Healthcare Open Thread

Today's Big News: Obama to Urge Oversight of Insurers' Rate Increases.

President Obama will propose on Monday giving the federal government new power to block excessive rate increases by health insurance companies, as he rolls out comprehensive legislation to revamp the nation's health care system, White House officials said Sunday.

...By focusing on the effort to tighten regulation of insurance costs, a new element not included in either the House or Senate bills, Mr. Obama is seizing on outrage over recent premium increases of up to 39 percent announced by Anthem Blue Cross of California and moving to portray the Democrats' health overhaul as a way to protect Americans from profiteering insurers.

Congressional Republicans have long denounced the Democrats' legislation as a "government takeover" of health care. And while they are likely to resist any expansion of federal authority over existing state regulators, they will face a tough balancing act at the meeting with the president to avoid appearing as if they are willing to allow steep premium increases like those by Anthem.

...The president's bill would grant the federal health and human services secretary new authority to review, and to block, premium increases by private insurers, potentially superseding state insurance regulators. The bill would create a new Health Insurance Rate Authority, made up of health industry experts that would issue an annual report setting the parameters for reasonable rate increases based on conditions in the market.

...The legislation would call on the secretary of health and human services to work with state regulators to develop an annual review of rate increases, and if increases are deemed "unjustified" the secretary or the state could block the increase, order the insurer to change it, or even issue a rebate to beneficiaries.

Legislation that blocks excessive premium increases by healthcare companies would be a great thing. But that isn't actually what this legislation is designed to do.


It is certainly designed to look like that's its central purpose, but it is really little more than a clever bit of politics to: 1. Give self-interested people currently happy with their private insurance some reason to support healthcare reform; 2. Undermine valid criticisms that the current Senate bill stands to exacerbate spiraling healthcare costs; and 3. Suck some of the wind out of the Republicans' obstructionist sails.

In other words, it's a bit of politics to get a healthcare bill passed.

And if you're thinking: But Liss! What about how it establishes that "Health Insurance Rate Authority, made up of health industry experts" who will block "unjustified" rate increases?!

Well, suffice it to say, I'm not impressed. This administration has shown itself to be unwilling to take on the insurance industry. Neither party is willing to take on the insurance industry. There's absolutely no reason to believe that a government-run "Health Insurance Rate Authority" will be any more likely to find rate hikes "unjustifiable" than the insurance companies' current cost-control experts find various denials of service, like organ transplants necessary for survival, "unjustifiable."

Especially when one notes who the "health industry experts" making up the panel will be: "The new rate board would be composed of seven members, including consumer representatives, an insurance industry representative, a physician and other experts like health economists and actuaries, the White House said."

Great. And if anyone thinks that "consumer representatives" and "physicians" who fancy themselves "health industry experts" are going to be on the side of patients, I encourage you to read the 1996 (and 2009) Congressional testimony of former insurance company medical reviewer Dr. Linda Peeno and see if you still feel the same way afterward.

In the spring of 1987, as a physician, I caused the death of a man.

Although this was known to many people, I have not been taken before any court of law or called to account for this in any professional or public forum. In fact, just the opposite occurred: I was "rewarded" for this. It bought me an improved reputation in my job, and contributed to my advancement afterwards. Not only did I demonstrate I could indeed do what was expected of me, I exemplified the "good" company doctor: I saved a half million dollars!

Since that day, I have lived with this act, and many others, eating into my heart and soul. For me, a physician is a professional charged with the care, or healing, of his or her fellow human beings. The primary ethical norm is: do no harm. I did worse: I caused a death. Instead of using a clumsy, bloody weapon, I used the simplest, cleanest of tools: my words. The man died because I denied him a necessary operation to save his heart. I felt little pain or remorse at the time. The man's faceless distance soothed my conscience. Like a skilled soldier, I was trained for this moment. When any moral qualms arose, I was to remember: I am not denying care; I am only denying payment.

Dr. Linda Peeno became a whistleblower. Her colleagues who didn't are the ones who will find their way to the Health Insurance Rate Authority panel.

In Other News: Obama Details Plan to Expand Health Care to Uninsured.

And with the bipartisan healthcare summit this Thursday, Obama urges Democrats and Republicans to compromise.

Discuss.