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The Killer and the Kid

Health Care’s Historic Flop

by HELEN REDMOND

I get weekly emails from Levana Layendecker of Health Care for America Now (HCAN) and Mitch Stewart from Organizing for America. In increasingly shrill prose, the two try to convince me to support whatever legislation emerges from Congress. They warn, “IF THE INSURANCE COMPANIES WIN, YOU LOSE.” I agree completely. That is why I won’t support any legislation Congress passes because the insurance companies have already won and we have lost.   

We need only look at the check lists of two of the most powerful people in health care reform to see who is benefiting most from the proposed legislation in Congress.

Karen “Killer” Ignagni, President and CEO of America’s Health Insurance Plans (AHIP) won the following:

Still in business making billions of profits for Wall Street investors and CEO’s of insurance companies

No cost controls that would decrease profits

Mandate giving us at least 30 million new customers and fined if they don’t buy coverage

Still able to deny doctor recommended care

Still able to increase premiums

Kill or weaken public option

Investment in 3000 lobbyists and 1.4 million a day paid off  

Then there is Billy “The Kid” Tauzin, President and CEO of the Pharmaceutical Research and Manufacturers of America  (PhRMA.) He was able to check off everything on his list:

Get a meeting with President Obama behind closed doors and make a deal to protect PhRMA profits

No drug reimportation from Canada or Mexico

Extend protections for lucrative biologic drugs

No negotiating drug prices for Medicare Part D

U.S. drug market continues to be the most profitable

There was even a big, last minute win for the misogynist Catholic Bishops. For thirty years these disgusting, sexist servants of God have fought to restrict access to abortion. Thanks to the betrayal of Nancy Pelosi and Jan Schakowski, the “ardent” defenders of women’s reproductive rights, the no-choice Stupak Amendment passed. The Democrats position on abortion is “safe, legal and rare” and the Stupak Amendment will make abortion rarer still.     

The xenophobes and racists won, too. Millions of undocumented human beings from every corner of the globe who work and pay taxes in the United States are ineligible for Medicaid and subsidies. The message: don’t get sick, but if you do, die quickly and if you don’t, we’ll deport you.

The insurance industry concocted a strategy well in advance of Obama taking office. The crisis they caused could no longer be ignored: 50 million uninsured, millions of medical bankruptcies, employers screaming about rate increases and dropping coverage in record numbers and thousands of health care horror stories in the media. According to Wendell Potter, the former Vice President of Public Relations at Cigna, now a whistleblower, “They [the insurers] knew they had a very big public relations problem, and they knew this day was coming. They knew they had to be perceived as coming to the table with solutions. It was a departure from their previous point of view. But they knew they would be slaughtered if it weren’t.”     

And there they were, just as Potter predicted – the Killer and the Kid, not only at the table, but at all the secret, behind closed-door meetings with the late Ted Kennedy and Max Baucus. Ignagni proclaimed, “We want to play. We want to contribute. We want to help pass health reform legislation this year.” And what a player she is. In an article titled, “Insurers poised to reap benefits from healthcare overhaul” Mark Merritt, a lobbyist, keenly observed, “While so many in this town have been playing checkers, Karen has been playing chess.” Checkmate for AHIP.

Senator Baucus has taken more money from the health and insurance industry than any other member of Congress. Elizabeth Fowler, Baucus’s chief health advisor, is a former VP of public policy for the insurance giant Wellpoint. She “helped” write the Senate bill. 

AHIP uses lobbyists and campaign contributions to shape legislation, not to kill or oppose it as HCAN and Organizing for America constantly claim. That’s what the 3000 lobbyists are doing every day in Congress – inserting industry friendly, arcane language and loopholes into unfathomable (except to industry lawyers and actuaries) 2000 page bills which the Democrats support. To be sure, insurers don’t like the public option but it’s so not robust, so eviscerated, so devoid of honesty keeping mechanisms it poses no competition or threat to profits as most political commentators now admit. Similarly, Ignagni wants tougher financial penalties for those who don’t purchase health insurance but it’s not a deal breaker, nor is accepting all patients regardless of health status. The industry has already announced premium increases and the added revenue will underwrite health care for those with “pre-existing” conditions.  

It’s obvious. THE INSURANCE INDUSTRY IS WINNING AND WE ARE LOSING. There is an inconvenient contradiction that both HCAN and Organizing for America attempt to obscure: President Obama and Congressional leaders are working hand in glove with the very corporate criminals both organizations excoriate. AHIP and PhRMA have unfettered access to politicians and a massive influence on health care legislation. Why? Because the Democratic Party, despite its populist image, is a party of big business, of capitalism, not a party of the people. Notwithstanding the occasional howl about “insurance industry abuses” (to hoodwink us into thinking they are curbing those abuses) current legislation entrenches the industry even further into the core of the health care system and is on the brink of handing them unprecedented billions in taxpayer money and a mandate. This is dangerous not only to our health, but to democracy. Once the spigot to billions in public money is open, the industry will oppose attempts to shut it off. The money will flow back into American politics as campaign donations and kickbacks to happy-to-help, pro-industry politicians of which there are no shortage on either side of the aisle.   

THE INSURANCE INDUSTRY IS WINNING AND WE ARE LOSING and anyone who follows the money knows it. Except Levana and Mitch.   

The organizations the two represent are the major purveyors of outright lies, lies of omission and half-truths about health care legislation by asserting the following: health insurance will get better, stable and more secure; health insurance will get cheaper; employers will have to offer good, affordable insurance and not shift additional costs onto you; if you lose your job you will always be able to afford insurance, and expenses will be capped. They assert Medicaid and Medicare benefits won’t be cut.

Here’s an inconvenient, honest-to-god truth: the legislation does nothing to solve the health care crisis. It’s estimated up to twenty million people will still be uninsured. There are no effective cost containment mechanisms in either bill because that would reduce profits. There are no controls on the price of premiums and the House bill permits charging twice as much for older people as for younger ones. More profits. Insurers can continue to deny physician recommended medical care and patient claims. Medical-loss ratio in favor of insurers, million dollar salaries for CEO’s and Wall Street investors untouched. The caps on out-of-pocket expenses are $5000 for individuals and $10,000 for families. These amounts result in medical bankruptcy now. Employers must pay 72.5 percent of premiums for individuals and 65 percent for families. That gives companies who currently pay a higher percentage an incentive to shift costs onto employees then dump them into the insurance exchange because it will be cheaper. The plans in the exchange will be high deductible, stripped down, tiered plans much like the ones available through the Commonwealth Connecter in Massachusetts. There will be an expansion of Medicaid but the history of the program reveals that just as it expands, it contracts. Eligibility criteria and reimbursement rates for Medicaid change with the fiscal fortunes of the states and federal government. It is truly stunning that health care reform will be paid for with billions in “savings” from the health care program for the elderly; Medicare. Why not use “savings” from the bloated 700 billion dollar military budget? The talk about fraud and waste in the Medicare program is a cover to cut benefits and seniors are right to be angry and mistrustful.

Levana and Mitch are playing chess, too. Their deceit is insidious and not without precedence. HCAN and Organizing for America are following in the footsteps of organizations that are created every time health care reform is attempted. They promote incremental changes to the system and the legislation urgently (health reform can’t wait!) and passionately promoted is not designed to solve the crisis, but rather to guarantee the continued existence and profit-making power of the insurance industry. Moreover, their job is to tamp down expectations for fundamental change, like single-payer, and convince the public the legislation, although not perfect, is the best we can get. It’s still “change we can believe in.”

Any bill that passes will be hailed as historic. It will be historic: historic in the sense that it’s yet another sellout in a long history of sellouts of the American people – bankrupt and broken, still desperate and dying for reform that makes health care a human right and where profit has no place.

HELEN REDMOND, LCSW, is a medical social worker in Chicago. She can be reached at redmondmadrid@yahoo.com. She blogs at http://helenredmond.wordpress.com