Mike Rogers Defends Wasting $700 Billion Annually

Rep. Mike Rogers (R-MI) receives a lot of money from the pharmaceutical, health and insurance industries, which probably explains why he's pushing false information about health care reform. While speaking at the Michigan Business and Legislative Forum last week, where he repeatedly bragged that he had read all 1000+ pages of the House health care bill, he argued that the House reform legislation would allow the federal government to use the results of comparative effectiveness research to ration costly treatments.

Rogers is wrong (he would have known that if he had read page 524 of the legislation). Pulitzer Prize winning PolitiFact.com says this claim is false:

But in this case, there actually are provisions in the bill about comparative research to make sure it is not used for rationing. Language in the House version of the health bill specifically states: "Nothing in this section shall be construed to permit the Commission or the Center to mandate coverage, reimbursement, or other policies for any public or private payer."

And let's be clear, comparative effectiveness research has been done by the government for years and years. The Obama administration wants to greatly expand the amount of research. The economic stimulus package also included more funding for comparative effectiveness research. And the bill included a similar disclaimer that it would not mandate insurers to cover or reimburse one treatment or medication over another.

FactCheck.org also says this claim is false, and so does the AARP:

"It boggles the mind" said AARP spokesman Jim Dau, how comparative effectiveness research has been portrayed by opponents of the health care plan as government rationing of care.

"It's just good common sense," Dau said of the research. "It's giving individuals and doctors better evidence-based research so that they can make better decisions."

What exactly is comparative effectiveness research? The Center for American Progress explains that "it evaluates different drugs, medical devices, and clinical procedures for the same illness against each other. In contrast, the bulk of research done today examines whether a specific treatment works compared to doing nothing, but comparative effectiveness research evaluates which therapy works best among a range of possibilities for the same illness or condition." This research is important because it can save money.

It’s estimated that one-third of procedures and treatments administered in the United States have no proven benefit and account for up to $700 billion annually in current spending. Moreover, some of these treatments can have harmful side effects, produce worse health outcomes, and then, as a result, add to the soaring costs of medical care.

I don't know about Mike Rogers, but I don't like paying $50 dollars for a pill that's not anymore effective than one costing a buck, and the media is full of articles questioning whether cholesterol drugs do any good or if angioplasty is advisable in all patients. My favorite story is from last fall when the NY Times published an article about one of the biggest medical trials ever organized by the federal government. It showed that generic diuretics (water pills) costing only pennies a day, and in use for high blood pressure since the 1950s, worked better than newer drugs that were 20 times as expensive. Not only that, the research revealed that the pricier drugs increased the risk of heart failure and stroke.

As CAP points out, "There is no incentive for the companies to fund research that compares their treatment to another since it is not in their best interest to determine if another treatment works as well or better than theirs. Because of this the federal government must invest in this research."

It just doesn't make sense for Rogers to criticize comparative effectiveness research unless he's hoping to protect his big donor's profits. Republicans want us to take charge of our health and spending on health care dollars, yet they seek to limit information about over-priced or hazardous medications or treatments. Not only can that be harmful to our health or downright deadly, it's a waste of money - as much as $700 billion annually.

(Cross-posted at Blogging for MI.)

We Should All Stand Up For Insurance Companies

After all, Michigan Rep. Dave Camp is standing up for insurance companies and, along with fellow Republicans, has "mounted a ferocious defense of the market's right to continue burning through taxpayer dollars."

Camp is also standing up for the pharmaceutical/health products/health professionals industries that donated money to his campaign committee for 2009-2010 and 2007-2008.

If Camp is standing up for insurance companies, we should too. As this PSA relates, insurance company CEOs have the right to their American dream just like the rest of us. They've looked out for our best interests for so long and now we should look out for theirs.

Besides, what's so American about competition?




(Cross-posted at Blogging for MI.)

Max Baucus Delivers - For the Insurance Industry

Senate Finance Chairman Max Baucus finally released his health care plan after months of haggling. I'm not too impressed, especially on the matter of affordability.

It would extend benefits to millions of people who are uninsured by broadly expanding Medicaid, the state-federal insurance program for the poor, and by offering subsidies to individuals and families with modest incomes to help them buy insurance.

The proposal would also set limits on out-of-pocket health care expenses. It would cap at 13 percent of household income — not including cost-sharing such as co-payments and deductibles — the cost of insurance premiums for middle-class Americans who just miss qualifying for the new government subsidies.

Starting in 2013, it would require nearly all Americans to obtain coverage or face a penalty of up to $3,800 a year for families.

Did the committee see this item in yesterday's USA Today?

An average family health insurance policy now costs more than some compact cars, and four in 10 companies will likely pass more of that expense on to workers, according to a closely watched survey of businesses released Tuesday.

The average cost of a family policy offered by employers was $13,375 this year, up 5% from 2008, the Kaiser Family Foundation and the Health Research & Educational Trust survey found. By comparison, wages rose 3% over that period, the study said.

Or this information from Kaiser?

Let's do some very simple arithmetic. Start with a fairly conservative assumption: If we assume that premium increases over the next ten years will average what they did over the last five (about 6.1% per year), the average premium for a family policy in 2019 will be $24,180. That's a big number. On the other hand, if we assume increases revert to the average of the last ten years—an average annual increase of about 8.7% and a very plausible scenario—premiums in 2019 will average a whopping $30,803, a very scary number.

If my employer doesn't provide health insurance, I'd be better off paying the $3,800 penalty. No wonder Democrats and Republicans have raised all kinds of objections. In fact, Democrat Jay Rockefeller expressed very strong opposition to various features of the bill, including affordability, and he was supported by Yale Professor Jacob Hacker.

Have To Ensure That Coverage Is Affordable: Hacker pointed out a public option would save approximately $150 billion over 10 years and allow the government to invest those savings into better and stronger subsidies.

Hacker is the person widely credited with coming up with the idea for a public option. Did I mention Baucus's plan doesn't include one?

The Baucus plan calls for the creation of private, nonprofit health insurance cooperatives to compete with private insurers, a compromise aimed at bridging the gap between Democrats who want a government-run insurance plan and Republicans who adamantly oppose that idea.

As insurers, the cooperatives could offer their coverage plans on the exchanges.

And in a nod to the stiff Republican opposition, the proposal does not include a trigger calling for the creation of a public plan if the legislation fails to make affordable health insurance widely available, a compromise step that Mr. Obama has indicated he could accept.

No trigger. No public option. Unrealistic subsidies. This isn't reform. It's a handout to the insurance industry. That's not to say the public option is dead in the water.

Instead, Mr. Baucus seems to have left the public option to the alternate health care legislation developing in the House, where more liberal Democrats strongly support the idea and the House speaker, Nancy Pelosi, has called it crucial to getting a bill adopted in her chamber.

We really need Pelosi to deliver on the public option. The bottom line on affordability according to Ezra Klein is that the premium subsidies aren't where they need to be, but are pretty good, particularly for folks making up to 300 percent of the poverty line. However, ...

The question is what happens when you get sick. And the answer is pretty much that people making more than 200 percent of the poverty line will be less ruined than they'd be under current law, but still facing tens of thousands of dollars in out-of-pocket expenses a year.

Medical bankruptcy, in other words, isn't going away. One fairly dramatic way to think about this is that health-care costs are so high in this country that we can talk about spending almost $900 billion helping low-income Americans afford coverage and still be left with a situation where coverage is unaffordable and illness rips through a family's savings.

So after months of wrangling and innumerable compromises meant to attract Republican never existed support, this is what we get from the Finance Committee. Baucus isn't crying though. In fact, he's laughing all the way to the bank where he's depositing the $3 million he got from the insurance industry.

The "Real Death Panels"

Americans United for Change takes on the "death panel" myth conservatives continue to push by pointing to the real culprits. Hint: It's not the government.

Americans United for Change unveiled a new television ad today called “Real Death Panels” that turns the table on the thoroughly debunked myth advanced by conservative politicians and pundits -- that ‘death panels’ are part of President Obama’s proposal for health insurance reform – by spotlighting the real death panels that exist in America today: private insurance companies that routinely deny claims made by policy holders or refuse to issue policies altogether, citing “pre-existing conditions,” with sometimes deadly consequences.

In a press release from Jeremy Funk, Press Secretary of Americans United for Change, he points out that “Conservative politicians and pundits will do anything to keep the “death panels” fantasy alive as part of an unscrupulous and concerted effort to kill health insurance reform. But where’s the hysteria from these same conservatives over the real death panels that exist right now in America with the big insurance companies denying millions of claims made by policy holders or refusing to issue policies altogether, citing “pre-existing’’ conditions?"

Some related info:

From HealthReform.gov: Coverage Denied: How the Current Health Insurance System Leaves Millions Behind. “Pre-Existing Conditions” Affect Millions of Americans

In an op-ed from NYT's columnist Nicholas Kristof: Health Care Fit for Animals

(Cross-posted at Blogging for MI.)

Washington Has Public Health Care, So Should We

Forty-eight million Americans now lack health insurance and 73% of voters want a choice of a private or public health plan. Support for that choice is bipartisan too - Democrats 77%, Independents 79%, and Republicans 63%.

With that kind of consensus, you'd think health care reform would be a slam dunk, right? Think again. There are lots of rotten apples in the bushel (insurance, big Pharma and for-profit corporations) trying to sink public health care and their rot is spreading to Republicans and Democrats.

Convert Arlen Specter is one example. He recently told David Gregory that he would not support a public plan. (News flash, Arlen. You're not really a Democrat, you're an opportunist.)

Sen. Evan Bayh of Indiana said he is “agnostic” about having a public plan as part of health care reform, and Senate Finance Committee Chairman Max Baucus of Montana said that he believes health care reform can be accomplished “without” a public option. Ha-ha. Baucus is a real comedian. Private health insurers have been cherry-picking patients, denying claims and refusing to insure people for years, and their costs are higher than public plans like Medicare. In fact, when Republicans opened Medicare to private insurers in the name of competition, it ended up costing the federal government 12 percent more. That's not reform.

Private insurers don't want to see their gravy train end and they're spending big money trying to keep public health care from expanding, just ask Sen. Ben Nelson of Nebraska. His biggest campaign donor is the insurance industry. According to Open Secrets, Nelson received $608,709 from the insurance industry in 2007-2008. That money won him over. Nelson said he's not interested in a public option. HuffPost explains why:

Nelson’s problem, he told CQ, is that the public plan would be too attractive and would hurt the private insurance plans. “At the end of the day, the public plan wins the game,” Nelson said. Including a public option in a health plan, he said, was a “deal breaker.”

So let me get this straight. Our politicians have the best public health care plan taxpayer money can buy, yet they're essentially saying we can't have it because they want to protect private insurers. What hypocrites. Americans voted Republicans out of power because they kowtowed to corporate greed and now we have Democrats doing the same thing. It looks like we need to do some housecleaning and throw some more rotten apples out of office.

Email Propaganda in My Inbox

I received the following email message from two different people yesterday.

Definitely something to consider before you cast your vote this election!!!

A short, but poignant, independent film on government-sponsored healthcare systems. Anyone who plans to vote for our new President in 2008 must see this.

This is the independent film: A Short Course in Brain Surgery

That link explains the film is part of the Free Market Cure Video Series created to inform Americans about the dangers of collectivized medicine and the benefits of free markets in health care. In this particular case, "A Short Course in Brain Surgery" highlights the story of Lindsay McCreith, "a man with a cancerous brain tumor who crossed the border to the U.S. to get the medical care that is rationed in his home country." You can read more about McCreith here and here.

I never heard of Free Market Videos so I decided to do some digging and hit pay dirt right away. An entertaining blog called the Hillbilly Report already dug up information on them. Basically, the film is partly funded by the Moving Picture Institute, a 501(c)(3) non-profit organization, and one of their board members is Freyda Levy. Freyda co-founded the New Jersey chapter of Americans for Prosperity - the limited government, free market group that teaches grassroot activitists how to lobby legislators - and she also serves on the board of Club for Growth. You get the picture.

The film and its backers are trying to convince voters that government health care isn't the answer, and they're using this one example from Canada to make their point. The problem is that no one ever said Canada's health care was perfect. We've all heard the stories about patients waiting for hours in Canadian emergency rooms. But guess what? The average length of stay in U.S. emergency rooms in 2005 hit 3 hours and 42 minutes. And for every Lindsay McCreith in Canada, there's a Nataline Sarkisyan in the United States. Nataline is the 17 year-old girl from California who died five days after her insurance company refused to approve her liver transplant.

Actually, Lindsay McCreith is fortunate that he had government health care to fall back on at the first sign that something was wrong. That's not the case for thousands of uninsured Americans. Consider these facts from Families USA:

In 2002, the Institute of Medicine released a groundbreaking report, Care without Coverage: Too Little, Too Late, which estimated that 18,000 adults nationwide died in 2000 because they did not have health insurance. Subsequently, The Urban Institute estimated that 22,000 adults died in 2006 because they did not have health insurance.

Across the United States, in 2006, twice as many people died from lack of health insurance as died from homicide.

Uninsured adults are more likely to be diagnosed with a disease in an advanced stage. For example, uninsured women are substantially more likely to be diagnosed with advanced stage breast cancer than women with private insurance.

The bottom line is that other countries health systems have their problems, but each one seems to deliver a better total package than the one here at home. That point was made in a new documentary on PBS called Sick Around the World. The film is underwritten by The Kaiser Foundation and hosted by Washington Post correspondent T.R. Reid. Jonathan Cohn says viewers will find this film has an evenhandedness viewers didn't find in "Sicko" (and I didn't find in "A Short Course in Brain Surgery"). This is what Cohn has to say:

In England, the film notes, patients frequently wait for elective services; in Germany, physicians are unhappy that they don't get paid more; in Japan, the government's hyper-aggressive price controls have led to chronic underfunding. And yet the new film also puts these drawbacks in their rightful context. Every system the film portrays has its problems, but overall each one seems to deliver a better total package than the one in the U.S.

The most interesting case study is probably Taiwan. A few years ago, when Taiwan decided to revamp its health care system, it studied other countries to determine which system might work best. Its conclusion? A single-payer system--one in which the government insures everybody directly--made the most sense.

[...] Today, the people of Taiwan have guaranteed access to health care--and, according to the film, it's very good health care. There are no chronic waiting lists, like you find in Britain, and the care is very advanced. Among other things, Taiwan is among the world leaders in establishing electronic medical records--an innovation that should significantly improve care by keeping doctors and nurses better informed about patient histories and, no less important, avoiding potentially dangerous drug interactions.

Cohn admits that politically single-payer is still a tough sell in this country, but "Sick Around the World" makes it clear that alternatives work well too.

The reports from Germany, Japan, and Switzerland make it clear that it's possible to have everything Americans like about their health care system--quick access, choice of doctor and provider, high quality care--while covering everybody and spending less.

That brings me back to that email I referred to at the beginning. I need to consider the candidates plans before I vote in November. Back to Cohn:

The presidential candidates don't talk about other countries, except (for opponents of universal coverage, like McCain) to bash them.

But both of the Democrats call for covering everybody--and for overhauling the system so that it can achieve the sorts of efficiencies the best systems abroad have realized. Their plans, if implemented as they've been drawn up, would make American health care look a lot like the Swiss version.

Neither plan would accomplish that transition overnight... Still, that's a far cry from what McCain and much of his party advocates, which is essentially to fix the existing patchwork with even more patches. And that's a crucial difference of which viewers (and voters) should be aware.

Hmm...patches or the efficiencies the best systems abroad have realized? No-contest. I'm voting Democrat.

(Cross-posted at Blogging for Michigan.)

Voters Favor Democrats Health Care Proposals

Health care is widely seen as the top domestic issue in 2008 and the Democrats continue to poll strong in this area. From the Kaiser Network:

U.S. adults favor health care proposals from Democratic presidential candidates more than plans from Republican candidates, according to a recent Los Angeles Times/Bloomberg survey.

According to the survey, 62% favor a requirement that large employers offer health insurance to employees -- a provision included in health care proposals from Sens. Hillary Rodham Clinton (D-N.Y.) and Barack Obama (D-Ill.) and former Sen. John Edwards (D-N.C.) -- and 31% oppose such a requirement. Fifty-one percent favor a requirement that individuals obtain health insurance -- a provision included in the Clinton and Edwards proposals -- and 39% oppose such a requirement, the survey found.

Forty-four percent favor tax credits to help individuals purchase private health insurance -- a provision included in health care proposals from former New York City Major Rudy Giuliani (R) and former Massachusetts Gov. Mitt Romney (R) -- and 45% oppose such tax credits, according to the survey.

Tax credits pretty evenly divide voters, but those opposing the credits (especially among the middle-class) could increase as more employers drop health insurance and premiums continue to climb. As a woman quoted in the LA Times article said:

"A tax credit is just a tax credit," VanDruff said. "You get that just once a year, and it is not going to cover the cost to you for health insurance."

"If you are rich-rich, you can afford it, and if you are poor-poor, they'll help you with it," she said of health insurance. "But if you are that in-between guy, you are in trouble."

There were two other significant results from the poll:

The survey found that 53% favor an expansion of Medicare to all U.S. residents and that 36% oppose such an expansion. "In one of the most politically significant results, the poll finds that independents and moderates were generally lining up with Democrats in the health care debate," the Times reports.

Independents lined with up Democrats because of "job lock." In all, 20% of independents said they or someone in their household were forced to stay in a job because it provided health care, compared with 13% of Democrats and 5% of Republicans.

(Cross-posted at BFM.)

Update: Thanks to DJ @ BFM for pointing out what I missed about the story above. Hillary Clinton's plan does include tax credits. This is how John Nichols @ The Nation describes it:

The Clinton plan maintains the current system of for-profit, insurance-industry defined health care delivery. The only real change is that, in return for minimal requirements regarding coverage of those with preexisting conditions, the government would pump hundreds of billions in federal dollars into the accounts of some of the country’s wealthiest corporations. The plan’s tax credit scheme would buy some more coverage for low-income families, which is good, but it would do so at a cost so immense that, ultimately, Clinton’s plan will be as tough a sell as the failed 1993 “Hillarycare” proposal.

Some more coverage is good, but Kucinich's Medicare-For-All is much, much better.

Insurance Industry 1, Sick Children 0

From Bush's press conference yesterday:

"And I believe strongly in private medicine.

Now, I think the federal government ought to help those who are poor. And it's one of the reasons why I worked on Medicare reform was to make sure that we fulfill our promise to the elderly.

But I don't like plans that move people from — encourage people to move from private medicine to the public, and that's what's happening under this bill."

Bush got what he wanted:

Republicans Speak: No Healthcare For Children

Even though this latest CBS News poll found an overwhelming majority of Americans supported the legislation:

WOULD YOU FAVOR OR OPPOSE EXPANDING S-CHIP?

Favor - 81%
Oppose - 15%

WOULD YOU BE WILLING TO PAY MORE TAXES TO EXPAND S-CHIP? (Among those who favor expanding S-CHIP)

Yes -74%
No - 17%

These men voted no on SCHIP here in Michigan: Camp, Hoekstra, Knollenberg, McCotter, Rogers and Walberg. They have tax-payer funded public insurance - and so do their children. Remember that when you vote in 2008.

We have seen the enemy...

I love Barbara Ehrenreich's style. She calls it the way she sees it.

We Have Seen the Enemy -- And Surrendered

Bow your heads and raise the white flags. After facing down the Third Reich, the Japanese Empire, the U.S.S.R., Manuel Noriega and Saddam Hussein, the United States has met an enemy it dares not confront — the American private health insurance industry.

With the courageous exception of Dennis Kucinich, the Democratic candidates have all rolled out health “reform” plans that represent total, Chamberlain-like, appeasement. Edwards and Obama propose universal health insurance plans that would in no way ease the death grip of Aetna, Unicare, MetLife, and the rest of the evil-doers. Clinton — why are we not surprised? — has gone even further, borrowing the Republican idea of actually feeding the private insurers by making it mandatory to buy their product. Will I be arrested if I resist paying $10,000 a year for a private policy laden with killer co-pays and deductibles?

It’s not only the Democratic candidates who are capitulating. The surrender-buzz is everywhere. I heard it from a notable liberal political scientist on a panel in August: We can’t just leap to a single payer system, he said in so many words, because it would be too disruptive, given the size of the private health insurance industry. Then I heard it yesterday from a Chicago woman who leads a nonprofit agency serving the poor: How can we go to a Canadian-style system when the private industry has gotten so “big”? [...]

How can we not?

Think of the damage. An estimated 18,000 Americans die every year because they can’t afford or can’t qualify for health insurance. That’s the 9/11 carnage multiplied by three — every year. Not to mention all the people who are stuck in jobs they hate because they don’t dare lose their current insurance.

Saddam Hussein never killed 18,000 Americans or anything close; nor did the U.S.S.R. Yet we faced down those “enemies” with huge patriotic bluster, vast military expenditures, and, in the case of Saddam, armed intervention. So why does the U.S. soil its pants and cower in fear when confronted with the insurance industry?

That's a question 89.6 million Americans who found themselves uninsured at some point during 2006-2007 would like to have answered too.

Health care premiums continue to rise

If you pay for any of your health insurance through your employer, this latest information won't surprise you. From USA Today:

Health care premiums rise 6.1%, far outpacing wages

Health insurance premiums paid by workers and their employers rose an average of 6.1% this year, outpacing inflation and pay increases and taking a bigger chunk out of families' budgets, according to a survey out Tuesday.

The cost was down from a 7.7% increase a year earlier, according to an annual survey of employers by the Kaiser Family Foundation, a non-profit research group.

This year's slowdown doesn't mean much when it outpaces wages, which rose an average of 3.7%, and inflation, which went up 2.6%, said Drew Altman, the foundation's president and CEO.

The cost for family coverage has risen 78% since 2001, while wages have risen 19% and prices for goods and services have risen 17% in that period, according to the report. [emphasis mine]

As one person commented following the article:

Jesus! Mary! Joseph! as my sainted mother used to say....

I am so discouraged with what is happening in this country I am ready to cry....

If you're interested, click here to read the Kaiser Family Foundation Employer Health Benefits 2007 Annual Survey.

Giuliani's (Non) Health Care Plan

Presidential hopeful Rudy Giuliani released details of his health care plan this week, which really fails to help the uninsured and more or less parrots the ideas of the Bush administration. Ezra Klein discusses it over at American Prospect - A Man With a (Non-)Plan - and says, "Rudy Giuliani's health care "plan" is less a good-faith reform proposal than a cudgel with which to bash liberals."

Klein bases that opinion on the following:

In the speech introducing and detailing his new health care proposal, Giuliani refers to the "Democrats" six times. "Single-payer" is said eight times. "Socialized medicine," or some variant thereof, makes nine appearances. "Uninsured" is never uttered -- not once.

So, what does Giuliani's plan actually offer?

A tax exclusion of up to $15,000 for families, and $7,500 for individuals, to help pay for health care. What Giuliani is relying on is people reading those numbers -- $15,000 and $7,500 -- without noticing that they don't denote the amount of money he's offering them, but the amount of money he's not taxing them on. And when we plug it into my magical Rudy Translation Machine (constructed with the help of friendly neighborhood economist, Dean Baker), we can watch how $15,000 can easily become … zero.

Let's stipulate a family of four -- a mom, a dad, and two children. The type of family Republicans like. And let's say your household income is $30,000 a year. Giuliani's tax exclusion will save you … nothing. Your income isn't taxable anyway. Bring it up to $40,000 … and it's still nothing. Your child tax credits are crossing out your taxable income. Indeed, according to the Center for Budget and Policy Priorities, 55 percent of the uninsured don't earn enough money to have any taxable income. This proposal -- unless changed from a straight exclusion to a refundable tax credit -- will do literally nothing for them.

Don't get me wrong, some families will save a few bucks. If you make $50,000, Giuliani's exclusion will save you $1,220. And if you make $70,000, you'll get a whopping $2,250. And the higher up the income ladder you go, the more our hypothetical family unit will save. Meanwhile, here's the kicker: According to the Kaiser Family Foundation, in 2006, premiums for family coverage amounted to, on average, $11,480. Giuliani's giveaway barely makes a dent.

So it's no surprise that Alan Cohen, head of Boston University's Health Policy Institute, looked at Giuliani's "vision" and said, "I don't think it's likely to increase coverage of people to any great extent, and I don't think it's going to get a handle on health care cost inflation in this country."

Schemes based around tax subsidies just don't work according to Klein, and he backs that opinion up with research from the RAND Corporation who recently examined whether government subsidies could solve the problem of the uninsured.

They researched the health care decisions of nearly 25,000 new health care subscribers in California. Their conclusion? "Government subsidies that cut health insurance premium prices in half for people without insurance would reduce the number of uninsured Americans by just 3 percent."

Three percent? That's no solution, Rudy.

The Center on Budget and Policy Priorities also examined whether tax incentives would be an effective way to expand health coverage and came up with a similar conclusion:

[...] proposed tax subsidies for the purchase of health insurance would likely be of little help to most low-income families, given the high premiums and out-of-pocket costs associated with individual-group coverage.

So, Giuliani's plan isn't much of a plan, but maybe that wasn't his point according to Dr. McCanne at Physicians for a National Health Program. He looked at Rudy's health care proposal and offered this comment:

Rudy Giuliani’s choice of health care advisors is all you need to know to understand his positions on reform. His decision to trump rational health policy with extremist libertarian ideology does tend to make you question his political skills. He obviously isn’t poll driven.

Rudy, polls show that a majority of the voters want a national health care plan and they're willing to pay more in taxes to get it. If you won't react to the will of the majority now, then you're not worthy enough to be president. The people deserve to have the ear of the next person in office.

Priorities

Chief Justice John Roberts Jr. was hospitalized Monday after suffering a seizure. He underwent a thorough neurological evaluation and is expected to make a full recovery. Roberts' medical workup probably included “a good M.R.I., CAT scan and EEG.” How fortunate that Roberts has federal health insurance to cover his hospitalization, tests and ongoing care.

We should all be so lucky. The U.S. is the richest country in the world, so there's no reason we shouldn't all have health care, living wages, secure retirements, etc. It all boils down to "Priorities" according to WorkingLife TV's inaugural film, a documentary filmed during the first few days of John Edwards' Road to One America poverty tour.

The right-wing pushes health care myth

Here's yet another right-wing soundbite that fails to pass the sniff test:

Waiting Times For Care? Try Looking At The U.S. - Nurses, Doctors Say It's Time To Debunk The Myths

"There's been a lot of clamor lately about delays in care in some other countries. But if you want to see some really unsightly waiting times, look at U.S. medical facilities," said Deborah Burger, RN, president of the 75,000-member CNA/NNOC.

While the problem has been largely overlooked by the major media, it was quietly exposed by the chief medical officer of Aetna, Inc. late in Aetna's Investor Conference 2007 in March.

In his talk, Troy Brennan conceded that "the (U.S.) healthcare system is not timely." He cited "recent statistics from the Institution of Healthcare Improvement… that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable," Brennan said. [...]

A Commonwealth Fund study of six highly industrialized countries, the U.S., and five nations with national health systems, Britain, Germany, Australia, New Zealand, and Canada, found waiting times were worse in the U.S. than in all the other countries except Canada. And, most of the Canadian data so widely reported by the U.S. media is out of date, and misleading, according to PNHP and CNA/NNOC.

In Canada, there are no waits for emergency surgeries, and the median time for non-emergency elective surgery has been dropping as a result of public pressure and increased funding so that it is now equal to or better than the U.S. in most areas, the organizations say. Statistics Canada's latest figures show that median wait times for elective surgery in Canada is now three weeks.

"There are significant differences between the U.S. and Canada, too," said Burger. "In Canada, no one is denied care because of cost, because their treatment or test was not 'pre-approved' or because they have a pre-existing condition." [emphasis added]

No wonder Canadians are pushing back against commercial efforts to open up their system to for-profit health services.

2008 Republican candidates on health care

It appears that Michael Moore touched a nerve with voters unhappy about health care if this is any indication:

“Michael Moore’s latest film, ‘Sicko,’ was a smash hit over the weekend. The documentary about the health care industry was sold out at all its ’sneak’ screenings in 43 locations around the country including Cleveland, Boston, Atlanta, and Detroit.”

Polls continue to show that voters feel this is our number one domestic issue, but what about our 2008 presidential candidates? I'll cover the Republicans first and get to the Democrats later this week.

McCain, Giuliani, Hunter and Paul don't even mention health care on their campaign websites. Ouch! Are they out of touch with voters or what? I did find some statements they made though. From McCain:

The Arizona lawmaker told ABC’s “This Week” that he and his staff are developing a health plan “that every American can take advantage of and afford.” The timing of an announcement is unclear, but he said its elements would include tax incentives for low-income people so they buy health coverage, community health centers, expanding the State Children’s Health Insurance Program, putting health care online, medical malpractice reform, and making health savings accounts more available.

Color me unimpressed. McCain will have to do better than that. Tax incentives so poor people can buy health coverage? Does he even know how much health insurance costs? If poor people had the money to buy insurance, they'd have it already.

Giuliani sounds a lot like McCain:

Among Republicans, former New York Mayor Rudolph Giuliani is working on a package of incentives to get more people to buy their own coverage in the individual insurance market and to make that coverage affordable. Health insurance should be more like car insurance, he says, where people pay out of pocket for minor repairs and maintenance.

At least Giuliani actually says he wants to make insurance more affordable, but his statement about car insurance shows how out of touch he is with the real world. I don't know of a single car insurance policy that covers maintenance, and the same goes for minor repairs.

Moving along to Tommy Thompson, former US Secretary of Health and Human Services, here's his plan to fix health care from his campaign website:

Governor Thompson believes we must build a system that is affordable and accessible for everyone. And we can do this without a government-run health care program that includes the worst aspects of socialized medicine.

Thompson is talking about Medicare when he talks about socialized medicine. From personal experience, I can say that Medicare has always provided good medical treatment for my loved ones from hip replacements to physical therapy to preventative measures like pneumonia shots, and overall they've all been happy with it. I suspect Thompson would like to see the government taken out of the program for personal reasons.

Thompson is the President of Logistics Health, Inc. He is also senior partner at Akin Gump, a Washington, D.C., law firm, and is additionally a senior advisor at the consulting firm Deloitte and is the chairman of the Deloitte Center for Health Solutions.

The WaPo picked up on this too and reported the following last summer:

Tommy G. Thompson, the former secretary of health and human services, proposed overhauling Medicaid in ways that he says would be good for the country. Critics contend that some of Thompson's recommendations also could be good for companies that he works for.

It might benefit Tommy Thompson's bottom line, but it won't help taxpayers. The Congressional Budget Office determined that, on average, the federal government is paying private plans 12 percent more than it costs to treat comparable beneficiaries through traditional Medicare.

How about the candidate that Republicans prefer to ignore - Ron Paul? He thinks Congress should pass the following series of bills to reduce health care costs and leave more money in the pockets of families:

HR 3075 provides truly comprehensive health care reform by allowing families to claim a tax credit for the rising cost of health insurance premiums. [...]

HR 3076 is specifically designed to address the medical malpractice crisis that threatens to drive thousands of American doctors - especially obstetricians - out of business. The bill provides a dollar-for-dollar tax credit that permits consumers to purchase "negative outcomes" insurance prior to undergoing surgery or other serious medical treatments. [...]

HR 3077 makes it more affordable for parents to provide health care for their children. It creates a $500 per child tax credit for medical expenses and prescription drugs that are not reimbursed by insurance. It also creates a $3,000 tax credit for dependent children with terminal illnesses, cancer, or disabilities. [...]

HR 3078 is commonsense, compassionate legislation for those suffering from cancer or other terminal illnesses. The sad reality is that many patients battling serious illnesses will never collect Social Security benefits-- yet they continue to pay into the Social Security system. When facing a medical crisis, those patients need every extra dollar to pay for medical care, travel, and family matters. HR 3078 waives the employee portion of Social Security payroll taxes (or self-employment taxes) for individuals with documented serious illnesses or cancer. It also suspends Social Security taxes for primary caregivers with a sick spouse or child. [...]

These bills won't help people. What good are tax credits if people don't have the money to pay their monthly premiums or purchase the medicine they need today? And what about that medical malpractice crisis mentioned? From the NY Times:

Lawsuits against doctors are just one of several factors that have driven up the cost of malpractice insurance, specialists say. Lately, the more important factors appear to be the declining investment earnings of insurance companies and the changing nature of competition in the industry.

The recent spike in premiums - which is now showing signs of steadying - says more about the insurance business than it does about the judicial system.

And I just bet the insurance industry would love to see negative outcome insurance gain acceptance, they'd make a lot of money from the millions of policies they'd sell, not to mention the money they'd save on lawyer fees. Finally, exempting social security taxes for terminal illnesses is a nice gesture, but it's just a drop in the bucket for a family facing crushing medical bills.

That brings me to Mitch Romney. Here's what he says about health care on his campaign website:

The health of our nation can be improved by extending health insurance to all Americans, not through a government program or new taxes, but through market reforms.

This statement somewhat contradicts the Massachusetts Health Care Reform Plan he helped initiate to cover the uninsured. The plan expands Medicaid eligibility and offers subsidies for the purchase of private coverage to low-income individuals and families, all funded by the government.

Massachusetts was motivated to come up with this plan in part because the federal government threatened to eliminate $385 million in federal Medicaid money unless the state reduced the number of uninsured people, and the state was already spending more than $500 million in federal and state money annually to compensate hospitals for treating the uninsured. They simply redirected that money to insurance coverage. Besides those government funds, Romney also earmarked an anticipated revenue surplus (tax dollars) for expanded coverage. All that funding sounds like a government program to me.

I'll leave it up to you to decide whether his plan was political grandstanding or not. I give Romney credit for doing something, although it still relies too heavily on the private sector for my tastes, and it fails to deliver good care at an affordable price. Physicians for a National Health Program aren't sold either:

Americans need more than affordable insurance; they need affordable health care. California Gov. Arnold Schwarzenegger plans to copy the Massachusetts reform in shrinking the numbers of uninsured people by forcing them to buy stripped down, bare-bones policies. With premiums for family coverage now averaging $10,000 a year, the only way that states can make premiums affordable is to strip down the plans, which then forces policyholders to pay out of pocket when they get sick. High deductibles, co-payments and benefit reductions are destroying the financial protection that insurance should provide. [...]

The big winners in the Schwarzenegger and Massachusetts health plans are private health insurance firms. The new insurance mandates will hand them billions in wasteful administrative fees that do not occur in government insurance programs such as Medicare.

I still prefer 100% universal health insurance over Romney's plan which leaves some people out.

"Getting to 98 or 99 percent insured is about the best that anyone is going to be able to do," said Karen Davis, president of the Commonwealth Fund, a New York-based foundation that sponsors research to improve healthcare.

Getting 98 or 99 percent of the people insured isn't good enough for me. I'll withhold my vote for the candidate with a better idea, but at this point in time I can definitely say it won't be a Republican.

Voters unhappy with health care nightmare

Some more polling data on health care to go along with yesterday's post:

WebMD Medical News

June 21, 2007 -- A new poll shows health care is the leading domestic issue on voters' minds, second only to Iraq as the most important issue in the nation.

Twenty-one percent of voters in the poll call health care the issue they'd most like to hear candidates talk about in the 2008 presidential election. The issue edges out immigration, the economy, and gas prices as voter's top domestic concerns. [...]

"We may be on the edge of our next great national debate on health reform," says Drew Altman, president of the Henry J. Kaiser Family Foundation, which conducted the survey.[...]

Nearly four in 10 of those surveyed said they want to hear candidates talk about coverage shortages and the uninsured. Close to three in 10 said health costs were their No. 1 concern.

Not surprisingly, voters feel the insurance industry is the problem:

Lack of insurance is not the problem - it's the insurance industry itself. A Zogby/UPI poll in February found that 42 percent of Americans said their insurer had refused to pay a medical bill. A USA Today/ABC poll in March found one in four Americans had trouble paying for medical care in 2006. Two thirds of those were insured.

That helps to explain this sentiment:

CNN/Opinion Research Corporation Poll. 5/4-06/07

"Do you think the government should provide a national health insurance program for all Americans, even if this would require higher taxes?" Yes 64%, No 35%, Unsure 2%

"Do you think the government should provide a national health insurance program for all children under the age of 18, even if this would require higher taxes?" Yes 73%, No 25%, Unsure 2% [emphasis added]

Our 2008 presidential candidates should take note of these polls. Voters aren't interested in expanding the market driven, private insurance-based system that perpetuates our present health care nightmare. National health insurance is the cure they want.

Dave Camp on universal health care: Woof-woof

It looks like the 72 percent of Americans who want universal health coverage - and the 63 percent who support universal health coverage even if it requires tax increases - will be ignored again (just like they were about Iraq) if Michigan Congressman Dave Camp (R) is any indication.

According to a link at MI Liberal, Camp believes the solutions to our health care problems lie in the private sector and not in more government programs. From The Hill:

I firmly believe we can and should solve America’s healthcare crisis in an American way. History is a great teacher, and if we choose to go down the path that Western Europe or Canada has, it will be no surprise when we come to the same destination — a universal healthcare system that leaves your family dog with better coverage and care than you get. As the Canadian Supreme Court once opined, “access to a waiting list is not access to care.” [emphasis added]

Really? Then how does Camp explain this recent study:

Health outcomes for patients in Canada are as good as or better than in the United States, even though per capita spending is higher south of the border, suggest Canadian and U.S. researchers who crunched data from 38 studies. [...] [emphasis added]

"In looking at patients in Canada with a specific diagnosis compared to Americans with the same diagnosis, in Canada patients had at least as good an outcome as their American counterparts – and in many situations, a better health outcome," said one of the 17 authors, Dr. P.J. Devereaux, a cardiologist and clinical epidemiologist at McMaster University in Hamilton.

"And that is important because in the United States, they're currently spending a little over $7,100 per individual on health care annually, whereas in Canada we're spending a little over $2,900 per individual annually," he said in a telephone interview from Brantford, Ont.[...]

Researchers began by asking the question: Are there differences in health outcomes (mortality or morbidity) in patients suffering from similar medical conditions treated in Canada versus those treated in the United States?

"Overall, Canada did better, and in fact we found a statistically significant five per cent mortality advantage to people with diagnoses in Canada compared to their counterparts in the United States," Devereaux said.

Or how about these statistics from the Fort Wayne News Sentinel?

France, Germany, Japan and Switzerland have less centralized systems, which provide much better results. They combine universal coverage with easy access to medical care. According to the Organization for Economic Cooperation and Development, none of these countries have waiting-list problems. Access to medical care tends to be easier in those countries than it is in the United States. [...] [emphasis added]

It is inaccurate to assume that we have the best high-tech care. Japan, which has universal care, has more CT scanners and MRIs per person than the United States. Germany and Switzerland are on a par with us. [...]

Victor Rodwin of New York University finds that on a per-capita basis, the French get more physician office visits and more drugs than their counterparts here.

Heck, even Cuba (gasp!) delivers good health care according to AlterNet:

They [Cubans] live longer than almost anyone in Latin America. Far fewer babies die. Almost everyone has been vaccinated, and such scourges of the poor as parasites, TB, malaria, even HIV/AIDS are rare or non-existent. Anyone can see a doctor, at low cost, right in the neighborhood.

The Cuban health care system is producing a population that is as healthy as those of the world's wealthiest countries at a fraction of the cost. And now Cuba has begun exporting its system to under-served communities around the world -- including the United States. [...]

Many elements of the health care system Cuba is exporting around the world are common-sense practices. Everyone has access to doctors, nurses, specialists, and medications. There is a doctor and nurse team in every neighborhood... If someone doesn't like their neighborhood doctor, they can choose another one.

House calls are routine, in part because it's the responsibility of the doctor and nurse team to understand you and your health issues in the context of your family, home, and neighborhood. This is key to the system. By catching diseases and health hazards before they get big, the Cuban medical system can spend a little on prevention rather than a lot later on to cure diseases, stop outbreaks, or cope with long-term disabilities. [...]

For health issues beyond the capacity of the neighborhood doctor, polyclinics provide specialists, outpatient operations, physical therapy, rehabilitation, and labs. Those who need inpatient treatment can go to hospitals; at the end of their stay, their neighborhood medical team helps make the transition home.[...]

I don't know how dogs fare in Cuba, but the article did say Castro provided scholarships to 90 poor Americans with the understanding that they have to agree to go back and serve their poor communities after graduation. Why the big investment in health?

Even more revolutionary than the right to health care for all is the idea that an investment in health -- or in clean water, adequate food or housing -- could be more powerful, more effective at building security than bombers and aircraft carriers.

That concept is lost on lawmakers like Camp who continue to support the war and their corporate buddies. Building bombs and aircraft carriers is a lucrative business for private contractors in Washington. According to Jim Hightower, government contracting has grown 86% under Bush's Republican administration and now totals nearly $400 BILLION dollars a year. It's no wonder Camp believes the private sector should play a role in health care reform (and get a piece of the pie):

"Too much government-provided healthcare limits private sector opportunities. We should be expanding access in the private sector, not crowding it out."

Never mind the fact that the public gets screwed (think donut holes, Katrina, Walter Reed): Medicare Is Defrauding Seniors

In 2005 alone, taxpayers lost $2.7 billion in overpayments [while i]nsurance companies that sell Medicare Advantage plans are substantially overpaid to market their plans...

And never mind the fact that corporate America is leaning in the same direction as most Americans:

Wal-Mart Stores Inc., AT&T Inc., Intel Corp. and Kelly Services Inc. joined forces with two labor unions in calling for an overhaul of the U.S. health-care system that would guarantee universal coverage by 2012.

I suspect Wal-Mart understands the economics behind universal health care because their business approach is similar. By pooling all Americans (vendors) together in the same pool, the government (Wal-Mart) can use its massive market share to bargain down prices and advocate for their interests.

On the other hand, I suspect Congressman Camp only advocates for the interests of the insurance industries and lobbyists who stand to benefit from expanding private health care.

Conyers' plan to cover the uninsured

In keeping with Cover the Uninsured week, here's information about John Conyers' Congressional Forum - Universal Health Care with Single Payer Financing - held in Washington today to educate and enlighten his Congressional colleagues about HR 676.

And here's some background to explain details of the single-payer plan from The Nation:

More than 47 million Americans are now living without health coverage. Representative John Conyers's United States National Health Insurance Act (HR 676) would create a single-payer healthcare system by expanding Medicare to every resident. All necessary medical care would be covered--from prescription drugs to hospital services to long-term care. There would be no deductibles or co-payments. Funding would come from sources including savings from negotiated bulk procurement of medications; a tax on the top 5 percent of income earners; and a phased-in payroll tax that is lower than what employers currently pay for less comprehensive employee health coverage. [...] To get involved, check out www.Healthcare-Now.org.

There are currently 62 co-sponsors of HR 676, including Rep. Carolyn Kilpatrick of Michigan, and almost 260 union endorsements in 40 states. Some of Michigan's unions throwing their support behind the bill include:

Local 6000, United Auto Workers (UAW), Michigan State Employees, Lansing, MI
Branch 3126, National Association of Letter Carriers (NALC), Royal Oak, MI.
Local Lodge 141, International Association of Machinists (IAM), representing airline workers at Northwest, United, Southwest, and Alaska. Detroit, MI
Local 547, International Union of Operating Engineers, Detroit, MI
Jackson/Hillsdale Counties Central Labor Council, AFL-CIO, Jackson, MI

Five Michigan steelworker locals endorse HR 676 too. The growing union support isn't surprising. Unions have traditionally bargained for and delivered good health insurance for their workers and families, but downsizing and off-shoring in manufacturing industries has resulted in workers losing their insurance altogether or being forced to pay more for less.

It's not just union workers facing health insurance insecurity though. From TPM Cafe:

26% of Americans say there has been a time in the last 12 months when they have been unable to afford necessary health care for themselves or a family member. Support for extending health care to all Americans trumps any tax-phobia: 66% of Americans favor "the government guaranteeing health insurance for all citizens, even if it means raising taxes."

There's still a lot of doubt a single payer system could surmount the special interest group lobbyists, but Congressman Dennis Kucinich thinks it has a good chance:

It is true that large corporations, who are currently making millions every year off the backs of every American who pays for health care, will fight hard to protect the unsustainable status quo as long as they possibly can.

But with health care costs rising faster than inflation with no end in sight; and with the abject failure of managed care to contain those costs; and with the number of uninsured growing steadily; and with American companies losing their competitive edge because they are paying so much more for health care than other developed countries; the opposition will not be able to hold justice at bay for much longer. So when people tell me that national health insurance is the right answer but is not politically feasible, I tell them that the opposite is true. Passage is inevitable - it is only a matter of time.

Another argument against public programs like Medicare is that private insurers are just more efficient, but that's simply propaganda according to Jonathan Cohn at TPM Cafe:

It works as propaganda because it’s consistent with the public’s deeply held skepticism of government. But it’s just not true. And this week Wall Street gave us yet more proof of that.

It happened yesterday after Aetna, one of the nation’s largest insurers, released its first-quarter earnings report. Earnings were up more than 3 percent – the kind of news that, one might suppose, Wall Street would greet with glee. Not so. Shares actually plummeted...by more than 20 percent.

Reason: Aenta’s medical loss ratio was going up – i.e., that it was spending more money on its patients – provoked a sharp rebuke from Wall Street.

The amount Aetna paid for covered services divided by the amount of premiums collected was 79.4%, up from 74.6%, but as Cohn points out:

"About 98% of the money that goes into the Medicare program comes back out as medical services - in good part because the program doesn't siphon money for marketing and profits. But, then, Medicare doesn’t have to satisfy investors. It has to satisfy voters. Big difference."

Absolutely, but I have a feeling when it comes to people's health that voters want every dime possible directed toward providing care, not delivering for the investors, which probably explains why 66% of Americans favor the government guaranteeing health insurance for all citizens, even if it means raising taxes. People know that Medicare has been a government success.

If you like Conyers' plan and believe that establishing a universal health care system is essential to resolving our nation's health care crisis, click here to sign his petition and support the passage of H.R. 676.

UPDATE: Click here to get more information about the Executive Summary of The United States National Health Insurance Act (HR676).

Cover the uninsured

This is "Cover the Uninsured Week" across the nation and here in Michigan. Americans may disagree about many issues, but according to a recent Kaiser Health Tracking Poll health care ranks second behind Iraq as one of the most important problems for the government to address for Republicans, Democrats and independents alike.

That doesn't surprise me. The plight of uninsured people continues to touch the lives of more and more Americans and their families. Here are some facts that show just how serious the problem has become [pdf file]:

Eight out of 10 people who are uninsured are in working families

Non-Hispanic whites make up half of the uninsured.

In 2005, more than 32 million of the uninsured had household incomes of $25,000 or more, compared with 14.6 million in households earning less. (The federal poverty level for a family of four in 2005 was $19,350.)

About 18,000 Americans die each year because they don’t have health coverage, according to the nonpartisan Institute of Medicine.

In 2005, 23.1 percent of the nation’s uninsured workers age 18–64 were in firms employing more than 500 people.

Our country has done a better job of insuring children than adults thanks to SCHIP (which is up for renewal this year), but there are still 9 million more children--more than the total number of kids enrolled in the first and second grades in U.S. public schools--still living without health coverage.

That's a shocking statistic. The Bush administration had no problem asking for $500 billion for the war in Iraq (the war based on a lie) and the President also wants the tax cuts scheduled to expire in 2010 made permanent, which means the top 1 percent of households would receive more than $1 TRILLION in tax benefits over the next decade, so why didn't he ask for money to insure those 9 million children? So much for compassionate conservatism.

On a state level, statistics show that Michigan's uninsured numbers are better than U.S. averages, but there's still lots of room for improvement. Gov. Granholm is working to help solve the problem, including her plan to help as many as 550,000 uninsured residents gain health coverage, however, the state is still negotiating with the Bush administration over this. Keeping people healthy should be a no-brainer. I don't know why the Bush administration is dragging their feet.

In the meantime, local communities are trying to fill the gap too. Genesee County voters supported a 1-mill levy last year that provides health coverage for those who earn too much to qualify for Medicaid, cannot afford insurance on their own and are not old enough for Medicare. The levy costs a taxpayer with a $150,000 home about $75 a year. This plan is making a difference for the more than 55,000 adults in Genesee County without health insurance, but some needs are still lacking - surgeries, hospital stays, substance abuse and dental care.

These programs are helpful in the short-term, but this is the bottom line according to Woodrow Stanley, county commissioner and member of the Genesee County Board of Health:

"This is more of a stop-gap for our community," Stanley said. "We can't afford the kinds of comprehensive coverage people need, but we're doing our best until national leaders take on the issue." [emphasis mine]

Republicans have demonstrated that they can't be trusted to do the right thing when it comes to people's health care, so I'd be very surprised if voters don't elect a Democrat like Edwards next time around - the only candidate that has a truly universal health care plan.

Voters sent a message about the war in Iraq last November and they're ready to send another one: No more donut holes, no more gaps in the level of care, and no more handouts to insurance companies and Big Pharma.

Republicans neglect our elderly population

My mother was hospitalized last week after a health emergency and she's being moved to a nursing home today. I wish to protect her identity so I won't go into details, but I will tell you she has Alzheimer's, and because of the added health issues she now requires round the clock care for all activities of daily living. As you might imagine,the past several days have been very difficult for us. There's a chance she'll recover enough to come home (she lives with my sister and brother-in-law), but that's a big "if" at this point in time.

Nursing homes can be scary places for patients, and also for families. We've all heard the horror stories of inadequate care or neglect and none of us want to see our loved ones end up in those kinds of places. We only want the best for them. That's what I woke up thinking about this morning. The facility they're transferring my mother to is nice, but my concern is what happens if this becomes a long-term proposition and her Medicare runs out. My mother is almost 90-years-old and outlived her money years ago. She was fortunate to have children she could live with, but none of us is in the position to help her with nursing home expenses. Mom will end up in a Medicaid facility once her Medicare runs out, and we'll just have to keep our fingers crossed that she ends up in a good place. The better nursing homes only take so many Medicaid patients and openings are hard to come by. It's shameful that the level of care an elderly person receives ends up depending on money.

It's also shameful that some insurers have taken advantage of those people who had the means to buy LTC insurance:

Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult — if not impossible — for policyholders to get paid. A review of more than 400 of the thousands of grievances and lawsuits filed in recent years shows elderly policyholders confronting unnecessary delays and overwhelming bureaucracies. In California alone, nearly one in every four long-term-care claims was denied in 2005, according to the state.

“The bottom line is that insurance companies make money when they don’t pay claims,” said Mary Beth Senkewicz, who resigned last year as a senior executive at the National Association of Insurance Commissioners. “They’ll do anything to avoid paying, because if they wait long enough, they know the policyholders will die.” [...]

“These companies have essentially turned their bureaucracies into profit centers,” said Glenn R. Kantor, a California lawyer who has represented policyholders.

Yet these concerns have been ignored by state regulators, advocates say, and have gone unnoticed by federal lawmakers who recently passed incentives intended to promote purchases of long-term-care policies, in the hopes of forestalling a Medicare funding crisis. [emphasis mine]

This is just one more example of privatized services failing to deliver. Washington may be helping the insurance industry by pushing these programs, but they're not helping the people victimized by the system, and they're not helping people like my mother who can't afford the luxury of private long-term care insurance, yet she worked and paid taxes her entire life. In fact, my mother was a "Rosie the Riveter" and worked in a factory during the war. She deserves the same level of care as the next person.

Locally, our state Republicans have shown the same disrespect and disregard for our elderly. Last week, they pushed through a late evening budget plan that would save the state more than $15 million by reducing the wages and hours for people who care for 40,000-plus low-income seniors and the disabled. Pay for home health care aides will be reduced to $7 an hour under their plan, and seniors must find the helpers on their own. They also cut funding to home-delivered meals by $97,000, which as one person said is a small cut, but it's somebody's grandmother who's going to get the phone call saying they can't get meals anymore.

I don't think there's any justification for cutting back services to our elderly or disabled, but that's not how state Republicans see it:

Senate Majority Leader Mike Bishop, R-Rochester, said the cuts are "painful" but argued that the GOP plan would adequately fund public safety, education and health care and help turn around Michigan.

"Once you get used to a certain level of government, it's hard to trim it back," Bishop said. "But we also know that we have an obligation to the state, to the citizens that we represent, to downsize government."

Excuse me, Sen. Bishop, but you also have an obligation to our elderly. They're citizens too. They paid taxes and contributed to society their entire lives, and now, when we should be doing for them, you want to kick them to the curb? That's disgraceful.

Put yourself in a poor person's shoes just once. How would you feel if your mother needed her adult diapers changed and you couldn't find someone willing to do it for $7 an hour? In fact, would you change diapers, give sponge baths, and strip dirty sheets for $7 an hour? Add into the equation that old people can be difficult and cantankerous to deal with, especially those with dementia, and the pool of caring people willing to work for poverty wages goes down considerably.

Sen. Bishop, you and your Republican cohorts in Michigan and Washington should be ashamed, most people treat they pets better than you treat our elderly.