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BRER RABBIT AND HEALTH CARE REFORM

My friend and fellow activist Santiago Leon just wrote this story, and I asked him if I could share it:

BRER RABBIT AND HEALTH CARE REFORM

You may be familiar with the story of Brer Rabbit and the tar baby from the Uncle Remus books. Brer Rabbit repeatedly outsmarts Brer Fox, who is constantly chasing him. At one point, Brer Rabbit is finally caught:.

“I’ve got you this time, Brer Rabbit,” said Brer Fox, jumping up and shaking off the dust. “You’ve sassed me for the very last time. Now I wonder what I should do with you?”

Brer Rabbit’s eyes got very large. “Oh please Brer Fox, whatever you do, please don’t throw me into the briar patch.”

After some conversation, Brer Fox does indeed toss Brer Rabbit into the briar patch. He listens for whimpers of pain. Instead, a minute or two later, he hears a familiar voice calling him from the top of the nearest hill:

“I was bred and born in the briar patch, Brer Fox,” he called. “Born and bred in the briar patch.” And Brer Rabbit “skipped away as merry as a cricket while Brer Fox ground his teeth in rage and went home.”

Why does the current health care commotion remind me of this story? Consider: we are told that something must be done about the insurance companies- they turn people down, they exclude pre-existing conditions, they cap lifetime benefits, they charge older people more than younger people and charge sick people more than healthy people. So Congress comes up with a health plan that prohibits the insurance companies from doing all those bad things- Brer Fox has finally caught Brer Rabbit!

What is the practical significance to the insurance companies of being told not to do all those wicked things? Well, why do insurance companies do those things in the first place? They do them to limit their risk of having to pay claims. And of course, if any one insurance company stopped doing those things, that insurance company would get all the sick people, would therefore have to raise its premiums and would therefore become uncompetitive. However, if Congress tells ALL the insurance companies not to do those things, then ALL of them can stop without fear of a competitive disadvantage. In practical terms, this means that all the insurance companies can reduce the number of people involved in those claims-reducing activities, which on the face of it would allow them to keep a higher percentage of the premiums they collect- good news for the insurance companies. However, not so fast- Congress may require the insurers to pay out a minimum of 85% of premiums in claims, which is a little more than they do now, so it looks as if they would not benefit from the reduction in administrative costs after all. But guess what? Since the insurance companies’ administrative costs will be reduced, they will now be able to keep a bigger slice of that 15% for executive salaries and profits. Bingo!

Furthermore, since the insurance companies are going to be required to accept all applicants, they will have more higher-cost enrollees and they will have to do what? Raise premiums, of course. Ordinarily that would be bad for business, except that Congress proposes to require everyone to buy insurance from these same companies, and plans to appropriate money to help them pay the premiums. Thus, as things are going, the final result of the health care reform process will be that insurance companies will have millions more customers, whose premiums are subsidized by the federal government. They will charge those customers (and all their existing customers) higher premiums than they do now, and they will have lower administrative costs. Small wonder, then, that the stock prices of health insurance companies have been rising.

What about Brer Rabbit? The insurance companies are about to be thrown into their version of the briar patch- a new world with millions of additional customers, subsidized premiums and reduced operating expenses. Little wonder that the insurance companies, despite a little quiet griping, have not turned on their giant propaganda machine to defeat health care reform- the reform plans could not be better for the insurers if they had written them. Of course, when you look at the recent increase in health care lobbying expenses, you realize that the insurance companies probably DID write the bills.

My prediction: when all is said and done, despite the bad-mouthing of the insurance companies by some legislators and advocacy groups, the insurance companies will “skip away as merry as a cricket.”

Santiago Leon is an insurance broker in South Miami who is active in progressive causes and health care reform.

Don’t forget to read the Comments

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Opportunity Squandered: health reform which is not change I can believe in. Lose/lose for the Democrats.

As a solid single payer advocate and Obama supporter who contributed and worked hard for his election, I am disgusted with the health reform proposals coming out of Congress. No serious cost control, no limit on what can be charged for policies, no limit on copays or deductibles, subsidies would be needed for 100 million Americans in addition to those on Medicare and subsidies are inadequate. Would surely increase the deficit as all entitlements do. Very likely to fail, as all individual mandate programs at the state level have done : Washington, Oregon, Tennessee, Mass. twice, Illinois, Maine, Vermont, usually within 3 years due to cost overruns. These proposals were written with only industry lobbyists at the table and are a gift to industry. Millions of policies and pills to be sold and insurance industry licking its chops as long as public option not included. Industry spending 150 million in August alone for TV spots to promote. Dems are in lose/lose state here. If this passes, it will cost a bundle and go over budget and likely fail since there is no cost control (some elements like preexisting conditions and lifetime caps are good but will cause insurers to raise rates) then Dems will lose “tax and spend” and “gov’t can’t do anything right” etc. True reform which this is not, would be set back a decade. Horrible. Best to kill this gift to industry written by industry lobbyists ASAP then go back to the drawing table without lobbyists. Proposal is patterned after the Mass plan written by Blue Cross and now failing due to cost overruns. Sick.

“I Don’t Want Forced Insurance”: A Letter You Can Fax In Your Name Via The Health Justice Website

You can send a fax in three simple steps via the website of Health Justice. There are several subject lines to choose from in regards to health care reform, each taking a different angle and priority. In regards to David Carr’s latest post on the subject here on BlueBroward.org, here’s one of the letters on the Health Justice website at www.1payer.net that pretty succinctly addresses a counter argument to what David wrote:

Mr. President and Legislators,

You have enunciated two principles of health reform. Both are based on a flawed understanding of what Americans need and want. Clearly you have been sheltered for too long in Washington.

The first flawed principle is the mistaken belief that Americans want to “keep the plan they have.” Nothing could be farther from the truth. I have been insured and I most decidedly DO NOT WANT to keep the plan I have. The health insurance companies are middlemen that tack a 15% “handling fee” on top of everything. The insurance company tells my doctor how she can (and cannot) treat me. The insurance company haggles with my doctor and me over payment of bills. The insurance company denies care with even the flimsiest excuse. How can you possibly believe that Americans have any desire to keep any health insurance company in business?

Allied to this ludicrous notion that any American “likes” health insurance that makes every effort to fleece us is the equally ridiculous notion that the Massachusetts forced insurance model is working or can ever work. Open your eyes, Mr. Legislator. Forced insurance is failing the people of Massachusetts. They face the choice of $800/month premiums for completely inadequate health insurance or being criminalized for not paying this outrageous premium. What kind of choice is that? Are you prepared to criminalize the choice of 50 million people who cannot afford or don’t want to boost the profits of health insurance companies by buying egregiously expensive and totally inadequate insurance policies?

The only real solution is the one that you and everyone else knows is the real solution; you are apparently too afraid of the insurance industry to recognize it. The only real solution is Expanded and Improved Medicare For All, similar to what is proposed by HR 676. Have some courage. Become a leader. Vote for what is right, not for what is wrong.

Health Care Reform and the Right Compromise

The emotional state of grassroots advocates for health care reform is precarious right now, something like the period in which Obama was on his way to winning the nomination but looked like he might get there too wounded to win the general election, thanks to the Rev. Wright controversy and intramural fighting with the Clinton campaign. Obama sometimes dithered or suffered from self-inflicted wounds. Democrats were split and we wondered if they could be united in time to win the presidency.

Currently, some activists are afflicted with doubt about how much effort to put into working for the President’s agenda when we’re not sure quite what that is. Is the public option an “essential element,” or is it something he is willing to compromise away in search of Republican votes that will never materialize?

Those who think a single payer plan is the right choice, and this public option stuff is already too much of a compromise, are particularly incensed. They see the emergence of some bastard co-op plan that will really be a way of funneling money to the insurance companies.

But just this last week, there have been several news analysis stories saying that the Democrats are now ready to push through a plan on a party-line vote, given that the Republicans seem united in opposing any semi-serious plan, compromise or no compromise. This does open up the possibility of Democrats solidifying their own positions – provided, of course, that we can round up enough Democratic votes for the same plan.

The best spin I can put on all this is that Obama has merely been trying to avoid sounding dogmatic when he says he is open to compromise on the public option. In principle, there might be many ways of structuring a plan to compete with traditional health insurance companies. He articulated it that way in a conference call with bloggers a few weeks ago, as reported in the Daily Kos:

With the topic the public option, and the fact that the Senate Finance committee is still considering the coop model as an alternative, I asked whether there was a coop model that would be an acceptable substitute to his vision of a robust public plan. He [Obama] gave the well-informed, wonky answer I’d been hoping for. His advisers have been looking at the details the coop approach, and have yet to find a model that answers the problems that co-ops have in getting off the ground and growing quickly enough to compete at the level that will be necessary in a public option. His team is looking for the evidence that exists to show that a co-op could provide that competition, and if they can find it, it might be an option. He then reiterated his commitment to having a robust public option.

Since then, however, it’s true that he has made several statements about the public option being “only a small part” of the overall plan.

If he really does fold like a cheap map, expect serious consequences. To quote from another Daily Kos post:

If the White House does end up letting the public option disappear without a major fight, many of President Obama’s most ardent supporters, inspired by his “Yes we can” attitude, will withdraw from politics, their previous cynicism once again affirmed by a broken system.

I think it’s important for the grass roots to send a clear message that he was right the first time, and that the public option really is essential, that it’s the right compromise, a necessary compromise – but also the farthest we should go in search of compromise.

Why Reaching for Single Payer Would Be Over-Reaching

I highly recommend reading Atul Gawande’s essay in the New Yorker, “Getting There from Here: How should Obama reform health care?” A key passage from the introduction talks about the single payer idealists and their contempt for those who portray themselves as pragmatists and compromisers:

The country has this one chance, the idealist maintains, to sweep away our inhumane, wasteful patchwork system and replace it with something new and more rational. So we should prepare for a bold overhaul, just as every other Western democracy has. True reform requires transformation at a stroke. But is this really the way it has occurred in other countries? The answer is no. And the reality of how health reform has come about elsewhere is both surprising and instructive.

He goes on to describe how the more universal plans that exist in other industrialized nations are all different in their particulars, and all arose evolutionarily rather than revolutionarily. One important difference is that nations like the U.K. made the transition at the end of World War II, building on institutions that had been established during wartime. That was the road not taken in the U.S., which instead built employer-sponsored healthcare into a powerful institution.

Perhaps we could have made a different choice in the 1940s and been the better for it. But today health insurance is something like a $400 billion industry (combined revenues, according to a 2007 survey). UnitedHealth Group alone had revenue of $81 billion and employs more than 70,000 people. You say the profits are criminal, and the employees are all uncaring jerks? Hey, I’ve had to fight to get them to pay claims, and I have no love lost for them or any other health insurer I’ve had the misfortune to deal with. But the corporations who profit from the current system and the employees who work in it aren’t just going to fall on their swords for the good of the nation. The stockholders are pension funds and grandmothers, not just robber barons. Some of those employees are good people, trying to do their best within the system, who are also Moms and Dads and friends whom we would hate to see lose their jobs, if we only knew them.

So the revolutionary overhaul that would sweep all that away and replace it with a supersized incarnation of Medicare seems to me to be a fantasy. I’m not even convinced it would be an improvement. The people who think the government can never do anything right (and therefore we can never trust it with anything important) are wrong, but so is anyone who thinks the government can never screw anything up. Good intentions can and do go horribly wrong. There is also a substantial body of management theory on how to achieve systemic change that suggests “big bang” overhauls that try to change everything at once run a much higher risk of failure than processes built around incremental change.

So when Obama talked in one of his recent Town Hall meetings about believing that a shift from our current system to single payer would be “too disruptive,” he had me nodding along with him.

So what’s the right balance between a change that is too incremental and timid and one that’s too radical? The plan for a “public option” seems to me to strike about the right balance, particularly if combined with tighter regulation to prevent health insurers from cherry-picking the people they insure and inflating profits with non-payment of claims. If we can establish a publicly-sponsored plan that sets a baseline of acceptable coverage, and make insurers compete to show that what they offer is superior, then we ought to achieve a better result. I’m not expecting a perfect result, but I do want to see a significant improvement, with room for further improvements to follow.

As Paul Krugman recently pointed out in the New York Times, those who decry this as a step toward something like the U.K. health system are way off base. The most ambitious of the current plans would leave us with a hybrid system of public incentives and regulation over private insurance, more similar to what they wound up with in Switzerland:

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

We need a system that works and that is a significant advance over what we have now. There are necessary compromises required to achieve it. But we can’t compromise away the whole goal.

Campaign Webmaster for Hire

While my initial motivation for starting BlueBroward.org was simply to help promote better grassroots organization of Broward Democrats, these days I do also have a crass commercial motivation. I’ve built up a business as a webmaster for hire, not only for campaigns but for small businesses and community organizations.

Actually, while it may be crass, this gambit hasn’t been as commercially successful as I’d like it to be. I need to work on my shameless self-promotion skills! So here I am asking for introductions to candidates you know who may need a website, or may need a better website. More details here: Campaign Website Package.

I’m also looking for small business clients, and there’s more detail about my services in general at carrcommunications.com.

Thanks for your help.

Fighting for Florida: Senator Dave Aronberg, YOUR Voice in Tallahassee!

I was born and raised in Florida my entire life, and although I’m still in High School, I keep up with the news and politics just as well as, and perhaps in greater detail than, your average College-educated Adult.

The political machine in Tallahassee never ceases to amaze me. From attempting to privatize Alligator Alley, to rewarding private contractors with automatic pay raises, many Floridians have given up on the idea of public servants actually standing up for their rights and being the voice of the ever increasingly “voiceless” consumer.

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But not so fast! There’s a rising star in Florida, and he’s standing with everyday Floridians no matter what. State Senator Dave Aronberg, a Democrat representing Green Acres, has continually fought for the little guy in his 10 plus years of public service. And Dave wants to continue his record of protecting the interests of everyday Floridians to the Attorney General’s Office.

Dave has been called “the strongest consumer advocate in Tallahassee” (Sun-Sentinel), and boy does he have the record to prove it! After graduating from Harvard University and then Harvard Law, Aronberg wasted no time getting right to work.

As an attorney, Aronberg worked closely with future Senator Bill Nelson to investigate and prosecute European insurance companies that refused to honor World War II-era policies sold to victims of the Holocaust. Dave was so successful defending victims of special interests money games, he became Assistant Attorney General for Economic Crimes, where he prosecuted cases such as the famous fake Shaman “Miss Cleo”.

In 2000, Dave was selected to be one of 15 White House Fellows from across the country. Perhaps the most prestigious fellowships in the Country, Dave served in two Presidential Administrations as Special Assistant to the Secretary of the Treasury Department for international money laundering.

Dave has served the consumer in the Senate for 6 years- now let’s continue in the Attorney General’s Office!

Then onto the Florida Senate to serve his fellow Floridians it was for Dave! It was here perhaps Aronberg realized his true calling- standing up for the everyday consumer and defending the interests of the state he loves so much.

The Senate’s youngest member, Aronberg wrote major consumer protection legislation, sat on the state’s Medicaid task force to enact major reforms to combat rampant fraud and abuse, and served as chair of the state’s Joint Legislative Committee on Everglades Oversight, leading the Senate’s efforts to secure federal funding for Everglades restoration.

Dave’s Sex Predator Legislation

Perhaps the most obvious indicator of his commitment, Senator Aronberg has returned more than four million dollars to Floridians who have called with consumer complaints!

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I love Florida, and I care deeply about it’s future. The millions of Floridians who are written off by the fatcats in the political machine that is Tallahassee in favor of the special interests and big companies deserve a voice, they deserve someone who will defend their rights no matter what, a true consumer advocate- they deserve Senator Dave Aronberg as their next Attorney General!

Senator Dave Aronberg for Attorney General!

Pay Attention to what IS (and isn’t) actually in this “Reform”

I pose that it is the obedient “mainstream” dems that are obstructing any meaningful reform efforts by supporting what could only be described as a Robber Baron’s wet dream that abandons any pretense of attempting to solve the real issues the concept of “reform” was supposed to address. Operating cost savings (costs are increased by further complicating an already unweildly “system”), portability (not in the bills), universal comprehensive coverage (tiers of coverage), helping our businesses to compete globally ( actually increases their responsibilities).

Our meetings have become populated by people on one side obsessively supporting a “robust” public option that DOES NOT exist and people on the other side obsessively protesting a “death panel” that DOES NOT exist. Attempting to discuss facts with people that are in “deaf” fighting mode is non-productive. It’s also pointless right now. Even Business Week, which is a pro-business publication, thinks what is coming out of congress smells to high heaven and has made note of the fact that Big Insurance has the decks stacked on both sides this time. That’s bad. Either way this goes this time, Corporate America wins.

Ever noticed that what seems to get the lockstep, organized support of people, usually ends up benefitting corporate America? It used to be just the righties, but pay attention…. us lefties are now being “herded”, too. I’m guessing that would be because wherever there is the possibility of money, favors or strategy there is someone, flying whatever flag they have to, to organize the masses and make it happen. What’s going on now is nothing but pure theater.

This “reform” has mutated into mandated, forced payment to private insurance companies by every citizen and business in this country.

My question is why/how does anyone think supporting the massive expansion of private insurance is going to improve a system of private insurance that has been proven to not work?

What I’m saying is…everyone needs to stop with the knee-jerk support for things that they haven’t actually read and understood.

I understand the need to have hope but two of the three bills have already been written. The third one is coming from the Senate Finance Committee which is all Blue Dogs and Republicans, so you have to know that will also be pro-private insurance. Showing your support for a “robust” public option at this point will change nothing. The bills are already written. It’s done. Now you have to decide if you support what actually IS in the bills…. not what you wish/hope for.

On top of everything else, the reform everyone is supporting not only does nothing to aleviate the burden of employers providing healthcare, it increases the burden. That burden is what has been crippling our ability to compete in business globally and has caused the migration of our jobs and businesses to overseas. To countries where the employees are covered by THEIR country’s single payer system and our companies are not burdened.

I want to remind everyone that two of the main goals of the healthcare reform concept that we voted Obama in to make happen was to 1.) aleviate the burden of employee healthcare from our businesses so that our economy could grow and better compete with other countries and 2.) make it so that individuals would no longer have their healthcare tied to their jobs. This “reform” actually does the opposite. The employer insurance mandate and the 8% penalty on larger businesses that don’t provide that private insurance could be the difference between hiring more people and expanding or continued shrinkage, more employment cutbacks and no new job creation. There is also no language in these bills that guarantees any portability for that mandated employer-provided insurance. But there is language that prevents businesses from utilizing the now-impotent public option.

Please, please, please read the links below carefully, all the way through. These are not about how terrific single payer is. They address what this “reform”, going on right now, is about and address the “public option” in particular as put forth in the HR3200 bill from the House and the HELP Committee bill from the Senate. They explain how tiny it is, how few people it would actually effect, how attempting to implement it could a nightmare exercise in the chicken or the egg because it wouldn’t be “pre-populated” with patients and doctors and therefore couldn’t command significant discounts, how it has been set up so that if they actually can implement it, private insurance would control its rates, not the other way around with it “keeping private insurace honest” and how even if we had a “robust” public option (which we DO NOT) it still wouldn’t control many costs and why it wouldn’t. The reality of the public option (as designed by congress) is that it is nothing more than an entirely impotent red herring that has been used to get the uniformed sheeple behind this insanity. It appeals to the desperate masses but has been designed for failure.

These links also address other things that people have been told this reform will do and the fact that there is no language in any of the bills to support these claims.

The no-bargaining pharma deal is just a cherry on top of what will be a mandated corporate raid on the American people and businesses.

This isn’t taking Big Insurance and Big Pharma head on. This is promoting gifting them with our individual and public treasure.

The politicians are being opaque and unspecific about what is in these bills because if the specifics of them were clearly broadcast in a way that everyone could wrap their minds around, NO sane person would support it. The point is to keep the average person confused enough for them to run on trust.

I also suggested reading more about what Mitt Romney did to Massachusetts and the disaster that it has become with rates skyrocketing and coverage plummeting. The reason I suggest that is because what is coming out of congress mirrors that scenario and is largely based on that format.

My bet is that by the time this is done, and all three bills are reconciled, there will be no public option language in the final bill. It will end up being pure mandated private insurance.

President Obama no longer says a public option is an absolute requirement for this “reform”. In fact the phrase used now is “insurance reform”, not healthcare reform. And all 8 talking points that the Whitehouse sent out recently specifically say “Insurance Companies”. Not one word about public options and no use of the term “healthcare reform”.

If you’ll notice, President Obama has consistently changed his language to fit what congress has written. Not the other way around, as most people imagine it should be, where he says what he wants and Congress changes their language.

Hope can be important, but knowlege is more important. From there you can make an informed decision about whether you support what is actually being offered.

Many older people that have Medicare have talked about wanting things to be better for their kids. It’s important that they, also, make sure what they’re supporting will make their grown children’s lives better in reality, not theory.

This means weighing all facts, evidence and suppositions; not just passing along proscribed guidance taken at face value. This is just politics for Washington but it is real life and death for actual people.

Personally, I’m sick of hearing that we “have to realize we’re never going to get a perfect solution”. Why? WHY should we HAVE to accept that, when there is a perfect solution (and only 30 pages because it’s not convoluted vs. 1000+ pages each for HR3200 & HELP) and the only thing standing in the way is our politicians and their owners. Why do we have to keep being told that we HAVE to accept what they give us, until we say it to ourselves, even? Now there’s the jedi-mind-trick. To make us fatalistic and more accepting of whatever THEY decide we’re allowed to have and that we should be appreciative of whatever idiotic thing that is; because “at least we got something”. We’re much easier to deal with that way. We truly are a nation of sheeple. It has to stop.

Have a nice evening,

Tracie

http://njoneplan.files.wordpress.com/2009/04/public_option_myths_and_facts-1.pdf

http://www.healthcare-now.org/bait-and-switch-how-the-“public-option”-was-sold/ by Kip Sullivan

http://www.pnhp.org/news/2009/july/more_of_the_same_is_.php by Leonard Rodberg, PhD

Surrender Reform Foes, or Be Destroyed!

I never thought I would compare Obama to Luke Skywalker, but after today’s Town Hall meeting I can’t resist.

“Return the Jedi” is my least favorite of the original Star Wars movies (though no worse than the more recent sequels). There’s a very silly sequence at the beginning where Luke and his friends seem to be loosing every fight and every attempt to escape from Jabba the Hutt. Our heroes are about to walk the plank and tumble into the maw of desert monster when Luke tells his captor, “This is your last chance Jabba…surrender…OR BE DESTROYED!” Jabba laughs, of course, but then it turns out R2-D2 is carrying Luke’s spare light sabre, and within minutes Luke has snatched victory from the maw of defeat.

Substitute Senate Minority Mitch McConnell for the alien mobster, and frothing-at-the-mouth wingnuts for Jabba’s sycophants. They may look like they’re winning, but they just don’t know what they are up against. Turns out Obama, our hero, has just been spotting them a few points to make the game more interesting.

I hope I’m right. Like a lot of people, I’ve been worrying that Obama and his administration are letting the chance of winning real reform slip away. But then I think about all the times over the year leading up to his election to the presidency when I thought he was losing. Times when Obama and Hillary Clinton were beating each other up and potentially creating openings for the Republicans in the process. Those dark days of the Jeremiah Wright controversy. Days when a few too many people interviewed on the news were expressing the belief that Obama was a Muslim, leading me to think he would be sunk by sheer stupidity. The aftermath of polls that showed the race very tight, tighter than it ever should have been, and pundits saying the support for Obama was actually weaker because of racist attitudes not necessarily captured by the polls.

Obama always showed an ability to make a comeback then. The Wright controversy was followed by a brilliant speech on race in America. Obama made peace with Hillary, and the supporters of the two weren’t as determined to tear their party apart as many Democrats feared at the time. The stupid people made the news, but the American electorate as a whole turned out not to be quite that stupid.

Ominous music swells in the background, all seems lost, and then comes hope and redemption.

I hope that’s what we’re seeing now, as Obama goes head on against absurd right wing talking points like “death panels” that are out to kill Grandma. I want to believe that all those dishonest tactics from the opposition will wind up making them look foolish, not make us feel foolish for ever believing in hope and change.

I found the Town Hall tremendously encouraging. Now, if Obama can just stay on message and keep making the case, without getting distracted by any more self-inflicted wounds that require a “beer summit” to put to rest.

That Luke Skywalker strategy is a little too stupid to work outside of a movie, and even that dunderhead Jedi probably wouldn’t try to pull it off twice.