By MARY LYNN CRAMER

When Senator Chris Dodd (D-CT) announced to the media last week that he has been diagnosed with prostrate cancer, he also commented on the importance of getting annual physical examinations. Good thing Dodd is not on Medicare. Medicare does not provide coverage for annual physical exams. As the leading Democrat on the Senate Health, Education, Labor and Pensions Committee, Dodd is a key player in the plan to overhaul the US health care system. So one would assume he knows that today’s Medicare has no dental coverage; no coverage for eye exams or eyeglasses; no coverage for hearing aids, no coverage for annual physical exams, or foot care.

For mental health services, Medicare participants must pay 50% of an outpatient therapist’s charge. Medicare will cover a “one-time ‘Welcome to Medicare’ physical exam.” However, there is a deductible that must be paid first, as well as a charge equal to 20% of the cost of each and every doctor’s visit or service. Other services and supplies not provided by Medicare include acupuncture, chiropractic services, several laboratory tests, long-term care, orthopedic shoes, prescription drugs, shots to prevent illness, and some surgical procedures given in ambulatory surgical centers (you can see the entire list of “What’s NOT Covered by Part A and Part B” on page 38 of the 2009 edition of the aforementioned “Medicare & You.”) For those items that are covered, there is a charge of at least 20% of the medical provider’s costs, and a deductible that must be met.

Given the reality of Medicare’s inadequate coverage for basic medical needs, why is it that “progressive” Democrats, as well as the “experts” interviewed daily by the liberal media like NPR and Democracy Now, keep saying “what we need is ‘Medicare for all’.” They repeatedly identify Medicare as the successful US “single-payer” program preferred by all its participants.

Possibly these spokespersons for Medicare-for-all, are not intentionally misleading the public. It could be that they don’t know anyone personally who depends upon Medicare for their health problems. Or, maybe they have never read US Department of Health and Human Services booklet entitled “Medicare & You” that sets out all the costs and coverage for participants. However, ignorance is no excuse for perpetuating the myth that Medicare is the model for single-payer health insurance. As a Medicare participant who is FOR single-payer health insurance, let me share a few facts with those who might not be familiar with the current Medicare program.

Most of the senior citizens I know cannot afford to have Medicare alone. To get the medical services the elderly need, at an affordable price, they must purchase---besides paying monthly premiums to Medicare (for Parts A/B)--- an additional private health insurance policy for Part C. This private Part C insurance covers all those things that Medicare will not cover, and there is no deductible and no payment for a % of the doctor’s costs. There is a co-pay for most medical services; as well as a monthly premium. Everyone in my state of Massachusetts (often acclaimed to be the model for national health care reform) is also required by law to purchase prescription drug coverage (Part D) from a private insurance company.

There is no way anyone could say that Medicare by itself is adequate coverage for all. It is not even adequate for the seniors who rely on it. I would like to see the Obamas and members of Congress try to cover their medical expenses with this so-called “single-payer” program. They would never trade the comprehensive coverage they have for Medicare. Medicare needs to be expanded to cover all basic medical needs (set out above). However, that is not in the President’s plan for health care reform.

You have to listen closely to those trying to sell “Medicare-for-all” to hear the underlying message. Listen to what politicians, medical experts and the President say about “cutting waste.” Where do they plan to cut it? From those very supplemental program payments to subsidized private insurance plans that make Medicare workable and affordable for low-income seniors. ABC News reported that there is bipartisan support to “squeeze an additional $35 billion out of Medicare over the next decade and larger sums in the years beyond…a step toward fulfilling President Barack Obama’s goal of curbing the growth of healthcare spending.” (7/28/09 “AP Source: Bipartisan Group Eyes Medicare Savings”)

Yes, Medicare is to be stripped of even more benefits. And the private insurance companies that now provide the supplemental programs, are ready to go along with this. Why? Because the trade off is so much more profitable: mandatory health insurance for all those millions of US citizens not yet insured. Just look at what US Representative Dennis Kucinich, the fearless champion for single-payer health insurance, had to say in a recent interview about private industry’s support for Obama’s proposed health insurance plan:

REP. DENNIS KUCINICH: “Right now what I see is a public plan that gives the insurance companies the option to pick the people’s pockets. As long as you have a public plan, which now is going to be supported by what? Cuts in Medicaid, on the other hand? And undermining benefits to the elderly? Are you kidding me? …Now, I will vote for it, if we can keep the single payer in, because I think it would be worth the price. But without the single-payer provision in it, I don’t know what’s in the bill that would really be worthy of supporting.”

However, there is no “single-payer provision” in the proposed bill, and Obama has repeatedly insisted that his so-called “public option provision” is not a “trojan horse” for single-payer. Kuchinich knows what is coming regarding “undermining benefits to the elderly,” and “cuts in Medicaid.” Will he and other “progressives” nevertheless vote for the proposal supported by Obama and the private insurance companies, if it includes a worthless “public plan?” For a discussion of the difference between “public option” and “single-payer,” and the “progressives” attempts to confuse the two, see the 7/24/09 article by Cook County Hospital clinician Helen Redmond, “The Selling of Single-payer Features.”

Conservatives point out that Dodd, Obama and the House Speaker Pelosi (D-CA), are very critical of the Congressional Budget Office report showing that the proposed health care reform proposals drafted in June would cost at least $1.6 trillion. Dodd called the CBO report “unfair” because, among other things, it failed to take into account “a reduction in funding for elderly care.” (See 7/31/09 article by Joe Emanual, “Obama Disputes Studies Saying Overhaul Will Cost Trillions”). Although there seems to be much confusion and not a little mystery about what exactly is in the 1000 page health care bill proposal, it does appear that most in congress--whether on the “left” or “right” of the issue--believe (1) it will contain no Single-Payer plan worthy of that name, and (2) cost savings for this national health care overhaul will come from cuts in Medicare and medical services for the elderly.

Congress and the insurance companies are not going to fight to improve or protect Medicare coverage for the elderly. It isn’t profitable. We, the citizens in need of adequate and good health care coverage, will have to fight for it ourselves. We need to educate ourselves, each other, and our members of Congress on the immediate need to adequately fund, expand, and protect Medicare for the elderly. Call them, and drop by the home office while congressional representatives are home during the August recess.. See what they actually know about existing Medicare coverage, and what they think of “Medicare for all?” Let them know what you know.

Mary Lynn Cramer, MA, MSW, LICSW, Senior Citizen, has a background in economics and clinical social work, and considerable personal experience with Medicare. She can be reached at mllynn2@yahoo.com

No, I am still PRO free market....

And ANTI-CORPORATISM.....

What seems to be confusing you, is that I AM CONSISTANT, I oppose Corporatism NO MATTER WHICH PARTY DOES IT....

Where you fully support Corporatism when it is done by YOUR TEAM....

And unlike YOU, I dont support putting those who are responsible for the PROBLEMS in charge of REGULATING and OVERSEEING the PROBLEMS that THEY CREATED....you know the old 'fox guarding the henhouse' scenario.

Specialty Laboratories facing state suit over alleged kickbacks

DeParle joined the board of Specialty Laboratories Inc., a California medical testing company, in April 2001. Two months later, lab inspectors caught the company using unlicensed personnel at its Santa Monica site. Officials suspended Medicare payments and threatened to revoke Specialty’s license to operate. The company corrected the deficiencies, but agreed to pay a $700,000 fine in 2002 to resolve the case. DeParle left Specialty’s board in June 2004.

Specialty also is among seven labs sued this February by California Attorney General Edmund G. Brown. The lawsuit, pending in San Mateo Superior Court, seeks to recover hundreds of millions of dollars for the state’s Medicaid program for what Brown termed “massive…fraud and kickbacks” over the past 15 years. The company has denied the allegations. Wendy H. Bost, a spokeswoman for Quest Diagnostics, which acquired Specialty Laboratories in 2007, said its services “were priced appropriately, and we intend to vigorously defend ourselves in the case.”

In every committee when the health care bill was considered, Democrats voted against an amendment that would require members of Congress and their staff to take the government-run public option as their health care plan.

Newt Gingrich on Sunday, August 9th, 2009 in an interview with This Week.

 

Most Democrats are opposed to giving up their health care plans

 

 

To build opposition to a public health insurance option, Republicans have been challenging Democratic lawmakers and White House officials to enroll in the government-run plan.
 
"If Members of Congress believe so strongly that government-run health care is the best solution for hard working American families, I think it only fitting that Americans see them lead the way," said Republican Rep. John Fleming, who is sponsoring a resolution encouraging lawmakers to enroll in the public option, in a statement on his Web site.
 
On the Aug. 9, 2009, episode of This Week , Former Speaker Newt Gingrich told host George Stephanopoulos that Democrats are squarely against the idea.
 
"An amendment was offered in every committee to ... have the members of Congress and their staff in any government option as a mandate. And if this is good enough for the American people, it's good enough for the politicians," Gingrich said. "In every committee, the Democrats voted no. Now, why is it they want to insist on a government-run system for ... people other than the Congress, but the Congress and their staff would be exempt?"
 
We wondered whether Gingrich's vote count was correct. To find out, we sifted through all the health care amendments offered in the House and the Senate committees.

Currently, members of Congress receive health insurance under the Federal Employees Health Benefit Program, which offers plans that range from basic coverage to plans that pay for special treatments and drugs. The system has earned high markets for efficiency, making it one of the models the White House has studied in coming up with its own ideas for health care reform.

It's important to note that under the Democrats' plan, the public option is just one choice that people would have in the health care exchange. The public option would provide basic coverage, but other plans would offer more extensive coverage likely at a higher price. Under the legislation now pending in Congress, no one would be forced to take the public option.

An amendment offered during the House Ways and Means Committee July 16 debate of the bill would have changed all that — but just for members of Congress and their staffs. Nevada Republican Dean Heller offered an amendment that would have required them to take the public plan. His amendment was rejected 18-21, with 21 of the 26 Democrats on the committee voting against it.

On the same day, members of the Education and Labor Committee adopted a resolution — code for "nonbinding" in congressional parlance — by Rep. Joe Wilson of South Carolina that expresses Congress' support that any member voting in favor of the public plan drop his or her federal employee benefits and enroll in the new program. Because the committee approved the resolution by voice vote — meaning members on the panel simply said "aye" or "nay" to express their support for the bill — it's impossible to tell who voted for or against Wilson's amendment.

The Energy and Commerce Committee heard a similar argument from Republican Rep. Roy Blunt of Missouri, who wanted to make the public plan mandatory for the president and the vice president as well as members of Congress. But Blunt's amendment never came to a vote because the Democratic leaders panel ruled it irrelevant to the overall bill.

Senators have been working on their own version of the health care bill, legislation that only the Health, Education, Labor and Pensions Committee has debated so far. On July 14, that committee adopted 12-11 a requirement by Republican Tom Coburn of Oklahoma that would require all members of Congress to enroll in the public plan. Nine of the committee's 12 Democrats voted against it.

That brings us back to Gingrich's claim. He's correct that Democrats in the House and Senate have generally voted against proposals to make the public plan mandatory for members of Congress. Even when Coburn's motion narrowly passed, nine of 12 Democrats voted against it. We can't assess the Democrats' positions on the voice vote in the House education committee or the energy and commerce panel where the motion was ruled irrelevant. So we can't be sure that Democrats voted against it in every committee. But based on the counts that are available, Gingrich's underlying point is correct that Democrats have generally opposed it. So we find his claim Mostly True.

link:[www.politifact.com]

The PLAN is good enough for YOU, but NOT them.......

WHY wont THEY lead the way on this, buy into like they want you Democrats to?

Visualizing The Health Care Lobbyist Complex

How the Democrats sold out health care reform

...

To understand this, Chad Terhune and Keith Epstein's August 6 BusinessWeek cover story, "The Health Insurers Have Already Won," provides essential reading. In it, Terhune and Epstein describe how the major health insurance companies, such as UnitedHealth and Aetna, crafted a sophisticated and strategic approach to shape health care reform to their liking.

Oriented primarily on the so-called "Blue Dog" conservative Democrats, this strategy isn't simply based on the crude legalized bribery by which industry lobbies buy off politicians in exchange for campaign contributions.

In fact, the industry has used its power to provide expertise and research to congressional staffers to assure that it has a major role in determining the problems that health reform is meant to address and the solutions that are being proposed. Pro-industry research is driving the reform debate in Congress, and the end result will be a health care bill with an industry seal of approval on it.

If this kind of industry influence might be considered the soft touch, the health insurers are also willing to bring down the hammer if necessary. Terhune and Epstein focus primarily on the role of UnitedHealth, the largest health insurer in the country, showing how the company has catered to members of Congress with seemingly reliable actuarial projections, and fact-filled PowerPoint presentations. "This puts a halo on us," Terhune and Epstein quote a UnitedHealth corporate flak as saying about one of its congressional outreach efforts. "It humanizes us."

These efforts are nothing like the nefarious role of the Lewin Group, an industry front group whose suspect research has abetted conservative propaganda against publicly funded health insurance, right? Liberal MSNBC cable show hosts Keith Olbermann and Rachel Maddow have called out the Lewin Group for producing corporate propaganda masquerading as research.

One problem with this picture, though: UnitedHealth owns the Lewin Group. So there you have it: the health insurers, not to mention Big Pharma, the hospital lobby and the rest, have health reform coming and going.

In fact, one might even describe this as bipartisanship in action: while the Lewin Group provides the GOP with its talking points, UnitedHealth and their friends are supplying congressional Democrats with theirs.

link:[socialistworker.org]

Lawmakers Reveal Health-Care Investments
Key Players Have Stakes in Industry

By Paul Kane
Washington Post Staff Writer
Saturday, June 13, 2009

 

Almost 30 key lawmakers helping draft landmark health-care legislation have financial holdings in the industry, totaling nearly $11 million worth of personal investments in a sector that could be dramatically reshaped by this summer's debate.

The list of members who have personal investments in the corporations that will be affected by the legislation -- which President Obama has called this year's highest domestic priority -- includes Congress's most powerful leaders and a bipartisan collection of lawmakers in key committee posts. Their total health-care holdings could be worth $27 million, because congressional financial disclosure forms released yesterday require reporting of only broad ranges of holdings rather than precise values of assets.

Senate Majority Leader Harry M. Reid (D-Nev.), for instance, has at least $50,000 invested in a health-care index, and Sen. Judd Gregg (R-N.H.), a senior member of the health committee, has between $254,000 and $560,000 worth of stock holdings in major health-care companies, including Bristol-Myers Squibb and Merck.

The family of Rep. Jane Harman (D-Calif.), a senior member of the House Energy and Commerce Committee drafting that chamber's legislation, held at least $3.2 million in more than 20 health-care companies at the end of last year.

The reports come on the eve of what is sure to be a dramatic health-care debate in Congress, beginning with a key Senate committee hearing Tuesday. With several proposals floating on Capitol Hill, the legislative battle could overhaul an industry that represents nearly 20 percent of the national economy.

While no congressional rules bar members from holding financial stakes in industries they regulate, some ethics experts suggest that it often creates the appearance of a conflict of interest, particularly if there is a chance that the legislation could result in a personal financial boost.

"If someone is going to be substantially enriched by the consequences of the vote, particularly if it represents a meaningful amount of their net worth, then there is a problem," said Harlan Krumholz, a professor of medicine at Yale University. "This is such important legislation that you don't want to be tainted by any conflict."

But many legal experts say the health-care industry is so predominant that it is impossible for lawmakers to avoid financial ties to that sector, suggesting that the best antidote is a clear disclosure system that makes every lawmaker's finances publicly available. Robert L. Walker, a Washington lawyer and former House and Senate ethics counsel, said that in many cases, members of Congress are "simply one of perhaps thousands or more" investors in a single corporation and such investments are not "prohibitive conflicts."

In many cases, the lawmakers' health-care holdings represent a small fraction of their assets. Harman, whose husband, Sidney, is the founder of electronics-maker Harman International Industries, is one of the wealthiest members of Congress, with a minimum net worth of almost $120 million.

The new data come from yesterday's release of financial disclosure forms for the House and Senate, though most of the House forms were accidentally posted online Wednesday, and subsequently the data were captured and posted online by congressional watchdog LegiStorm.

The first big congressional moment on health care comes Tuesday in the Senate's Health, Education, Labor, and Pensions Committee, which will consider a liberal-leaning proposal that includes the creation of a "public plan" meant to be a government-administered alternative to private health insurance.

On that 22-member panel, at least eight senators have financial interests in the health-care industry worth a minimum of $600,000 -- and potentially worth as much as $1.9 million. The investors include Sen. Johnny Isakson (R-Ga.), a senior member of the panel, who holds at least $165,000 in pharmaceutical and medical stocks, and freshman Sen. Kay Hagan (D-N.C.), who holds at least $180,000 in investments in more than 20 health-care companies.

The hearings will be led by Sen. Christopher J. Dodd (D-Conn.), who is filling in for Sen. Edward M. Kennedy (D-Mass.), the committee chairman, who is battling brain cancer. Dodd's wife, Jackie Clegg Dodd, serves on the boards of four health-care companies, receiving more than $200,000 in salary and stock from her service in 2008, according to the Associated Press.

Dodd's aides say his wife's financial interest will not have any impact on his leading role in the health-care debate, noting that she is not a lobbyist and has never represented clients before any branch of the federal government.

"Jackie Clegg Dodd's career is her own; absolutely independent of Senator Dodd, as it was when they married 10 years ago," Bryan DeAngelis, Dodd's spokesman, said in a statement. "The senator has worked to reform our health care system for decades, and nothing about his wife's career is relevant at all to his leadership of that effort."

Reid's aides also said he could be a fair arbiter of the legislative debate, pointing to a letter enclosed in his disclosure from his investment manager at Wells Fargo declaring that neither the senator nor his wife has any role in choosing financial moves. "All decisions on purchases, sales and retention of assets in the above mentioned investment management accounts . . . were made in the sole discretion of Wells Fargo Bank, N.A., without input from Harry and Landra Reid," the letter said.

Later this month the Senate Finance Committee will take up the debate, with at least a half-dozen senators on the panel holding stakes in health-care companies. Sen. John F. Kerry (D-Mass.) and his wife, ketchup heiress Teresa Heinz Kerry, hold at least $5.2 million in companies such as Merck and Eli Lilly.

Sen. Michael D. Crapo (R-Idaho), one of the few lawmakers who listed the specific values of his stock holdings, held $16,879 worth of stock in companies such as St. Jude Medical at the end of last year.

Health care is not the only industry that is both heavily regulated by Congress and heavily invested in by lawmakers. As The Washington Post reported Thursday, more than 20 members of the House leadership and the House Financial Services Committee hold investments in companies that received more than $200 billion in federal bailouts.

On the Senate banking committee, at least a half-dozen senators had significant investments in companies that benefited from the $700 billion bailout legislation that the panel helped draft last fall. Sen. Charles E. Schumer (D-N.Y.) reported $18,000 to $95,000 in investments in Freddie Mac and Fannie Mae bonds, and also that he sold at least $15,000 in Fannie "step-up" bonds at the end of last year. The committee's ranking Republican, Sen. Richard C. Shelby (Miss.), reported holding $260,000 to $850,000 in money market and retirement accounts with Countrywide, Citigroup and Wachovia.

Staff writers Dan Eggen, Garance Franke-Ruta, Carol D. Leonnig, Sarah Lovenheim and Ben Pershing, along with research editor Alice Crites, staff researcher Madonna Lebling and graphics editor Karen Yourish, contributed to this report.

Will $1.2 Million a Day Convince Congress to Buy Big Pharma's Rx for Change?