A NAtional Nursing Leader's Position On National Health Reform Legislation

"Diary of a Wimpy Health Care Bill"


By Rose Ann DeMoro
Executive Director, National Nurses United, AFL-CIO and California Nurses
Association and member of the Executive Council of the AFL-CIO

Posted: March 23, 2010 08:07 PM

http://www.huffingtonpost.com/rose-ann-demoro/diary-of-a-wimpy-healthca_b_510706.html


Passage of President Obama's healthcare bill proves that Congress can
enact comprehensive social legislation in the face of virulent rightwing
opposition. Now that we have an insurance bill, can we move on to
healthcare reform?

As an organization of registered nurses, we have an obligation to provide
an honest assessment, as nurses must do every hour of every day. The
legislation fails to deliver on the promise of a single standard of
excellence in care for all and instead makes piecemeal adjustments to the
current privatized, for-profit healthcare behemoth.

When all the boasts fade, comparing the bill to Social Security and
Medicare, probably intended to mollify liberal supporters following
repeated concessions to the healthcare industry and conservative
Democrats, a sobering reality will probably set in.

What the bill does provide

-Expansion of government-funded Medicaid to cover 16 million additional
low income people, though the program remains significantly under funded.
This limits access to its enrollees as its reimbursement rates are lower
than either Medicare or private insurance, with the result some providers
find it impossible to participate. JR... I WOULD EMPHASIZE "MANY" PROVIDERS) Though the federal government will
provide additional subsidies to states, those expire in 2016, leaving the
program a top target to budget cutting governors and legislatures.

-Increased funding for community health centers, thanks to an amendment by
Sen. Bernie Sanders, that will open their doors to nearly double their
current patient volume. JR... HOW WILL THIS BE FUNDED?

-Reducing but not eliminating the infamous "donut hole" gap in
prescription drug coverage for which Medicare enrollees have to pay the
costs fully out of pocket. JR... $ 250 to Seniors this year, THE DONUT HOLE DOES NOT CLOSE COMPLETELY UNTIL 2020!

-Insurance regulations covering members' dependent children until age 26,
and new restrictions on limits on annual and lifetime on lifetime
insurance coverage, and exclusion of policies for children with
pre-existing conditions.

-Permission for individual states -- though weakened from the version
sponsored by Rep. Dennis Kucinich -- to waive some federal regulations to
adopt innovative state programs like an expanded Medicare.

All of these reforms could, and should, have been enacted on their own
without the poison pills that accompanied them.

Where the bill falls short...

-The mandate forcing people without coverage to buy insurance. Coupled
with the subsidies for other moderate income working people not eligible
for Medicare or Medicaid, the result is a gift worth hundreds of billions
of dollars to reward the very insurance industry... that created the present
crisis through price gouging, care denials, and other abuses.

-Inadequate healthcare cost controls for individuals and families.

1. Insurance premiums will continue to climb. Proponents touted a "robust"
public option to keep the insurers "honest," but that proposal was
scuttled. After Anthem Blue Cross of California announced 39 percent
premium hikes, the administration promised to crack down with a federal
rate insurance authority, an idea also dropped from the bill.

2. There is no standard benefits package, only a circumspect reference
that benefits should be "comparable to" current employer provided plans. JR... Define "Basic" coverage NOT!

3. An illusory limit on out-of-pocket medical expenses. But even in the
regulated state exchanges, insurers remain in control of what they offer
and what will be a covered service. Insurers are likely to design plans to
attract healthier customers, and many enrollees will likely find the
federal guarantees do not protect them for medical treatments they
actually need. JR... What have I been saying?

-No meaningful restrictions... on claims denials insurers don't want to pay
for. Proponents cite a review process on denials, but the "internal review
process" remains in the hands of the insurers, and the "external" review
will be up to the states, many of which have systems now in place that are
dominated by the insurance industry with little enforcement mechanism.

-Significant loopholes in the much touted insurance reforms:

1. Provisions permitting insurers and companies to more than double
charges to employees who fail "wellness" programs because they have
diabetes, high blood pressure, high cholesterol readings, or other medical
conditions.

2. Permitting insurers to sell policies "across state lines", exempting
patient protections passed in other states. Insurers will likely set up in
the least regulated states in a race to the bottom threatening public
protections won by consumers in various states. JR... Think... CREDIT CARD Companies!!!

3. Allowing insurers to charge three times more based on age plus more for
certain conditions, and continue to use marketing techniques to
cherry-pick healthier, less costly enrollees.

4. Insurers may continue to rescind... policies, drop coverage, for "fraud or
intentional misrepresentation" -- the main pretext insurance companies now
use.

-Taxing health benefits for the first time. Though modified, the tax on
benefits remains, a 40 percent tax on plans whose value exceeds $10,200
for individuals or $27,500 for families. With no real checks on premium
hikes, many plans will reach that amount by the start date, 2018, rapidly.
The result will be more cost shifting from employers to workers...
and more people switching to skeletal plans that leave them/YOU... vulnerable to financial ruin.

-Erosion of women's reproductive rights, with a new executive order from
the President enshrining a deal to get the votes of anti-abortion
Democrats and a burdensome segregation of funds, that in practice will
likely mean... few insurers will cover abortion and perhaps other
reproductive medical services.

-A windfall for pharmaceutical giants. Through a deal with the White
House, JR...(Can you say Billy Tauzin?) the administration blocked provisions to give the
government more power to negotiate drug prices and gave the name brand drug makers
12 years of marketing monopoly against competition from generic competition
on biologic drugs, including cancer treatments.

"Most Critically, the bill strengthens
the Economic and Political Power of
a PRIVATE INSURANCE BASED SYSTEM based on $$profit$$ RATHER THAN PATIENT NEED!"

JR... "THIS IS CORPORATISM!!! The patient/policy holder is merely a conduit through which TAXPAYER $$$'s will flow to the INSURANCE Industry!"

As former Labor Secretary Robert Reich wrote after the vote "don't believe
anyone who says Obama's healthcare legislation marks a swing of the
pendulum back toward the Great Society and the New Deal. Obama's health
bill is a very conservative piece of legislation, building on a Republican
(a private market approach) rather than a New Deal foundation. The New
Deal foundation would have offered Medicare to all Americans or, at the
very least, featured a public insurance option."

Unlike Social Security and Medicare which expanded a public safety net,
this bill requires people...

-- in the midst of the mass unemployment and the worst economic downturn
since the Great Depression -- to pay thousands of dollars out of pocket to
big private companies for a product... that may or may not provide health
coverage in return. JR... "BASIC" coverage has yet to be defined....

Too many people will remain uninsured, individual and family healthcare
costs will continue to rise largely unabated and private insurers will
still be able to deny claims with little recourse for patients.

If, as the President and his supporters insist, the bill/law is just a start,
let's hold them to that promise. Let's see the same resolve and
mobilization from legislators and constituency groups who pushed through
this bill to go farther, and achieve a permanent, lasting solution to our
healthcare crisis with universal, guaranteed healthcare by expanding and
improving Medicare to cover everyone.

Here is the Bill that may correct the various assaults on everyday Americans by the Insurance Industry by bringing competition to the health care finance marketplace... and a real choice for YOU...

Our Medicare You Can Buy Into Act now has over 80 cosponsors in the House and over 40,000 citizen cosponsors at WeWantMedicare.com. It's a simple bill, to let you and me buy into Medicare. You want it, you buy it, you got it. Become a citizen sponsor NOW! Thanks John Russell

www.wewantmedicare.com

Leaders of the National Nurses United have raised many of these concerns
about the legislation for months. But, sadly, as the healthcare bill moved
closer to final passage, the space for genuine debate and critique of the
bill's very real limitations was largely squeezed out.
Much of the fault lies with the far right, from the streets to the
airwaves to some legislators that steadily escalated from deliberate
misrepresentations, to fear mongering, to racial epithets, to hints of
threatened violence against bill supporters.

For its part, the administration and its major supporters shut out
advocates of more far reaching reform, while vilifying critics on the
left.

Both trends are troubling for democracy, as is the pervasive corruption of
corporate lobbying that so clearly influenced the language of the bill. JR... Insurance Industry AUTHORED Legislation!
Insurers, drug companies, and other corporate lobbyists shattered all
records for federal influence peddling and were rewarded with a bill that
largely protected their interests, along with a Supreme Court ruling that
will allow corporations, including the health care industry, to spend
unlimited sums in federal elections. THIS ladies and gentlemen IS CORPORATISM!!!

Rightwing opponents fought as hard to block this legislation as they would
have against a Medicare for all plan. As more Americans recognize the bill, (now LAW)
does not resemble the distortions peddled by the right, and become
disappointed by their rising medical bills and ongoing fights with
insurers for needed care, there will be new opportunity to press the case
for real reform. Next time, let's get it done right. JR... Medicare for ALL!

Annotations and Comments By John Russell, MS/ARNP, MBA Health Systems Mgt., 2006-08 Democratic Nominee, U.S. House, Dist. 5, Fl.
http://www.johnrussellforcongress.com I am NOT a candidate this election cycle!

Original Article
Distributed by:
All Unions Committee For Single Payer Health Care--HR 676
c/o Nurses Professional Organization (NPO)
1169 Eastern Parkway, Suite 2218
Louisville, KY 40217
(502) 636 1551
Email: nursenpo@aol.com
http://unionsforsinglepayerHR676.org
03/25/10