Sunday, September 06, 2009

We Need To Reform Health Care

Lobbyists Attack Reform Without Disclosing Work For Health Insurance Companies

Chart: Who's Paying to Kill Health Reform?

We've got the rest of the world baffled

The American healthcare system has long proved incomprehensible to those living in other rich industrialized countries where long ago all people gained access to good medical care. The real mystery has been why Americans have accepted that in the richest country on Earth, which spends far, far more on healthcare than any other country on the planet, almost 50 million people go without health insurance.

Health Care Reform Is Not About Pleasing Conservatives
Republicans have diminished themselves to irrelevancy — it doesn’t matter what they think about the public option because they have admitted that will not vote for a reform bill.

And so, it’s no longer about pleasing the other side. It’s about increasing access, lowering costs, ending predatory insurance practices — and whipping Democratic support for reform. Let’s get to it.

Insurance Company CEO Compensation 2006-2007
Aetna - Ronald A. Williams
2007: $23,045,834 - 2006: $19,802,476

Cigna - H. Edward Hanway
2007: $25,839,777 - 2006: $21,014,486

Coventry Health Care - Dale B. Wolf
2007: $14,869,823 - 2006: $13,034,126

Health Net - Jay M. Gellert
2007: $3,686,230 - 2006: $6,066,913

Humana - Michael B. McCallister
2007: $10,312,557 - 2006: $5,798,613

UnitedHealth Group - Stephen J. Hemsley
2007: $13,164,529 - 2006: $15,549,028

WellPoint - Angela Braly
(2007) - $9,094,271

WellPoint - Larry C. Glasscock
(2006) - $23,886,169

Leading health plan CEO paychecks, 2008
Aetna - Ron Williams - $24,300,112

CIGNA - H. Edward Hanway - $12,236,740

WellPoint - Angela Braly - $9,844,212

Coventry Health Care - Dale Wolf - $9,047,469

Centene - Michael Neidorff - $8,774,483

AMERIGROUP - James Carlson - $5,292,546

Humana - Michael McCallister - $4,764,30

Health Net - Jay Gellert - $4,425,355

Universal American - Richard Barasch - $3,503,702

UnitedHealth Group - Stephen Hemsley - $3,241,042

The Cost of Not Having a Public Option
The California Nurses Association just sent out a press release highlighting new report from the Commonwealth Fund that projects a 94% increase in health insurance premiums by 2020, if effective reforms aren't enacted. From the e-mailed release:
Private insurance premiums for employer-sponsored coverage will rise by 94 percent by 2010, on top of the 119 percent increase since 1999, according to the Commonwealth Fund report. The increases in premiums from 1999 to 2008 were four times greater than the rise in family incomes, even prior to the current recession.

"These findings are merely the shocking state of premiums, not even including a concurrent jump in out-of-pocket costs for deductibles, co-pays, and other fees. It's no wonder that medical bills now are the leading factor in 62 percent of bankruptcies, and half of American families are rationing medical care because they can't afford it," noted Deborah Burger, RN, co-president of the 86,000-member California Nurses Association/National Nurses Organizing Committee.
California's Real Death Panels: Insurers Deny 21% of Claims
More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, amounting to very real death panels in practice daily in the nation's biggest state, according to data released today [September 2, 2009] by the California Nurses Association/National Nurses Organizing Committee.

CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, the six largest insurers operating in California rejected 31.2 million claims for care – 21 percent of all claims. [...]

With all the dishonest claims made by some politicians about alleged 'death panels' in proposed national legislation, the reality for patients today is a daily, cold-hearted rejection of desperately needed medical care by the nation's biggest and wealthiest insurance companies simply because they don't want to pay for it," said Deborah Burger, RN, CNA/NNOC co-president. [...]

"Every claim that is denied represents a real patient enduring pain and suffering. Every denial has real, sometimes fatal consequences," said Burger. [...]

Rejection of care is a very lucrative business for the insurance giants. The top 18 insurance giants racked up $15.9 billion in profits last year.

Independent Inquiry into HMOs' Handling of Health Insurance Claims
Los Angeles - Attorney General Edmund G. Brown Jr. today [September 3, 2009] announced that deputies in his office are launching an independent inquiry into how Health Maintenance Organizations review and pay insurance claims submitted by doctors, hospitals and other medical providers.

This investigation is prompted by reports that California's five largest health-insurance providers are denying insurance claims at rates of up to 39.6 percent.

"These high denial rates suggest a system that is dysfunctional, and the public is entitled to know whether wrongful business practices are involved," Brown said.

$2.3 Billion Pfizer Settlement Is Not Enough to Deter Organized Crime in the Pharmaceutical Industry
[September 2, 2009] Today's $2.3 billion settlement between Pfizer and the U.S. Justice Department for unlawful prescription drug promotion may sound large, but it's not enough to ensure drug companies will curb their bad behavior. In fact, it just shows there is competition in the pharmaceutical industry. Pfizer has broken a record just set by Eli Lilly & Company in January for what was then described by the Justice Department as the "largest individual corporate criminal fine" in U.S. history (more than $500 million in criminal penalties for off-label promotion of Zyprexa). Now, a scant seven months later, Pfizer has broken this record with a criminal fine of $1.2 billion, the largest criminal fine ever imposed in the U.S. for any matter. (The rest of the $2.3 billion represents civil penalties.)

The U.S. pharmaceutical industry, long one of the most profitable in the country, with profits last year of close to $50 billion, has engaged in an unprecedented amount of criminal activity in the past decade, all aimed at increasing sales, often by illegally promoting drugs for diseases for which evidence that benefits outweigh harm is lacking (also known as illegal off-label promotion). When doctors are induced, either by being bribed or misled by drug companies, to prescribe drugs for such purposes, there is a reasonable chance that the drugs will do more harm than good and patients may be seriously injured or killed by such promotion.

In addition to Pfizer and Eli Lilly (Pfizer also pleaded guilty to criminal charges for off-label promotion of Neurontin in 2004), other drug companies found to have engaged in criminal activity in the past 10 years include Abbott, Schering-Plough, Astra-Zeneca, Purdue and Bayer.

Unfortunately, the ever-escalating fines are unlikely to stop drug companies from continuing to bribe doctors because they represent just a fraction of drug company profits and no one has gone to jail.

There is no doubt that the pharmaceutical industry has made major contributions to the health of the public, but it must also be considered part of well-organized crime in this country. [...]

Until corporate titans are forced to fork over a much larger proportion of their illegally gotten profits and are put behind bars, nothing will change.

California Attorney General Called To Investigate Insurance Companies’ Anti-Health Reform Advocacy
The Los Angeles Times reported today [September 3, 2009] that the California-based Consumer Watchdog has submitted a letter to Attorney General Jerry Brown calling for an investigation of insurance giants Wellpoint and United HealthCare (UHC). The complaint comes in response to the insurance companies’ practice of actively encouraging employees to engage in anti-health care reform political activity. According to Consumer Watchdog, “while coercive communications with employees may be legal, if abhorrent, in most states, California’s Labor Code appears to directly prohibit them.”

UHC was exposed last month for creating a call center that directed employees to anti-health reform protests. More recently, Wellpoint launched a “grassroots Web site” urging employees to “make [their] voice heard” by contacting Congress in opposition to health reform. It appears that these tactics may have been a violation of California law. According to the watchdog organization’s letter, UnitedHealthCare’s anti-reform hotline and Wellpoint’s astroturf lobbying website may violate California laws meant to prevent employers from influencing the political activity of its employees.

Red States Have the Largest Numbers of Uninsured. They're Also Opposed to Healthcare Reform. Why?
And of course, they're the people who have been regularly told that taking any help from the government is "socialism" - although Medicare does seem to have slipped in under the radar.

Reform, Irony And Self-Interest
A couple of weeks ago, Sam Stein noted the states with the highest rates of uninsured people, which just so happen to be the states where opposition to reform is strongest. Gallup found "large swaths of populations in the South and West" with large segments lacking coverage, and these are the same parts of the country with "the largest percentage of populations who believe widely perpetuated mistruths about the Obama agenda."

In other words, those in states that stand to benefit most from reform have been convinced to oppose reform.

Focus on Justice Makes Health Solution Obvious
At its core, our health care debate is also about justice. Unlike most developed nations, we continue to treat health care as a commodity. We ration it (no nation has the resources to meet all its citizens’ health care needs), but we ration capriciously, by income and employment.

Ironically, the cure is right at our fingertips: Simply expand Medicare to all Americans.

Dear President Obama
It would be so easy. You don’t have to reinvent the wheel with this so-called “public option” that’s a whole new program from the ground up. Medicare already exists. It works. [...]

Most of us will do damn near anything to get out from under the thumbs of the multi-millionaire CEOs who are running our current insurance programs. Sign me up!

This lets you blow up all the rumors about death panels and grandma and everything else: everybody knows what Medicare is. Those who scorn it can go with Blue Cross. Those who like it can buy into it. Simplicity itself.


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