My Real Politik

Swine Flu and Health Insurance Reform

A Presidential Panel has come out with a report speculating that almost half the US population could contract swine flu (H1N1) this flu season. The panel has been looking to the Southern Hemisphere where it's winter right now to see how the swine flu has affected them.

The panel estimates that anywhere from 60 to 120 million Americans could see swine flu symptoms, 2 million could be hospitalized, 300,000 people could require intensive care, and almost 90,000 deaths could be caused by the influenza strain. This is almost double to rates of a typical flu season adding on to the 200,000 hospital admittances already expected this year. This would also lead to anywhere from 50-100% of all ICU beds to be occupied by H1N1 victims.

This sounds like a massive strain on hospitals and health care providers and yet, no one seems to be drawing any connections to the health reform debate. If H1N1 does affect half the population, then it would be reasonable to assume that at least 20 million will contract it without health insurance (according to the CBO's uninsured estimates).

Would these people seek the proper medical care? Would they be able to acquire a vaccine? It's still unclear whether there will be administrative costs to distribute a vaccine on a massive scale (which could cost upwards of $1billion).

As far as I know, there has not really been a pandemic during the  insurance era and certainly not at a time when the health care system is so close to reform. Why is no one reporting on this?

I imagine there have to be lots more complications here- if people elect not to get vaccinated or receive treatment or if they're unable to do so, how will this effect the spread of the disease? Will the vaccines be mandated, or would that constitute too much government oversight? How are hospitals going to cope with a massive flood of patients that may not be able to pay for their care?

People who feel the government needs to stay out of health care may want to think twice when considering the US has signed a $2 billion contract to make the H1N1 vaccine available for everyone by mid October. Of course, it is also possible that this whole swine flu scare is overblown- there's a LOT of money to be made from a pandemic scare. Interestingly enough, according to a British poll, almost 30% of nurses would refuse the vaccine due to potential side effects and doubts to its effectiveness.

No conclusions here. But why is no one else asking these questions?

You can find the full government report here. It's extremely interesting.

Meet the Press: Armey, Daschle, Colburn, and Maddow

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This is a great Meet the Press that aired this past Sunday. Former House Majority leader and town-hall-protests organizer (Chairman of Freedomworks) Dick Armey, former Majority Leader Tom Daschle, Senator Tom Colburn (R-Ok), and MSNBC talk show host Rachel Maddow.

There are a lot of interesting points and criticisms made on both sides, and I think this was a really good gage of where the leaders of both sides of this debate are at.

If you have the time, I'd STRONGLY suggest watching this.

It's the News Stupid!

In recent months, Fox News has championed free speech with positive coverage of the Health Care Town Hall protesters as well as the infamous Tea Party protesters in March. Is their current coverage reflective of how they've covered numerous protests in the past? Let's take a look.

As a disclaimer, I'm not trying to say that Fox News is bias and that other networks (MSNBC, CNBC, CNN, et al) are not. However, FNC is the only network that uses "fair," "balanced," "without the bias," and "we report, you decide"  in their slogans. Their blatant barrage of conservative masturbation is anything but "fair and balanced."

Duke Professor Responds to my Criticism

Shortly after posting my criticism of Dr. Lewis's analysis of HR 3200, I sent him an email asked whether he'd like to respond. He did, and we had a couple email correspondences. He was extremely cordial and said that he appreciated the invitation to comment on this issue (as I asked him to comment in the blog, and to join our facebook group).

He says his post was not an analysis, but simply a number of questions he waited to raise about the bill. He also is largely concerned that this bill could pass before the Congress and the public have a chance to properly consider the consequences of this bill.

Here's a more direct response in his words:

"I have been getting emails from lawyers advising that my conclusions were far milder than the reality. For instance, the tax surcharges increase over time; capital gains (on the sale of a home, for instance) are part of the "income" used to figure the higher rates; the capacity to buy private insurance after 2013 is subject to ruinous conditions; etc.

As to context, the context of the bill is the establishment of a massive new federal bureaucracy, under a new Commissioner, that will have virtually unlimited power to control health care in this country. That is the institutional context. This Commissioner will use the IRS, for one example, as an means to enforce his decrees. Given 1017 pages of legalese, it is possible for apologists to find all kinds of passages to cite in order to wiggle out of accepting the basic fact that this is a complete government takeover of the medical industry, in which we will all become wards of the state and doctors will be treated as postal employees. THAT is the context, and that is the fact that the legalese (and our "representatives") are intended to obfuscate."

One response that I do have here is with his note that "it is possible for apologists fo find all kinds of passages to cite in order to wiggle out of accepting the basic fact that this is a government takeover." As i pointed out earlier, it's largely been the critics of Health Care Reform that have been cherry picking sections of this bill to advocate opposition. This is exactly what Dr. Lewis did by combining unrelated to sections, and omitting large portions of text.

We had a number of email correspondences over the weekend, and I imagine we will have a few more. I will update you with any new emails.

Duke Professor Gets HR 3200 Completely Wrong

This is an analysis of HR 3200 as written by Duke University Professor John David Lewis, and posted on his web site classifiedideals.com. This write-up has been making its rounds and was recently read aloud by Rush Limbaugh on his radio show. As i did a side-by-side comparison of this analysis to the actual bill, I noticed that large portions of text had been redacted, completely unrelated sections had been paired together, and that this was by and large an extremely jaded and misrepresentation of HR 3200. 

I've emailed Dr. Lews, asking if he had a response to my objections. I'm also blasting this out to as many news organizations as I can. I'll be sure to post a response if I get one.

This is an egregious example of how misinformation is being propagated about health care reform.

Below is his analysis and my stipulations. I've also provided links to each section in the bill so that you can see them for yourself.

UPDATE: I've spoken with the Professor via several emails. I've posted some of his response here.

Protesting in fear, NOT in conspiracy

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Here's a really interesting interview with one of the now infamous "town hall protesters" Katy Abram on MSNBC's Hardball. She's clearly not some ultra right-wing Republican zealot nor is she part of some "astroturf" campaign to bring down the President. She's a slightly uninformed, concerned American- much like all of us.

I think Lawrence O'Donnell is really fair with his questioning throughout the interview. He does manage to point out that Katy, while impassioned, is not exactly fully informed on the issues.

Katy: "I heard [the President] say in a quote on television that... it may take five or ten years, but we will move to a single payer health-"

HB: "He has never said that."

Katy: "I heard it on TV! I heard it on TV, I heard him saying it... this was a couple years ago... maybe 2002..."

The Obama quote she's referencing is part of a video mashup that was shown on Drudge and Fox News that de-contextualizes a number of Obama speeches, and it has already been debunked.

What we have here is a victim of misinformation. I can empathize because I've been one too. I think we all have. It's easy to become ensnared by the emotionality of propaganda and misinformation- that's why it works so well. "Socialism," "death squads," "nazis," "America is dead," "radical communists"- these are all key terms used by ideologues to illicit fear- fear that provokes people to act because they're forced to feel they have no other choice.

I'm not saying Katy represents all or even a majority of the opponents to health reform. However, I do believe that there is a large population of people who are protesting this bill based on misinformation and propaganda. I think instead of demonizing the people that disrupt these town hall meetings with cries of "socialism," we should instead try to understand why they believe what they do. We can't fight the opposition by attacking the foot soldiers- we need to attack the root of the problem. The PROBLEM is the proselytizing of fear- if we don't stop it now, it could tear us apart.

Health Care Reform 101

Health Care Reform Page

Health Care Reform is perhaps one of the most contentious issues I've seen played out around the country since I've been alive. It's somewhat disturbing to me that we see more contention for health care reform then we did for starting a war in Iraq that has cost us not only our reputation, but almost $700 billion over six years- that's twice the $239 billion that the CBO estimates health care reform will cost over a ten years.

However, there are two sides to opposition and the support. There are those who choose to have an informed debate, and those who let their passions and fears control their opinions. I wrote a little over a week ago about the need to come together and form a consensus. Yet, we can't understand the arguments until we understand what we're arguing about.

So in between working and searching for work, I've taken a lot of time to investigate this health care reform. Its important to understand H.R. 3200 (which is the House bill) as compared to the Senate bills. It is important to understand where Obama is coming from. And it is important to understand what is fact and what is fiction when it comes to this reform.

Most of your know that I am a proponent of health care reform, but I am much more a proponent of informed debate, for otherwise, reform i fear will lead to unrest. I've included links to the bills, to various bipartisan articles and polls. Hopefully, while Congress is in recess and hearing out what the people want, we the people can be sure to understand exactly what it is we're fighting for or against.

Thank you

Health Reform Page

The Health Care Misinformation

Misinformation is being propagated on both sides of the debate. For a good breakdown of the misleading information being propagated by the Left and the RIght, I'd suggest Politifact's Health Care page or Factcheck.org's Articles and the Wire.

Here are a list of the most misleading rumors and who has supported them (sources: factcheck.org and politifact.com):

*FALSE: The Health Care Reform bill pushes euthanasia and "end of life" options onto senior citizens, requiring them to undergo "suicide" counseling every five years

• WHO: House Minority Leader John Boehner and Republican Policy Committee Chairman Thaddeus McCotter (R- Michigan) publicly stated in mid-July that a provision in the House bill "may start us down a treacherous path toward government-encouraged euthanasia." This claim has been repeated numerously by Rush Limbaugh, Sean Hannity, Sarah Palin and Betsy McCaughey (former Lt. Governor of New York). 
• IN FACT:
  
  • Section 1233 of H.R.3200 actually expands Medicare coverage for a program that already exists- one which has had bipartisan support for over a decade.
  • The section in question "require[s] Medicare to pay for voluntary counseling sessions helping seniors to plan for end-of-life medical care, including designating a health care proxy, choosing a hospice and making decisions about life-sustaining treatment. It would not require doctors to counsel that their patients refuse medical intervention."
  • These sessions are strictly between a physician and the patient- no member of the government is involved
  • It also does NOT mandate these sessions- they're strictly voluntary. 
• ANALYSIS: This is largely a misrepresentation of a provision that is intended to provoke fear and disgust; considering senior citizens by far are the largest opponents to medical reform (despite the fact that 77% of senior citizens are already on government-run Medicaid), it's reasonable to assume that this bit of misinformation is a major issue of concern
• For more information, you can read this article by the bi-partisan factcheck.org "False Euthanasia Claims"

The People's Perspective

There are mixed results when weighing public opinion polls on Healthcare Reform. The overall takeaway is that a majority of Americans favor reform of some kind, and are willing to favor a government option. However, concerns over costs and the potential risks to their current health care coverage are weighing heavily on American's minds. This leads to varying ambiguity with many Americans essentially expressing cautious and hesitant support.

Also, support for health care reform varies largely along political lines as well as generational lines. An large majority of Democrats support reform while an equally large majority of Republicans oppose it. Health care reform is also significantly less popular among older Americans then among those 18-30 years old. 

According to the most recent CNN Opinion poll (as of August 3rd), an overwhelming majority of Americans support health care reform (74%-77%). Yet when specifically asked whether they support Barack Obama's health care reform, support is split virtually 50-50.

According to a CBS News poll:

• 52% of Americans feel the U.S. needs to fix its health care system now as part of fixing the overall economy
• 55% feel it is the government's job to guarantee health insurance to all Americans (down from 64% in June)
• Roughly 70% of all Americans are concerned that the creation of a government run option could either degrade the quality of the care they already receive, or increase the costs for their coverage
• Between 70% and 80% of Americans feel that if the government does not reform health care:
  
  • the cost of their own health care will go up
  • they could be without health coverage at some point
  • the number of uninsured in the U.S. will go up

In a similar CBS News poll taken in June:

• 72% of Americans favor a government-run health care option
• 57% are willing to pay higher taxes to improve health care
• 65% of Americans favor providing coverage for everyone over keeping the costs of medical reform down
• 50% feel the government can do a better job then private insurance companies in providing health care
• 59% feel the government can do a better job at keeping costs down then private insurance companies

The President's Proposal

President Barack Obama has made Health Care Reform a major campaign proposal since before his  Congressional election in 2005. He's openly expressed his support for a single payer system, though he has specifically advocated against single payer in his current reform efforts. According to Obama, "our health care system has become a disease care system, and the time for change is well overdue."

Obama's first reform initiatives were actually imposed by the American Recovery and Reinvestment Act (the stimulus bill [summary]):

• Health insurance benefits for people who lose their jobs are now subsidized at almost 65% through COBRA. 
• New funds were also directed towards the computerization of health records and towards research on the effectiveness of medical procedures.

It is important to distinguish that unlike the failed attempt at reform during the Clinton administration, Obama has chosen to lay forth a series of recommendations and to let Congress hash out the details of a specific bill.

Here is a breakdown of the Obama proposal (a full writeup (8-pages) is available here):

• Invest in Electronic Health Information Technology Systems so that hospitals and doctors can maintain electronic medical records with the intention of cutting costs and medical redundancy
• Provide support for disease management programs, and require more cost transparency
• Shift payment to health care providers away from a per-service basis to a more quality-based system in an attempt to value quality over quantity of care
• Attempt to study and combat the disparities in health care for wealthy Americans as compared to lower income families
• Cap malpractice insurance costs for doctors
• Establish a National Health Insurance Exchange to ensure market competition
• Eliminate subsidies to the Medicare Advantage program (Medicare's private option)
• Allow Americans to purchase prescription drugs from foreign markets that charge less
• Prevent drug companies from blocking the use of generic drugs
• Allow Medicare to negotiate for cheaper drug prices (which is currently banned under the 2003 Medicare Prescription Drug Improvement and Modernization Act)
• Reimburse employers for a portion of catastrophic premiums for their employees
• Provide tax credits for families and small businesses to help them afford insurance
• Require all large employers to contribute towards health coverage for their employees or towards the cost of a public plan
• Guarantee insurance eligibility for all, regardless of pre-existing conditions
• Expanding eligibility for Medicaid
• Require all children to be covered with some form of insurance
• Provide incentives for preventative care

Specifically, Obama has also called for a government funded health care option that would compete with private insurers, and has requested that health reform be budget neutral. 

The White House has also made large efforts to provide platforms for people to learn about Obama's Health Reform, including sponsoring live web discussions with officials on on healthreform.gov and even through the White House group on Facebook (live discussions and chats on facebook can be seen here when they happen). 

A detailed map of each state with detailed statistics on the current costs, as well as proposed provisions can be found here: