Wendall Potter on amendment planned by Rockerfeller, Lincoln, Franken

[laughingliberal]

There was a time, in the early 1990s, when health insurance companies devoted more than 95
cents out of every premium dollar to paying doctors and hospitals for taking care of their members. No more. Since President Bill Clinton's health reform plan died 15 years ago, the health insurance industry has come to be dominated by a handful of insurance companies that answer to Wall Street investors, and they have changed that basic math. Today, insurers only pay about 81 cents of each premium dollar on actual medical care. The rest is consumed by rising profits, grotesque executive salaries, huge administrative expenses, the cost of weeding out people with pre-existing conditions and claims review designed to wear out patients with denials and disapprovals of the care they need the most.
This equation is known as the medical loss ratio (MLR), an aptly named figure that is widely seen by investors as the most important gauge of an insurance company's current and future profitability. In a private health insurance industry that collected $817 billion this year, a 14 percentage point difference in the MLR represents $112 billion a year! Over 10 years, that would be more than enough to pay for health reform.

Thanks to the efforts of several senators who pushed for a minimum MLR to be included in reform legislation, the current Senate bill requires insurers to provide an annual rebate to each enrollee if non-claims costs exceed 20% in the group market and 25% in the individual market.
Sen. Al Franken (D-Minn.) is now leading a group including Sens. Jay Rockefeller (D-W. Va.) and Blanche Lincoln (D-Ark.) to introduce an amendment that would go further by requiring that 90 percent of the money consumers spend on health insurance premiums go directly to health care costs.

The senators are proposing a reform that strikes at the heart of a health insurance system that puts profits first, and it would have a profound effect. When MLRs increase, that eats into profits, and Wall Street becomes very unhappy. A case in point is Aetna, the nation's third largest publicly-traded health insurance plan. Three years ago, the company reported that its quarterly MLR had inched up from 77.9 percent to 79.4 percent in 12 months. On the day this was disclosed, Aetna's share price plunged 20 percent as investors sold off their shares, reducing the company's market value by billions of dollars. <snip>

http://www.huffingtonpost.com/wendell-potter/the-insurance-industrys-l_b_382001.html

This could help speed the demise of the for profits and might make the bill worthwhile if it passes and is left in the final bill.

[JDPriestly]

1. K&R

[laughingliberal]

2. AM kick

One of the few pieces of encouraging news in a while

[PHIMG]

3. What? Real health insurance reform in a Health Insurance Reform Bill! HERESY!!!

Come on just think how much less money Baucus will get if his party passes real reform.

Private Health Insurers just need to go away, do what HR-676 does -- pay off the insurance company shareholders, nationalize the businesseses, roll everyone over to Medicare over 5 years, slowly lay off the insurance co. employees -- give them normal unemployment + 20% for 2 years and retraining benefits and reap the hundreds of billions in savings.

[laughingliberal]

4. They do need to go away. We aren't going to get single payer but this amendment is one

we should get behind. If it passes and survives it will do more to make insurance more affordable for their customers than anything and it will do more to bring them down even than the public option, imo.

[PHIMG]

5. I'm so sick of this "We won't get single payer"

First off yes we won't get "Single Payer" because that term is garbage. We want "Medicare For All".

Secondly, if you want something you shouldnt say we can't get it. You should say : "It's going to take work" which is true.

What do you think would have happened if MLK went around saying "We aren't going to get a Civil Rights Act."

STOP SAYING WE CAN'T GET SOMETHING. THAT IS A SELF FULFILLING PROPHECY.

The world does not revolved around *this* Congress. WE ARE THE ONES WE'VE BEEN WAITING FOR.

Get involved in the movement. Find a local group at www.healthcare-now.org

[laughingliberal]

6. I have been involved and I take umbrage with your tone

I write and call so often, I'm sure I'm on a stalker watch list. I am a lifelong, left wing liberal who was part of the movement which drove LBJ out of office over Viet Nam. My parents marched with MLK and I met him 2 days before he was killed. I really don't need people screaming at me on message boards about getting involved.

The bills before the Congress and Senate now are absolutely unsatisfactory to me. But this amendment is a big improvement and I resent being yelled at for posting this.

Sheesh! I get accused of wanting a pony by one side and not doing enough by the other.

[PHIMG]

8. Language is important.

Everyone who wants something needs to be positive about getting it. When you say : "oh we aren't going to get" you are doing your opponents works. Take umbrage with that if you wish. Or take it as a opportunity to change your tactics a little in service of your goal.

[laughingliberal]

10. I don't need the lecture. I've been out here on the battle field a very long time

I have been absolutely positive in my communications with the PTB that we need single payer or "Medicare for all." I am on a message board for Democrats who, I would hope, are in support of the same goals for HCR. It is not doing my opponents' work. It is, as I see it, a discussion with others fighting for the same goals. Do all the positive thinking you want. I will continue to write and call and make my wishes known and, of course, there could always be a last minute miracle and I hope there is. But, I am not going to not support an amendment which could make the bill that is before the Senate now a much bigger hammer against the insurance companies. I am not going to dig my heels in and say "Medicare for all or nothing."

You are free to disagree with me but I do not care to argue about it any longer. See, it could work this way. You can have your view of it and I can have mine.

[PHIMG]

13. You take this all too personally.

Did you ever allow for the fact that my comments were directed to the community at large and not just yourself?

[laughingliberal]

15. Another lecture? Geez! nt

[PHIMG]

16. Yeah here's another one: Grow up! n/t

[laughingliberal]

17. Mean nt

[Vidar]

7. K&R.

[LiberalAndProud]

9. This has to pass. Please oh please oh please ...

[laughingliberal]

11. Harry Reid is my Senator. I have already written to let him know I support this amendment

crossing fingers

[LiberalAndProud]

12. Congratulations. Ben Nelson is mine.

How's that for one-upmanship?

[laughingliberal]

14. Lol! nt

[laughingliberal]

18. This amendment added to today's news about the possibility of allowing earlier buy ins to Medicare

could actually result in reform. I mean the kind of reform which actually provides some affordable access to health care to people. Not as much as I would like but if these 2 things make it in it will, I believe, tamp down the worst abuses of the health insurance crime families and get us on the road to Medicare for all which was once my preference. Lately, I'm starting to think the whole damn system is so broken we need to go UK style totally socialized medicine. Then we could get the profit motive out of the damn hospitals and diagnostic centers, too. AFAIK, they have not been asked to do much of anything to lower their costs.