Health Insurance

HEALTH REFORM: The Public Plan Question

Veteran health advocate and researcher Stan Dorn is guest blogging for us today. Stan has worked on health policy for 25 years at the state and federal level. He began as a legal aid attorney helping low-income Californians obtain health care. Later as health division director at the Children's Defense Fund he led the organization's health policy team in a national campaign that contributed to the creation of the Children's Health Insurance Program -- and he helped defeat Newt Gingrich's proposal to replace Medicaid with a block grant.  He is now a senior research associate at the Urban Institute. The views here are his own.

If health reform legislation does not guarantee a public option, could progressives support it, in good conscience?

I hear this question a lot. My answer is yes -- so long as the bill provides millions of low-income uninsured with affordable, comprehensive health coverage.

HEALTH REFORM: O'Reilly. Oh Really?

In case you missed it...Bill O'Reilly backs the public plan.

I want that. I want, not for personally for me, but for working Americans, to have a option, that if they don’t like their health insurance, if it’s too expensive, they can’t afford it, if the government can cobble together a cheaper insurance policy that gives the same benefits, I see that as a plus for the folks.

(Hat tip to Think Progress).

COST: What Goes Up... Goes Up

It's that time of year again. The annual survey of just how much health insurance premiums rose this year, and and what it tells us about the future.

Premiums for employer-sponsored family health insurance in 2009 rose to $13,375 -- a five percent increase. That's a moderate rise, given recent trends, but it's still a lot given that general inflation actually fell 0.7 percent in the survey period, and wages went up 3.1 percent.

The annual report by the Kaiser Family Foundation and the Health Research & Educational Trust (HRET), found that since 1999, premiums have gone up a total of 131 percent -- while wages rose 38 percent and inflation increased 28. Back in 1999, a family policy cost $5,791.

Drew Altman, president and CEO of the Kaiser Family Foundation, said that the five percent increase is relatively modest, given recent historical trends. He didn't anticipate a return to "the kind of really astronomical trends" of double digit hikes seen in 2002-03, but it's likely that premiums would rise a more typical 8 or 9 percent in coming years (unless major national health reform legislation changed the scenario, and even then cost-saving measures might not be felt immediately.)

The survey analysis found that family premiums, if they rise at the average rate of the last five years, would surpass $24,000 in another 10 years. If they rise at the average of the last decade (8.7 percent), it would be a startling $30,800.



HEALTH POLITICS: Deja Betsy All Over Again

We're not sure where Betsy McCaughey will show up after the President's speech tonight, but we'd be surprised if we didn't hear from her... The Health Care Blog had a nice piece last weekweek. Here's a taste:

Betsy McCaughey's extravagant claims of eager Democratic euthanasiasts hiding behind health care reform have been exposed,  eviscerated, and enshrined as just plain evil.  

Of  course, that's the kind of behavior you'd expect from Bad Betsy, the hyper-partisan political pit bull. But what about Good Betsy, the founder and chairman of the non-profit Committee to Reduce Infection Deaths (RID)?

As someone who's been involved in the patient safety movement since the mid-1990s, I've admired her pugnacity and plainspokenness. Unfortunately, when I decided to look a lot more closely at RID, it turned out that Good Betsy was not quite "the real McCoy" either. The assertions she makes about herself and her organization teeter at the border between exaggeration and being deliberately misleading....

COVERAGE: There's No Subsitute for the Truth About Insurance Market Reforms

The Wall Street Journal has an editorial out Wednesday purporting to tell the truth about health insurance reform -- an admittedly hard thing to find these days.

Not surprisingly, the conservative editorial board opposes proposals for guaranteed issue and community rating. Such reforms, where implemented, have raised costs, the Journal says.

Ironically, in attacking these reforms, which are designed to make the individual insurance market more affordable and fair for all Americans, the Journal is really making the case for an individual mandate.

Yes, "if insurers are forced to sell coverage to everyone at any time, many people will buy insurance only when they need medical care," which is precisely why every comprehensive health reform proposal being discussed, requires all Americans to purchase health insurance. Yes, community rating could lead to adverse selection, unless all individuals, healthy and sick, old and young, are required to purchase health insurance.

HEALTH CARE: These are the Times that Try Health Reformers' Souls

These are the times that try our souls.

Right-wing vigilantes are disrupting town halls on health reform all over the country. Senator Jim DeMint, a Republican from South Carolina, openly calls for perpetuating health care's status quo -- 50 million uninsured (and rising) and cost trajectories we cannot sustain -- so that President Obama, leading a country at war and facing the worst economic crisis in 80 years, will be "crippled." A well-orchestrated and even better funded Big Lie campaign, scares our nation's seniors into vocally opposing reform efforts that will actually strengthen the Medicare program and help them get the care they need when they need it.  The Enemies of social progress are happy tonight.

Still, the Finance Committee continues to trudge on with goals of a bipartisan agreement. President Obama and leading Democrats remain faithful, for now, that we can win both Republican and Democrat support for the comprehensive health reform that our country so dearly needs. As a health economist who has spent more than 15 years in Washington, I understand why bipartisanship, in ways big and small, is better for health reform in the long run. I have devoted the last four years of my professional life to that goal.  I also understand how hard this aspiration is -- not least for the small group of Republicans who truly want to find common ground.   

But as we begin the August recess, we should get a few things straight.  The most important word of "comprehensive bipartisan health reform" is the first. Comprehensive.

HEALTH REFORM: Sebelius Says Americans Want Peace of Mind

In a The Washington Post op-ed today, Health and Human Services Secretary Kathleen Sebelius reminded us why we're talking about health reform in the first place -- because Americans want peace of mind.

Health care is not supposed to be a guessing game. Americans who have coverage should not have to wonder -- am I going to be dropped from my plan if I get sick? What happens if I lose my job?  No one should be one illness away from bankruptcy. No one should have to choose between food and shelter and medicine for themselves or their children.

The HHS Secretary says that in the current system, health insurance companies have all the power. They can deny coverage for pre-existing conditions, cherry-pick who gets covered, offer bare bones coverage plans, or charge sky-high premiums. For Sebelius, peace of mind means putting power and choice back in the hands of consumers. In a system that promotes health care coverage choice, "insurance companies... will know that if they don't deliver a great value, their customers will flee."

COVERAGE: Tough Choices for the Uninsured

Pierre Aterianus, 57, of Whitefish Bay, Wisconsin, has a problem, reports the Milwaukee Journal Sentinel. In January, he was laid off from his job. For seven years, he had been an engineer at the household garbage disposal manufacturer InSinkErator.

Aterianus didn't just lose his livelihood; he also lost his health insurance. Now Aterianus can't afford to visit the doctor. According to the Sentinel, his last doctor visit cost him $597.50 -- more than one-third of his monthly income and significantly more than the $150 he has left every month after paying his mortgage and real estate taxes. Every month, Aterianus has to choose between competing necessities -- food, utilities, or health care.

HEALTH POLITICS: Waxman, the Legislator

We've been inundated for months with profiles (some quite good) of Max Baucus, Chuck Grassley, even Peter Orszag, maybe the first celebrity budgeteer. Now, Henry Waxman finally gets some ink-stained love as he works to get sweeping legislation, which would give all Americans affordable health care they can count on, through his committee this week.

During the Bush administration, as the top Democrat (ranking, then chairman) on the House Oversight and Government Reform Committee, Waxman investigated topics ranging from pre-war intelligence on Iraq to the aftermath of Hurricane Katrina. From that perch, Waxman was widely seen as fiercely partisan. That goes with the territory (and he is of course a liberal Democrat who disagreed strongly with Bush policies). But Politico's Patrick O'Connor reminds us that Waxman, now chairman of the House Energy and Commerce Committee, isn't just a dogged investigator. He's also a gifted legislator. He steered the climate bill to passage, between the demands of liberals and moderates. Now he's aiming to do the same for health. O'Connor writes:

HEALTH CARE: How Do We Decide What Matters?

When it comes to health benefits, what is most important to you? Are there certain benefits that are absolutely necessary? Are there some that you could do without?

That's exactly what the Center for Healthcare Decisions wanted to know. They recently released the report "What Matters Most: Californians' Priorities for Healthcare Coverage."

Understanding public priorities for health care benefits is a big deal for lawmakers. Currently, Congress is charging ahead toward health care reform, and figuring out how to design minimum benefit standards for health plans is part of their agenda. A minimum benefits package will make sure Americans have insurance that means something, that they will get the care they need, not a bunch of runarounds and denials of coverage. One way lawmakers can connect with American values on health care is to understand what the American people want in their health benefit package.