Press Play

Morning. The Hill's got a piece up today featuring HCAN's support for giving everyone the choice of a public health insurance plan. There are some factual errors, but it's not the most horrific article. Here's my contribution:

“We want quality affordable healthcare for all Americans in 2009; comprehensive benefits that meet people’s needs; and a choice of private or public health insurance plans,” said Jacki Schechner, the coalition’s communications director. “We believe everybody should have the choice of public health insurance.”

In related news, Jonathan Cohn wrote an excellent summary of the latest Jacob Hacker paper released yesterday. Hacker argues in favor of the choice of a public health insurance plan in his report titled "Healthy Competition." Here's an excerpt of the Cohn write:

Still, the focus of the paper is on what a public plan could do that private plans couldn’t--starting with innovation:

a new public health insurance plan for the non-elderly (and Medicare, through its association with the new plan) can and should be centrally involved in obtaining better information to improve physician and patient decisions, as well as insurer decisions about coverage, pricing, and benefit structure. Because of its broad and national reach, the stability of its enrollment, and the unparalleled opportunity for data collection and use, the new public health insurance plan is the player in the system that will have the largest incentives to make these investments.

Hacker also emphasized a point he, and other public plan advocates, have made before: That a public plan is an essential backstop to private plans, since--even with the best regulations--some private insurers might find ways to avoid covering sick people or addressing their needs properly. In other words, a public plan is essential to make sure private plans don’t keep conducting business the way many of them do now.

But it is on cost control where, Hacker said, the advantages of a public plan are most apparent. It’s not just that public insurance plans operate with lower administrative costs. It’s also that public plans have more bargaining leverage--and, to some extent, are more willing to use their bargaining leverage--than private insurers. A recent report from the Lewin Group backs up this claim: It found that a public plan, using government bargaining power, could reduce premiums dramatically--by around 30 percent.

I cannot emphasize enough how important it is for you to care about making sure we all get the choice of a public health insurance plan. Insurance companies are fighting it with everything they've got for a reason.

Choose Choice

I have been out of the office in meetings all morning, and I am now being asked to go back to the scene of the crime for another 2-hour meeting this afternoon. I'm considering chaining myself to my desk in protest. There ought to be a law.

Anyway, on a less melodramatic note, here's a little health care-related reading for your afternoon. Consumer Reports has a new investigative piece online exposing junk private health insurance plans and showing you what it means to be underinsured. Here's a snippet:

Just ask Janice and Gary Clausen of Audubon, Iowa. They told us they purchased a United Healthcare limited benefit plan sold through AARP that cost about $500 a month after Janice lost her accountant job and her work-based coverage when the auto dealership that employed her closed in 2004.

"I didn’t think it sounded bad," Janice said. "I knew it would only cover $50,000 a year, but I didn’t realize how much everything would cost." The plan proved hopelessly inadequate after Gary received a diagnosis of colon cancer. His 14-month treatment, including surgery and chemotherapy, cost well over $200,000. Janice, 64, and Gary, 65, expect to be paying off medical debt for the rest of their lives.

(...)

"Rice is rice and gasoline is gasoline. When you buy it, you know what it is," [Karen] Pollitz said. "Health insurance—who knows what it is? It is some product that’s sold by an insurance company. It could be a little bit or a lot of protection. You don’t know what is and isn’t covered. Nothing can be taken for granted."

That's why you should be demanding health care reform legislation includes giving everyone the choice of a public health insurance plan. That plan would set the standard for benefits, be transparent, be affordable based on your income, and give you a benchmark by which to evaluate private health insurance plans. You'd be able to figure out if insurance companies were padding their bids. You'd know if they were trying to rip you off. You'd finally have an alternative to the complicated, Wall Street-driven health insurance industry.

Wouldn't that be nice?

Pea-brained

I'm surprised no one else caught this gem. Bill Maher interviewed Joe the Plumber on his show last week, and Joe said:

"Republicans and Democrats up on the Hill, they have a Pinochle game going right. Or you know, they move it here and they move it there, and where's the pea?"

Pinochle's a card game.

Joe's a moron.

House Call

This is pretty cool. Kal Penn left House to work for the White House. From EW via Politico:

KAL PENN: Yes. I was incredibly honored a couple of months ago to get the opportunity to go work in the White House. I got to know the President and some of the staff during the campaign and had expressed interest in working there, so I'm going to be the associate director in the White House office of public liaison. They do outreach with the American public and with different organizations. They're basically the front door of the White House. They take out all of the red tape that falls between the general public and the White House. It's similar to what I was doing on the campaign.

Color me impressed.

Video Interlude

National Journal did a little video piece about using the web effectively for advocacy work. I'm a fan because it features two of my favorite people - Sean Gibbons from CAP and Levana from HCAN. Watch it here.

Read the Fine Print

The Lewin Group released a report yesterday evaluating the possible impact of a new public health insurance plan on the health care landscape. Some of the findings are decent. Some have a little bit of a "rile up the docs, hospitals, and insurers" tone.

But what's most fascinating about The Lewin Group is this (emphasis mine):

The Lewin Group is an Ingenix company. Ingenix, a wholly-owned subsidiary of UnitedHealth Group, was founded in 1996 to develop, acquire and integrate the world's best-in-class health care information technology capabilities. For more information, visit www.ingenix.com. The Lewin Group operates with editorial independence and provides its clients with the very best expert and impartial health care and human services policy research and consulting services.

If the name Ingenix is familiar, it's because it's been in the news lately as the firm used by insurers like United (and others) to rip people off. From the AP:

In January, UnitedHealth agreed to pay $350 million to settle a suit by the American Medical Association and others over the issue. UnitedHealth agreed to pay $50 million toward creation of an independent claims database and eventually close down the Ingenix databases.

Rockefeller and other lawmakers say more accountability and transparency is needed in how insurance companies determine out-of-network rates.

More than 70 percent of workers are enrolled in plans that allow them to go out of network. Typically, those plans will pay a set percentage, say 70 percent, for an out-of-network visit.

But when patients go out of network, their plan doesn't actually pay 70 percent of the cost. It pays 70 percent of what it determines is the "usual, customary and reasonable" cost.

UnitedHealth and Ingenix were allegedly manipulating claims data so the "usual, customary and reasonable" costs were too low, leaving patients to pay more. Cuomo's office said Ingenix was understating the market rate for doctor's visits across New York state by 10 percent to 28 percent.

Smell a rat? Me too. Richard's quoted in Politico today commenting on The Lewin Group findings:

"The study focuses on the fact that the public health plan can save people a lot of money and depending on its design, it will have different impacts on insurers and providers," said Richard Kirsch, national campaign manager for Health Care for America Now, which favors the public plan option.

Kirsch said physicians could see more savings than identified in the study, which did not account for lowered administrative costs associated with billing multiple insurance companies.

And We're Back...

Comcast has one nice guy. I think his name is Michael. The dude was no nonsense. He figured out my modem reset itself, waited while I dug an old ethernet cable out of the closet, and walked me through the set up process. Good thing I'm marginally tech savvy. It was pretty easy, and now we are back in action.

Cable TV's all funky again though. Comcast says there's a problem in the area and the technicians are working on it, but when I offered to cancel my upcoming appointment, my new best friend Michael suggested I hang onto it just in case.

Sounds like Michael knows what's up.