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Newsletter "What's Going On?" June 26, 2010

June 26th, 2010

Note on the new law

Newsletter delayed this week.  Computer problems. 

The Nation reported this week that “If Republicans persist in making…calls for repeal of reform, and if those calls are coupled with talk about cracking down on entitlements…the GOP will stir uncertainty with regard to which party can be trusted to protect Medicare and Social Security.

Be wary of reports of town hall meetings held under the title of “America Speaks” that were scheduled to occur this weekend.  They were sponsored by a libertarian organization unfriendly to Medicare, Social Security and the new health care reform legislation, an organization that’s currently promoting its agenda under the umbrella of fiscal conservatism.  Healthcare-NOW advised last weekend: “There will be protests outside many of the June 26 meetings to demand "Hands off Social Security and Medicare-Make Wall Street Pay." Here is the press release for the protest rally that will be held in Detroit. If there is one near you, join it!”

Recent Premium Increases Imposed by Insurers Averaged 20% for People Who Buy Their Own Health Insurance, Kaiser Survey Finds

Average spending on health per capitaFrom Health Care for America-Now, cited by Don McCanne: Premium hikes have surpassed the growth of medical costs, wages and overall inflation. From 2000 to 2008, premiums for families enrolled in employer-sponsored health plans increased 97 percent, while rates for individuals in workplace health plans climbed 90 percent. During that same period, private insurers’ payments to health care providers rose only 72 percent, medical inflation increased 39 percent, wages grew 29 percent and overall inflation climbed 21 percent. Health insurers are basing increases on something other than medical inflation, wages or general inflation.  http://hcfan.3cdn.net/d8f62f1fc66d8e0224_q6m6bnff1.pdf

REPORT:  “Some States Won’t Be Able To Effectively Review Unreasonable Premium Increases.”  Think: Alabama

Peter Van Vranken: Aetna scraps 19% rate increase for individual policyholders LA Times by Duke Helfand - A second insurance company in California has killed plans for double-digit rate hikes for individual policyholders because of errors in its filing that would have inflated premiums, state regulators said Thursday. Connecticut-based Aetna Inc. had sought an average 19% increase in rates for its 65,000 individual customers, but pulled back after multiple math errors in its paperwork were found by its own staff and by an independent consultant working for the state.  Peter asks: “How come they never make a mistake in favor of their customers and not their bottom line? “

Average Health Spending per Capita, updated.

Reaction to passage of healthcare reform billAlso from Van Vranken: Twenty-seven buyers spent a collective $2.3 million on anti- health care reform ads in the past month, political advertising guru Evan Tracey tells Pulse. Compare that to the paltry $300,000 spent on the other side. Tracey says the ads he has seen lately are heavy in Obamacare rhetoric and span Congressional and gubernatorial races. Also of note: Some of the pro-reform funds have been going toward doc-fix campaigns rather than defending the reform law itself. Pulse

Note the table from the Gallup organization.  Healthcare reform is popular with all ages except seniors.

Maggie Mahar writes, “Opponents of reform will continue to pretend that at some point in the future, “Obama-care” will mean drastic across-the-board cuts in reimbursements to doctors who take Medicare patients, forcing many to abandon their patients. The Senate’s bipartisan action on Friday should serve as a reminder that this just isn’t true. Congress never has and never will implement the blind cuts that the SGR formula calls for. The SGR has nothing to do with the reform legislation President Obama signed in March. In fact, the Affordable Care Act hikes payments to many physicians.”

Reuters: "Americans spend twice as much as residents of other developed countries on healthcare, but get lower quality, less efficiency and have the least equitable system, according to a report released on Wednesday. The United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found. ... Previous reports by the nonprofit Fund ... have been heavily used by policymakers and politicians pressing for healthcare reform."  "In 2007, health spending was $7,290 per person in the United States, more than double that of any other country in the survey. ... And yet Americans get less for their money,” said the Commonwealth Fund's Cathy Schoen. The analysis uses five health care measures -- quality, efficiency, access to care, equity and the ability to lead long, healthy, productive lives. "Overall Britain, whose nationalized healthcare system was widely derided by opponents of U.S. healthcare reform, ranks first, the Commonwealth team found" (Fox, 6/23).   Kaiser Daily Health Policy Report.  Another analysis released this week, this time of OECD data, reaches about the same conclusion.

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A separate Commonwealth Fund Report provides an overview of the health systems of 13 countries -- Australia, Canada, Denmark, England, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. The report highlights who and what is covered under the various country health systems as well as each system's organization of the delivery (Squires, 6/23).  


Tort reform, anyone?  In a recent Gallup Poll, physicians attributed 26% of health care cost to defensive medicine. 

Surprise: the slight increase in favorability ratings that are emerging for the health care reform bill is generated almost entirely by increasing Republican support.

Politico Pulse: “SENATE GOP ASKS ABOUT THOSE DEADLINES - Sen. Mike Enzi and 27 other Senate Republicans want to know why the high-risk insurance pools weren't established by June 21, as required by the reform law. They're also asking questions raised by CBO about how HHS is going to deal with a lack of funding. '[I]t is crucial that this program be fixed and fully funded,' Enzi writes in a letter to Sebelius. 'I am disturbed by the Administration's failure to fund this program and my colleagues and I want answers about when this assistance will be provided and how much it will take to actually provide the coverage promised.'” http://bit.ly/biYsis

Application forms for Early Retiree Reinsurance benefits are available from HHS, from a report by the Colorado Insurance Insider.

Several interesting articles from the New England Journal of Medicine:

         Health Care Reform and Primary Care: The Growing Importance of the Community Health Center,

         Fixing Medicare’s Physician Payment System, by Bruce Vladeck, former Medicare administrator.  Nice, two pages, not technical.  “And (some) pundits argue that….fee-for-service payments are so intrinsically counterproductive that we should just scrap them in favor of something better.  Except that no one know what that something is.”

Health Care Reform and Cost Control  Peter R. Orszag, Ph.D., and Ezekiel J. Emanuel, M.D., Ph.D.

From time to time I see indications that enthusiasts for health care reform believe that the entire system should be not-for-profit.  Ran into an article this week that makes precisely the opposite case.

Kaiser Health News staff writer Phil Galewitz, working in collaboration with USA Today, writes about the soon-to-be launched federal health care site. "Wish finding health insurance were as easy as shopping for an airline ticket? A federal government website that starts July 1 takes a step in that direction. The site, for the first time, will give consumers a list of all private and government health care plans for individuals and small businesses in their areas" (Galewitz, 6/23). Read entire article. Kaiser Daily Health Policy Report

Politico also reports: The American Cancer Society Cancer Action Network is out with a new poll of cancer patients and survivors that shows the public still doesn't really know about provisions of the law that you'd think would be popular. Nearly 70 percent didn't know that the overhaul would relieve them of out-of-pocket costs for preventive care, and 64 percent didn't know about the high-risk pools. If even this group doesn't know about the provisions, proponents still have their work to do. But it also suggests that there's room for the polling numbers to improve once the public finds out about some of the law's benefits.

Igor Volsky notes that a coalition of health advocacy groups has placed new barriers in the way of the GOP effort to block the reform bill.

The Commonwealth Fund   June 18, 2010 -- During a slow-moving political storm marked by what Harvard pollster Robert Blendon calls "Level Four" anger, the last thing Democratic candidates want to face in (November) is 11 million angry seniors. 

But when seniors in Medicare Advantage—the popular program of private health care plans in Medicare—open their mail this fall and find out how their coverage will change next year, they won't be happy.

The Chicago Tribune: "[T]he nation's health system is continuing to fray, raising the prospect that the country could experience a crisis before the law establishes a health care safety net in 2014. ... [S]tate governments struggling with budgets savaged by the recession are contemplating further cuts in health care aid for the poor, despite the promise of more federal dollars. At the same time, several million unemployed Americans and their families who have used federal assistance to hold on to health insurance from work will lose coverage in coming months as the special assistance program expires. Those with jobs face their own challenges as employers continue to look for ways to pare back health benefits and shift more costs to employees, if not drop health coverage altogether. And people in all walks of life face rising health care prices and skyrocketing insurance premiums, which in many places are rising at double-digit rates this year."    From the Kaiser Daily Health Policy Report. 

Jonathan Cohn, author of Sick, writes that, “Even with the Grandfather Clause Protection, Change is Coming to Most Health Plans.”  And it’s not very surprising. 

NAHA, the North Alabama Group, recently presented Dr. Pippa Abston speaking on “Holding Our Applause: What’s Wrong With the New Healthcare Law and How We Can do Better .”  Her talk made Michael Moore’s blog.  Congratulations!

Who’d be interested in planning a Birthday Bash for Medicare when it turns 45 this July?  We ought to be able to get some cake, serve it with candles to some elected officials, local TV and newspapers.  Let me know if you’re interested. 

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Sunday, July 11. Healthcare-NOW! will be hosting it's standing activist conference call at 7pm (CDT). Please use this Dial-in Number: 1-218-862-1300 and Conference Code: 441086.

Thursday, July 22.  8 PM Central.  PNHP Conference Call.  Call me for the number and the Conference Code.

July 30.  Medicare Birthday. Healthcare-NOW is “looking to July 30th this year as a major day of action to protest the cuts and privatization of our hard-won entitlement programs. These cuts are simply, ‘off the table.’  We hope you will consider activating your network on July 30th to demonstrate at your local Congress person's office, your state capitol, a private insurance company, or another target that you think will bring awareness, media attention, and pressure on our elected officials. Healthcare NOW will help to support your efforts with sample press releases, media kits, post cards, petitions, staff support, and email blasts. We need you on the ground to make the noise, and collectively, our work to protect these important programs will build our networks in advocating for what we know can help alleviate so much of the unnecessary suffering in this country: expanded and improved Medicare for All.  Please let Healthcare-NOW staff know if you are interested in planning actions for July 30th at info@healthcare-now.org.”


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