Posts tagged with 'AMA'

Weekly Pulse: The Push for a Public Plan

Posted Jun 17, 2009 @ 11:03 am by Lindsay Beyerstein
Filed under: Health Care, Immigration     Bookmark and Share

Healthcare reform is back in the news, as legislators and interest groups spar over the promised public component of Obama’s healthcare plan.

In very simple terms, this is a fight between groups with a vested interest in expensive healthcare and everyone else. This week, the American Medical Association warned Obama that a public plan could restrict patient choice. But for millions of Americans, getting a choice between healthcare and no healthcare wold represent a 100% increase in their healthcare options. Obama’s public plan would also give people the choice of keeping their private health insurance. The public plan is an additional option, not a diminution of options.

The AMA is a powerful interest group, but it doesn’t speak for all physicians. Several prominent groups representing doctors and medical students, including the American Association of Family Physicians, co-signed a declaration supporting Obama’s push for a public plan this week.

Expect the health insurance lobby to fight the public option tooth and nail, says economist Dean Baker in AlterNet. It’s smart business from their perspective. Platitudes about the free market aside, no real capitalist welcomes competition. As Baker points out, a public plan represents competition to health insurance companies. For every dollar Medicare pays to providers, it spends two cents on administration. Whereas private insurers spend about fifteen cents on the dollar in administrative costs. Baker estimates that if a public plan were available, insurance profits would drop by 20-30%, all things being equal.

Former president Bill Clinton invited about 20 progressive bloggers to his Harlem office on Monday for a seminar-style discussion about the work of the Clinton Foundation. Several staff from Media Consortium member organizations were in attendance, including yours truly. Healthcare was a major topic of conversation. Emily Douglas of RH Reality Check, who also attended the meeting, writes:

The former President observed that the country, emerging from a “post-9/11 emotional straitjacket” has become “more communitarian” — and that President Obama has fewer budget issues, and less Republican opposition, to content with when attempting reform.  But, most importantly, “everything is worse now” — health care spending has doubled, more are uninsured, and disposable income, adjusted for inflation, is down.

Clinton said that he’s optimistic about the prospects for healthcare reform this year, but he encouraged Obama to drive a hard bargain with congressional Republicans. All things considered, the former president said, it would be better to pass healthcare with 60 votes for the sake of the Obama administration’s long-term relations with congress. The alternative would be to pass healthcare through budget reconciliation, which would require only 51 votes, but which would incur a lot of ill-will among Republicans. However, Clinton cautioned against writing a weak bill to avoid reconciliation. In Clinton’s opinion, if we don’t contain healthcare costs by moving to outcomes-based medicine and making our healthcare delivery systems more efficient, the system will be unsustainably expensive.

James Ridgeway of Mother Jones has also been mulling the challenge of writing a bill that’s acceptable to enough Republicans to avoid a budget reconciliation fight. Ridgeway fears that sweeping structural reform will take a back seat to political expediency. He fears that by trying to please everyone, Obama could end up pleasing no one:

One disturbing possibility is that health care could become a replay of the credit card legislation. The pattern goes something like this: First, we get a propaganda blitz heralding sweeping changes. But although the final legislation corrects some of the most egregious abuses, it doesn’t change the system’s underlying flaws. So, for example, insurance companies may be required to cover people with preexisting conditions—a need Obama illustrated vividly in his AMA speech with moving references to his mother’s battle with cancer. We might see what the president called “more efficient purchasing of prescription drugs,” which presumably means faster approval of generics and giving the government greater power to haggle with Big Pharma over drug costs. We will likely see incentives for health care providers to offer more cost-effective—and, hopefully, better—treatment. These things are not meaningless, and they will provide a modicum of relief to some struggling Americans. But they do virtually nothing to strike at the deeper problems of the for-profit health care system. And they offer only a fraction of the savings that a single-payer system would provide.

If the healthcare debate sounds vague and abstract, that’s because it is. There are several competing bills coalescing, but at this point, there’s no overall vision for reform. Everything is up for grabs. Never afraid to think big, Sen. Bernie Sanders (I-VT) is circulating a petition for single-payer healthcare, with an assist from Chelsea Green.

Surely the weirdest healthcare story of the week comes from Tracy Clark-Flory of Salon: An anti-choice blogger who claimed to be carrying a non-viable pregnancy to term out of pro-life principle was exposed as a hoaxster when an alert reader identified her “dead baby” as a doll. It’s not clear why the 26-year-old social worker perpetrated the hoax. Jessica Valenti of Feministing injects a note of compassion for the perpetrator, “Though as angry as this makes me, I’m with Sadie at Jezebel on this: ‘It’s tempting of course to use this as a chance to take an easy bash at anti-choice, and revel in anything that makes them look foolish, but frankly, I’m just sad for this woman.’ As am I.”

This post features links to the best independent, progressive reporting about health care. Visit Healthcare.newsladder.net for a complete list of articles on healthcare affordability, healthcare laws, and healthcare controversy. And for the best progressive reporting on the Economy, and Immigration, check out Economy.Newsladder.net and Immigration.Newsladder.net.

This is a project of The Media Consortium, a network of 50 leading independent media outlets, and created by NewsLadder.

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Weekly Pulse: Keep Your Friends Close and Your Enemies Closer

Posted May 13, 2009 @ 12:24 pm by Lindsay Beyerstein

This week, the White House teamed up with healthcare industry giants for a two-day PR blitz on health reform. A coalition of industry leaders sent a letter to president Obama over the weekend, pledging to help contain healthcare costs. The signatories include PhRMA (drug makers), Advamed (device manufacturers), the AMA (doctors), the AHA (hospitals), AHIP (health insurance), and SEIU’s Health Care project. The corporate signatories are the very same interest groups that have fought U.S. healthcare reform for generations. AHIP, America’s Health Insurance Plans, helped torpedo the Clinton plan in the 1990s with the infamous “Harry and Louise” TV spots.

Progressive healthcare writers are divided as to whether Obama’s rapprochement is a good sign. One school of thought is that the interest groups have finally seen the writing on the wall. Arguably, the industry realizes that some kind of healthcare reform is inevitable and they hope to get the best possible deal by cooperating. Another perspective, not necessarily incompatible with the first, is that this kind of “cooperation” will ultimately co-opt Obama’s reform program.

Mike Madden summarizes the main thrust of the industry charm offensive in Salon:

Some of the organizations that have fought hardest against changing the system in the past are — for now, at least — saying they’ll work for it this time around. To demonstrate how serious they are, they joined Obama Monday to say they’ll work voluntarily to cut the growth rate of healthcare costs by 1.5 percent each year for the next decade. Unchecked, costs would increase by more than 6 percent a year, so the administration says the country — private employers and the government combined — would save $2 trillion from the effort. An average family of four could save $2,500 a year within five years.

The letter itself offers few details as to how the industries will actually go about saving money. More to the point, there’s nothing forcing these groups to follow through on anything they’ve pledged to do.

Still, if you parse the platitudes, the industry is diverging slightly from Republican anti-reform rhetoric. The GOP has been crusading against comparative effectiveness research (CER) ever since the stimulus bill set aside a billion dollars to fund it. CER is just research to discover which treatments give the best outcomes for the money, but the GOP would have us believe that it’s a stalking horse for rationing. Whereas, the industry coalition’s letter talks about cutting costs by “aligning quality and efficiency incentives” and “adherence to evidence-based best practices”–basically, big words for “studying the evidence” and “trimming the fat”–the core of the CER agenda.

Steve Benen of the Washington Monthly thinks the new conciliatory posture is encouraging evidence that the Republican opposition to reform is in such disarray that the industry is prepared to make nice with the Obama administration:

…I’m encouraged anyway, in part because it suggests the right’s opposition is completely falling apart, as the reform push picks up needed momentum, and in part because it brings these heavy-hitters into the tent, where they’re far less likely to start launching vicious attacks.

Andy Stern, president of the Service Employees International Union (SEIU), also secured a seat at the table. As Ezra Klein suggests in the American Prospect, the fact that Stern is in the room is a testament to his skill as a coalition builder. SEIU represents millions of Americans, including many healthcare workers. Stern told Klein that the group had set itself a June 1 deadline to put forward concrete proposals that can be assigned dollar figures. The Finance Committee’s first bill drops in June, so the committee will have to work fast if they want to see their suggestions incorporated.

Josh Holland of AlterNet says we should beware of the healthcare execs’ blandishments. Holland notes that they promise to reduce the growth in costs to “only” 4.7% a year:

There’s no news here — “voluntary” codes  of conduct, self-regulation and industry-driven initiatives for the private sector to address complex policy issues have long been a standard tactic for heading off real regulation, real accountability measures, systemic reforms.

In Mother Jones, James Ridgeway agrees that the initiative is a mere publicity stunt, seeing as there’s nothing but the threat of public embarrassment to hold the group to any of its pledges.

“Public embarrassment”? From Big Pharma and the health insurance companies–-two of the most shameless industries in the history of corporate capitalism? In any case, even if the $2 trillion reduction is achieved, it clearly won’t come out of industry profits.

Even if we do get healthcare reform this year, what would the end product look like? In the Nation, Trudy Lieberman, director of the health and medicine reporting program at CUNY, takes a hard look at the messages the president has sent so far. She foresees a package that’s congenial to Obama’s corporate allies:

It’s becoming clearer that reform will include some or all of these options: requiring everyone to carry health insurance (an individual mandate à la Massachusetts); subsidizing a portion of the 85 percent of the uninsured who can’t afford to buy a policy; taxing some of the health benefits workers now get from employers to pay for insurance for the uninsured; letting people keep the coverage they have even though it’s likely to cover less as time goes on; shoving more people onto Medicaid; and trying to get insurers to insure sick people. There may or may not be a public insurance option–maybe like Medicare, or maybe not–that would compete with private insurers and theoretically reduce the cost of insurance.

All this conciliation is not cost-free. In the following video, economist Richard Wolff tells The Real News that Obama risks a grassroots backlash if he caters to corporate interests on healthcare. People want better healthcare, not just a choice of bad options. If the result of “reform” is an inferior public plan alongside the private system, employers will have an incentive to push their workers onto the public plan, and we’ll all be worse off.

The president may not support a true national healthcare plan, but don’t count the friends of single payer out yet. Doctors and other advocates for single-payer healthcare crashed a Senate Finance Committee meeting this week to protest their exclusion from a series of roundtable discussions on healthcare policy, as Laura Flanders reports on GRITtv. “Every lobbyist in America is at the table, when are the American people going to be heard?” shouted one activist. A handful of activists were arrested when they refused to come to order.

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