President Obama in remarks yesterday calling on Congress to vote on healthcare reform within the next few weeks:
Everything there is to say about healthcare has been said and just about everybody has said it. So now is the time to make a decision.
President Obama in remarks yesterday calling on Congress to vote on healthcare reform within the next few weeks:
Everything there is to say about healthcare has been said and just about everybody has said it. So now is the time to make a decision.
Who knows, but maybe the President of the United States is actually smarter than I am.
The Administration successfully parlayed the WellPoint rate hikes in California — increases that in fairness were logical and justified at least to some extent — into a symbol of the need for reform by highlighting the financial burden on small businesses and families trying to afford healthcare coverage (and once again demonizing millionaire health plan executives).
Now the President has backed opponents of reform into a corner by agreeing to incorporate into his revised healthcare proposal four additional Republican ideas. These ideas, which Republicans stressed in last week’s bipartisan healthcare summit, include a greater emphasis on combating fraud and waste, alternatives for resolving medical malpractice disputes, increased Medicaid payments to doctors, and the inclusion of HSA plans in insurance exchanges.
The subtext is that the Administration has compromised (and compromised again), and now it’s the Republicans turn. Don’t hold your breath. Republicans have refused to compromise all along, and my guess is they will continue to refuse to compromise. Their strategy is obstruction.
Obama, meanwhile, has laid the groundwork for Democrats to push through reform — even if it requires the use of reconciliation — without appearing too bad in the eyes of the public. When faced with the inevitable conservative cries of outrage, the President can just say, “Hey, we tried to compromise and look what happened.”
All of which seems like pretty shrewd politics, especially considering that six in 10 Americans already blame Republicans for not compromising enough on healthcare reform. Of course, winning the U.S. Senate election in Massachusetts would have been a better strategy, but hey, any port in a storm.
Blue Cross Blue Shield of Michigan — one of the companies skewered by HHS Secretary Sebelius in her report on individual health insurance premium increases — announced yesterday a statutory underwriting loss of $257 million in 2009, including a $94 million loss in its individual business serving members under age 65. The reasons for the individual losses were familiar, according to BCBS-MI:
The state’s broken regulatory system will continue to drag down financial performance in the individual market until a fair and balanced system is put in place. The current system allows out-of-state for-profit insurers and nonprofit HMOs to reject unhealthier and costlier-to-insure applicants in the individual insurance market. BCBSM accepts all applicants, regardless of their condition or cost.
Overall, however, BCBS-MI reported statutory net income of $12 million in 2009, largely because of investment gains of $242 million. Essentially, BCBS-MI lost a lot of money on its individual and Medigap lines, posted a profit on its other business lines, and was a big winner in its investment portfolio — up 14% — because of rebounding securities markets in 2009.
For additional color on the company’s financial performance, here’s a video of BCBS-MI vice president of finance Paul Mozak on the 2009 results.
We have officially jumped the shark on healthcare reform with this ABC News report depicting President Obama as Super Mario — complete with music, video game sound effects and animations of Obama, Speaker Pelosi and Blue Dog Democrats (literally portrayed as little blue dogs).
Wall Street analysts have had a mixed reaction to preliminary estimates from the Centers for Medicare and Medicaid services suggesting that Medicare Advantage capitated payment rates will rise 1.38% in 2011 prior to adjustments. UBS analyst Justin Lake said the increase was “slightly below our 2.5% expectation but more than made up for by no change in risk score adjustment.” Christine Arnold of Cowen said the 2011 increase will net out to about 0.7% versus a Wall Street consensus of down 1% to 2%. “While the Street is likely to be elated by the rate announcement, Medicare Advantage medical trends are rising around 5% and rates falling shy of trend is a bad thing,” she said.
From the website of the Centers for Medicare and Medicaid Services, “FAQs: Individuals Arriving from Haiti for Medical Care.”
May Haitian individuals admitted on humanitarian parole qualify for Medicaid?
Yes. Individuals granted humanitarian parole are ordinarily non-qualified aliens ineligible for any benefits as non-qualified aliens. However, the Refugee Education and Assistance Act of 1980 permits Cubans and Haitians who have been granted humanitarian parole to be provided benefits as Cuban/Haitian Entrants. Therefore, Haitians granted humanitarian parole because of the earthquake are qualified aliens exempt from the 5-year waiting period, and if otherwise eligible, may receive all Medicaid services available under the State plan. The emergency services restriction affecting some non-citizens does not apply.
Oppenheimer analyst Carl McDonald reacting to the furor surrounding WellPoint’s profits and planned rate increases:
I would like to be the first to express my complete and utter outrage at Kraft Foods. While hardworking Americans are suffering from the worst economy in a generation, Kraft Foods reported 2009 net income in excess of $3 billion, and an operating income margin of 13.7%. Clearly, there is no more basic a human need than food, and yet this company had no problem paying its CEO almost $17 million in 2008. I can feel the excruciating pain of so many people across the country that are having a difficult time putting a decent dinner on the table each night, and we need to work together to stop the abusive price increases this company is perpetrating on the American people.
I demand that the federal government immediately establish a Committee on Food Prices to set the appropriate amount that Kraft can charge for Oreo cookies, Oscar Mayer wieners, and Philadelphia cream cheese. It doesn’t matter to me that the price of sugar, milk, and whatever it is that actually goes into a wiener are increasing; we need to end the gouging that consumers endure every day….
The paragraphs above are satire. I’m actually a big Kraft Foods fan. Almost everything above is something that either a Senator or Representative has said over the past few weeks about a managed care company (mostly WellPoint) or the industry generally. It highlights the inherent unfairness of singling out a specific company like WellPoint ($2.7 billion in profits and margin of less than 5%) versus almost any company in the S&P 500, like Kraft ($3.0 billion in profits and a margin in excess of 13%).
As I predicted in January in my most roundly vilified post to date (and as this Reuters report suggests), House Democrats are putting together the votes to push through healthcare reform. It’s not yet clear whether the House will pass the Senate bill (as I had predicted) or whether Democrats will use reconciliation to pass a slightly improved version (i.e., Obama’s compromise of the House and Senate bills). Either way, I’ll be anxious to count how many anti-reform protesters forego needed benefits proffered by the legislation as a matter of principle.
U.S. Sen. Tom Harkin (D-IA) during President Obama’s healthcare summit last week, in response to Republican calls for a step-by-step approach to healthcare reform rather than comprehensive legislation.
If we want insurance reforms, you can only do that if everybody’s in the pool. You can only get everybody in the pool if you make it affordable for middle class families and others. You can only make it affordable for middle class families and others if you have cost controls….That’s why you can’t do this incremental approach.
The New York Times had a long piece this weekend titled The Cost of Doing Nothing, offering a bit of historical extrapolation on the consequences of prior failures to enact some type of healthcare reform:
If President Nixon’s plan had passed, the United States might be spending a trillion dollars a year less than it does now, and President Clinton’s plan would have reduced spending by some $500 billion a year.
Or as Dandy Don Meredith said, “If ‘ifs’ and ‘buts’ were candy and nuts, wouldn’t it be a Merry Christmas?”