Thursday, August 13, 2009

David Axelrod on Healthcare Insurance Reform

Flo & Bo haven't yet taken advantage of guest bloggers, and this piece on healthcare insurance reform, like the package itself, is a hybrid.

The actual bill is 1,000 pages long, tough reading even for wonky wonks. So I'm passing along some information I received this morning from David Axelrod, a senior adviser to President Obama.

Mr. Axelrod is the father of a 25 year old daughter who suffers from severe epilepsy. Prior to the advent of the newest epilepsy drugs, his daughter experienced daily seizures so severe that she suffered brain damage. She's only now beginning to have stable, quiet brain, and the Axelrods are discovering what her true abilities and potential may be. (This wasn't in Mr. Axelrod's e-mail- it's information I read a few months ago when Newsweek did a special report on epilepsy.) I think it's important information to know because unlike members of Congress and other long-term governmental employees, Mr Axelrod knows first-hand what it means to battle for coverage and live in fear that a family member might not get needed care.

I'm a parent who has faced concerns like these. And while I can't know or understand every single nuanced thing in the healthcare insurance reform bill, I'm very sure that Mr. Axelrods's concerns align very closely with mine. The concerns I worry about, now and in the future, look a lot like the Axelrod's, not because I have a severly handicapped adult child. But because I could. Any one of us could face a catastrophic illness or event that forever changes our ability to secure healthcare in the system we currently have.

You should base your decisions about whether reform measures are good things or bad things for you, your family, and your country based on the changes that are proposed. It's helpful to remember that making healthcare affordable for everyone makes you safer, too. Without vaccines, some members of your Bible Study group will die. Some children in your kid's Girl Scout troops will too. Having basic, affordable healthcare for all citizens is not the same as subsidizing everyone's luxury vacation. Nor does it mean pulling the plug on Grandma.

Be wary of rumors and ideas that are circulating but are NOT part of the bill before the Congress. The only things that can become law--and affect you and your healthcare--are the items that are addressed in the bill itself. is a good site for learning what is true, partially true, and not true at all. You should check on the things that don't seem right to you. Be sure any information that concerns you is in context. Beware of short, scary soundbites. Look to see who said it, when, and if it makes sense to you when you have all the facts.

These points explain what will change if the Congress passes the reform measures that are before them. I've used them to evaluate the proposed changes and form my decision to support the bill before Congress.

From Mr. Axelrod's e-mail:

8 ways reform provides security and stability to those with or without coverage

1. Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.

2. Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.

3. Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.

4. Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.

5. Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.

6. Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.

7. Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.

8. Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won't be allowed to refuse renewal because someone became sick.

Learn more and get details:


Anonymous said...

I like all the reforms. What I question is the methodology for generating the reforms. Why can't we add thousands and thousands of private health insurers, with the reforms mentioned, and skip the government insurance? If there is a good answer to this question I would find myself feeling a little less skeptical.

Barbara Olson, MS, RN, FISMP said...

Seems like we're not short of a free market insurance at this point. I can't picture how my kids are going to fit into anyone's "desirable, open-market" pool. As I understand it, competition from the feds will make private insurers have to achieve profitability using a random risk pool (not the tightly filtered one they can currently construct).

TJL said...

The more I see the lack of evidence and logic that lies behind most of the reform opponents' scary messages, the more I hope congress finds the spine to ram, if necessary, these reforms through. The reforms are already being diluted in the interest of placating the shrill voices of opposition. I'm all for "bipartisanship", but when one side's position is based purely on myths and fear, it becomes time to just get it done. The time is now.

Reality Rounds said...

I am sick (pun not intended) to death that the senate finance committee has left out end of life decision in the health care bill. We are a bunch of cowards in this country.

Anonymous said...

In terms of the "scary" stuff said about the "death panels" apparently there was somthing on pages 425-430 which the Senate Finance Committee hurriedly removed before its recess. With respect to Barbara's comments on "free market insurance", I am not sure we have a free market insurance system right now. I am trying to suggest that we fix what is broken in private insurance with legislation, minus the government insurance option and push prices down in this manner. If the government can't run a used car program properly, how can we expect them to run health care properly? We need health care reform no doubt, but without doing it through a centralized government. Politicians are just not credible. For example FDR introduced Social Security promising it would be voluntary, would cost only 1 percent of the first $1,400 of income, the money paid in would always be tax deductible, it would remain in a Retirement Trust Fund and never be spent for anything other than retirement benefits and those annuity payments to retirees would never be taxed as income. In 1958 Social Security set asides were moved to the general fund and in 1993 we lost our income-tax deduction and we now pay taxes on 85 percent of the money we paid into the system even though we'd paid taxes on it when it was earned! This is your central government at work. By the way all this happened under Democratic congresses.(I am registered as an independent as I believe party politics are fading away in favor of internet influences like this blog). I agree with President Obama that this is NOT a public takeover but rather a public option. What I disagree with is that the public option will not have the behaving influence that is intended and reforms will fail because the wrong mechanism was used. Central planning is being introduced in increments, all in the guise to benefit citizens. Thomas Jefferson said, "A government big enough to give you everything you want, is strong enough to take everything you have." Put the reforms burden on private insurance and flood the market with many insurance companies so that risk pools are made less expensive with the law of large numbers. Super charging the feds is the wrong road to take with needed reforms.

Reality Rounds said...

Tom why is it OK to announce failed government programs, aka Cash for Clunkers, and not also name some enormous private sector fails that have actually ruined people's lives and health? Would you rather trust Enron, Lehman Brothers, Country Wide, Haliburton, or the Chicago Cubs to your health care? I work in the cluster f*ck (sorry Barb) that is health care, and we need a public option. It is not perfect in other countries, but it does work. I am not sure how throwing more sh*t (sorry Barb) at the fan, ie a bunch of independent private insurers, will solve anything.

Barbara Olson, MS, RN, FISMP said...

I've just been having so much fun over here that I decided to see what more I could do by continuing the insurability issue over at On Your Meds (which may need to be renamed Stay On Your Meds or Get On Some Meds, assuming you are insured and can afford some).

Medscape made my blog public, so you should be able to read at least part of the post without registering. If you need to register, it's pretty low-hassle and I recommend doing so.

People should discuss these issues. But the death panel thing has been thorough debunked. Here's a link to a piece where the topic and intent of the measure included in the bill is explained by my very own (blood) red-state Senator, Johnny Isakson:

Anonymous said...

To reply to David Axelrod, the "private" insurance that you comment on so derisively is the best system in the world hands down. I put private in quotes because it does needs fixes. I just don't want to fix it with Obama Care. For example our system produces infant mortality which is is higher here than Sweden for example but that is to be expected from a population of 300 million people. (We do better when we reach 80 with mortality than anybody else because of our system). Look at it this way. To compare us with populations of 9.2 million, (Sweden), 30,000 (San Marino), and 82 million (Germany), with America's I submit that their systems may work because of the homgeneity of their populations and therefore the small number of different risk groups. That won't work here! Our population of 300 million is too big and diverse. I respectfully suggest that if you are in the medical field, stick to what you do best. A great chef does not necessarily know how to run a restaurant and a medical person does not necessarily know how to run health insurance.
The other disturbing part of this debate is that the people in charge, Obama, Pelosi, and Reid aren't even discussing other solutions that could work without the single option insanity. They are ruining the Democratic party in the process. From a bureaucratic socialistic angle the British health care system is the third largest employer in the world behind the Chinese Army and the Indian rail system! Britain's population is half of ours. Think of how many people Obama's single option healthcare will employ as bureaucrats and while you are thinking about it think of how well Medicare runs right now with its bureaucrats. It runs like crap despite years and years of "fixes and improvements" made by government.
We can't undo this once it is in place by electing different people to office. So lets not do it the single option way to begin with. Use government as a check and balance on private insurance and some of those other big companies you mentioned and things will work out much better for my daughter 30 years from now.

TJL (another Tom) said...

It's amazing to me how quickly the lemmings follow the soundbites: "Government is always bad.... everything the government towuches...." blah blah blah, without a MENTION of the catastrophes meted on the world by an unrestrained "free" market. Need an example? How about 1929, and, well, let's see... maybe, 2008???
Give it a rest, Tom - or better yet, give it some thought. All the complaints about healthcare are about the current, privately-run "system" which is no system at all. Profit-driven organizations determining human outcomes. The pure private system has failed, and that's why we're in this pickle. Time to put away the shovel, and put a door on the microwave.

Anonymous said...

Hi TJL. I just heard today that Mr.Axelrod may be embroiled in some sort of corruption scandal directly tied to health care reform. Yes the health care system is broken but it can be repaired without the government running it. Corruption in the public or private sector gets fixed with checks and balances. Yes there is corruption in the private sector. I admit that. Will you admit that the post office is bankrupt, government raided the social security lockbox, and medicare is bankrupt? Why do you worship at the holy grail of 'government can help me'or 'government can fix it' when they have NEVER got it right in yours or my life time TJL? Government and its solutions are broken no matter who is in charge, Bush or Obama. The private sector can do anything better and faster than government. Many who are calling names at the healthy debaters for questioning the wisdom of the government option of the bill, will regret that they ever supported this bill.

Anonymous said...

I love the changes that the Senate's version, "The Affordable Health Choices Act" make to financing the bill. "The Congressional Budget Office 'estimates' this proposal will cost $615 billion over 10 years". The House version from the House Tri-Committee, "America's Affordable Health Choices Act of 2009 (H.R. 3200) "estimates the net cost of the proposal (less payments from employers and uninsured individuals) to be $1.042 trillion over ten years." The House expects to pay for half of this with cost savings in Medicare (laughable) and a surcharge on individuals making $280,000 per yer or more. Now, I know that most people who make this amount more or less will be smart enough to stop working at the $279,000 mark eventually. So doesn't this point to a system that will be bankrupt less than 15 years from now? (I'm being generous). My sources for this entry are Http:// and Http://
The bottom line is who is going to pay for the free universal health care? Where will the doctors and nurses come from after the existing ones get tired of working for free? It doesn't work in any of the other industrialized nations. That is why America's health care delivery system is the envy of the world. People come from all over the world to get procedures done here, including Canada. Lets fix this problem without the federal government option people. I know we can do it. Comments please. No chanting mantras or name calling would be appreciated. The collectivists and other assorted liberals are excused from this request as they can't help it. My request is mainly directed at the 'politically mature' medical elites who don't know what they are getting into. Like I said folks, a great chef doesn't necessarily know how to run a restaurant and a great medical professional doesn't necessarily know how to run an insurance program.

Reality Rounds said...

"That is why America's health care delivery system is the envy of the world. People come from all over the world to get procedures done here, including Canada."
Yes, Canadians,Swedes, Danes, Irish, Scots, etc, are so envious of America's 47 million uninsured, daily medical bankruptcies, American companies moving to foreign lands because they can not afford American health care, real live human beings waiting until they are deathly ill until they seek treatment in the overburdened ER because they can not afford primary care. Small businesses having their insurance rates go up 40% in one year (that would be my husbands company). The rest of the world is green with envy at our high infant mortality rates. Which BTW, are the best indicator of a health of a society. Please don't pin infant mortality on "large and diverse" populations. We are still the richest country in the world, last time I checked, and allowing infant's to die because health care is so lacking in poor communities, is shameful. Make no mistake that the foreigners who come to the US for our, agreeably, state of the art health care, are wealthy. Very wealthy. Just like the wealthy in America don't have to worry about paying for procedures, neither do these people. That means nothing to me.
So who is going to pay for universal health care? I am, you are ,we all our. I am fine with paying more to take care of my fellow man/woman. (and I do not make near the $280,000 mark). America spends way more on health care than any other industrial nation. In a few years health care spending will be 40% of our GDP. Costs need to be reigned in, without all the scare tactic nonsense of "death panels." Yes, I may be a lowly "medical elitist" who knows not what she does, but I still support, as does the American Nurses Association, a public option for health care. Silly me.

Creative Commons License
Florence dot com by Barbara Olson is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.