Wednesday, October 28, 2009

Keeping up the pressure


That's the number to call every day for the next few weeks. I personally think the health care bill in the House is still worth supporting, although it could certainly be strengthened.

For instance, the prospect of a "public option" that quickly becomes nothing but expensive dumping ground is deeply disturbing for reasons both pragmatic and political. Call the teenagers working for your Representative and your Senator and demand that they work to make the public option stronger. (Your background music will be like the comic relief in a busy day for Blue Dogs who already helped insurance companies win big and are now desperately working to deny care to immigrants and women needing abortions. No wonder they no longer answer their phones).


[As currently conceived] the public option would barely make it into the list of top 10 US health insurers. And the opt-out provision could cut enrollment by another 20%(2) or more.

Remember: No other insurance companies will be told where and how they can compete -- only the "public option." How is that a "level playing field"? The end result is likely to be something called a public option, which is used primarily to placate progressives -- and which provides the political cover needed to force people to pay usurious private-insurance premiums. When this pseudo-public plan fails to deliver savings, reform opponents will use its failures as proof that public insurance doesn't work.

That would make the watered-down "public option" worse than no public option at all. One suggestion: Write or call your Representative and ask that they...restore the robust plan...and while you're on the phone, here are a few other things you might mention:

The Wyden "Free Choice" Amendment:
The President and other Democrats told the American people they would provide "all Americans" with the choice of a public option. Instead, they've artificially restricted access to it (while leaving private insurers free to pursue everyone). The Wyden Amendment will deliver what the Democrats promised, and will lower overall health costs.

The Kucinich Amendment
: The so-called Kucinich Amendment would have allowed states to opt out of the Federal system to create intrastate single-payer plans. It was approved by the Education and Labor Committee, but was stripped from the final House bill. The end result? The Senate says states can "opt out" of the public option, but the House says they can't opt out of the private system. That doesn't seem right.

Tolerable premiums and out-of-pocket costs
: It's hard to ask a family of four living on $88,000 to pay 12% of its income in premiums, yet still face $1,500-per-person copays and total possible costs of $10,000 per year. (That's better than the Senate version, however.) These provisions have to be made less onerous for working families. Health analysts used to employ a guideline that said 12% of family income should be the total expense for healthcare, or the "ceiling" on possible health costs, not - as this bill would have it - the floor or minimum cost.

No dumping or foul play
: Many of the insurance industry's bad behaviors are banned by the House bill (which, complaints aside, has many good features.) But there need to be stronger protections against subtle abuses designed to drive sick people out of private plans. These abuses might include planned provider shortages in needed specialties (e.g. oncology, high-risk neonatology), delays in claims payment, and obstructionist use of prior authorization program.

Make drug costs manageable: Jane Hamsher describes the perils faced by breast cancer patients, and those with other conditions that require expensive patented drugs. Many of Jane's concerns will be addressed by the bill's caps on out-of-pocket costs, and by the elimination of lifetime maximums. But more should be done to ensure that drugs are made generic as quickly as possible, and to restrict the insurance industry practice of labeling them "experimental" and refusing to cover them.

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