Consumer Reports and Health Care

I suspect that almost all my readers have at some time turned to a reliable source for information about the safety, reliability, and value of a home appliance, a car, an electronic device, a computer, a packaged food product, or even a mutual fund. One such source stands out for its fairness, thoroughness, independence, and reliability: Consumer Reports, published by the Consumers Union. We know their ratings by the familiar circles:
On the other hand, we have also probably made choices based on a friend's preference, celebrity association, or what "a guy who knows a guy" said. Some of those choices have come back to bite us. That's why we learned to go to a reliable source.

So when the internet, the airwaves, the cable networks, and the water cooler talk is full of all kinds of ridiculous claims about health care reform, we need a place to turn. Some say the proposals will solve all our health care problems. Does anyone really believe that? Others say to adopt these proposals will set us on the path of becoming like Soviet Russia. That is also preposterous. So where can we go to hear from someone who is looking out for consumers? Glen Beck? Ken Olbermann? I don't think so. Both of them are trying to sell us something, to get their fingers in our wallets.

That's why when the Consumer Union provides a report on health care reform, I am interested. They are not trying to play with my emotions or trick me with a sleight of hand. They have in mind specific proposals that can help consumers, and others that can hurt us. They tell about both.

And the Consumers Union says that key elements of health care reform will make a big difference to help the masses of us who are drowning in rising health costs. Take a little time to look at what they say about requiring insurance companies to do things such as

• "Spend at least 85% of your premium on health care (at least 80% if you buy an individual policy or get your plan from a small employer), or rebate you the difference." That would stop them from robbing consumers to pay huge executive salaries.
• "Openly compete against each other for your business based on better care and price."
• "Clearly list what they charge, and what they cover, so you can easily comparison shop on the Internet."

They go on to say, "Of course, the industry is terrified that these controls will stop their greedy practices. Maybe that’s why they’ve been spending millions on lobbying and scary ads to make sure you don’t get these and other guaranteed benefits in the health reform bill." For specific information about how the current proposals will keep costs down, look at their paper on Oversight of Insurance Companies, Control Over Costs.

For more good information, go see their proposals about health care reform at their Consumer Reports Health website.

Some Health Priorities

Saturday morning the Laymen's League at my church, Mt. Level Missionary Baptist Church, asked me to lead a discussion on health insurance reform. The people there were quite knowledgeable and had convictions about how these matters should be settled. We agreed on a list of priorities, which we put into a letter, signed, and sent to Representative David Price and Senators Kay Hagan and Richard Burr. If you agree with these priorities, why not contact your Congressional representatives, too. Here is a copy of our letter.

Members of the Laymen’s League

Mount Level Missionary Baptist Church

316 Hebron Road

Durham, NC 27704

September 19, 2009

Rep. David Price

411 W. Chapel Hill Street

NC Mutual Building, 9th Floor

Durham, NC 27701

Dear Rep. Price,

Today we met to discuss health insurance reform as part of our Laymen’s League Men’s Breakfast. Many of us are concerned about this issue because of its direct effects on our families. We want to make clear to you what we believe is important to include in any legislation that will set out to reform health insurance and health care access.

1. Everyone should have access to quality health care, regardless of income or age.
2. Young people should be able to continue longer on their parents’ insurance policies.
3. Insurance companies should not be able to exclude pre-existing conditions, drop coverage, deny benefits, and other forms of discrimination against the sick.
4. Insurance coverage should be fully portable regardless of whether a person gets a new job, loses her or his job, retires, or experiences other changes in employment.
5. Medicare should remain strong for senior citizens.
6. There should be caps on out-of-pocket expenses for any person or family, both annually and for a lifetime.No one should have to go bankrupt over health care costs.
7. Large employers should continue to contribute to health insurance costs.
8. Small businesses should have opportunities for the same affordable health insurance plans that large businesses have.
9. There should be prescription drug coverage without gaps.
10. People should be able to keep health insurance they like.
11. People should be able to choose their doctors.
12. Big insurance and health care monopolies should have to face real competition to bring prices down.
13. Health disparities affecting minorities should be addressed.
14. Chronic diseases such as diabetes, glaucoma, high blood pressure, and others should be priorities for affordable treatment.

We would appreciate hearing back from you concerning our priorities. Thank you for your hard work on our behalf.

Sincerely,

Robert Crouch, Chair (signatures on attached page)

Listing Reasons for Health Care Reform

I found an excellent summary of the reasons to support the current health care reform proposal. It came in an email from Health Care Can't Wait.

A lot of angry, over-the-top rhetoric is muddying our discussion of health care reform. To help clear things up, here’s a brief summary of President Obama’s plan, including how it will stop insurance company abuses and help you—even if you currently have a strong health benefits plan.

Health care reform will stop insurance company abuses.

• Insurance companies won’t be able to refuse to pay a claim or give you coverage because of “pre-existing” conditions.
• Your out-of-pocket expenses will be capped. No more going broke because of a serious illness or injury.
• Insurance companies won’t be allowed to charge women higher rates than men or drop you if you get sick.
• Insurance companies will have to cover your children until age 26 instead of dumping them at 19.

Health care reform will hold down rising costs.

• A public health insurance option will force private insurers to compete and will lower costs for everyone.
• By requiring companies to pay their fair share, we’ll stop them from dumping their health care costs on the rest of us.

Health reform means affordable care will be there for you, no matter what.

• If you lose your job,
  
• or your kid loses his.
  
• If you get sick.
  
• When you retire. Affordable health care will be there for you, no matter what. That means you and your family can’t fall through the cracks
  
• and won’t go broke because of health care bills.

The reality is that health care costs are spiraling out of control, and everyone in America deserves quality and affordable care. Health care reform simply can’t wait. We will all be better off with real reform.

There is a good new site to correct the masses of misinformation going on about health reform. People who believe in truth and morality need at least to listen to each other and make sure they are not running around fighting against empty enemies. There are no death panels. There is not a takeover of the health care system in this plan. Frankly, I wish the plan would do more than it does to reduce costs, but this is the compromise plan.

Even if You Have Employer-Subsidized Health Insurance, You Don't Really

At the excellent "think-tank" blog on economics and finance, The Baseline Scenario, James Kwak has posted an article on health insurance that draws back the curtains, blows away the fog, and shatters the mirrors of illusion. The "in-your-face" title is "You Do Not Have Health Insurance." He says that unless you are over 65 in the U. S., the word "insurance" does not really apply. I'll quote the first section to spell out the heart of his argument, which will knock you over.

Right now, it appears that the biggest barrier to health care reform is people who think that it will hurt them. According to a New York Times poll, “69 percent of respondents in the poll said they were concerned that the quality of their own care would decline if the government created a program that covers everyone.” Since most Americans currently have health insurance, they see reform as a poverty program – something that helps poor people and hurts them. If that’s what you think, then this post is for you.

You do not have health insurance. Let me repeat that. You do not have health insurance. (Unless you are over 65, in which case you do have health insurance. I’ll come back to that later.)

The point of insurance is to protect you against unlikely but damaging events. You are generally happy to pay premiums in all the years that nothing goes wrong (your house doesn’t burn down), because in exchange your insurer promises to be there in the one year that things do go wrong (your house burns down). That’s why, when shopping for insurance, you are supposed to look for a company that is financially sound – so they will be there when you need them.

If, like most people, your health coverage is through your employer or your spouse’s employer, that is not what you have. At some point in the future, you will get sick and need expensive health care. What are some of the things that could happen between now and then?

Your company could drop its health plan. According to the U.S. Census Bureau (see Table HIA-1), the percentage of the population covered by employer-based health insurance has fallen every year since 2000, from 64.2% to 59.3%.

You could lose your job. I don’t think I need to tell anyone what the unemployment rate is these days.

You could voluntarily leave your job, for example because you have to move to take care of an elderly relative.

You could get divorced from the spouse you depend on for health coverage.

For all of these reasons, you can’t count on your health insurer being there when you need it. That’s not insurance; that’s employer-subsidized health care for the duration of your employment.

Once you lose your employer-based coverage, for whatever reason, you’re in the individual market, where, you may be surprised to find, you have no right to affordable health insurance. An insurer can refuse to insure you or can charge you a premium you can’t afford because of your medical history. That’s the way a free market works: an insurer would be crazy to charge you less than the expected cost of your medical care (unless they can make it up on their healthy customers, which they can’t in the individual market).

In honor of the financial crisis, let’s also point out that all of these risks are correlated: being sick increases your chances of losing your job (and, probably, getting divorced); losing your job reduces your ability to afford health insurance.

There is more in the article, explaining some further dangers about companies rescinding policies, denying claims, not covering various critical procedures, and COBRA that help us realize how precarious our health coverage is. As he points out, unless your job is insured (there is no way you can lose your job or go out of business), your access to health care is not insured.

We need this reform. Make it plain to your Congressional Representatives.

Pay to Play: Health Lobbies Buy Their Access

"This is not a democracy. It's an auction." Those are the words of a bumper sticker we stuck on a car I used to own. The obscene amount of money that are spent to elect and influence government officials keeps growing because it works. Money keeps buying access. If you might have money to give, then candidates and incumbents want to talk with you. If you already gave money, they want to keep the relationship for next time. And savvy lobbyists know what kinds of assistance and treatment specific legislators want. They also know how to sway the direction of corporate news and the TV-watching and talk show-listening public. In U. S. politics, money makes the world go 'round.

Michael Winship of truthout reports that enormous amounts of money have been spent on lobbying against health care reform in the second quarter of 2009: over $133 million in three months from insurance companies, pharmaceutical companies, and hospital corporations alone. This does not include spending by other organizations such as the Chamber of Commerce and political action groups which is also on a grand scale.

According to community organizing, there are two kinds of power: organized money and organized people. Theodore Lowi, in The End of Liberalism, wrote that organized money had managed to dominate U. S. politics so heavily that we now operate by a de facto new constitution. Representative government flows from powerfully organized lobbies. Theologian John Howard Yoder warned Christians not to be fooled by the rhetoric of democracy, the rule of the people, when the U. S. polity is better described as a plutocracy, the rule of the wealthy.

There is faint hope in that community organizing has experienced a renaissance in the past quarter century. But grassroots movements still have most of their influence at the local level, and occasionally at the state level. There are ambitions for more national power from grassroots groups, but for now the organized money is in the lead.

I'm going to keep on asking folks to demand that Congress listen to the people and get us a universal health care plan that cuts costs and promotes preventive care. We may be a voice crying in the wilderness, but the voices of Isaiah and John both made a difference when they stood up for the truth.

Making the Message Plain on Health Care

Here is a short video made for TV that makes the key point about why the public option is so critical. A single-payer system would be even better, but a public option will address the key problem of uninsured people and rising costs by creating a different playing field for selling health insurance plans.

Asking for Too Little on Health Reform

I have been a fan of the single-payer approach to funding health care since the 80s. When the possibilities for reform in the 90s went corporate, then crashed, I was disappointed. Ever since, what has happened is the consolidation of Big Health and more and more interference with our health care decisions.

I have had to change primary physicians three times since the mid-1990s, even though I have stayed on the same health insurance plan. I am having all kinds of trouble getting my daughter an appointment with a doctor of her choice now that she has grown out of her pediatrics practice. The current system does not allow us to choose our own doctors. Bureaucrats in corporate offices tell us who to see.

My primary care physician changed practices last year, and my wife's primary care physician followed him a few months later because the big behemoth health provider in our town was giving them too many regulations and rules on how to practice and to whom they could make referrals. Now their new practice has joined a "health management" firm, and I can already feel the regimentation squeezing me when I go for an appointment.

When the Presidential campaigns were promoting health care reform, which everyone knows we need, the head honcho of my insurance provider started funding a media disinformation campaign to make sure that his high-profit non-profit could prevent competition that might bring down our costs. This disinformation is now widespread, and Big Health is winning the battle.

An article by Jeff Cohen at truthout got me thinking. I was campaigning for the "public option" as a form of competition to reduce health care funding and improve services. Yet I keep hearing people say, "I believe in the single-payer plan, but since that is not going to pass . . . ." Well maybe it is not going to pass, but it is the best solution. Why not ask for the best, and see how close to it the policy debate will move? To provide for more people, to reduce overhead and paperwork, to end profiteering by excluding the sick, to stop proliferation of unnecessary procedures, to make sure no one loses access to health care, we need a single-payer system. As my friend Steve Bumgardner keeps telling me, the Medicare system works and is already in place. As Cohen says, "Medicare for All" is the solution. Tell your Congressional Representatives to support HR 676, the Expanded Medicare for All Act.

Hagan Announces Support for Public Option

Thanks to Michael Westmoreland-White for finding this information. Talking Points Memo describes Hagan's press conference statement in support of the public insurance option. I know I did not make it happen with my letter and blog yesterday, but with the support of plenty of other folks, she saw the light. That's a big step in the right direction. Now we need to press on and get a bill passed without gutting it.

Questions to Ask Congress About Health Reform

I sent the following to the senators from NC about health reform. Something has to change. For now, my family is getting by pretty well, but it keeps getting harder. My wife and I have good jobs (at the moment), but many people who make less or have been laid off must be struggling seriously in this economy. Being poor ought not to mean that a person does not deserve medical care. I encourage you to ask for answers from your Senators and Congressional representatives.

My wife and I have watched our health costs skyrocket. Insurance is eating up more of our income each year. We worry about our kids who are approaching the age that they will not be our dependents. What will they do in an entry level job if health benefits keep being diminished?

Health care ought not to be a luxury. Everyone needs access. People should not have their finances ruined by a standard hospitalization.

A public healthcare option should be available to all citizens. That way, the semi-monopoly that exists as "private insurance" plans will have to compete with a plan that has its primary purpose the public health, not profits.

Do you support a public healthcare option as part of healthcare reform?

If so, do you support a public healthcare option that is available on day one?

Do you support a public healthcare option that is national, available everywhere, and accountable our government?

Do you support a public healthcare option that has the clout to establish rates with providers and big drug companies?

As a constituent, I would really like to know the answers to these questions. Please respond to these questions in writing via email.