Welcome to DU! The truly grassroots left-of-center political community where regular people, not algorithms, drive the discussions and set the standards. Join the community: Create a free account Support DU (and get rid of ads!): Become a Star Member


eridani's Journal
eridani's Journal
July 30, 2013

Happy Birthday Dear Medicare! Happy Birthday to You!

You can watch the Medicare 48th Birthday Celebration in Seattle on YouTube now at

Stop! in the name of health
Don't take our Medicare!

(to a very well known tune. Although we were probably less The Supremes than The Postmenopausal Female Tenor YaYa Sisterhood)

Hey there Congress, we know just where you’re going
When you talk about cutting down our spending
We know you’re lying to our nation
To try to cut our health and education

This time don’t treat us like dirt
Leaving us sick and hurt
Think it over
Think it over

Stop! in the name of health
Don't take our Medicare!
Stop in the name of health
Don't take our Medicare!
Think it over
Think it over

We know that you’ve pretended to be nice
We even fell for it maybe once or twice
Are all those corporate donations
Worth more than our health and education?

But now we’re up in arms
And we’ll resist your charms
Think it over
Think it over

Stop! in the name of health
Don't take our Medicare!
Stop in the name of health
Don't take our Medicare!
Think it over
Think it over

We’ve tried so hard, so hard to be patient
Hoping you would stop this desecration
Each time that Congress gets together
We’re afraid of losing Medicare forever

Stop! in the name of health
Don't take our Medicare!
Stop in the name of health
Don't take our Medicare!

July 26, 2013

Medicare Rights Joins Congressional Briefing on Medicare Cost Sharing

Earlier this week, Joe Baker, president of the Medicare Rights Center, participated in a Congressional briefing sponsored by the Alliance for Health Reform and the Kaiser Family Foundation on proposals to restructure Medicare cost sharing. The panel discussed multiple proposals to streamline the Medicare benefit structure, including:

•combining the Medicare Part A and Part B deductibles;
•introducing copayments or coinsurance for specific services;
•prohibiting or limiting “first-dollar” supplemental coverage;
•adding an out-of-pocket spending cap to Original Medicare; and/or
•further income-relating Medicare deductibles, premiums or out-of-pocket caps.

The message was simple—pursued for the purposes of reducing the deficit or saving costs, efforts to redesign or simplify Medicare cost sharing would shift costs to most people with Medicare. Mr. Baker spoke about the known risks of increasing health care cost sharing, including decades of research demonstrating that added out-of-pocket costs cause people to forgo both needed and unneeded care.

In short, imposing financial hardship on those who cannot endure added costs would leave many people with Medicare with no choice but to self-ration health care. It would put the health and economic security of older adults and people with disabilities at risk—risk that is most pronounced for people with low, fixed incomes and those with high and persistent health care needs.

Read the briefing summary.

Watch the briefing on C-SPAN.

Read Medicare Rights’ press release.

July 25, 2013

How Much Could Medicare for All Save You?


The Motley Fool

But could it be that the ACA isn't really needed at all? Could an alternative idea -- "Medicare for all" -- actually do a better job of controlling medical costs, and making health care affordable for Americans?

Harvard Medical School visiting professors David Himmelstein and Steffie Woolhandler recently noted on the pages of The New York Times that a Medicare-for-all health care system -- known commonly as "single-payer" --is an incredibly efficient operation, in terms of costs.

On average, only 2% of the revenues that flow through Medicare are needed to cover overhead costs. In contrast, patients who subscribe to private health insurance spend 14% of their money -- seven times as much -- just paying for the overhead costs doctors incur from juggling the multitude of insurance procedures required for different patients subscribing to insurance plans.

In contrast, the U.S. government itself agrees that the ACA -- the system we've settled upon instead of offering Medicare for all -- costs more than a move to a cheaper, more efficient, and better single-payer system. The U.S. Government Accountability Office calculates that a switch to single-payer would shave $400 billion a year off the national health-care bill.

Little wonder, then, that a 2008 survey published in the Annals of Internal Medicine found that 59% of physicians polled support Medicare for all.

If an individual consumers think they're better off with a private health insurance plan from WellPoint -- or from UnitedHealth Group, Aetna, or Cigna -- then fine. They could still sign up for one of those, either as a supplement to Medicare-for-all or, if they prefer, as an exclusive plan, and choose not to participate in Medicare at all. For that matter, there should be no need to require anyone to buy any insurance whatsoever.

About The Motley Fool

The Motley Fool is a multimedia financial-services company dedicated to building the world's greatest investment community. Reaching millions of people each month through its website, books, newspaper column, television appearances, and subscription newsletter services, The Motley Fool champions shareholder values and advocates tirelessly for the individual investor. The company's name was taken from Shakespeare, whose wise fools both instructed and amused, and could speak the truth to the king -- without getting their heads lopped off.

Comment by Don McCanne of PNHP: This article is truly remarkable because of its source. The Motley Fool "champions shareholder values and advocates tirelessly for the individual investor." Although they didn't get everything right (they would include private insurance options and would have no requirement to even be insured), nevertheless this is a particularly strong statement for Medicare for All from a Wall Street source that is just now joining the parade.

Perhaps even more remarkable are the comments posted in response to this article. Considering that these comments are from the investment community, there is strong support for Medicare for All. Inevitably, as with most comment sections, there is a representation of ill-informed, ideologically-driven and sometimes belligerent comments, but those can be ignored.

We should take home from this the lesson that many in the investment community understand that Medicare for All really does make sense from the business perspective. We should tailor our message accordingly.
July 17, 2013

Insurers continue to game the ACA

The Wall Street Journal


Since insurers can no longer pick and choose their customers, they will employ a range of subtler tools, including marketing campaigns and carefully designed plans aimed at the customers the insurers most want.

"They want to attract the right risk," said Siva Namasivayam, chief executive of SCIO Health Analytics Inc. His firm helps insurers identify customer types, such as "entry-level singles" and "healthy baby boomers," each with projections on likely costs. The firm pinpoints, by ZIP Code, where the different types tend to live, so the insurer can target its marketing geographically.

Highmark Inc., a Pittsburgh, insurer, said it has around 100 targeted campaigns aimed at particular types of consumers, including recent college graduates and retirees not yet eligible for Medicare. It sends walk-in
tractor-trailers to college campuses and sets up booths at community events such as charity walks. "We have to be more one-to-one than we were historically," said Steven Nelson, a senior vice president at Highmark.

Blue Cross & Blue Shield of Rhode Island also plans to aim at certain populations, including young men. Last year, the insurer promoted one of its low-cost plans with a campaign that included posters on the walls of men's bathrooms in bars. "You don't need beer goggles to fall in love with this health plan," one slogan said.

Comment by Don McCanne of PNHP: One of the great advantages of the Affordable Care Act was that it would finally bring an end to insurance company chicanery in which they were able to selectively insure more profitable healthy individuals while keeping the more costly sick individuals out of their plans. At least, that's what the new requirements for guaranteed issue (they must sell the plans to everyone, not only the healthy) and community rating (they cannot charge higher rates for the sick) were supposed to do. But insurers have a much larger bag of tricks.

Although insurers can no longer reject applicants who fail medical underwriting standards, they have learned to selectively market their plans to healthier populations, and they will continue to do so. They intensify their targeting to younger, healthier individuals while avoiding marketing to higher cost individuals. As this article indicates, an industry has arisen to help insurers select their targets for marketing, based on the health of selected groups or on the average health in geographical regions (ZIP Codes). This adds yet more administrative costs to our system already tremendously overburdened with administrative waste.

Not only do insurers market selectively to the healthier, they also are taking advantage of risk adjustment. Since insurers who take on clients with greater medical problems are paid more through these adjustments, it is to their advantage to include individuals with unfavorable diagnoses but whose health care needs are actually quite minimal. An individual might technically be diagnosed as a diabetic but require very little care, and yet the insurer can receive adjustments that are designed for a more severe diabetic with multiple complications. So it is to their advantage to enroll patients with just a touch of bad disease. They are already doing this in the private Medicare Advantage plans.

If an insurer misjudges and ends up with higher cost risk pools, they can no longer dump only those with greater needs, but they can pull their plans from the regions where they are experiencing high spending.

Insurers are masters at innovation. No matter how many laws and regulations they face, they will always find other ways to work the system. That's just plain old good business. And that is the problem. We don't want our health care defined by what is good for the industry; we want it defined by what is good for patients. We won't get that until we establish our own public system dedicated to the primacy of patients.

And about that Blue Cross & Blue Shield of Rhode Island campaign that included posters on the walls of men's bathrooms in bars with the slogan, "You don't need beer goggles to fall in love with this health plan." Although there are ten categories of essential health benefits, insurers are allowed flexibility within each category. Those young men would be well advised to read their plans carefully to see if they exclude sexually transmitted diseases and injuries while intoxicated. Insurers know no boundaries.
July 17, 2013

Top Conservative Activist Enthusiastically Endorses Government-Run Health Care


A top conservative leader endorsed a government-run health care program similar to single-payer during an appearance on CSPAN’s Washington Journal on Sunday morning, telling a caller that TRICARE — the Department of Defense’s health care program for more than 9 million active duty uniformed personnel and their dependents — works even better than the Affordable Care Act.

Dean Clancy, the Vice President of Public Policy at Freedom Works, an organization that vehemently opposes President Obama’s health care law and advocates for eliminating most government regulations in the health care system, admitted that the government program is “fairly popular” with military members:

CALLER: Good morning. I have looked at all the insurance companies all over the world and the governmental plans all over the world and it comes back to one item that sticks out that would work for everybody, employers, retired people, people who have a small business, people who have low insurance and high insurance. That is TRICARE. TRICARE is what would lower everything and increase everything as far as services and there is not a doctor who doesn’t know about TRICARE. [...]

CLANCY: TRICARE is an employer provided insurance for Pentagon employees and their families. I think it is fairly popular with them. It may have some problems, but in general it works better than Obamacare is likely to do. Employer provided insurance works pretty well, in fact Congress has the best employer provided insurance in the country, it’s the gold standard.
July 9, 2013

Deficit hawk Pete Peterson just cut a check to Social Security Works--WA. Bwahhhaaaa!

See the following thread for the winning video


Conservative billionaire Pete Peterson, a major financier in the effortto dismantle Social Security, Medicare, and Medicaid, just got some egg on his face courtesy of the Social Security Works- Washington coalition, the Economic Opportunity Institute and PSARA.

The winning video in the Pete Peterson Foundation’s video contest – which had the goal of “compiling videos of people across the country letting Congress and the President know why fixing our nation- al debt is so important” – was “Just Scrap the Cap”, which represents the antithesis of Peterson’s austerity agenda.

If you haven’t seen it, “Just Scrap the Cap” is a humorous plea to shore up Social Security’s long-term finances by eliminating the current FICA wage cap of $113,700. Also known as “Scrapping the Cap”, this change would require billionaires like Peterson to pay the same Social Security tax rate as the guy who shines his shoes. Watch it here: www.justscrapthecap.com

Here’s the best part: After the votes were tallied and it was determined "Just Scrap the Cap" received the “Fan Favorite” award, Peterson was forced to cut a $500 check to Robby Stern, Social Security Works Washington Chair. Robby signed the check over to Social Security Works Washington and has promised that the coalition will use the money wisely: “We will use the $500 to finance our educational efforts and our Scrap the Cap campaign. We want to save Social Security from Peterson and his band of wealthy supporters.” Surely Mr. Peterson will be pleased to hear his money is going to a good cause.

Alex Stone is Communications & Technology Manager at Economic Opportunity Institute & a PSARA member. He helped direct and acted in the award winning video.

July 3, 2013

Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America

Book by Barbara Ehrenreich Some quotes below.


“Breast cancer, I can now report, did not make me prettier or stronger, more feminine or spiritual. What it gave me, if you want to call this a “gift,” was a very personal, agonizing encounter with an ideological force in American culture that I had not been aware of before—one that encourages us to deny reality, submit cheerfully to misfortune, and blame only ourselves for our fate.”

“There is a vast difference between positive thinking and existential courage.”

“I couldn't help noticing that the existential space in which a friend had earnestly advised me to 'confront [my] mortality' bore a striking resemblance to the mall.”

“But the economic meltdown should have undone, once and for all, the idea of poverty as a personal shortcoming or dysfunctional state of mind. The lines at unemployment offices and churches offering free food includes strivers as well as slackers, habitual optimists as well as the chronically depressed. When and if the economy recovers we can never allow ourselves to forget how widespread our vulnerability is, how easy it is to spiral down toward destitution.”

“I do not write this in a spirit of sourness or personal disappointment of any kind, nor do I have any romantic attachment to suffering as a source of insight or virtue. On the contrary, I would like to see more smiles, more laughter, more hugs, more happiness and, better yet, joy. In my own vision of utopia, there is not only more comfort, and security for everyone — better jobs, health care, and so forth — there are also more parties, festivities, and opportunities for dancing in the streets. Once our basic material needs are met — in my utopia, anyway — life becomes a perpetual celebration in which everyone has a talent to contribute. But we cannot levitate ourselves into that blessed condition by wishing it. We need to brace ourselves for a struggle against terrifying obstacles, both of our own making and imposed by the natural world. And the first step is to recover from the mass delusion that is positive thinking.”

Profile Information

Gender: Female
Hometown: Washington state
Home country: USA
Current location: Directly above the center of the earth
Member since: Sat Aug 16, 2003, 01:52 AM
Number of posts: 51,907

About eridani

Major policy wonk interests: health care, Social Security/Medicare/Medicaid, election integrity

Journal Entries

Latest Discussions»eridani's Journal