Wyden announces health care overhaul

It's been over a decade since the last serious attempt to overhaul America's health care system. Today, Senator Ron Wyden announced his own effort - called the Healthy Americans Act.

The plan would end employer-based health care, replacing it with a system of universal private insurance - guaranteeing every American a benefit plan that's as good as Members of Congress get.

He made the announcement flanked by SEIU President Andy Stern, Safeway CEO Steve Burd, and other business, labor, and health care leaders.

From the Associated Press:

A dozen years after Congress rejected a Clinton administration plan for universal health care, an Oregon Democrat is readying a proposal to provide health care coverage to all Americans through a pool of private insurance plans.

"Employer-based coverage is melting away like a Popsicle on the sidewalk in August," said Sen. Ron Wyden, a member of the Senate Finance subcommittee on health care. ...

Wyden said his new plan would allow workers to carry their health insurance from job to job without penalty. More efficient administration and more promotion of competition for health care plans, he said, would allow greater coverage while costing no more than the government is paying today for health insurance coverage.

Called the "Healthy Americans Act," the plan would cover all Americans except those on Medicare or those who receive health care through the military ... and would save $1.4 trillion in total national health care spending over the next decade.

Simultaneously, Wyden unveiled a new website - StandTallForAmerica.com - to organize grassroots support for the health care reform effort.

Comments

  • Garrett (unverified)
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    Good for Wyden. I don't know why we just don't either A: Expand Medicare or B: Expand the V.A. They're already 2 great systems that are already in place and could just be expanded. I'm going to enjoy watching Republicans use the same old tired "how are you going to pay for it" argument.

  • Jon (unverified)
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    What about their underwriting guidelines? I cant get private insurance because I am bit outside their "height/weight" ratio. (Nevermind the only things I have ever been in the hospital for are a broken ankle and an appendicitis in my 38 years).

    I cant see private insurance companies going for this. It wouldnt benefit them financially. And thats all they care about.

    And judging from the crap my dad has to deal with on Medicare and the VA systems, I dunno if thats the best way to go.

  • Garrett (unverified)
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    Of course it wouldn't benefit private insurers...think about this though. Insurance rates have what...doubled, tripled over the last 15 or 20 years? Employers used to have about 4-5% of their budgets on health insurance and now it's up to 15-20% if they provide healthcare. We're paying for healthcare no matter what we may think. Just because you don't directly shell the money out of your pocket doesn't mean you're not paying for it. Every employer I've had that gives you insurance shows that cost in their compensation diagrams and such. You're also paying for it in taxes. When someone goes to the hospital and they're uninsured someone pays for it.

    Insurance companies are reaping RECORD profits. It would probably be different if the US Insurance company only had to answer to their shareholders (the American people).

    I know the VA and Medicaid have their problems but honestly...Medicaid is no bigger hassle than my insurance company. Have you ever tried to file a claim with an insurance company?

  • TomCat (unverified)
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    I now work without health insurance, after my old job was downsized due the the Bushwhacked economy. I'm glad Wyden is doing something, but 2012 is a bit of a wait for the 45 million Americans who go without health care today.

  • BlueNote (unverified)
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    Just saw wire service story about South Dakota Democratic senator having a stroke? With a Republican governor, we may lose control of the senate if things go badly for Senator Johnson. God speed his full recovery!

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    Jon asked, What about their underwriting guidelines? I cant get private insurance because I am bit outside their "height/weight" ratio.

    Under Wyden's proposal, the insurance companies could NOT turn your down. Not only that, but they'd be required to offer the same plan to everyone in the state - regardless of age, gender, genetic background, or pre-existing conditions.

    Here's a snip from StandTallForAmerica.com, which has lots of details:

    The Healthy Americans Act creates a system of tax benefits and premium reductions that will ensure every American can afford a high-quality, private health plan that is comparable to what Members of Congress enjoy now. Previous and existing health problems, occupation, genetic information, gender and age will no longer be allowed to impact eligibility or the price paid for insurance. Rather, insurance companies will be required to cover every individual who chooses to enroll and can not raise prices or deny coverage if individuals are sick.

    [Full disclosure: I manage the Stand Tall for America website, and it's sponsored by Wyden for Senate.]

  • BlueNote (unverified)
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    Sorry for off topic post above, but it seems to me that Democratic control of the Senate is a cornerstone of getting serious consideration for Wyden's plan.

    In any event, Medicare is a wonderful program that only needs a few tweaks to serve everyone in the USA. Medicare reimbursement rates to Pacific NW Docs are about the lowest in the country due to some statistical abnormalities caused by the large market share (and artificially low stated costs) of Kaiser Permanente during the data gathering period. With some adjustments to achieve nationwide equity on doctor cost reimbursement, Medicare should be good to serve the US for the next hundred years.

    My employer pays nearly a thousand dollars a month for my family's medical insurance for a policy which is less comprehensive (and with many more deductible items) than my parents have under Medicare. I would happily trade my private policy for a more cost effective and comprehensive system such as Medicare, even if I would also need to purchase a private "supplemental" policy as many + 65 seniors do now.

    Thanks Senator Wyden!

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    Incidentally, if you have any questions about this plan, go ahead and ask away. I'm not a policy guy, but I've been working with the documents over at Stand Tall for America for a couple of days now -- and can help you find the answers.

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    TomCat wrote, I'm glad Wyden is doing something, but 2012 is a bit of a wait for the 45 million Americans who go without health care today.

    Hey Tom -- I'm not sure where you got 2012 from, but the implementation date in the legislation is two years from enactment. Basically enough time to get everything organized...

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    What about unemployed? Their options for coverage are? How can a min. wage earner affordable health coverage without someone paying for it? I find it inconceivable that tax deductions will close the gap between even reduced price coverage and ability to actually pay for it it form the pockets of a min. wage earner.

    Color me extremely skeptical that even if passed and implemented, this will get us to universal coverage.

  • Chris (unverified)
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    It's exciting to see a significant push for health care reform coming from Oregon. In addition to Senator Wyden's plan, we've got former Governor Kitzhaber's We Can Do Better project, which is trying to drive change at the state level. The details of the two plans seem to be fairly different, making me wonder if they could potentially be at odds with each other.

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    Lestat -- The system is designed to meet the needs of low-income and middle-income folks.

    In the nonpartisan independent analysis, it says that "people who do not have enough income to pay taxes are assumed to be eligible for the program with full subsidies."

    Partial subsidies go all the way up to 400% of the poverty line. (I think that's about $80,000 for a family of four.)

    In that document, there's also a chart that shows the impact on various income levels. On average, most families would actually see their out-of-pocket expenses go DOWN.

    How? Because this system will reduce the overall cost of health care for everyone.

    There's lots more info over at Stand Tall for America

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    The details of the two plans seem to be fairly different, making me wonder if they could potentially be at odds with each other.

    I asked that same question. Wyden's legislation includes greater and easier opportunities for state waivers - so, Oregon could go it's own way, if it wanted.

    The two concepts would seem to be complementary, not competing.

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    In response to lestatdelc, Wyden's plan would subsidize low-income earners (in fact everyone up to 400% of poverty) on a sliding scale, He's also requiring all employers to contribute something toward health care -- he's taking some of the burden off employers who currently pay full freight, but imposing some responsibility on those who now pay nothing.

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    Thanks for the follow-up responses. I read through the "How it works" page over at StandingTall website and nothing at all was mentioned about such matters.

  • Scott (unverified)
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    If I just read the above posts correctly, Novick stated that employers paying full freight (i.e., major employers like Boeing, Exxon Mobil, Pacificorp) will see their costs reduced, while small employers that currently don't provide health insurance will be forced to pay?

    Looks like the small business owner will be subsidizing the big oil companies that pay full benefits.

    Imagine that, effectively a direct profit subsidy from the local coffee shop with 4 employees to Starbucks. Hmmmmm?

  • peter (unverified)
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    color me unimpressed. i skimmed the text of the bill to fill in the gaps left unaddressed on the website (lots of gaps there, kari, you should have something in-between the depth of the bullet points/summary and full text of the bill).

    it does some things really well, such as spreading the costs across a wide group of payers. bring costs down by creating a larger pool of insured. requiring coverage. subsidizing those who cannot afford coverage. etc. it even gracefully manages the transition.

    my two biggest problems: 1) "Every time an individual interacts with state, local and federal government .. they can be required to verify their enrollment in a private health insurance plan"

    No thanks, this is a deal breaker in itself.

    2) Competition. Rather than subsidizing basic and catastrophic coverage, and letting insurance companies offer voluntary value-added plans, we are forced to buy from competing state-sanctioned (by the Health Help Agency) private plans. Why is this a problem? Well, how do private companies compete? By offering better plans, or... by cutting costs? How do they cut costs? By making it difficult to get the care you need. Currently these are responsible for inflating the insurance industries administration costs, and there is little in this plan that I can see getting rid of this problem.

    This plan should be called Healthy Insurance Companies Act. Why should we tax employers and individuals to pay for insurance companies to profit by engaging in their favorite health care denying activites? Let's tax employers and individuals to pay for basic health care for everybody--instead insurance companies admin costs--and let the insurance companies offer bonus plans on top of the basic package.

    I'm usually Wyden's biggest chearleader, but this is your basic DLC/"Third Way" claptrap that is only better than nothing because it would bring coverage to the uninsured.

  • peter (unverified)
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    scott,

    there is a contribution schedule, employer contributions are based on their ability to pay, and small businesses pay significantly lower than large businesses. the top-rate for a small business (10%) is lower than the lowest rate for the big business (17%).

    small business contributions range from 2-10%, big business contributions range from 17-25%.

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    Again thanks for the follow-ups up-thread, but without digging into the and trying to decipher the text of the legislation PDF, there is nowhere on that site which addresses basic questions like the unemployed or min. wag earners, etc. which I asked about up-thread. Not that the replies I received are bad, but there should be basic FAQs and basic information about such things on the website.

    The selling points on the plan saving money, etc. are well and good, but single short-sentence (even bullet point) addressing of such matters as the sliding scale subsidizing of low-income earners, etc. is vital.

    Just offering some constructive suggestions about it Kari.

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    Lestat & Peter -- I appreciate your constructive feedback on the site. We're working hard over here developing those kinds of materials. I'd really encourage you to dig in to the independent analysis PDF -- it's got lots of easy-to-understand stuff.

    Scott... there are plenty of big employers not paying anything right now (Wal-Mart). Every employer would pay roughly 25% of the per-person health care cost in their state - and pay it on a headcount basis. So, if the average cost of health care is $400/mo (making that up), then employers would pay $100/mo per employee.

    That money would be combined with federal government money (formerly spent on medicaid) plus the individual's personal contribution to cover the cost of the package.

    There's a chart in the independent analysis that describes what the impact is on families at different levels. Folks under $40,000 would pay less for health care than they do now. Folks in the $40-50,000 range would pay $81 more annually. Folks in the $50-150,000 range would pay roughly $330-340 more annually. Because of the phase out of the tax deduction for folks above $150,000, they'd pay substantially more than they do now -- $150k-$200k would pay $740 more each year. $200-250k would pay $1830 more each year. $250k in annual income would pay $2230 more each year.

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    Better coverage and wider availability are good things. But they don't really address the rising costs, which is precisely why fewer employers want to provide health insurance much less comprehensive health insurance. We could hatch a plan to insure that every single American gets to have health insurance, but that doesn't mean that everyone could afford to actually use it.

    Seems to me that it'd make more sense to tackle the costs side of the equation and if we can bring that down then the availability side would improve.

  • Jon (unverified)
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    Garret- I know the VA and Medicaid have their problems but honestly...Medicaid is no bigger hassle than my insurance company. Have you ever tried to file a claim with an insurance company?

    Yeah, many times. Insurance companies suck. They do anything they can to not pay.

    Bluenote- My employer pays nearly a thousand dollars a month for my family's medical insurance for a policy which is less comprehensive (and with many more deductible items) than my parents have under Medicare.

    Hey, at least your employer pays it. I am a contract worker, and I dont have coverage at all. But my wife does through her work. However, her employer only pays for her. To add myself and our kids, we have to pay about $700/mo out of pocket. I had coverage from my previous employer, but we had to pay for all of it ourselves.

    I dunno. I see offered wages going down significantly at the professional level if employers are forced to cover this, and prices going up at the retail level. It will all be paid for somehow.

  • charlottesweb (unverified)
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    This sounds like a step in the right direction, but I'm wondering how it relates to someone like me: I'm a fulltime caregiver for a disabled husband. I technically don't "work", so if I want medical coverage currently, I have to pay exorbitant premiums for minimal coverage.

    What is the problem with going to a single payer system, saving everyone a lot of headaches (except, of course, the insurance companies)?

    Unfortunately, this legislation probably won't help me a bit since I should be able to sign up for Medicare in a few years.

    What strikes me is that our politicians appear to be waking up to some of the needs of the Suffering Majority rather than the Almighty Corporations since the last election. I would be willing to bet that both Senator Wyden and Senator Hatch are coming up for reelection in '08. I'm not knocking it. I just hope something comes of all of this.

  • TomCat (unverified)
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    Hi Kari,

    It came from page 2 of the AP article: "The group, created in 2003 by legislation sponsored by Wyden and Sen. Orrin Hatch, R-Utah, recommended that the government take steps to guarantee that all Americans have basic health insurance coverage by 2012." Looking at it a second time, I think I misunderstood. So you're saying that 2012 is no longer the target date, correct?

  • earls (unverified)
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    Acording to the "medical / insurance / and health care" money grabbers we have the best health-care in the world which no doubt is taking care of Mr. Tim JOhnson as you read this. You or I working on a "doe dick" job somewhere in the rural bellies of this country would most likely die by the time they figured out our problem. Yes it like resturants, the education system, and most everything else in the good old USA, quality depends upon you financial status:

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    TomCat -- That may be the target date of the Citizens' Health Care Working Group. But not of this legislation.

    Charlotte, as someone who wants to pay for your own health insurance (as I do), there are very few options - and as you point out, they're very expensive. Under the Wyden plan, you'd have many more options - same as everyone else - and they'd be much less expensive. On top of that, if you're under ~$80,000 income for two-income family (actually 400% of poverty line), your benefit would be subsidized.

  • TomCat (unverified)
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    Thanks Kari,

    How about for those of us who have been Bushwhacked to a state below the poverty line? ;-)

  • Robert Harris (unverified)
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    What will be the extra costs to employers? How much total will the "health care tax" and the extra payroll taxes on the health care dollar conversions cost.

    How exactly is there an overall savings here? Employers pay more, and many workers pay more. The only savings I see would only be realized based on a prseumption that the health care costs would continue to go up as they have in the past. That will not occur because businesses are simply cutting down on coverage anyway to contain costs. So savings seem illusory.

    This sort of makes it look like we're simply getting more money from employers, and some middle and upper income employees, to pay for coverage for the uninsured without tackling the real issue. Cost.

    I used to think that it would be best to use the health delivery infrastructure we had as we transitioned to a single payer system. However, if this is the compromise that would fly with the health care industry, I don't think that will work. We can copy any one of two dozen health systems from other industrialized countries that do a better job at a lot less cost.

    I've represented many people who lost everything because of health care costs. They lost their homes, their jobs, their life savings. They've filed bankruptcy. Changing the system to cover everyone and actually saving a lot of the cost would immeasurably assist these people. If some health industry employees lose or have to change their job, or some doctors see have earnings cut in half (so they make as much as doctors in other industrialized countries). Well, I guess I think thats a price worth paying, and a system worth fighting for.

  • Daniel Haszard (unverified)
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    Only 9 percent of adult Americans think the pharmaceutical industry can be trusted right around the same rating as big tobacco.

    Zyprexa, which is used for the treatment of psychiatric disorders, such as schizophrenia and bipolar disorder, accounted for 32% of Eli Lilly's $14.6 billion revenue last year.

    Zyprexa is the product name for Olanzapine,it is Lilly's top selling drug.It was approved by the FDA in 1996 ,an 'atypical' antipsychotic a newer class of drugs without the motor side effects of the older Thorazine.Zyprexa has been linked to causing diabetes and pancreatitis.

    Did you know that Lilly made nearly $3 billion last year on diabetic meds, Actos,Humulin and Byetta? Yes! They sell a drug that causes diabetes and then turn a profit on the drugs that treat the condition that they caused in the first place!

    I was prescribed Zyprexa from 1996 until 2000. In early 2000 i was shocked to have an A1C test result of 13.9 (normal is 4-6) I have no history of diabetes in my family.

    <hr/>

    Daniel Haszard

  • Paul (unverified)
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    Kari,

    Does this plan cover alternative health care providers? It will be quite useless to me if it does not cover my health care providers.

  • Jane Smith (unverified)
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    Wonderful Idea!! The health care costs are going up and up every year. If one is uninsurable, it is very, very hard- a struggle. I heard of people going overseas for operations when they cannot afford out of pocket. This is a very important issue for the next generation as well. Hope it goes through. It is also important to include people with congenital and chronic diseases as well.

    The health care costs are the highest in the world. It is very difficult for the average family to be self-insured in the event of a crisis. Thank you,

    Jane

  • Jane Smith (unverified)
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    Wonderful Idea!! The health care costs are going up and up every year. If one is uninsurable, it is very, very hard- a struggle. I heard of people going overseas for operations when they cannot afford out of pocket. This is a very important issue for the next generation as well. Hope it goes through. It is also important to include people with congenital and chronic diseases as well.

    The health care costs are the highest in the world. It is very difficult for the average family to be self-insured in the event of a crisis. Thank you,

    Jane

  • TomCat (unverified)
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    Kari, thanks for your comment on Politics Plus. I'll put your new site in my links list as soon as I do my maintenance on the blog today.

  • DAN GRADY (unverified)
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    I am a bill collector. I have collected debt of every legal description, and for the first 18 years of my now 23 years was in the field of medical collections for the most part.

    I won't collect for another medical provider again!

    Acronyms, HMO's, PPO's, and the assortment of private insurance companies, and medical providers forming the very socialist concept of a collective system of medical providers owned and operated on the assumption that a cost/benefit/profit formula should be a foremost consideration when administering health care. If you think the evolution of healthcare delivery in America has changed for any other reason, and that the idea was to be able to deliver more care to more patients by holding down costs, you are either a wealth doctor, or an insurance executive, or just so health or rich not to care.

    When I lived in Las Vegas until we moved here in ’99, I was working for the top agency in the state that had the largest inventory of assignments of medical providers in the state, and as you might imagine we received many out of state patient accounts. I had been hired to work medical assignments that were for the most part disputed claims to the patient’s insurance. I was exposed to Oregon’s evolution of coverage as it related to out of area services, and had many opportunities to argue the minutia of these plans with their legal counsel as well as claims adjusters who’s main function was to detract, or discourage payment whenever the opportunity presented itself. This is a practice that all the insurance companies were deploying to one extent or another.

    The point could be explained in it’s evolution over a 25 year period as Medicare/Champus standardize the claim forms for hospitals, and then all medical providers. These codings that were used in concert with these forms made the previously simple process of a claim, deliciously complicated for the medical providers, and patients to argue their claims to be paid, and eventually to ever receive the services at all!!

    That’s right, the process of standardizing the claims though effective in saving money for Medicare/Champus patients was perverted over time by the private sector to eventually cast the sickest, and most costly patients out of their insurance rolls, and to deprive services with patients still in the system. The medical providers have less, and less to say about how to treat patients, and the profit motive has more, and more to do with what kind of care a patient will receive, whether the procedures a needed, or wanted to begin with.

    Capitation became the final straw for me, as one month years ago I was part of a crew of specialists asked to work a huge number of unpaid claims over $2500.00. As we were to find out after rebilling hundreds of thousands of dollars in claims, we waited in great anticipation for a flood of checks from insurance companies that were suspiciously easy to process that showed up in the form of a cancelled check of $0.00!! The insurance company, nor the medical providers we had been collecting for many years didn’t think it was important to tell us that they had been paid in advance for their services in a contractual agreement that had the insurance company deploy a formula of how many patients they should expect to see, and paid them 3 months in advance and that we were collecting the excess that the insurance company was not obligated to pay!!

    This should not have been a big surprise, as they were evolving to this but, I would point out that the whole motive to provide care has been perverted to a profit motive, and little else. A Medicare/Champus single universal payer system is the only way in our form of democracy/free enterprise to deliver effective health care to everyone, instead of whomever can afford to be insured, or better put whom the insurance companies deem as affordable patients.

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