Letters: The Register Guard July 2, 2015
by Lou Sinniger, Eugene
The U.S. Supreme Court’s 6-3 affirmation of the Affordable Care Act on June 25 means the act’s here to stay — until we make it better.
We certainly can’t go back to a time when people were denied health care based on previous medical conditions.
The problem with the ACA is the high cost of health insurance. The ACA doesn’t control health insurance prices — health insurance premiums are driving the market, and that’s one major reason why our health care costs are more than twice that in any other developed nation.
The other reason is the cost of pharmaceuticals. Medicare is forbidden by Congress to negotiate drug prices with Big Pharma. In other nations, the costs of prescription drugs are one-half to one-third the cost here. The U.S. Department of Veterans Affairs pays 40 percent less for its pharmaceuticals than the rest of us.
Medicare turns 50 years old on July 27, and we should celebrate it. It covers most of those age 65 and older while Medicaid covers those who live in poverty. The VA covers most of our veterans.
Letters: The Register Guard, June 30, 2015
by Sally McCoy, Eugene
In his June 29 letter, Reginald Jensen cited some numbers to support his contention that health care costs in Europe and the United Kingdom are higher than in the United States. He challenged single-payer advocates to support their position with facts.
In my search for facts, I was unable to reconcile Jensen’s facts with what I discovered. The Organisation for Economic Cooperation and Development reports that in 2012, health care spending in the United States was 17.6 percent of Gross Domestic Product, not the 11.5 percent figure Jensen gave. Furthermore, our spending was two-and-a-half times greater than health care spending in the rest of the developed world.
U.S. life expectancy is shorter than in other developed nations — 78.8 years in 2012, compared with 81.5 years in the United Kingdom. In 2012, the United States spent $8,233 per person on health care. The average in other developed nations was $3,268.
[From our Single Payer friends with the Vermont Workers Center. Here is an op-ed by VWC organizer Kate Kanelstein. Kate visited us in Oregon with a statewide tour several years ago.]
This OpEd by VWC lead organizer Kate Kanelstein was published in the Burlington Free Press.
July 1, 2015
Last week the US Supreme Court upheld subsidies for buying private health insurance in states with federally-run marketplaces or exchanges.
The court’s decision has been an enormous relief for the millions of people who stood to lose access to coverage had the subsidies been revoked, and is seen as a vindication of Obamacare. However, many people with healthcare issues are asking whether it’s time to move beyond Obamacare’s market-based insurance system -- in which subsidies ultimately flow to the big private insurance companies -- and instead ensure that our public dollars go towards meeting the needs of our families and communities.
As in many other states, here in Vermont the rollout of the Affordable Care Act’s healthcare exchange has only increased -- rather than resolved -- our continuing healthcare crisis, with the failure of private contractors to make the Vermont Health Connect website work resulting in a series of mishaps -- most recently in the form of Blue Cross Blue Shield of Vermont claiming back payments from 6,000 people for care they thought was covered. Thousands of us have experienced healthcare uncertainty and unaffordable costs, with grave implications for our health and ability to make ends meet for our families.
Our frustrations should be directed at CGI and Optum, the private, for-profit contractors hired by the state to roll out the VHC website, as well as the Shumlin administration for failing to hold these contractors accountable.
But we risk missing the forest for the trees if we don’t acknowledge that the roots of the flawed VHC rollout lie in fact in the market-based approach of the Affordable Care Act, with its insurance industry-guided design, complete with tiers of coverage and eligibility restrictions. Rather than ushering in a new era of treating healthcare as a right and a public good for all, the ACA has enshrined a fundamentally unjust market-based system with different and unequal insurance products, different and unequal prices for health services, and different and unequal access to care.
Health insurance premiums will rise next year for the more than 200,000 people in Oregon's individual market — though not as much as originally decreed for three carriers.
According to the Oregon Insurance Division's final rate decisions released today, the hikes affect about 10 percent of Oregonians, those in individual and small group plans.
According to the Oregon Insurance Division's final rate decisions released today, the hikes affect about 10 percent of Oregonians, those in individual and small group plans.
Individual market hikes range from 8.3 percent for Kaiser Foundation Health Plan of the Northwest to 37.8 percent for Health Republic Insurance Co.
A premium for a “silver” standard plans will range from $271 to $389 a month for a 40-year-old in Portland. Kaiser has the lowest monthly premium and PacificSource Health Plans the highest.
A study first conceived by Sen. Michael Dembrow in 2013 that passed without funding, has repassed with $300,000 in state money after private donations came up short. Support for the study has a bipartisan history, but as a thorough and objective study comes closer to a reality, the political pressure mounts against it. The state money, however, is enough for the study to move forward.
By Chris Gray, for The Lund Report, June 30, 2015
The Oregon universal healthcare financing study bill cleared the top budget committee after a contentious hearing Monday, with $300,000 attached to design the best way of financing a universal healthcare system in Oregon.
House Bill 2828 has been a top priority of Sen. Michael Dembrow, D-Portland, as well as single-payer activists, who believe it will lead to their preferred method of healthcare financing system through a government-managed health insurance plan. But the bill specifically asks for an objective study weighing four options, pointedly not recommending any option such as single payer.
The hearing was subject to an array of misinformation about the bill, perhaps the result of behind-the-scenes pressure from the hospital and insurance industry lobbies, which could stand to lose millions if Oregon adopted single-payer. Now, a substantial amount of money spent by government and Oregon businesses intended for patient care is being diverted to industry profits and lucrative salaries for hospital management even at non-profit hospitals.
In particular, Sen. Betsy Johnson, D-Scappoose, who had previously supported an unfunded study in 2013, joined all but one of the Republicans in opposing HB 2828 in the Ways & Means Committee, telling her colleagues she was worried that private money could bias the outcome, since the study was projected to cost twice as much as the state allocation -- $600,000 -- and was relying on private sources for the reminder.
‘Subsidies upheld, but health needs still unmet’: doctors group
Physicians for a National Health Program, June 25, 2015
Although the Supreme Court has upheld the premium subsidies under the Affordable Care Act, the law remains incapable of remedying the U.S. health crisis, physician group says
Physicians for a National Health Program, an organization of 19,000 doctors who support single-payer national health insurance, released the following statement today:
Today’s decision by the Supreme Court in King v. Burwell to uphold the Affordable Care Act’s premium subsidies in about three dozen states will spare more than 6 million Americans the health and financial harms associated with the sudden loss of health insurance coverage.
For that reason alone the decision must be welcomed: Having health insurance is better than not having coverage, as several research studies have shown.
That said, the suffering that many Americans are experiencing today under our current health care arrangements is intolerable, with approximately 35 million people remaining uninsured, a comparable number underinsured, and rapidly growing barriers to medical care in the form of rising premiums, copayments, coinsurance and deductibles, and narrowing networks.
by Evan McMurry
Mediaite, June 29th, 2015
Senator and 2016 presidential candidate Bernie Sanders (I-VT) told ABC News’ George Stephanopoulos Sunday morning that he would move for a “Medicare-for-all, single payer” health care system, though he acknowledged that this was not an immediately practical goal.
“We need to join the rest of the industrialized world,” Sanders said. “We are the only major country on earth that doesn’t guarantee health care to all people as a right, and yet we end up spending much more than they do.”
“So I do believe that we have to move toward a Medicare for all, single-payer system,” Sanders said, adding that he had “certainly voted for” the ACA. “It’s not going to happen tomorrow, but that certainly should be the goal.”
[Old news, but still relevant!]
By Andy Borowitz
The New Yorker, October 1, 2013
UNITED STATES (The Borowitz Report)—Millions of Tea Party loyalists fled the United States in the early morning hours today, seeking what one of them called “the American dream of liberty from health care.”
Harland Dorrinson, 47, a tire salesman from Lexington, Kentucky, packed up his family and whatever belongings he could fit into his Chevy Suburban just hours before the health-insurance exchanges opened, joining the Tea Party’s Freedom Caravan with one goal in mind: escape from Obamacare.
“My father didn’t have health care and neither did my father’s father before him,” he said. “I’ll be damned if I’m going to let my children have it.”
FORTUNE, June 26, 2015
COMMENTARY by Eleanor Bloxham
A new round of consolidation in the insurance industry could be pointing the way toward a single-payer system.
Is the market moving us to universal health care?
Following the Supreme Court ruling yesterday, Fortune’s Laura Lorenzetti reported that health insurers who provide insurance through the exchanges were “among the big winners from the Supreme Court’s Thursday decision to uphold Obamacare subsidies.”
The largest health insurers including UnitedHealthcare UNH 0.75% , Aetna AET -1.92% , Cigna CI -1.01% , Anthem ANTM -3.32% , and Humana HUM -0.80% have been in merger talks over the last few weeks. Yesterday afternoon, the Wall Street Journal said, “Let the deal music play. In affirming a central tenet of the Affordable Care Act for the second time, the U.S. Supreme Court has removed a major source of uncertainty for the insurance industry. That is good news for investors banking on consolidation. Indeed, within hours of the decision, Humana stock popped on renewed talk that Aetna had made an offer.”
Indeed, one merger could happen as early as next week according to the New York Times, which is reporting that “A new round of consolidation in the health insurance industry appeared closer as companies seek to grow larger, driven in part by cost-cutting and opportunities that are part of the Affordable Care Act,” noting that Humana “could reach an agreement by next week” with either Aetna or Cigna making the purchase.
The scope of the mergers could be huge and result in unprecedented health insurance giants. On June 16, Fortune’s Shawn Tully wrote that “In the merger world, no sector is hotter than health insurance” and that if UnitedHealth and Aetna “were combined today, they would rank fifth on the Fortune 500, leapfrogging the likes of AT&T, Ford, and Apple.”
In her ruling, Laura Cali said the sale was fair, just and equitable.
by Diane Lund-Muzikant
The Lund Report, June 24 2015
Late Thursday afternoon, Oregon’s Insurance Commissioner announced that she had approved the sale of Agate Resources to a Fortune 500 company. Agate is the parent company of Trillium Community Health Plan, a coordinated care organization in Lane County.
In her ruling, Cali mentioned that she considered over 50 public comments in support and opposition to the transaction but found “no material or reasonable objections,” adding that the sale would not “substantially reduce the security of and service to be rendered to policyholders.”
Centene Corporation has agreed to pay $80 million for the transaction, and those dollars will be dispersed to Agate’s shareholders – Trillium has 5,000 shares of common stock outstanding, LIPA, 3,000 shares and Agate, 2,000 shares.
Earlier, the Eugene Register Guard reported that the “Oregon Insurance Division has blacked out the identities of Agate’s 217 individual owners and the payouts they would receive under the sale.”
The majority of these shareholders are Lane County physicians and also include Coplin, who earned $492,324 last year. That compensation package included a $96,230 bonus and stock awards of $46,000. The previous year, Coplin earned $366,530. Trillium, which has more than 100,000 Medicaid members, reported a profit of $22 million in 2014, up from $3.9 million in 2013 and $1.15 million in 2012. Compared to other plans, its earnings before interest and taxes were $36 million.
At the end of 2015, Trillium expects to have $47 million in capital and surplus. Agate provides administrative services for Trillium and LIPA – a group of 217 physicians.
Experts had warned that a finding in favor of the plaintiffs would eviscerate the healthcare law
Chief Justice John Roberts, as well as Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan were in the majority that upheld Obamacare. (Photo: Mark Fischer/flickr/cc)
Handing a victory for President Barack Obama and the Affordable Care Act—as well as millions of people who gained more affordable healthcare under the law—the U.S. Supreme Court on Thursday ruled that individuals who get their health insurance through an exchange established by the federal government will continue to be eligible for tax subsidies.
The "ALEC-fueled" case, King v. Burwell, dealt with whether the Affordable Care Act provides subsidies to everyone in the country who qualifies for them on the basis of income level, regardless of whether they get their insurance through a state-run exchange or an exchange run by the federal government. Basing their argument on just four words buried in the massive legislation, the plaintiffs claimed that subsidies were supposed to be only for those purchasing health care through state-run health exchanges—not the federal one.
Experts warned that a finding in favor of the plaintiffs would eviscerate the healthcare law.
Affirming the decision of the Fourth Circuit, the justices voted 6-3 to uphold the subsidies. Chief Justice John Roberts, as well as Justices Anthony Kennedy, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan were in the majority.
Updated by Ezra Klein
VOx, Policy and Politics, June 22, 2015
Is Medicaid a bad idea?
That's what Tyler Cowen asks after reading a working paper from economists Amy Finkelstein, Nathaniel Hendren, and Erzo Luttmer. The paper is highly technical, but its headline finding is that a dollar in Medicaid spending doesn't lead to anything near a dollar in value for Medicaid beneficiaries.
It finds this two ways. First, if you test whether Medicaid users would pay the price of their Medicaid coverage if the government took it away, they say no. This makes some sense, as they are very poor, and one reason they have Medicaid is they don't have the money to buy insurance on their own.
The more interesting finding is the second one: if you look at where Medicaid's money goes, less of it than you might think goes to covering the uninsured — and more goes to paying back the people who are already covering the uninsured.
But the paper's conclusions are more complicated than that makes them sound. Read closely — and depending on your values — the paper either isn't saying anything very new, or it's arguing something quite radical: if Medicaid is overrated, it might be because all health insurance is overrated.
"Bigger insurance companies mean increased leverage and unfair power over negotiating rates with hospitals and physicians," the organization continued. "More often than not, consolidation increases costs and reduces options for consumers and we believe this would hold true in the health insurance market."
Dave Jones, California's top insurance regulator, echoed these warnings in an interview this week with the L.A. Times: "Generally speaking, further consolidation in the health insurance industry is not a good thing for consumers, employers or medical providers. It means the potential for future price increases as a result of less competition."
A report (pdf) released last year by the Commonwealth Fund finds that the U.S. health care system is already the most expensive in the world yet delivers the worse care among 11 industrialized nations. Many are calling for a universal, publicly-funded health care system to replace the for-profit model behind this dismal performance.
Register-Guard, JUNE 20, 2015
by Charlie Swanson, HCAO Eugene
With U.S. Sen. Bernie Sanders, I-Vt., running for president, we should elevate the conversation about health care in this country.
Sanders has introduced federal legislation to treat health care as a public good. Timely, high-quality health care helps not just individuals, but also society as a whole.
We spend more tax money on health care than nearly every other industrialized nation, yet lots of additional private resources are still needed. Why do we have such expensive care? Largely because we divide people into numerous risk pools.
Those most likely to have costly health care are covered primarily at taxpayer expense: older people and disabled people through Medicare, poor people through Medicaid, veterans through Veterans Affairs, active duty military through Tricare.
We leave those with the lowest risk, primarily workers and their families, to be covered by private health insurers. That ensures the profitability of insurance companies, which taxpayers subsidize because employer-provided insurance isn’t taxed.Read More