Fact Sheet: The Health Care Bill

Jane Hamsher at Fire Dog Lake has put together a fact sheet about the "health care bill" (click on the title of this post for her original comments as well as references):

Myth	Truth
1. This is a universal health care bill.	The bill is neither universal health care nor universal health insurance. Per the CBO: Total uninsured in 2019 with no bill: 54 million Total uninsured in 2019 with Senate bill: 24 million (44%)
2. Insurance companies hate this bill	This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009. The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.
3. The bill will significantly bring down insurance premiums for most Americans.	The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised. Annual premiums in 2016, status quo / with bill: Small group market, single: $7,800 / $7,800 Small group market, family: $19,300 / $19,200 Large Group market, single: $7,400 / $7,300 Large group market, family: $21,100 / $21,300 Individual market, single: $5,500 / $5,800 Individual market, family: $13,100 / $15,200
4. The bill will make health care affordable for middle class Americans.	The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use. A family of four making $66,370 will be forced to pay $8,628 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income — out of which they would have to cover clothing, credit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.
5. This plan is similar to the Massachusetts plan, which makes health care affordable.	Many Massachusetts residents forgo health care because they can’t afford it. A 2009 study by the state of Massachusetts found that: 21% of residents forgo medical treatment because they can’t afford it, including 12% of children 18% have health insurance but can’t afford to use it
6. This bill provide health care to 31 million people who are currently uninsured.	This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies.
7. You can keep the insurance you have if you like it.	The excise tax will result in employers switching to plans with higher co-pays and fewer covered services. Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.
8. The “excise tax” will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages.	There is insufficient evidence that employers pass savings from reduced benefits on to employees.
9. This bill employs nearly every cost control idea available to bring down costs.	This bill does not bring down costs and leaves out nearly every key cost control measure, including: Public Option ($25-$110 billion) Medicare buy-in Drug reimportation ($19 billion) Medicare drug price negotiation ($300 billion) Shorter pathway to generic biologics ($71 billion)
10. The bill will require big companies like WalMart to provide insurance for their employees	The bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage.
11. The bill “bends the cost curve” on health care.	The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019. “Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries. In 2009, health care costs were 17.3% of GDP. Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP) Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)
12. The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition.	Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012 Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.
13. The bill prohibits dropping people in individual plans from coverage when they get sick.	The bill does not empower a regulatory body to keep people from being dropped when they’re sick. There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.
14. The bill ensures consumers have access to an effective internal and external appeals process to challenge new insurance plan decisions.	The “internal appeals process” is in the hands of the insurance companies themselves, and the “external” one is up to each state. Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal level.
15. This bill will stop insurance companies from hiking rates 30%-40% per year.	This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country.
16. When the bill passes, people will begin receiving benefits under this bill immediately	Most provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014. Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.
17. The bill creates a pathway for single payer.	Bernie Sanders’ provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn’t create a pathway for single payer. Obama told Dennis Kucinich that the Ohio Representative’s amendment is similar to Bernie Sanders’ provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system.
18. The bill will end medical bankruptcy and provide all Americans with peace of mind.	Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class. In 2009, 1.5 million Americans declared bankruptcy Of those, 62% were medically related Three-quarters of those had health insurance The Obama bill leaves 24 million without insurance The maximum yearly out-of-pocket limit for a family will be $11,900 on top of premiums A family with serious medical problems that last for a few years could easily be financially crushed by medical costs

Public option, private deals

As Miles Mogulescu writes at Huffington Post, even as Obama promoted the public option as a politically feasible compromise instead of Medicare for all -- and most analysts considered it to be politically necessary if not having health insurance was to be criminalized -- he had already promised the pharmaceutical and hospital industries that it would not be in the final bill.

One big sham.

The Democrats now do the work of the Republicans, and the Republicans benefit by opposing the obviously shitty result, eventually regaining control of government, when they in turn will provide the means for the Democrats to regain control. Round and round we go, both parties taking turns being the spokesman for the same moneyed interests, a tiresome game of good cop–bad cop but with grave consequences that nobody can any longer deny (endless expanding war, widening gap between rich and poor, disappearance of the middle class).

Unfortunately, that's how our "democracy" is set up: like a sports contest. Winner-takes-all is not representative democracy. And it has now been perfected to the opposite of democracy, in which our only choice is to vote against someone, since there is nothing to vote for.

[Election Reform]

Doug Racine sabotages single-payer in Vermont

As reported last week, gubernatorial candidate Senator Doug Racine "unveiled his long-awaited health care reform bill", In fact, his bill is a revision of S.88, an already-introduced bill to establish a single-payer system and universal coverage in Vermont (along with its companion bill in the house, H.100). Racine's version, however, changes it to instead establish a committee to study a few options for a couple of years that might then move us towards universal "access".

This is despicable.

human rights, Vermont

President has made a mess of health care reform

Douglas Turner writes in The Buffalo News (click the title of this post):

A year ago President Obama strolled confidently into the garden of good and evil, bit deeply into the apple and created the mess he and congressional Democrats are in now concerning health insurance reform.

Only a few heady weeks into his presidency, Obama called his first White House health care summit. It was not with those who got him elected, folks from the neighborhoods, the universities, the clinics and officials from hard-pressed state and local health agencies.

Thinking he was still in Chicago, Obama blithely muscled such non-entities aside and settled in with silk-suited brass from the health insurance trade, the hospital conglomerates and the prescription drug business.

With trusted Chicago aides at his elbow, Obama made an amoral deal with the drug manufacturers that has poisoned everything that happened since. He had a debt to pay. The drug makers had donated tens of millions to his Senate and presidential campaigns.

Just after this summit, Obama secretly promised the Rx people that there would be no government jaw-boning with the industry to get lower prices for seniors and others. Obama also promised them there would be no drug importation from Canada and other reliable foreign countries.

This, after then-candidate Sen. Obama promised his administration would enter into talks for lower prices and would bring cheaper but identical products in from Canada. As a U. S. senator and presidential candidate, Obama voted for both.

I am indebted to reporters Tom Hamburger, who broke the story last year about this amazing turnabout, and Paul Blumenthal, who recently added important details. Obama’s 180-degree switch sent a signal to all legislators with close ties to special interests. Obama had campaigned on transparency and chasing lobbyists out of town. Now, it all moved behind closed doors, just as in the ferment over Hillary Clinton’s failed health care proposals 15 years before. The lessons then and now: Don’t trust the people.

On April 15, 2009, there was a secret meeting at the Democratic Senate Campaign Committee at which the drug industry outlined its advertising campaign for health insurance reform. Another part of the $80 billion deal was filling in some, but not all, of the doughnut hole in Medicare Part D.

Seeing that Obama didn’t believe his own campaign rhetoric about transparency, the Senate Finance Committee began its secret talks on what constituted health insurance reform. Max Baucus, D-Mont., is chairman. Charles E. Schumer, D-N. Y., is a prominent member. Baucus emerged on June 20 and called Obama’s unsavory deal with the drug industry “a once-in-a-lifetime opportunity.” It certainly wasn’t for sick people with limited incomes.

Not long afterward, Senate Democrats got all wobbly about the public option that passed the House. This would be a government-supervised and subsidized insurance program. It would have been the best yardstick by which private health insurance costs could be measured and controlled. On Oct. 28, Sen. Joe Lieberman, D-Independent, said he would block any bill that contained the public option. Many senators, awash in insurance industry money, shed crocodile tears at the demise of the public option.

Obscured in quarrels over details is the collapse of public trust.

Now, instead of cost control, we are arguing over a symbol: The idea that Democrats need to pass something, even though it won’t produce better health care.

Nothing better symbolizes that special hell into which Obama’s dealings sent health care than a rule being shaped by Rep. Louise M. Slaughter, D-Fairport, and chairwoman of the Rules Committee. She would have the House symbolically approve the Senate bill that would cost New York taxpayers $1 billion a year in added Medicaid costs. Part of the money subsidized payoffs to Vermont, Nebraska and Michigan to buy their senators’ votes last Dec. 24.

Eric Rosenbloom Distortions - LI Offshore Wind Initiative

Promoters of an industrial wind energy plant off the shore of Jones Beach, Long Island, New York, attempted some time ago to debunk a few of the findings in the early but still comprehensive and persuasive paper “A Problem With Wind Power”. Theirs was a weak effort indeed, but since it is still occasionally cited as definitive, this refutation from January 2009 deserves to be reposted. Answers follow each “distortion” and “truth” pair from the Wind Works 4 LI group.

‘The Distortion’
No power plants have been shutdown in other countries with wind turbines because wind is an intermittent resource.

‘The Truth’
Both Germany and Sweden have shut down nuclear reactors with the intent of supplying the loss of capacity with wind power (http://msnbc.msn.com/id/8058171/)&(http://news.bbc.co.uk/2/hi/europe/4536203.stm)

Intent is very different from what actually happens. In fact, Germany has essentially halted their planned shutdowns of nuclear plants and will now extend their operations. Germany is planning 26 new coal plants, 8 of them on a fast track for 2010. Sweden has not in fact shut down any nuclear plant and is now planning to build new ones.

‘The Distortion’
If you build wind turbines you need backup generation

‘The Truth’
Electric grid systems can handle a certain percent of wind power without needing additional generation. The 140MW able to be produced by the wind park is within these parameters. The grid is already designed to compensate for loss-of-load contingencies when large power plant units suddenly become unavailable.

Because a system can handle contingencies doesn’t mean that’s the way it should be operated normally. Furthermore, as the system is already designed to handle dropouts of major suppliers, then it would have to be expanded to also be able to handle sudden drops in production from a wind energy plant. In other words, most of the time the system can indeed already deal with large fluctuations of wind production, but it then also has to still be able to handle the loss of a major supplier or two – so more excess capacity is needed to ensure reliability.

‘The Distortion’
Because other electric generators need to be running at lower efficiencies in ‘spinning reserve’ they will actually pollute more than the avoided emissions from the wind turbines

‘The Truth’
The fact is: electrical generating units are constantly varying their outputs, starting and stopping, as the demand for electricity rises and falls throughout the day. When not running or burning less fuel, they pollute less!

This “distortion” isn’t even in Rosenbloom’s paper. Nevertheless, the fact is that running thermal plants at a lower output than their ideal, running them in spinning reserve, ramping them up and down, and starting and stopping them – all of this increases carbon emissions per unit of electricity supplied. It is like stop-and-go city versus smooth highway driving. Wind – intermittent, highly variable, nondispatchable – on the system would increase all of these inefficient uses. Whether or not that inefficiency would cancel the theoretical savings of taking wind energy into the system is easily determined by records of fuel use. And so far, there is no such evidence of less fuel use per kilowatt-hour provided on any grid. In fact, coal use in the U.K. and the U.S. has increased in recent years relative to electricity use.

‘The Distortion’
Other countries are reducing their subsidies for wind power

‘The Truth’
This is what is supposed to happen with any industry as it reaches a sustainable point in any market. E.g. Spain began to reduce subsidies in 2002 and their wind generating capacity still grew 33% in the last two years. (in the USA fossil fuels still receive very large subsides despite overwhelming market penetration)

Development in Germany has slowed dramatically with a decline in subsidies, and development in the U.S. has gone up and down with the existence of the Production Tax Credit. Spain continues to fund its wind industry with future carbon credits sold to others. The fact is, the wind industry lobbies hard for subsidies and could not thrive without them. In the U.S., compared with 44 cents for coal, $1.59 for nuclear, and 25 cents for natural gas (the three main sources of electricity in the U.S.), wind received $23.37 per megawatt-hour of its electricity production in 2007, according to the Department of Energy’s Energy Information Administration (click here). And that’s only federal (not state or local) financial (not legislative) intervention and ignores the 5-year double-declining-balance accelerated depreciation that is available to wind.

‘The Distortion’
The German Energy Agency report issued in February 2005 said increasing wind generation would raise costs by 3.7 times

‘The Truth’
Completely false. We encourage you to visit the agency’s website and read their report to see for yourself that Mr. Rosenbloom’s claim was uniformed (http://www.deutsche-energie-agentur.de). The true additional cost per household is 12 euro a year.

Obviously, this means that projected increases of electricity costs would be 3.7 times more with a large wind program than without. Dena’s page for the publication states that “[t]he expansion of wind energy will cost private households between 0.39 and 0.49 euro cents per kWh in 2015”. That’s up to 25 euros for 5,000 MWh. Table 8 in the English-language summary shows the different costs between expanding wind and not from 2007 to 2015 under three pricing scenarios: While the cost increase from 2007 to 2015 for private households (“nonprivileged consumers”) is 1.9-2.8 times more with wind, for industry (“privileged consumers”) it is 3.8 to 5 times more.

Rosenbloom’s paper also puts this economics issue in the context of several studies having concluded that the goal of CO₂ mitigation can be achieved much more cheaply by other means. The Long Island [N.Y.] Power Authority rejected the project in Long Island Sound for simple economic reasons.

The Distortion
The US Fish and Wildlife Service rejected the use of monopole towers as a means to mitigate bird deaths

The Truth
Completely False, the document Mr.Rosenbloom cites, actually promotes the use of monopoles to mitigate bird deaths. It appears he didn’t read his own citation. (http://www.fws.gov/habitatconservation/wind.pdf, pg.6 statement #1)

The FWS recommendation to use monopole towers (on page 3 of the document) is simply an acknowledgement that lattice towers provide roosts. It does not suggest that using a monopole tower makes it safe to operate a wind turbine in flyways and feeding and gathering areas. While the industry points to the tower design to absolve itself, the problem remains the giant blades, both directly and by the turbulence behind then, not to mention habitat fragmentation, degradation, and destruction.

wind power, wind energy, wind turbines, wind farms, environment, environmentalism

Wind Watch web site and Rosenbloom want your money for our work

… the shady Eric Rosenbloom …

"Eyes black as coal and when he lifts his face every ear in the place is on him. Starting soft and slow like a small earthquake; And when he lets go, half the valley shakes." …

… unethical …

… clean up its act …

… the ethically bankrupt Rosenbloom is an equal opportunity abuser …

… in January he went back to the dark side. …

… Rosenbloom's request that you send HIM money …

… unethical scoundrels such as Eric Rosenbloom …

So wrote Bob Gorman, managing editor, at the Watertown Daily Times (New York) in an obviously libelous, misinformed, and vaguely antisemitic rant last month.

Despite complete accommodation of Gorman's concerns by National Wind Watch, he flew off the handle anyway, taking his professional and perhaps personal frustrations out on "the shady Eric Rosenbloom", whose "crime" seems to have been simply to actually engage with Gorman rather than cower obsequiously.

(It should also be noted that, as clearly stated on its "About" page, National Wind Watch "is a 501(c)(3) charitable corporation registered in the Commonwealth of Massachusetts" and "All of the work for NWW is by unpaid volunteers", and on the "Donate" page, "Every dollar goes directly to providing the information that campaigners around the world rely on".)

Medicare for all!

Stop the medical insurance bail-out bill! Dave Lindorff writes at Counterpunch:

When Obama came to my neighborhood this week to press for public support for his health “reform” bill, he wasn’t just greeted by tea-party hecklers. Speaking to a large group of mostly supportive students and local residents at Arcadia University in Glenside, the president at one point mentioned that “people on the left” want “single-payer.” But before he could add that that approach wasn’t going to happen, he found himself drowned out by cheers calling for Medicare for all and single-payer.

That kind of says it all.

I’m with Marcia Angell, editor of the New England Journal of Medicine. The Obama plan for health care “reform”, as well as the two versions passed by the House and the Senate, are all devious disasters that do nothing to solve the nation’s burgeoning health care crisis, and in fact, will make it worse.

The only thing to do at this point is to take the whole stinking pile of paper and put it in the compost heap. Kill it.

This whole effort was never about reform from the day last March when the new president called on Congress to begin deliberations on health care reform. It was about catering to the wishes of the big players in the Medical Industrial Complex--the big pharmaceutical multinationals, the hospital companies, the physicians and, most of all, the insurance industry. People and their health care needs had little or nothing to do with this.

That’s why we’ve ended up with proposals that would do nothing to control costs, that would force health young people to buy unregulated, high-cost and high-profit plans that would be money in the bank for the insurance industry, and that would finance any subsidies for the poor by cutting back on benefits for the only group of Americans who currently have a form of single-payer insurance--the elderly with their Medicare.

President Obama began this whole obscene nightmare with a lie, when he said that even though single-payer systems clearly work to open access to all and keep costs down while providing better overall health results in places like Canada and some European countries, they cannot be applied in America “because that would mean starting over from scratch.” He knew when he said it that this was a lie. America already has a well-run and successful single-payer healthcare program in place that is bigger than the entire Canadian health care system, and that’s Medicare, which was established in 1965, and which currently finances the care of 45 million Americans. You just have to be 65 or disabled to be eligible for it.

As Dr. Angell pointed out on a recent Bill Moyers Journal segment, the simplest way to solve America’s health care crisis would be to just start a gradual expansion of Medicare, say by lowering the age of coverage to 55, and then 45, and then 35, until everyone was covered and the insurance industry was pushed out of the health sector. ... Medicare gives the elderly a freer choice of physician and treatment than any but the most gold-plated private insurance executive health care plan.

Obama continued this lie when he claimed, in his last mention of the issue during his State of the Union address to Congress, that he and Congress had considered every idea. In fact, he and Congress have for the last year, carefully prevented any consideration of the idea of single-payer, or of expanding Medicare to cover every American. Bills that would do that, authored by Rep. John Conyers (D-MI) in the House and Sen. Bernie Sanders (I-VT) in the Senate, were blocked from hearings or votes in both Houses by Democratic leaders, at the White House’s urging, while the White House itself barred single-payer advocates from any of its discussions.

Instead the president met behind closed doors with the lobbyists of the various health care industries, to cut deals with each sector in order to gain their support for his “reform” plan. It was as if the Department of Justice had called meetings with the various crime families of the Cosa Nostra in order to cut deals before developing a plan to “tackle” the Mafia. ...

The US currently devotes 17.5 percent of Gross Domestic Product to health care, and if this “reform” in any of its guises is passed, that share of the economy devoted to health care will quickly rise past 20 percent, with no end in sight. This is madness. Expanding Medicare to cover everyone, as I have written earlier, would actually save everyone money immediately, and the country as a whole. Consider that the most expensive consumers of health care--the elderly--are already in the system. Adding younger, healthier people to Medicare would cost incrementally much less. That’s why the Canadians spend about 9 percent of their GDP on healthcare, while covering every Canadian, while we spend nearly twice as much and leave 47 million of our citizens uninsured and unable to visit a doctor.

How could it be cheaper to add everyone to Medicare? Expanding Medicare to cover everyone would probably cost somewhere between $800 billion and $1 trillion a year. That sounds like a lot of money, until you consider that we already spend $100 billion a year to care for veterans through the Veterans Administration, and $400 billion a year to care for the poor through Medicaid. We also spend $300 billion a year subsidizing hospitals that have to provide “free” charity care to the poor who don’t qualify for Medicaid, too. Since all those people would be covered by Medicare under Medicare-for-All, that’s $800 billion a year in current expenditures saved right there.

... You don’t want to pay more taxes? Well wait. If you were covered by Medicare, you and your employer would no longer have to pay for private insurance, which would mean a savings to workers of thousands of dollars a year, and even more to employers who currently pay the majority of health insurance premiums for employees. The net savings would be enormous.

Nobody has talked about this.

Universal Medicare would make American companies more competitive in the global marketplace, where other companies are not responsible for health care costs of their workers. It would make Americans wealthier, because they would no longer be paying for health care out of their own pockets. It would make everyone more secure, because they would no longer have to fear losing access to health care if they lost their job, and would eliminate most bankrupties, which are reportedly caused by medical bills.

So we know what needs to be done.

And we know that the current “reforms” on offer don’t do it.

So Dr. Angell is right. Obamacare needs to die.

There is reason to hope that it will die. Republicans oppose it, though not for any decent reason. They want unregulated private insurance and unlimited profits for health care industries. Ditto some conservative Democrats, who are also anti-government ideologues whose wallets are stuffed with health industry swag. But their reasons for oppposing health bill don’t matter. All that is needed is for a few progressive members of the House and Senate to admit that the health bills being considered are not reform, but the antithesis of reform, and to also vote against it, and Obamacare will be dead.

At that point we can start seriously demanding that the Congress and the President act to bring us real health reform in the way that really works: expanding Medicare to cover everyone.