Monday, July 13, 2009

Health Care Monday: rather devastating Edition

Ezra Klein: Health Care Should Not Be a "Benefit"

Marriott International -- the company behind the hotels -- is considered among the best employers in the country. Low turnover, good benefits and good access to the higher-ups. Forbes ranks it at #72 on their "Best Companies to Work For List." And reading this blog post by CEO Bill Marriott, it's easy to see why. "During these tough times," he writes, "it has become more difficult for employees at many U.S. companies, including Marriott, to work a sufficient number of hours to continue to qualify for health benefits." As such, Marriott has "suspended measuring hours worked to maintain health care benefits."

That's a good, humane policy. But in being the exception to the rule, its very existence is an excellent argument against the employer-based health-care system. Access to health care should not be dependent on the kindness of your employer. It should not be dependent on the value that the marketplace attaches to a worker's precise set of skills. It should not be dependent on choosing an industry that doesn't go through wrenching change and downsizing 20 years after you first entered it (as happened to any number of manufacturing workers or, for that matter, California state employees).

It can seem like a gauzy platitude, but in the 21st century, the richest nation the world has ever known should be able to make health-care coverage a given; not a perk, not a gift, and certainly not a "benefit."

Amato: Quote of the Day: Debbie Stabenow on the 'public option'

Debbie Stabenow was on CNN's State of the Union this morning and made the case for the public option.

STABENOW: Well, my first choice and very strong choice is a public option. And I have to say, Wolf, that what my friends are saying, Senator Gregg and Senator Alexander really are scare tactics that have been put forward by folks that don't want to change the system because they make a lot of money off the current system right now.

The reality for families today is if there's an insurance company bureaucrat between you and your doctor telling your doctor what they're allowed to do because of what they'll pay for, telling you what they'll pay for, putting you through all kinds of bureaucracy to try to figure out if you can get care, assuming you're not dropped if you get sick or can't get insurance if you have a pre-existing condition. So what we're talking about is putting somebody on your side, being able to make sure that the insurance company, the for profit insurance company won't provide you with a low cost insurance policy for your family that you have another choice.


If you missed Bill Moyers' interview on Friday night with Wendell Potter, take the time to watch it online. Potter's perspective matters a great deal --- after nearly 20 years as an executive at a major health insurance company, he's become a whistleblower, explaining the way the industry "put profits before patients," and is doing everything possible to block health care reform now.

The entire interview really is, to borrow a phrase, must-see TV, but to just show two excerpts from the program, this one helps explain how and why Potter became disillusioned, and why he's coming forward.

And this excerpt talks in some detail about how the industry operates.

This is his first television interview since leaving the health insurance industry, and it's rather devastating. "Looking back over his long career, Potter sees an industry corrupted by Wall Street expectations and greed. According to Potter, insurers have every incentive to deny coverage -- every dollar they don't pay out to a claim is a dollar they can add to their profits, and Wall Street investors demand they pay out less every year."

C&L:Bill Moyers Journal: CIGNA Chief Admits: Michael Moore's SICKO "Hit The Nail On The Head"

It's a blockbuster admission that we already knew: The health care insurance industry was petrified that Americans would see Michael Moore's Sicko and realize that government-run health care was something that would be good for citizens and lead to better health outcomes.

CIGNA Public Relations Chief turned whistleblower Wendell Potter said the words to Bill Moyers that no insurance company wanted said out loud in this country:

BILL MOYERS: You were also involved in the campaign by the industry to discredit Michael Moore and his film "Sicko" in 2007. In that film Moore went to several countries around the world, and reported that their health care system was better than our health care system, in particular, Canada and England. [..]

So what did you think when you saw that film?

WENDELL POTTER: I thought that he hit the nail on the head with his movie. But the industry, from the moment that the industry learned that Michael Moore was taking on the health care industry, it was really concerned.

BILL MOYERS: What were they afraid of?

WENDELL POTTER: They were afraid that people would believe Michael Moore.

Of course, we knew this. We've been screaming it for years. Still, it's difficult to pierce through that Beltway bubble to those politicos that are still hemming and hawing as the insurance industry insiders fill their campaign coffers.
The full episode (which I cannot recommend highly enough) is available on



Barack Obama is right that our health care system is so wasteful and poorly organized that it is possible to lower costs, expand access, and raise quality all at the same time -- and even have money left over at the end to help pay for other major programs. He's also right that to achieve these reforms the health care industry must join the 21st century and computerize its medical records -- and indeed there is $20 billion in the stimulus package to pay for it.

Unfortunately, that $20 billion is likely to be squandered on buggy, inadequate proprietary software sold by the very companies that lobbied for the money, unless the Obama administration takes decisive action to promote the adoption of better-quality "open source" health IT. So reports Phillip Longman in his tour de force cover story in the latest issue of the Washington Monthly.

Done right, digitized health care could help save the nation from insolvency while improving and extending millions of lives at the same time. Done wrong, it could reconfirm Americans' deepest suspicions of government and set back the cause of health care reform for yet another generation.

Read Longman's story, "Code Red," here.

digby: Whip Appeal
Mike Lux asks the Dems a most important question: do they want to be political failures or not?

The internal debate on health care strategy for Democrats can be boiled down to this: do we choose the approach whose specifics are more popular with the public and will almost certainly work better in practice once it gets passed, or do we want to go with something that has some bipartisan support and may avoid an all out war with the insurance industry?


The first thing to understand in all this is the consequences for the Democrats for the next generation and probably longer if they pass some convoluted, complicated, unworkable compromise that doesn't change the abusive patterns in the insurance and pharmaceutical industries and doesn't begin to control health care costs. If they pass a compromise that doesn't meet regular people's needs, folks will figure it out very quickly, as most people deal with the health care system all the time. If the Democrats twist up this bill to make insurance companies and their Republican allies happy, it is end of story for this generation of Democrats -- our party will not recover from screwing up health care.
Our system is designed to put the politicians' base self interest, egos and insecurities to use to make them worry about losing their seats if they fail to deliver for their constituents. But the incentives are skewed, with many of them more concerned about their opportunities for personal wealth and protecting their fellow members of the ruling class (that last being part of the design as well.) So, Lux's exhortation is not as straightforwardly logical as it first sounds.

Still, they should care about power if nothing else. That's universal. And the idea of being out of power for a generation should scare them --- it wasn't long ago that they were living that nightmare. And I would very much doubt that being the instruments of the demise of the Democratic party will win them much favor among the insurance company titans in the long run. Masters of the Universe don't like losers.

Lux winds up his post with this:

So face your fear, Max Baucus. Tell you health industry allies no, Jim Cooper. Work through your fear of commitment, Evan Bayh and Ben Nelson and Blanche Lincoln and Mary Landrieu. Let's put together a bill that actually works and move forward sometime soon, in our lifetimes preferably. It's time to get this done.
Some of us feel that these people need some extra nudging and the PCCC is asking for your vote on who next to send a message to:

In the last 72 hours, two senators named in our TV ad -- Blanche Lincoln (D-AR) and Kay Hagan (D-NC) -- announced support for the public option!

The big lesson? Pressure works. TV ads work. Now it's our job to keep the momentum high. So we'll be running versions of our hard-hitting ad in targeted states -- pressuring individual Senate Democrats back home where it hurts most. We just need you to help us decide where.

Click here to cast your vote!

On the voting page, you'll see profiles of eight senators -- including how much money they've taken from the health and insurance interests, whether they sit on important committees, and their statements on the public option. Each version of the ad will feature the names of a senator's local constituents who "signed" our ad -- representing the 76% of Americans who demand a public option. It will also display the senator's big contributors.

We know that these ads are working. Not only have our ads been featured in the New York Times and Washington Post (which said we're rattling Democratic senators), but MoveOn and Blue America have been running ads in Sen. Hagan and Sen. Lincoln's home states. And the result? They are coming around. Two down, eight to go.

Vote here!

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