Maine Owl

Cross posted at Dirigo BLue

Last week, this diary was posted at The Great Orange Satan, my visit to Susan Collins' office, in which the writer, Angela Quatranno describes her attempt to determine Sen. Collins' position on the need for health insurance/care reform. She posted a document she says was given to her by a staffer - the veracity of this document was confirmed to me by another source. It reads:

I continue to have many reservations about the Obama Administration?s health care policies, the bill reported by the Senate Health Committee, and the legislation approved by the House committees. The Washington-run public insurance plan that would be created by these proposals would have the federal government administer the plan and determine benefits, premiums, and payments to physicians and hospitals. Proponents of a public plan claim that it would challenge private insurers to compete on cost and quality. Opponents see it as unfair competition for private insurers and the first step down the path toward a single-payer system because a public plan most likely would lead to the collapse of the private market.

Collins' statement that "the federal government administer the plan and determine benefits, premiums, and payments to physicians and hospitals," is of interest, since currently Medicare does exactly this same thing (of course, for-profit insurers do the same thing, but they aren't part of our elected government). Also, the Veterans Administration hospital system goes even further than that, actually providing care to veterans and those who qualify. That Maine has one of the highest per capita counts of those aged 65 and older (2nd behind Vermont) as well as retired and active duty servicemen and women ought to weigh heavily in the balance for Maine's junior senator.

Apparently these demographic groups do not:

I oppose the Washington-run public plan proposed by the Administration. The nonpartisan Lewin Group has concluded that a public plan open to all and offering Medicare-level reimbursement rates would result in 119 million Americans losing their private coverage. This kind of mass shift would destabilize the insurance market and is also inconsistent with the concept of building on our current system. It also would run contrary to my commitment to ensuring that families are allowed to keep health care coverage that is working for them.

As was noted in these pages, , the Lewin Group is hardly a non-partisan think tank:

Generally left unsaid amid all the citations is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation's largest insurers.

More specifically, the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association, a physician's group, of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied its parent company and other insurers with data that allegedly understated the "usual and customary" doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.

This practice of providing bogus data seems prevalent in the for-profit insurance system, as Wendell Potter explained in his testimony to the Senate Committee on Commerce. Collins' colleague, Olympia Snowe, sits on that committee - perhaps the two of them could get together at some point and have a little chat.

Collins' continues:

I also oppose having a single-payer system for our country. The experience in other countries with single-payer systems demonstrates that it causes many patients to face long delays in needed tests and treatments. For example, some Canadians are forced to come to American hospitals for treatment because they face lengthy delays in Canada.

Here Collins' repeats conservative talking points that have long since been debunked. First, it is important to remind her that our own Medicare system is a single-payer, and was used by Taiwan as a model for their own health care system. Secondly, those 46 million Americans that do not have health insurance face long delays as well, delays that often result in their ailments becoming acute, and requiring invasive - and expensive - care.

And while the Canadian system is not without fault (what system is), it is telling that Collins does what most opponents of single-payer do: not mention that France not only has a single payer system that covers everyone in that country, a system similar to our Medicare, but that it provides the best care in the world for half the cost that Americans pay (percentage of GDP).

There's more:

Nobody knows what "health care co-ops" actually would be. Huffington Post has a good item showing media fumbling on this concept. I don't pretend to know anything either.

But that won't stop me from speculating: "Co-ops" will be regional-flavored marketing offices run by insurance companies for the benefit of insurance companies. Marketing, including garbage imagery of happy customers, will be their purpose.

The twist in the law will be that the taxpayer will inject a pile of cash into these operations, basically helping insurance company bottom lines by having the public pay for their deceptive marketing practices.

Remember, this is just speculation.

Impeccable logic: health not war

Olympia Snowe has made up her mind on health insurance reform. There is not to be a public option. Period.

"It's not in our plan or currently on the table," she said.

Her "unannounced" appearances around the state this past week therefore would seem to have less to do with "gathering input" (as WCSH teevee put it) than just seeing if any of the rubes are upset that Snowe has been batting on the insurance company team since day one.

H/T to Glenn Greenwald for this great item on paid shills, in particular Lanny Davis. This on White House insurance transparency is in the same item:



I'd rather forgotten this, but it fits right in with stuff I've been posting recently: President Obama promised completely open transparency in reforming health insurance by saying the negotiations would be "on C-Span." But how's that worked? Despite a lot of "stakeholder" discussion, the Obama transparency plan has been to hold closed-door meetings with health care executives and lobbyists while putting up a vigorous defense against lawsuits seeking to overturn the Bush White House policy of keeping visitor logs secret.

At his July 22 press conference, President Obama responded to a question about the secret visitor logs:

THE PRESIDENT: Well, on the list of health care executives who've visited us, most of the time you guys have been in there taking pictures, so it hasn't been a secret. And my understanding is we just sent a letter out providing a full list of all the executives. But frankly these have mostly been at least photo sprays where you could see who was participating.

With respect to all the negotiations not being on C-SPAN, you will recall in this very room that our kickoff event was here on C-SPAN, and at a certain point you start getting into all kinds of different meetings -- Senate Finance is having a meeting, the House is having a meeting. If they wanted those to be on C-SPAN then I would welcome it. I don't think there are a lot of secrets going on in there.

Evidently there were some secrets going on in there, given the industry-friendly position shifts that have been revealed in the last couple of weeks, including on the need for a public plan and prohibition on use of government clout to reduce drug prices.

Seller's market


Chad Terhune, Senior writer at BusinessWeek, is co-author of the article "The Health Insurers Have Already Won"

This report confirms the death of the public plan.

Terhune: ... there's not going to be a public plan. And I could have told you that from my reporting earlier in the summer, just was not going to happen.

In my mind the real money quote in this interview describes exactly how the Democratic legislation will be shaped to enhance private insurance profits through nasty employer/individual mandate coupled with reduced minimum benefits. Here is the money quote,

Terhune: ... they want to whittle that [the minimum benefit] down to where you and I would have to pay more out of pocket, insurance would cover less. They've been very persuasive on that, knocking down that number of what the minimum benefits would be. ... OK, if you say these are the minimum benefits, these are the package, and it comes with an actuarial figure, that's basically a percentage of how much the insurance company pays on average and how much you and I as consumers would pay out of pocket. And at one point it was about 76 percent, being the percentage the insurance company would pay, and we would pay the rest in co-pays, deductibles out of pocket. And over time, through the Senate Finance Committee, that's gotten whittled down to about 65 percent. [emphasis added]

My Democratic registration card is being ripped up as I write this.

Matt Lauer: Is it dead?

Howard Dean: No, you really can't do health reform without it.

This is all very fascinating because I read in my Bangor Daily News this morning an Associated Press story with the lede,

Bowing to Republican pressure and an uneasy public, President Obama's administration signaled Sunday it is ready to abandon the idea of giving Americans the option of government-run insurance as part of a new health care system.

The idea is Secretary of Health and Human Services Kathleen Sebelius said over the weekend that the public option is "not the essential element" of health reform. Lauer had an Obama quote calling the public option a "sliver" of the total effort, in other words something easily cast aside in compromise.

Howard Dean, on the other hand, evidently sees the public option as something comparable to Medicare or the VA system. That looks like fantasy to me. Obama certainly does not and probably never has given public option this kind of weight.

I'll see you at the town office, where I'll be signing my Green Party registration card.

This from the Friday column certainly is true.

Krugman:

So far, at least, the Obama administration?s response to the outpouring of hate on the right has had a deer-in-the-headlights quality. It?s as if officials still can?t wrap their minds around the fact that things like this can happen to people who aren?t named Clinton, as if they keep expecting the nonsense to just go away.

What, then, should Mr. Obama do? It would certainly help if he gave clearer and more concise explanations of his health care plan. To be fair, he?s gotten much better at that over the past couple of weeks.

But I don't think Krugman quite gets the reason Obama and the Democrats aren't more able to get those "concise explanations" of the real plans out there--employer/individual insurance mandates and secret drug deals broadly will be disliked once understood. The lunacies for now are a distraction from the fact Obama is in the process of eviscerating his own campaign promises.

Harsh reality.

Obama flops, Democrats lack credibility


Obama can't be honest: secret deal with pharma and other holes of duplicity big enough for wingnuttia to rip through

Update: Via Corrente, Huffington Post has uncovered an internal White House memo that confirms the Obama deal with Big Pharma.

Today the Bangor Daily News reprinted an interesting Washington Post op-ed piece by Danielle Allen on problems of their own making the Democrats are having in the health insurance reform fracas. Towards the beginning of the piece is its best observation:

In his debates with Hillary Clinton in the winter of 2008, Barack Obama flatly denied that his approach to reforming health care would require an individual mandate requiring everyone to buy health insurance. Events have proved him wrong.

His administration now agrees with the analysts who argue that only by ensuring that no one games the system can reform be made to work. The mandate serves to ensure that individuals do not buy insurance only when they are ill. Other elements of the reform similarly serve to ensure that neither insurance companies nor employers will game the system. As Paul Krugman has argued in the New York Times, each of these strategies to prevent gaming is necessary to make the whole thing work. The point, though, is that the push for implementation has turned Obama's policies into something other than what he promised.

Bingo. Obama and the Democrats can't be honest about what they are doing without highlighting how different Obama the president is from Obama the Democratic candidate.

There are good items at Huffington Post and Time's Swampland that trace the story of how Obama has weaseled around through secret deals his earlier promises to cut costs by forcing drug companies to negotiate prices.

So now I see in my email David Axelrod saying I should forward the White House "Reality Check" on health reform. I'm glad to do it (below). I suppose if they could be honest that the plan is to include employer and individual insurance mandates along with unwieldy regulations designed to keep financial wizards and other crooks from gaming that kind of system, it would be easier to "hear" what they are trying to do. But I note that there is no mention of these essential aspect anywhere in the Reality Check site. A close reading also reveals private-insurance-friendly statements like "as long as the policyholder pays their premium in full." Does that mean if you get sick and can't pay, then they can drop you?

Here is my answer to all these problems: single payer.

There is plenty else underneath the surface of the (apparent) Democratic plan that undermines its credibility. See here at Corrente, for example. The Democrats have no way to just hand out to people at the town halls and elsewhere a one-sheet that explains exactly what their plan would do. You wouldn't have to be on the lunatic fringe to feel betrayed.

White House "Reality Check" below: