Friday Follies

I just got off the phone with Quest Diagnostics trying to find out why a $94 bill from April 2008 is back in collections even though Quest assured me the insurance company mistake that started the problem in the first place had been taken care of months ago.

The collections agency usually puts through a recording, but today I got a real live obnoxious human. After many frustrating minutes explaining I owe nothing and the man on the other end of the line threatening to ruin my credit, I proceeded to explain in no uncertain terms I am not paying them a "f*cking dime." Those were my exact words. Ask my coworkers. Everyone heard.

And the best part? No one flinched. Not one person.

I love my job. I get to fight the good fight for a living.

Not the most pleasant way to wrap up a week, but I declare I've earned my Friday. Most of today was spent out of the office, actually. I went up to the Hill to watch Richard tape a segment for The Colbert Report. It should air sometime in August. I'll keep you posted.

But for now, happy weekend. Have a good one.

Maxed Out

If this doesn't make you mad, then I don't know what will. From The Hill:

Sen. Chuck Grassley, the senior Republican on the Finance Committee, has assured his GOP colleagues that he will not sell them out and strike a private deal with Democrats on healthcare reform, according to Republican senators.

Grassley (Iowa), who is known for having a close relationship with Finance Committee Chairman Max Baucus (D-Mont.) and has been negotiating behind closed doors with Democrats for weeks, made the promise to the entire Senate Republican Conference at a meeting late on Wednesday, according to several senators who attended.

(...)

Grassley, Enzi and Sen. Olympia Snowe (R-Maine), members of the so-called Group of Six, told Senate Republican leaders and colleagues at the meeting that they would not commit to the legislation without first consulting the entire GOP conference.

(...)

And Grassley’s approach is markedly different from the one Baucus took when he was the ranking Democrat on the committee in 2001 and Republicans were trying to pass a massive package of tax cuts.

Baucus struck a deal with Republicans before giving the Democratic Conference a chance to review the deal, a maneuver that enraged his party leaders and gave bipartisan momentum to President George W. Bush’s tax package, which ultimately became law.

Grassley is not about to do that on the healthcare deal, Republicans say.

Not that this is the least big surprising, but Grassley's now admitting he plans to screw Baucus, and the leading Dem on Finance still insists on playing nice. It's infuriating.

The good news is there's hope:

Now that Baucus is unable to report a deal by the end of next week, pressure will grow on Democratic leaders to force action on the Finance panel. That would mean pressing Baucus to report a bill with minimal GOP support or moving ahead without Baucus’s input.

Fine by me. SO fine by me.

Absolute Disconnect

CNN just did a segment on false advertising in the health care debate and then went to commercial break and ran a false ad warning about government-run health care.

Way to stick to the truth. Here's a novel idea. If you're going to debunk the authenticity of an ad and you're a NEWS channel, refuse to run the ad.

I know. Money trumps principle. But it would nice if it didn't.

Catching Up and Winding Down

The busier I get, the harder it is to find time to blog. Apologies for the radio silence all day. I will do my best to make it up to you tomorrow.

Speaking of tomorrow and radio, I'm scheduled to chat with Jack and Rich at 9am. I've done the show a couple of times before, and it's pretty entertaining. If you find yourself with a spare moment, check it out.

All for now. G'night moon.

A Homerun

Our online team rocks.

Take a look at the Facebook ad that totally did the trick.

Pick Up The Phone

Today's the big day. It's National Health Care Call-in Day.

Tell Congress Health Care Can't Wait - Support H.R. 3200 (the House bill)

877-264-4226

You can also use our Click to Call tool. Plug in your info, and it calls you back with an instant connection to your Members of Congress.

If you need a little more help with message, the bottom line is this: We need health care reform now, and we need it to be good. We have to make sure health care is truly affordable for families and businesses, and we need a strong public health insurance option to lower costs and make the insurance companies behave better.

That's it. Easy enough. Now get dialing!

He Gets It

Rep. John Larson (D-Conn.), chairman of the House Democratic Caucus, via HuffPo:

"Democrats in the House have already held 10 Caucus meetings on health care, 79 hearings on health care reform, 550 town hall events in their districts about health care, and three House Committees have heard 45 hours of debate and amendments on our health care reform legislation. The American people have been waiting 75 years for us to get this done."

Main Street Speaks

Great write from a small business owner on how health care reform will help him:

We got a letter earlier this month from our company health-insurance provider, informing us that our policy had been canceled for late payment of the premium. No warning or notice, just a cancellation letter. After lots of begging and pleading, a $3,700 check, and four days of heartburn for yours truly, we got it reinstated.

I suspected that the real reason for the cancellation was that we had the audacity to actually file some significant claims. The policy has a $5,000 deductible, but I had an appendectomy last year (about $18,000) and a few other claims as well. The insurance company assured us that this was not the case: Lots of small businesses had gotten cancellation notices, because lots of companies are falling behind on their premiums in this economy and the insurance company is cracking down.

Somehow I didn't find that very reassuring. On the contrary, this incident reinforced my strong conviction that the idea that health care reform isn't good for small businesses is arrant nonsense. If there is one thing the federal government can do to help my company, health care reform is it.

Consider the position we're in with the above-mentioned incident. Unlike almost anything else we buy, health insurance is not something we can simply get from another vendor. In writing policies, insurance companies require that you have continuous coverage, or else they will exclude coverage for all pre-existing conditions (which when you get to be my age can be a lot of things). Thus cancellation of the policy would have permanently undermined our ability to get insurance.

I'm not saying we should be able to pay late with impunity. But a system in which we are subject to the shifting policies of an all-but-unregulated private insurance company that effectively has the power to deny our ability to get coverage anywhere is absurd.

Further, I had to spend several days sweating this issue, working with our office manager to fix it, trying to decide whether to tell people about the problem or wait until we got it resolved. This was time and energy not spent on anything having to do with what NewWest.Net is in business to do.

How Health Reform Helps You

NYT has a great chart online here. Also in the NYT, a quote from Richard on subsidies and affordability:

Richard J. Kirsch, the national campaign manager of Health Care for America Now, a consumer group, expressed concern. “If Congress sets the limit at 300 percent of the poverty level,” Mr. Kirsch said, “millions of middle-income families would not be able to buy insurance because they could not afford the premiums on their own.”

And HCAN's August recess plans get a little love in the LA Times via the Associated Press:

Health Care for America Now, a coalition of labor and progressive groups supporting Obama, will at least match the $2 million in TV ads it's run this month and send members to lawmakers' town hall meetings, said Richard Kirsch, its national campaign manager.

Gone Off The Tweet End

I've made no secret of how much everything about Chuck Grassley's using Twitter bothers me, but does anyone else find it particularly disturbing that a U.S. Senator doesn't know the difference between patients and patience?

Take a look at his latest rant:






Looks like I am not alone in noticing the ignorance. From Media Matters:

Sen. Grassley Has Abandoned Bipartisanship (And The English Language)

Not Helping

A few weeks back, a couple of girlfriends and I were wandering around downtown trying to figure out where to stop off for a drink. It was one of those situations when we all knew there were places we'd been, but we couldn't think of anything good. One friend mentioned how cool it would be to have an iPhone in that moment with the app that picks a spot for you based on your locale. (I'm assuming there is - in fact - that app b/c A. I trust her and B. I'm learning there is an app for everything).

That incident led me to download the poor man's version of said app from the blackberry library on my phone. I was playing with it this morning to see how well it worked, and I typed in "restaurant." I got several spots seemingly close to my house, but this was the very first suggestion:

Eating Disorder Treatment PROG

Fighting Back

We've got an ad up today in 8 states. It targets Republicans voting against or standing in the way of good health care reform:



If "Fighter" looks familiar, that's because we used it last October during election season. We've brought it back because we know it works.

Dogging You Out

You may know there's a hold up in Congress right now because of the Blue Dogs. What you may not know is why.

If the Blue Dogs get their way, middle-class people will end up paying three times as much as a member of Congress for health care.

The Blue Dogs are proposing eliminating financial support for millions of middle-class Americans who have to purchase health care on their own. In the House bill as it is right now, people making 400% of poverty would get help. Blue Dogs want that number down to 300% which would leave a whole slew of people unable to afford the only health care available to them. The Blue Dogs are doing it to avoid having to raises taxes on the rich.

Without protections for middle-class families, millions of people would have to pay $1,050 a month for health insurance which is three times what members of Congress pay ($357/month). Health Care for America Now believes Blue Dogs should support the surcharge on families who earn more than $350,000 instead of making middle-class families pay thousands of dollars for health insurance.

Note: The average premium for family coverage nationally is $12,600 which is $1,050/month. The family premium for federal employees for the standard health coverage plan is $357/month.

A broad coalition of 19 major organizations sent a letter to Speaker Pelosi and Chairmen Rangel, Waxman, and Miller earlier this week stressing the urgency of making sure health care is truly affordable for middle class families. This is the text of that letter:

On behalf of the undersigned organizations, we want to express our strong support for enacting comprehensive health reform legislation this year that makes good on the promise that adequate, affordable health coverage and care will be made available to all Americans.

We commend your tireless efforts that are leading us towards this goal.

As the President and you have emphasized, America’s families are most concerned about the affordability of health coverage and care. It is essential, therefore, that health reform result in families getting meaningful health care coverage at an affordable cost. As a result, our organizations consider affordability to be of paramount importance.

We commend you for providing sliding-scale premium subsidies to families up to 400 percent of the federal poverty line. This is particularly important in rural and other areas where most residents have modest incomes and need assistance for coverage to be affordable. With family health premiums now averaging close to $13,000 per year, premiums alone constitute a significant portion of income even for people at the upper end of this standard. That is why this provision in the House bill is so important.

The House bill also recognizes other key elements of premium affordability. Some of the most important ones include:

• The bill limits premium rate differences based on age so that premium differentials are no higher than a two-to-one ratio.

• The subsidies in the bill ensure that lower-income families receive greater protection so that they pay lesser percentages of income in premiums.

• The bill exempts people from the individual mandate requirement if their economic circumstances make premiums unaffordable.

• The bill assures that health coverage at work includes standard benefits and meaningful contributions from employers and also includes protections for workers who cannot afford employer coverage.

Additionally, the House bill recognizes the importance of adequacy of coverage and the need for affordability of cost-sharing to protect families from catastrophic costs. A recent national study found that 62 percent of all bankruptcies were medical in 2007 and that 92 percent of these bankruptcies had medical debts exceeding $5,000 or 10 percent of family income, despite the fact that most had health insurance.

We strongly support some of the key attributes of the House bill that are designed to make the costs of health care affordable. In particular: (1) as in the FEHBP, it is important that there be reasonable limits on the total out-of-pocket costs patients must pay for their health care; and (2) lower-income people need premium subsidies based on plans with higher actuarial values so that they have adequate coverage protection, and they need the protection of lower out-of-pocket caps.

Our organizations will work tirelessly together with you to support and strengthen these key provisions that are designed to make health coverage and care affordable.

Sincerely,

AARP
AFL-CIO
American Cancer Society Cancer Action Network
American Federation of State, County and Municipal Employees
American Heart Association/American Stroke Association
American Medical Student’s Association
American Public Health Association
Communications Workers of America
Community Catalyst
Consumers Union
Families USA
Health Care for America Now
National Education Association
National Partnership for Women & Families
National Patient Advocate Foundation
National Women's Law Center
PICO National Network
Service Employees International Union
United Food and Commercial Workers

Lewinsing Their Religion

It's been one of those days. It kicked off with a migrane that came on out of the blue, and it's ending up with a slew of little "headaches" in the metaphorical sense.

On the good news front, the WaPo finally wrote the Lewin Group expose on who they are and how their "findings" are bought and paid for:

To Rep. Eric Cantor of Virginia, the House Republican whip, it is "the nonpartisan Lewin Group." To Republicans on the House Ways and Means Committee, it is an "independent research firm." To Sen. Orrin Hatch of Utah, the second-ranking Republican on the pivotal Finance Committee, it is "well known as one of the most nonpartisan groups in the country."

Generally left unsaid amid all the citations is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation's largest insurers.

More specifically, the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association, a physician's group, of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied its parent company and other insurers with data that allegedly understated the "usual and customary" doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.

In January, UnitedHealth agreed to a $50 million settlement with the New York attorney general and a $350 million settlement with the AMA, covering conduct going back as far as 1994.

I've written about Lewin before here and here.

Here's more on how the lies citing Lewin have been spreading:

"The nonpartisan Lewin Group predicts that two out of three Americans who get their health care through their employer would lose it under the House Democrat plan," Cantor, the second-ranking member of the House Republican leadership, said in a July 12 commentary in the Richmond Times-Dispatch.

"The independent Lewin Group analysis found that a new public plan could mean that 118 million Americans will lose their current health care coverage, and 130 million Americans could end up on a government-run health care plan," Sen. John McCain of Arizona, the 2008 Republican presidential nominee, said in a Senate speech in April.

Since then, adjusting its analysis to reflect the latest version of legislation drafted by House Democrats, Lewin has estimated that 88.1 million workers would shift from private, employer-sponsored insurance to the proposed public plan.

The Congressional Budget Office came to a different conclusion, saying that enrollment in the House Democrats' proposed public plan would total about 11 million to 12 million people.

And the important nugget that's been left out of the Republican rhetoric:

Though the millions of people Lewin was describing would lose their current employer-sponsored coverage, they wouldn't be forced into a government-run health plan, Sheils said in an interview. Rather, they would be able to choose between the government plan and other private options.

"People would indeed lose what they have, but they might very well be better off," he said.

Where Your Premiums Go

UnitedHealth Group, the nation’s largest health insurer by revenue, today reported $859 million in net income, or profit, for the second quarter of 2009.

Saying No Means More of the Same

John's in France right now trying to deal with an eye "situation" and Blue Cross Blue Shield back here in the US:

For all intents and purposes I have no insurance. I have a crap shoot. Not only are the details of my plan unknowable, but they appear to change with the luck of the draw, depending who answers the phone that day at Blue Cross' 800 number, spin the lucky wheel, headquarters in hell.

His frustration is not unique, but he tells a good story, and his is a reminder of why it is so important we do something now.

Let the Republicans play politics and try to stop progress. Let them formulate rhetoric and invent bogeyman to try to scare people away from change. Let them be on the wrong side of history. Let them back up the Blue Cross Blue Shield's of the world and perpetuate the nightmare of skyrocketing premiums, shrinking coverage, and endless runarounds.

My advice to Democrats: Don't be one of them. Nitpicking is not the way to be heroic. Vote for reform that is going to make health care in this country better. Take this opportunity to be one of the good guys. And instead of just worrying about getting re-elected, try doing something that actually makes you worthy of being re-elected.

Picture Perfect

From WaPo:

AM Radio

I'll be on Jeff Santos' radio show around 9am. It's turning into quite the regular Monday morning gig. I like it.

You can listen live online here.

Obama Gets It

Make Him Stop

Related: Grumpy Old Man (6/7/09)

It's Been A Week

I sent the following text to a friend last night:

U know ur standards are low when u get home, the cat hasn't thrown up, and u think...ok, not such a bad day after all.

Things are moving so quickly, it's tough to keep the site up to speed. But here's a little summary of what's been going on and what we're waiting on:

The House release its legislation on Tuesday. Our official statement is here.

H.E.L.P passed its bill out of committee on Wednesday. Our official statement is here. We also made an ad thanking Senator Dodd:



The AMA endorsed the House bill yesterday. You can see the letter here.

Finally, the President's planning to speak about health reform at 3:15pm, and we continue to wait for something - anything - to come out of the Senate Finance Committee. We shall see.

Chartastic

Media Matters created a chart of how the Republican chart made the rounds:

Republicans Chart Course to Nowhere

The Republicans - in an effort to recycle more stale strategy from '93/'94 - have released a chart trying to paint the Democrats' health care plan as overly complicated. You can see a copy of it to the left.

It makes no sense.

But the best part of this Tactic: Fail! is the Democratic response:



You can read more from Jason here.

Twisted Logic

This is too good to ignore. But it gets a little confusing so stick with me.

Republicans tried out a new tactic today. They decided if Democrats want the public health insurance option so badly, there should be an amendment to the HELP bill forcing Members of Congress and their staff to enroll in the public option.

See the disconnect? The public option would be just that. An option. A choice. No one would be forced into anything. Here's HHS Secretary Sebelius in Politico:

“That’s correct,” Sebelius said. “In fact, there are protections in the bill. Congress and the president, certainly, are very concerned that we don’t want to dismantle the private market. ... We don’t want folks dumping their current coverage and moving toward either a public option or other private plans. It is really to close the gap, if you will, and find affordable coverage ... for those Americans locked out of the system.”

The bills treat the federal government like any other employer that offers insurance, restricting its ability to drop private coverage and push people into the public system.

See that? There are protections in the House and Senate bills that make sure employers don't force people out of private insurance into the public option. You'd think that would be cool with Republicans, right? No one's getting forced into anything. But wait? This isn't a logical fight. It's ideological. Hmmm...

Although many Republicans might agree with that goal, they are looking at the issue from a different vantage point.

“Sen. McCain believes, if there is a public option, that members of Congress should have to relinquish the current plush federal health care plan and use the public option, just like millions of Americans who will be forced to,” McCain spokeswoman Brooke Buchanan said in an e-mail.

But no one is being forced into anything. So no matter which way you spin it, the whole scheme makes no sense.

But here's the kicker. Sen. Coburn introduced the amendment...and it passed. Republicans voted for it out of spite thinking We'll show them! But Senator Dodd, Senator Kennedy (by proxy), and Senator Mikulski said, "Sure, we'll join the public option," and the silly thing passed. It will never actually go anywhere, but it's still excellent that the Republican plan backfired so spectacularly.

I have a feeling now is when it starts to get really fun.

The First Step Is Admitting They Have A Problem

Not that I need to get any more fired up than I already am these days, but this made me mad:



I'm told this kind of thing happens all the time, and I'm not discovering anything new. (Or as my friend Levana said ever so delicately, "How long have you lived in DC?"

But it doesn't make it any less infuriating. The tip came from Jane who is going to be at the House bill markup tomorrow with Hilda Sarkisyan whose daughter died because her insurance company denied her a liver transplant until it was too late.

Remember, Wendell Potter worked for CIGNA at the time Nataline Sarkisyan died:

BILL MOYERS: You put these techniques to work, representing Cigna doing the Nataline Sarkisyan case, right?

WENDELL POTTER: That's right.

BILL MOYERS: And that was a public relations nightmare, you called it. Right?

WENDELL POTTER: It was. It was just the most difficult. We call them high profile cases, when you have a case like that — a family or a patient goes to the news media and complains about having some coverage denied that a doctor had recommended. In this case, Nataline Sarkisyan's doctors at UCLA had recommended that she have a liver transplant. But when the coverage request was reviewed at Cigna, the decision was made to deny it.

It was around that time, also, that the family had gone to the media, had sought out help from the California Nurses Association and some others to really bring pressure to bear on Cigna. And they were very successful in getting a lot of media attention, and nothing like I had ever seen before.

PROTESTERS: Shame on Cigna! Shame on Cigna!

WENDELL POTTER: It got everyone's attention. Everyone was focused on that in the corporate offices.

Again, if you missed it, you can watch the full Potter interview here. That too will make you mad.

Happy Birthday To Us

I'm not one to downplay a birthday (especially my own), but I totally missed the chance to point out HCAN turned 1 last week.

Health Care for America Now launched July 8th 2008 in DC and 52 cities nationwide. According to our first press release (which I had to go back and check), we started out with 100 member organizations. We're now at 1071.

Ezra Klein has a nice write up today about HCAN and its significance in the fight for comprehensive reform:

Last week, the Health Care for America Now coalition celebrated its first birthday. Formed, well, a year ago, with an initial infusion of $40 million and a coalition list that includes MoveOn.org, SEIU, the Campaign for America's Future, and pretty much every other institution even vaguely on the left, HCAN has quickly become the dominant grassroots player on health-care reform. Which is really saying something.

Voice of Reason

In today's WaPo, Richard Cohen tells it like it is:

When I was in the Army and known to my friends as "Combat Cohen," I could not get over the fact that, during an era of almost universal military service, the American public supported high Pentagon spending despite firsthand knowledge of astounding waste and theft. I cite, for instance, the well-known and frequently witnessed pillaging of food by mess sergeants. From tasting their stuff, I can say that theft is what they did best.

Now I am similarly perplexed. Many, if not most, Americans have some experience with our nation's mostly private health-care system. Yet they still fall prey to the scare tactic that nothing -- but nothing -- could be worse than a government takeover of the system. How things could be worse than they are now, I cannot imagine.

In the past two months, I have spent many hours accompanying a loved one to hospital emergency rooms -- all of them privately operated. The rap on what is sometimes called socialized medicine is that if the government ran the system, the wait would be interminable. Well, I am here to tell you that even when the government does not run the system, the wait can be interminable.

And uncomfortable. In one hospital there was not enough space in the emergency room for all those seeking treatment. My friend got moved from a bed -- where she was relatively comfortable -- to a wheelchair in the hallway. There she sat, in agony, for about six hours. Something similar happened at another emergency room, though this time she was given a cot. The wait, though, was just as long.

The emergency room has become the equivalent of the family doctor. It is where you go if you don't have a family doctor or if you do have a family doctor -- and it's after hours or the weekend. It is also where you sometimes have to go in order to be admitted to a hospital. The staff is mostly courteous, sometimes wonderfully solicitous, but the constant triaging of new people can put you on a treadmill to nowhere. The emergency room is the great leveler of American life. Everyone gets miserable treatment.

On Friday, Bill Moyers interviewed Wendell Potter about health care and such matters. Potter is the former head of corporate communications for Cigna, the nation's fourth-largest health insurer. By his own characterization, he is one of those insurance executives who flew from meeting to meeting in private planes and hardly ever touched ground to meet real people. One day he did. He went to an outdoor health clinic over the Virginia border from his home town in Tennessee. This is what he told Moyers:

"What I saw were doctors who were set up to provide care in animal stalls. Or they'd erected tents to care for people. . . . And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care. People drove from South Carolina and Georgia and Kentucky, Tennessee -- all over the region."

Thank God we don't have socialized medicine.

Into this debate about the role of government in medical care, I come jaded by experience. In addition to having been Combat Cohen, I was also Cohen of Claims when I worked for an insurance company. This means that whenever someone says something about "government bureaucrats," I smile because I was once a non-government bureaucrat. It is not government bureaucrats who say that certain treatments will not be covered, and it is not the government that purges insurance rolls of the sick or the old, and it is not the government that makes money -- lots of money -- on health insurance. It is private enterprise.

But as Potter points out, the insurance industry sets out to spook the public with talk of "socialized medicine," "government bureaucrats" and "government-run health care." My loved one recently had to return to the emergency room because she was dehydrated. Her insurance company listed the reasons someone could return, and dehydration was one of them. They still denied her claim. The government had nothing to do with it.

The ongoing health-care debate is complex -- not as interesting as Michael Jackson or Sarah Palin. But in deciding what to do and who to support in the current attempt to reform health care, don't rely on insurance industry propaganda, but on your own experience. Recall the last time you went to the emergency room and ask yourself whether the government could possibly do a worse job. If the answer is yes, you might need medical attention more than you realize.

You Can Quote Me

Sometimes I like my own quotes so much, I feel the need to share. From Politico:

Jacki Schechner, a spokeswoman for the progressive group Health Care for America Now, said, “It’s very clear that the Republican goal is to kill health care reform and they will do everything they can to stall and delay. They have no intention of creating reform that will actually work for the people of this country. They’re more interested in political tactics and loaded talking points.”

The title of the piece is Republicans search for health language which I think is very telling.

When you have a real plan, you don't have to hunt for rhetoric. I'm just saying.

Also from Politico tonight - the latest on likely timelines:

The Finance Committee has struggled to find consensus on paying for the $1 trillion overhaul bill, although Grassley told reporters Monday that the committee would release a bill later this week. The House is more likely to approve a bill before it adjourns July 31.

White House Press Secretary Robert Gibbs suggested the president would ask lawmakers to forgo their August recess to work on the bill.

“I'm sure the president will encourage them to continue to stay and do what needs to be done in order to have that happen, understanding, again, that this is a big priority of the president,” Gibbs said.

(...)

Rangel promised to mark up the House health care bill this week, and Baucus told the president that he would mark up the Finance Committee bill next week – something that Rangel said he thinks will help reassure House Democrats that the Senate will act.

We expect to have a House bill tomorrow. HELP markup will be done soon, and if Baucus and Grassley can get it together, we'll finally have movement out of Finance this week. Considering the lift, it all sounds pretty much on track to me.

Talking Points and Pointed Talk

Morning. I expect most of today's news to focus on Sotomayor's confirmation hearings, but it doesn't mean there won't still be movement behind the scenes on the health care front.

One important note: $1 trillion is an arbitrary number, and if cutting down legislation to meet that number means keeping health care unaffordable for millions of middle class, working families, then we will not have succeeded at meaningful reform.

It's complicated, but here's what you need to know. The House is looking at making changes to its draft legislation to get the overall cost down to under $1 trillion. But to do that, they would have to cut subsidy levels from 400 percent of poverty to 300 percent of poverty and limit access to the insurance exchange. That means many working families will continue to pay premiums they can't afford and still have thousands of dollars in out-of-pocket expenses.

That's not good policy.

Congress need to take a long hard look at what it's sacrificing to meet a random dollar amount.

Also, this morning, I want to make sure to keep the spotlight on Wendell Potter and his interview with Bill Moyers from Friday night. Wendell exposed the health insurance industry in a very real and honest way. Here are some more excerpts from that hour:

On Sicko:

BILL MOYERS: So what did you think when you saw that film?

WENDELL POTTER: I thought that he hit the nail on the head with his movie. But the industry, from the moment that the industry learned that Michael Moore was taking on the health care industry, it was really concerned.

BILL MOYERS: What were they afraid of?

WENDELL POTTER: They were afraid that people would believe Michael Moore.

On Republican talking points:

BILL MOYERS: Why do politicians puppet messages like that?

WENDELL POTTER: Well, they are ideologically aligned with the industry. They want to believe that the free market system can and should work in this country, like it does in other industries. So they don't understand from an insider's perspective like I have, what that actually means, and the consequences of that to Americans.

They parrot those comments, without really realizing what the real situation is.

I was watching MSNBC one afternoon. And I saw Congressman Zach Wamp from Tennessee. He's just down the road from where I grew up, in Chattanooga. And he was talking-- he was asked a question about health care reform. I think it was just a day or two after the president's first-- health care reform summit. And he was one of the ones Republicans put on the tube.

And he was saying that, you know, the health care problem is not necessarily as bad as we think. That of the uninsured people, half of them are that way because they want to "go naked."

REP. ZACH WAMP: Half the people that are uninsured today choose to remain uninsured. Half of them don't have any choice but half of them choose to, what's called, go naked, and just take the chance of getting sick. They end up in the emergency room costing you and me a whole lot more money.

WENDELL POTTER: He used the word naked. It's an industry term for those who, presumably, choose not to buy insurance, because they don't want to. They don't want to pay the premiums. So he was saying that half... Well, first of all, it's nothing like that. It was an absolutely ridiculous comment. But it's an example of a member of Congress buying what the insurance industry is peddling.

On Wall Street-driven health care:

WENDELL POTTER: Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.

I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.

For example, if one company's medical loss ratio was 77.9 percent, for example, in one quarter, and the next quarter, it was 78.2 percent. It seems like a small movement. But investors will think that's ridiculous. And it's horrible.

BILL MOYERS: That they're spending more money for medical claims.

WENDELL POTTER: Yeah.

BILL MOYERS: And less money on profits?

WENDELL POTTER: Exactly. And they think that this company has not done a good job of managing medical expenses. It has not denied enough claims. It has not kicked enough people off the rolls. And that's what-- that is what happens, what these companies do, to make sure that they satisfy Wall Street's expectations with the medical loss ratio.

Again, if you haven't watched the program or read the transcript, you should. It's all here.

Insurance Insider Tells All

Former Insurance Industry Executive Wendell Potter was on Bill Moyers Journal last night. I cannot recommend this hour enough. Wendell exposes the insurance industry for all its despicable behavior and behind-the-scenes tactics to influence Congress and thwart real reform.

He talks about Cigna's handling of the Nataline Sarkisyan case and the insurance industry's media and political strategies to discredit Michael Moore's Sicko:

BILL MOYERS: And there was a political strategy. "Position Sicko as a threat to Democrats' larger agenda." What does that mean?

WENDELL POTTER: That means that part of the effort to discredit this film was to use lobbyists and their own staff to go onto Capitol Hill and say, "Look, you don't want to believe this movie. You don't want to talk about it. You don't want to endorse it. And if you do, we can make things tough for you."

BILL MOYERS: How?

WENDELL POTTER: By running ads, commercials in your home district when you're running for reelection, not contributing to your campaigns again, or contributing to your competitor.

BILL MOYERS: This is fascinating. You know, "Build awareness among centrist Democratic policy organizations--"

WENDELL POTTER: Right.

BILL MOYERS: "--including the Democratic Leadership Council."

WENDELL POTTER: Absolutely.

BILL MOYERS: Then it says, "Message to Democratic insiders. Embracing Moore is one-way ticket back to minority party status."

WENDELL POTTER: Yeah.

BILL MOYERS: Now, that's exactly what they did, didn't they? They--

WENDELL POTTER: Absolutely.

BILL MOYERS: --radicalized Moore, so that his message was discredited because the messenger was seen to be radical.

WENDELL POTTER: Absolutely. In memos that would go back within the industry — he was never, by the way, mentioned by name in any memos, because we didn't want to inadvertently write something that would wind up in his hands. So the memos would usually-- the subject line would be-- the emails would be, "Hollywood." And as we would do the media training, we would always have someone refer to him as Hollywood entertainer or Hollywood moviemaker Michael Moore.

BILL MOYERS: Why?

WENDELL POTTER: Well, just to-- Hollywood, I think people think that's entertainment, that's movie-making. That's not real documentary. They don't want you to think that it was a documentary that had some truth. They would want you to see this as just some fantasy that a Hollywood filmmaker had come up with. That's part of the strategy.

BILL MOYERS: So you would actually hear politicians mouth the talking points that had been circulated by the industry to discredit Michael Moore.

WENDELL POTTER: Absolutely.

I suggest you put aside some time and watch the program. Or read through the transcript. It'll make you mad, but that's a good thing. We need anger. We need action. This is it, folks. Now is the time we push Congress to do something. Right now.

Hot and Cold

I'm going to have to leave the office soon while I can still feel my toes.

But going into the weekend, the latest news on the health care reform front can be summed up by stating the obvious:

Fixing health care is hard.

Seriously. Explain to me why anyone expected this wouldn't be an arduous process rife with ups and downs and stalls and restarts. Today we found out the House markups are being pushed back a tad. Ok. Whatever. So let's put in a little extra work and smooth over some of the rough patches. HELP is making good progress. We are farther along now than we have ever been, like, ever, and we have the President, Congressional leadership, and a majority of the American public on the same page when it comes to one of the largest components of the whole deal - a new public health insurance option. In my book, we are doing just fine.

Keep that in mind if you watch the talking heads on TV this weekend spew all shades of contradictory, unfounded garbage.

And with that, I'm off. Have a good one.

Jaxsicle

There's air-conditioned, and then there's "you could store meat in here" cold.

My office is painfully close to the latter.

Rally Revisited

I got some cool photos today from our June 25th rally that I am totally reposting without permission. I know. I'm a rebel. Here you go:

Talk Radio

It did get a little heated. You can listen here. I would have liked even more time to get everything out, but for what we had, I'm content.

Call Congress

No excuses. It's free.

Today is our National Call-in Day. Please be polite. Ask to talk with someone who can tell you the Senator's or Representative’s position on health care.

Call 1-877-264-HCAN (4226) to be connected to your Members of Congress.

Here is a sample of what you could say to Senators:

I’m calling from Health Care for America Now to make sure that Sen. _____ knows that we need real health care reform in 2009.

Please tell ____________ to support the legislation from the HELP Committee that provides:

* Coverage we can afford
* Comprehensive benefits we can count on
* Choice of a private or public health insurance plan
* Equal access to quality care

Here is a sample of what you could say to Representatives:

I’m calling from Health Care for America Now to make sure that Rep. _____ knows that we need real health care reform in 2009.

Please tell ____________ to support the legislation from the House Leadership that provides:

* Coverage we can afford
* Comprehensive benefits we can count on
* Choice of a private or public health insurance plan
* Equal access to quality care

Now Back To The News

In case you missed it, Reid steps up:

Senate Majority Leader Harry Reid (D-Nev.) on Tuesday ordered Finance Chairman Max Baucus (D-Mont.) to drop a proposal to tax health benefits and stop chasing Republican votes on a massive health care reform bill.

Reid, whose leadership is considered crucial if President Barack Obama is to deliver on his promise of enacting health care reform this year, offered the directive to Baucus through an intermediary after consulting with Senate Democratic leaders during Tuesday morning’s regularly scheduled leadership meeting. Baucus was meeting with Finance ranking member Chuck Grassley (R-Iowa) Tuesday afternoon to relay the information.

According to Democratic sources, Reid told Baucus that taxing health benefits and failing to include a strong government-run insurance option of some sort in his bill would cost 10 to 15 Democratic votes; Reid told Baucus it wasn’t worth securing the support of Grassley and at best a few additional Republicans.

Nice. Continuing to court Senator "Go work for the government" Grassley is a rotten idea, and the more pressure support Baucus gets to go in the opposite direction, the better.

Got Perspective?

I know I can't be the only one who thinks the MJ thing is gross. For the record, this is what I put up on Facebook:

Unacceptable

UPDATE 2: Our statement:

Richard Kirsch, National Campaign Manager, Health Care for America Now:

“Today, President Obama unequivocally reaffirmed his commitment to a public health insurance option as part of comprehensive health care reform this year. We believe too that a national robust public health insurance plan that is ready on day one is central to lowering costs, injecting competition into the health insurance market, ensuring access to care in every corner of the country, and keeping the insurance companies honest. We look forward to working with the President and Congressional leadership to accomplish these goals.”

UPDATE: Instant damage control? Just add email:

THE WHITE HOUSE
Office of the Press Secretary
_____________________________________
FOR IMMEDIATE RELEASE
July 7, 2009

Statement from the President on Health Care Reform

"I am pleased by the progress we're making on health care reform and still believe, as I've said before, that one of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest. I look forward to a final product that achieves these very important goals."

The headline links to today's WSJ article that reads:

Mr. Emanuel said one of several ways to meet President Barack Obama's goals is a mechanism under which a public plan is introduced only if the marketplace fails to provide sufficient competition on its own. He noted that congressional Republicans crafted a similar trigger mechanism when they created a prescription-drug benefit for Medicare in 2003. In that case, private competition has been judged sufficient and the public option has never gone into effect.

Untrue. The Medicare part D trigger was designed never to be pulled. It only mandates a public option be introduced if there are less than two private competitors in a market. It says nothing about price or quality or access. It's a handout to insurance companies and drug companies. It's rotten for consumers. But wait, there's more:

On Monday, Mr. Emanuel said the trigger mechanism would also accomplish the White House's goals. Under this scenario, a public plan would kick in under certain circumstances when competition was judged to be lacking. Exactly what circumstances would trigger the option would have to be worked out.

94% of the health care markets in this country are considered 'highly concentrated,' meaning one or two large companies control access and set prices and determine what they will and won't cover. Every 30 seconds, someone in this country declares bankruptcy due in part to medical debt. How bad does it have to get before we do something substantial. No more wait and see. The insurance companies have had years to get their act together. In 1993/94, they said, "There has to be a better way." Really? Where's that way? Because they've managed to run health care in our country into the ground.

No more "if they can't do it." No more "one last chance." We need to fix it now and fix it right.