Health Care

Reject Bad Advice and Bad Policy. Defend Medicare, Social Security.

Roger Hickey — Mon, 30 May 2011 22:48:40 -0400

Last week’s special election in New York’s 26th Congressional district was a political earthquake, demonstrating that the American majority, even in the most Republican of districts, will reject a candidate who embraces cuts to Medicare benefits or major changes to that most popular program. And, since almost every Republican in the House – and now the Senate – has voted for such drastic changes, Democrats across the country are happily learning how they can campaign to win back the House and keep the Senate.

But we can’t let Democrats undercut themselves again. Even as most of them practice their talking points about the Republican plan to dismantle Medicare, prominent beltway Democrats and Washington pundits are advising candidates that pressing their advantage on Medicare would not be the right thing to do. And others are urging Democrats to embrace policies – like cutting Social Security benefits – which would just as unpopular as dismantling Medicare and would confuse voters and undermine a winning message.

On May 25th, the day after Cong. Paul Ryan’s budget was soundly trounced in NY-26, when all around the country progressives were celebrating, Ryan was warmly received at a Washington conference on the deficit, sponsored by Wall Street mogul, Peter Peterson. At that event, former President Bill Clinton declared from the stage that, while he opposed Ryan’s plan for dismantling Medicare, he hoped that the NY-26 election didn’t mean that Medicare would be untouchable this year – a message he then delivered offstage directly to Rep. Ryan, the leader of the GOP plot to kill Medicare. And at that same Peterson event, Obama economic adviser Gene Sperling publicly declared the Administration’s strong interest in cutting Social Security benefits – either by raising the retirement age or by messing with Social Security’s cost-of-living formula.

So here we go again. Democrats start to unite around a winning economic issue, but major leaders of their party, repeating the case made by Washington Post editorialists and many beltway think tankers, warn them not to go there – that serious “adjustments” to Medicare (and Social Security) are inevitably necessary – and that campaigning as the champions of these programs is irresponsible, because, while it might help Democrats win the next election, it would be bad for the country. Reducing America’s deficits must be our priority, they solemnly declare, and these entitlement program must be cut.

This is horrible political advice that would deprive Democrats of a winning message.

But it is also bad policy advice. If Democrats side with the huge American majority who want a party that will protect and strengthen Medicare and Social Security, they shouldn’t campaign with their fingers crossed behind their back. A new Democratic majority in the House can come back to Washington in 2013 and join a strengthened Senate majority in pursuing good public policy that can revive the economy and bring down the deficit – while keeping their promise to protect the social contract.

There are plenty of serious economic proposals that accomplish those goals, without cutting or undermining Medicare, Medicaid or Social Security, starting with CAF’s Citizen Commission on Jobs and the Deficit and Representative Jan Schakowsky’s Deficit Reduction Plan. And, while they didn’t get the prominent visibility in an event designed to drum up panic on the deficit, the Peterson Deficit Summit actually featured plans from the progressive Economic Policy Institute and the Roosevelt Campus Network, both of which achieve reasonable budget balance while investing in growth and without doing stupid damage to our increasingly popular social safety net. (The Progressive Caucus Budget Plan also accomplishes the same goals.)

Apparently Bill Clinton agrees with Republicans that Medicare benefits have to be cut. What the various progressive plans have in common is the recognition of a simple fact: the growing costs of entitlements are driven by spiraling health care inflation in the larger economy. Medicare and Medicaid actually have a better cost control track record than the health care system as a whole. And all these “progressive“ deficit reduction plans repeat the truth that seemingly eludes Gene Sperling: Social Security has its own source of revenue and does not contribute a dime to the deficit. Now the policy implications of these insights are not easy, but they can be politically popular. In addition to attacking the immediate causes of deficits by reversing the Bush tax cuts for the rich, ending at least two wars, cutting obsolete military spending , and regulating the banks – all popular with the American majority – we are going to have to go after the driving forces in the American health care system: the complex of insurance companies, drug cartels, hospital and doctor syndicates, and the food-chemical industrial complex, all of which make Americans unhealthier, while driving up the cost of health care far above the Medicare trend line.

So Democrats have a choice: they can follow the advice of Bill Clinton, Alice Rivlin, and the Washington Post editorial board and give up on making the 2012 election a referendum on the very popular idea that we should protect and strengthen Medicare, Social Security and Medicaid. Or we they can fight like hell for these programs the American majority strongly supports, win that election, and come back to Washington ready to create jobs, stimulate healthy economic growth, and bring down deficits through healthy growth, new revenues, and good public policy designed to control overall health care costs. There is no doubt which is the best political strategy. It also happens to be better policy.

NOTE: One of the things that encouraged Democrats like Kathy Hochul to fight and win on Medicare is the strong speech President Obama made on April 13 declaring he would fight to protect Medicare. Because of that speech, the protests at Republican town meetings during Congressional recesses allowed Dems to stand up and fight. But we didn’t know what Obama was going to say until he gave the speech. So BEFORE the speech, we mobilized: we and other groups like MoveOn generated thousands of emails and phone calls to the White House. As you can see from this pdf of press coverage, even Nancy Pelosi was moved to call Obama by our email alert. The President should give us advance warning, especially when he’s going to do something progressive. But we have to work together to push the President – and his party – in the right direction.

The End of an Era: Nation-Building at Home After Bin Laden's Death

Daniel Marans — Tue, 03 May 2011 10:03:37 -0400

In uncertain times like these, there is a thrill to be had in the occasional moment of moral clarity. Osama bin Laden’s death on Sunday was one such moment. Let’s hope it marks the close of an era lived in the shadow of September 11th, and the start of a period devoted to the more complex, but equally patriotic task of solving our country’s stubborn domestic problems--even if it rarely evokes the same sense of national unity as hunting a Bin Laden.

September 11th is a buried memory for me. But the shocking news Sunday night brought it vaguely back to life. We were still looking for that guy? Has it really been ten years?

September 11, 2001 was my second day of ninth grade at the Ramaz School in Manhattan. I was in the throes of freshman jitters, still getting used to waking up at 6 am for my school bus commute from Teaneck, NJ. Shortly after getting to school that day, though, the principal announced the attack on the World Trade Center over the loudspeaker. My adolescent anxieties were immediately supplanted by more pressing fears. Were we safe? Were our parents safe?

Bad news awaited me at home in New Jersey. The parents of two elementary school friends were missing. It would take months to confirm their deaths. The mood in my house was somber and anxious.

Almost ten years later, my friends’ loved ones are still gone. Nothing can bring them back.

I like to think of Bin Laden’s death not as closure for their deaths, but as the closing of a chapter in the country’s history. For nearly a decade we have turned our vast resources outward, pursuing enemies the world over—some real, some imagined. Even as our nation grew more unequal, Wall Street speculation steadily engulfed the economy, and the health and standards of living for most of our nation’s citizens deteriorated, we drew a sense of unity and pride, for a while at least, from our commitment to “defeating the terrorists” who had perpetrated 9/11. We were still a great nation, it seemed, because we could take it to the bad guys, and make them pay for their crimes.

In the end, our national obsession with avenging 9/11 failed both to catch the criminal responsible for the act (we spent billions of dollars and inestimable amounts of human life in wars that, arguably, until now, had not resulted in Osama bin Laden’s death or capture), and to bolster our national self-esteem (the world viewed us, and we felt, like failures). It allowed us to be swept up into the horrific and misbegotten Iraq War, as well as tolerate significant rollbacks of our civil liberties and a dangerous rise in Islamophobia. Terrorists emboldened; country dejected.

Meanwhile, the damage of neglecting the home front has been incalculable, including to the service men and women who risked their lives at Ground Zero and in Iraq and Afghanistan. Could it be any more ironic that Bin Laden’s death comes only five months after Congress passed the law paying for the health care expenses incurred by the cancer-stricken 9/11 rescue workers?! Then again, maybe it is poetic that the former only happened after the latter came to be.

The fight against terrorism must no doubt continue. But maybe with Bin Laden gone, we can turn our formidable attention to the more contentious and less euphoric pursuit of domestic nation-building. Our biggest priorities right now should be ending unemployment, reforming our financial and health care systems, and fighting climate change and other environmental disasters. Accomplishing those tasks will require us to work together in unprecedented ways to challenge entrenched interests. It will not always unite us as a country, or give us a warm and fuzzy feeling inside the way the hunt for Bin Laden did.

Consider the healthcare reform battle. There was no health care crisis moment akin to 9/11 for the country to rally around. It took years of momentum, and a watershed presidential election, followed by months of tense partisan wrangling, compromising with special interests and town-hall shouting matches that almost tore the country apart. When the President signed the law giving 30 million Americans health insurance, crowds massed outside the White House—only they were protesting, not celebrating, as they were after Bin Laden’s death. And yet there is no doubt that is was the right thing to do. We are a better country for it.

Likewise, if we succeed in providing relief to the million families whose homes were foreclosed upon, and the 14 million Americans who remain unemployed, or reducing our deficit by taxing the rich, rather than slashing Social Security and Medicare, it will be because of persistence and good organizing, not because of heart-rending footage we see on TV.

The mundane work of building a stronger, happier and more compassionate country is far less of a rush then nailing the bad guy. And frankly, it is also more divisive. But it is no less of a patriotic duty. Our fellow Americans need us. Once the understandable joy over Bin Laden’s death peters out, we should embrace domestic nation-building with the dedication of genuine patriots.

Scott Walker's Health Care Hypocrisy

Daniel Marans — Mon, 28 Feb 2011 15:36:28 -0500

If Wisconsin Governor Scott Walker is so concerned about the price of public sector workers’ health care benefits, why isn’t he clamoring to cut underlying costs?

To justify the massive benefit cuts they are inflicting on teachers, janitors and nurses, Republican governors like Scott Walker in Wisconsin are claiming that the health care benefits enjoyed by public sector unions are “financially unsustainable” and “bankrupting the state.” It is ironic then, that while organized labor has been at the forefront of reforms that cut medical costs, Republican governors have actively fought cost-cutting measures, most notably in their stalwart opposition to stateside implementation of the Affordable Care Act.

Rather than working to find solutions that ease their budget deficits without fleecing middle class workers, Walker and his allies are throwing workers and their families over board. For proof, we need look no further than the king of union-busting himself, Gov. Scott Walker.

Exhibit A: One of Walker’s first moves as Governor was to order his Attorney General to file a lawsuit against the Affordable Care Act.

Exhibit B: Hidden in the now-infamous bill stripping public employees of their collective bargaining rights is a provision granting the governor executive authority to lop people off the Medicaid rolls and drastically increase premiums.

There you have it: Complaining about skyrocketing costs on the one hand, and enacting policies that do nothing to change the underlying problems. That’s because, for the most part, Republican governors couldn’t care less about exploding medical costs. They're interested in busting unions and eviscerating what remains of our social safety net.

Meanwhile, unions, who led the national fight for the Affordable Care Act, which will produce massive health care cost savings in the coming years, are now at the cutting-edge of local pilot projects aimed at further reducing costs. Atul Gawande, a doctor who has conducted incredibly revealing investigations of the country’s health care costs, recently profiled the achievements of a wildly successful pilot project that the Atlantic City, NJ casino workers’ union has undertaken. Tired of having to accept stagnant wages in order to maintain their increasingly expensive health care benefits, the union adopted an unconventional, comprehensive preventive care regimen. By providing patients with regular examinations it was able to identify a core group of 1,200 chronically ill plan members who were in and out of the hospital on a regular basis. Then it assigned teams of “health coaches” to work with these people on troubleshooting burgeoning medical issues before they flare up, taking the proper medicines, and adopting healthier lifestyles—better diets, better exercise, less tobacco, alcohol and drugs.

One year later, the results are amazing. Here's Gawande describing the findings of a third-party evaluation of the Atlanatic City union plan's cost-savings:

So the union’s health fund enlisted an independent economist to evaluate the clinic’s one-year results. According to the data, these workers made up a third of the local union’s costliest ten per cent of members. To determine if the clinic was really making a difference, the economist compared their costs over twelve months with those of a similar group of Las Vegas casino workers. The results, he cautioned, are still preliminary. The sample was small. One patient requiring a heart transplant could wipe away any savings overnight. Nonetheless, compared with the Las Vegas workers, the Atlantic City workers in Fernandopulle’s program experienced a twenty-five-per-cent drop in costs.

A 25 percent drop in costs?!

It turns out that a small number of people with horrific health problems are responsible for the vast majority of the union’s costs. It sounds cruel to think of human suffering as if it were a number on a ledger, but by identifying the neediest, most neglected patients, the casino workers’ union was able to improve people’s lives and ease the financial burden of all the workers in the union.

So if Scott Walker is as concerned about costs as he claims, let him be the first to try the casino workers’ union’s experiment on a statewide level. Then he can talk about benefit cuts.

Why Judges Matter

Robert Borosage — Tue, 01 Feb 2011 14:46:25 -0500

Republicans have obstructed the confirmation of unprecedented numbers of Obama judicial nominees. Vacancies have grown so bad that even Justice Roberts, the partisan Chief Justice, urged the Senate to act, since the undermanned courts were getting overwhelmed.

But the ruling yesterday by a Federal District Court Judge in Florida, declaring the entire health care reform unconstitutional shows just why Republicans obstruct nominees.

Judge Roger Vinson is a 71 year old, ultra conservative, Reagan appointee, semi retired in "senior status." He would have been very unlikely to hear the case if there weren't a vacancy in the 11th circuit.

Republicans want to turn the constitutional clock back. They want not simply to overturn the Warren Court legacy, particularly on the right to privacy and on equal rights. They want to overturn the jurisprudence of the Roosevelt Court, and go back to the days of the robber barons where even the existence of unions was deemed an unconstitutional restraint of trade.

They can't roll back popular reforms legislatively. Their hope is to capture the courts with Federalist Society trained and vetted ideologues, and use judicial activism to attack basic guarantees. At risk are basic bread and butter concerns that all Americans have: affordable health care, the right to organize, the right to equal pay, the right to clean air. The decisions of the gang of 5 on the Supreme Court in Bush v. Gore, and in Citizen's United suggest even our democracy is at risk from right-wing judicial extremism. So Republicans hope to run out the clock, block as many Obama nominees as possible, hoping that a Republican takes back the White House in 2012, when they'll push to stack the courts with right-wing zealots.

That is why the fight of nominees is so important. And why Republican obstruction should be confronted -- by the President, by the Senate leadership and by progressive groups no matter what their primary issue or concern. Vinson's lawless decision shows what is at stake.

How Health Care Reform Repeal Would Affect You

OurFuture.org Staff — Tue, 18 Jan 2011 15:54:07 -0500

Right now, Republicans in Congress are hard at work trying to repeal or severely weaken health care reform. Below are some of the protections and assistance already available to you as a result of health care reform that you would lose if the Republicans get their way:

Your children can no longer be denied care for preexisting conditions.
Your insurance company is no longer be able to cancel your plan because you get sick or put a lifetime benefit limit on your coverage. Annual benefit limits on coverage are now tightly regulated as well.
Small businesses with 25 or fewer employees can deduct up to 35% of their health care premium costs from their taxes, making the cost of coverage cheaper.
All insurance plans now have to report how much of your premiums they spend on care and provide you rebates if they spend too much on profits. This increased transparency will protect you and make your insurance work better for you.
Your insurance company now has to offer you "first-dollar" coverage of preventative care, which means they have to pay for it even if you haven't paid your full deductible.
All Medicare Part D enrollees who enter the "doughnut hole" will get a $250 rebate check in 2010 towards filling that coverage gap. They will also get a 50% discount on all brand-name and biologic drugs in 2011, with the amount increasing every year to completely phase out the doughnut hole by 2020.
Medicare enrollees now get a free annual wellness visit and personalized prevention services, and cost-sharing for preventative care has been eliminated.
Overpayments to insurance companies to support their profits through the Medicare Advantage program have been frozen and will be phased down in subsequent years, which means your payments will go farther towards your care and not towards insurance company profits.
Young adults are now able to stay on or go back to their parent's insurance plan until they are 26 years old if they don't have access to their own insurance through an employer.
If in the past you've been denied insurance due to a preexisting condition, you can now get coverage through a temporary reduced-rate high-risk pool, which won't be able to deny you coverage due to preexisting conditions.
You can still get Medicaid or children's health insurance (SCHIP) if you qualify. State Medicaid programs will be required to continue existing coverage.
Money is being provided to expand current community health centers and create new ones, giving you access to new places for free or low-cost care.

These are just the reforms that are already in effect. Over the next couple of years even more reforms will go into effect, providing additional protections to consumers and making health care more affordable--but not if Republicans get their way. Learn more about these reforms at healthcareforamericanow.org.

Liberal Groups to Propose Routes to Smaller Deficit

OurFuture.org Staff — Tue, 30 Nov 2010 09:54:29 -0500

As President Obama’s fiscal commission faces a deadline this week for agreement on a plan to shrink the mounting national debt, liberal organizations will unveil debt-reduction proposals of their own in the next two days, seeking to sway the debate in favor of fewer reductions in domestic spending, more cuts in the military and higher taxes for the wealthy. The proposals from two sets of liberal advocacy groups highlight the deep ideological divides surrounding efforts to deal with the nation’s budgetary imbalances.

Tea Party Gets Played: Electeds Want Govt Health Care

Dave Johnson — Tue, 23 Nov 2010 18:43:30 -0500

If there is one thing that Tea Party members hate, it's government health care. I guess that's why so many of them want the government to keep away from their Medicare. (You may have seen ad after ad last month blasting Democrats because Obamacare "cut Medicare." See some of the ads below.)

ANYway, now some of the Tea Party got elected and are on their way to Washington, and what is the first thing they want? See if you can guess. Here is a hint: it's government health care.

That's right, after campaigning against government run health care -- and campaigning that they should be in office instead of Democrats because Democrats cut their government-run Medicare, which they didn't actually do, now they are IN office and they want them some of that government health care for themselves.

Tea Party Members don't want them to do that at all. From TPM: Poll: Republicans Want Anti-HCR GOPers To Just Say No To Gov't Health Care,

... a new national poll from Democratic firm PPP, which shows big majorities of GOP and independent voters saying the politicians who ran against the health care reform law should forgo the health care benefits they're entitled to as employees of the federal government.

Just 28% of Republican respondents said that new anti-reform members should take their federal benefits, while a whopping 58% said they shouldn't.

Among independents -- who voted for the GOP in big numbers on Nov. 2 -- 56% say politicians who made health care repeal a cornerstone of their campaigns should deny themselves their government benefits. Only 27% said they should take them.

Tea Party members say they shouldn't. But they will.

Here are some of the ads complaining that Democrats should be thrown out for cutting Medicare:

Making Sense - Health Care Reform

Terrance Heath — Mon, 11 Oct 2010 13:19:43 -0400

Health Care and States: From Adversaries To Partners

Isaiah J. Poole — Mon, 23 Aug 2010 15:53:27 -0400

Underemployed And Didn't Have Health Insurance ...

Dave Johnson — Fri, 09 Jul 2010 14:24:30 -0400

I just talked to an old friend yesterday and got bad news. He was another person laid off in the 2000 crash, in his late 40s at the time, so he hasn't been able to get anything since then except the odd short-term contracting gig. Certainly not anything that provided health insurance. (This is not the same person I wrote about in Too Old For A Job, Too Young For Medicare Or Social Security the other day. As I said, there are a lot of people in this situation and not just in Silicon Valley...)

He had a heart attack a year ago, probably because he couldn't get regular physicals, advice, cholesterol medication, etc. He ended up $300,000 in debt -- a joke for someone with no income, who had long ago burned through his 401K. Good thing he didn't have a house to lose.

Now it’s colon cancer.

He’s 59, didn’t have health insurance so he couldn’t afford to get a colonoscopy or other screening, and it reached stage 3 before it was discovered. He had surgery to remove a big mass and is starting chemo this week. So we’ll see how it turns out.

He can get Medicare and Social Security in a few years, if he makes it. But there is no way he is going to find a job. You know that, I know that, and if he does what conservatives want and can even find a minimum-wage "greeter" job with no insurance anyway all he would be doing is displacing someone with fewer skills who will have an even harder time finding a job. But he doesn't get unemployment anyway because he was a "contractor" which really just means "employee" but the government doesn't enforce employment laws anymore. Ask anyone over 40 who is looking for work about that.

Conservative and Blue Dog policies have failed us.

So, conservatives and "Blue Dogs" in Congress, what about those COBRA subsidies for all these long-term over-40 unemployed people who Can. Not. Find. A. Job! And what's with cutting off their unemployment benefits? What is the matter with you people? These are the very people who need help most. These are the victims of the banksters who you gave hundreds of billions to bail out, and who paid themselves bonuses with the money.

And, by the way, COBRA itself is also expiring, so these people won't be able to get insurance if they can magically come up with the cash while unemployed. Oh, and what's with that 2014 date for starting health care reform? That's a long way off.

At the request of the previous President you conservatives and Blue Dogs certainly came up with plenty of cash in a hurry to bail out the banksters, who used it to pay million-dollar-bonuses and still are not giving loans because liquidity wasn't the problem, demand was. (Liquidity vs demand translation: they didn't need the money, we did.) Now, after your 8-year conservative orgy of spending like crazy on tax cuts and military and wars and subsidies for oil companies and big ag companies and big pharma companies and big companies and big companies and big companies and then crashing the economy We, the People need some help.

We, the People need some help. But now there is a new President who wants to help the people instead of the big companies and suddenly it's "deficit, deficit, deficit" and "socialist, socialist, socialist." Yet even though every single one of us knows the deficits were caused by tax cuts for the wealthy plus military spending increases, fixing that is off the table, not to be discussed, crazy talk, by fringe leftists.

Here is a fact. We didn't have big deficits and huge debt before the Reagan tax cuts, and we kept our infrastructure up to date, and we had a middle class, and our companies actually made things and served their customers. This is because with high top tax rates it took time to build up a fortune, so companies had to be connected to their communities and their communities had to work. Since the tax cuts everything is fast-buck schemes and windfall profits and the next quarter and sell off assets and privatize good things that served the public, etc. Since the tax cuts everything is greed and short-term.

So if you want to cry about the deficits you caused with your tax cuts, then make the country and economy work again by returning to the pre-Reagan top tax rates. And pass and extend COBRA subsidies and unemployment benefits, until unemployment gets back to 5%. Pass another stimulus, because the last one was too small, and a third of it was wasted on tax cuts that leave nothing behind but debt. Pass job creation programs.

Ands Congress needs to get things going by passing the George Miller "Local Jobs for America Act!" .