Who's running for what? :Part 2, Jan stays put.

by: BobB

Mon Jun 08, 2009 at 08:41:50 AM CDT


(geez, this thread has devolved into an ongoing discussion of policy.  we've lost our way... - promoted by bored now)

Despite the naysayers who have problems with diaries about who might run for what, the Founding Fathers set us up as a representative democracy, so, before we can talk policy, we have to talk about who wants to risk life (style at least) and huge amounts of money (only Illinois Reps. would think that $2,400 per person and tens of thousands for transfers are 'limits') to draft or administer those policies.

Today, one of the keystone possibilities made her decision to stay where she is.  9th CD US Representative Jan Schakowsky decided to stay where she felt she could do the most good.  She told Lynn Sweet of the Chicago Sun-Times:

She told me a statewide contest "would have been very exciting," but she wanted to take advantage of "this moment in history" to use her House leadership position -- she is part of Speaker Nancy Pelosi's inner circle -- to work on pending health care and energy legislation. 
BobB :: Who's running for what? :Part 2, Jan stays put.

This decision starts a possible cascade of decisions, and can help shape races up and down the ticket.  Spill what you know, or hear and help PSB make news.

 
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Who's running for what? :Part 2, Jan stays put. | 50 comments
Dag nab it! (1.00 / 1)
I was really looking forward to not voting for Schakowsky for Senator on February 2!
Lucky for you, that's still possible... (0.00 / 0)
but, can you not make the same comments over and over, that's the real question?
[ Parent ]
He can. (0.00 / 0)
But won't.

"In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose." -- I.F. Stone
[ Parent ]
Within days health care is about to be decided (4.00 / 1)
That's my impression and by that I mean the public option without triggers and with real competition which while it's a ways from single payer might approximate a first step in that direction. Within days or weeks big pharma and big insurance hope to craft a public-option appearing set of rules and convince liberal Republicans and conservative Democrats in the Senate to support it. Olympia Snow and Ben Nelson types.

But yes actually Jan is likely more valuable in the House than in the Senate. Pretty much any Democrat Illinois elects would be left of the center of the Senate, and that tends to be good enough. We already have a strong progressive in Durbin.

Lisa Madigan would be a good pick as it would clear the path for Quinn.

Jeff Wegerson

Decided? Within days? (0.00 / 0)
Maybe it's a nit about word choice, but I don't see the fate of the public option being decided within days. Within days the Democratic leadership's draft bills will be put forward, and at this point it is essentially certain they will include a public option. If you happened to notice, that was one of Reuters' "Top Stories" this morning. I think we can expect a big floor fight over the public option, which is what I would call the decision point, but that's still a couple of months away.

Incidentally, it sounds strange to my ears to hear single-payer advocates and the insurance industry mouthing the same mantra -- that private insurance companies are so hopelessly incompetant they can't stand the competition. I don't share that view.

Bill Thomasson

Permission to reprint explicitly granted

[ Parent ]
I never said they were incompetent. (0.00 / 0)
The requirements are simply different. A single-payer plan can charge according to ability to pay, asking big payments from those who can afford them while letting the poor pay little or nothing, all the while guaranteeing full and complete coverage to everybody. Private, for-profit insurers won't do that; it doesn't make business sense to cover people who can't pay.

"In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose." -- I.F. Stone
[ Parent ]
Premiums (0.00 / 0)
The public option, like private insurance, will be supported by premiums. In both cases, the premiums will be subsidized for those otherwise unable to afford them. In this respect, the two choices will not differ. In fact, I can see no difference except in the identity of the people shuffling the paper. So I can see no basis for believing the public option will drive private insurers out of business except a belief that private insurers are incompetent.

A tax-supported single-payer system is something entirely different.

Bill Thomasson

Permission to reprint explicitly granted

[ Parent ]
Well, I'm guessing that $1 out of every $700... (0.00 / 0)
of public system premiums won't go to the C.E.O. of that system, unlike one of the major private systems.  That will probably help make them competitive, IMHO.
[ Parent ]
Competitive? Of course (0.00 / 0)
There's no possible question that the public option can compete on equal terms with private insurers. But the allegation is that it will be so incredibly better that the private companies won't be able to compete. I don't see that. Certainly a 0.1% saving won't do it. (BTW, just for curiosity, which insurance company is that?)

Bill Thomasson

Permission to reprint explicitly granted
[ Parent ]
United Health Care... (0.00 / 0)
[ Parent ]
Interesting (0.00 / 0)
If I'm not mistaken, United Health Care is the actual carrier for my AARP Medicare supplement insurance. I wonder whether my premiums are being included in the base from which that calculation is made.

Bill Thomasson

Permission to reprint explicitly granted
[ Parent ]
Not just 0.1% (0.00 / 0)
The point is that private insurers need to make a profit, whereas a public system is happy just to break even.

It should be pointed out that the people who've been expressing worry about private insurers not being able to compete are mostly the insurers themselves, or lobbyists on behalf thereof. They probably don't consider themselves to be incompetent; they just don't want to give up any of their cash cow.

Of course, it would be far more efficient to abolish private insurance and go to single-payer.

"In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose." -- I.F. Stone

[ Parent ]
Yes, insurers are saying that (0.00 / 0)
Which I find even more puzzling than the similar claim by single-payer advocates. I believe that pointing out the implication -- that they are so completely incompetant they can't stand fair competition -- should eliminate any credibility they might have on the issue.

Bill Thomasson

Permission to reprint explicitly granted
[ Parent ]
To play Devil's advocate... (0.00 / 0)
...conceivably the government could pour massive subsidies into its plan in order to offer comprehensive coverage for free or at a price so cheap that private insurers couldn't possibly match it and stay in business.

This isn't going to happen, of course, and it's hard to believe that these people would believe it would.

What claim by single-payer advocates do you find puzzling, and why? Once again, we don't claim that private insurers are too incompetent to finance health care in a fair, humane, and sustainable way. They could, but won't, because they can make a lot more money doing it the way they're doing it.

"In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose." -- I.F. Stone

[ Parent ]
I think Gary is right (0.00 / 0)
The public option will not be free but will still have premiums but they should be less than private insurers are now.

  The option will be more attractive to younger and healthier people since it will be less expensive.  It will also be more attractive to older people with a pre-existing condition who can't get coverage.  Even some conditions that are manageable with medications like high blood pressure can stop you from getting health insurance on your own.  

  I think what the private industry is afraid that in order to be competitive they will need to lower their rate and cover more conditions.  That means a much lower profit margin.  That is the biggest difference is that the large companies are a "for profit" industry and they add a significant amount of overhead to the healthcare costs.

If employers are forced to cover their employees,  look for more temp workers or part time workers.  If your employer offers poor coverage at a higher cost than the public option would you be forced to buy into that plan?  I know most employers are looking to get out of the paying for health insurance.  It seems that would be one way to go and maybe offer a bonus to those that choose to opt out.

Quite frankly I have never met anyone that at the age of 65 did not sign up for Medicare even if they could easily afford to keep their private insurance.  Most people I know have the supplement and that is kind of crazy as well.  My mother has the supplement and it runs her about $200.00 per month.  She is now too old for any elective surgery, she visits the doctor about 4 times a year and most of her medication is generic.  I am not sure what they would do for her if she broke her hip or something like that because I don't think she would survive the surgery.  So even at her age the insurance company is making a huge profit and I would not doubt that is pretty much the same with a lot of elderly people.


[ Parent ]
Why? (0.00 / 0)
Why will premiums for the public option be lower than private insurers? Lower than now, yes. There is a big push to make the healthcare system more efficient and to cut the fees paid healthcare providers. But that will lower premiums for public and private plans equally. The only way the public plan can offer significantly lower premiums is by being significantly more efficient. Which is exactly what I see both single-payer advocates and the insurance industry claiming but I find implausible.

why will the public option be attractive to older people with pre-existing conditions? As you know, under healthcare reform the insurers will be required to accept everyone regardless of pre-existing conditons.

Why is overhead a big factor under healthcare reform. Aside from claims processing, which will be the same for public and private options, the biggest part of today's overhead is sales and underwriting costs. Which will become minimal once the government-run insurance exchange is in place. And profit is not a big enough fraction of the total premium to matter to the average purchaser.

I remain convinced that the main reason people will choose the public option versus some private insurer is comfort with the carrier they have chosen.

Why --- Well, frankly I don't understand what you are saying about employers. None of the major proposals, so far as I know, are talking about requiring employers to provide employee health insurance. And most of the reform proposals are addressing the individual/small business market, on the assumption that the negotiating power of large businesses allows them to get the best deal possible at today's level of healthcare costs.

Medicare If you still have employer-provided insurance when you turn 65, then signing up for Medicare as secondary insurance is a waste of money. I eventually figured out that I was never going to see a dime of return from my Medicare premiums and dropped it until my wife lost her job.

I am frankly shocked that you would urge me to drop my Medicare supplement. That's like urging me to drop my homeowner's insurance because I'll probably never have a major fire. The purpose of insurance is to cover you against possibly unlikely but disasterous occurrances. Anybody at any age can come up with somehting that requires a prolonged hospital stay. What if you only have Medicare? Surely you know the answer: Bankruptcy!!. If the government would allow my to buy insurance that covered unlimited hospital stays, I would do so.

Bill Thomasson

Permission to reprint explicitly granted

[ Parent ]
Private insurers won't be allowed ... (0.00 / 0)
to continue doing things the way they're doing them. Most notably, public option or no public option, they will be required by law to accept everyone regardless of pre-existing conditions. And with everyone required to have insurance -- adverse selection no longer possible -- this will not particularly cost them money. The two requirements go hand-in-hand.

And of course you're right that nobody believes this guff about massive government subsidy of the public option. If the insurers tried to claim that they would have even less credibility than with the claim they are incompetant.

Incidentally, I will mention at this point that a saw in today's paper (the Reuters on-line news feed, to be precise) that some people are starting to push cooperatives as an alternative to the public option. Based just on what I saw in that article I'm not clear either how these cooperatives would work or why anyone other than those opposed to government per se would find them more politically acceptable than the public option. but I'm willing to listen.

Bill Thomasson

Permission to reprint explicitly granted

[ Parent ]
BTW, it's even worse... (0.00 / 0)
according to the story I'm citing, it's $1 out of $700 spent on ALL healthcare, if I'm reading it right.

That's stunning!

[ Parent ]
Correction #2- According to the back of the napkin... (0.00 / 0)
math done by a commenter to the piece I linked to, it appears that I was closer in my first statement, that it was about $1 in $700 of premiums paid @ United Healthcare, not all healthcare.

Sorry.

[ Parent ]
Horserace Threads (4.00 / 1)
I have problems with speculative threads but that hardly makes me a naysayer. Instead, my disdain is based in the belief that those conversations are a little like reading People magazine or the Enquirer---it's a coffee-clatch at best, PR spin/cheap polling at worst. Sure, they can be entertaining chats but they are hardly agenda-setting and they don't do much to develop or attract interesting candidates, much less inform or shape policy.

It's rather woeful that we can get all frothed for who's running, who might be running, who brushed up against an idea of running, but can't muster anything similar for the actual policies that affect our everyday lives, including campaign finance reform which, frankly, we should have paid a lot more attention to. Why?

The caps read $2,400 but they aren't really. They reset annually, not per election period, so the cap is actually much higher and disproportionately favors office holders versus challengers. But you wouldn't know it from what our legislators are saying. According to them, Illinois has just sliced reform bread. The reality is our prospective pool of policy-promoting candidates has shrunk. Dramatically.

I'm pleased with Rep. Schakowsky's decision and believe it's one that privileges principle and policy. Transforming into a full time telemarketer, as she described it, might have won her the Senate seat but it would have squandered her seniority and the 9th district would lose the benefits of her leadership.  

She also set an announcement date and kept it, unlike others who appear to be purposely delaying their announcements, thus locking out other aspiring public servants by debilitating their organization and fundraising capabilities.

I wasn't referring to you... (3.00 / 1)
:-)

Why don't you write a diary about the different election reform bills and their pluses and minuses?  It would kill two birds, so to speak.

[ Parent ]
This crush on Randall has to end ;-) (0.00 / 0)

[ Parent ]
I wasn't referring to Randall. :-) n/t (0.00 / 0)

[ Parent ]
you need to brush up on your fec regs... (0.00 / 0)
i can only assume that you want to use a different example or you don't really understand the actual limits on federal campaign contributions...

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting
[ Parent ]
federal limits... (4.00 / 1)
Contribution Limits for 2009-10 [PDF]

 Individual Donor Limit:
Candidate Committee: $2,400/election
PAC: $5,000/yr
State/Dist/Local Party Committee: $10,000/yr (combined limit)
Natl Party: $30,400/yr

Biennial limit of $115,500 ($45,600 to all candidates and $69,900 to all PACs and parties)

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting

[ Parent ]
Pretty sure... (4.00 / 1)
the good natured jab in the original post, and certainly my subsequent comment, were both about state limits, or at least the limits of state officials ;-))  
[ Parent ]
opps... (3.00 / 1)
my bad!  i obviously misunderstood what bob was saying...

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting
[ Parent ]
Suze is right. Bored, can you fix my link to the story? (0.00 / 0)
I'm having problems with the new html scheme.

Thanks.

[ Parent ]
Jan makes the smart play (4.00 / 1)
Because I've long argued that a well-presented progressive position is a winning stance, and also because I'd like to see more boldness in Congress, it's with some bittersweetness that I digested Jan's not-wholly-unexpected decision. But she made the smart call on a tough call, and I think her decision was a blend of pragmatism and altruism.

A couple weeks ago I thought, in particular, about the health care battle to come. Which I think will still be a battle unless all the insurers sign on to "public-option." I just couldn't imagine Jan being absent from what has been a core issue for her, essentially taking a leave of absence from her congressional post to become a full-time statewide candidate. Not with the risks involved in that race. Jan could have won, and would have been very competitive, but it was no easy race either, with two separate sets of hurdles. I give her congratulations.

speculation reigns until madigan annoucnes (4.00 / 1)
i am a big fan of jan's and hope she will do some real oversight on the intelligence oversight committee, but i also think it is no surprise she is staying put for reasons that have been discussed over and over.

but until madigan announces the real dominoes won't begin to fall.  some friends were at an event for her last week, but no word on what her plans are.  given the amount of state-only money she is continuing to raise, the bet has to be on madigan/quinn for governor and kennedy/giannoulias for senate.

i was at an event for giannoulias a few weeks ago and (aside from any other reasons not to support him) i was genuinely disappointed with his command of the issues.  not (yet?) ready for prime time.  i also met chris kennedy for the first time last week and i think he is going to have to work on his glad handing ability.  for someone (possibly) running for office, he was not really interested in campaigning or at least he didn't think i was important enough to be friendly to.  that said, he has a lot of positive attributes as a candidate that cannot be ignored.  


It's too bad that we couldn't have two good politicians... (0.00 / 0)
running for two different slots.  

I guess that still begs the question of whether progressives will demand that Mike Madigan step down before they support Lisa.  If not, we're just asking for more of the same.

[ Parent ]
i like lisa, but i won't vote for her... (0.00 / 0)
(for governor) if her father remains as speaker/party chair.  i'd rather have a republican, any republican, that concentrate power in the hands of a single family...

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting
[ Parent ]
I'm not sure if there's unanimity amongst... (0.00 / 0)
progressives, unfortunately.

Thanks for fixing the link.

[ Parent ]
i believe that... (0.00 / 0)
as a student of power, that's my thing.  too much power in the hands of a few is bad.  but i don't think voters in illinois tend to think that way...

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting
[ Parent ]
we live in a weird society (3.00 / 1)
That asking to have the Governor as the child of the Speaker/chair of party is even entertained as a serious ask.
[ Parent ]
lisa (downtowner) has the news about e. hastert... (4.00 / 2)
at her blog.  good assessment, worth the read...

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting
What's interesting (0.00 / 0)
Roland Burris appears to care about his job a little bit.

He's for the public option of the American Health Choices Act, and as far as I know, no trigger either.  

Maybe he can be 'George Ryan' and do all of... (0.00 / 0)
the "Right Things" on the way out the door, since he doesn't have to run for re-election.

THAT might be the real topper for the mausoleum.

[ Parent ]
Some Answers (0.00 / 0)
Well first of all I would never tell anyone to drop their supplement the point I was making was that insurers make a sizable profit even on the supplement.  

My mother is 89 and she does pay $200.00 a month for the supplement.  My COBRA is less than $400.00 a month and that includes my prescriptions.  Mom pays at least another $40.00 a month for the Medicare Part D. If she were to have a serious injury or aliment like a stroke I doubt there would be any heroic measures at this point. I was just making the point that even with Medicare the private insurance companies have a market that provides them with a good income.

There has been talk about requiring employers to offer health insurance as way to combat the rush to a public plan.  Employer subsidized insurance in a private company would help keep the premiums higher for private insurers since the full cost would not be born by either party.  Since employers would not be able to buy into the public plan it would force the market to maintain the higher costs for private insurers.  Though again could someone opt out if the plan was less attractive than the public option?  The employer may be forced to offer it but is the employee forced to accept it?

Medicare has a 3 to 4% overhead as compared to private insurers that have a 20 to 30% overhead.  That is a lot of money that gets wasted.  Some of it is the claims etc.  I forget who first said it but it remains true.  Insurers make their money on delaying and denying claims.  I have spoken to many doctors over the last 5 years and most of them will tell you that dealing with Medicare is less expensive for them as well.  They get paid less for the services but they get paid more promptly and with less push back.  One doctor I met told she does not even accept non-Medicare patients because then she would need too much staff to deal with the insurance companies.  

I doubt that the insurers are going to easily give up on the ability to deny coverage because that is where they make their money. A public option that is not trying to turn a profit will be less restrictive but in all likelihood will still have to carry restrictions as well.  So if you have  cancer and you lose your job a private insurer might not have to pick you up but the public option might require a higher premium.

Of course this is all arguments around a health plan that has not been defined as of yet.  Will health benefits be taxed?  Will private insurers be forced to accept everyone even someone in expensive medical treatment currently?  Can they charge a higher premium for high risk people?  There is a lot unknown as to how much regulation will happen and what a public option would look like.

Without a robust public option though I doubt we will see much change in the way things work.

The way I see it (0.00 / 0)
We are now beginning to see draft plans, but newspaper reports just hit the highest of the high points. Plus, these plans may change as the legislative process continues. We are now hearing that the public option doesn't have the votes and we may see cooperatives instead. So a lot of the details we're talking about aren't clear at this point.

If requiring employers to offer health insurance is being pushed as an alternative to the public option, which I hadn't heard, then questions about the relation between employers and the public option don't apply. But I'm not clear that requiring employers to offer insurance would require them to subsidize it. My wife once worked for a company that subsidized her coverage but not the additional cost to extend coverage to me. And, of course, the number of one-person bussinesses (e.g., yours truly) is large and growing these days.

But given the existence of a public option, there has been a lot of talk about allowing small businesses to enroll their employees in that. I don't know how the current draft plans read, since that's not one of the newspaper high points. Large corporations, on the other hand, don't need the public option to get a good deal. A potential customer that will be spending millions of dollars a month has all the bargining clout anybody might want.

I have indeed been impressed by the speed with which Medicare pays. I'm not so sure about pushback -- I've heard doctors complaining about how hard and expensive it can be to get certain Medicare claims approved. Medicare has the same incentive to deny coverage, when possible, that private insurers do. And pushback may be why I haven't yet heard anything about payment for the colonoscopy I had in April. That sort of delay would be standard for a private insurer, of course, but when you see it with Medicare you suspect something is going on. (To be sure, it may just be that the hospital's billing is fouled up.)

The insurance companies have already agreed to give up the right to deny coverage in return for requiring (almost) everyone to have insurance. You can't have one without the other, in either direction. And getting (almost) everyone covered is the main goal of healthcare reform.

A complex subject here. This is an interesting discussion.

Bill Thomasson

Permission to reprint explicitly granted

[ Parent ]
Whoa, there. (0.00 / 0)
The insurance companies have already agreed to give up the right to deny coverage in return for requiring (almost) everyone to have insurance.

No, they haven't given up the "right" to deny coverage.

What they will give up, assuming that this round of reforms unfolds as expected, is one particular method of denying coverage, namely, the ability to not sell at all to persons with "pre-existing conditions."

But this isn't the only way for them to get out of covering people who are deemed to be risky. Another way is price discrimination, to set the cost of coverage for such people to more than they would reasonably be able to pay. Another is to load up their policies with co-pays, limitations, etc.

I've experienced this myself. I have dental coverage through work. Yet I had to shell out $1300 out of pocket for a dental implant (and will probably have to pay for the crown as well) because my insurance company decided that they don't pay for dental implants.

Worse, I have a friend who has a chronic disease that weakens his immune system. Insurance won't cover anything related to this disease. And since the disease weakens his immune system, basically any illness that he gets could be considered related. Under a mandate plan, he would be essentially required to give free money to an insurance company, or risk being fined.

"In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose." -- I.F. Stone

[ Parent ]
Hmmm ... (0.00 / 0)
In Massachusetts, which serves as the model for the current federal plans being developed, everybody pays the same premium. The sort of price discrimination you describe is illegal. I'm pretty sure I've heard the insurance companies agree to that, except that they want to be able to set different premiums according to the insured person's age.

Dental insurance, of course, is totally different. Most Americans don't have any dental insurance at all, and at one level don't really need it: Dental costs are never going to bankrupt anyone. Unless your employer is picking up part of the cost, dental insurance is a bad deal financially, regardles of coverage. I believe I've had dental insurance for about 10 years of my life, and have always understood that it would pick up only part of the cost.

Bill Thomasson

Permission to reprint explicitly granted

[ Parent ]
Same premium? (0.00 / 0)
Not quite.

I checked out this claim on mahealthconnector.org, a price quote site. You must input your family size, date of birth (and your spouse's if applicable) and zip code. So by playing around using different inputs I got some idea of how results varied.

There is some variation in price by location -- not a lot. But interestingly, the number of plans found was different in different locations, even those as close as Cambridge (02138) and Boston proper (02297). So evidently a plan can be offered in selected locations only. Red-lining out poorer areas would be an easy way to discriminate.

While varying my age didn't change the number of plans, it did make the prices vary. Making myself ten years younger brought it down by around ten percent. Being ten years older increased it by about twenty percent.

"In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose." -- I.F. Stone

[ Parent ]
Good research (0.00 / 0)
Of course, there are legitimate reasons why companies can only offer coverage in specific areas. A staff-model HMO can only offer coverage in areas where it has a clinic in operation. A group-model HMO, such as we mostly have in Illinois, can only offer coverage in areas where it has a contract with at least one physician-hospital organization. And not all areas even have such organizations. Only a fee-for-service plan (boo!) can legitimately offer coverage state-wide.

Bill Thomasson

Permission to reprint explicitly granted
[ Parent ]
Oh yeah, and... (0.00 / 0)
...this LA Times article is very timely:

An investigation by the House Subcommittee on Oversight and Investigations showed that health insurers WellPoint Inc., UnitedHealth Group and Assurant Inc. canceled the coverage of more than 20,000 people, allowing the companies to avoid paying more than $300 million in medical claims over a five-year period.

It also found that policyholders with breast cancer, lymphoma and more than 1,000 other conditions were targeted for rescission and that employees were praised in performance reviews for terminating the policies of customers with expensive illnesses.

[snip]

[WellPoint president Brian] Sassi said rescissions are necessary to prevent people who lie about preexisting conditions from obtaining coverage and driving up costs for others.

"I want to emphasize that rescission is about stopping fraud and material misrepresentations that contribute to spiraling healthcare costs," Sassi told the committee.

But rescission victims testified that their policies were canceled for inadvertent omissions or honest mistakes about medical history on their applications. Rescission, they said, was about improving corporate profits rather than rooting out fraud.

"It's about the money," said Jennifer Wittney Horton, a Los Angeles woman whose policy was rescinded after failure to report a weight-loss medication she was no longer taking and irregular menstruation.

"Insurers ignore the law, and when they find a discrepancy or omission, they rescind the policy and refuse to pay any of your medical bills -- even for routine treatment or treatment they previously authorized," Horton said.

She and others from around the country accused insurers in testimony of gaming anti-fraud laws to take policyholders' premiums, only to drop people who developed serious illnesses. They testified that they or a deceased loved one had had policies canceled over innocent mistakes and inadvertent omissions on their applications.
A Texas nurse said she lost her coverage, after she was diagnosed with aggressive breast cancer, for failing to disclose a visit to a dermatologist for acne.

The sister of an Illinois man who died of lymphoma said his policy was rescinded for the failure to report a possible aneurysm and gallstones that his physician noted in his chart but did not discuss with him.

But this will stop as of now, right? Wrong.

Late in the hearing, Stupak, the committee chairman, put the executives on the spot. Stupak asked each of them whether he would at least commit his company to immediately stop rescissions except where they could show "intentional fraud."

The answer from all three executives:

"No."

"This is precisely why we need a public option," [Rep. John] Dingell said.

Actually, it's precisely why we need single-payer. If a public plan is optional, someone who didn't choose it and who then gets sick could still have his or her insurance cancelled for bogus reasons. (Yes, new regulations may make a lot of the old bogus reasons inapplicable. They'll come up with new ones. They're very good at that.) All the public option will do at this point is make the government pick up the tab, which I'm sure is fine with Sassi and friends.

"In order for somebody to win an important, major fight 100 years hence, a lot of other people have got to be willing -- for the sheer fun and joy of it -- to go right ahead and fight, knowing you're going to lose." -- I.F. Stone

[ Parent ]
Devolved? (0.00 / 0)
Au contraire. Not having conducted a poll or anything to vet the hunch, I'd say this is really the heart of PSB. But what the heck, I'm no expert ;-))) Thanks, A.  
i didn't know how to convey the appropriate... (0.00 / 0)
level of sarcasm in my comment.  i don't know that it's the heart of the blog, but i am amused that a horse-race thread has become a policy thread...

"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting
[ Parent ]
Not much going on in the horse race (0.00 / 0)
Until there are more people declaring there is not much going on in the horse race so we may as well discuss policy.
[ Parent ]
You rarely do ;-) (0.00 / 0)

[ Parent ]
no kidding!!! (0.00 / 0)


"We have a lot of kids on the ground acting like adults and we have a lot of adults in this room acting like kids," President Obama told his advisors about all the infighting
[ Parent ]
Who's running for what? :Part 2, Jan stays put. | 50 comments
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