The Trail: A Daily Diary of Campaign 2008


The Rundown

Health Care Fight Divides Democrats

By Ben Pershing
The traditional narrative for any big Washington policy fight is typically Democrats vs. Republicans, or occasionally, "change" vs. "more of the same." But the increasingly heated debate over health care reform isn't quite breaking down along those lines yet, as the primary battles today are happening within the Democratic party.

The contours of a health care bill, particularly whether it should include a public plan or "option," Politico writes, "has touched off an increasingly fierce Democratic civil war on Capitol Hill." It appears likely there will be some sort of public option. Nancy Pelosi said on MSNBC Wednesday that no bill would pass the House without one, though the American Medical Association is opposed to the idea. The current debate is focused mostly on how the new health care system would work, and not as much on what will be an equally contentious issue -- who's going to pay for it. "To date, interest groups remain reluctant to appear intransigent and risk getting shut out of negotiations," the Los Angeles Times notes, but that will change soon as funding plans get clearer on the Hill.

President Obama will be in Green Bay this afternoon to hold a town hall meeting on health care. (Will he get a question on Brett Favre? Can he invoke some sort of emergency powers to force Favre to stay retired? We digress.) The event, Ceci Connolly writes, is designed to spotlight the Wisconsin town's smart health care practices and how other cities could become more effective and efficient by adopting similar strategies. On the other end of the spectrum, experts continue pointing at McAllen, Texas, as an illustration of how health care shouldn't work, following Atul Gawande's story on the subject in The New Yorker that has been the talk of the health care commentariat for several days. Ezra Klein jokes (we think) that "all health-care-related commentary must now, by law, include a reference" to Gawande's story.

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Posted at 8:30 AM ET on Jun 11, 2009  | Category:  The Rundown
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I sit on the board with Utah association of Health underwriters and for health insurance reform. Several interesting changes took place with H.B. 188 passage earlier this year that seems all too familiar on the federal level. The spirit of the bill allows private market place remedies. It essentially guarantees insurance providers a "no loss" or "no gain" over competing carriers in the insurance exchange portal which is On the surface it seems not to be attractive to participating carriers (voluntary at this point). But you have to understand the carriers’ goal is to cover their administration fees. That can be accomplished now. The other half of the equation is providers and their billing practices that need to be reformed. That is on the agenda. Keep an eye on Utah because the national health care debate seems much the same ground we have already covered.

You must be in the health care business from some touch point to make statements of fact in face of historical proposed changes. When you are in the system from any touch point (insurance, provider, hospital, Medicare or patient) you get it because of real time experience.
I often quote the Switzerland health care system as an example of tough questions that we will have to face at some point down the time line. Did you know that premature babies there are not resuscitate upon birth if they cannot draw breath? Did you also know that is the same with senior care with system failure? They don't extend life of a senior with multiple failures like intubation as example. Anyone in the business of paying claims knows that single most expensive bill in NICU for newborns and seniors in acute intensive care / hospital.
These decisions were made based upon cost vs. quality outcome. Are we as a nation prepared to make that type of decision or definition of when to incubate a newborn or a senior? To define the conditions? With a litigious society I think not. This is why we need tort reform. Without tort reform medical provider costs will never drop. Liability costs with medical providers are nearly half of operating expenses. With health insurance carriers it translates to about 10% of every premium dollar collected.
I don't think we are hearing about tort reform because most of the house and senate are lawyers. In the healthcare system there is no total innocence. Insurance executives with bonuses, doctors overbilling, hospitals overbilling because the street gang thug got dropped at their door with no insurance.

Posted by: mikeoliphant | June 12, 2009 1:13 PM

I suggest to show the name of lawmakers to public for whom is against healthcare reform and accepted donations from insurance companies and pharmaceutical companies.

If countries like Canada, Taiwan and British can have public healthcare systems, why we can't?

Those healthcare insurance companies just like another GM or AIG. They are protected too much.

Don't elected those lawmakers who has accepted donations from insurance companies and pharmaceutical companies. Let them down for next election.

Posted by: maxlee5454 | June 11, 2009 3:30 PM

Here's my experience.

I was "retired" at age 60 in 2003 after the major bank I worked for was taken over by another major bank. It was ok with me.

I got a nice severance package, which included my existing health care benefits and COBRA, which took me to within 7 months of medicare eligibility.

I had a major health care provider for years while I was employed - I applied to this same provider for an equivalent policy. I was turned down for "pre-existing condition" reasons.

I knew however that the law in my state required the insurer to sell me a policy because I had one that was ending under COBRA and had had no break in coverage. They did.

The cost was $1,120 per month. Luckily I only needed it for 7 months.

Medicare works and its fine by me. I purchased a supplemental insurance policy (which costs $390 a quarter) and a prescription drug policy (about $32 a month). I still pay the medicare deductible and drug co-pays.

Without Medicare I simply could not afford health insurance and I (and millions of old people) would join the ranks of the uninsured - and my income is higher than the average in my state.

Health care "reform" without a government option is a waste of time and will accomplish nothing.

Posted by: toritto | June 11, 2009 2:45 PM

It is a violation of the Hippocratic Oath to oppose single payer, plus it's economically stupid. Paying 70% of what we pay now will give us 100% coverage, 0 deductible, free choice of doctors, security when seeking a new job, and greatly reduced expense for businesses.

The insurance companies deserve to be unemployed. Don't feel sorry for them because they'll still have health care, which, ironically, is something they would NOT do for you.

Posted by: rooster54 | June 11, 2009 11:45 AM

Anyone who has accepted donations from insurance companies and pharmaceutical companies should be excluded from this decision making process.

For the record, I expressly deny my insurance company any use of my premium payments for the purpose of lobbying against a single payer system. My premium payments are for the purpose of paying my medical costs as they are incurred. That is all. It is a fraud and a betrayal to use my own money to fight against my expressed interests.

Insurance companies deserve to be thrown out, because that's what they've done to their clients, with deadly results. Because people have died from this abuse, they're guilty of murder for money as well.

Don't trust paid propaganda bought with money that was supposed to pay for your health care. Trust your doctor. The insurance companies have proven they can't be trusted. They have your money, but you still have your vote and your voice.

Posted by: rooster54 | June 11, 2009 11:31 AM

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