Progressives should, IMO, disagree with SEIU Pres. Andrew Stern on Nat'l Health goal (Chirolas)

[Tace]

Do you think the health companies will willingly give up the golden goose that makes them rich as it destroys our ability to compete in the Global market place?

William Chirolas -- World News Trust

March 13, 2007 -- There are times when one must disagree with allies in the fight for health care reform, and this is one of them. Andrew Stern, president of the Service Employees International Union, has been a friend of progressives and now wants to move beyond the employer-based health coverage that currently covers 60 percent of us, noting that by 2012 25 percent of the American workforce will be contingent workers (temps) with no coverage.

Stern notes that the debate has moved from 1993's "Health care is a right vs. Health care is a privilege" to a corporate competitive need, as we can not export or compete if we are the only country to build into our product and service pricing the cost of the employers' health care coverage policy -- and a corporate concern is a place where Congress seems more able to pass legislation to solve the problem. Logical -- and indeed one would say the union president is on the right path so far.

But Stern appears to be afraid of giving Insurance company management a hook to use to scare their workers away from joining his union. It is impossible to develop an insurance company approach that keeps you covered at a flat cost, because in a job-changing world, the insurance companies still want to be able to deny standard coverage if you had been sick, out of work and therefore not covered, and were now going to work for another employer.

And Stern has drunk the GOP/Insurance Company Kool Aid about the need to worry about reining in costs. He hasn't worked out the fact that reining in costs equates to denying coverage -- directly by way of insurance company rules on what is covered, or indirectly by way of making something more expensive than something else a person wants to spend their money on. He misses the public health need to get preventive care to everyone, even the ones so cheap that they'd deny that care to themselves if given the choice -- and given an incentive that was greater than a few dollars.

Someone should point out that Canadians with a state-provided health care payment system live 2.5 years longer than we do, or that our children's health outcomes is down there at the Third World level of a country like Malaysia.

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http://www.worldnewstrust.com/index.php?option=com_content&task=view&id=1571&Itemid=10204

[Selatius]

1. One of the biggest reasons for the rise in health care costs: Underwriting.

It's not CEO salaries or retirement packages. Those are drops in a bucket. The biggest cost incurred in private health care is the process of coming up with reasons not to give you coverage or denying applicants from getting coverage. Next biggest cost is probably advertising. Single-payer systems in countries like France dispense with the costs inherent with underwriting and advertising/lobbying.

[daveskilt]

3. HMO costs are unreal

I employee 8 people just to fight with HMOs to get them to pay the pittance they pay (about half medicare rates on DRG or RUG)

not to mention the HMO's themselves will tell you that on average roughly 25c to the dollar go to admin costs on their side. the costs I pay as a hospital CEO (and trust me - the CEO salary really is a drop in the bucket :) ) in employing people to fight with the HMOs are taking away resources I could use for patient care instead. The total cost of managed care is hard to quantify once you look at the indirect costs on the provider side as well.

Medicare by contrast has a less than 2% administrative cost - they also pay more than any HMO to the provider and cost the provider much in less in billing, reporting, and collection on a per patient basis.

[daveskilt]

2. I have dealt with the SEIU a lot - NOT interested in workers rights

The SEIU in my experience have been more interested in lining their pockets than in protecting workers.

My bias is obvious - I am a hospital CEO.

I have no issues with many other unions, but the SEIU make me sick. They offered to "help us keep wages at a managable level" in return for agreements to let them into several of our facilities where the nurses had voted NO in the past.

I pay my staff well over local rates and most unions don't have anything more to offer staff in return for dues - the SEIU tried to get into my workers paychecks through colluding with management against workers interests. Not to mention some of their bully tactics - following staff home, threatening their families, endangering patients by stealing charts and damaging equipment.

On the universal health care issue - I am all for it.

I get paid less than my costs for medicaid patients and loose money - then I pay more and have a hefty benefits bill. I only make up the difference on medicare and to a MUCH lesser extent the HMOs.
If Everyone was on a govt health plan the rates for providers would eventually go up - HMOs main purpose is to deny and limit coverage. that means more money I can invest in patient care and wages. Not only that but I have 8 staff members whose sole purpose is fighting with HMOs to get them to pay what they owe us for services rendered. No HMO means putting most of those folks back into direct patient care. better care for less cost - everyone wins. I would even suggest having businesses paying in a portion as a flat fee based on # of employees.