TUESDAY, Oct. 6 (HealthDay News) -- Expanding health coverage to adults may result in later savings from reduced Medicare spending on these individuals after they turn 65, especially for the uninsured with cardiovascular disease, diabetes or severe arthritis, according to research published online Oct. 6 in the Annals of Internal Medicine.
J. Michael McWilliams, M.D., of Harvard Medical School in Boston, and colleagues analyzed data from 2,951 adults who were continuously insured before the age of 65, and another 1,616 who were continuously or sometimes uninsured before this age. They assessed annual Medicare spending after age 65 for each participant.
The researchers found that total annual Medicare spending was $1,023 higher for the previously uninsured, which was a significant difference. The previously uninsured had higher annual hospitalization rates for complications related to cardiovascular disease or diabetes (9.1 versus 6.4 percent) and joint replacement (2.5 versus 1.3 percent).
"There are good reasons to believe that insurance coverage in the pre-Medicare years would reduce expenditures during the Medicare years, and health reform advocates will certainly take heart from the authors' conclusions. Unfortunately, because the data and methods used in this study are not capable of supporting causal interpretations, the savings to Medicare are unlikely to be as large as this study suggests," writes the author of an accompanying editorial.
The study was supported by the Commonwealth Fund. Several co-authors reported relevant consulting work and legislative testimony.
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Adviser Soapbox
Capitalist Case For Nonprofit Health Insurance
John E. Girouard 10.12.09, 7:09 PM ET
If you want to know what went wrong with our health care system and the best way to fix it, all you have to do is look back a few decades to a time when health care was a community concern, considered as essential as any public utility. It should be again, not just because it makes sense but also because it's the most profitable way to go.
The irony in the current debate over a "public option" health plan is that we once had a form of socialized medicine. Blue Cross, the most recognizable name, began in 1929 as a tax-exempt insurer covering a community of teachers in Dallas. Blue Shield was started as a tax-exempt insurer to cover employees of mining and lumber companies in the Pacific Northwest, with a group of local doctors providing care through a service bureau.
We lost the positive aspects of affiliation health insurance starting in the 1960s and through the 1980s when Wall Street discovered there was money to be made turning nonprofit health insurers, hospitals and nursing homes into investor-owned companies. What we got was a massive conflict-of-interest--profit vs. public good--that has culminated in a dysfunctional health delivery system that has undermined our economy, reduced our national wealth and torn our social fabric.
One might argue whether our estimated 47 million uninsured is a moral shame, but there is no argument that millions of people clogging our emergency rooms and other social services because it's their only option is a crime against our economy, both in direct costs and loss of productivity.
A solution that would have something for everyone and meets the test of minimum government intervention would have three tiers of coverage:
1. Primary Care Community Nonprofits: States, regional groups, hospital consortiums and communities would be encouraged to form nonprofit health insurance companies guaranteeing at reduced premiums a primary level of care--ambulatory, emergency room, routine physicals, and so on. Every citizen would be required to be covered.
This would immediately add 47 million new customers generating premium payments into the pool of available revenue. There would be no qualifying exam nor any discrimination based on pre-existing conditions.
Those who paid their mandatory premiums could deduct them on their income- tax returns. Those who failed to pay their premiums might be subject to a minimum tax penalty or some other mechanism to encourage compliance.
These nonprofits might then, like municipalities, be able to turn to the financial markets to raise capital for building projects and other needs, perhaps issuing tax-exempt bonds.
2. Reinsure Catastrophic Risk: Community nonprofits would be required to do what large companies do when self-insuring. They set aside enough reserves to cover their employees up to a set threshold above which they reinsure themselves. Nonprofits could do the same thing, passing risk on to for-profit companies against a financial disaster from big-ticket losses that could result from a single disaster, a disease outbreak, or just having a high percentage of elderly patients needing extensive care.
The for-profit reinsurance business ought to be highly profitable if well-managed. The number of transactions they would have to handle would be vastly reduced, driving down costs. But for this to work, these companies would need to be reinsured as well, much as banks are. That's where government steps in, just as it does in the banking industry.
3. Create a Federal Health Insurance Corporation: Just as we regulate the banking industry because it is essential, requiring banks to pay insurance premiums to guarantee deposits, the role of the federal government would be to act as the insurer of last resort. Such an agency would guarantee claims above a set amount, allowing private reinsurers to calculate their risks more accurately and set competitive, profitable premium rates.
This is not a public option, it is a public imperative. It is what we expect from government after a hurricane or other natural disaster. It seems logical that in the event of a health insurance disaster, Uncle Sam should be ready to step in for the public good. And it seems equally logical that the federal government should be in the business of setting standards and regulating an industry that provides a public service, just as we regulate water, power and public transportation companies.
This three-tiered approach contains elements that should appeal to most interest groups. The nonprofit primary care level eliminates the conflict of interest that currently exists between profit and the rendering of a crucial public service. Insurance companies would go back to doing what they are supposed to, managing risk instead of managing care.
This system is close to what members of Congress refer to as "the same health insurance we have." Once a year federal employees get to choose who their health insurer is from a list of a dozen or so approved providers. A covered employee with a chronic disease can switch insurers if he or she decides a different company offers a better plan, without an exam and regardless of pre-existing conditions.
This system should appeal to both sides of the "public option" argument.
Liberals who want to see everyone covered and the profit motive taken out of medical decisions would see their aims met as more citizens would likely seek out and receive preventive care instead of waiting until they need to be rushed to an emergency room at enormous expense.
Conservatives who want government to spend less and do more to stimulate the flow of capital and the creation of wealth would achieve their goals in the form of the private financing of nonprofit insurers and in the presumed net reduction in the cost to taxpayers of providing emergency and social services to the uninsured.
John E. Girouard of Washington, D.C., is a financial writer and the author of "The Ten Truths of Wealth Creation."
I always liked Senator Clair McCaskill. fib
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I feel that I’m in an alternative universe. For eight years some people called anyone who disagreed with the President’s foreign policy or war in Iraq unpatriotic. Then in the course of two weeks, those same people cheer when the United States does not get selected for the Olympics and boo when our President is the unanimous choice for the Nobel Peace Prize. Go figure.
Congratulations Mr. President for standing up to the scorn and derision of your opponents in the election when you firmly stood for the proposition that strength meant being willing to talk to your enemies, not just your allies. Thank you for the confidence and wisdom to say that a hand will be extended when their fist is unclenched. And thank you for understanding that our national security rests on our principles, the example we set for the world, and our alliances along with the excellence and strength of our military, rather than exclusively the latter. God Bless America.
http://clairecmc.tumblr.com/post/208582433/the-twilight-zone
I notice that the entire site has problems. There is no access to blogs of ANY group.
Hope it is some re-organization. Below is an URL to Chris Hass. fib
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http://my.barackobama.com/page/community/group/OrganizingforHealthCareBlog
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I assure you it is very difficult putting yourself in the shoes of someone with cerebral palsy. fib
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Video about history of the Associaition:
http://www.overstream.net/view.php?oid=ruarngm0uusx
If we are going to fight let's go for the real thing.
Enough with the Public Option, it covers, at best 5% of us, when Obama says, if you like what you have you can keep it, the most important statement is lacking: if you hate it, you can leave it. All the PO does is to create another entitlement for people to resent.
By eliminating the middleman, you pay a lot less and Drs get pay better.
Single payer is actually an easier sale, as it answers that very human question: "What's in it for me?"
http://healthcare4all.org/
Must read http://kucinich.us/index.php
Enough with the public option, it covers, at best 5% of us, when Obama says, if you like what you have you can keep it, the most important statement is lacking: if you hate it, you can leave it. All the PO does is create another entitlement for people to resent.Single payer is actually an easier sale, as it answers that very human question: "What's in it for me?"
Le's fight for the real thing.
Please join me in demanding your Medicare ASAP, regardless of age:In FB: http://www.facebook.com/event.php?eid=147637363022In MyBO: http://my.barackobama.com/page/event/detail/gpk4ptRead Rep. Kucinich analysis below, and let's go after the real thing.The Private Mandate Sausage Machine
Tuesday, 15 September 2009
Dear Friends, It is said one should not ask how sausage or laws are made. Are you concerned about a public option? Let me share with you some insight about health care legislation which may not be good for your health.A lesson in politics. The Kucinich Prediction: Here's what's going to happen ...
House will make a big deal about keeping/putting a public option in HR3200 because it competes with insurance companies and will keep insurance rates low.
The White House will refer to the President's speech last week where he spoke favorably of the public option.
The Senate will kill the competitive public option in favor of non-competitive "co-ops". Senate leaders like Kent Conrad have said the votes to pass a public option were never there in the Senate.
The bill will come to a House-Senate Conference Committee without the public option.
House Democrats will be told to support the conference report on the legislation to support the President.
The bill will pass, not with a "public option" but with a private mandate requiring 30 million uninsured to buy private health insurance (if one doesn't already have it). If you are broke, you may get a subsidy. If you are not broke, you will get a fine if you do not purchase insurance.
This legislative sausage will be celebrated as a new breakthrough and will be packaged as health insurance reform. However, the bill may require a Surgeon General's warning label: Your Money or Your Life!The bill that Congress passes may pale in comparison to the bill that millions of Americans get every month for having or not having private health insurance. It will take four years for the new legislation to go into effect. During that time we are going to build a constituency of millions in support of real health care, a constituency which will be recognized and a cause which is right and just: Health Care as a Civil Right.
How to Watch the Speech
By David M. Herszenhorn
Charles Dharapak/Associated Press
A meeting on health care reform in Reston, Va.
In his speech to Congress on Wednesday night, President Obama will press his case for major health care legislation, not just with lawmakers in the audience, but also with a deeply wary public watching at home.
And while Mr. Obama will probably talk in clear, plain-spoken terms, decoding his remarks and the reaction he gets will require both a careful ear and a keen eye. Here are some of the main things to listen and look for:
Will he reiterate his support for a government-run insurance plan — or finally state outright that he can accept a compromise that might disappoint liberals?
Will the president give a shout-out to influential Republicans like Senator Charles E. Grassley of Iowa — or threaten to barrel over opponents?
Will centrist lawmakers sit on their hands — or give him a big ovation?
Will Mr. Obama reassure elderly voters worried about Medicare cuts? Can he do that even while explaining how the country can afford to subsidize health coverage for more than 40 million Americans who currently have none?
"Without the drug war, America's most decimated neighborhoods would have a chance to recover. Working people could sit on stoops, misguided youths wouldn't look up to criminals as role models, our overflowing prisons could hold real criminals, and -- most important to us -- more police officers wouldn't have to die."
http://www.leap.cc/cms/index.php
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Now, digg this:
http://digg.com/d312kVB
One cop straight out of The Wire crunches the numbers with Esquire.com's political columnist to discover that America's prohibition of narcotics may be costing more lives than Mexico's — and nearly enough dollars for universal health care. So why not repeal our drug laws? Because cops are making money off them, too.
Capitalism: A Love Story
(Documentary) An Overture Films release of a Paramount Vantage, Overture Films presentation in association with the Weinstein Co., of a Dog Eat Dog production. (International sales: Paramount Vantage, Los Angeles.) Produced by Michael Moore, Anne Moore. Executive producers, Kathleen Glynn, Bob Weinstein, Harvey Weinstein. Co-producers, Rod Birleson, John Hardesty. Directed, written by Michael Moore. With: Michael Moore, Frank Moore. By LESLIE FELPERIN
By returning to his roots, professional gadfly Michael Moore turns in one of his best films with "Capitalism: A Love Story." Pic’s target is less capitalism qua capitalism than the banking industry, which Moore skewers ruthlessly, explaining last year’s economic meltdown in terms a sixth-grader could understand. That said, there’s still plenty here to annoy right-wingers, as well as those who, however much they agree with Moore’s politics, just can’t stomach his oversimplification, on-the-nose sentimentality and goofball japery. Whether "Capitalism" matches "Fahrenheit 9/11" or underperforms like Sicko" will depend on how much workers of the world are ready to unite behind the message.
Pic reaped mostly ecstatic applause at its first press screening in Venice — no great surprise, given the largely leftist persuasion of film-fest auds, especially in Europe. Still, "Capitalism’s" worldview is resolutely U.S.-centric, apart from the odd approving mention of some foreign nation. Nevertheless, pic is likely to make considerably more offshore, where "socialism" isn’t considered a cuss word, than at home.(...)"
"Politics of the possible"
Tuesday, September 1, my SO and I had a face to face meeting with our congresscritter, Rep. Zoe Lofgren.
I had emailed her office last week, asking to set up a meeting. They called me Monday, said she'd had cancellations, could I come the next afternoon for a ten minute meeting. Of course I said yes - I'm unemployed, and live a few blocks away, but even if I'd been working I would have taken time off.
Knowing full well that ten minutes just wouldn't be enough to cover all of the issues I was concerned with, I typed up a list - my own words, the real concerns I had.
At the top of that list was healthcare. Then came GLBT issues. Then economy and finance, and more.
We brought copies, one for us, one for Zoe, one for her aides.
Yes, she has to be diplomatic, she has to negotiate with the rest of the House. She declined to comment on my sentiment that Grassley and Baucus were a waste of space. I felt like she was trying not to chuckle.
But I also felt that she needed to hear from the little people - the working (or unemployed) person, the woman trying to start a small consulting business, the people paying the highest tax rates when working because they're gay, childfree renters without tax shelters.
If people like me are willing to fork over for singlepayer, or at least a strong public option, then the rest of the contry can give up a little for the assurance that they and their children will have healthcare regardless of their economic circumstance.
She agreed with me on the GLBT items, talked about trying to get some of the more strident religious folks to see how gay marriage really isn't a threat to their religious freedom.
She told me, she has to be diplomatic, but as an activist, I don't.
Activists and advocates don't need to put their positions in terms of compromise, and we shouldn't.
The right wing knows this, and is ready to fling shit.
We need to push, and hard. We need to let our congresspeople know what we need.
Believe me, Rep Lofgren will be seeing me again. I'll be keeping track, and there will be praise given or questions asked.
Your Reps work for you. Make the time to go see them. Write down your concerns, so they have stuff to take back to Washington with them.
Have Mexican Dishwashers Brought California to Its Knees?
Posted by Daniel Griswold
An article published this week by National Review magazine blames the many problems of California on—take a guess—high taxes, over-regulation of business, runaway state spending, an expansive welfare state? Try none of the above. The article, by Alex Alexiev of the Hudson Institute, puts the blame on the backs of low-skilled, illegal immigrants from Mexico and the federal government for not keeping them out.
Titled “Catching Up to Mexico: Illegal immigration is depleting California’s human capital and ravaging its economy,” the article endorses high-skilled immigration to the state while rejecting the influx of “the poorly educated, the unskilled, and the illiterate” immigrants that enter illegally from Mexico and elsewhere in Latin America.
Before swallowing the article’s thesis, consider two thoughts:
One, if low-skilled, illegal immigration is the single greatest cause of California’s woes, how does the author explain the relative success of Texas? As a survey in the July 11 issue of The Economist magazine explained, smaller-government Texas has avoided many of the problems of California while outperforming most of the rest of the country in job creation and economic growth. And Texas has managed to do this with an illegal immigrant population that rivals California’s as a share of its population.
Two, low-skilled immigrants actually enhance the human capital of native-born Americans by allowing us to move up the occupational ladder to jobs that are more productive and better paying. In a new study from the Cato Institute, titled “Restriction or Legalization? Measuring the Economic Benefits of Immigration Reform,” this phenomenon is called the “occupational mix effect” and it translates into tens of billions of dollars of benefits to U.S. households.
Our new study, authored by economists Peter Dixon and Maureen Rimmer, found that legalization of low-skilled immigration would boost the incomes of American households by $180 billion, while further restricting such immigration would reduce the incomes of U.S. families by $80 billion.
That is a quarter of a trillion dollar difference between following the policy advice of National Review and that of the Cato Institute. Last time I checked, that is still real money, even in Washington.
Today I had the privilege to interpret for Maxine Waters at the town hall meeting on healthcare.
The good news, the insurance mignons that have been disrupting so many of these meetings with all of their racist and anti-Semitic poison do not have enough cojones to show up in Compton.
The bad news, even in the most liberal of the bills, the public option is no more than a token, it will not cover more than 10 million people and it is not a choice, most people will NOT have an option, much like today, worse yet, by making insurance mandatory, the rest of us will be left even more at the mercy of the insurance companies than we are today.
So even as a matter of strategy this lukewarm reform is no reform. As someone pointed out today, we elected Barack Obama, not Mitt Romney, even under the best light as presented by congresswoman Waters, this is the Romney plan implemented in Massachusetts, it is not working there and it will not work nationally.
The public option is just a misnomer to appease the left, not an option at all, puzzling since last time I check the majority in congress IS THE LEFT, so who are they appeasing?
Healthcare is a right protected and provided by the government to senior citizens, children, veterans and their own employees, as such, equal protection under the law demands that it be provided to all.
Medicare for everyone today, it is a constitutional issue, not a matter of congressional negotiations subject to debate.
Health care is such an important issue and we are proposing reform in a very important and crucial time. That is why it is imperative that those who care about what happens to reform come out and participate. Our President has always been clear about needing our help to get the job done.To bring the CHANGE that we all seek in this country. This is it folks. We need to come out and get to some townhalls, call our representatives and congress members, attend local events in support of reform, and reach out to our familiy member and friends. Health care reform cannot happen without us. We need a very strong presence in the next month to show our congress that we mean business and we want REAL reform NOW!!!!
Please volunteer with OFA now!!!! Get involved AGAIN!!! If President Obama ever needed your support for any of the issues it is Health Care. Your fellow Americans needs you! 46 million uninsured need you! We need you!
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Thank you for writing to express your opposition to proposed restrictions on private coverage of preventative services for reproductive care in health reform legislation. I appreciate the time you took to write to me on this important issue, and I welcome this opportunity to respond.
The Senate Finance Committee is currently debating health care reform proposals. One proposal would create a Health Insurance Exchange through which individuals and small businesses could purchase health insurance. In order to assist those not able to afford health insurance, some individuals and families would receive subsidies to help pay for the health insurance. Insurers would provide an essential benefits package, which would be determined by the Department of Health and Human Services after receiving recommendations from a federal advisory committee. The Senate Finance Committee is currently considering restrictions on the insurance packages offered in the Exchange, specifically restricting preventative services for reproductive care, including abortion.
I share your concerns about the proposed restrictions, and I have contacted Finance Committee Chairman Max Baucus (D-MT) to express these concerns. These restrictions would leave many American women worse off than they are today. I believe that reproductive health services should be treated no differently than any other health care service or benefit in the current health care reform discussions. While I understand that many individuals may not want to purchase health insurance that covers reproductive services, everyone should have the opportunity to select health insurance without those services restricted.
I support preventative reproductive care because I believe that services such as family planning are incredibly valuable. Please know that I will keep your comments in mind as I continue to review health care reform legislation in the 111th Congress.
Again, thank you for writing. If you have any further questions or comments, please do not hesitate to contact my Washington D.C. office at (202) 224-3841. Best regards.
Further information about my position on issues of concern to California and the Nation are available at my website http://feinstein.senate.gov/public/. You can also receive electronic e-mail updates by subscribing to my e-mail list at http://feinstein.senate.gov/public/index.cfm?FuseAction=ENewsletterSignup.Signup.
more from NARAL:
Very interesting and well presented. I wish we learned this much and this way watching television. fib
http://www.time.com/time/2008/health_care/index.html
