Tag Archives: AHIP

One of the biggest selling points of the healthcare reform legislation — a reason why we are suppo

One of the biggest selling points of the healthcare reform legislation — a reason why we are supposed to just accept the massive concessions to the insurance industry and drug companies — has been the promise that the private insurers would finally be banned from the disgraceful practices of denying coverage to people with pre-existing conditions.

Well, not so fast, says a report in the Washington Post Sunday.

Reporter David Hilzenrath interviews several policy wonks and concludes that the insurers will still have a variety of ways to violate the spirit and intent of the law. For example:

they could try to cherry-pick through more subtle means. For example, offering free health club memberships tends to attract people who can use the equipment

Or how about this scam:

to avoid patients with costly, complicated medical conditions, health plans could include in their networks relatively few doctors who specialize in treating those conditions

Some are aware of the problem and trying to find ways to neutralize the abuses.  But, Hilzenrath adds,

Unless lawmakers tackle the problem effectively, a reformed health-care system could continue to reward insurers for avoiding rather than treating illness

We already know how accomplished they are at that practice, as was evident in the report last month from the California Nurses Association/National Nurses Organizing Committee that in California six of the largest insurers have rejected on annual average nearly one-fourth of all claims since 2002.

Here’s CNA/NNOC representative Donna Smith debating an insurance executive on the data on CBS Friday.

The insurance trade lobby AHIP (America’s Health Insurance Plans) agreed to the idea of what is called “guaranteed issue”, the willingness to sell policies to people even if they did once have acne or a yeast infection.

But only in exchange for an individual mandate forcing everyone not covered to buy insurance. Big of them.

The mandate alone will be a massive bailout, especially as accompanied by the public subsidies for middle income people to buy private insurance and what are, at best, dubious controls on price gouging by the insurers.

It’s not just that the insurers are greedy — well maybe just a little — but that their first obligation is to make profits, not to guarantee care.

As Hilzenrath notes:

AHIP has been trying to shape the legislation in ways that could help insurers attract the healthy and avoid the sick

And, they have long perfected marketing techniques to do so —

From the messages they advertise to the overall level of coverage they provide and the smallest enticements they add to their benefits packages.

Techniques for which they will now have a lot more money to exploit in advertising.

If we should have learned anything about the insurance industry, it’s that they can not be reformed, and will find ways to abuse whatever regulations and restrictions the Congress may impose.

That’s exactly why many of us have continued to advocate for removing their choke hold over our health care system by adopting a single payer/Medicare for all reform.

Rep. Anthony Weiner is sponsoring a Medicare for all amendment that will come up on the House floor presumably sometime this month.  And with the travesty that has been unrolling in the Senate Finance Committee, wouldn’t it be nice to see the House leaders walk into a conference committee session with Baucus and company with a Medicare for all bill on the table.

Ask your Congress member to support Medicare for all, for the best reform. It might be the best vote they will ever make.

Nurses Greet AHIP in San Diego: the Protests cont…

The tradition of brave and proud nurse activism for guaranteed healthcare on the single-payer model continued today thanks to Janice Webb, RN, and her nurse intervention at  the convention of the health insurance industry in San Diego, AHIP.  They’re the lobbyists for the insurance giants who make money by denying care to the very patients that Janice cares for at UC-San Diego Medical Center.

As nurses last month shook up the Senate Finance Committee, which led to an important meeting with Senate power broker Max Baucus’ office this week, Nurse Webb took her protest to directly challenge those who are at the main cog in our broken and dysfunctional health care system.  

With thousands of well-paid insurance executives around her waiting to hear from Jeb Bush and Howard Dean, Janice marched up to the stage at the San Diego Convention, where  the moderator was droning on about how hard AHIP is working to find healtcare solutions — meaning legislation that will protect their position at the center of power over our health and the profits they make from the pain and suffering of patients.

Taking the mike, Janice held up a copy of an $11 billion dollar check, Janice then declared, to a mix of cheers and boos, “Nurses have the solution.  You all need to get out of healthcare.  We took up a collection and want to present this check to you to go away so we can finally institute a humane single-payer system for this nation…everybody in, nobody out!”

Of course it did not last long.  Burly security men rushed the stage, grabbed Janice and a companion, and hustled them off.  Hysterical AHIP security guards angrily denounced Janice, and demanded her arrest.  

Instead, the police officers smiled, asked Janice if she had any warrants out, and started to describe the healthcare cutbacks they’re facing due to SDPD’s trouble with affording ever-rising insurance premiums, and escorted her outside  where she was given a raucous welcome from a crowd of nurses, teachers, patients, doctors, and progressive democrats.

Taking the mike again–this time to the cheers of the crowd, Janice said, “They refused my check of course, but they’ll take every bit of money my patients can come up with.  Insurance corporations, nurses and patients want you out of our lives!  How many lives ruined by these corporate executives?  How long will Washington let them deny care, delay care, cancel policies, buy off Washington policies, and masquerade their marketing plans as healthcare reform?  Forcing people to subsidize insurers is NOT healthcare reform.”

Janice was followed by Jeffrey Gordon, a Physicians for a National Health Program member, who brought along a half-dozen of his patients who have been bankrupted or sickened by their insurance companies. You probably saw the report today from PNHP how unpayable medical bills, and income lost as a result of illness, now account for a shocking 62 percent of personal bankruptcies, a number that is rising. Too bad the healthcare reform bills now being framed in the Senate won’t solve that problem — in fact, it will likely make it worse by forcing more people to buy insurance without effective cost controls for ever rising premiums and out of pocket costs.

Gordon told the crowd, “As I was driving here I knew I was in the right place because there’s a whole flock of corporate jets lined up right over there.  We’re here to tell AHIP that it’s time to get rid of their jets.”  He added, “The power of those people across the streets keep the people in Washington from talking about the real problems in healthcare in this nation.  And if you don’t make the right diagnosis there is not cure–which is to get rid of the health insurance industry.”

Jim Gothe, a board member of the California Teachers Association followed Gordon’s point, saying “the bad news is that they’re paying for this conventino with money from students, teachers, retiress.  What sense does that make?  Students are the future of this state!…CTA believes healthcare is a human right for all people.”  The local CTA rep, Kathy Rallings continued his point saying, “My one-year-old son had open heart surgery when he was 3 months old.  You know what that means?  He has a preexisting condition FOREVER.  That means his life will be spent following healthcare…not his dreams.”

It’s not too late.  We will get single-payer in this country because we cannot care for all our patients while also subsidizing AHIP.  Help it along.  Tell Max Baucus that he should still hold a hearing on single-payer, or co-sponsor one with the health committee to provide a real side by side comparison with the plans they are proposing, so the American people can judge for themselves which approach will really produce a reform plan that covers everyone, improves quality of care, and includes genuine cost controls — and gets the hands of AHIP off our necks once and for all.

Single payer activists from coast to coast have done a great job getting the message to Congress, but we have to keep it up. Please Fax Baucus and other committee chairs today.  Healthcare is too important to let Washington get wrong.

Pics  

The Health Care Reform Coalition Has Its Epiphany

(Not totally a local issue, but it involves a lot of local players, and continues on a subject that gets a lot of attention around here, so I thought I’d share.  Reprinted from my site.)

There’s something of a consensus that Netroots Nation didn’t offer enough adversarial panels and instead largely consisted of bloggers agreeing with one another.  But that’s not true.  I personally witnessed the most adversarial panel of the weekend, and it was spectacular, because finally, both factions of the debate about health care policy on the left were able to come together and understand the political contours of the brewing fight in the Congress.

over…

The panel was entitled “Time for Action: How the Netroots Can Lead on Healthcare Reform,” and was put together by Eve Gittleson, who blogs at Daily Kos under the moniker nyceve.  There’s a good liveblog of the panel here, but what you need to know is that Gittleson stacked the deck.  She had some great health care activists who are doing great work in different areas of the space: Giuseppe Del Priore, MD, MPH a New York cancer surgeon; Hilda Sarkisyan, whose daughter, Nataline, died after being denied a liver transplant by Cigna; Rocky Delgadillo, Los Angeles City Attorney, who is pursuing civil and criminal investigation into insurance practices; Geri Jenkins, RN a member of the Council of Presidents of the California Nurses Association/National Nurses Organizing Committee.  And then Ezra Klein, associate editor for The American Prospect and a health care policy guru, appeared at the end of the panel.  The aforementioned speakers were all powerful advocates.  Sarkysian, whose family HAD health insurance and still couldn’t get their daughter what she needed, said bluntly “This is not a good country anymore.”  Del Priore discussed the need for doctors and patients to handle questions of care and the need to arrest insurance executives for their crimes in denying coverage.  Rocky Delgadillo outlined the schemes, like rescission (even based on spousal applications), that insurers are engaging in to maximize profit at the expense of patient care.  He also mentioned how California regulators ignored a million-dollar fine to Blue Cross because they feared they would lose the case if it went to court, which is just unbelievable.  And Jenkins argued that the insurance industry will play no role in reforming health care, and we need to move immediately to a not-for-profit system.

Good points all.  And then Eve turned to Ezra:

Eve: Ezra, why does HCAN want to condemn Americans to this kind of system? I get confusing emails from Elizabeth Edwards and MoveOn talking about the atrocities of the insurance industry, then marginalizing the only viable solution. Can you explain this new Edwards HCAN initiative, the TV commercials, etc. . . What’s it all about? What are they trying to do? It seems there are three initiatives on the table–676, Wyden  and HCAN.  What’s wrong with Wyden and Edwards? And a follow-up…what can we realistically expect from President Obama?

I hope you don’t mind that I’m sand-bagging you. I love you, really, Ezra. I just don’t agree with you on this point.

This apparently startled Mr. Klein.  But for him to not know the position of Eve and the CNA and an activist like Hilda Sarkysian speaks a lot to his cloistered state in Washington.  Because I know all about this fight.  I made one positive comment about HCAN upon their launch and took massive amounts of crap for it.  I was called a defeatist and admonished for not being true to the cause.  My only point was that having an organization with $40 million dollars to spend on calling out health insurers on their garbage is going to be tremendously helpful to whatever reform we get through the Congress, and furthermore I didn’t see them having much of a place at the table in the policy debate.  In other words they were finally an organization concerned with moving public opinion and playing the health care debate out on political grounds rather than policy grounds.  And on the panel, Klein echoed the importance of politics over policy:

You can take a lot of approaches to health reform. You can emphasize policy, politics, principles, or some mix thereof. Judging from the panel, Health Care for All, and the California Nurses, could use a bit more politics in their approach. It was a panel about “health reform” — not care or policy, but “reform” — at a conference of engaged politicos that never mentioned the Senate, or votes, or the conditions required for presidential signature.

There was a lot of talk about “fighting” insurers and other special interests, but not much about what that fight will look like, or where it will take place, or who decides the winner. My argument, was that, for reformers, insurers aren’t the real enemy. Setting them up as the opponent actually gives them too much credit. Insurers are stupid, profit seeking beasts — the enemy is American politics, and in particular, the structural feature of the US Senate that have repeatedly killed health reform in the past. No matter what your policy preference, that’s where your organizing has to be focused, because that’s where the actual fight happens: In Congress. Not on panels, or on blogs, or among the Left. In the US Senate, where you have to get to 60, or at least figure out how to get rough Democratic unity for using budget reconciliation and then convince Kennedy and Carper to vote “aye” on the same bill.

This is basically the same argument Ezra makes continuously on his site, but it appeared to hit the audience like they never heard it before.  And considering that it’s largely the correct analysis, it was generally well-received, I thought.  I spoke later with Eve, who told me that she had a conversation with someone from HCAN and “they are not the enemy.”  What a concept – all elements of health care advocacy on the left working together, for a change, toward a common goal.

Now granted, this week they all had a big juicy target.  AHIP, the health insurance lobby, put together a fake grassroots front group called The Campaign for an American Solution.  Of course, that “solution” involves funneling more cash and customers to the same broken insurance system we have now.  Now, who was the very first group to coordinate a counter-attack on this front group on the first stop of their listening tour in Columbus, OH?  That’s right, HCAN

Well, that didn’t take long.

A day after Politico reported the health insurance industry is launching a health care reform campaign next week, the progressive reformers are firing back.

Health Care for America Now announced Friday that it plans a news conference and a rally next week to counter the insurance industry’s Campaign for an American Solution, which launches in Columbus, Ohio, on Tuesday with a roundtable discussion among uninsured locals.

“They’re pretending that the health industry represents the American public, and we need to make it really clear to them and the public that all they represent are their own profits,” said Richard Kirsch, national campaign manager for Health Care Now.

Indeed they did attend the launch, and got to ask some tough questions, confronting the head of AHIP and asking her how an insurance industry group could possibly be objective in pushing for lower rates and higher quality coverage when they are concerned solely with the profit motive.  It got heated, and I’m glad they did.  And all of a sudden, Daou’s Triangle started closing.  Rep. Pete Stark came up with a great quote:

“America’s Health Insurance Plans’ new ‘Campaign for an American Solution’ rings as true as the tobacco industry’s efforts to end smoking. There is nothing grassroots about it. It is designed, financed, and coordinated through their Washington trade association with the singular goal of protecting their profits.

“I hope it is true that these companies intend to be a positive force in health reform efforts, but I tend to be cautious when the fox starts drawing up plans for a new henhouse.”

HCAN called up the hotline for the Campaign for an American Solution that they set up for the public to provide input… and they got an answering machine.  They’ve trickled this out one by one and pretty much ruined the launch of AHIP’s front group.  That’s REALLY important for the future of health care reform.  Because on the policy the views are far closer on the left than most people imagine.  Everyone knows that whatever system is ultimately put forward can be paid for in a far better manner than the current wasteful, inefficient system.  So expense should never be a deterrent, meaning we can build whatever system we choose and it is extremely likely to go revenue-neutral very quickly once we eliminate the shoddy budgeting of the current broken system.  We know that health insurers will not jeopardize their profit margins unless they’re forced to.  Once you recognize these two realities, the policy goals become fairly clear.  The political goals have to include attack dogs pushing back on the false memes of the right and the insurance industry, and pressuring the Senate to do the right thing.

Now Obama’s plan includes some better regulation toward insurers (including guaranteed issue and community rating) and a public option to compete with the private insurance market and take the step toward a sequential single-payer.  (His latest addition to the plan, a tax credit for small businesses who offer quality health care, is borrowed directly from the Clinton plan, raising hopes that eventually he’ll just borrow all of it, as he should).  Despite this being a fairly modest set of reforms, McCain and the right are going to denounce it as government-run “Hillarycare” anyway.  So it’s vital to have a broad coalition to give as good as they’ll get from the right and give the lawmakers backbone to push the policy forward.  Matt Stoller writes:

Coalitions are strange beasts, with multiple moving parts, but they are also the only way anything gets done.  A coalition has a core of organizers behind it, and a variety of groups out in front who each take different roles.  Some people can talk to Republicans, some people can talk to Democrats, some people threaten, some people cajole, some people talk to businesses, etc.  HCAN is driven by labor in the form of SEIU, the NEA, AFSCME, and United Food and Commercial Workers, as well as groups primarily funded by labor such as Americans United for Change and the Campaign for America’s Future.  It is also driven by direct mail and Foundation based organizations,  such as La Raza, Planned Parenthood, Center for American Progress Action Fund, Center for Community Change, and the National Women’s Law Center.

Stoller goes on to make the point that HCAN should broaden their mandate and make this a fight about general health, and I agree.  Going after convenience stores that sell fatty, sugar-laden food to kids sounds like it could be a part of their mandate.  The farm bill, the transportation bill (more mass transit and more livable, walkable cities means healthier lives), and others could be brought onto the field of battle.  But the larger point is that coalitions of this nature are built because they work.  And the benefit is that they give lawmakers breathing space to do their job and the spine to do it right.  This moment in health care demands that everyone understands the political spade work necessary to reach the desired outcome.  So out of the ashes of that contentious NN panel came something pretty special.  Groups across the center-left ideological spectrum working together to end the health care crisis in America and restore treatment as a basic human right.

Why We Fight

I will be discussing this and other state political issues on KRXA 540 AM at 8 this morning

Today I will be in San Francisco for the National Day of Protest against health insurance corporations and for truly universal health care – which only a single-payer system can provide. I wanted to take a moment and explain why I will be out there demonstrating against these criminals.

I currently do not have health insurance. My part-time job does not offer it and when I last looked into individual coverage I could not afford what was being offered to me. But more importantly, it’s not health insurance that I need – but health care. They are not the same thing. Health insurance companies have a long and ugly record of denying care and claims even to those they insure. We have discussed here the horrifying stories of Nataline Sarkisyan and Nick Colombo, young people whose insurers denied them life-saving treatment until protests forced them to back down. In Nataline’s case, as we will never forget, it came too late, and she died.

Courage Campaign (where I do some work) has partnered with the California Nurses Association and LA City Attorney Rocky Delgadillo to put out an ad lambasting insurance company practices. It’s based on the true story of Patsy Bates whose health insurance was canceled by HealthNet in the midst of her chemo treatments for breast cancer.

Speaking for myself, I see this ad and the protest at Moscone Center as fundamentally linked. Health insurance is a toxin, not a cure – the profit motive means that there will always be a desire to cut benefits, even in spite of government regulations (the recission practices Delgadillo is investigating are currently illegal under CA state law but they happen anyway).

Last year I was one of the leading voices on this blog against the mandated insurance plan proposed by Arnold and nearly passed by the legislature. It was not going to succeed in making health care more affordable and it was not going to succeed in making it more available. Mandated insurance plans haven’t worked anywhere they’ve been tried in the US, including in Massachusetts – whereas single-payer systems have a long record of success around the world.

We protest, we fund ads, we get outraged, and we fight because we believe health care to be a fundamental human right. Every one of us deserves to have it when they need it, without regard to cost. When someone gets sick their first thought should not be “how will I pay for this?”

As we debate specific health care reforms, that focus on human rights needs to remain at the center of our work. Health insurance companies inherently disagree with it – to them health care is something only those who can afford it deserve to have. It is that mentality that we fight against and protest against today. I’m not naive; single-payer health care will not be an easy political victory. But as polls continue to show growing support for it, and growing revulsion at insurance company practices, it can’t hurt to give Californians a reminder of why their health care is so screwed up – insurance companies are at the core of the problem. Today, we fight back.

Terry McAuliffe to be Protested June 19th

AHIP, America’s Health Insurance Plans, decided downtown San Francisco would be a good place for the health insurance company lobbyists and executives to hold their convention. Not surprisingly, thousands of people will take to the streets at noon on June 19th at the Moscone center to protest getting ripped off by the health insurance companies and rally for SB 840 in California and HR 676 nationally.

One of the key people being protested is none other than former DNC Chair Terry McAuliffe who is a keynote speaker for the industry. Which adds some context to his quotes in yesterday’s New York Times on the Clintons’ enemies list and rewarding of friends:

“The Clintons get hundreds of requests for favors every week,” said Terry McAuliffe, the chairman of Mrs. Clinton’s presidential campaign. “Clearly, the people you’re going to do stuff for in the future are the people who have been there for you.”

Finally, we’ve recovered from McAuliffe’s disaster as DNC Chair when he ran it like the DLC and was proven incapable of moving beyond transactional politics to a post-McCain/Feingold fundraising party that isn’t a subsidiary of special interests. And yes, we’ve also moved beyond his success in perfectly executing a Clinton campaign strategy that took her from undisputed presidential front-runner to junior senator. But there is he is, using his name and connections to help out those who have helped them while Americans suffer.

In my opinion, one of the most important outcomes of Clinton’s loss was that they won’t get back control of the DNC — which is great news for Democrats. But T-Mac is a reminder that we all need due diligence in the process of choosing the next California Democratic Party Chair so that we can reform the CDP to also move into the 21st century.

Currently, there are 1,904 pledged attendees at the rally according to the neat online organizing tool. Check to see which groups have currently pledged how many, get your group involved, and join in this important event.

450 – California School Employees Assn.

400 – California Nurses Assn.

200 – California Alliance for Retired Americans

200 – California Universal Health Care Organizing Project

100 – Cindy Sheehan for Congress

54 – Others

50 – Green Party SF

47 – Health Care for All-Marin

40 – American Medical Student Association

30 – Gray Panthers SF

25 – Wellstone Democratic Renewal Club

25 – United Educators of San Francisco

20 – Amer. Fed. of Teachers, local 2121

20 – Neighbor to Neighbor

20 – West Country Seniors

20 – Senior Action Network

20 – Older Women’s League of San Francisco

20 – Hermanson for Congress

20 – HAT

20 – Green Party San Meteo

15 – California Physicians Alliance

15 – Socialist Action

14 – Health Care for All-Santa Cruz

12 – International Longshore and Warehouse Union, local 6

10 – California Alliance for Legislative Action

10 – Office and Professional Employees International Union, local 3

10 – San Francisco for Democracy

9 – American Postal Workers Union – SF

9 – UC-Santa Cruz students for Single Payer

5 – Chris Jackson for Community College Bd

5 – Young Workers United

4 – Health Care for All-Sonoma

4 – FORUM SF