February, 04 2009, 11:00pm EDT
New Report Shows Why Health Care Reform Must Include Obama's Public Health Insurance Plan
WASHINGTON
National health care reform legislation must provide consumers the option to join a new public health insurance plan that would directly compete with private health insurance plans, according to a new report, "A Public Health Insurance Plan: Reducing Costs and Improving Quality" released today by the Institute for America's Future. The report compares the long and successful track record of Medicare, which would partly serve as a model for a new public health insurance plan, against the record of private plans, and argues that such a model is the best way to drive down costs and improve health care quality.
During the campaign, President Obama proposed a public health insurance plan as part of a new National Health Insurance Exchange, through which individuals and small businesses could purchase health coverage. Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, has made a similar proposal.
"The public health insurance plan will be a major point of contention as the debate over health care reform heats up," said Roger Hickey, co-director of the Institute for America's Future. "Groups representing consumers and patients are aligned in favor of Obama's proposal, and the insurance, drug and hospital industries are arrayed against such a proposal."
Frank Clemente, health care expert and author of the report, joined Hickey on a conference call today to release the report. "There is overwhelming evidence that a public health insurance plan controls spiraling health costs much better than private insurance, while providing high-quality care and the broadest choice of providers to consumers," said Clemente. "Giving consumers the ability to choose between competing public and private health insurance plans will save the system enormous sums of money and give consumers peace of mind."
Richard Kirsch, national campaign manager for Health Care for America Now, a coalition of groups working hard to make quality health care affordable, joined Hickey and Kirsch on today's call. Kirsch pointed to new public opinion data by Celinda Lake that shows most Americans want a public health insurance plan.
Said Kirsch, "Including the choice of a new public health insurance plan in comprehensive health care reform is the only way to bring down costs and force private insurance companies to compete. We need a guarantee of quality, affordable health care for all in 2009, and the public clearly understands the importance of having a choice of a private or public health insurance plan. The public clearly understands it's how we hold insurance companies accountable and guarantee we will have quality, affordable health care when we need it."
# # #
**For more information, including the full report, a one-page brief of key findings, and public data, please visit: https://institute.ourfuture.org/public_plan**
Major findings from "A Public Health Insurance Plan: Key to Controlling Costs and Improving Quality" [PDF] include:
- Private insurers' health care spending has grown much faster than Medicare spending over the last 25 years. Private health insurers' average annual spending growth per enrollee was 29 percent higher than Medicare spending growth between 1983 and 2006, and it was 59 percent higher between 1997 and 2006, according to Centers for Medicare and Medicaid Services data. The spending was for comparable benefits and despite Medicare's much older and therefore much costlier population. The beginning of these two time periods correspond to major reforms to Medicare's provider payment policies designed to deliver greater value for our health care dollar.
- The private health insurance market is highly consolidated and needs competition from a public plan to lower skyrocketing premiums. In 16 states the dominant carrier accounts for at least 50 percent of private insurance enrollment. In 40 states the top three carriers account for between 60 percent and 100 percent of the market. Despite this consolidation, dominant insurers are not driving hard bargains for reduced prices from hospitals because insurers want to offer their customers access to flagship hospitals, which are not reducing their rates to private carriers because the hospital market has also become highly concentrated. In this increasingly consolidated insurance and hospital marketplace, employer-paid premiums have increased an average of 12 percent a year since 1999.
- Insurance company and hospital profits have skyrocketed during this consolidation. The combined profits of 15 of the country's largest private health insurance companies rose from $3.5 billion in 2000 to $15 billion in 2007 - an increase of 330 percent, according to company SEC filings. CEOs at the health insurance companies were compensated a combined $147.5 million in 2007 - an average of $10.5 million each, or 259 times more than the $40,690 an average worker made that year. U.S. for-profit hospitals reported $43 billion in profits in 2007, their best single-year jump in profits in at least 15 years, according to the American Hospital Association.
- Administrative costs are dramatically lower under public health insurance plans, resulting in enormous savings to the system. The administrative costs and profits of Medicare Advantage plans, which are run by private insurers, were 11 percent of spending in 2005, according to the Congressional Budget Office (CBO). By comparison, Medicare's public plan had administrative costs of less than 2 percent. A Government Accountability Office study found an even bigger gap - private Medicare Advantage plans spent 16.7 percent of their revenue on administrative costs and profits in 2006. Moreover, private health insurance industry spending for administration and profits jumped 12 percent a year from 2000 to 2005 - 40 percent faster than overall health spending growth and 50 percent faster than growth in hospitals' and physicians' spending. Private health insurance industry employment grew 52 percent from 1997 to 2007, but during the same period private health plan enrollment of those under 65 rose by just 3.4 percent.
- Public health insurance plans' much greater bargaining power achieves more reasonable provider costs than do private health insurance plans. Medicare pays hospitals about 25 percent less than do private insurers for comparable benefits, according to the Medicare Payment Advisory Commission (MedPAC). Yet, virtually all hospitals participate with Medicare. Medicare pays physicians 19 percent less than do private insurers for comparable services, according to MedPAC. Yet, 97 percent of all doctors are taking new Medicare public plan patients, virtually the same rate as are accepting private PPO patients. The number of physicians billing Medicare is growing much faster than enrollment growth in Medicare Part B, which pays for physician care.
- In a head-to-head competition, the public Medicare plan is much better at containing costs than private Medicare Advantage plans. Private Medicare Advantage plans are being paid 14 percent more than Medicare's public plan for providing comparable coverage in 2009, according to MedPAC - nearly $1,250 more per Medicare beneficiary. CBO has found that private Medicare Advantage plans are no more cost-effective than the public Medicare plan, but that those enrolled in Medicare's public plan are at greater risk of health problems and therefore more costly to cover.
- The quality and effectiveness innovations occurring under the public Medicare plan show that public plans have greater potential to drive the quality revolution than do private plans. Like with Medicare, the large market share of a new public plan for people under 65 will have the resources, power and incentive to reshape market practices to promote quality and cost effectiveness. Public plans have more incentive than private plans to improve quality in order to curb costs because they operate under tight fiscal constraints, and they operate in the open and are widely scrutinized by the government, providers and the media, unlike private insures. Private insurers have limited incentive to conduct comparative effectiveness research and disseminate findings because the research is very expensive and its benefits, if made public, are not theirs alone.
- Public plans increase choice, competition and accountability. A public plan offers people an alternative to private insurance as well as broader access to health care providers. A public plan will promote competition, which will place an important check on both public and private plans. A public plan will promote accountability and transparency because it must meet the test of democratic support. In comparison, the billing, payment, and care management practices of private insurance plans, as well as their claims and outcomes data, are mostly proprietary and of limited access to government oversight.
The Campaign for America's Future is the strategy center for the progressive movement. Our goal is to forge the enduring progressive majority needed to realize the America of shared prosperity and equal opportunity that our country was meant to be.
LATEST NEWS
Liberal Justices Grill Attorney in Supreme Court Case on Criminalizing Homelessness
"Where are they supposed to sleep? Are they supposed to kill themselves not sleeping?" asked Justice Sonia Sotomayor of unhoused people who have been barred from sleeping outside in Grants Pass, Oregon.
Apr 22, 2024
As housing rights advocates and people who have been unhoused themselves rallied outside the U.S. Supreme Court Monday to demand an end to the criminalization of homelessness, the court's three liberal justices demanded to know how the city of Grants Pass, Oregon can penalize residents who take part in an act necessary for human survival—sleeping—just because they are forced to do so outside.
After an attorney representing Grants Pass, Thomas Evangelis, described sleeping in public as a form of "conduct," Justice Elena Kagan disputed the claim and reminded Evangelis that he was presenting a legal argument in favor of policing "a biological necessity."
"Presumably you would not think that it's okay to criminalize breathing in public," said Kagan, who was appointed by former President Barack Obama. "And for a homeless person who has no place to go, sleeping in public is kind of like breathing in public."
Evangelis is representing the city in Grants Pass v. Johnson, a case stemming from a 2018 lawsuit filed by an unhoused woman, Debra Blake, who accused officials of "trying to run homeless people out of town."
"On any given day or night, hundreds of individuals in Grants Pass, Oregon, are forced to live outside due to the lack of emergency shelter and affordable housing in their community," the original lawsuit stated.
The city has passed ordinances banning people from sleeping or camping on publicly owned property, with violators subject to fines of hundreds of dollars.
A lower court ruled that the city's bans were in violation of the Eighth Amendment, which bans excessive fines and cruel and unusual punishment, "when there was no other place in the city for [unhoused persons] to go."
The city's only homeless shelter, Gospel Rescue Mission, has 138 beds, and the plaintiffs have said there is frequently no room for many of the hundreds of unhoused people in Grants Pass.
On Monday, Justice Sonia Sotomayor appeared inclined to agree with the plaintiff in the original lawsuit who claimed Grants Pass ultimately wanted unhoused people to leave the city. She pointed to comments city officials have made about their aim "to remove every homeless person and give them no public space."
"Wasn't Grant Pass's first-attempt policy choice to put people, homeless people, on buses so they would leave the city?" she asked Deputy United States Solicitor General Edwin Kneedler. "Police officers would buy them a bus ticket, send them out of the city. But that didn't work because people came back because it had been their home... So then they passed this law, and didn't the City Council president say, 'Our intent is to make it so uncomfortable here that they'll move down the road,' meaning out of town, correct?"
Kneedler acknowledged that the statement was made at a City Council meeting.
"Not only is [sleeping] something that everybody engages in, but it's something that everybody has to engage in to be alive," Kneedler said in response to a question from Justice Ketanji Brown Jackson. "So if you can't sleep, you can't live, and therefore by prohibiting sleeping, the city is basically saying you cannot live in Grants Pass."
The city argued in its case that prohibiting local officials from regulating and banning homeless encampments in public places would cause more people to sleep outdoors—an argument U.S. Rep. Cori Bush (D-Mo.), speaking at the rally outside the court, said exposed "how absurd our country's approach to the unhoused crisis is."
"Instead of enacting real solutions to the unhoused crisis, Grants Pass has taken this case all the way to the Supreme Court and is calling for the court to overturn a landmark decision from 1962 that says the government cannot punish people based on status. So we're here today to demand the Supreme Court support humanity, adhere to constitutional precedent, and protect the rights of our unhoused neighbors," said Bush, who has spoken about previously being unhoused herself and sponsored related legislation.
"A person should never be punished for not being able to afford rent or a home," Bush added. "A person should never be punished for sleeping outside or in a car when they have no other place to go. A person should never be punished for simply existing. We need universal housing, universal housing vouchers, and a permanent federal rental assistance program—these are all tangible steps that would actually solve this crisis."
The case arrived at the high court four months after the U.S. Department of Housing and Urban Development released annual data showing a 12% increase in homelessness last year from 2022, largely due to a sharp rise in the number of people who were without housing in 2023 for the first time in their lives. Experts often argue the federal figures are an undercount.
On Monday, the Eviction Lab at Princeton University released new data showing that in 25 of the 32 cities it analyzed, an increase in eviction filings was seen between 2022-23.
"The country lacks millions of units of affordable rental housing, and in those units that are available, a record number of tenants are paying well beyond their means," reported the Eviction Lab. "High interest rates prevent younger, middle-class renters from buying homes, which in turn increases demand in the rental sector."
Considering the dynamics contributing to a growing unhoused population, Sotomayor asked of people facing homelessness in Grants Pass: "Where are they supposed to sleep? Are they supposed to kill themselves not sleeping?"
The conservatives on the Supreme Court, who make up the majority, signaled a willingness to rule in favor of the city, with Chief Justice John Roberts acknowledging that the case is centered on "a policy problem because the solution, of course, is to build shelter to provide shelter for those who are otherwise harmless," but noting that "municipalities have competing priorities."
The answer to the questions being asked at the Supreme Court Monday "is not complicated," said Rep. Delia Ramirez (D-Ill.). "Unhoused people need housing. Housing is the answer. Housing NOT Handcuffs."
Ramirez repeated a phrase that was seen on many signs held by rally attendees, who included the national grassroots economic justice group VOCAL and organizers with the Southern Poverty Law Center (SPLC) and the National Homelessness Law Center (NHLC).
"What the Supreme Court decides in this case will say a lot about what kind of country we are and what country we want to be," said Efrén Olivares, director of strategic litigation and advocacy at the SPLC. "We demand a future without policies like the one before the court and a government that instead works to ensure that the right to affordable housing is guaranteed for all."
A ruling in the case is expected in June.
Keep ReadingShow Less
Green Groups Cheer $7 Billion in 'Solar for All' Grants
"Solar for All is exactly the type of investment the country needs to re-imagine our clean energy future," said one campaigner. "It's great to see President Biden jumpstart this landmark program."
Apr 22, 2024
Climate action advocates on Monday celebrated the Biden administration's Earth Day announcement that it is distributing $7 billion in Solar for All grants "to develop long-lasting solar programs that enable low-income and disadvantaged communities to deploy and benefit from distributed residential solar, lowering energy costs for families, creating good-quality jobs in communities that have been left behind, advancing environmental justice, and tackling climate change."
The U.S. Environmental Protection Agency estimates that the awards—which are going to 60 applicants, including states, territories, tribal governments, municipalities, and nonprofits—will fund solar projects that positively impact over 900,000 households nationwide while reducing 30 million metric tons of carbon dioxide equivalent emissions. The grant competition was made possible by the Inflation Reduction Act, which President Joe Biden signed in August 2022.
"The United States can and must lead the world in transforming our energy systems away from fossil fuels," said Sen. Bernie Sanders (I-Vt.), who joined Biden on Monday to announce the solar grants—$62.45 million in funding will go to his state—and the Vermont Climate Corps.
"The Solar for All program—that I successfully championed—will not only combat the existential threat of climate change by making solar energy available to working class families, it will also substantially lower the electric bills of Americans and create thousands of good-paying jobs," noted Sanders. "This is a win for the environment, a win for consumers, and a win for the economy."
The Mandan, Hidatsa, and Arikara Nation and Indigenized Energy will get over $135 million to work on solar projects in tribal communities across five states.
Cody Two Bears, executive director of Indigenized Energy, said that the award "will serve as a catalyst for tribes and energy justice communities like ours who are leading the way in building our own clean energy systems within our lands."
"This is a once-in-a-generation award that will begin to transform how tribes achieve energy sovereignty," Two Bears added. "The shift from extractive energy to regenerative energy systems will be the legacy we leave for our future generations."
Two massive victories today! @POTUS announces the #AmericanClimateCorps, putting young people to work in good jobs combating climate change AND the Solar for All program w/ $7B for solar in disadvantaged communities. \n\nThis is the FDR-level ambition we\u2019ve been calling for! \ud83d\udc4f\ud83c\udf89— (@)
Margie Alt, director of Climate Action Campaign (CAC), a coalition of a dozen national groups, highlighted both the emissions cuts and that in low-income communities across the United States, "families will see savings—approximately $400 per household."
"The president also announced the launch of the ClimateCorps.gov—a new website featuring 2,000 new job listings in climate and conservation," she pointed out. After years of pressure from campaigners, Biden in September announced the American Climate Corps, which was inspired by former President Franklin D. Roosevelt's Civilian Conservation Corps.
"We're thankful to the Biden administration for making these priorities a reality," said Alt. "While Republicans in Congress make every attempt to roll back climate progress, climate champions in Congress and throughout the administration are standing strong in their commitment to America's clean energy future; a future where all Americans have access to clean energy, good-paying jobs in the clean energy industry, and see direct savings from this clean energy boom."
I\u2019ve pushed for a Climate Corps to create jobs while protecting our health, planet, and future\u2014so it\u2019s wonderful to see @POTUS marking Earth Day this year with major investments in both the American Climate Corps and @EPA\u2019s Solar for All program! We need bold action on climate.— (@)
Paula GarcÃa, senior energy analyst and energy justice lead at the Union of Concerned Scientists (UCS), which is part of the CAC coalition, also applauded the awards, saying that "the Solar for All grant program is a key part of the larger suite of clean energy investments advanced by President Biden and Congress that will help the United States combat climate change."
"Directing investments toward low-income and disadvantaged communities is imperative to ensuring a just transition to clean energy," GarcÃa stressed. "If we don't prioritize these populations, we risk exacerbating historical injustices and piling additional burdens on those who have been disproportionately affected by environmental harm."
"The announcement of these grants is an important step forward," she continued. "While UCS research has shown clearly that more ambition is needed to meet climate goals, phase out fossil fuels, and advance environmental justice, the Solar for All program will help create much needed momentum toward ensuring the many benefits of a decarbonized economy, including public health protections, reduced consumer energy costs, and increased energy resilience, are reaching everyone."
.@POTUS just announced $7b to fund residential solar projects. It will: \n\u26a1\ufe0fPower nearly a million low-income households\n\ud83d\udcb5 Save each household in the program $400 a year\n\ud83d\udc77\ud83c\udffe Create 200,000 jobs\n\nThis program is a key step towards the #GreenNewDeal.\n\nhttps://t.co/9LxOnz13FI— (@)
Jean Su, who directs the Center for Biological Diversity's Energy Justice program, similarly said that "Solar for All is exactly the type of investment the country needs to re-imagine our clean energy future."
"Broad community-based solar is our brightest hope for protecting people and our climate from the scourge of fossil fuels," she added. "These targeted investments mean low-income families get clean energy that is affordable, resilient, and protects our ecosystems. It's great to see President Biden jumpstart this landmark program. I look forward to its expansion, along with steps to curb fossil fuels with a climate emergency declaration."
Her group and the youth-led Sunrise Movement are among the organizations that have long demanded a climate emergency declaration from Biden, who is reportedly reconsidering it in the wake of the hottest year in human history and as he prepares for a November rematch against former Republican President Donald Trump—whose election could mean a surge in planet-heating pollution, according to an analysis published last month.
Emphasizing the difference between the Democratic Party and the GOP, climate reporter David Roberts called the solar grants "amazing stuff that would not happen if Republicans were in charge" and said, "Thanks Biden!"
Keep ReadingShow Less
West Bank Pogrom 'Underscores Urgent Need to Dismantle Apartheid': Amnesty
"The appalling spike in settler violence against Palestinians in recent days is part of a decadeslong state-backed campaign to dispossess, displace, and oppress Palestinians in the occupied West Bank," said one Amnesty official.
Apr 22, 2024
Amnesty International said Monday that the ongoing surge in deadly violence by Israeli settlers and soldiers in the West Bank "underscores [the] urgent need to dismantle apartheid" in the illegally occupied Palestinian territories.
For more than a week now, Israeli settlers have been attacking West Bank Palestinians in towns and villages including Al-Mughayir, Duma, Deir Dibwan, Beitin, and Aqraba, killing at least four people including a child; wounding dozens of others; and destroying homes, vehicles, and other property.
Israel Defense Forces (IDF) troops have either stood and watched or participated in the settler attacks, which the Israeli human rights group B'Tselem and others are calling a "pogrom."
Amnesty said the "alarming spike in violence by Israeli settlers against Palestinians across the occupied West Bank in recent days highlights the urgent need to dismantle illegal settlements, end Israel's occupation of the occupied Palestinian territories, and its longstanding system of apartheid.
"The appalling spike in settler violence against Palestinians in recent days is part of a decadeslong state-backed campaign to dispossess, displace, and oppress Palestinians in the occupied West Bank, including East Jerusalem, under Israel's system of apartheid," Amnesty Middle East and North Africa regional director Heba Morayef said. "Israeli forces have a track record of enabling settler violence and it is outrageous that once again Israeli forces stood by and in some cases took part in these brutal attacks."
"Establishing Israeli settlements in the occupied Palestinian territories flagrantly violates international law and constitutes a war crime," Morayef added. "Violence is integral to the establishment and expansion of these settlements and to sustaining apartheid. It's time for the world to recognize this and pressure Israeli authorities to abide by international law by immediately halting settlement expansion and removing all existing settlements."
The latest wave of settler violence was sparked by the disappearance of Binyamin Achimair, a 14-year-old Israeli from the illegal settler outpost of Mal'achei Hashalom who went missing on April 12 while herding sheep near the village of Al-Mughayir east of Ramallah. As Israelis searched for Achimair, settlers began attacking Al-Mughayir's residents and property.
Achimair's body was found the following day. Israeli officials said he was killed in a "terrorist attack." However, no Palestinian resistance group has claimed responsibility for the incident. A 21-year-old Palestinian man was arrested Monday in alleged connection with the boy's death.
Late Friday, IDF troops and armored vehicles surrounded the Nur Shams refugee camp east of Tulkarem and besieged the community of more than 6,000 Palestinians during a 50-hour raid in which residents were shot, homes were destroyed, and scores of people were arrested.
By Saturday, IDF soldiers had killed 14 people in the camp, including at least one child. More than 40 other Palestinians were wounded.
"I saw one of my relatives, Jihad Zandiq, put his hands in the air to the soldiers but then they shot him anyway from point-blank range and killed him. Half of his skull exploded," eyewitness Mahmoud Qazmouz toldMiddle East Eye on Sunday.
Palestinian officials said Israeli troops attacked first responders attempting to rescue victims, including a volunteer paramedic who was shot in the leg.
Meanwhile, a funeral was held Sunday for Mohammed Awad Allah Musa, a 50-year-old Palestinian Red Crescent Society volunteer paramedic who was shot dead Saturday by Israeli settler-colonists while trying to reach Palestinians wounded by rampaging settlers in the town of Sa'wiyah south of Nablus.
The Nur Shams raid and ongoing settler attacks came as the U.S. State Department on Friday announced new sanctions targeting far-right Israeli settler leaders including Ben Zion Gopstein, the founder and head of the Jewish supremacist group Lehava.
The Biden administration—which backs Israel with billions of dollars in military aid and diplomatic support—is also reportedly considering imposing sanctions on the IDF's Netzah Yehuda battalion over war crimes committed in the West Bank before the current Israeli war on Gaza, including the January 2022 death of Omar Assad, a 78-year-old Palestinian American man.
Responding to the prospect of the first-ever U.S. sanctions on his country's military, far-right Israeli Prime Minister Benjamin Netanyahu said Sunday that "I will fight it with all my strength."
According to the Palestinian Health Ministry, at least 485 Palestinians have been killed by Israeli soldiers and settlers in the West Bank since October 7, when Gaza-based militants attacked Israel. More than 1,100 people were killed in the attack—some by responding Israeli forces—and over 240 Israelis and others were kidnapped by Hamas and other militants.
Israel's 199-day retaliatory assault on Gaza—which critics including Israelis have called genocidal—has killed at least 34,151 Palestinians, mostly women and children, while wounding over 77,000 others, according to Palestinian and international officials. At least 11,000 Gazans are missing, presumed dead and buried beneath the rubble of the hundreds of thousands of homes and other buildings that have been destroyed or damaged by Israeli bombardment. Around 90% of Gaza's 2.3 million people have been forcibly displaced, and Israel's continued obstruction of humanitarian aid delivery has fueled a burgeoning famine in which dozens of people, mostly children, have perished.
Keep ReadingShow Less
Most Popular