American Values Alliance | Practical voice for progressive valuesAmerican Values Alliance | Practical voice for progressive valuesAnyone who wants to understand the American health care system should study Daniel Lee’s excellent piece in the 7/27/08 Indianapolis Star (“Hospitals see growth as healthy”).
Recently, the Indianapolis Star, New York Times, Indianapolis Business Journal and Wall Street Journal have noted the activities at WellPoint. Most noteworthy is the decline in its stock value following a disappointing earnings prediction from management. It has lost approximately 50% of its value in the last several months.
Have you lost track of the SCHIP battle?
I apologize for the long absence from the healthcare blogosphere. It has been a couple of months since you have heard from me.
The answer is no. The question refers to the record $227 million spent by health care lobbyists in the first half of 2007, as reported in the The Times of Trenton ( N.J.) on Sept 19. What it can buy is perpetuation of the corrupt practice of buying influence under the guise of free speech. It would be bad enough if the money were buying influence for some relatively benign commercial interest, but spending millions to continue the health care status quo is another matter. Health care cost and availability are our greatest unsolved domestic problems. What should be a right of citizenship is in America a commodity to be bought and sold like any other.
The lobbying is led by the greediest lobby in the country, PhRMA, the pharmaceutical consortium led by former U.S. representative Billy Tauzin of Louisiana.He didn't wait long for his reward. He earns $2 million per year in the job he took a couple of milliseconds after leaving congress where he crafted the " Medicare Modernization Act" in 2003. Please recall that one feature of that act was a prohibition against Medicare using its purchasing power to get the best prices from the drug companies.
Wow! Angela Braly ranked by Forbes ahead of Hillary Clinton and Queen Elizabeth on its list of powerful women. No. 16 in the country! This is heady stuff, indeed. It is good for Indianapolis to have such a prominent national figure in our midst. Known for her " public policy expertise", she is called a " hardheaded negotiator and workaholic", who is " not about to roll over for the likes of Michael Moore". I think it is legitimate to ask if she will use this extraordinary power in the service of better public policy or larger profits?
Colorado recently formed a blue ribbon commission to study its state healthcare dilemma. To do this, it engaged The Lewin Group to analyze alternative proposals to expand coverage. The Lewin Group has performed similar analyses in several states and is a respected analytical/consutling group.
Both houses of Congress have now passed a version of the sCHIP reauthorization/expansion bill; it now goes to a conference committee. In my opinion, this is a big step forward for those who believe in a larger role for the federal government in health care and a diminished role for private insurers. In addition to insuring 3 million more uninsured children, a couple of additional wonderful things might survive the committee: increases in tobacco taxes and cuts in excessive premium payments to private insurers for Medicare Advantage. The passage generated some truly bizarre commentary from Republicans such as this from Pete Sessions of Texas: "The bill uses children as pawns in a cynical attempt to make millions of Americans completely reliant on the government for their health care needs." Mr. Sessions evidently prefers the benign, compassionate attention to health care needs that comes with reliance on private insurers, not to mention unaffordable premium levels (why do you think these kids have no insurance?). He has also apparently forgotten that his state has the largest percentage of its population uninsured in the nation.
The New England Journal of Medicine and the New York Times have recently reported on the current efforts to reauthorize the State Children's Health Insurance Program ( SCHIP), the highly successful program begun in 1997 as part of the Balanced Budget Act. Thanks to this program and continued enrollment growth of Medicaid, the number of uninsured children fell from 11.1 million in 1998 to 8.3 million in 2005. As the employer-based insurance system continues to erode, more children become uninnsured, but most of these losses have been offset by SCHIP and Medicaid. This doesn't sit well with conservatives.
Here is some everyday math to contemplate: America's current national health care expenditure is about $2 trillion per year, about 16% of GDP (growing about 2-3x faster than the economy). That is about $7 thousand per person, about twice what any other industrialized country spends. In that $2 trillion is approximately $300 billion in administrative expense for all segments of the system, the overwhelming proportion generated by private sector demands. Let's say we have 45 million uninsured (a reasonable consensus figure). Multiply $7 thousand times 45 million and you get $315 billion, enough to cover all our uninsured even at the current exorbitant levels. Interesting, eh?
Of course all administrative costs cannot be eliminated, but most of them can. The Take Home Message: don't let your conservative friends who defend private health insurance tell you we cannot afford expansion of publicly financed programs, e.g. Medicare, to cover more people.The money is already in the system, just wasted on activities that add no value to individual or public health.
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