Tag: Policy/Politics

Health Affairs makes an apPaul(y)ing choice

Sep 22, 2008• 10

By Matthew Holt

Health Affairs ran a couple of partisan analyses last week. Joseph Antos, of AEI, Gail Wilensky, former Bush 41 HCFA administrator, and Hans Kuttner labeled the Obama plan as excessive tax and spend socialized gulag regulation.

In the other analysis, four liberal academic wonks — Thomas Buchmueller, Sherry A. Glied, Anne Royalty, and Katherine Swartz — derided the McCain plan as the counter-productive ravings of a right wing nutjob. OK so they didn’t exactly say that, but you get the message. No surprises here.

The McCain plan is so far out of the mainstream that, when Bush proposed something very similar in 2006, he could not even get it introduced into a Republican-controlled Congress. Obama’s plan is a wishwashy centrist Democrat plan that doesn’t even pretend to get to real universal coverage and ignores the fact that the vast majority of Democrats prefer a straight single-payer plan (and so does he when scratched hard!).

So who does Health Affairs chooses to create a middling compromise between these two?

Free Lunch: David Cay Johnston off the leash

Sep 20, 2008• 5

By Matthew Holt Freelunch

A version of this review appeared at Spot-on last week, but as you know over there I get heavily edited by Chris Nolan who’s a real journalist and all that. The beauty of the zero cost of publishing online is that you can show lots of versions. This is what it looked before it got to her. Enjoy.

Despite being buried in Health 2.0 work, somehow I’ve been managing to read a few books lately. But none of them have been quite as staggering as Free Lunch, the latest from former NY Times investigative reporter David Cay Johnston.

Johnston’s best known for his exhaustive investigation into how corporations and very very rich individuals subvert the tax code so that they pay less, while the rest of us pay more. But in this book (probably because he’s no longer a NY Times Reporter and is off the leash of restraint that the Grey Lady seems to put on its reporters) he gets almost biblical in calling out the cheats, crooks and murderers.

And when I say murderers, Johnston is talking about John Snow, Bush’s former treasury secretary — yup the one who did such a great job regulating the sub-prime mortgage market that the potential for a credit and housing collapse in the latter part of this decade was avoided…oh, wait….

Forcing the candidates to get real on health care change

Sep 16, 2008• 9

By Robert Laszewski

Let’s pretend that either Senator Obama or Senator McCain will be able to implement their respective health care reform plans if elected. This exercise should be easy. We’ve been doing it for months now.

Or, we can get real and expect them to do the same.

For all the arguments both candidates are making that they are change agents, including over their competing health care reform proposals, this dirty little secret remains –– neither Senator’s health care plan has a chance of being implemented.

When is the same spending more spending?

Sep 16, 2008• 2

By Matthew Holt

When it’s routed through the government because their spending is done with mythically different dollars than private spending. Or at least it is in the bizzaro world of free-marketeer policy analysts. Let me explain…

A couple of weeks back a small consulting firm working for McCain sent me an article written by University of Minnesota economist Roger Feldman about the cost of Obama’s health plan. They were complaining that I hadn’t featured their analysis. So I read the report which suggested that the Obama plan would cause $450 billion in health spending. Bear in mind, Obama suggests that it’ll cost $65 billion, so this is quite some stretch.

I was going to write a long, learned article about this, but instead I’ll just show you the email back & forth.

Golden Rule Founder dies

Sep 16, 2008

By Matthew Holt

It is not seemly to speak ill of the dead so this is all you’ll hear from me about the passing of Patrick Rooney, founder of Golden Rule. An obituary is here.

The problem with astroturf

Sep 15, 2008• 5

By Matthew Holt

….is that sometimes real weeds might sneak in and mess up the nice green carpeting you’re laying down.

To wit, here’s an exchange between an SEIU member and AHIP President Karen Ignagni at the AHIP astroturf meeting in Ohio. When asked why Wellpoint’s CEO is still talking about profitability (and going off message to the political world when going on message to Wall Street), Ignagni starts off about “No Margin, No Mission”.

Err … Karen, that’s the line used by non-profits that (theoretically) have a mission to do some social good. The mission of investor-owned companies like Wellpoint, Healthnet, Aetna, United, et al is to make a profit. Your opponents can show you lots of “insurance companies” that do a pretty good job (or at least as good as your members and usually better) and don’t make a profit. Hint: one’s called Medicare, another is the VA.

And at another astroturf forum a different AHIP spokesman also showed a lack of comprehension of basic economics when he apparently said that it is necessary for the insurance industry to make profits to cover costs. Err no, you have to cover your costs to cover your costs — profit is on top of that!

Has Steve Poizner gone soft?

Sep 12, 2008

By Matthew Holt

California’s de facto health insurance commissioner Lisa Girion reports on California’s actual Insurance Commissioner Steve Poizner’s agreement with Healthnet. After all that fuss, the deal is that Healthnet pays $14m in canceled medical bills, reinstates around 1,000 canceled policy-holders and pays a $3.6m fine. Poizner agreed to this despite all his tough words of not too long ago.

How is it that the punishment fine is less than the cost of the offense? So let me see. Don’t pay $14m in medical bills you’d agreed to insure, and either get away with it, or run the slight risk of not getting away with it and pay $18m several years later. That’s a deal any self-respecting egregious booty capitalist would take. And let’s face it being one of those is a requirement of the job to run a health plan these days.

Of course, the separate $9m fine Healthnet has already seen in one case alone—handed down by an arbitrator whose decisions cannot be overturned later—gives a clue to what the real damages will be in the courts should these cases get there.

So no wonder Shernoff and the trail lawyers are pissed that this settlement may undercut their case. And why has Poizner rolled over?

UPDATE: Darrel Ng, Press Secretary at the CA Department of Insurance is working late on Friday and responded to this post "One of the highlights of the settlement is that by accepting the payments and health insurance, patients do not have to forgo future litigation. So while I know critics have made the assertion that their case may be undercut, I’m not sure why they would believe that’s the case." Darrel didn’t explain why the fine for one case in arbitration was three times the fine for 1,000 cases from the DOI.

McGuire not in prison. Reyes is. Anyone understand?

Sep 12, 2008• 18

By Matthew Holt

So Bill McGuire has settled with CALPers in the scandal where he backdated the value of his United HealthGroup stock options. He’ll pay a $30m fine which sounds a lot but is a rounding error on his net worth. So it appears that his troubles are over.

Meanwhile Gregory Reyes the CEO of Brocade did exactly the same thing and he’s doing 21 months in the big house as well as paying a similarly big fine.

For that matter Steve Jobs apparently did the same thing too, and just today Apple settled with the SEC for a mere $14 million (or about 8 minutes of iPhone sales) and Jobs himself doesn’t seem to be paying anything.

Isn’t there something about equal treatment under the law in one of those fuddy-duddy 18^th century documents we Americans are so keen on? Can anyone explain the rationale behind these differences in treatment?

Remember pensions? The big differences between Obama & McCain’s health care plans

Sep 11, 2008• 8

By Robert Laszewski Politics

This election is different than any other on the issue of health care because both candidates are giving us serious blueprints to reorganize America’s health care system and those blueprints are very very different.

As voters, you have a huge and critically important choice on health care.

There are dozens of details upon which they differ and for those I would point you to my comprehensive posts on the McCain Health Care Plan and the Obama Health Care Plan.

But to understand their big idea differences, I would point you to our pension system to better understand where McCain and Obama are going on health care. Back in the 1960s and 1970s, it was common for workers to have what is called a defined benefit pension plan.The worker got a promise from the employer that when retirement came he’d get a certain monthly benefit — often about 60 percent of his final average earnings. That might be $2,000 a month — every month for the rest of his life. Therefore, a defined benefit.

Palin’s health care sense on target

Sep 8, 2008• 29

By Don Johnson Palin

Alaska’s Sarah Palin, who is running for vice president with Sen. John McCain, has better health care policy sense than Sen. Barack Obama and his running mate, Sen. Joe Biden.

Palin has pushed for less regulation of health care providers and more competition, while Obama and Biden are pushing for socialized medicine and ultimately a single-payer plan patterned after the failed systems in Canada and the U.K.

Her approach, which is described here by the Washington Post, is supported by many physicians and advocates of a pro-competition approach to health care and health insurance market reforms, and it will be opposed by executives and employees of entrenched hospitals and local health care monopolies and ologopolies who don’t want to lose business to independent clinics and specialty hospitals.