[eggplant43]

--------------------------------------------------------------------------------

November 16, 2003
For Middle Class, Health Insurance Becomes a Luxury
By STEPHANIE STROM

DALLAS — The last time Kevin Thornton had health insurance was three years ago, which was not much of a problem until he began having trouble swallowing.

"I broke down earlier this year and went in and talked to a doctor about it," said Mr. Thornton, who lives in Sherman, about 60 miles north of Dallas.

A barium X-ray cost him $130, and the radiologist another $70, expenses he charged to his credit cards. The doctor ordered other tests that Mr. Thornton simply could not afford.

"I was supposed to go back after the X-ray results came, but I decided just to live with it for a while," he said. "I may just be a walking time bomb."

Mr. Thornton, 41, left a stable job with good health coverage in 1998 for a higher salary at a dot-com company that went bust a few months later. Since then, he has worked on contract for various companies, including one that provided insurance until the project ended in 2000. "I failed to keep up the payments that would have been required to maintain my coverage," he said. "It was just too much money."

Mr. Thornton is one of more than 43 million people in the United States who lack health insurance, and their numbers are rapidly increasing because of ever soaring cost and job losses. Many states, including Texas, are also cutting back on subsidies for health care, further increasing the number of people with no coverage.

The majority of the uninsured are neither poor by official standards nor unemployed. They are accountants like Mr. Thornton, employees of small businesses, civil servants, single working mothers and those working part time or on contract.

"Now it's hitting people who look like you and me, dress like you and me, drive nice cars and live in nice houses but can't afford $1,000 a month for health insurance for their families," said R. King Hillier, director of legislative relations for Harris County, which includes Houston.

Paying for health insurance is becoming a middle-class problem, and not just here. "After paying for health insurance, you take home less than minimum wage," says a poster in New York City subways sponsored by Working Today, a nonprofit agency that offers health insurance to independent contractors in New York. "Welcome to middle-class poverty." In Southern California, 70,000 supermarket workers have been on strike for five weeks over plans to cut their health benefits.

The insurance crisis is especially visible in Texas, which has the highest proportion of uninsured in the country — almost one in every four residents. The state has a large population of immigrants; its labor market is dominated by low-wage service sector jobs, and it has a higher than average number of small businesses, which are less likely to provide health benefits because they pay higher insurance costs than large companies.

State cuts to subsidies for health insurance to help close a $10 billion budget gap will cost the state $500 million in federal matching money and are expected to further spur the rise in uninsured. In September, for example, more than half a million children enrolled in a state- and federal-subsidized insurance program lost dental, vision and most mental care coverage, and some 169,000 children will lose all insurance by 2005.

"These were tough economic times that the legislature was dealing with, and the governor believed in setting the tone for the legislative session that the government must operate the way Texas families do and Texas businesses do and live within its means," said Kathy Walt, spokeswoman for Gov. Rick Perry.

She noted that the legislature raised spending on health and human services by $1 billion this year, and that lawmakers passed two bills intended to make it easier for small businesses to provide health insurance for their employees.

Those measures, however, will not help Theresa Pardo or other Texas residents like her who have to make tough choices about medical care they need but cannot afford.

Ms. Pardo, a 29-year-old from Houston, said that having no insurance meant choosing between buying an inhaler for her 9-year-old asthmatic daughter or buying her a birthday present. The girl, Morgan, lost her state-subsidized insurance last month, and now her mother must pay $80 instead of $5 for the inhaler.

Rent, car payments and insurance, day care and utilities cost Ms. Pardo more than $1,200 a month, leaving less than $200 for food, gas and other expenses. So even though her employer, the Harris County government, provides her with low-cost insurance, she cannot afford the $275 a month she would have to pay to add her daughter to her plan.

When Morgan's dentist recently wanted to pull a tooth, Ms. Pardo hesitated. The tooth extraction proceeded, but: "I had to ask him, if you pull this tooth, will it cause other problems? Because if it does, I can't afford to deal with them."

Lorenda Stevenson said her choice was between buying medicine to treat patches of peeling, flaking skin on her hands, arms and face and making sure her son could continue his after-school tennis program. "There's no way I will cut that out unless we don't have money for food," she said.

Mrs. Stevenson's husband, Bill, lost his management job at WorldCom two years ago, when an accounting scandal forced the company into bankruptcy. They managed to pay $900 a month for Cobra, the government policy that allows workers to continue their coverage after they lose their jobs, but when the cost rose to $1,200, they could no longer afford it.

When their son, a ninth grader, needed a physical and shot to take tennis, Mrs. Stevenson turned to the Rockwall Area Health Clinic, a nonprofit clinic in Rockwall, a city of 13,000 northeast of Dallas. The clinic charged her $20 instead of the $400 she estimated she would have paid at the doctor's office.

"I sat filling out the paperwork and crying," she said, tears streaming down her face. "I was so embarrassed to bring him here."

A salve to treat her skin condition costs $27, and she pays roughly $50 a month for medications for high blood pressure and hormones. She does without medication she needs for acid reflux, treating the conditions sporadically with samples from the clinic.

Carol Johnston cannot afford even doctor visits. A single mother in Houston, she lost her job in health care administration in May and said she was still unemployed despite filling out 500 to 600 applications and attending countless job fairs.

Cobra would have cost $214 a month, or more than one-fifth of the $1,028 in unemployment she gets a month. As it is, her monthly bills for rent, car, utilities and phone exceed her income.

She got a 12-month deferral on her student loans, and Ford pushed her car payments back by two months. The Johnstons rely on television for entertainment and almost never use air-conditioning, despite Houston's muggy, hot climate.

Now Ms. Johnston's 16-year-old son is losing the portion of his insurance that covered treatment for his learning and emotional disabilities because of state cutbacks.

Ms. Johnston herself does not qualify for Medicaid, the government insurance program for the indigent, because her income is too high, the same reason she qualifies for only $10 a month in food stamps. "I worry, I worry so much about making sure my son is safe," she said.

As for her own health, Ms. Johnston has two cysts in one breast and three in another but has had only one aspirated because she cannot afford to check on the others. "Do I have to move to Iraq to get help?" she asked. "They have $87 billion for folks over there," she said, referring to money Congress allocated for military operations and rebuilding.

Experts warn that allowing health problems to fester is only going to increase the costs of health care for the uninsured. "As Americans, when are we going to realize it's cheaper to save them on the front end than when they get cancer and show up in the emergency room?" said Sandra B. Thurman, executive director of PediPlace, a nonprofit health clinic in Lewisville, Tex.

Many hospitals and neighborhood clinics here say that the well-heeled are now joining the poor in seeking their care. Emergency rooms are particularly hard hit, since federal law requires them to treat anyone who walks through their doors for emergency treatment, regardless of whether they can pay.

Public hospital emergency rooms are even harder hit, since private hospitals will move quickly to shift uninsured patients to them. And clinics for the poor are also seeing an increase in demand.

A clinic run by Central Dallas Ministries charges patients $5 for a doctor visit, $10 for medication and $15 if laboratory work is needed, but often settles for no payment from many of the 3,500 patients it treats each year.

"I'm not real optimistic it will get a lot better," said Larry Morris James, executive director of Central Dallas Ministries. "Demographic and economic trends tell you that it's probably going to get worse."

For Irma Arellano, the problem has already hit home. Mrs. Arellano is a secretary in the Royse school district northeast of Dallas, which provides her health insurance for $35 a month but offers no discounts for her three children or husband.

Two years ago, the Arellanos paid $269 a month to insure the family. The price jumped last year to $339 and this year to $780, more than their monthly mortgage payment.

Her husband works for a small landscaping company that does not offer insurance. So Mrs. Arellano is insured, but her husband, Jose, and their three children — Jackie, 16; Joe, 15; and Anthony, 13 — are going without insurance.

The Arellanos' income, which ranges from $2,800 to $3,200 a month, makes them ineligible for state-subsidized insurance. Their basic expenses run $2,000 a month or more.

"I'm one of those people in the middle," Mrs. Arellano said. "We don't make enough to pay for insurance ourselves, but we make too much to qualify for CHIP," the government-subsidized program for children.

So her children were recently at the Rockwall clinic for the physicals they need to participate in after-school sports, paying $25 instead of the $100 or more Mrs. Arellano would have paid at the doctor's office.

The family has catastrophic insurance, but Mrs. Arellano is uncertain how much longer she can afford it. Mr. Arellano's income typically drops in the winter, and his wife is hoping the children will then qualify for the state insurance program.

Even so, newly initiated regulations require families to reapply for the insurance every six months, rather than once a year, so they are not likely to qualify for long.

"I'll take what I can get," Mrs. Arellano said.



Copyright 2003 The New York Times Company

[eggplant43]

Medicare Prescription Drug Legislation: Concerns for Rural Beneficiaries

November 14, 2003
Updated November 18, 2003

About 9 million Medicare beneficiaries live in rural America and face special challenges in accessing prescription drugs. Our September study, Medicare Prescription Drug Legislation: What It Means for Rural Beneficiaries, found that, compared to urban beneficiaries, rural beneficiaries have less prescription drug coverage, spend more for needed prescriptions, and rarely have stable access to private health insurance plans who will deliver the drug benefit under the recent proposals. The report suggested policies that would assist this vulnerable group. While some of these proposals appear to have been included in the conference agreement, others apparently were rejected, leaving doubts about whether the legislation fairly and adequately helps rural beneficiaries. Specifically, the emerging conference bill, compared to the Senate-passed legislation, includes:

• Larger prescription drug benefit gap: Medicare prescription drug coverage would cut off after spending hits one threshold and begins again when it hits another – creating a benefit gap or donut. The conference bill appears to have a gap of about $2,800, twice as large as the already-troubling gap in the Senate bill. This will affect rural beneficiaries who tend to have higher costs and fewer options for paying for drugs in the gap.

• Less assistance for low-income beneficiaries: The conference bill tightens the income and assets tests for extra assistance for low-income seniors. It would also eliminate Federal Medicaid funding to fill in the gaps in the Medicare drug benefit. Both provisions would disproportionately affect rural beneficiaries who are 20 percent more likely to have income below 150 percent of poverty. Up to 1.7 million rural beneficiaries could have their current drug coverage reduced, unless cash-strapped states replace the lost federal funding.

• Weakened prescription drug "fall-back": New, untested private insurers would deliver the prescription drug benefit. Acknowledging private insurers’ under-service in rural America , the Senate plan included a fallback that would let Medicare offer a drug benefit in areas where two or more private plans fail to do so. However, the conference bill appears to give rural beneficiaries only one private insurer option if they stay in traditional Medicare, forcing them to consider trading access to their doctor to join a Medicare HMO and gain lower cost sharing for needed drugs.

• Harmful premium support demonstration: "Premium support" effectively caps Medicare spending for the traditional program and private plans, shifting greater risk and costs to seniors. The demonstration proposed, which would begin in 2010, would target six sites - including small cities. Given their lower income, rural beneficiaries would be particularly hard pressed to pay more to stay in traditional Medicare.

• Inequitable and anti-competitive HMO and PPO payments: The conference agreement builds on the current overpayment to private plans, increasing base rates to well over 20 percent above the cost of the traditional program, and including a $12 billion slush fund to keep private insurers in Medicare. Not only is this anti-competitive and costly, it would require rural seniors to pay for this private system even though most would likely lack access to it.

• Arbitrary cap: A last-minute change to the conference agreement would cap the amount of general government funding to Medicare, setting it apart from other programs and setting the stage for cost-cutting measures that could erase recent gains in Medicare reimbursement rates for rural providers, increase beneficiary cost sharing, or otherwise harm the program.

• Weakened drug cost containment: Policies to promote access to generic drugs and reimportation of U.S.-made drugs appear to have been watered down in the conference agreement. This hurts not only rural seniors but other rural residents who frequently lack insurance for medications.

Adapted from: JM Lambrew, B Briesacher. ( September 2, 2003 ). Medicare Prescription Drug Legislation: What It Means for Rural Beneficiaries. Center for American Progress. Note: A study from Families USA (May 2003) found a much larger number or rural beneficiaries inNorth Dakota (68,181) andSouth Dakota (85,738).

[AKA Arizona]

A huge not funny joke.
I have one of those good paying jobs but like the rest our health care sucks.
We are blessed we do not great health issue, but were not getting any younger and I understand the desperate need.
The part my company pays is just enough for me, never mind our 1 daughter still in school, fortunately MS has the CHIPs program she is covered. My wife HA she is SOL as long as she is in school we could not afford my coverage plus hers and have food in the house every week.
What needs to be done?

[eggplant43]

What needs to be done?

Frankly, I don't know at this point.

I guess we need to start with acknowledging that we have a problem, that the problem is serious, and then we, as a people need to decide to take action to resolve the problem. I think almost everyone agrees there's a problem, but no one seems to be able to do anything about it, or willing. Lot's of lip service, very little action.

There have been some very heated debates about this here before, so I hope we can have a meaningful conversation this go around. I'd say that I believe that we need to have some kind of Universal Health-care. If other countries can do it successfully, I don't see why we can't.

There are those that argue that the quality of the care would be reduced, and that may well be true. From my perspective, some is better than none. The question I think we all need to ask is: if we keep doing what we are doing today for the next five years, will things be better, worse, or the same?

One thing I feel strongly about is that whatever system is determined to be the appropriate one, that it be the care system of the Congress, as opposed to the current very specialized care they have created for themselves, or "what's good for the goose, is good for the gander". I don't say this in jest, it simply seems to be fare to me. After all, I employ them, they have the best, and I have nothing.

I hope we can have a meaningful conversation about this without rancor and side-taking.

[eggplant43]

from the November 21, 2003 edition - http://www.csmonitor.com/2003/1121/p03s01-ussc.html

Seniors' old friend turns foe, for some
Many retirees criticize the AARP on Medicare - a sign that the advocacy group's clout is under new scrutiny.
By Gail Russell Chaddock | Staff writer of The Christian Science Monitor

WASHINGTON - Senior citizens in the cavernous Senate Caucus Room - once the scene of hearings on the sinking of the Titanic - this week heartily booed the organization that is arguably the flagship in Washington's fleet of powerful lobbying groups.

The meeting, while focused on a controversial Medicare deal making its way through Congress, also revealed a growing rift among seniors over the AARP - once known as the American Association of Retired Persons - as well as the strategy for improving healthcare for seniors.

More than 500 seniors hissed at the mention of pharmaceutical companies and at another backer of the proposed prescription drug plan: former GOP Speaker Newt Gingrich, who once called for an end to the Medicare system altogether.

But when the AARP came up, they roared disapproval. "Down with the AARP!" the crowd shouted. "I'm shocked and outraged and I want to give up my membership," says Bill Toto, a retired teacher from Huntington, Long Island. He added, repeating a claim by Democratic lawmakers who organized the rally: "They're in the drug and insurance business and they stand to gain."

On one level, the scene was skewed. These seniors were a select group, bused in by labor unions to protest the Medicare drug plan and cheer its Democratic critics. But it also signals deeper rifts within the senior community going into this fight, expected to come to a House vote Friday.

Old allies diverge
For decades, the 35-million strong AARP has been the most reliable ally of Democrats on Medicare issues. They were present at the creation of the Medicare system in 1965 and lobbied hard to expand the system to include prescription drugs - a move they said should cost at least $750 billion over the next 10 years.

The $400 billion plan announced this week falls far short of that goal. But national AARP leaders say it's the best seniors can do for now, and are backing that claim with a $7 million media campaign: "The proposed prescription drug Medicare bill isn't perfect. But millions of Americans can't afford to wait for perfect."

Senior Democrats cried foul. "The AARP has forgotten where they come from, because once you get into the business of making money with the devil you forget your mission," says Rep. Charles Rangel (D) of New York, referring to royalties the AARP receives from insurance marketed to its members. Opponents of the largely GOP-crafted Medicare bill worry that the clout of an AARP endorsement will be enough to win passage of what they say is a deeply flawed bill.

Longer lives, more political power
American seniors are living longer and gaining political clout. During this decade, the 65-and-over demographic will grow at a higher rate than the total US population, and three to four times as high after 2011, when the baby boomers begin to retire, according to US census data.

But as this group matures, significant differences are surfacing on once monolithic, so-called senior issues, such as healthcare. Many Americans work into their 70s, and live active, independent lives well beyond that. That's one reason the AARP in 2001 dropped the words "retired persons" from its full name, retaining just the initials.

Such splits are also surfacing in voting patterns. "The senior vote was always viewed as people over 65 and always viewed as a slam-dunk Democratic vote ,and during the '90s it wasn't," says pollster John Zogby.

The challenge of representation
For senior organizations such as the AARP, representing such a big tent group is a challenge, never more so than in the complex and wide-ranging Medicare bill.

The bill aims to add a prescription drug benefit to a system still focused on acute care for seniors in hospitals. It offers seniors a choice between a stand-alone drug plan for a private health plan that offers drug coverage.

To get the bill under the $400 billion limit, lawmakers are also proposing gaps in coverage for prescription drug costs between $2,200 and $3,600. Premiums and deductibles would be waived for the lowest-income seniors.

What especially alarms Democrats and some senior groups is the prospect of a competition between traditional fee-for-service Medicare and private coverage by 2010.

In final negotiations over the bill, that competition was reduced to demonstration projects in six metropolitan areas. But it's still a lightning rod for critics who say it could undermine traditional Medicare.

"It's hard to explain the AARP's decision on this. If you look at this plan narrowly from the point of view of middle- and upper-income elderly who form the bulk of AARP membership, they will get more in benefits than they pay in taxes," says Henry Aaron, a senior fellow at the Brookings Institution.

"From a self-interested standpoint, it's a good deal, but it is a bad deal for many elderly and disabled people," he adds.

In response to the AARP decision, Democrats release a new poll by Peter D. Hart Research that found that 61 percent of AARP members view the pending Medicare bill unfavorably. AARP spokesman call the poll "slanted."

Senior Democrats also called on AARP CEO William Novelli to avoid appearance of a "conflict of interest" by make a commitment not to market "discount cards, pharmacy drug benefit plans, or any other managed care health plan offerings to Medicare beneficiaries called for in this bill."

Republican leaders hailed the AARP decision, which they say will help secure a favorable vote in the House, where the plan is under fire both from Democrats and from GOP conservatives, who say the plan does not ensure enough competition with private plans to drive down Medicare costs.

Medicare reform passed the House by a single vote last June. GOP vote counters say the AARP endorsement may give them a slightly higher margin, when the renegotiated bill comes up for a final vote this week.

[eggplant43]

On the new Medicare plan:


http://uggabugga.blogspot.com/2003_1...32186096906550

[eggplant43]

The Math

If you ask me, getting a really interesting analysis out of Brian Weatherson's health care statistics required doing a bit more math. For example, total US health care expenditures per capita are $4,287 of which 44.2 percent comes from the public sector. In the socialist paradise of Sweden, by contrast, a much larger 85.7 percent of health care expenditures per capita are from the public sector. In Sweden, of course, health care is universal, so there are no uninsured and there's no one afraid to switch jobs because his pre-existing condition might make it impossible to get new coverage.

I take it that everyone, when they let their principles slide, would, all else being equal, prefer to get their health care for free rather than pay for it out of pocket. Similarly, employers would rather not pay for their employees coverage. But moving to Sweden's universal care system would require a big tax hike, right? Not so right. In Sweden, where men live longer, women live longer, infant mortality is lower (not unrelated to the above facts), and there are more doctors per capita, per capita health spending is just $2,053. 85.7 percent time $2,053 equals $1,759.421 in per capita public spending. Using the American numbers you get $1,894.854 in per capita public spending. In other words, if you like small government, you should prefer socialist Sweden to private sector America.

But have I just picked some funny outlier here? Not really. The mean French taxpayer shells out just $1,680.36 for his universal coverage, UK taxpayers (who, admittedly, get crappy care compared to the rest of the world, socialist or otherwise) are giving just $1,371.72 even the relatively lavish Canadian government is spending just $1,712.832 per capita on health care.

So...libertarians, small government conservatives, anti-tax activists of the world -- where are you? Why not try universal care? Admittedly, it's bad for insurance companies, but it would be good for (a) companies that currently provide health benefits, (b) people who don't currently have health care, and (c) people who pay taxes. What's not to like? Keep in mind that if you wanted to keep the state health care sector at exactly the same level that we have now, US health care benefits could be more generous than those offered anywhere else in the world.

Posted by Matt Yglesias at November 20, 2003 02:13 PM | TrackBack

Found Here:


http://www.matthewyglesias.com/archi...72.html#001872

[eggplant43]

House tentatively passes drug bill after lengthy vote

DAVID ESPO, AP Special Correspondent

Saturday, November 22, 2003
©2003 Associated Press

URL: sfgate.com/article.cgi?file=/news/archive/2003/11/22/national0602EST0478.DTL


(11-22) 03:18 PST WASHINGTON (AP) --

The Republican-controlled House approved a sweeping Medicare drug bill early Saturday in an epic struggle settled near dawn. The vote was 220-215.

The vote capped an extraordinary roll call that began at 3 a.m. and dragged on for roughly three hours before the GOP leadership could overcome a rebellion by conservatives in their own ranks and the nearly unanimous opposition of Democrats.

The vote sent the measure to the Senate, where supporters expressed growing confidence they also would prevail. President Bush is eager to sign the bill, which would give 40 million seniors and disabled Americans a prescription drug benefit and a new option for private health care coverage.

"After this legislation goes into effect, low-income seniors will never be confronted with the choice of putting food on the table or paying for life-saving prescription drugs," House Speaker Dennis Hastert said well after midnight, just before the lights dimmed in the chamber to signal the beginning of the longest roll call in the history of the House.

But House Democratic Leader Nancy Pelosi said seniors know that her party gave birth to Medicare during the Great Society, adding, "we want to protect it and strengthen it. America's seniors have also known where Republicans stand, for four decades they have waged war on Medicare."

The bill represented a political compromise of sorts -- the new prescription drug benefit, coupled with federal subsidies designed to give private insurance companies incentives to establish new managed care plans around the country.

Republicans said these new plans, either preferred provider organizations or HMOs, would modernize Medicare, providing better coverage at lower cost. Democrats expressed skepticism, saying they marked the first step on the road toward privatization.

Dozens of lawmakers waited out the drama of the middle-of-the-night roll call, as Hastert, his lieutenants and Department of Health and Human Service Secretary Tommy Thompson shuttled from one GOP holdout to another seeking enough votes to prevail.

©2003 Associated Press

[Servant of Eru]

I'll tell you what needs done. We need to quit wasting our funds on terrorism, pull the pluck out of Iraq and Afghanistan, and fix things IN the "Homeland" before we worry about things outside of it. I've experienced this first hand when my mom had a stroke that almost killed her, was in the hospital in intensive care for three weeks (Not cheap I tell you), and in rehab in the hospital for three more weeks. Fortunately we qualified for MediCal, but we could only have it if we got rid of all our liquid assets over $3000 which includes every bank account, and possesion we could sell or access, including my $6500 I earned, any vehicles besides one car, and our house. My God, do you know how little that is in reality? My dad has an '86 Ford Bronco that he uses to haul trash (We're too far out in the boonies to get trash pickup), and they said it was valued at $3500 when in actuality, it's a heap of garbage itself, it's just that they use the values that CA DMV uses for taxes, so of course they're jacked up as far as lavishly imaginable to squeeze every bit of property tax out of you they can. We barely qualify for insurance for me and my siblings, but only under the state run low income families policy, which has pretty negligible mental health care costs, and those in actuality are even worse then physical health care costs, because while if you are hospitalized, you're going to have some sort of coverage because you simply can't come up with the money, but if you're clinically depressed, you're hospitalized or DEAD by the time you're in critical condition. My family needs counseling desperately right now, but we can't come up with the $green$.

Rant over.

[eggplant43]

It's very sad what it has to come to. We spent $315,000.00 on my dads care until there was nothing left, and then he went on MediCal for his final two years. We never regretted spending all his funds, but there has got to be a better, more rerasonable set of choices for your family than the situation you are now in.

[bassetman]

Eggy, I had a contract with a hospital since 1981 to provide services. It did not include health insurance. My ins. costs went from $50/mo to $549.00/mo. last year. Just this last week they decided not to continue the service I provided and ended my contract. I don't know how much longer I am going to be able to afford to pay for health ins. out of my savings.

As I said in my are you better off thread, is this the recovery?

[eggplant43]

You are younger than I am. I can assure you, it only gets worse from here. There may be pretty fabric, but beneath it, everything is rotten, just waiting to be revealed.

As Americans, I believe we can do better for each other, so much better.

[bassetman]

I agree with you eggy! Despite Mulder's claims of negativity, some of us are really trying to make this a better place!

[eggplant43]

Joe Conason's Journal
Turning healthcare over to the private sector will cost taxpayers more, not less.



Nov. 24, 2003 | The "efficiency" that will bankrupt us
Enthusiastic advocates of Medicare privatization always insist that such measures will rein in costs, improve efficiency, and apply "market discipline" to federally subsidized healthcare. Senate Majority Leader Bill Frist regularly utters the same clichés, as he did again this week while seeking to end debate on the pro-privatization prescription-drug bill. "We just think that competition through the private sector, through bulk purchasing and negotiation, is a more effective means to hold down prices," he said on Sunday.

As the Washington Post reports today, however, the Medicare bill that is about to become law "would steer at least $125 billion over the next decade in extra assistance to the health care industry and U.S. businesses." The legislation's lavish provisions benefiting insurance companies, HMOs, hospital corporations, and other allegedly efficient providers tacitly acknowledge the unspoken truth about healthcare: Turning healthcare over to the private sector will probably cost taxpayers more, not less. Rather than encouraging savings, the bill actually guarantees higher costs.

Lobbyists for the "efficient" private insurers demanded and won a new rule that will give them the same rates paid by traditional, fee-for-service Medicare -- plus an additional $12 billion slush fund for the private programs, designed to "persuade" them to do business in places where they have already begun to abandon their clients. (The success of the healthcare lobby no doubt is connected to its political generosity. Nearly two dozen of the Bush Pioneers, fat cats who have bundled more than $100,000 for the president's campaign, are connected with the industry.) Health economist Marilyn Moon finds these fat payoffs "very ironic," since, as she explains, "To increase participation in private plans, we are going to overpay them for the foreseeable future."

As a scion of Health Corporation of America, the nation's largest operator of private hospitals, Frist himself stands to benefit substantially from congressional largesse to the industry, as do members of his family. (See this thorough probe of the wealthy lawmaker's "blind trust" published in Nashville Scene last summer.) When Frist blathers on about the best way to tend to the nation's health needs, he never mentions the ongoing scandals in the private health sector -- such as the enormous Medicare fraud scandal that his family firm settled with the Justice Department last winter. Nor does he seem eager to discuss the scandals that currently beset other major providers such as Health South and Tenet Healthcare Corp.

Americans spend more per capita on healthcare than most industrialized nations that manage to insure all of their citizens -- and now, thanks to this bipartisan idiocy, we will spend billions more on companies that are notorious for waste, fraud and abuse.

[Al-Firdaus]

Well, the bill has passed. Go out, get a shovel and begin digging deep into your pockets, you older americans. The senate has just screwed you.
P.S. Don't forget to lube yourself.