Consumer Power Report #189

Published August 7, 2009

I sent a copy of the last newsletter to the White House hall monitor that wants to know if there is “anything fishy” going on out there. I explained in a cover note that I was trying to save them the trouble of waiting for one of their snitches to pass it on.

I would encourage you to do the same. Let’s make sure the White House is fully apprised of all the fishiness by flooding them with copies of CPR and anything else you might think of. If they want to see something really fishy, you might want to attach a copy of H.R. 3200 and send it to [email protected].

But what is the thing this administration has with fish? First, chief-of-staff Rahm Emanuel is famous for sending dead fish to his political opponents, and now this. Curious.


IN THIS ISSUE:


THE BATTLE OF IDEAS?

There is so much going on out there in the world that it is hard to stay on top of it all. One great resource are the blogs by my colleague Jeff Emanuel (no relation to Rahm). He is keeping track of all the political back and forth.
Jeff Emanuel’s Blog

Red State also published a video of an AARP meeting in Texas where the AARP representative said this was “a listening session because we want to hear from you.” But when the audience began to speak she didn’t like what she was hearing and tried to close the meeting. Wow.
Texas AARP Meeting

Reason Foundation put together a video explaining just how fishy all the opposition to ObamaCare really is.
Reason Foundation

CBS News featured the town hall meetings in a report that also interviews FreedomWorks’ Max Pappas. The report notes that some of the most vehement rallies are in heavily Democratic districts. This is an excellent discussion and it reminds me of what journalism is supposed to be about.
CBS News

Just one more video to share. This is Dr. Tom Price (R-GA), a Member of Congress on the Education and Labor Committee, making a heartfelt and serious statement to the rest of the committee.
Tom Price


THE TOLL ON PUBLIC OPINION

This is all taking a toll on popular support for ObamaCare. Bloomberg reports on the latest Quinnipiac University survey that shows, “President Barack Obama’s approval rating is falling amid concerns about the U.S. economy and his push to revamp the U.S. health-care system”

It was a big survey with 2,409 respondents and it found 50 percent now approve of the president’s performance and 42 percent disapprove. That is down from 57 percent and 33 percent in late June, an incredible drop in just a month. The article goes on to say, “The poll found that voters disapprove of the way Obama is handling the economy by 49 percent to 45 percent. On his effort to overhaul of the health-care system, 52 percent disapprove of his handling of the issue while 39 percent approve.”

SOURCE: Bloomberg

Rasmussen published a poll that found, “Forty-eight percent (48%) of U.S. voters now rate the U.S. health care system as good or excellent (while) just 19% rate it as poor. This contrasts with this past May when 35% rated it as good or excellent and a year ago when only 29% said the same. Interestingly, the survey finds a huge partisan divide on the issue, but independents are even more likely to rate it positively than the national average, at 59%.”

Obviously the health care system itself hasn’t changed much in this time, but people are beginning to appreciate what they have when faced with the current alternatives.

SOURCE: Rasmussen

The Gallup organization put together a “Top Ten Takeaways” from its recent polling that is a very useful summation. It finds:

1. Most Americans do not believe that the U.S. healthcare system is in a state of crisis.

2. Americans are not convinced that healthcare reform will benefit them personally.

3. Americans agree that healthcare costs are a major problem for the country.

4. The push for healthcare reform is occurring in an environment characterized by high levels of concern about fiscal responsibility, government spending, and the growing federal deficit.

5. Americans have relatively little confidence in Congress.

6. Americans continue to have more confidence in President Obama on healthcare issues than in either the Democrats or Republicans in Congress.

7. Americans have mixed or ambivalent views of the role government should have in healthcare.

8. On a case-by-case basis, Americans favor many specific proposals that have been put forth as ways of reforming healthcare.

9. Americans appear ambivalent at this juncture on the overall merits of passing a broad healthcare plan.

10. All in all, while the majority of Americans ultimately favor passage of healthcare reform, many are willing to wait until next year to see it happen.

There is plenty of more-specific information and qualifications under each category, including the conclusions that, “Americans also appear dubious about the benefits of what they perceive to be less-than-fully-informed representatives in Washington rushing into a new healthcare reform law when the need for such legislation is not the highest on the public’s agenda.”

SOURCE: Gallup


DRILLING DOWN

Drilling down into the debate, American skepticism is well founded, as reflected in two recent reports by extremely well-respected researchers, Steven Parente and Ronald Bachman.

Steven Parente is an economist at the University of Minnesota and a principal of HSI Network, a health economics research firm. He wrote a short article for the Manhattan Institute’s City Journal in which he estimates the real cost of the House and Senate bills currently on the table would be about double what CBO estimates. He writes, “The CBO is actually being kind to the would-be reformers. Its analysis likely understates–by at least $1 trillion–the true costs of expanding health coverage as current Democratic legislation contemplates.”

How can that be? Parente explains, “The discrepancies between our estimates and CBO’s stem from our different assumptions about a key issue.” CBO estimates only 11 million people would switch from private coverage to a “public option,” while Parente (and other researchers such as the Urban Institute) estimate it would be more like 40 million.

He further explains, “Why the difference in these estimates? We believe that we have better data on this issue than the CBO, which uses simulation models of health-insurance plans based on much older health-plan data–typically from 2001 or even 2000. Our estimates are grounded in 2006 commercial-insurance data to which the CBO doesn’t have access.”

The market and the available data have changed significantly between 2001 and 2006, largely because of the advent of health savings accounts and other forms of consumer-driven health. We now know a lot more about how people respond to lower-cost coverage options than we did in 2001.

Parente concedes that both estimates are just that — estimates — and could be wrong. However, “If the House or Senate bill passes, we should know who’s right by 2014-15, shortly after the bills take effect and costs start to explode.”

SOURCE: Parente

Ron Bachman is an actuary with the Center for Health Transformation. He writes, “health reform in Washington has never been about health or healthcare. It is about power.” The prospect of controlling $2.5 trillion in annual spending is delicious for Members of Congress who want to pass out goodies to their friends (and campaign contributors).

He points out that the federal government is already in control of half of all health spending in the U.S. “Yet, these government controlled programs exemplify out of control spending, waste, fraud, abuse, and the lack of modern technology that the president so confidently states that the federal bureaucracy will change once all healthcare is under their control.”

He says, “If improving health and controlling healthcare costs was the goal, why would the president and Congress ignore the non-partisan study by the American Academy of Actuaries which identified an approach (Consumer Driven Health Care) where ‘total savings generated could be as much as 12 percent to 20 percent’ and future ‘trend rates (are) lower than traditional plans by approximately 3 percent to 5 percent.'”

He concludes, “Mr. President, show the country, employers, and voters how to successfully implement health reform before the 180 million with private health insurance who are moving towards healthcare consumerism suffer from your political Hellth Reform.”

SOURCE: Bachman


CONSUMER-DRIVEN HEALTH STILL ROLLING

As ObamaCare comes crashing down, we have to show folks there is a better way. Fortunately, there is in fact a better way, and the evidence is piling up that consumer-driven care not only works to save money and improve health, but is growing in popularity as well.

I had an op-ed published in Press Enterprise in Riverside County, California, headlined, “Power to the Patient.” I write, “While Congress chases one unproven idea after another to lower costs and improve Americans’ health care, it is ignoring the one approach that has been absolutely proven to work: consumer-driven health care.” It goes on to lay out the evidence for how well this approach is working.

SOURCE: Press Enterprise

CAHI has published a short paper by Roy Ramthun covering much of the same ground, “Only Consumers Can Bend the Cost Curve.” He also ticks through the evidence and concludes, “These results should not be surprising. Consumer driven health care is bending the health spending curve because it gets people more actively involved with their own treatment, and no one is more concerned with their own treatment than people who are ill.”

SOURCE: CAHI

The Atlanta Business Journal reports, “Consumer-driven health plans’ popularity (is) rising.” Staff writer Lisa Schoolcraft writes, “The reason CDHPs gained popularity is ‘because everyone was looking for an answer to gaining control over health-care costs and nothing else has worked,’ said Tony Holmes, principal at consulting firm Mercer LLC’s health and benefits division.” She quotes a number of benefit consultants who say the plans are working because they lower costs by changing behavior.

SOURCE: Atlanta Business Chronicle

Plan Sponsor Magazine reports, “A gloomy economic forecast could prove to be a sunny future for the health-care consumerism trend as more employers seek lower-cost solutions.” The article by Bruce Shutan cites Regina Herzlinger as predicting, “that consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs) will grow substantially in number because of the recession and rising uninsured population, which, in turn, will lower rate increases as the market becomes more competitive.”

The article goes on to quote several other experts including Paul Fronstin, Jay Savan, and me. It writes, “Scandlen praises Whole Foods CEO John Mackey for meeting with all of his employees, walking them through the numbers, and helping foster understanding about what sort of choices the company faced. He suggests that the employee communications investment be made at least six months to a year in advance of the rollout date so that people have enough time to develop an understanding of the consumerism concept.”

SOURCE: Plan Sponsor Magazine


RATIONING

Fox News ran a story quoting Dr. Ezekial Emanuel (Rahm’s brother) as saying treatment should be denied to people “who are irreversibly prevented from being or becoming participating citizens. An obvious example is not guaranteeing health services to patients with dementia.” The story goes on to interview Dr. Samuel Fink who says such a policy would be “absolutely horrible”; he says he would stop being a doctor under such a regime.

SOURCE: Fox News

Emanuel’s point of view is no longer considered controversial among the elites of this country. A few weeks ago the New York Times Magazine ran a major article on “Why We Must Ration Health Care.” I won’t go into the article here, except to note that is was written by the execrable Peter Singer — the Australian “bioethicist” recruited by Princeton University who believes (really) that a squirrel’s life is worth as much as a human’s and that defective children should be killed up to the age of two.

That such a man has any credibility at all is mind-boggling. That one of the most prestigious universities in America would pay him mega-bucks for spouting such drivel is staggering. And that his thoughts on rationing would be taken as unremarkable by commentators in the Atlantic and the Daily Kos is frightening.

One of his arguments — that “rationing” will always be done one way or another — is basically correct. But it is also the strongest possible argument against any kind of national system of financing health care. Such a system means that “we” (society) will make collective decisions on who is worthy of living and who is not.

Without such a system “we” (each) are free to choose a health program that comports with our individual values. That means I may want to spend more money on coverage so that my handicapped infant or elderly grandmother will be well-cared for in their times of need. If YOU, on the other hand, are too cheap to pay for that, good luck. But why should I be saddled with YOUR choices?

SOURCE: Peter Singer in the New York Times


READER RESPONSE

Greg,

I read through your comments and info as fast as I could tonight and marveled at what is unfolding and taking place in the country. While I may be part of a number of special interest group — conservative and down to earth in fairness and integrity, I dislike the egregious and blatant lying and deceiving posturing that is for the most part taking place in Washington.

As a registered nurse, disabled but still working in the field, I can say this is one very serious situation. The Obama health care proposal is the exact opposite of what we should have in place or even attempt to touch.

His plan comes down to one thing — RATIONING. Costs to cover everyone will mean cutting out bits and pieces of the health care system as we know it.

I care for the disabled and poor. Their needs are just as important as our President’s and Congress’s needs. But in the infrastructure of his plan are the means to cut out services for those who are considered a “burden” to/for the system. The infirm, the deformed, the elders, and anyone who cannot contribute to the country’s well being are being targeted. What’s good enough for us is not good enough for them. How dare we suggest such a thing!

The thousand-page document also has quite a few special interest groups that are supported through creative language and interpretation. One such group, Planned Parenthood, will be revived and add their contributions to the demise of those who cannot speak for themselves. Check out www.StopTheAbortionMandate.com and see where a gigantic amount of money would be spent to not only snuff out life but to disconnect our country’s family structure.

I could go on and on, but you have the means to pass on what needs to be said. Keep doing it — all angles as you can. We have one month – August – to pull in our legislators and show them the real thing!

Eloise Schwarz, RN-BC, MBA, CCM
[email protected]

Dear Greg,

Washington is about to build an electronic health system that gives industry and government the right to use our health records without consent. Make it clear: Americans want progress with privacy!

Tell the folks making our health records digital: “Ensure My Privacy is Protected! Don’t use tax dollars to buy primitive electronic systems that prevent us from controlling our sensitive personal information.”

Sign this petition so meaningful and comprehensive privacy protections are required for all electronic health records and patients have a seat at the table.

Requiring that we control who sees our personal health information is essential to trust electronic health records. The Health IT Policy Committee needs to hear from us. Please sign the petition NOW to send them our strong recommendations for privacy.

Thank you,

Deborah Peel, MD
Founder & Chair

Ashley Katz
Executive Director