Co-opted and Placated

Dennis Kucinich is very good at being Dennis Kucinich. An acquired taste, Dennis never pretends to be anyone but Dennis. I’m not a big fan and I seldom agree with him, but I respect his unrelenting desire to fight windmills. The Cleveland Plain Dealer carried an op-ed piece written by Congressman Kucinich on March 14, 2010 that was vintage Dennis.

Congressman Kucinich is a strong advocate of a single payer health care system. He is not bashful about this. His distrust of insurance companies in 2010 rivals his love affair with the banks and CEI in the late 70’s. He is nothing if not consistent. As a leading member of the Progressive Caucus of the Democratic Party, he added numerous amendments to the House’s health care bill that would have pushed our country in a direction most of us would want to avoid. As his extreme measures were stripped from the bill, he and his fellow Progressives swore that they would not vote for any bill that failed to include a strong public option.

We’ve discussed the public option several times over the last year. There is little need to revisit the weakness of this concept again in this post. What is relevant today is Congressman Kucinich’s adamant opposition to the poorly written bill passed by the U.S. House of Representatives and the unrestrained vitriol he unleashed on the hodgepodge that emerged from the Senate.

As President Obama and Speaker Pelosi rushed to find 216 votes to pass the Senate bill in the House, Congressman Kucinich suddenly became relevant. The Today Show and other morning broadcasts, the Sunday new shows, and the weekday opinion programs all discovered Dennis. Congressman Kucinich was going to vote NO, even if he was the deciding vote. Fox News and Michael Moore (!) applauded his gumption, though for entirely different reasons. Democratic Party leaders rushed to Countdown with Keith Olbermann and the Rachel Maddow Show to declare that Dennis Kucinich led a group of one. They sneered at his presidential runs and other solitary crusades.

What a difference a plane ride makes. President Obama visited Strongsville this week. Several local members of Congress got a ride from Washington aboard Air Force One. Air Force One, the magic plane. Do you remember the Newt Gingrich melt down after Bill Clinton gave him a ride on AFO? Dennis didn’t have a chance. By the time the plane landed, Congressman Kucinich was UNDECIDED. His move to YES was a forgone conclusion. Now cited for his leadership just a week after he was dismissed by the party’s chiefs, Dennis Kucinich was co-opted. It turns out that some strongly held positions are no match for a really cool plane ride.

My representative in Congress is Marcia Fudge. Many of my fellow insurance agents have contacted their Congressman. Most of my clients are small business owners and some of them have tried to talk to their representative. I know that other chamber of commerce presidents have called Congress. Not me. I resisted calling Congresswoman Fudge as a constituent, agent, business owner, or even as President of the Beachwood Chamber of Commerce. Why? There didn’t seem to be any reason to waste the time. Marcia Fudge’s vote was never a doubt. I couldn’t see any value in the exercise and I didn’t want to get aggravated.

I can’t explain why, but I changed my mind on Monday. Maybe it was Dennis’s conversion. Perhaps it was the mindless attacks on my industry or my disdain of smoke and mirrors. Whatever the reason, I finally contacted Congresswoman Fudge’s office on Tuesday. I spoke with legislative aide Beverly Charles.

I started our conversation by establishing my Democratic Party bona fides. Regular readers of this blog know that they are extensive.

I asked Ms. Charles a very simple question. “What is Congresswoman Fudge’s position on the health care legislation?” I was told that she was UNDECIDED. I was surprised. I talked with Ms. Charles for about thirty minutes. She was fully versed in the Speaker’s talking points. Her knowledge on the subject appeared to be a mile wide and an inch deep. She emailed her thanks the next day. I offered this blog and the opportunity to meet in person to provide more useful info.

Was Congresswoman Fudge really UNDECIDED? Absolutely not. According to the New York Times and Doctors for Health Care Solutions, she had already made her decision. DOHCS had been asked to have 75 members, all wearing white lab coats, to appear on short notice to serve as stage props when Marcia holds her press conference. This assumes that she gets a press conference. Since she was always counted as a YES, her announcement is hardly news. But my question is does Ms Charles know as much about her boss’s position on the issue as she does about this legislation, or was I simply being placated? I think we know the answer.

President Obama asked Congress for Courage at this week’s pep rally in Strongsville. There has been very little courage exhibited by this Congress.

No Short Cuts

In “Dreams From My Father”, future president Barack Obama introduces his readers to his entire family. We meet both of his grandfathers, Stanley Dunham of Hawaii by way of Kansas and Hussein Onyango Obama of Kenya. We learn how these two men influenced both him and his father. The central theme of the book was about making your own way in the world, a task made more possible with hard work and clear thinking. Every corner cut resulted in failure. Every job done well led to greater success. I just finished the book while on vacation. It was terrific.

In fact, the book should be read by lots of people. I’m going to give my copy to my girlfriend’s son, Alec. Someone else who should read the book, someone else who might benefit from the lesson on “Dreams From My Father” would be the guy who wrote it, Barack Obama.

President Obama was on TV again this morning. The news was showing a clip from yesterday’s pep rally. Can’t tell you where this one was. They all look alike. The president rails against the evil insurance companies. The President complains about insurance company rate increases. Someone is brought up to cry about losing his/her insurance after getting sick and getting dropped for not paying the premium. The solution to all of our problems is to pass the BILL. Crowd cheers. Cut to commercial.

Will someone please call Barack Obama? We need the young, brilliant, hard worker to push aside our current president. We need real leadership, not just on this issue, health care, but on jobs, finance reform, national security, and all of the other major issues of our time. Right now we have slogans and scapegoats. We are cutting corners and racing towards disaster.

I’ve been busy this week and have only seen bits and pieces of Countdown with Keith Olbermann and the Rachel Maddow Show. Both had guest hosts. Here is what I saw and what you may have missed:
1. Dennis Kucinich (D-OH) said “The insurance companies are the problem”.
2. Dr. Howard Dean said “The insurance companies are the problem”.
3. Bart Stupak (D-Mi) is leading a group of 12 anti-abortion fanatics.
4. Diana Degette (D-Co) leads the Pro-Choice Caucus, 190 strong, who won’t give up any more ground.
5. If the BILL doesn’t pass, it will be all (fill in the blank)’s fault.
6. Liz Cheney is so much like her father, even Kenneth Starr is repulsed. (Nothing to do with health care, but truly weird and interesting.)

We are contemplating the overhaul of nearly 20% of our economy and the participants are locked in their little battles, digging in their heels, and shouting out their slogans. No matter how many of these shows you watch, you will never learn how we are going to provide health care for 300+ million Americans and, more importantly, how we are going to pay for it. Really. Taxes that kick in eight years from now aren’t real. Creating massive changes and hoping that the good stuff, the parts you like, aren’t impacted is simply childish.

WWOD? What would Obama do? Maybe the real question is what would the real Obama do? The guy from the book might have, like his father before him, first tried to just bluff his way through the battle. But once he encountered a set-back or two, the book’s Barack Obama would have realized that he needed to fully apply himself to the task. He would have succeeded by out-thinking and out-working his opponents. He would have built a consensus and found a feasible solution to our health care morass. Not a plan that merely sounded good, but one that actually could succeed.

We’ve seen the bluffs, the set-backs, and the short cuts. The guy demonizing the insurance companies isn’t going to get the job done. Now is the time for the other Obama to emerge. The one we elected. The one we, as a country, need.

DAVE

www.bogartcunix.com

It's Alive

Time to grab the pitchforks? Are the torches ready? No. No. No. The monster is not at our gates. For the moment, it is but a rumor.

Once again, Keith Olbermann is touting the Public Option. Eleven, count ‘em, eleven US Senators want to put the Public Option back on the table and then pass it by reconciliation. Who are these eleven senators? Please, you already know.

Which US Senators make up the reliable left, the team that can always be counted on to see only one side of every issue? Let’s say them together in alphabetical order:

Michael Bennet (D-CO)
Sherrod Brown (D-OH)
Roland Burris (D-IL)
Diane Feinstein (D-CA)
Al Franken (D-MN)
Kirsten Gillibrand (D-NY)
John Kerry (D-MA)
Pat Leahy (D-VT)
Jeff Merkley (D-OR)
Bernie Sanders (I-VT)
Sheldon Whitehouse (D-RI)

To be fair, there are an equal number, or possibly even more, US Senators who are incapable of seeing anything but the other side of every issue. The reliable right is just as much a problem as the above group.

Mr. Olbermann and guests quickly delineated the problems with our current health care system. There are a large number of uninsured and underinsured Americans. All problems would be resolved with the Public Option. Can’t you just imagine it? As it is currently designed, the Public Option will lower the deficit, cover the masses, cure cancer, and guarantee that your home team will win the World Series.

Cue the movie clip. Details? We don’t need no stinking details. OK, enough fun, back to work.

There are no details, no real numbers, no real world plans. My past post provided a comprehensive explanation of the specific benefits of Medicare, a program designed to pay most, but nowhere near ALL, of the costs of medical care. A plan that does not cover prescriptions, a senior citizen with just Medicare is woefully underinsured. Yet with all of these holes, Medicare is still underfunded. Before we create a new Public Option, shouldn’t we first fix the current one?

The Rachel Maddow Show follows Count Down with Keith Olberman on MSNBC. Her thrust was that there was no reason to worry about the Republicans. The other party is simply not going to help. Unfortunately, she may be correct. One can spend all day listing the flip-flops of Senators as esteemed as Orrin Hatch and Charles Grassley. The reconciliation issue doesn’t bother me.

I don’t mind the use of power. My concern is what the use of power gets us. Ms. Maddow’s guest last night was Senator Bernie Sanders. He was almost frothing at the mouth at the prospect of passing this massive change to our health care system by a simple majority. He was shouting out his wish list for other reforms that could be attached to the bill. Why stop at health care? In less than two minutes he offered education reform (more $), housing reform (more $), and, well you get the idea.

What was never discussed, two shows in a row, was a single detail about this mythical Public Option. Can such a plan really work? Who knows? But if it would guarantee an Indians World Series victory, I want to hear more.

DAVE

www.bogartcunix.com

The One Year Anniversary of Health Insurance Issues With Dave, and yes, Anthony Weiner Still Hates Me

Today marks the first anniversary of this blog. Please allow me to again thank Brad Kleinman and David Toth of WorkSmart for teaching a class on eMarketing and social networking for the Beachwood Chamber of Commerce last January. Their motivation and the wonderful feedback I receive from you, my readers, keep me excited about producing these posts.

On September 21, 2009 I posted an article entitled Anthony Weiner Hates Me. Mr. Weiner is a Congressman from New York City who is entirely convinced that insurance companies are an unnecessary drain on our system. He has preached from the alter of single payer government run health plans on the Rachel Maddow Show, Countdown with Keith Olbermann and the Huffington Post. Mr. Weiner even shows up on the Sunday morning shows every now and then. His extreme views make for good television. Congressman Anthony Weiner was on the Daily Show with Jon Stewart last night.

Anthony Weiner and Jon Stewart have been friends for a long time. How long? Half the interview was dedicated to the threat of exposing incriminating photos from the 1980’s each still had in his possession. That was the interesting part of the interview. The rest? Nothing terribly new.

Realizing that he didn’t have a lot of time, Mr. Weiner spoke in bullet points.
• Medicare is a single-payer system that works.
• We should extend Medicare to people 55 and older. Why start at age 65?
• We should extend Medicare as an option to recent college graduates who are no longer covered by their parents’ policies.
• We should extend Medicare as an option to people who have lost their jobs.
• Medicare has a 1% overhead vs. the insurance companies at over 30%
• We should cap what insurance companies can charge.

Somewhere in this tangle of talking points, Mr. Weiner stopped to take a breath. And here is where the friendship, or the pictures from the 80’s, paid off. Jon Stewart didn’t challenge any of his friend’s assumptions. He allowed this fact-free, totally unsupportable, completely unrealistic presentation to proceed. Jon Stewart, someone unafraid to confront, intellectually, Jim Cramer and Keith Olbermann, devolved into the Memphis Grizzlies defense and watched LeBron James drive to the hoop. Mind you, I wasn’t looking for a hard foul (continuing the basketball metaphor), but I would have appreciated an attempt to protect the basket, or truth.

This blog has dealt with the good and bad of Medicare numerous times. I’m not sure you have the patience to reread much of that. It is still vitally important to note that Medicare does serve a purpose. Medicare is an important part of our current mish-mosh of payers. And of course, anytime the government is involved in writing checks, a lot of what services are, or are not, available are determined by Washington. But Medicare was never designed to pay all the costs of health care for anyone.

Let’s talk about the specifics of Medicare. It wouldn’t be fair, easy but not fair, for me to cherry-pick this. So this is what Medicare really does and doesn’t cover.

PREMIUM – $110.50 per month, assuming you make less than $85,000 per year.

MEDICARE Part A

Semiprivate room and board, general nursing, and miscellaneous services and supplies:
First 60 days - You pay $1,068
61st day through 90th - You pay $267 per day
91st day and after while using
Your 60 lifetime reserve days - You pay $534 per day
Thereafter - YOU PAY EVERYTHING

Skilled Nursing Facility Care
You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital.
First 20 days - You pay $0
21st day through 100th day - You pay $133.50 per day
101st day and after - YOU PAY EVERYTHING

Blood
First three pints - You pay everything
Additional amounts - You pay $0

Hospice Medicare pays for all with very limited coinsurance
For outpatient drugs and inpatient respite care

MEDICARE PART B

Medical Expenses – In and out of the hospital and outpatient treatment such as physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests and durable medical equipment,

First $135 of Medicare approved amounts - You pay $135
Remainder of Medicare approved amounts - You pay 20%

Part B Excess Charges, the amount above
Medicare approved amounts YOU PAY EVERYTHING

Blood
First three pints You pay everything
Next $135 of Medicare approved amounts - You Pay $135
Remainder of Medicare approved amounts - You pay 20%

Clinical Laboratory Services - You pay $0

Home Health Care
Medicare approved services
Medically necessary skilled care
Services and medical supplies - You pay $0
Durable medical equipment
First $135 of Medicare approved amounts - You pay $135
Remainder of Medicare approved amounts - You pay 20%

Foreign Travel - YOU PAY EVERYTHING

Sorry, there was no way easy way to explain this policy. Above are the basics, the shell. What does this really mean?
1. There is no prescription coverage.
2. There are huge gaps as to what is and isn’t adequately covered.
3. People who rely strictly on Medicare are woefully underinsured.

How underinsured? A study released today at the fifth annual
Community Oncology Conference in Scottsdale, Arizona clearly states that “Medicare covers only 56% of the actual costs of administering chemotherapy and providing related infusion room services to seniors with cancer”. We have already discussed how Medicare has reduced the payments to medical providers. According to the report, Mr. Weiner’s favorite single payer has reduced the payments for cancer drug infusion room services by over 25% since 2004. Are the doctors silently bearing these reductions? Are you and I paying more for these and other services as the cost for care is shifted, more each day, to those of us with private insurance?

There were lots of other holes in Congressman Weiner’s presentation. I appreciated that he has now reduced this imaginary overhead expense for Medicare from the unlikely 4% that he had claimed last summer to the impossible 1% of last night. But I know that this is already too long.

There was one saving grace to Congressman Anthony Weiner’s appearance on the Daily Show. When asking Mr. Weiner about his Mayoral ambitions, he wondered aloud whether Michael Bloomberg could have been defeated. Without hesitation Mr. Weiner opined “I would beat him like a rented mule”. See, I’m not the only person Anthony Weiner hates.

DAVE

www.bogartcunix.com

I Don't Quit

A threat? A promise? President Barack Obama ended his State of The Union speech with a clear statement of his personal resolve and optimism. He was forceful. He was clear. For one hour last night, Barack Obama was the guy who ran for the presidency last year. It was a strong performance.

How strong? The initial reaction on Fox News was subdued and restrained. MSNBC’s Keith Olbermann, Rachel Maddow, and Chris Matthews seemed reinvigorated and emboldened.

This blog, Health Insurance Issues With Dave, deals with one particular issue, health care, So what did the President say about our issue last night? The quick answer – not too much.

Thirty-two minutes into his speech, President Obama touched upon health care. He mentioned that he had gotten close to passing legislation. He noted that his plan was not politically popular. He admitted that they, he and the Democrats in Congress, had handled this badly. He acknowledged emerging trust issues. He dared the Republicans to offer alternate suggestions. But that’s it.

There were no specific goals. No mention of shared sacrifice. No direction. And in the end, at no point did President Obama take the time to explain what he was going to do to make changes in our health care system more possible, productive and palpable. He threw the ball back to Congress where the Democrats will muck it up and the Republicans will dig in their heels.

President Obama said that he won’t quit. Great. I don’t want him to quit. I want him to start.

DAVE

www.bogartcunix.com

Crossing The Line

“They’re doing it behind closed doors!” roared Susan Robinson. “Did you hear Nancy Pelosi say that the promise of transparency was just campaign talk?”

A lifelong resident of Bay Village, a lifelong Republican, Susan Robinson (yeah, yeah, yeah I changed her name) registered as a Democrat in the spring of 2008 and voted for Hillary Clinton in the Ohio primary. It is one thing to cross party lines and to cast one’s ballot, in the privacy of the voting booth, for a member of the other party. Susan Robinson did more. She publicly self-identified as a Democrat. She has the junk mail to prove it. And now she is a sort-of Democrat, a sort-of Republican, and totally ticked off.

Disillusioned and betrayed, Susan Robinson and countless others voted for change. It was as if the voters approved Issue 6 to reorganize Cuyahoga County government and then installed Jimmy Dimora as the new chief executive.

The latest news, appropriately for this discussion leaked by a nameless Democratic official, is that the President, the Senate and the House may have reached a compromise on the plan to tax so-called “Cadillac” health plans. As always, the words compromise means that the House caved. The deal is that the tax would be on family plans that cost $24,000 per year instead of $23,000. The other part of the deal is that the employees of state and local governments and all union employees would be exempt until 2017.

Feel free to take a moment to reread the last sentence. Do you understand why a tax should apply to everyone but state and local government employees and members of a union? Neither do I. Will the law specify which unions are official skip the tax unions or will any old union do? Can we form our own unions? Can each of us create our own unique, self-contained, tax avoiding union?

We’ve now crossed the line from short-sighted and ill-advised to just plain dumb. Divisive, too.

Please, somebody tell me, what happened to helping the working poor acquire affordable health insurance?

DAVE

www.bogartcunix.com

Opposites Attract

“Goals. Why do you keeping harping about goals, Dave? The President said that we are going to cover the uninsured, make health care affordable, and we can keep our current insurance. Aren’t those the goals?”

Those are goals. In that same vein, I would like to start each day with a smile on my face and a song in my heart.

Real goals, well defined and achievable, are in short supply. This past Sunday’s Cleveland Plain Dealer illustrated our current goal-less struggle.

Let’s begin on Page 5 of Section A. A Chicago Tribune story entitled “Health bills can sink even those insured” comes with a picture of a kindly older gentleman helping out at a Christmas pageant. Even though he has insurance, he is getting clobbered with the copayments from his prescriptions following his heart transplant. Forget the fact that what Mr. Fraas really needed was disability insurance because his real problem is a lack of income, the theme of the article can be found in this sentence: “Meanwhile, Fraas learned that even with good insurance, medical care can break a family’s bank.”

We have heard before how unfair it is for unhealthy people to also suffer financially. So it must be safe to say that one of our goals is really comprehensive coverage that totally protects a family, NO MATTER WHAT.

Not so fast.

On Page 2 of Section G that same Plain Dealer had “A less than-honest policy is taxing” written by New York Times columnist Bob Herbert. This editorial page article discusses one of the more controversial details of the recently passed Senate bill, the tax on so-called Cadillac health plans. An excise tax of 40% will be imposed on family policies that cost more than $23,000 per year and individual plans in excess of $700 per month.

The Joint Committee on Taxation projects that this tax will generate over $150 billion over the next ten years. How? The deep thinkers behind this scheme think that your boss will refuse to pay this tax, buy a cheaper insurance policy, and since he or she just saved so much money, you will get a raise! The government will collect billions of dollars in new income tax. You will be forced to migrate to a health insurance policy with higher deductibles and copayments. You will be forced to become a better consumer.

So our goal is to have consumers (us) pay more of our health care expenses?

What do Hollywood romantic comedies and bad legislation have in common? The plot lines always revolve around the theory that opposites attract. Just because I really enjoyed Bruce Willis and Cybil Sheppard in Moonlighting, doesn’t mean I can suspend my disbelief about this bill.

DAVE

www.bogartcunix.com