The United States has most expensive health care system in the world. And still, 50 million people are left out.
From coast to coast, people struggle with medical bills they can’t afford to pay. The uninsured struggle to get care. And the debate continues.
From Wall Street in New York City, to K Street in Washington, where industry lobbyists mount their slick campaigns to advance their clients’ interests.
From Congress to the White House, and on to the Supreme Court.
From the suites to the streets, from the emergency rooms to the golf courses, the Battle Over Health Care is on.
The Battle Over Health Care: What Obama’s Reform Means for America’s Future by Rosemary Gibson and Janardan Prasad Singh, Rowman & Littlefield Publishers, Inc. 2012. More info at: www.BattleOverHealthCare.org
by Rosemary Gibson and Janardan Prasad Singh, Rowman & Littlefield Publishers, Inc. 2012
- Provides a non-partisan analysis of the health care reform law
- Traces uncanny similarities between Wall Street’s banking and financial sector and the health care industry
- Shows that health care has its own price bubbles, conflicts of interest, and too-big-to-fail syndrome
- Shines a light on the behind-the-scenes deals struck with the health insurers, drug companies and hospitals and reveals how Americans could have gotten a better deal
- As the US Supreme Court deliberates on the individual mandate that would require all Americans to have or purchase health insurance, the court of public opinion may matter more
- A 60-year-old uninsured person earning $48,000 a year will pay about $10,000 a year for health insurance to comply with the mandate
- Nothing in the health care reform law stops the rise in private health insurance company premiums
As the most substantial health care reform in almost half a century, President Obama’s health care overhaul was as historic as it was divisive. In its aftermath, the debate continues. Drawing on decades of experience in health care policy, health care delivery reform, and economics, Rosemary Gibson and Janardan Prasad Singh provide a non-partisan analysis of the reform and what it means for America and the its future. The authors shine a light on truths that have been hidden behind a raucous debate marred by political correctness on both sides of the aisle. They show how health care reform was enacted only with the consent of health insurance companies, drug firms, device manufacturers, hospitals, and other special interests that comprise the medical-industrial complex, which gained millions of new customers with the stroke of a pen. Health care businesses in a market-oriented system are designed to generate revenue, which runs counter to affordable health care.
Gibson and Singh take a broader perspective on health care reform not as a single issue but as part of the economic life of the nation. The national debate unfolded while the banking and financial system teetered on the brink of collapse. The authors trace uncanny similarities between the health care industry and the unfettered banking and financial sector. They argue that a fast-changing global economy will have profound implications for the country’s economic security and the jobs and health care benefits that come with it, and they predict that global competition will shape the future of employer-provided insurance more than the health care reform law.
Order your copy of The Battle Over Health Care!
From the authors’ note on the back cover:
We assess what was won and what was lost when the spoils were divided on the political battlefield.
The same people who have made health care unaffordable, wasteful, and too often harmful were rewarded with an even larger canvas on which to paint America’s health care future.
In the end, with the stroke of a pen, health care reform merely shifts the risk of bankruptcy of individuals and families to the bankruptcy of the federal government.
Health care has caught the same Wall Street fever that afflicted the banks . . . and has its own way of privatizing gains and socializing losses. . . .
The solution is to reduce the health care industry’s culture of dependency on the blind generosity of the public.
If the individual mandate cost $25 a month, would the Patient Protection and Affordable Care Act be debated in the U.S. Supreme Court this week? Perhaps not.
The individual mandate is a distraction from the real issue that the health care reform law didn’t fix: health care is too expensive and unaffordable.
See what Secretary of Health and Human Services Kathleen Sebelius said on ABC News last January when she was asked what people should do when their health insurance premiums increase too much.
She replied, “They should contact the governor of their state and state legislature demanding that those laws be changed.”
The health care reform law didn’t really make health care affordable. It papered over the real cost with subsidies.
Why isn’t health care affordable? Health care has caught the Wall Street fever and become just like the banks. See how health care and the banks operate the same way, documented in The Battle Over Health Care: What Obama’s Reform Means for America’s Future.
Just like the banks, health care has its own price bubbles, toxic assets, too-big-to-fail syndrome, conflicts of interest, the ratings game, and the tendency to privatize gains and socialize losses.
The result? Even with the reform law and subsidies, the cost will still be high for many Americans.
A single 60-year old woman earning $48,000 won’t be eligible for subsidies and will pay more than $10,000 a year for health insurance, in addition to out-of-pocket expenses.
A family of four with a 40-year old head of household earning $48,000 will pay more than $3,000 a year even with subsidies.
Health care reform merely transferred the risk of bankruptcy of individuals to the risk of bankruptcy of the federal government. And there is nothing in the health care reform law to stop the bleeding.
This is what Americans should be protesting about — call it Occupy Wall Street Health Care.
Rosemary Gibson led national quality and safety initiatives at the Robert Wood Johnson Foundation in Princeton, NJ for 16 years. She is the author of The Wall of Silence and The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health and What You Can Do To Prevent It.
by Rosemary Gibson
Author, ‘The Treatment Trap, Wall of Silence”
Cross-Posted from Huffington Post
Posted: 11/15/11 12:25 PM ET
The U.S. Supreme Court announced that it will review the constitutionality of President Obama’s individual mandate that will require Americans to obtain health insurance by 2014 or pay a penalty, Adam Liptak wrote in the New York Times. The Court will hear oral arguments in March 2012 and a decision is expected in June during the showdown of the presidential election.
If the Supreme Court defers to elected officials in the executive and legislative branches and determines that the individual mandate is constitutional, the decision then moves to the court of public opinion. That court will be divided based on those who have to pay for health insurance from their own pocket and those who don’t.
Consider this. While many individuals and families will be eligible for substantial federal subsidies to defray the cost of health insurance, others will not. A single individual who is 59 years old and earns $48,000 may end up paying $10,172 a year for insurance and up to an additional $6,250 in out-of-pocket costs, or one-third of their income, according to the Kaiser Family Foundation’s calculator that estimates how much premiums could cost in 2014.
Those who have to pay huge chunk of their income for health insurance won’t care about the Supreme Court’s interpretation of the U.S. Constitution; they will care about the constitution of their own wallets and checking accounts.
A mandate to buy a product whose price will be hugely expensive and uncontrollable is the real problem that no one wants to talk about. Premium costs are fueled by the medical industrial complex and rampant overtreatment, as reported in The Treatment Trap.
The federal government does not have the authority to limit premium increases. That authority resides in the states, and only 26 of them and the District of Columbia have the power to limit rate hikes.
Maine is one of the states that can veto rate increases but the health insurance industry is chipping away at that authority. Earlier this year, a Republican-sponsored health insurance law passed in Maine that allows insurers to duck future state-level reviews of their premium increases if they are less than 10 percent a year and if they spend at least 80 percent of their premiums on claims, John Richardson of the Portland Press Herald reported. How many people do you know that gets a 10 percent raise every year?
This coup by the health insurers is apparently not enough. In a court battle in Bangor, Anthem Health Plans of Maine is suing the state because it says that regulators violated state law and the U.S. Constitution when it reduced the 3 percent premium increase it requested. The state says that it has the authority to reduce the company’s profit to keep premiums affordable for Mainers.
What happens in Bangor won’t stay in Bangor. That’s why the National Association of Insurance Commissioners filed a brief in support of the state. Writing in the Washington Post, Julie Appleby quoted the Commissioners’ brief which said that a decision in favor of the insurance company “has the potential to destabilize a key aspect of insurance regulation and will have far reaching effects impacting all states.”
If the industry is successful in Maine, it will challenge other states’ authority to keep premiums in check.
Republicans argue that competition will help bring down prices. In fact, competition among hospitals and other health care providers is fueling the medical arms race. Health insurance companies pass the costs onto premium-payers.
Even if federal subsidies were universal and no one had to pay any money out of pocket for health insurance, the subsidies would be like a Band-Aid on a metastatic cancer that will devastate the country’s financial corpus.
President Obama, the Congress and the Supreme Court are fiddling while Washington is burning through wads of borrowed money.
Author, ‘The Treatment Trap, Wall of Silence”
Cross-Posted from Huffington Post
Posted: 10/21/11 06:42 PM ET
As the congressional super committee looks for $1.5 trillion in deficit reduction, Republicans on the Senate Finance Committee urged repeal of President Obama’s health care reform, The Hill reporter Sam Baker wrote this week. The truth is that Republicans are playing a two-sided game over repeal. Here’s how.
You’ll remember that in February of this year, House Majority Leader John Boehner led Republicans in the House of Representatives to vote for the repeal of the health care reform law even though the Senate didn’t have the votes to do the same. It made for a good show of solidarity with the Tea Party that had swept Republicans into office in the 2010 mid-term election.
But wait a minute. Why would Republicans want to repeal health care reform? Sure, they don’t want to see Obama succeed on his signature domestic issue. But their natural allies, big health care businesses — drug companies, device manufacturers, health insurance companies — gained a whopping 32 million new customers beginning in 2014 with the stroke of Obama’s pen on March 23, 2010.
What businesses would ever get that many new prospective customers – with government subsidies to boot? Even better, each customer will spend, on average about $8,000 a year on health care. The medical-industrial complex will divide the lucrative spoils. This means that another 32 million people are at risk of having unnecessary cancer-causing CT scans, open heart surgeries and stents and drugs which I wrote about in The Treatment Trap.
Los Angeles Times reporter, Norm Levy, reports that conservative experts think that if the GOP wants to dismantle the law, they need to replace it with something else. They’ll need a replacement, too, if the US Supreme Court declares the individual mandate unconstitutional.
Are Republicans having a moment of compassion for people without health insurance? Hardly.
The truth is that Republicans face great peril if they succeed in repealing the reform law and denying the medical-industrial complex the hundreds of billions of dollars they expect in revenue from Obama’s health care reform. Expect a big push back from an apoplectic industry.
Levy from the LA Times quotes Mary Grealy, president of the Healthcare Leadership Council, a coalition of executives of big health care industry companies, ‘Wholesale repeal leaves you with nothing.” That’s right. Repeal of health care reform leaves the health care industry with nothing.
That’s not an option for Republicans who have conspired with the big-moneyed health care interests whose bottom lines depend on the blind generosity of the American taxpayer.
Health care is still so lucrative now that private equity firms are jumping on the bandwagon and pouring money into health care with the expectation of profits in the next couple of years. See my earlier blog post:They want to get in, grab the money, and go before health reform’s Independent Payment Advisory Board (IPAB) kicks in beginning in 2015. Maybe.
Republicans and the industry are targeting the IPAB and anything that gets in the way of them taking a larger share of America’s income. The board acts like a circuit-breaker if Medicare spending shoots up too much in a given year. It’s the only part of the health care reform that has a meaningful chance of making Medicare sustainable as the boomers reach their 80s and 90s.
Of course, the medical-industrial complex doesn’t care about that. It claims that the board will allow government bureaucrats to get in between you and your doctor. Here’s the truth.
Drug and device companies want to get in between you and your doctor so they can market every drug and device known to humankind right on your IPad and IPhone. This gives new meaning to direct-to-consumer advertising. People will succumb to all kinds of gimmicks — treatments, tests and surgeries that can cause more harm than good.
Whatever happens, Wall Street-driven health care will find its way into your wallet.
Rosemary Gibson is the author of The Treatment Trap: How the Overuse of Unnecessary Medical Care is Wrecking Your Health