After spending about a half-billion dollars over a decade to block meaningful health care reform, health industry lobbyists and their Republican allies are ramping up their efforts this week to block a public health-care option favored by the President.
Yesterday, Congressional hearings and the President's White House televised meeting on health care reform shone a new spotlight on the issue as the political battle heats up. (Note: Bill Scher's indispensable Progressive Breakfast has a complete round-up of news on those fronts.) Meanwhile, grass-roots reformers organized by Health Care for America Now (HCAN) are coming to Washington on Thursday to lobby for real change, including the public option that gives consumers a choice between a public plan or using private insurance.
UPDATE: A new Senate report finds that these same insurance companies fighting health care reform have yet another reason to uphold the status quo: They've been bilking consumers of billions of dollars in medical bills the companies should have paid themselves. No wonder the insurance industry opposes the real competition represented by a public health care option.
Not surprisingly, the public, most polls show, backs the public option approach by over 60% to as much as 76% percent, as a new Wall Street Journal/NBC poll found. Strikingly, even half of self-identified Republicans favor a public option. Yesterday, the AFL-CIO added to the rising chorus calling for change by revealing the results of an online poll that offers a breadth of response that's compelling: over half of the roughly 23,000 people who took the survey said they couldn't afford health care. As the AFL-CIO Now blog reported:
Out-of-control health care costs are forcing working families to forgo needed medical care and shredding family bank accounts, while private health insurance companies deny claims and, far too often, refuse to provide coverage.
The results of the 2009 Health Care for America Survey--sponsored by the AFL-CIO and Working America--show that more than half of the 23,460 people who took the survey cannot get the health care they need at a price they can afford and one-third say they forgo basic medical care because of its high price. In a nearly unanimous response, survey takers say health care reform is urgent.
Says AFL-CIO Executive Vice President Arlene Holt Baker:
"Our current system is broken and this survey shows how our fractured system hurts both the insured and uninsured alike. The time for real health care reform is now. We simply can't wait any longer."
Amber was one of the people who submitted a story out of a total of 6,409 stories dealing with struggles with the broken health care system. The Florida resident says she has health insurance but:
"I find myself trying to determine what is going to get refilled, and if I can still see the doctor for follow up....I just don't have the copay because I still have to afford the gas to get to and from work. I am constantly finding myself rationing my medication and not taking it as prescribed because I can't afford to get it all the time."
Despite the clamor for an alternative that offers real competition, the right-wing continues to spread misinformation on the plan -- largely unchallenged by mainstream media outlets. Wednesday morning, as noted by Media Matters and the Health Care for America Now blog:
On June 24, CNN's American Morning co-host John Roberts did not challenge former New York Lt. Gov. Betsy McCaughey's assertions that the Affordable Health Choices Act "basically" "pushes everyone into an HMO-style plan" and that most Americans will have to "go through what they call a 'medical home,' which is this decade's term for an HMO gatekeeper." However, under the proposed legislation, individuals already enrolled in a health care plan or receiving health insurance coverage are able to keep their coverage and are not "pushed" into "an HMO-style plan."
McCaughey later stated that "most Americans will have no options. When they file their taxes, they're going to have to staple a proof, like a W-2, that they've enrolled in one of these qualified health plans, with the limits of choice: limits of choices of doctors, limits of choices of when you can see a specialist, when you can have a diagnostic test." In fact, individuals do not have to enroll in "qualified health plans."
McGaughey, a right-winger whose previous claim have been shredded by critics as the work of a serial fabricator, represents the desperation tactics of a party and industry fighting overwhelming public opinion favoring health care reform.
Now the health insurance industry has piled on, escalating its apocalyptic rhetoric in a blistering letter to Congress Tuesday claiming that the competition it might face from the public health-care option would destroy the entire industry. Among other extravagant claims:
"A government-run plan no matter how it is initially structured would dismantle employer-based coverage, significantly increase costs for those who remain in private coverage, and add additional liabilities to the federal budget," said the letter from America's Health Insurance Plans (AHIP) chief Karen Ignagni and Scott Serota, the head of Blue Cross.
The right-wingers' attacks targeting health care reform have become so ludicrous that SEIU has crafted a witty ad lampooning them, as shown in a brainstorming session by the not-so-fictional Healthy Americans Against Reforming Medicine (HAARM):
In the real world of political advocacy, AFL-CIO President John Sweeney, among other critics, has denounced the industry's extremist claims. Those assertions are part of a long history of Big Business opposition to any health care reform, including the "socialized medicine" of Medicare, over the last 60 years. Sweeney points out:
For far too long, Americans have struggled under a broken health care system dominated by insurance companies who care about one thing - their own profits. Passing health care reform that includes a quality public health insurance option is crucial to America's workers because it will provide a competitive impetus for companies to reduce overhead expenses and lower costs.
Anyone who wants to keep their current insurance is free to do so, but it will be their choice between a private and public option, not their insurance company's. Not surprisingly, polling shows that the people overwhelmingly favor a public health insurance option being included as a part of health care reform.
The 'chicken little' letter from the big insurance companies shows that their true agenda is to hold onto their record profits and bonuses by preventing Americans from being able to choose between private insurance and a quality public health insurance option.
Richard Kirsch, the National Campaign Director for HCAN, underscores the absurdity of the health insurance industry's claim that a competitive option would destroy it:
"With more than 150 million customers, billions spent in marketing and building brand name recognition, contracts in place with businesses throughout America, and well-established provider networks, how can the insurance industry say it can't compete with a public health insurance option? The insurance industry is clearly aware it's failed to meet the needs of its customers. If it was doing such a great job, wouldn't it welcome the chance to compete?"
Actually, it doesn't welcome competition, as shown by the recent antitrust complaint to the Justice Department asking it to look into monopolies by health insurers that jack up costs and squelch competition. Sen. Charles Schumer joined Health Care for America Now and other experts in asking for an investigation and reform:
Senator Charles Schumer (D-NY) joined Health Care for America Now (HCAN) - the nation's largest health care campaign - in releasing a new report today that shows extreme health insurance industry consolidation has resulted in a market failure where a small number of large companies use their concentrated power to control premium levels, benefit packages, and provider payments in the markets they dominate. As a result, health insurance premiums have skyrocketed, going up more than 87% - on average - over the past six years.
"This is the starkest evidence yet that the private health care insurance market is in bad need of some healthy competition," Senator Schumer said. "A public health insurance option is critical to ensure the greatest amount of choice possible for consumers. We believe that it is fully possible to create a public health insurance plan that delivers all the benefits of increased competition without relying on unfair, built-in advantages. If a level playing field exists, then private insurers will have to compete based on quality of care and pricing, instead of just competing for the healthiest consumers."
After reviewing the report entitled "Premiums Soaring in Consolidated Health Insurance Market," David Balto, former Policy Director of the Federal Trade Commission and now a Senior Fellow at the Center for American Progress, sent a letter -co-signed by HCAN - to the Department of Justice Antitrust Division asking for a comprehensive investigation into the health insurance marketplace.
And what do consumers get for all this near-monopoly power that insurers want to preserve? Little but a litany of abuses, as summarized by Health Care for American Now:
Most people don't trust health insurance companies and with good reason. They are a powerful industry that is not easily prodded, pushed or intimidated into doing the right thing by their members.
Insurance companies routinely abuse the trust of patients and providers alike. A new report by Health Care for America Now outlines the habitual abuses perpetrated by health insurance companies, including leaving patients with high out-of-pocket costs, denying coverage for medically necessary care, preventing doctors from delivering care they feel is best for their patients, and unduly delaying reimbursement to patients and providers.
The report demonstrates how health insurance companies repeat the same abuses over and over again, despite being reprimanded and fined by state insurance agencies. For example, the report notes how the Texas Department of Insurance has fined United Healthcare millions of dollars for violating the state's prompt payment law. The 2007 fine, $4.4 million dollars, was "the second time in two years and the fourth time since 2001 that Texas fined United Healthcare for the same type of violation."
But Texas is not the only state where United Healthcare has perpetrated that particular abuse. The report also gives examples of similar fines being levied in Arizona, Georgia, North Carolina, and Ohio. And that is just the tip of the iceberg.
Insurance companies are clearly not intimidated by state regulators. These companies seem to consider the fines they incur just the cost of doing business. How much money must they be saving by breaking prompt payment laws if they are willing to keep violating the law over and over again?
So if the public wants a public option and the non-competitive private insurance industry can't deliver affordable, accessible health care, what's keeping Congress from backing it strongly right now? Mostly extravagant health care industry spending on campaign donations and lobbying, especially when it comes to centrist Democrats who are balking at the public option supported by President Obama. Statistics guru Nate Silver has even quantified the link between health care donations and the positions taken so far by moderate Democrats:
The insurance industry's influence appears to swing about 9 votes against the public option. Whatever number of senators wind up supporting the public option, add 9 to it, and you'll have a decent ballpark estimate for what the level of support might be if not for insurance industry contributions...
The single senator who's position on the public option is most likely to have been changed by lobbying money is Mark Warner of Virginia, who has already raised $69,000 from insurance industry PACs in spite of having been in the Senate for less than six months. Absent industry money, the model estimates about a two-thirds likelihood that Warner would support the public option; with it, the model thinks the chances are very low. Indeed Warner has been mum on the public option to date.
Ranking next on the list is Harry Reid, who has taken some $78,800 from insurance industry PACs and who has also yet to articulate a position on the public option in spite of his status as Majority Leader. If the model is right, Reid's noncommittal stance on the issue might be better conceived of as tacit, if somewhat soft, opposition. Following Reid is Kent Conrad of North Dakota, who has floated a compromise bill that would replace the public option with a co-op system, a version of which the Senate Finance Committee appears likely to adopt.
Whatever role money plays in Senate decision-making on health care reform, it's clear that without citizens voicing a call for real reform, as with Wednesday's lobbying day, the public health care option critical to reform could be weakened even as support grows for it.
A compelling case for the public health insurance option designed to lower costs and keep health insurers honest started airing on TV last week in the states of key senators in Arkansas, Delaware, Florida, Iowa, Louisiana, Maine, New Mexico, North Carolina, Oregon, and Washington. Take a look -- and then ask if the health care industry or the public asking for reform will have the final say: