Obama to Endorse Public Plan in Speech

Obama to Endorse Public Plan in Speech

Source: WSJ
WASHINGTON -- President Barack Obama, in a high-stakes speech Wednesday to Congress and the nation, will press for a government-run insurance option in a proposed overhaul of the U.S. health-care system that has divided lawmakers and voters for months. White House officials say the president will detail what he wants in the health-care overhaul, as well as say he is open to better ideas on a government plan if lawmakers have them. Democratic plans call for requiring most Americans to carry health insurance. Failure to comply could cost families as much as $3,800 a year, according to a new Senate proposal. The president is likely to say that a government-run insurance plan, known as the "public option," will not provide a level of subsidies that give it an unfair advantage over private insurers, according to aides familiar with the speech preparations.
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Under the plan, people who earn between 100% and 300% of the poverty level (or between about $22,000 a year and $66,000 a year for a family of four) would face fees ranging from $750 to $1,500 a year. For taxpayers with incomes above 300% of poverty, the penalty starts at $950 a year and reaches as high as $3,800 for families. Nearly 12 million people fit in this category, according to the National Institute for Health Care Management. The idea behind the penalty is that those who can afford insurance but don't buy it are imposing costs on the entire health system. Under the proposal, nearly 12 million people who currently have no insurance could be subject to such fines, according to figures compiled by the National Institute for Health Care Management. Starting next year, the plan also calls for annual fees of $6 billion on health-insurance providers, $4 billion for medical-device makers, $2.3 billion on drug makers and $750 million on clinical laboratories. The fees would be levied on individual companies based on market share. Insurers also face an excise tax of 35% for any health plan worth more than $8,000 a year for individuals and $21,000 a year for families.
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Congressional leaders, meanwhile, breathed new life into a proposal for a legislative mechanism to trigger a public plan if private insurers fail to reduce health-care inflation or cover the uninsured. House Majority Whip James Clyburn (D., S.C.) said the idea -- suggested by moderate Republican Sen. Olympia J. Snowe of Maine and embraced by moderate Democratic Sen. Ben Nelson of Nebraska -- could save the public option from its opponents.
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Instead of a public option, the Senate Finance Committee proposal authorizes federal funds to create nonprofit insurance cooperatives. The government would provide loans to help start the cooperatives and grants to make sure they met state solvency requirements. People who earn up to 300% of the poverty level would be eligible for tax credits to help them buy insurance, and some would also be eligible for certain cost-sharing assistance. Families of four earning between about $66,000 and $88,000 would be eligible for credits that go toward their premiums and caps so the cost of their coverage doesn't exceed 13% of their income. LinkHere

California's Real Death Panels: Insurers Deny 21% of Claims
“The United States remains the only country in the industrialized world where human lives are sacrificed for private profit, a national disgrace that seems on the verge of perpetuation," she said.

PacifiCare's Denials 40%, Cigna’s 33% in First Half of 2009
More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, amounting to very real death panels in practice daily in the nation's biggest state, according to data released Wednesday by the California Nurses Association/National Nurses Organizing Committee.
CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, six of the largest insurers operating in California rejected 47.7 million claims for care -- 22 percent of all claims.
The data will be presented by Don DeMoro, director of CNA/NNOC's research arm, the Institute for Health and Socio-Economic Policy, at CNA/NNOC's biennial convention next Tuesday, Sept. 8 in San Francisco. The convention will also feature a panel presentation from nurse leaders in Canada, Great Britain, and Australia exploding the myths about their national healthcare systems.
"With all the dishonest claims made by some politicians about alleged 'death panels' in proposed national legislation, the reality for patients today is a daily, cold-hearted rejection of desperately needed medical care by the nation's biggest and wealthiest insurance companies simply because they don't want to pay for it," said Deborah Burger, RN, CNA/NNOC co-president.
For the first half of 2009, as the national debate over healthcare reform was escalating, the rejection rates are even more striking.
Claims denial rates by leading California insurers, first six months of 2009:
•PacifiCare -- 39.6 percent
•Cigna -- 32.7 percent
•HealthNet -- 30 percent
•Kaiser Permanente -- 28.3 percent
•Blue Cross -- 27.9 percent
•Aetna -- 6.4 percent
"Every claim that is denied represents a real patient enduring pain and suffering. Every denial has real, sometimes fatal consequences," said Burger. LinkHere