be near a stove. The cost of an oxygen tank is prohibitive for them in their situation. The O2 company offered them a "deal" - a used tank which they can have for only $300.00. Never mind how they are going to pay for Judy's other treatment for her illness.

I told Judy to apply for disability. To me that looks like the only solution to her problem. Disability isn't wonderful, but it will give her a small income each month, and most importantly, access to medicare.

There is something dreadfully wrong with a system that chews people like these two up and spits them out. They deserve so much more. They have worked hard all their lives, and this is what they get? GRRRRRRRRRRRRRRRRR!

I don't know if the new health care reform will help people like Joe and Judy or not, but dammit, it should.

[xoxoxoBruce]

But Sam, if they had become lawyers or investment bankers they wouldn't be in this fix. Or they could have chosen richer parents.

[TheMercenary]

Originally Posted by SamIam

Here are two tidbits I gleaned while perusing the Center on Budget and Policy Priorities’ site.

Insurance exchanges are only for a certain class of people. Not anyone can enter one.

[SamIam]

It is my understanding that the question of who will qualify for health exchanges is still up in the air as legislatures try to reconcile the House and Senate version of the health care bill. I keep finding different articles that say different things. Which ones are right?

Originally Posted by SamIam

It is my understanding that the question of who will qualify for health exchanges is still up in the air as legislatures try to reconcile the House and Senate version of the health care bill. I keep finding different articles that say different things. Which ones are right?

As I understand it, both the House and Senate will allow large employers (those that currently offering employee coverage) into the Exchanges after a period of time (2-3 years after implementation) so that am employer now only offering 1 or 2 options to employees will be able to offer more options to employees in the future.

The Senate bill also allows new employees of these large employers to choose a plan from the Exchange as soon as they are created.

The biggest difference between the plans is that the Exchanges are administered at the federal level in the House version and at the state level in the Senate and the state can chose to restrict or expand access to the Exchange.

[classicman]

Originally Posted by SamIam

I keep finding different articles that say different things. Which ones are right?

Short answer is we don't know yet.

[classicman]

. . . or gone into politics.

Srsly, sorry to hear of yet another tale of how the system is broken. It's gonna get better - certainly can't get worse, I hope.

[TheMercenary]

From what I understand, anyone who can get insurance through their employer has to get it that way. In fact when we changed to a new company they mandated that people took insurance with them to be employed. It caused a huge problem for some people as they tried to figure out if it was legal and those who had insurance via spouses or Tricare went back and forth with them for a few months until the finally gave in, but you had to provide them with proof that you actually had it. I think they were anticipating the coming changes in the reform. But basically you had no choice to get it on your own. And the new companies premiums are about $300 more per month on the family plan and the ductable is twice what our previous company offered. So basically they can do anything they want.

[TheMercenary]

Oh, the insurance companies will gladly participate, that is why they let the insurance insiders help craft the Bill. Of course this is a huge win for them that is what I have been saying all along. This will make them quite a bit richer. It remains to be seen whether or not they will allow open access to the exchanges. To date there is no evidence that they will allow those who get insurance through their employers to enter the exchange. They basically have those people by the balls and will continue to charge them ever increasing rates and co-pays.

So the $10-20 million that the insurance industry has pumped into a media campaign in the last few months to kill the bill is just a publicity stunt because they like the legislation so much.

Just as dealings with the Obama administration and congressional Democrats soured last summer, six of the nation's biggest health insurers began quietly pumping big money into third-party television ads aimed at killing or significantly modifying the major health reform bills moving through Congress.

That money, between $10 million and $20 million, came from Aetna, Cigna, Humana, Kaiser Foundation Health Plans, UnitedHealth Group and Wellpoint, according to two health care lobbyists familiar with the transactions. The companies are all members of the powerful trade group America's Health Insurance Plans.

http://undertheinfluence.nationaljou...ed-chamber.php

BTW, the Exchange can also regulate (or negotiate) premiums, co-pays and administrative costs, selecting the most favorable for inclusion in the Exchange.....more in the House version than the Senate's, which as I have noted, gives far more flexibility to the states.

The anti-trust provisions, again the House version is better, would also provide the mechanism (ending anti-trust exemption) for further controls.

added:

sam...here is a good explanation of the Exchanges in the House and Senate bills:



In conclusion, if one believes the Exchanges are just a "fantasy", nothing is likely to change that.

[TheMercenary]

'can also regulate (or negotiate) premiums' is not a mandate to do so or hold down costs for the already insured. The majority of companies, including medical device manufactures, have all stated they intend to pass any costs or increased taxation on to the consumers and insured. The difference between the Hose version and the Senate version is huge with the difference between state based exchanges and a nationally based exchange is significant.

In the end there is very little in the new bill that will hold down costs or control costs to the already insured. The insurance companies are happy with the compromise as they gain 30 million new sources of income, paid by the individual or paid for by the taxpayers, matters not to them. 10 million dollars is pissing in the wind for insurance companies, sort of like that BS number of how many jobs the current Congress has created with their whorish spending and artifically proping up the economy.

[TheMercenary]

CBO estimates that the cheapest plans for small businesses, by 2016, will approach $20,000 for a family. That is a SIGNIFICANT increase in costs. And that is for the cheapest plan. And they are not even sure if their numbers are correct.

Yea, I would say the insurance companies are going to come out way ahead in this Bill, and so does the CBO.

In general, however, small employers would provide plans with a greater
amount of coverage than Bronze plans, as they do under current law. The
average premiums in 2016 for plans provided by small employers cited in
the recent analysis by CBO and JCT—about $7,800 for single policies and
$19,200 for family policies—differ from the amounts cited above for
individual Bronze policies primarily because the average actuarial value of
coverage purchased by small employers would be substantially higher than
the Bronze level (about 85 percent, CBO estimates, rather than 60 percent).
The premiums for specific employers could deviate significantly from those
averages for various reasons.

http://www.cbo.gov/ftpdocs/108xx/doc...ronze_Plan.pdf

Originally Posted by TheMercenary

CBO estimates that the cheapest plans for small businesses, by 2016, will approach $20,000 for a family. That is a SIGNIFICANT increase in costs. And that is for the cheapest plan. And they are not even sure if their numbers are correct.

Yea, I would say the insurance companies are going to come out way ahead in this Bill, and so does the CBO.

http://www.cbo.gov/ftpdocs/108xx/doc...ronze_Plan.pdf

CBO also said premiums wont increase for most Americans and the plan is deficit neutral at the least and will likely result in deficit reduction long term...and you discount both.

So I do like how you cherry pick CBO data.