Health Insurance Industry Still Wants To Cancel Sick People's Coverage

[dmagicglock]

It doesn't... I was correlating education, and in the higher income, I specifically said legal and health care - because many of the high income earners are CEOs, and big business guys are Reps. I posted that article on here in another thread, I just can't find it at the moment.

gotcha, well i'm off to bed... we'll have to pitch an idea for the 9 o'clock time slot to foxnews to replace sean hannity since "hannity and colmes" is no longer on and its just hannity. We could bring this fair and balanced wholesome goodness to primetime!

[Disclaimer]

Higher income brackets (specifically in the legal and health professions) and well as higher educated people also tend to vote democrat.

Just ran across this article tonight... it somehow kinda maybe not at all fits in this thread.

http://www.huffingtonpost.com/2009/07/10/only-six-percent-of-scien_n_229382.html

A new study by the Pew Research Center finds that the GOP is alienating scientists to a startling degree.

Only six percent of America's scientists identify themselves as

Republicans; fifty-five percent call themselves Democrats. By

comparison, 23 percent of the overall public considers itself

Republican, while 35 percent say they're Democrats.

The ideological discrepancies were similar. Nine percent of

scientists said they were "conservative" while 52 percent described

themselves as "liberal," and 14 percent "very liberal." The

corresponding figures for the general public were 37, 20 and 5 percent.

Among the general public, moderates and independents ranked higher

than any party or ideology. But among scientists, there were

considerably more Democrats (55%) than independents (32%) and

Republicans (6%) put together. There were also more liberals (52%) than

moderates (35%) and conservatives (9%) combined.

"These results were not a complete surprise," said Scott Keeter,

Director of Survey Research at Pew, in an interview with the Huffington

Post. He said they can be mostly attributed to "the difference between

Democratic and Republican parties with respect to issues."

The wide ideological and partisan gap among scientists may have been

exacerbated by the Bush administration, which often disputed broad

scientific consensus on topics such as evolution and climate change.

Keeter acknowledged this factor, but said that "many of these

disputes probably predate the Bush administration," noting that

scientists have favored liberal views in numerous past studies.

Religion also plays a role. Republicans tend to promote the

centrality of religion more often than Democrats, and while 95 percent

of the public said they believe in "God" or "a higher power," only 51

percent of scientists claimed either.

"Many Republicans, especially the Evangelical wing of the party, are

skeptical of evolution, and have argued for the teaching of creationism

and intelligent design in school," said Keeter.

The results could merely be a reflection of how scientists see the

world, rather than of partisan loyalties. In a series of questions

posed, the study found that the answers of scientists were consistently

more in line with liberal viewpoints than those of the general public.

"The Republican Party has a number of leaders within it who have

challenged the accuracy of scientific findings on issues such as

climate change, evolution and stem cell research," Keeter told the

Huffington Post.

"It suggests that scientists who are Republicans might feel some

dissonance from the party's position on some things that are important

to them. And while there are Republicans in the scientist sample, there

are really not that many," he said.

[Disclaimer]

Dennis Kucinich Schools Prominent Wingnut Doc at This Week's Single Payer Hearing

http://crooksandliars.com/susie-madrak/not-ready-dennis-kucinich-demolishes

Ah yes, I'm not surprised that psychiatrist David Gratzer testified this week that the Canadian healthcare system is just awful and how the poor deprived Canadians are simply pouring across the border to the Mayo Clinic to get specialized medical care.

Oddly enough, he forgot to mention that the Canadian government was not only sending them across the border, they were picking up the check. Yes, it's a system so awful, even Canadian conservatives defend it.

How gratifying it was, to see Dennis Kucinich lay the smackdown on this guy.

Dr. Gratzer has been a prominent freemarket advocate since his college days and has been riding that gravy train ever since. He is especially beloved of freemarket conservatives because of a piece he wrote two years ago that hit the wingnut sweet spot: "The Ugly Truth About Canadian Health Care."

He's a fellow at the Manhattan Institute, a "non-partisan" think tank funded by the usual partisan suspects:

The Manhattan Institute received $19,470,416 in grants from 1985-2005, from foundations such as the Koch Family Foundations, the John M. Olin Foundation, Inc., the Lynde and Harry Bradley Foundation, the Scaife Foundations, and the Smith Richardson Foundation. The Manhattan Institute does not disclose its corporate funding, but the Capital Research Center listed its contributors as Bristol-Myers Squibb, Exxon Mobil, Chase Manhattan, Cigna, Sprint, Reliant Energy, Lincoln Financial Group Foundation, and Merrill Lynch.

So I think you can see where he's coming from. And really, what could make the right wing more excited than a Canadian doctor, criticizing the Canadian health care system?

Just recently, he wrote an op-ed for the Wall St. Journal which Media Matters debunked, and is famous for pushing HSAs (health savings accounts), which are sort of the health care version of privatizing Social Security. (Naturally, wingnuts love them!)

You're probably not aware that for the past decade or so, right-wing American groups have been pouring a lot of money into Canada to undermine their health system. (Can you guess why? I knew you could! So American health care corporations can make a killing there, too!)

Dr. Gratzer's biggest thing is hammering away on wait times - even though the long wait times are mostly for non-urgent care. (You can read a rebuttal about many of the common myths here.) He also thinks the way to bring down the cost of prescription drugs is... to cut back on those pesky FDA requirements!

While serving as an adviser to Rudy Giuliani's campaign, he was called out by Factcheck.org and others for supplying a bogus cancer statistic Rudy used in an ad:

Rudy Giuliani's latest radio ad, which began airing in New Hampshire this week, draws a stark picture for anyone diagnosed with prostate cancer in England. "I had prostate cancer, five, six years ago," the Republican presidential candidate says in the ad. "My chance of surviving prostate cancer, and thank God I was cured of it, in the United States, 82 percent. My chances of surviving prostate cancer in England, only 44 percent under socialized medicine.”

The pushback was fast and furious:

"You would get an F in epidemiology at Johns Hopkins if you did that calculation," said Johns Hopkins professor Gerard Anderson, whose 2000 study "Multinational Comparisons of Health Systems Data" has been cited by Gratzer as a source for his statistics.... Five-year prostate cancer survival rates are higher in the United States than in Britain but, according to Howard Parnes of the National Cancer Institute, this is largely a statistical illusion.... Both Anderson and Parnes say that it is impossible, on the basis of the available data, to conclude that Americans have a significantly better chance of surviving prostate cancer than Britons.

British health officials were also quick to point out the error:

The Office for National Statistics says that the five-year survival rate from prostate cancer in Britain is 74.4 per cent.

Mr Giuliani’s campaign did not give an immediate response. But a spokeswoman has previously insisted that he would continue to repeat the statistic and run the advertisement. She said the 44 per cent figure came from an article in a “highly respected intellectual journal” published by the right-wing Manhattan Institute, which he had read because “he is an intellectually engaged human being”.

The article’s author, David Gratzer, who is an adviser to Mr Giuliani’s campaign, has acknowledged to The New York Times that the statistic is seven years old and “crude”.

He said that it came from the Commonwealth Fund, which specialises in health policy issues. But the same organisation has since issued a statement accusing Dr Gratzer of misusing its research.

The Commonwealth Fund responded:

In fact, the five-year survival data cited in the City Journal article do not come from The Commonwealth Fund report, and cannot be calculated from that report. What the report, Multinational Comparisons of Health Systems Data, 2000 by Gerard F. Anderson and Peter S. Hussey of Johns Hopkins University, includes are data on prostate cancer incidence and mortality rates in the two countries.

Specifically, The Commonwealth Fund report features a chart showing that, in 1997, the incidence of prostate cancer in the U.S. was 136 per 100,000 males and the mortality rate (death rate) was 26 per 100,000 males. By comparison, in the U.K. the prostate cancer incidence was 49 per 100,000 and the death rate was 28 deaths per 100,000. (The prostate cancer incidence rate—which is the number of men diagnosed with the disease in a given year—in the U.S. is thought to be higher because prostate cancer screening is much more common in this country.)

The incidence rates simply report the number of men diagnosed with prostate cancer in a given year. Prostate cancer mortality rates report the number of men who died of the disease in a given year. Neither speaks to length of survival, and that figure can not be calculated using the others.

Yes, Dr. Gratzer (like most right-wing true believers) is prone to seeing what he wants to see, and then insisting it's the truth. How refreshing to see him treated as the willful nincompoop he is.

[Disclaimer]

I still stand by my economically efficient argument.

The Economist: Reforming American health care

America’s health care is the costliest in the world, yet quality is patchy and millions are uninsured. Incentives for both patients and suppliers need urgent treatment

NO ONE will be astonished to hear that health care costs more in Indiana than in India. However, a few might be surprised to learn that Americans spend more than twice as much per person on health care as Swedes do. And many may be shocked to be told that in Miami people pay twice as much as in Minnesota, even for far worse care.

The American health-care system, which gobbles up about 16% of the country’s economic output, is by far the most expensive in the world (see chart 1). The Congressional Budget Office (CBO) estimates that on current trends spending on Medicare and Medicaid, the government schemes for the old and the poor, will rise from 4% of GDP in 2007 to 12% in 2050. The prospect of long-term fiscal disaster is the main reason why efforts to reform health care are gaining momentum in Washington, DC. As Peter Orszag, the director of Barack Obama’s Office of Management and Budget, puts it, “that ‘long term’ keeps getting closer and closer.”

The system has its defenders. They point out that countries should expect to spend more on health care as people age. Americans are wealthy enough to choose extra health care over other things. Their free-spending approach calls forth the invention and speedy adoption of valuable new drugs, devices and procedures, whereas Europe’s stodgy and stingy (not to mention socialist) health-care systems deny coverage and ration care, to the detriment of their people’s health.

A poll carried out for The Economist by YouGov highlights Americans’ beliefs about the state of their system. Although 68% of them rate the care they receive as “excellent” or “good”, 52% are dissatisfied with the quality in the country as a whole. Only 25% think the system works pretty well and requires only minor changes; 40% think fundamental change is needed and 29% think it should be completely rebuilt. Some results are shown in chart 2. A fuller version is available at www.economist.com/yougovpoll.

The doubters have a better case than the defenders. Granted, medical inventions are readily embraced by American doctors and patients. In specific instances—technology to save babies born prematurely and statin drugs to reduce cholesterol, to take two—the benefits of spending greatly outweigh the costs. But if the system in general were providing value for money, America’s vast expenditure would at least be reflected in a healthier population than in more frugal countries.

Alas, it is not. Comparisons with other rich countries and within the United States show that America’s health-care system is not only growing at an unsustainable pace, but also provides questionable value for money and dubious medical care. Three troubling symptoms stand out: uneven quality of care, inadequate coverage and soaring costs.

Start with quality. Evidence is mounting that spending more does not necessarily buy better health. On the contrary, it appears that many Americans are getting mixed or even downright dreadful health care. In a recent study economists at the OECD found that America does indeed do well on some measures, such as breast-cancer survival rates and cervical-cancer screening, compared with other rich countries. However, it does worse in other areas. American infant mortality was 6.7 per 1,000 births in 2007, against an OECD average (excluding Mexico and Turkey) of 4.0. The death rate after haemorrhagic strokes was 25.5% in American hospitals but only 19.8% in OECD countries as a group.

Jonathan Skinner, an economist at Dartmouth College, cautions that factors other than health-care systems—attitudes to teenage pregnancy, say, or smoking—may influence the numbers. Even so, he thinks the system is wasteful. In a paper in the Journal of Economic Perspectives last year he and Alan Garber, of Stanford University, argued that America’s health system was “uniquely inefficient”, producing too little per unit of input and consuming far too much of the country’s resources.

Mr Skinner is involved with another worrying line of research. The Dartmouth Atlas project has scrutinised variations in health outcomes and spending involving Medicare. It has found wide differences in costs across the country—less than $5,000 per person in Salem, Oregon, in 2006; a bit more than $8,000 in San Francisco, in line with the national average; more than $16,000, and rising fast, in Miami—but no connection between higher spending and better outcomes. In fact, the evidence points in the other direction: outcomes tend to be better where costs are lower. Mr Orszag points to the Dartmouth work to argue that up to 30% of America’s health-care spending is sheer waste.

The second symptom is coverage. Uniquely among rich countries, America’s system of health insurance is not universal. Around 49m people have no health insurance. On current trends, within a decade 60m will be without cover. Studies have shown that not all these people are indigent: a quarter or more can afford insurance, but choose not to buy it.

They know they are unlikely to be left to die in the streets. With the truly poor, the free-riders turn up at emergency rooms. This is hugely inefficient, because pricey late interventions and operations could very often have been avoided with a much smaller investment in preventive care. Insured people and taxpayers are forced to cross-subsidise such “uncompensated” and wasteful treatments to the tune of tens of billions of dollars per year.

Other rich countries cover almost all their citizens in one of two ways. Some, such as Britain, Canada and Sweden, have “single payer” systems, in which taxes support a public service. Others, notably the Netherlands and Switzerland, oblige individuals to buy insurance. France has a mixed public-private system.

After decades of failed attempts at reform, a consensus appears to be emerging in America around the principles needed for universal coverage. One likely change means a restructuring of America’s failed health-insurance markets. Firms are today allowed to pick the safest patients and reject the sickest. In future they will have to take all comers. Because this imposes unfair burdens on firms that attract lots of older or sicker people, reform is likely to include government-funded mechanisms for risk pooling or reinsurance. The Netherlands, in particular, uses such an approach.

American health insurers, having long opposed this idea, have performed a startling U-turn in recent weeks. America’s Health Insurance Plans, their chief lobbying group, now says it is willing to accept such heavy-handed reforms—if they are accompanied by a requirement that all Americans purchase coverage. This may seem a cynical ploy to expand their business, but some compulsion is needed to get around the selection problem. Any legislation is likely to include subsidies to help the poorest pay for cover.

If done properly, this will in time move America towards the Swiss and Dutch models of universal private insurance. These are not perfect, to be sure. Regina Herzlinger of Harvard Business School observes that the Dutch reforms have led to rapid consolidation of insurers and hospitals, fuelling resented price increases. She favours the decentralised Swiss model, which preserves individual choice and competition. Others note that Swiss health-care costs are high by European standards. But they are a third less, as a share of GDP, than America’s, and the country’s excellent health outcomes should be the envy of American reformers. Our poll suggests that an individual mandate would be unpopular, with only 21% in favour and 53% opposed. Respondents did favour having the option to buy from the government, by 56% to 23%.

Such reforms would expand coverage, but could exacerbate the third symptom, cost, as the experience of Massachusetts, a trailblazing state that has already implemented a plan for universal coverage, suggests. The state faces possible bankruptcy unless it finds a way to rein in costs.

continued...

[Disclaimer]

Your money or your life

Indeed, tackling inflation in American health care remains the most important and difficult part of the treatment. According to our poll, cost is a tender nerve: 61% thought the high cost of care and insurance was a bigger problem than the number of uninsured, against 31% who believed the reverse. Only 21% would be willing to support a reform plan if they had to pay more in insurance or tax; 62% would not.

Some common diagnoses are wide of the mark. One is price gouging by drug companies. In fact, pills account for barely a tenth of health-care spending in America and similarly small shares elsewhere. But aren’t costs lower in Europe because of price controls? Europe does indeed spend less on new branded drugs, but also uses fewer generic drugs and pays much more for them. And Switzerland actually has higher drug prices than America (as does Canada). Greedy drugmakers are not the main cause of America’s runaway costs.

Nor are baby-boomers, though they are often blamed for health-care inflation because there are a lot of them and they are getting old. Ageing will clearly push up costs in time (see our special report in this issue), but it is not the main culprit yet. The CBO estimates that ageing accounts for only a quarter of the health-care inflation to come in the next few decades, and the share in other rich countries is similar.

Doctors’ generous pay is another popular culprit. But doctors in several European countries are well paid too. The OECD estimates that general practitioners in America earn 3.7 times the average wage. Their British counterparts earn 4.2 times their national average. American specialists earn 5.6 times the average wage, against 7.6 times for their Dutch colleagues. Yet health-care costs in Britain and the Netherlands remain lower than America’s. The real problem is not how much American doctors are paid, but how. The system of medical reimbursement warps incentives for doctors, insurers and patients that lead Americans to consume more and more medical services. There is strong evidence that Americans use pills, procedures, scans and other expensive forms of health care more often than do patients in other rich countries, and not always to good effect.

America’s insurance system encourages overuse in several ways. One is the tax break that favours health insurance provided by employers, which leads to excessively generous coverage and hence over-consumption. Another is the fact that American health insurers earn a lot of revenue from administering the health plans provided to employees by big corporations which, in effect, insure themselves. This leaves insurers with no incentive to curb costs, because more spending means fatter management fees.

The incentives facing doctors are even more perverse. Most doctors are not paid a fixed salary, still less rewarded for better health outcomes. Integrated American systems such as Kaiser Permanente and the Mayo Clinic are exceptions to this rule, and Britain’s National Health Service (NHS) is trying to adopt a similar approach. But most doctors and hospitals are paid more if they provide more services, regardless of the results. Predictably, this leads to far higher rates of doctors’ visits, specialist referrals, scans and so on.

For instance, the OECD countries have an average of 11 magnetic-resonance imaging machines per 1m people. America has 25.9. America uses them more often, too: 91.2 times per 1,000 people per year, compared with the OECD average of 39.1. Similar tales can be told about other pricey kit.

This incentive problem even extends to patients. If patients pay very little out of their own pockets they have little desire to curb consumption. Though this is a problem in many OECD countries, in America the proportion of out-of-pocket spending has declined sharply in the past few decades. And a new report by McKinsey, a firm of management consultants, identifies a more subtle problem. Having examined insurance and out-of-pocket spending for several health risks, it concludes that Americans are generally “over-insured and under-saved”. It is prudent for individuals to have comprehensive health insurance against catastrophic health risks such as heart attacks or cancer. But McKinsey finds that Americans with private health insurance often have generous coverage for non-essential and even medically unjustified care (see chart 3). This encourages over-consumption.

The power of sunshine

A second big factor pushing up health costs is the lack of competition among operators of American hospitals. Thanks to a wave of consolidation in recent years, argues Harvard’s Ms Herzlinger, “most parts of the United States are dominated by oligopolistic hospital systems.” George Halvorson, who heads Kaiser Permanente, insists that “there is an almost total lack of price competition among providers.”

Nimble upstarts and innovators are challenging the incumbents in some areas. Such efforts range from specialist heart hospitals, which get better outcomes at more reasonable prices than local general hospitals, to retail clinics at Wal-Mart stores. Remote medicine, in the form of technology for tele-care or medical tourism to Thailand and Costa Rica, also poses a threat. But medical lobbies are using political influence and outdated regulations to thwart competition where they can (for example, through rules preventing a doctor from treating a patient in another state).

To counter this, reforms could allow federal regulators to overrule state-level obstacles to entrants such as clinics staffed by inexpensive nurse-practitioners. More transparency would help too, by empowering patients to choose hospitals and doctors providing good value and better results. Electronic medical records would make shopping around easier.

Another useful way to promote transparency and value would be to evaluate the cost-effectiveness of new drugs, devices and treatments. This may be common sense, but it is rarely done in America. Britain’s National Institute for Health and Clinical Excellence (NICE) pioneered this approach, and other European countries have followed it. Andrew Dillon, the agency’s chief executive, accepts that “the NICE model is not transportable in precise form” but he still insists that “one can dissect and apply what is relevant to other countries.”

In America, the drugs and devices lobbies are violently opposed to a NICE-style agency that could issue mandatory rulings. They paint a scary picture of Americans being denied access to life-saving new drugs by faceless bureaucrats. In Britain NICE has come under fire for rulings that limited access to expensive drugs for Alzheimer’s and cancer on the NHS. America could get around this problem by requiring and perhaps even funding studies, but leaving insurers and individuals to decide whether to pay for treatments.

More competition and transparency would help, but the main goal of any reform plan must be to address the perverse incentives that encourage overconsumption and drive up costs. Medicare has been tinkering with “pay for performance”, a promising experiment. Mr Halvorson insists that by rejigging incentives other health providers can also create their own “virtual Kaisers”.

If American reformers doubt the power of incentives, they should visit Sweden. Like other relatively cheap OECD systems, Sweden’s single-payer model has been plagued by long waiting-lists—a sign, to American conservatives, of the rationing that goes with socialised medicine. Swedish health officials tried and failed to cut queues by increasing direct funding for hospitals and even issued an edict requiring hospitals to cut queues for elective operations to three months. Then, last year, the health ministry said it would create a fund into which it would pay SKr1 billion ($128m) a year for local authorities that managed to reduce waiting times to that threshold. Nine months ago virtually none of the counties passed, but this month the health minister revealed that nearly all had cut their queues to three months or less.

Anders Knape, the head of the organisation representing county governments, ascribes this to “a dramatic change in incentives”. In the past, he explains, hospital bosses believed waiting lists were a sign of being overloaded, so they tolerated them in the hope of winning more funding. With the new scheme, however, “no queues means more resources”.

If getting incentives right can mobilise even a state-run health system like Sweden’s, surely there is scope for such reforms to fix America’s mess too. If the United States couples its efforts to expand coverage with such a radical restructuring of the underlying drivers of cost inflation, there is every reason to think its health system can become the best in the world—and not merely the priciest.

Interesting?

[Disclaimer]

Research Firm Cited by GOP Is Owned by Health Insurer

http://www.washingtonpost.com/wp-dyn/content/article/2009/07/22/AR2009072202216_pf.html

The political battle over health-care reform is waged largely with numbers, and few number-crunchers have shaped the debate as much as the Lewin Group, a consulting firm whose research has been widely cited by opponents of a public insurance option.

To Rep. Eric Cantor of Virginia, the House Republican whip, it is "the nonpartisan Lewin Group." To Republicans on the House Ways and Means Committee, it is an "independent research firm." To Sen. Orrin Hatch of Utah, the second-ranking Republican on the pivotal Finance Committee, it is "well known as one of the most nonpartisan groups in the country."

Generally left unsaid amid all the citations is that the Lewin Group is wholly owned by UnitedHealth Group, one of the nation's largest insurers.

More specifically, the Lewin Group is part of Ingenix, a UnitedHealth subsidiary that was accused by the New York attorney general and the American Medical Association, a physician's group, of helping insurers shift medical expenses to consumers by distributing skewed data. Ingenix supplied its parent company and other insurers with data that allegedly understated the "usual and customary" doctor fees that insurers use to determine how much they will reimburse consumers for out-of-network care.

In January, UnitedHealth agreed to a $50 million settlement with the New York attorney general and a $350 million settlement with the AMA, covering conduct going back as far as 1994.

Ingenix chief executive Andrew Slavitt said the Ingenix data was never biased, but Ingenix nonetheless agreed to exit that particular line of business. "The data didn't have the appearance of independence that's necessary for it to be useful," Slavitt said.

Lewin Group Vice President John Sheils said his firm had nothing to do with the allegedly flawed Ingenix reimbursement data. Lewin has gone through "a terribly difficult adjustment" since it was bought by UnitedHealth in 2007, because the corporate ownership "does create the appearance of a conflict of interest."

"It hasn't affected . . . the work we do, and I think people who know me know that I am not a good liar," Sheils said.

Lewin's clients include the government and private groups with a variety of perspectives, including the Commonwealth Fund and the Heritage Foundation. A February report contained information that could be used to argue for a single-payer system, the approach most threatening to private insurers, Sheils noted.

But not all of the firm's reports see the light of day. For example, a study for the Blue Cross Blue Shield Association was never released, Sheils said.

"Let's just say, sometimes studies come out that don't show exactly what the client wants to see. And in those instances, they have [the] option to bury the study -- to not release it, rather," Sheils said.

Asked to comment, Blue Cross Blue Shield Association spokesman Brett Lieberman said, "We're still working with Lewin on a study, and, you know, we don't talk about our studies until they're done."

In testimony last month to a House committee, Lewin disclosed its affiliation with UnitedHealth and Ingenix in its written submission, but in his oral testimony he did not bring it up until asked, according to a transcript.

"The Lewin Group is committed to providing independent, objective and nonpartisan analyses of policy options," the firm said at the front of its written submission to the Energy and Commerce Committee. "To assure the independence of its work, The Lewin Group has editorial control over all its work products," the firm added.

Lewin produced one of the most widely cited statistics of the health care debate: That, under a particular version of a public option, the number of people with private, employer-sponsored coverage would decline by more than 100 million.

Opponents of the public option have invoked the finding as proof that offering a government-run health plan would not just create competition for private insurers -- it would deprive people of their existing employer-sponsored coverage and lead to a government takeover of the health care system.

"The nonpartisan Lewin Group predicts that two out of three Americans who get their health care through their employer would lose it under the House Democrat plan," Cantor, the second-ranking member of the House Republican leadership, said in a July 12 commentary in the Richmond Times-Dispatch.

Since then, adjusting its analysis to reflect the latest version of legislation drafted by House Democrats, Lewin has estimated that 88.1 million workers would shift from private, employer-sponsored insurance to the proposed public plan.

The Congressional Budget Office came to a different conclusion, saying that enrollment in the House Democrats' proposed public plan would total about 11 million to 12 million people.

Sheils said the CBO apparently assumes only small employers would be able to shift their workers into the proposed health insurance exchange, where individuals could shop for coverage among regulated options, while Lewin assumes that all employers could do that. The House bill would leave open ended the question of which employers would ultimately be eligible to use the exchange.

The CBO has not responded to requests for comment.

President Obama and other backers have sold the option of a government-run health plan as a check on insurers -- a new source of competition that would hold them more accountable to consumers, especially in markets where industry consolidation has left little competition among private insurers. Obama has pledged that, if people like their current coverage, they will be able to keep it.

Insurance companies have been trying to block the public option, saying it would undercut their prices and put them out of business by slashing payments to doctors and hospitals.

Lewin's findings have been somewhat distorted in the political debate. The firm's analysis of the public option is far from one-sided.

As Sheils explained it to the Energy and Commerce Committee, people would opt for the public plan because they would find it more attractive -- mainly because it would charge much lower premiums.

Politicians have argued that the public plan would place bureaucrats between patients and doctors. However, Lewin wrote that, like traditional Medicare, the federal program for the elderly, a public plan would do less than private insurers to restrict medical care.

Though the millions of people Lewin was describing would lose their current employer-sponsored coverage, they wouldn't be forced into a government-run health plan, Sheils said in an interview. Rather, they would be able to choose between the government plan and other private options.

"People would indeed lose what they have, but they might very well be better off," he said.

[dmagicglock]

haha saw this and even tho' I know I should just let this thread die, I couldn't resist posting it. It's a picture for a post card the republicans wanted to send out in response to the democratic healthcare. It was blocked by the dems because they felt it was misleading, anyways I'll let you be the judge!

[Disclaimer]

No picture, you fail at interwebz

[dmagicglock]

^ your comp fails at interwebz, it comes up on my comp just fine, but since you can't see it.... here's the link!

http://www.rollcall.com/pdfs/healthchart072309.pdf

[Disclaimer]

Dueling Health Care Flow Charts: Reality vs. GOP Propaganda

Reality flow chart:

GOP Propaganda flowchart

[Disclaimer]

Top Ohio doc likes where Obama is going with health care plan

ELYRIA — The president of the Ohio State Medical Associations said Thursday he likes the direction in which President Barack Obama is going with his plans for health care reform.

Dr. Roy H. Thomas said after Obama spoke in Shaker Heights about health care reform that the idea of making it easier for people to access private insurance with government subsidies is similar to what OSMA has been a proponent of for years.

“It’s something the president alluded to — a health care exchange,” Thomas said. “OSMA is not interested in a government-run program, but the idea of facilitating access to private insurance markets, with appropriate regulations, is very appealing.”

Thomas, an Elyria native and eye surgeon who has his own practice, Elyria Eye Clinic on East Broad Street, said government programs such as Medicare are consistently underfunded, and he fears that a government-run health care program would follow the same path.

“Every year they fail to keep up with inflation, and physicians constantly keep having to go back to Congress asking them not to cut rates,” he said.

Thomas called Obama a “likeable and very capable man” and said they both share the same vision of making sure everyone is covered.

Thomas said he hopes there are some stipulations added to that coverage, however, that include a focus on wellness and prevention so treatment can be more effective, more personal responsibility on the part of patients, and a mandate that requires people to have their own insurance, so if they lose their job they don’t lose their coverage.

[dmagicglock]

http://www.rasmussenreports.com/public_content/business/healthcare/july_2009/53_now_oppose_congressional_health_care_reform

interesting poll about people and their support or lack there of for healthcare. It looks like those that make less want it handed to them and those who make more don't want to pay for someone else's healthcare.

[psyco1]

From a somethingawful.com thread.

http://forums.somethingawful.com/showthread.php?threadid=2732476

There have been a lot of debates and discussions recently, both on this forum and in other venues, about the state of healthcare. Looking at the rising costs of health insurance, and at the growing numbers of the uninsured, many are calling for government intervention, and the institution of a system where care is guaranteed to all - usually described as "universal" healthcare. It's a fascinating topic - the issues involved include humanitarian, financial and ideological ones. Unfortunately, debate on the subject is characterised by a startling phenomenon: one side is right, and the other is completely wrong.

Given the importance of medicine, I feel that it would be useful to clarify this issue. I will explain clearly, and with evidence, why it is that universal healthcare of any sort would be better than the current system in every significant way. If you find yourself disagreeing with this assertion, I ask that you read on before replying, as all conceivable objections will be addressed and resolved.

Why The Current Situation Is Bad

At the moment, healthcare in America is provided mostly by private entities, who charge high fees. These fees can be attributed largely due to the difficulty and expense of the medical profession, and although they are significantly higher than those of similar nations this difference is only a small portion of healthcare costs. There then exists the health insurance industry, a loose network of corporations that charge individuals or organisations premiums and will pay for their health costs if any are incurred.

Unfortunately, this system has enormous problems. As of 2006, 44.8 million people in America do not have health insurance. Many are unable to afford it, many are denied coverage by insurers who believe that as customers they will not be economical, and others choose not to purchase it. Without health insurance, the up-front costs of health care are impossible for most people to afford. In fact, 50.35% of all bankruptcies were caused, at least in part, by medical fees. In 2001, this was 2,038,549 bankruptcies.

Furthermore, health insurance does not fully cover medical expenses. Different insurers and different plans have many exemptions, co-pays, threshholds and other expense-minimising devices. As a result, 62% of those two million bankruptcies occurred despite the debtors having health insurance coverage for the duration of their illness.

As well as failing to provide care, and driving individuals into bankruptcy, the existing system is also exorbitantly expensive. Health care spending is now 15% of U.S. GDP - the highest in the world. The costs to businesses, who commonly pay premiums for their employees in lieu of salary, rose by 13.9% in 2003. The annual cost increase has been above inflation since at least 1981. Paying more doesn't result in more value, either - obesity, diabetes, and similar disorders are more common in the United States than anywhere else in the developed world, the U.S. is ranked 72nd in overall health, and life expectancy is below that of 41 other countries.

What Is Universal Health Care?

Universal Health Care, or UHC, refers to a wide range of different systems, the common characteristic of which is that a nation's government guarantees all its citizens access to healthcare. Every developed nation (OECD member) in the world, apart from the United States, has a UHC system. There are three main types:

In a fully public system, there is no or little private healthcare, and the health insurance industry is not a significant one. Medical service providers are government employees, and the education of doctors is also subsidised. The most well known example of a fully public system is the original English NHS, although a private sector is now developing in the U.K. as well.

In an optional public, the government provides the same services, but a private health services industry also exists (generally regulated), and . Sometimes health insurers exist, used by people who prefer private services. This is the most common, and examples include Australia and Sweden.

In a subsidised private system, the government pays for health care, but it is provided by private entities. Either the government acts as a health insurer for the populace, or it pays the fees for private health insurers to do so. This is done in Canada.

For the purposes of discussion, I will be assuming the characteristics of an optional public system, like those used in most of Europe. However, the benefits of UHC apply to all of the above types of organisation.

How UHC Will Improve Things

The single largest problem with healthcare in America is that many people don't have it. It's obvious how UHC solves this: by providing it to all citizens directly (or paying for it to be done). By definition, this is no longer a problem under UHC. All developed nations other than the United States make this guarantee to their citizens, and have so far been able to uphold it. The two reasons which make a person uninsurable - insurer decisions and lack of money - will no longer exist.

The second major problem with the current system is its high cost. This can be divided into two parts: individual cost, and government cost - which to the individual shows up as taxation. UHC is inherently cheaper - far cheaper - due to economies of scale, the bargaining position of monopolies with regard to drugs and salaries, reduced administrative costs, and the lack of a profit motive. When it comes to individual health care costs:

According to the World Health Organisation, average American individual spending on healthcare is $3371 per year. Since this includes the uninsured and those covered by their employers, actual costs are higher. For comparison:

Australia: $1017

Canada: $916

Sweden: $532

United Kingdom: $397

The first of those is the second-highest in the world - meaning that Americans pay, not including taxes, more than three times as much as citizens of any other nation. This would be somewhat justifiable if they received better healthcare, but again - 28% have no care at all, life expectancy is below all other developed nations, and general health rating is below all other developed nations.

It is commonly assumed that this difference in cost is because under UHC systems, higher taxes are required to fund the system. Not so. As mentioned, UHC is a great deal cheaper than private healthcare, and as a result America's health-related taxation is also the highest in the world. According to the OECD, in 2006, American government spending on healthcare was $2887 per person. For comparison:

Australia: $2106

Canada: $2338

Sweden: $2468

United Kingdom: $2372

American healthcare taxes are in fact the highest in the OECD, with France second at $2714. In conclusion, every single UHC system in the world costs less money for individuals, requires lower taxes, and provides better care to more people than the American health care system. By implementing UHC in the U.S., things can only get better.

Edited July 26, 2009 by psyco1

[psyco1]

Frequently Raised Objections

There are many incorrect arguments against the implementation of UHC in the United States. In order to better facilitate discussion, I will explain the errors found in the most common.

"America isn't Europe!", or It Won't Work Here

The argument from American exceptionalism states that what works in Europe will not work in the U.S. It's said that this is because European nations have more people in less space, resulting in less logistical difficulties, and because European government is more competent.

Firstly, not all developed nations are European. The most obvious example that counteracts the logistical argument is Australia, where there are 20 million people in only slightly less space than America's 300 million. This does indeed affect prices, as can be seen by comparing Australia to Sweden or the U.K. - but it doesn't bring them anywhere near the levels currently experienced in America.

The argument that American government is uniquely incompetent, and cannot do things that every other nation in the world can do, is simply nonsense. Not only has America, and American government, achieved many things that other countries have not, America has so many resources and the improvement in care and cost from moving to UHC is so large that even with incredible inefficiencies it would still be a good idea.

"It is immoral to force me to pay for others' healthcare."

You are already paying for others' healthcare. Furthermore, you are paying far more than you would be under UHC. The U.S. government incurs massive costs from paying hospital fees when ER visitors have no money, and from the limited coverage that it provides, which cannot take advantage of economies of scale and which has to subsidise corporate profit.

As demonstrated above, U.S. taxes devoted to healthcare are the highest in the world. Even if you choose not to have health insurance, under the current system, you are still paying more for others' healthcare than you would be paying for theirs plus your own under UHC.

"This is socialism."

It is not socialist to recognise that there is a service the free market is inefficient at providing, and to decide it should better be provided by the government. Even the most staunch libertarian admits that there are some services in this category, such as national defence.

Secondly, it is irrelevant whether this is a "socialist" policy; it's effective. It costs less and provides better care to more people, and as a result is used literally everywhere else in the entire world. Those who want to ensure that society remains ideologically committed to market capitalism need to look for other issues, as if they cling to this one they will only end up providing evidence against their position.

"I don't want more government bureaucracy."

UHC will involve much less bureaucracy than is commonly assumed, as it can replace the existing partial systems like Medicare and also the plethora of state-specific programs. Regardless, the lives and money saved are more important than any potential expansion of the state.

"Why don't we try making the system even more private instead? That might help."

It might. However, there's no evidence to suggest it, and many reasons to presume it wouldn't. By its nature, the less publicly-supported a system, the more people will be unable to purchase health services.

The only potential gain would be reduced costs due to some sort of market mechanism, and in practice this has never occurred; every private healthcare system that has ever existed in world history has proved inefficient and been replaced by public systems, and given the demonstrable gains that have resulted the U.S. must follow.

"Doctors will be paid less."

They probably will. In nations with UHC, doctors often earn less - for example, U.S. doctors earn 30% more than Canadian doctors - but this isn't an inherent problem. It is still one of the highest-paying professions in the world, and there are many other ways of attracting skilled people to medicine - such as subsidising their education.

It is sometimes claimed that doctors paid less in a country with UHC will instead go elsewhere where they can be paid more, but once the U.S. has UHC there will not be an elsewhere to go.

"Medical research is funded by the payments of the rich in the current system, and will be reduced."

It is not true that most medical research is done in the United States. In 2000, U.S. research spending was $46 billion, but European spending was also $43 billion. And although U.S. research spending doubled in the last decade, the funding's efficacy has actually decreased.

Secondarily, if the option for private healthcare still exists - and there is no reason why it should not - there will still be people choosing to pay more for a higher quality of care, faster service, et cetera. Their profits will still be reinvested in the development of new drugs, equipment and understanding of the human body, as they still are in nations with UHC today. Even in the United States, private spending accounts for only 57% of research spending.

"With the option of private healthcare, the rich will 'opt out' and costs will go up."

This isn't necessarily true at all; although private healthcare is usually allowed in UHC nations (for good reasons), it doesn't have to decrease the taxes paid by all to support the public system!

"Other countries fix drug prices, so the US has to pay more for drugs."

This is another common misconception. U.S. healthcare does not include higher pharmaceutical spending than other countries; it's around the average or even slightly lower. From the OECD:

Canada: 17.7%

Germany: 15.2%

Iceland: 13.3%

Australia: 13.3%

US: 12.4%

Sweden: 12%

Ireland: 11.6%

In Conclusion

Thank you for reading. To those who were not previously supporters of UHC, I apologise if anything seemed condescending, but there's no shame in being wrong due to not having all the facts or having been misled. If anyone has questions feel free to ask, and hopefully we can now discuss what sort of UHC system ought to be implemented or how the political will for it can be gathered, rather than being bogged down by misconceptions about its desirability.

[Ryan_c_F]

Um.. psyco, don't really know where to start.

You're making a LOT of assumptions (or whomever you quoted is). Either way, they're not all accurate points.

With regard to payment, it's not fair that we've got to pay for others' healthcare already. What you seem not to understand is that we're currently running a 1.7 TRILLION DOLLAR DEFICIT at the current taxation rate. Obama has said publically, "we're out of money," and this is before the $500 billion+ dollar increase to the system to publically fund health care, create the infrastructure to pay for the thing, etc.

Where is that money going to come from?

Socialist health care programs don't work for countries of our scale. Period. Japan, with as good as their health care is, is only one-third the population size of the United States. Germany is less than that. France is barely 20% the size of our country. Britain is smaller than that. They've all got different governmental entities sorting out logistics problems.

Even at that level, the wait times are literally killing people. Want a biopsy? Wait three months. Need a round of chemotherapy, but you're a bigger risk for not surviving the treatment process than the next guy in line? Sorry, government help denied. Next. The health care communities are literally replete with stories of people whose cancers progressed beyond treatment while they were waiting for diagnoses. In a country this size, it would be nightmarish.

Your semi-final point, by the way, is incredibly short-sighted of you:

"With the option of private healthcare, the rich will 'opt out' and costs will go up."

This isn't necessarily true at all; although private healthcare is usually allowed in UHC nations (for good reasons), it doesn't have to decrease the taxes paid by all to support the public system!

"Yeah, if you want good health care, you can pay twice. You don't get to complain; you're rich! What are you worried about?!"

Let's punish the people who are successful so that citizens who can't succeed on their own can live longer. That's exactly what this country needs. Useless people living longer and successful people becoming overtaxed malcontents.

So far, this administration has been either deliberately or unintentionally incorrect about virtually every prediction made thus far. Job losses, economic recovery, cost of government stimulus, effect of bailouts and governmental takeovers.

Why do you people keep trusting that this is going to be any different?

[dmagicglock]

looks like a vote is going to be pushed back till at least October. This makes me happy because it gives the public another couple months to find out how big of a fraud this proposed legislation is... and then hopefully it won't pass.

http://www.breitbart.com/article.php?id=CNG.830beb0d4e1b839b7394c48af39ed809.291&show_article=1

[Disclaimer]

Health Care Spending in Developed Countries

http://thetoiletpaper.com/blog/2009/health-care-spending-in-developed-countries/

[dmagicglock]

this means nothing because the WHO rankings include things like accidental deaths and homicides, which are irrelevant to quality of healthcare IMHO.

[dmagicglock]

You lose.. everyone. We can't afford 'cash for clunkers'.. how can we possibly afford national health care??

lol very funny

[Disclaimer]

this means nothing because the WHO rankings include things like accidental deaths and homicides, which are irrelevant to quality of healthcare IMHO.

Right in the graphic:

"The WHO's assessment of each health system is based on the overall level of health and responsiveness, and the distribution of responsiveness, financial contribution, and health in the population."

The US Health Care System: Best in the World, or Just the Most Expensive?

http://dll.umaine.edu/ble/U.S.%20HCweb.pdf

Comparison study shows U.S. low in primary care physician visits

http://news.ucsf.edu/releases/comparison-study-shows-us-low-in-primary-care-physician-visits/

[dmagicglock]

you can be professor gates and I can pretend to be sgt. crowley and we can agree to disagree because this is all thats going on...

[Disclaimer]

http://www.nytimes.com/2009/07/31/opinion/31krugman.html?_r=1

Health Care Realities

By PAUL KRUGMAN

At a recent town hall meeting, a man stood up and told Representative Bob Inglis to “keep your government hands off my Medicare.” The congressman, a Republican from South Carolina, tried to explain that Medicare is already a government program — but the voter, Mr. Inglis said, “wasn’t having any of it.”

It’s a funny story — but it illustrates the extent to which health reform must climb a wall of misinformation. It’s not just that many Americans don’t understand what President Obama is proposing; many people don’t understand the way American health care works right now. They don’t understand, in particular, that getting the government involved in health care wouldn’t be a radical step: the government is already deeply involved, even in private insurance.

And that government involvement is the only reason our system works at all.

The key thing you need to know about health care is that it depends crucially on insurance. You don’t know when or whether you’ll need treatment — but if you do, treatment can be extremely expensive, well beyond what most people can pay out of pocket. Triple coronary bypasses, not routine doctor’s visits, are where the real money is, so insurance is essential.

Yet private markets for health insurance, left to their own devices, work very badly: insurers deny as many claims as possible, and they also try to avoid covering people who are likely to need care. Horror stories are legion: the insurance company that refused to pay for urgently needed cancer surgery because of questions about the patient’s acne treatment; the healthy young woman denied coverage because she briefly saw a psychologist after breaking up with her boyfriend.

And in their efforts to avoid “medical losses,” the industry term for paying medical bills, insurers spend much of the money taken in through premiums not on medical treatment, but on “underwriting” — screening out people likely to make insurance claims. In the individual insurance market, where people buy insurance directly rather than getting it through their employers, so much money goes into underwriting and other expenses that only around 70 cents of each premium dollar actually goes to care.

Still, most Americans do have health insurance, and are reasonably satisfied with it. How is that possible, when insurance markets work so badly? The answer is government intervention.

Most obviously, the government directly provides insurance via Medicare and other programs. Before Medicare was established, more than 40 percent of elderly Americans lacked any kind of health insurance. Today, Medicare — which is, by the way, one of those “single payer” systems conservatives love to demonize — covers everyone 65 and older. And surveys show that Medicare recipients are much more satisfied with their coverage than Americans with private insurance.

Still, most Americans under 65 do have some form of private insurance. The vast majority, however, don’t buy it directly: they get it through their employers. There’s a big tax advantage to doing it that way, since employer contributions to health care aren’t considered taxable income. But to get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.

And it’s thanks to these rules that employment-based insurance more or less works, at least in the sense that horror stories are a lot less common than they are in the individual insurance market.

So here’s the bottom line: if you currently have decent health insurance, thank the government. It’s true that if you’re young and healthy, with nothing in your medical history that could possibly have raised red flags with corporate accountants, you might have been able to get insurance without government intervention. But time and chance happen to us all, and the only reason you have a reasonable prospect of still having insurance coverage when you need it is the large role the government already plays.

Which brings us to the current debate over reform.

Right-wing opponents of reform would have you believe that President Obama is a wild-eyed socialist, attacking the free market. But unregulated markets don’t work for health care — never have, never will. To the extent we have a working health care system at all right now it’s only because the government covers the elderly, while a combination of regulation and tax subsidies makes it possible for many, but not all, nonelderly Americans to get decent private coverage.

Now Mr. Obama basically proposes using additional regulation and subsidies to make decent insurance available to all of us. That’s not radical; it’s as American as, well, Medicare.

[Disclaimer]

The 'liberal' media is hard at work again.

CNN Anchor Rips Into Health Care CEO Who's Funding Anti-Reform Effort

http://www.talkingpointsmemo.com/livewire/2009/08/cnn-anchor-rips-into-health-care-ceo-whos-funding-anti-reform-effort.php

A CNN anchor today tore down Rick Scott, the founder of an organization that's been funding anti-health care reform protests and the former CEO of a hospital company that, as Sanchez pointed out, paid $1.7 billion to settle charges of overcharging Medicare and Medicaid.

It was brutal.

Sanchez started simply, asking Scott, the founder of Conservatives for Patients' Rights, if he takes credit for the recent disruptions at health care reform events. Scott responded, "It'd be nice to, right?" before saying he thought everyone should go to meetings, but "oughta be nicer about it."

Then Sanchez started in on him, describing the charges and fines against Scott's company, the Columbia Hospital Corporation.

"Some would argue, and it would be hard to say they're wrong, that you would be the poster child for everything that's wrong with the greed that has hurt our current health care system," Sanchez said.

Scott tried to defend himself, saying other companies were fined in the big health care fraud scandals of the 1990s. Sanchez stopped him.

"How much more wrong can you be than what you just said? Not only is your company screwed up, and you just admitted to it, but you said look at all the other companies, they did the same thing," Sanchez said. "It doesn't sound like a sterling system we have here, does it?"

And when Scott tried to shirk responsibility for the fines, saying they were leveled after he left the company, Sanchez put his foot down.

"No, no, no, no! You're playing with the facts, sir!" he said.

"Some people are gonna look at your record ... and say, 'This is the guy leading this charge? Is he the one we should be listening to?' Not exactly a perfect past when it comes to what's right for taxpayers and patients," Sanchez said.

"Absolutely," Scott said.

Sanchez also tore into Scott for buying up all the hospitals in an area and shutting down all but one. "Is that good for patients?" he asked.

"Absolutely. Now, first of, that didn't happen," Scott responded. He went on, saying it's good for patients to go to the hospital with the best equipment. Sanchez also reminded Scott of charges of poor, dirty conditions at his hospitals.

http://www.youtube.com/watch?v=NwjcxyuUf5A&feature=player_embedded

[dmagicglock]

meh CNN is in the bag for Obama care, he's attacking this guys credibility and looks silly while he looks calm and collected. Why not question him on the legislation, or what he disagrees with it, instead of attacking him over stuff from 10 years ago. Nice job trying to create a distraction from the real issue, this legislation sucks, even if you are for universal healthcare this isn't the way to go about it.

[Disclaimer]

HHS: Insurance Companies Encourage Employees to "Revoke Sick People's Health Coverage"

http://voices.washingtonpost.com/health-care-reform/2009/08/hhs_insurance_companies_encour.html

You might have known that insurers can deny health coverage based on preexisting medical conditions, but here’s something else to worry about: They can take away the coverage you thought you had when actually need it, the government says.

The Department of Health and Human Services put a spotlight on that practice Tuesday in its continuing campaign to build support for an overhaul of health insurance.

“When a person is diagnosed with an expensive condition such as cancer, some insurance companies review his/her initial health status questionnaire,” the HHS said in a posting at HealthReform.Gov. In most states, insurance companies can retroactively cancel individuals' policies if any condition was not disclosed when the policy was obtained, "even if the medical condition is unrelated, and even if the person was not aware of the condition at the time.”

“Coverage can also be revoked for all members of a family, even if only one family member failed to disclose a medical condition,” HHS said.

The department cited recent research by the staff of the House Committee on Energy and Commerce, which found that three large insurers rescinded almost 20,000 policies over five years, saving $300 million in medical claims.

At least one insurer included such savings in an employee performance evaluation.

“Simply put, these insurance company employees are encouraged to revoke sick people’s health coverage," HHS said

The research compiled recently for a House hearing included more detail.

WellPoint and Assurant told the committee that they automatically investigate the medical records of every policyholder with certain conditions, including leukemia, ovarian cancer, brain cancer, and becoming pregnant with twins, the committee staff wrote.

In November 2006, after a Texas resident was found to have a lump in her breast, Wellpoint investigated her medical history and concluded that she had been diagnosed previously with osteoporosis. The insurer rescinded her policy and refused to pay for treatment of the lump, the committee staff wrote.

Today’s HHS post, which draws on a variety of studies going back as far as 2001, shows how the Obama administration is trying to give people reasons to support an overhaul of health care even if they are satisfied with their existing coverage. It also reflects a stepped-up focus on health insurers, which are increasingly being cast as bogeymen in the debate.

Under the current system, something as relatively simple as seasonal sneezing can jeopardize your financial security, HHS argues, citing a 2001 study for the Kaiser Family Foundation.

“Even when offering coverage, insurers can exclude whole categories of illnesses related to a preexisting condition. For example, someone with a preexisting condition of hay fever could have any respiratory system disease – such as bronchitis or pneumonia – excluded from coverage,” HHS said.