Simple Coverage

Throwing down the gauntlet

simplecoverage — Mon, 31 Aug 2009 19:29:08 +0000

What does healthcare reform have to do with energy policy, climate change and regulation of the internet?
Perhaps quite a bit more than may appear at first glance.
As President Obama becomes more invested and directly involved in healthcare reform, passage of legislation becomes a direct reflection on his broader legislative agenda.
If the President delivers ObamaCare in the manner he has proposed, he will carry a much larger stick into the battles that follow. If not, he will encounter a much more difficult battle winning Blue Dog Democrats and other moderates in the future.
When President Clinton tackled ambitious health care reform and lost, it crippled his early legislation agenda.
That is why the ongoing behind-the-scenes negotiations are critical no matter what your views on the larger issues.
At stake is not just healthcare reform, as important as that may be.
The political momentum and capital gained from a clear victory may also tilt the scales on key policy issues to follow, including climate change and internet regulation.

Remembering an icon

simplecoverage — Wed, 26 Aug 2009 13:52:18 +0000

No healthcare debate. Not today.
No matter what your position on healthcare reform, today’s issues must be put on hold.
The passing of Sen. Ted Kennedy compels us to pause and reflect on the passing of a true advocate.
Among those causes that the Massachusetts Senator held most dear, healthcare reform topped the list.
You may agree with his positions; you may disagree.
What is indisputable is Sen. Kennedy’s passion and compassion, especially for those who are less fortunate.
And today, as the nation mourns the passing of a political icon, that is something we can all embrace.

Give us something to believe in

simplecoverage — Thu, 20 Aug 2009 14:31:49 +0000

This is not going in the right direction.

As Americans learn more about the issues surrounding proposed healthcare reforms, they are less certain about their own healthcare futures.

Simply put, consumers are losing confidence that the “solution” is just that.

Instead, they appear to wonder if things will be worse.

As a poll released today indicates:
“A monthly survey of consumer sentiment on health care issues shows that Americans’ confidence in insurance coverage, affordability and access dropped more than 5 points in July, after having risen slightly in June,” The Associated Press/CBS News reports. “Among seniors eligible for Medicare the drop was even more striking – 10.4 points – suggesting the health care debate is raising alarm bells for older people.” The survey, part of the health care consumer confidence index compiled by the nonpartisan Robert Wood Johnson Foundation, was “conducted even before coverage of raucous town hall meetings that highlighted public opposition to Mr. Obama’s Democrats’ health overhaul plans.” The overall confidence level for July “was 97.2, down from 102.3 in June. The highest possible score is 200, the lowest zero.”

Who can blame them?

There are many criticisms of proposed reform. Some valid; some not; even more contrived. But the bottom line is that most Americans don’t know their peronal bottom line. “How does this affect me?,” is still an unanswered question for many. And it is the question that matters most.

Healthcare reform will continue to be debated with arguments all around the edges. That will not change public opinion in its favor. Until someone explains in clear terms the impact to consumers on a personal level, many Americans will be skeptical and fearful. Who can blame them?

If you want to pass legislation, give us something to believe in.

Time to downshift

simplecoverage — Tue, 18 Aug 2009 16:37:57 +0000

Too much. Too fast.

Get outside the Beltway. Get outside the rhetoric of the left and the right. Get outside the interests of those who want to make money and those who fear they will lose money from healthcare reform.

When you do, you will find much of Middle America is concerned. Some are downright frightened. And despite the dismissive attitude of many in the media, they have good reason.

Massive (there is no other word for it) healthcare reform hits right in the breadbasket. Yes, change is needed. But not just any change. And, there are real legitimate concerns about the direction that change will take to cause many consumers to pause.

Taxes will go up for some. Our national debt will go up for all. Existing providers relationships will change, perhaps in unanticipated ways. The nation’s drift toward socialized medicine will accelerate. Those consquences matter.

And, the unintended consuquences of healthcare reform are what legitimately concerns many. Trust us no longer works.

Consumers heard the “trust us” line with the massive bailout of the financial services industry. What they saw in return was a boondoggle for some and a government unable to explain how this happened.

We cannot afford that same kind of “oops, we didn’t think of that” moment with healthcare reform.

It is time to downshift. Incremental change is warranted. Start with cost controls. Proceed with adequate assistance for uninsurable. Focus on meaningful preventive medicine and wellness programs. But stop short of massive government mandates until these steps have time to work.

In short, let’s fix what we can fix now without the “bailout boondoggle” risks of revamping an entire industry. and the financial burden that would heap on already stressed Middle America.

That is change we can really believe in.

The Health Care All-Spin Zone

simplecoverage — Fri, 14 Aug 2009 15:56:04 +0000

When it comes to your views on Obamacare and healthcare reform, there are facts, and then there are more facts.

Which facts you share depends to a disturbing extent on from where they are derived.

I am a former journalist, and now a consumer advocate who tracks the healthcare policy debate. And I am ashamed of the unabashed spin that print journalism puts on this debate on a daily basis. I am speaking specifically of the three newspaper that really matter: the New York Times, the Washington Post and the Wall Street Journal. No, they do not misrepresent the facts. That would be far too obvious. But they do manage the debate by what stories they pursue and how they are presented.

Even a casual daily reading of these publications refinforces the view. The Journal, more conservative and business oriented, focusess heavily on the impact of legislation on business and the economy, raising questions and creating doubt. The Times and Post, which lean to the left, are intent on illustrating current health care woes and discounting criticisms of reform. They each do an admirable job of reporting, albeit with a decided slant. But, if you only read one, you sorely miss the complete context the debate deserves.

Growing up as a journalist in the 1970s, I was admittedly altruistic. Print journalism was only pure form of news reporting, I thought. Television journalism was looked upon with disdain. Indeed, the frequent histironics of today’s Fox News and MSNBC especially serve as a sad vindication of our views. This isn’t news, this is dribble.

I am saddened to see that print journalism is following that course.

The healthcare debate deserves unbiased, comprehensive news reporting. We are not getting it. That is a shame.

Read this before the Town Hall meeting

simplecoverage — Thu, 13 Aug 2009 14:51:25 +0000

The frenzy around Congressional Town Hall meetings over healthcare legislation is both understandable and unfortunate.

It is understandable that constituents are concerned over how the 1000-plus page bill will monumentally change how health care is delivered and paid for. It is unfortunate because at least some of those concerns are based upon misinformation.

There are plenty of legitimate questions to ask about the plan’s financial impact, its effect on the individual medical market and its ultimate and unmistakeable policy drift toward socialized medicine.

Some issues raised, though, are based on simply misinformation.

This report helps sort things out:

Business is good for fact-checkers. Various news organizations as well as FactCheck.org and PolitiFact.org, have weeded through the rhetoric on both sides of the health reform debate.

CBS News asked Brooks Jackson, FactCheck.org’s director, and Wall Street Journal reporter Alicia Mundy to address six top health care myths:
(1) Does the bill encourage euthanasia? No.
(2) Will health services be rationed? Not really, and besides, it happens already.
(3) Will reform be “deficit neutral?” Probably not.
(4) Will reform mean the government could pay for abortions? Possibly, the bills are neutral on the issue.
(5) Will there be Medicare cuts? Democrats want to cut expenses, but not services.
(6) Will people be able to keep their current insurance? You can keep your plan, but reform may mean your plan changes over time

Fact Check

simplecoverage — Wed, 12 Aug 2009 14:03:11 +0000

With the significant amount of unknowns regarding the current version of healthcare legislation and the significant spin put on those unknowns, it is important to be grounded in what is known.

The Milwaukee Journal Sentinel has put together a brief, but helpful, list, which we share with you.

With lawmakers home for their August recess, a fierce battle has broken out over what precisely is in the mammoth health-care bills being pushed by congressional Democrats.

Here is a look at a few of the most contentious parts of the legislation.

Q:Does the legislation include provisions to encourage senior citizens to commit suicide?

A: No. This has become one of the most misleading, inflammatory claims made in the health-care debate, advanced repeatedly by conservative commentators and Republican lawmakers working to stoke fears among seniors.

Rep. Virginia Foxx (R-N.C.) recently suggested that the Democratic health care bill would “put seniors in a position of being put to death by their government.” There is no such provision.

The House bill would give seniors on Medicare the option to sit down with a doctor for an “advance care planning consultation” every five years to discuss options should they become seriously ill or unable to make medical decisions. Topics could include the development of a living will and directives for care.

“These are important discussions everyone should have so they are fully informed and can make their wishes known,” Dr. J. James Rohack, president of the American Medical Association, said in a statement. “It’s plain, old-fashioned patient-centered care.”

The provision is endorsed by the AARP.

Q:Will the government start paying for abortions?

A: That’s unclear.

Neither House nor Senate versions of the health care legislation contains any requirement that federal funding be made available for abortions.

Claims that tax dollars will be used for abortions, as a television ad from the Family Research Council contends, are premature and somewhat misleading.

But the legislation is short on many details. Depending on how future regulations are written, it is possible that some women who receive federally subsidized insurance could buy plans that cover abortions.

Under the most popular Democratic proposals, millions of Americans would buy their insurance in a new, highly regulated marketplace in which private insurers and the government would offer a choice of health plans. Many of those people would qualify for federal aid to defray the costs of at least part of their premiums.

It appears unlikely that the government would require the plans in this marketplace to cover abortions. In fact, one version of the legislation explicitly prohibits such a requirement.

But some private insurers in the exchange may cover abortion services. If a woman who receives public subsidies for her coverage selects one of those plans, it could be argued that the government is helping to fund abortions.

Q: Will illegal immigrants receive free health-care benefits?

A: Provisions in the House and Senate bills explicitly prohibit people who are “not lawfully present in the United States” from receiving federal aid to help them buy health insurance in the new exchanges.

Congressional Democrats have resisted Republican efforts to put tougher documentation requirements on those applying for aid, arguing that it could discourage many poor people from signing up for health insurance.

No matter what happens with the legislation, undocumented immigrants will almost certainly still be able to obtain care in emergency rooms, a major burden in some parts of the country.

Q: Will the government ration care?

A: This is almost impossible to say, although if the legislation passes there may be less “rationing” than there is now.

Under the nation’s current system, private insurers and the federal government put a variety of limits on what kinds of medical procedures, imaging and drugs they will pay for.

Millions of people with pre-existing conditions face even more limits, as private insurers refuse to sell them policies.

A cornerstone of the Democratic health-care overhaul is a larger role for the government in introducing more standards to the system to regulate coverage and expand information about the most effective treatments.

Both House and Senate bills would prohibit insurers from denying coverage to anyone with a pre-existing condition, thus eliminating one form of rationing in the current system.

The legislation would also give the federal government the authority to set minimum benefits levels that insurers would have to offer in order to sell policies in the new exchanges. That could mean more coverage for millions of individuals and many small businesses that currently are shut out of the healthcare system.

Most controversially, the bills would fund more research into the comparative effectiveness of various drugs and medical procedures.

The legislation does not dictate that the research be used to limit coverage of any procedures.

And many doctors and other health-care experts see this kind of research as critical to improving the quality of care.

Nonetheless, some critics say the provisions someday could allow the government to use this research to limit what Medicare or other government insurance programs would cover.

Coming soon to a county fair near you

simplecoverage — Thu, 06 Aug 2009 02:37:38 +0000

Congress is going home for August recess.
Perhaps more than any recent year, representatives are are going to get an earful. Not necesarily criticisms, but questions.
And most of those questions will be about healthcare. How much will it cost? Who will it cover? When will it start? And, the most pressing question of all for each constituent, how will it affect me?
All politics are local, and that is especially the case when you hit people with the double whammy of healthcare and their pocketbooks.
If their representatives are honest, they will have to confess that the answers are still less than clear, the details left to be worked out.
That will not satisfy many. And it should not. While much has been written about the healthcare debate, little has been done to honestly explain its impact. Politicizing has overshadowed genuine discussion.
On the county fair circuit this month, as Congresspersons sit down with their constituents and try to make sense of the details, perhaps an overdue dialogue can begin.

Free health care should come with a price

simplecoverage — Thu, 30 Jul 2009 14:56:43 +0000

I am not conservative. I am not liberal. I am pragmatic.
I care less about the political theory and more about the bottom line.
The pragmatic side of me, the one that pays taxes and worries about the direction of my country, is troubled by what is missing in the debate over healthcare reform.
Personal responsibility. That is what is missing.
As the federal government prepares to implement a $1.6 trillion overhaul and mandate more invasive regulation of small business, isn’t it time we dealt with one of the primary causes of the problem?
Specifically, we are an unhealthy nation.
Yes, some of us lose the wellness lottery and incur diseases and conditions through no action of our own.
But many others, frankly, invite poor health through their own actions. Overeating, smoking, drinking, lack of exercise, even excessive tanning. We treat our bodies without regard for the consequences. Vanity and gratification have replaced responsibility.
It is unfortunate and even sad. But now, it also is more costly to those of us paying taxes. As the government picks up the tab for the predictable consequences for these poor choices, taxpayers will be footing the bill.
If we are really going to reform healthcare in a meaningful way, we are sending exactly the wrong signal. We are effectively saying “go ahead without regard to the economic consequences, we will pick up the tab.”
It is time that personal responsibility took center stage. Or, at least, personal consequences.
We need to encourage wellness with both a carrot and a stick. Reward those with healthy lifestyles and economically penalize those who make unhealthy choices.
Specifically, more properly reflect the cost of choices for those receiving taxpayer subsidies. In economic terms, internalize the external costs. If you smoke, you will be taxed or your benefit reduced. Same with other unhealthy lifestyle choices.
The result? A more robust healthcare system and a healthier population.
Now, having raised this suggestion, I have little doubt that it will be seen as too intrusive. It should not be. People can smoke. People can tan. People can eat themselves silly. The choices are still there. But make them take personal and economic responsibility for those choices. Free health care should not be one sided. Expectations can and should be placed on those receiving the benefit.
After all, if we really want to reform healthcare, it is time we looked inwardly at what makes us unhealthy to begin with.
Let’s address the real problem here, not simply throw money at the result.

Something is missing here

simplecoverage — Wed, 29 Jul 2009 15:39:17 +0000

As the pundits and politicians debate and decipher runaway health care costs and how to control them while providing better coverage for all, there is curiously little talk about one of the key inputs.
Where is tort reform? You remember the problem, the issue of random runaway jury verdicts that disproportionately drive up medical malpractice–and ultimately consumer–costs. Why is that not squarely on radar screens?
It should be.
A confession: I am an attorney.
A more revealing confession: The medical malpractice system is still in desperate need of change and no healthcare reform is complete without addressing it.
Do not get me wrong. Doctors are sometimes negligent (just like lawyers, plumbers and taxicab drivers) and should be financially responsible when they fail to meet the standard of care for their profession.
But that is not what happens today in any comprehensible manner.
Instead, only five percent of claims ultimately go to trial. Of those, 80 percent result in verdicts for the defense (the medical professional) and less than 1 percent end with a monetary judgment for the plaintiff.
The problem is the cumbersome, inefficient and often self-serving (as in the case of lawyers) process that can drag on for years. In this case, time is literally money. As the litigation process unfolds, the clock is ticking and health care costs rise.
States have taken the lead in dealing with this inefficient and often unfair system by creating review panels and even considering “no-fault” systems, where it is the outcome that defines the compensation.
Congress has utterly failed.
That is unfortunate.
Comprehensive healthcare reform can only occur if tort reform is addressed as well.
Something is missing here.