Thursday, August 9, 2007

SCHIP Travesty Will Prevail if Bush Doesn't Veto...

The SCHIP debacle continues in Washington. There have been too many gullible Republicans who went along with this who apparently were frightened to death of the “sound bite” about them hating children.

Children would now be defined as people under age 25. That would happen in all states, and we know that many would continue the perversion of including adults as well. Remember that Wisconsin now spends 75% of its funding on adults, not children!

The income level provisions of this travesty have been increased to 400% of the federal poverty level, up from 200%. That is more than $80,000 for a family of four! Imagine just how many employers will appear on the next BadgerCare “embarrassment list” with that income benchmark in place.

SCHIP would become a permanent entitlement program whereas it has been forced through periodic re-authorization up until now. Imagine how this entitlement will spin out-of-control if the President would sign the bill.

Funding comes from a diverse group:

We all understand that the tax on tobacco products will increase in order to pay for this largesse. That goose will die off quickly enough, so many other sources will ultimately be tapped.

We didn’t know, however, that private insurance policies would be taxed as well. This “fair share” tax would begin at $375 million in year one, but we all know that number will pale in comparison to what we’ll see in five years and beyond. This on top of the "crowding out" of private insurance plans every time a person elects to be part of their state's SCHIP. Seems that "big insurance" was squarely in the cross hairs as the Democrats sought to incrementally increase the numbers of people on "government run health programs".

And, Congress "bravely" takes on the senior lobby by taking money away from the successful Medicare Advantage program that is now used by some 8 million seniors in lieu of regular Medicare plans. The CBO analysis indicates that as many as 3 million of the current users will be forced out of the programs by the funding reductions. These programs were, of course, made possible by insurers coming to the table as the original program intended to secure better levels of coverage and coverage in outlying areas. "Big insurance" was again in the cross hairs without regard to the seniors who were enrolled in this better deal.

The private sector is about to take a big hit from the liberals.

It is imperative that we let President Bush know we want him to hold his position and veto this abomination when it finds its way to his desk. It appears that his veto has a good chance of standing given that the House passed its version by just 225 to 204. Many congressional representatives would have to reverse their positions in order to sustain a veto.

In the meantime, each of us must contact our elected representatives who voted for this travesty to advise that we are disgusted with their work product and to assure them that we’ll remember through multiple election cycles. And, we need to talk with those who voted the right way so they aren't frightened into changing their vote if the President vetoes the bill.

Saturday, July 21, 2007

SCHIP Expansion is Wolf in Sheep's Clothing...

How does this continue to happen? How can people continue to have the wool (no pun intended) pulled over their eyes…other than by willful ignorance?

The threat of Presidential veto of the newly proposed SCHIP expansion has again met with the usual press reports. He is denying the poor children their rightful coverage, etc., etc. It is interesting that, even with the Bush-bashing that has gone on for years, the current Congress rates even lower amongst the general population.

This is not about the children! The truth of this matter is simply that this expansion of SCHIP (BadgerCare in Wisconsin) is a ploy to include more adults in the program rather than more children. The additional children we all want in this program can be afforded under the President’s proposed SCHIP increase. But, in order to pervert this well-performing program, those who would see government-run healthcare are using this program as their “Trojan Horse”.

They reason that by adding multiple billions of dollars, more and more states (like Wisconsin that already uses 75% of the current funding to bring adults into the program) can use the increased funding to apply to adults. This happens as the qualifying poverty-level income multiples are increased. This permits people earning far in excess of poverty-level incomes to participate in government-funded health care plans. As this group increases, the private sector health plans lose more and more people…exactly what those who seek a total single payer system desire.

This is back-door socialism. It appears there are enough ignorant Republicans who’ve signed on to support this travesty to at least have gotten this through the Senate. Among those Republicans is Sen. Hatch (R-Utah) who spoke at the Capital Conference hosted by the National Association of Health Underwriters early in 2007. He spoke eloquently as to how this perversion wouldn’t be permitted to happen. He must’ve found some politically-expedient reason for supporting it. This “go along to get along” mentality is a serious threat to us conservatives. And, any number of liberal Democrats and middle-of-the-road Republicans are happy.

As an aside, the tobacco tax increase that has been included as the funding mechanism will succeed in putting cigars out of the reach of mere mortals. With the tax increase going from the capped amount of $0.05 per cigar to a capped amount of $10.00 per cigar, only the “fat cats” will puff cigars. This staggering Federal increase coupled with the hefty cigarette/cigar tax increases added by many states, will effectively kill that industry. Tobacco is a legal product by the way. This reeks of hypocrisy…but why should any of us be surprised at that?

That “industry” is the goose laying all these golden eggs, and it will be killed by the “do-gooders”. We’ll then all awaken to find ourselves taxed to cover the certain budgetary shortfalls thus created by these mandated programs. Back-door socialism will have created government-run health care and we’ll be unable to do anything about it.

This must be headed off in the House of Representatives even with President Bush’s stated position of vetoing the bill in its present form.

Monday, July 16, 2007

Health Care Reform or Insurance Reform - The Political Reality

A guest Blog posted on behalf of Terry Murphy:



Democrats in the Senate just recently announced their health care reform plan known as Healthy Wisconsin. In fact, just one day after providing the details of the plan, they put their idea into their version of the State Budget and passed the plan out of the Senate. Their reform plan is theoretically one step away from being sent to the Governor’s desk to be signed into law. This is the most sweeping and expensive legislation in our state’s history and the vast majority of Wisconsin citizens have no idea the plan even exists, let alone what the plan will do to them. How could this possibly happen? Well, that’s a discussion for another day. Instead, the question we ask today is why are all of the government reform plans reforming insurance rather than reforming health care?

Both the Centers for Medicaid and Medicare Services (CMS) and a study found in the New England Journal of Medicine show that just 12 cents out of every insurance dollar goes to the cost of insurance administration, leaving the vast majority of the insurance dollar (88 cents) going to the cost of health care. While we recognize health care costs include some administrative costs of their own, the fact remains that the vast majority of insurance premiums collected are spent on health care, not the cost of financing such care through insurance. Knowing this fact, why would anyone devote all of their time and effort in trying to reform how we finance our health care (through insurance), rather than trying to reform actual health care costs? Healthy Wisconsin, like nearly all of the other reform plans introduced in the last year, focuses on how we finance health care by replacing our current insurance system with a government run taxing system. Even if their taxing approach actually reduced some of the insurance administrative costs (the 12 cents), because their plan doesn’t address the cost of health care (the 88 cents), health care will still be unaffordable, making either the insurance or the taxes to pay for such care unaffordable.

Senate Democrats estimate an initial payroll tax of 16% in order to pay for their program. First, this estimate makes a bold assumption that all health care providers (doctors, hospitals, nursing homes, etc) will voluntarily reduce their costs by about 40%. Does anybody in Wisconsin believe this assumption is realistic? Therefore, like the Massachusetts reform plan, the 16% payroll tax estimate will likely be much higher. Secondly, since 2000, health care inflation averaged 12% per year, compared to increases in US Household Income at 3.7%. A provision of Healthy Wisconsin states that health care increases in Wisconsin should not exceed the national average. This means that if health care inflation remains at 12%, payroll taxes for Healthy Wisconsin are guaranteed to increase each year, far outpacing what Wisconsin residents can afford. By the second year of their plan, payroll taxes would have to increase to nearly 18%, and by the third year, the payroll tax would balloon to over 20%. Exactly how is this plan supposed to help Wisconsin citizens?

The problem with Healthy Wisconsin and all of the other government based reform plans is that none of them set out to reform health care costs. Why? Perhaps the answer is that reforming health care costs is not “politically” attainable. To reform, or control health care costs, government has but two options. The first option would require the government to get control of health care providers by either dictating what they can charge or using the more radical approach and taking over the health care providers like the Canadian system. Regardless of what public opinion says about wanting “universal” health care, politicians know that Wisconsin citizens do not want government involved in their health care. Therefore, this option is not one likely to be found in a health care reform plan. However, if any of the government based reform plans like Healthy Wisconsin ever became law, as health care costs continued to increase, thereby increasing taxes, this would be the only option left for government to control health care costs. A scary thought indeed.

The second option would be for Government to let the market work to control health care costs, through transparency and competition. Unfortunately, for many politicians, this option takes far too long to work, and mistakenly gives the appearance of not doing anything in the eyes of voters. Politicians believe voters are looking for a silver bullet and the fact is there are no silver bullets in health care reform. The other problem with this second option is that it cannot be put into a 30 second sound bite that politicians could campaign on. It is truly sad that we have politicized health care reform, and that the only option that will work is not even being considered by many politicians because it isn’t politically acceptable. This is wrong for Wisconsin and wrong for Wisconsin consumers.

A recent report showed that Wisconsin enjoys some of the highest quality health care in the nation. Most surveys find that the majority of citizens like the health insurance plan they have purchased. Wisconsin citizens are smarter than some politicians give them credit for. The government can play a large role in this second option, by working to help the private market work better in controlling health care costs. The Coalition for Sensible Health Care Solutions has provided a blueprint for health care reform in Wisconsin. It works to address health care costs, and yet still works to improve the efficiency of our insurance industry. It is this second option that should be considered by any legislator who doesn’t care about politics, but instead cares about making health care affordable for his or her constituents.

We have to stop wasting our time, effort and resources with attempts to exclusively reform insurance only because it is politically acceptable. Instead, we have to start trying to reform health care costs and work to improve the efficiency of insurance because it is the right thing to do. Each year, Wisconsin consumers face another double digit increase in health care costs because we have avoided the second option. We cannot afford to wait any longer.

Terry Murphy is the owner of East Towne Insurance Services, Inc. (an employee benefits brokerage firm in Milwaukee). Mr. Murphy is also the Legislative Committee Chairman of the Wisconsin Association of Health Underwriters (WAHU). WAHU is an association of insurance professionals who work directly with consumers in the financing of their health care. WAHU is a chapter of the National Association of Health Underwriters covering the insurance needs of over 100 Million Americans.

Friday, June 29, 2007

Google Could Revolutionize Healthcare...

Google has been thought to be considering working on ways in which people could store their health records on Google and have them readily available for personal needs. It has been quite careful about letting outsiders in on its plans but has just taken action that could suggest this idea is gaining traction.

Google recently appointed its new Health Advisory Council and it is comprised of some 22 very heavy hitters:

Dean Ornish, Founder and President, Preventive Medicine Research Institute

Douglas Bell, Research Scientist, RAND Health, RAND Corporation

Delos M. Cosgrove, CEO, Cleveland Clinic

Molly Coye, CEO, HealthTech

Dan Crippen, Former Congressional Budget Office Director & Reagan White House Asst.

Linda M. Dillman, EVP, Risk Management, Benefits & Sustainability, Wal-Mart

John Halamka, CIO, Beth Israel Deaconess Medical Center & Harvard Medical School

Bernadine Healy, Former NIH Head, Health Editor & Columnist, U.S.News & World Report

Bernie Hengesbaugh, COO, American Medical Association

Douglas E. Henley, EVP, American Academy of Family Physicians

David Kessler, Former FDA Commissioner, Vice Chancellor-Medical Affairs & Dean, School of Medicine, UCSF

John Lumpkin, Sr. VP, Director of Health Care Group, Robert Wood Johnson Foundation

John Rother, Group Exec. Officer of Policy & Strategy, AARP

Anna-Lisa Silvestre, VP, Online Services, Kaiser Foundation Health Plan, Inc.

Greg Simon, President, FasterCures

Mark D. Smith, President & CEO, The California HealthCare Foundation

Paul Tang, Internist & VP, Chief Medical Officer, Palo Alto Medical Foundation & Chairman, Board of Directors, American Medical Informatics Association

Sharon Terry, President & CEO, Genetic Alliance

John Tooker, EVP & CEO, American College of Physicians

Doug Ulman, President, Lance Armstrong Foundation

Robert M. Wachter, Professor of Medicine, UCSF, Assoc. Chairman, UCSF Department of Medicine, Chief – Medical Service, UCSF Medical Center

Matthew Zachary, Founder & Executive Director, The I’m Too Young for This! Cancer Foundation for Young Adults

The private sector is stepping up its game!

Google is among the most innovative organizations in the world and should not be undersold as to the potential for success in this undertaking…if that’s what it is.

Wednesday, June 27, 2007

Americans Living in Canada Comment on Health Care...

A recent survey of some 310 Americans who have experienced use of health care services in both the U.S. and Canada produced expected results. The full survey results are available here.

The overall result had 74% rating the overall quality of U.S. health care as excellent or good, while 50% of the same group gave Canadian health care a similar rating.

The nod was given to U.S. health care in the areas of accessibility, timeliness, quality, and available technology. Canada scored higher in the areas of personal cost of both health care and pharmaceuticals. Obviously, the government pays the costs of permissible care in Canada, so it was expected that personal financial exposure would be limited.

Wait times in Canada were comparatively quite long with people citing too few specialists and too little government funding.

As government funding was exhausted in Canada, services were rationed by imposition of longer wait times and cancelled surgeries.

This group had experienced U.S. health care within two to five years of the time of the survey and had been covered by Canadian health care since the time of their arrival in that country. The respondents were scattered across the provinces with higher concentrations where the population was greater.

Monday, June 25, 2007

Senate Dems Use Interesting Tactic to Mount Health Plan...

Senate Democrats used an embargo of the press as they pushed an 11th hour health plan proposal out front of every other proposal. They scheduled an informational hearing for 11:00AM today (Monday), but refused to release details of their health plan proposal until Monday morning.

That seems a very strange way to encourage true debate on this most critical subject. Why, if your health plan is a genuine proposal and worthy of debate, would you keep the information to yourselves. How can we even think of this plan as worthy given the manner in which it is being exposed to public scrutiny?

It appears to be an extension of the Wisconsin Employee Trust Fund package of health plans with provisions for taxes on both employers and employees to pay for the program. The tax rates proposed appear, at first glance, to be low considering that the coverage is quite extensive with minimal co-payments and small deductibles. The plan would be made mandatory for all citizens of Wisconsin except those who are covered under existing federal plans or BadgerCare.

We encourage debate on all proposals…but we need to know the details of each well before the debate begins. These same Senate Dems plan to vote on the Budget Bill on Tuesday, and this plan is now going to be part of that Budget Bill. It appears to be simply a ploy! They cannot be sincere in this effort using such tactics.

Friday, June 22, 2007

BadgerCare Publishes List to Embarrass Employers...

Wisconsin offers its version of the SCHIP programs called BadgerCare as we’ve discussed previously. Wisconsin has received approval from the federal Department of Health and Human Services to offer BadgerCare to adults as well as to the children for which the program was originally intended.

As a matter of fact, The DHHS Secretary, Michael Leavitt, points out that 75% of the Wisconsin program’s funds are spent on adults. Another tidbit is that Wisconsin covers nearly twice as many adults as children. Not bad for a children’s health program, huh?

Since the state wants to embarrass employers with employees participating in BadgerCare, we’ll certainly assist by adding the link to the list at http://dhfs.wisconsin.gov/badgercare/pdfs/employers0307.pdf .

Obviously, since “everyone” hates Wal-Mart from what I read in the news, Wal-Mart is at the top of this nasty list with 897 employees. Never mind that Wal-Mart employs more than 27,800 people in Wisconsin, just ridicule them for this 3.2% that managed to obtain BadgerCare.

How could that happen? Well, BadgerCare has established some rules that may explain this “unintended consequence”. First, if an employer offers its employees health insurance coverage but doesn’t pay at least 80% of the premium cost, the employee may be eligible. If the employee is earning less than 185% of the federal poverty level, then that person and his or her dependents are eligible for BadgerCare.

How much is 185% of the federal poverty level? For a single person, it is $1,574 per month. For a husband and wife with two children, it is $3,183 per month. For a family of 8, it is $5,329 per month.

Could it be that BadgerCare is too permissive in its attempts to cover children (when nearly twice as many adults as kids are covered)? Could it be that the 80% level of premium contribution placed on employers is too high? Could it be that BadgerCare is intended to bring as much federal largess into our state as possible (ignoring that we over-taxed Badgers are also paying federal taxes)?

Oh, and another thing! Among the culprit employers are these:

The United States Postal Service
The YMCA
Goodwill Industries
The State of Wisconsin

Thursday, June 21, 2007

Uninsured In America...

Stuart Browning has produced at least three pieces depicting issues within the health care debate.

The piece titled Uninsured in America is found here .

I hope you'll agree that this needs to be shared with as many people as you can get it to as quickly as you can.

We'll look at two more over the next few days.

Thursday, June 14, 2007

Consumers Demand Transparency...

A recent survey (completed in February 2007) conducted for the PNC Financial Services Group by the Boston-based research firm of Chadwick Martin Bailey found that consumers (especially those with high deductible health plans) want more transparency in health care administration.

The survey was based on telephone calls conducted with 150 executives from U.S. hospitals or health systems, 50 executives from insurance organizations and an online survey of 1,000 U.S. consumers.

Six of ten people who have high deductible health plans strongly agree that their families have become more conscious of health care costs, and some 22% said they compared doctors and hospitals to find the best value for their money.

This finding supports the changing environment that is being brought about by consumer directed health care. As consumers are reintroduced to the process of buying their health care, they are quickly becoming more aware of costs and outcomes. As the consumer directed movement continues to expand, it is becoming clear that the marketplace is responding with pricing transparency, better knowledge of outcomes and generally more informed patients.

Hospitals are working diligently to improve their overall ranking in terms of outcomes. Physician groups are focusing on patient communication. Entrepreneurial companies are developing point-of-sale claims pricing systems to enable patients to learn true costs and to pay for services with debit cards.

Employers are very conscious of wellness programs as a part of the solution to bring health care costs down, thus reducing the cost of insurance benefit plans while gaining a healthier and more productive workforce.

Employers are learning if they don’t already know it, that they must share the premium savings with their employees through funding of Health Savings Accounts and Health Reimbursement Accounts. Those who used the high deductible health plans primarily as vehicles to shift costs are coming to understand that this was a short-sighted approach.

Consumer directed health care is maturing and expanding. That frightens some in government and industry. Some in government don’t relish the idea of empowering the individual since people begin to understand that they don’t need big government to take care of them.

Some in industry and labor circles are similarly wary of these programs. Again, control of members can be threatened when the individuals begin to make their own decisions.

Some in the health care industries are not anxious to see patient independence since they are comfortable with the status quo. However, those same health care providers are being forced to change. They will either adapt to this new era, or risk being relegated to the junk heap as another entity that failed to take the necessary action.

There is a growing tide sweeping over the health care landscape and it is called consumerism.

Tuesday, June 12, 2007

Wisconsin Health Plan Follow-up...Chapter Two

Another interesting tidbit that was included in the Lewin Study but wasn’t highlighted is this:

Of the some 2.958 million persons currently receiving health insurance benefits through an employer in Wisconsin, the cost for the Wisconsin Health Plan (WHP) will be less than the current costs for only 736,000 persons.

That means that the WHP, a lesser plan, will cost more for the other 2.222 million persons.

Is that not significant enough to warrant mention rather than to be buried on page 49?

How many other nasty surprises are yet to be found?

Is this really what Wisconsin citizens desire?