Search Results for "poverty"
Senate Health Bill: Less, Later, and Holy Complexity Batman (P2)
Published November 20, 2009 @ 11:15AM PT
We covered the good parts of HR 3590, the new Senate healthcare reform bill, in Part 1. Now, on to the Less, Later, and Holy Complexity Batman aspects.
Less
- Numbers: HR 3590 costs less than the House bill, $849 billion vs. $894 billion. It lowers the deficit less, $127 vs $139 billion (see more dollar comparisons here.) It manages this by covering less of the population (94% vs 96%) and delaying major insurance reform. That costs less, but it also does less. There are also unintended consequences like skyrocketing insurance premiums prior to 2014 due to implementation of consumer protections in 2010. Hey, if private insurers have to pay out and can’t get rid of you, they are going to charge more. Plus in 2014 they’ll have to take riskier customers. Their business is to make money, not spend it; they’ll circle the wagons.
Does the New Senate Health Care Bill Get the Job Done?, Pt 2
Published November 19, 2009 @ 12:37PM PT
In evaluating the new Senate bill, I’m defining “get the job done” not through how well it does on creating the tools for serious cost control (Ezra Klein is your man for that), nor am I defining success as winning the enmity of health insurance companies, although Wall Street clearly hates this bill -- in and of itself reason to be optimistic about its effect for Main street! No, for right now I'm solely looking at the bill through the lens of whether it does enough to make health insurance affordable both to those who already have it and those currently uninsured who would get it under the Health Exchange.
In Part 1, I shared my relief at some strong changes Sen. Harry Reid had made to his predecessor bills from Senate Finance and Senate Health, Education, Labor and Pensions, causing me to say, “Woohoo!” But there are other elements of the bill that should help keep coverage affordable for the vast majority of Americans, even if they're less spectacular.
Under “Meh,” we have one bad idea from Finance that’s been kicked to the curb, provisions for Medicaid which, after much ado, are exactly where we thought they’d be, and Reid’s compromise “state opt-out” public option, which is slightly worse than we thought it’d be, although it's less because the idea is unsound and more because we're making it compete with one arm tied behind it's back.
Does the New Senate Health Care Bill Get the Job Done?, Pt 1
Published November 19, 2009 @ 01:05AM PT
Senate Majority Leader Harry Reid scheduled a press conference for this Thursday to formally unveil the long, long, LONG-anticipated full Senate bill. Which of course means it all leaked semi-intentionally Wednesday night. (Man, I’m glad the Senate isn’t in charge of keeping state secrets… oh wait…)
The initial reporting will largely focus on the sheer scope of reforms in the bill and the superficial price tag as scored by the Congressional Budget Office -- $848 billion over 10 years while reducing the deficit by nearly $130 billion. Democrats will champion the expansion of coverage to 94% of Americans and how the cost-controls in the bill reduce the deficit even more past the 10-year window. Republicans will blast the sheer length of the bill (2,074 pages, which honestly seems like a bargain considering the complexity of the issue) and their usual nonsense about government takeovers, death panels, and how cutting a single dollar from Medicare waste will make the Virgin Mary cry. And of course those not content to actually talk about reforming our morally and economically bankrupt health care system will get drawn into sideshows about Reid reverting to the same abortion language we’ve talked about all year, or the titillation of something we’ll all come to know as “the Botox tax.”
But before the madness of political punditry overtakes us, allow me to focus on one key question that will unquestionably get lost in the shuffle. Does this new Patient Protection and Affordable Care Act do enough to put quality health care coverage affordable to low- and middle-income families? At the end of the day, if we haven’t made standard, comprehensive coverage within reach of the pocketbooks of working families in America, we just haven’t gotten the job done.
5 Steps to Get Americans on Board With Health Reform
Published November 18, 2009 @ 06:00AM PT
The latest AP poll repeated the same tired trends in public healthcare reform sentiment. We are generally for it, until pollsters start presenting aspects as trade-offs. Once they hit one that resonates with one of us, we will promptly be against reform. We really can’t help it. As Change.org members regularly point out, we’re not a country that values solidarity, social worth or even basic human rights when they interfere with profits and self-interest. The United States is the nation of Me, not of Us. So, given we are unlikely to change our basic fabric any time soon, how do we get the public on board with meaningful healthcare reform?
I have the solution, and all it takes is 5 simple steps in public education. Before any of our brethren is allowed to answer another popular opinion poll regarding healthcare reform, they will be required to dig up one simple piece of information and digest 4 more. Follow these steps, and I predict a 99% "for healthcare reform" rating in the next poll.
Is National Healthcare Reform Repeating Massachusetts' Mistakes?
Published November 10, 2009 @ 06:00AM PT
So where are we, as a nation, on health reform? You can compare the plans currently in play in an excellent summary here. But I can sum it up in two words: Massachusetts 2.0. Remember, MA was the first state to require all residents to have health insurance, with hardship exceptions. This was coupled with an employer mandate. It now has the highest percent insured population in the country, 97.4%. It is also drowning in healthcare costs, and looking for ways to cover them. The basis of its model: expand private insurance and use public insurance as a safety net. That has a familiar homey (or should I say House-y) ring to it, doesn’t it?
Given that Obama has studiously avoided talking about, much less praising, the MA effort, it’s ironic that Congressional efforts have mirrored this universal coverage pilot so closely. For instance, MA took the Congressional approach of tackling coverage first, and costs later. Nearly five years after its inception, MA universal healthcare is encountering steep resistance to proposed measures that would bend the cost curve, like Pay For Performance programs. As a result, insurance premiums continue to rise. They are expected to go up 10% for 2010. That’s not a good omen, as both chambers of Congress rely primarily on Medicare reimbursement cuts and pilot P4P programs to achieve cost savings.
More ominous yet, doctors in MA are cherry-picking patients based on their insurance plans. In MA as everywhere else, there is a shortage of primary care physicians. When demand is greater than supply, power shifts to those who provide the service. The complexity of the insurance behemoth wasn’t addressed during the MA overhaul, and it was in fact strengthened by a coverage mandate that did nothing to decrease insurance administrative bureaucracy. So doctors continue to pay for their correspondingly large administrative staff by preferentially seeing private plan patients. Some actually refuse to see poor patients on state-subsidized public plans.
Can Children Get Congress To Protect Their Health?
Published November 04, 2009 @ 06:43AM PT
Marian Wright Edelman is a lifelong advocate for disadvantaged Americans and is the President of the Children's Defense Fund (CDF).
In 1931, Grace Abbott, the Chief of the U.S. Children’s Bureau, gave a speech about her long and frustrating workdays in our nation’s capital trying to advocate for children’s needs. She said she felt all alone standing with her baby carriage on the sidewalk watching a great traffic jam moving toward the Capitol where Congress sits.
She saw all kinds of vehicles including the tanks and trucks the Army put into the street; "the handsome limousines in which the Department of Commerce rides…the barouches in which the Department of State rides with such dignity…[and] the noisy patrols in which the Department of Justice officials sometimes appear." And so she stood on the sidewalk watching, "because the responsibility is mine and I must, I take a very firm hold on the handles of the baby carriage and I wheel it into the traffic."
And so must we parents and grandparents and child care providers and educators grab the handles of our baby strollers and the hand of our children and walk into the traffic headed for Congress. We must make them hear and respond to the urgent, but still too ignored, needs of our 8.1 million uninsured children. We must break through the political den of powerful special interests like the insurance and drug companies with their fleet of well paid lobbyists.
Today, the Children’s Defense Fund is organizing a Champions for Children’s Health Stroller Brigade in the nation’s Capitol to send an urgent and clear message to our political leaders that real health reform for children must be enacted this year. Children’s unmet health needs have been lost in the debate’s "big" issues. Unless we act now, millions of children could be worse, rather than better off, as a result of pending health reform legislation.
Many Roads to Divide and Conquer Healthcare
Published November 04, 2009 @ 06:05AM PT
Have you noticed throughout the healthcare reform debate that most everyone seems unable to see the forest for the trees? We get hung up on illegal immigrants, abortion, the disabled, the poor, the pre-existing conditions crowd, the young, the old, the military, the employed, the self-employed, the government-employed, retired union members, small businesses, and large businesses. So much minutia, so little time. What if didn’t have to be like this?
As we know, there’s a plan for everything. Over 65 or disabled? There’s Medicare and perhaps CLASS. In poverty? There’s Medicaid. Slightly over the poverty line? We’ve got an Exchange for you. Eligible child? Try S-CHIP. Employed? Let’s hope your employer offers one of the 1,300 high-cost private health plans. Self-employed or unemployed? Good luck with that, try the Exchange. Got a pre-existing condition? We’ve got a risk pool with a waiting list that you can’t afford anyway. Work for the government? You’re in luck – it’s got the widest selection of health plans available in the US! All this complexity and division puts patients themselves at a decided disadvantage.
