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Health-Care Reform to Dump Poor Kids?

admin — Wed, 27 May 2009 03:10:51 +0000

Oleta Fitzgerald, director of the Children’s Defense Fund’s Southern Regional Office, says she is concerned over the welfare of Mississippi children if either of the two health-care reform packages considered by the U.S. House and Senate ever make it into law.

The House passed H.R. 3962 earlier this month, and Senate Democrats managed to beat back the threat of a Republican filibuster a few weeks ago, allowing the Senate to move forward with debate on the Patient Protection and Affordable Care Act, H.R. 3590. Both bills promise big reforms in the health-care and health-insurance industries. The Association for American Medical Colleges states that nearly 15 million people will be newly eligible for Medicaid and the Children’s Health Insurance Program under H.R. 3590, at an estimated cost of $374 billion over 10 years.

Fitzgerald says both bills contain huge holes regarding CHIP coverage for Mississippi children: “Right now, the fight over health-care reform in the House and Senate is all about abortion and the public option, but the children are getting lost in this discussion,” Fitzgerald said.

The issue, she said, centers on Mississippi’s unconventional requirement for CHIP eligibility.

Many states recently expanded their Medicaid program requirements to accept people who are a little further from the federal standard for poverty. Eleven states recently extended CHIP-eligible families’ income levels up to 200 percent of the federal poverty level, or higher. ($20,800 for an individual or $35,200 for a family of three).

But instead of expanding Medicaid, Mississippi set up a new health insurance program that contracts with private insurance companies. The states that expanded Medicaid will continue to receive federal support for those programs under both the bills under discussion in the House and Senate. But in Mississippi, all children and their families over 150 percent of the federal poverty level ($16,245 a year for an individual and $27,465 a year for a family of three) would go into an insurance exchange created by the House and Senate bills. The Senate bill plans to put CHIP-eligible kids in an exchange by the year 2019, while the House bill has them transferred by 2013.

Insurance exchanges do not promise the reliability of a government health program, Fitzgerald warns.

“Going into the exchange could require co-pays and premiums, the children would get lumped in with adults, and it’s not clear what requirements the insurance companies would have for their benefit packages,” she said.

There is also the question of permanence. Exchanges like the ones proposed by the House and Senate bills have not always been long-lasting. Texas, Florida, North Carolina and California all attemptedâ€”and failedâ€”to create enduring insurance exchanges, primarily because private insurers tampered with the market.

A July report issued by the California HealthCare Foundation tried to pinpoint some of the factors that killed the California insurance exchange, which closed its doors in 2006. According to the report, the California exchange became too expensive when the clients it served became too costly. An exchange requires a certain number of healthy individuals to complement the more sickly participants of the exchange’s customer base; otherwise the cost of participation becomes too high for all participants.

But insurance companies in California lured healthy customers with lower premiums and steered the more sickly individuals into the exchange, creating a disproportionately expensive customer base.

“People involved in operations of the California exchange agreed that when there is competition for the same customers within and outside the exchange, the exchange is in ‘extreme peril’ of becoming a victim of adverse selection,” the report states. “If an exchange attracts a disproportionate share of higher risk individuals and groups as the California exchange did at various times, it cannot succeed.”

Fitzgerald said Mississippi’s eagerness to boot CHIP-eligible children from the program to keep down state costs is another factor complicating the new bills.

“Another problem is enrollment. We need enrollment in the exchanges to be simplified, because enrolling in state health programs have a history of being anything but simple in Mississippi,” Fitzgerald said, referencing a Medicaid policy championed by Republican Gov. Haley Barbour, which requires Medicaid recipients to meet Medicaid personnel “face-to-face” to be considered for program renewal.

CDF is working with its national office in trying to insert an amendment in the Senate bill though Democratic Sens. Robert Casey and Jay Rockefeller, which would keep all children up to 300 percent of the federal poverty level in the CHIP program until the new insurance exchange is thoroughly vetted.

Watch the video related to health care reform bill

Big Pharma & Friends Poised for Massive Profits from Health Care Reform

admin — Fri, 08 May 2009 03:12:27 +0000

While Democrats shoot themselves in both feet trying to explain how their proposed health care reform will be able to contain costs over time, there is another much better organized group who is pushing very hard to get this legislation through and is poised for dramatic profits at the expense of the American taxpayer.Â That group is the lobbyists that represent Big Pharma, the American Medical Association, hospital groups, and insurance companies.

According to OpenSecrets.org these groups put up $484 million in lobbying money in 2008, getting ready for this legislation.Â You can just imagine how much they are spending this year.Â The reason you can imagine the sum must be quite large is because Obama and company are doing absolutely nothing to address the key issues of how these groups plan to profit from a government-backed stream of millions of new customers.

The trend in the last several years is that employer-sponsored health care plans are shrinking and individual policies are too expensive for many.Â Government and private insurance are cozying up and private insurance companies are playing a middle-man role in programs like Medicare and Medicaid. At stake is the dividing of the hundreds of billions of dollars per year pie created by fraudulent Big Pharma sales.

The lobbying scenario is quite different than the previous Clinton attempt at a health care overhaul.Â At that time health industry was by and large against what was going on. This time they are fully on board and pushing very hard to make something happen, jockeying for their position in the New World Health Order.

The sad reality is that this group profits from sickness.Â They like poor health.Â They know individuals and companies canâ€™t afford what they have to offer, so they have to call it â€œhealth careâ€ or â€œhealth insurance,â€ and run a publicity campaign designed to make the American public feel guilty for not paying for everyoneâ€™s often fraudulent care.

Their current agenda is to bilk dying cancer patients of $50,000 to $100,000 with drugs that have no chance of curing anything yet extend life two or three months.Â By the way, I have a solution for this problem.Â No payment should be owed unless the cancer treatment given extends life a full year past the conclusion of the treatment.Â Writing that into the current legislation would immediately stop massive fraud.

Big Pharma really got excited a few years back when they saw minorities were the biggest new users of the expanded Medicare program, responsible for a 5% increase in drug sales when other demographics were flattening.Â This new pot of gold, the 46 million currently uninsured, are quite frankly the most unhealthy members of the population due in no small part to their own failures to take care of themselves.Â Big Pharma is licking its chops because this is not care for emergency needs, this is ongoing sales of highly profitable drugs that â€œneedâ€ to be taken every day and are a major cash cow.

Obama is making no effort to be able to negotiate drug prices with this band of thugs â€“ as their lobbies are running roughshod over Republicans and Democrats alike.Â Imagine an industry where you can sell a product for 100 times what it costs to produce, because taxpayers foot the bill.Â That is the general Big Pharma mark up, and many drugs sell for a thousand times their cost to produce.Â This issue isnâ€™t even addressed.

On top of that, many of the best-selling drugs being crammed down the throats of Americans are completely useless in terms of improving the public health.Â This includes statins, bone drugs, brain drugs, and many other types of medication.Â Furthermore, the actually safety of the majority of these drugs is almost completely unknown, which is why there are millions of injuries requiring hospitalization each year and over one hundred thousand needless deaths per year.Â There is one drug scandal after another, as Big Pharma tries to wrack up sales while hiding risk data and hoping to make a killing before they are stopped.

How can the American public be so gullible as to stand for this.Â There is no way taxpayers can carry the burden of this fraud.Â It is what is already driving the high cost of health care and unless it is addressed adding millions of new users to this system will only make it worse and more costly for everyone.

Just about everyone I know is in favor of some sort of health care safety net for people with serious health problems, especially those that were not caused by their own doing.Â Of course everyone would like health care to be more affordable.Â However, the current health care system is already being scammed for hundreds of billions per year.Â The newly proposed system will simply expand the scope of the existing problem.Â It is high time that someone in power take the bull by the horns.

No sane solution even has a chance as long as there are the big-spending lobbies buying the laws they want, spending their money to make sure taxpayers will keep sending them hundreds of billions more each year.Â There are many elements within the health care system that are nothing but parasites.

Watch the video related to health care reform bill

It’s time now to focus on Arizona’s health-care system

admin — Sun, 03 May 2009 03:12:49 +0000

Since last spring, the noisy and sometime rancorous health-care-reform debate has kept all eyes and ears on Washington. It now appears the probability is high that a health-care-reform bill will be signed by President Obama. Given what our state is contemplating with respect to the next round of budget cuts, I think some sharp focus on health care in Arizona is needed – now.

Gov. Jan Brewer has rightfully placed all options on the table in her difficult and, at times, bruising work with other state leaders to address what is approaching a $2 billion shortfall in our state budget.

This includes a request by the governor to all state agencies asking for plans that will cut each agency’s budget by 15 percent. A significant part of these reductions will come from the Arizona Health Care Cost Containment System (AHCCCS) and other state health programs. AHCCCS is Arizona’s Medicaid program.

At first blush, a 15 percent AHCCCS reduction may seem like a necessary although painful action that we must take. However, the math behind a 15 percent cut at AHCCCS isn’t so straightforward. It is critical that our state’s leaders and the general public appreciate the fact that every dollar spent in AHCCCS is matched by $3 from the federal government. The real formula that would quickly emerge from a 15 percent reduction by AHCCCS is cut one dollar and lose three more.

The elimination of Arizona’s KidsCare program also is being contemplated. If this insurance is eliminated for 47,000 children in Arizona, we will not save a dime for the people of this state. Once uninsured, many of these children will need health care, but they will become at-risk for delayed care due to the cost of that care.

Routine health care matters. Illness or injury left untreated can quickly evolve into serious or even catastrophic health-care issues. As a result, many of these children eventually will get their care in the most expensive health-care settings – ERs and hospital rooms. A great deal of the costs for this care will then be shifted to Arizona’s insured consumers.

If we assume that national health-care reform will significantly cover more people, we also should assume it will take many years for this coverage to be implemented. In my view, retaining KidsCare until another plan becomes available makes good sense for Arizona.

Another cut being proposed is a 30 percent reduction in the state’s contribution to Graduate Medical Education. This cut ultimately could reduce the number of physicians in the state.

Hard decisions must be made to address the state’s climbing budget shortfall, and all of us must be part of the solution. Our governor and Legislature deserve that support. However, decisions that look good on paper or even on a budget spreadsheet in the short term, can prove highly damaging to the state’s fiscal health and people’s physical health in the long term.