We thought that AARP’s position on universal health care was peculiar, so we began to look into what others voices were saying. Here is a very interesting sample, compiled by UP board member Trude Diamond.
Background
1. Universal Healthcare News at The Progressive Review - June, 2007
Source: http://prorev.com/healthplan.htm
Section Title: VOICES YOU MAY NOT HAVE HEARD ON MEDICARE
JOHN HESS, HEALTH WRITER [Note from Trude: A NYT reporter who died in 2005 -- no mention of what exactly his "once again" refers to, obviously not HB 676] - “Once again, the AARP has stabbed America’s elderly in the back. For more than 30 years now, it’s been held up as a scarecrow - a monster representing 35 million greedy geezers. . . Briefly, the AARP is not a league of the elderly, but a marketing agency with a shady past. It peddles insurance, travel, advertising, and anything else it can get its hands on. It has a mailing list - not a membership - of 35 million customers. If you turn 50, they’ll try to get your name on it. It calls itself an ‘association’ and goes through the motions in an effort to dodge taxes and commercial mailing rates, and it’s been in constant trouble with the IRS and the Postal Service.”
2. AARP to Reap Huge Profits from Flawed Medicare Drug Bill
Senior’s Group Makes $163 Million Annually on Insurance Sales
Source: http://www.yuricareport.com/Medicare/AARP_to_ReapHugeProfitsFromMedicare.html
News Intelligence Analysis - Nov 23, 2003
The American Association of Retired Persons (AARP) derives significant income from the sale of health and life insurance policies, and stands to make hundreds of millions more under the Medicare Prescription Drug bill now being debated before Congress. Yet the AARP’s financial interests in the bill have received scant attention.
The AARP’s current insurance-related revenues come in several streams.
1- They receive royalties from “AARP” insurance policies marketed to their members by United Healthcare, MetLife and others. Last year these royalties amounted to $123.283 million.
2- They receive list access fees from insurance firms that market to their membership. In 2002, such fees totaled $10.794 million.
3- AARP receives “Quality Control fees” from insurers that amounted to $893,000 last year.
4- AARP also earns investment income on the premiums received from members until such premiums are forwarded to United Healthcare and MetLife. In 2002, AARP earned $26.708 million in such investment income.
2007 AARP Statements and External Comments
Trude’s preview: AARP’s forward-thinking opening volley in Jan 2007 was soon followed by business as usual statements and actions.
If you are pressed for time, skip right to Item #8 at the end. If you want to more fully understand the context with a bit of history, read all the items.
AARP has partnered with for-profit insurers (United Health and Aetna), while stating AARP would use its bargaining power to get the best benefits package for the lowest prices for its members. (1) What if you’re too young to join AARP but still uninsured? (2) As an AARP member, I priced its offering for me when I got fired in June, and found that its health insurance through United Health-the same company I’m already insured by through my former employer-had higher deductibles and higher premiums than continuing my employer’s coverage at full cost to myself through COBRA. Pathetic!
1. Health Care for All: Big Business to the Rescue?
As unlikely as it seems, big business may be the force that brings about universal health insurance.
Source: http://www.pnhp.org/news/2007/january/health_care_for_all.php - reprinted from AARP Bulletin
By Daniel Gross
AARP Bulletin
January 2007
As unlikely as it seems, big business could emerge as the force that finally brings about universal health insurance. In the first week after the November elections, the CEOs of General Motors, Ford and Chrysler met with President Bush to discuss issues they faced, including health care costs. That same week, America’s Health Insurance Plans, a trade group of large insurers, released a 10-year, $300 billion proposal to provide health insurance for all children and 95 percent of adults-through a combination of tax breaks for individual taxpayers and the expansion of government programs such as Medicaid.
[NOTE FROM TRUDE: In comment #5, AHIP's disingenuous involvement in this issue is revealed. You can click that link above right now, read it, and return here from the link in that comment.]
“I think we’re getting to a tipping point where this country is going to be willing to move on health care,” said Wal-Mart CEO Lee Scott in an appearance on the Charlie Rose show last year. “Business and labor are going to have to participate and probably play even more of a leadership role than government … and then bring the political side along with them.”
To Rose, the solution to America’s health care crisis is relatively simple. “We need some form of universal coverage that would be funded centrally by the government, but delivered privately through existing mechanisms like HMOs,” he said. The program, he suggested, could be funded by a tax on imports.
The discussion is clearly being prompted by bottom line issues: Soaring health care costs are a major problem for business. Companies in the United States compete against rivals in developed countries (Japan, Germany and France) where the government funds health care, and against developing countries (China, India) where neither business nor society at large is responsible for health insurance. Either way, American companies that provide health insurance are at a competitive disadvantage.
In 2005 money-losing General Motors spent $5.3 billion to cover the health costs of 1.1 million employees, retirees and dependents. Ross noted that, on a per-car basis, General Motors spends more money on health insurance than on steel. But Old Economy behemoths like GM aren’t the only ones suffering. “Since the beginning of this decade, health insurance premiums for average employers have increased 87 percent, compared with overall inflation of 18 percent,” said Joel Miller, vice president of operations at the Washington-based National Coalition on Health Care (NCHC), a nonprofit alliance of business, unions and consumer groups. These higher costs cut into operating margins and reduce the capacity of businesses to grow.
[NOTE FROM TRUDE: NCHC - another unholy alliance, potentially, because insurers are one of the business sectors involved]
2. National Institute of Health Policy (focusing on the Upper Midwest states) - by Dave Durenberger
Source: http://www.nihp.org/Commentary4%2019%2007.pdf = April 17, 2007
AARP’S HEALTH MARKET EXPANSION … AARP, United Health Group, and Aetna
will soon launch a bold experiment to improve healthcare quality and outcomes by changing the healthcare marketplace. Those of us who have long hoped Medicare payment policy would change the U.S. health care system for the better had begun to lose hope when Republicans in 2003 sought to turn Medicare and seniors over to unmanaged private health insurance plans. I myself was critical of AARP for providing the political cover for Republicans and some Senate Democrats to vote to sell the program to the highest private bidders. On Monday of this week AARP announced plans to significantly expand their Medicare product offerings, including a new managed care plan for the 55-64 age group market. AARP intends to use this expanded market power to drive improvements in health quality and care coordination.
We have to trust the AARP Board. And we have to help them shape this bold plan. And why
not? Economists tell us that in any market the commodity in short supply can leverage change.
In health care that commodity is buyers with information and resources to help consumers
make informed choices. Employer coalitions have waxed and waned. Only the Federal
Employee Health Benefits Program (FEHBP) has proven the point. Since it began giving
federal employees national and local health plan choices back in 1960, millions of FEHBP
employees and retirees are making a difference.
My recommendation is that AARP consider playing a similar role to FEHBP. Unlike FEHBP, but like MN Advantage (the MN State employee plan), AARP would pre-qualify the plans available to me in MN to assure adherence to benefit and performance standards.
[NOTE FROM TRUDE: Durenburger is optimistic on April 17. Then reality sets in with other observers on April 26. See item #3.]
3. Schwarzenegger Meets Secretly with AARP: Healthcare “Reform” by Requiring Everyone to Buy Private Insurance
Source
AARP, the health insurance giant with almost a $billion in revenues, is planning a California-wide education campaign on healthcare reform, and is teaming up with California Governor Schwarzenegger’s campaign to cover the uninsured by forcing them to buy private health insurance. “We don’t want to miss this very unique opportunity in California,” said Mark Beach, a spokesman for the group. SF Chronicle, 4-26-2007
AARP is concluding deals with Aetna and Unitedhealth which it expects to double its HMO membership. Dawn Sweeney, CEO of AARP Services, told reporters that AARP has about 7 million policyholders in a variety of programs, include Medicare prescription drug plans and supplemental insurance that pays for some of the co-payments and deductibles that Medicare does not cover. AARP receives an average of $185 million a year in royalty and revenue payments from its health insurance. AARP expects to double the number of people in its branded products over the seven years and estimates it will garner an additional $1.5 billion in royalty payments as a result. USA Today, 4-17-2007
Arnie’s secret visit
Source: http://www.pasadenaweekly.com/article.php?id=4571&IssueNum=69 - April 26, 2007, by Joe Piasecki -
Schwarzenegger to come to Pasadena Monday for a no-Democrats AARP health care forum.
Currently pushing a controversial plan to require all Californians to purchase medical insurance, Gov. Arnold Schwarzenegger will address an unpublicized health care forum hosted by AARP, formerly the American Association of Retired Persons, on Monday at the Pasadena Convention Center, the Weekly has learned.
Not invited to the event, however, are state Democratic leaders with competing health care reform packages up for debate in the Senate and Assembly.
For its part, AARP has “promised not to promote this beyond our membership,” said spokeswoman Charee Gillens, who referred all questions to Schwarzenegger’s office.
Gillens did say, however, that the purpose of the invitation-only event was to highlight the need for health care reform.
With both parties silent in the meantime, the real question is, “Is this really a governor’s event or an AARP event?” asked Alicia Trost, spokeswoman for state Senate President Pro Tem Don Perata, a Democrat from Oakland whose health care plan was expected to be heard in committee yesterday.
Both Trost and staff working for Assembly Speaker Fabian Nuñez, a Los Angeles Democrat whose health care reform bill was discussed in legislative committee on Tuesday, confirmed that Perata and Nuñez had not been invited.
The 38-million-member AARP boasts 3 million members in California, making it the largest advocacy organization of its kind in both California and the nation.
National AARP CEO Bill Novelli is also expected to be in Pasadena on Monday.
While being excluded from an AARP-generated event would come as a shock, Trost said Perata would not expect to be part of any Schwarzenegger public relations campaign.
With three competing plans, two of them Democrat-generated, “It’s too early for everyone to be standing up together,” she said.
Although both Democratic bills would not need any support from Republicans to get to the governor’s desk, “We definitely want to work with the administration,” said Trost.
Meanwhile, a spokeswoman for another citizens’ rights group said all three plans are flawed in at least one significant way - protecting the public from price-gouging.
“If you’re an insurance company, you’d have to be breaking out a cigar in celebration over the fact that none of these three new proposals is going to do anything to regulate health insurance rates or make the finances of the for-profit insurance companies any more transparent,” said Judy Dugan, research director for the Santa Monica-based Foundation for Taxpayer and Consumer Rights.
“All twist themselves into knots trying to work within the current system of private health insurance, which is exactly what has gotten us to the point of having 7 million people uninsured in California,” said Dugan.
The Foundation for Taxpayer and Consumer Rights was also the leading proponent of Pasadena’s Measure B, a campaign finance reform law twice-approved by voters that makes it illegal for city officials to accept money or gifts from those who have benefited from their decisions in office.
Schwarzenegger’s health insurance plan would require all Californians to purchase health insurance from a private carrier, but place few controls on the quality and price of coverage. It would also force businesses to spend 4 percent of their payroll costs on providing insurance to employees or paying into a state fund for uninsured workers.
4. Let’s skip the gimmicks and enact real reforms
Source: http://www.pnhp.org/news/2007/january/lets_skip_the_gimmi.php
By MERTON C. BERNSTEIN
HEALTH CARE
Special to The Kansas City Star
Published on Wed, Jan. 24, 2007
(Merton C. Bernstein is a Coles Professor of Law Emeritus at Washington University. He was principal consultant to the National Commission on Social Security Reform and is a founding board member of the National Academy of Social Insurance.)
To tame costs and extend coverage, we must harvest savings where now we sow and reap inefficiently. The Schwarzenegger and Massachusetts gimmicks and the plan shaped by the same people who designed the perplexing and inefficient Part D - health insurers and AARP - plow other fields. Instead of savings, they increase nonbenefit costs. That’s not reform.
[NOTE FROM TRUDE: The article below gives enlightening background on the HMO industry's strategy for confounding the Medicare Modernization Act's intention. See item 8's AARP statement of its intent to provide "a counseling service" to help members figure out the best plan for them in the HMO mess it supports. What we need is a plan that's straightforward enough for consumers to understand on our own - a plan without intricacies meant to mask high profits and ridiculous levels of waste.]
5. The Medicare Privatization Scam - in The Nation, July 16
Source: http://www.thenation.com/docprem.mhtml?i=20070716&s=lieberman
Trudy Lieberman
In the next few weeks Congress will decide whether to cut $54 billion in overpayments to Medicare insurers, igniting a battle that may well determine whether the program survives. On one side are Medicare supporters, who want it to continue as a successful social insurance program. On the other is the insurance industry, which is spending millions and lobbying hard to put Medicare on a fast track to privatization, a goal long sought by fiscal conservatives and their allies in right-wing think tanks.
The seeds of the conflict were sown in 2003, when Congress passed the Medicare Modernization Act (MMA), which gives seniors a prescription drug benefit that is sold and administered by private insurers, not the government. This drug benefit, known as Part D, opened new markets for insurers, some of which have profited handsomely from the government’s gift. The story of one of those companies, Humana, a forty-six-year-old carrier based in Louisville, Kentucky, shows what’s at stake.
Before 2003 Humana, a regional company peddling health insurance, including HMOs, was hardly a household name. One of its policies had been a big money loser, and the company was struggling to dig its way out of a financial hole. Vice president Steve Brueckner called the MMA “an unprecedented opportunity to establish relationships,” and his company made the most of it. Humana gained 4 million new policyholders and reported to stockholders in April that it had amassed “record breaking revenues.” What’s more, Humana has become a national brand poised to sell policies in the non-Medicare market, where people will increasingly be forced to buy their own health coverage, especially if an “individual mandate” becomes a solution for the country’s healthcare woes. “Part D transformed the company,” says Bridget Maehr, an analyst for A.M. Best, an insurance rating service.
Humana’s game plan centered on the options the MMA gave seniors for obtaining their benefits. They could keep traditional Medicare, in which the government provides the benefits, and buy a “stand-alone” drug benefit; or they could get the new drug coverage plus regular Medicare benefits provided by one of the Medicare Advantage plans, which include HMOs, the less restrictive preferred provider organizations (PPOs) and private fee-for-service plans, which usually offer traditional Medicare benefits, drug coverage and benefits for extras like dental, vision and chiropractic care. There are no limits on specialist referrals, and seniors can choose any doctor who accepts the insurer’s fee schedule.
Some Medicare Advantage plans were not new. Medicare HMOs had been around since the 1970s. But by the late 1990s, conservatives had seized on HMOs, as well as new options such as medical savings accounts and PPOs, as ways to speed up privatization. Under the guise of “consumer choice,” always a popular concept, Congress authorized four new kinds of plans, in the 1997 Balanced Budget Act, that would compete with traditional Medicare.
In theory, private plans, particularly managed care, would reduce the program’s escalating costs. Government payments, it was argued, would allow these plans to offer both standard and extra benefits and encourage efficient, low-cost care. However, after 2003 the government began shoveling huge sums of money into the Medicare Advantage plans to entice seniors to leave the traditional program-in effect subsidizing privatization even more and bringing right-wing think tanks like the Heritage Foundation closer to their objective of ending Medicare as social insurance. The ultimate goal, of course, is to make seniors bear future costs, sparing their benefactors the need to pay more taxes to keep Medicare afloat. This year the government will pay insurers on average 12 percent more than it costs to provide the same benefits to people who stay in the traditional program, according to the Medicare Payment Advisory Commission (MedPAC), an independent group that advises Congress. HMOs will get 10 percent more, but private fee-for-service plans will get a whopping 19 percent more, a subsidy that lets them offer rock-bottom premiums and lots of extras-at least for now.
An unlikely player in the 1997 debate was the National Right to Life Committee. Worried that Medicare HMOs would euthanize old people, the committee lobbied Congress to allow private fee-for-service plans in the 1997 law as an alternative to managed care. Carriers were slow to market them, and in December 2005 only about 200,000 Medicare beneficiaries had signed up. But thanks to the federal honey pot, all that has changed. By February of this year, 1.3 million seniors had chosen fee-for-service plans, a sixfold increase that makes them the fastest-growing segment of the Medicare Advantage program.
Former House Speaker Dennis Hastert of Illinois also did his part to give an edge to certain fee-for-service plans. As Congress put the finishing touches on a catch-all bill late last year, Hastert got the House Rules Committee to insert a provision that gives sellers a larger window of time to sell these plans. They can be sold all year, not just between November 15 and March 31, the only time other Medicare Advantage plans can be sold. According to the New York Times, Aon, a large Chicago-based carrier, pushed for the change to help its subsidiary Sterling Life, the first carrier to market private fee-for-service plans in 2000. Aon recently told stock analysts that its health insurance business had a strong first quarter with good growth, “driven primarily by Sterling.” According to the Center for Responsive Politics, Aon is the twentieth-largest insurance contributor to political campaigns. It has given generously to the Illinois Republican Party and to Hastert. In the 2003-04 election cycle, Hastert received a run-of-the-mill contribution of $5,000; in 2005-06, as fee-for-service plans were becoming more important, Aon and its affiliates gave Hastert $23,900.
From the start, Humana saw gold in Medicare Advantage and embarked on a strategy of government-sanctioned bait and switch: Offering the lowest premiums in most counties across the United States (some as low as $1.87 per month), and selling through agents stationed in Wal-Mart stores, Humana signed up more than 3 million seniors just for its stand-alone drug benefit. It was willing to trade off smaller profits for the prospect of eventually switching seniors to the more lucrative Medicare Advantage plans. On average, seniors pay about $100 a year for Humana’s stand-alone plans, versus about $800 for its other Medicare Advantage plans. To get people into those other plans, Oklahoma regulators say, it paid agents commissions that were five times higher than commissions for stand-alone plans. This spring Humana announced that 100,000 people had moved to Medicare Advantage plans, and most chose private fee-for-service options. “It reflects good value for seniors and their preferences,” says Humana’s outgoing chief actuary, John Bertko. It’s also good value for Humana. Says one Washington insurance consultant: “An additional 100,000 people contributing to top line revenue is not insignificant-it’s an extra billion dollars.”
Private fee-for-service plans are also catching on with United Healthcare, Aetna and Blue Cross Blue Shield, the country’s insurance giants, which like these plans not only because of generous government payments but also because they are easy to administer. There are no cumbersome networks of doctors and hospitals to police and little oversight of the quality of treatment delivered to beneficiaries. So insurers are prospecting for new markets, selling fee-for-service plans to employers obligated to provide health benefits for their retired workers. The Michigan Public School Employee Retirement System, for example, just moved 115,000 retirees into a fee-for-service plan sold by Michigan Blue Cross Blue Shield.
Nearly 20 percent of the 43 million Medicare beneficiaries have enrolled in Medicare Advantage, up from 13 percent in 2004. Citigroup estimates that one-quarter of all beneficiaries will belong to one by 2010. “Enormous growth prospects remain,” Citigroup analyst Charles Boorady told investors in February.
All that, of course, depends on what happens in Congress. When the Congressional Budget Office estimated the bill for the overpayments at $54 billion for five years and $149 billion over ten, cuts seemed likely. After all, Medicare’s chief actuary, Richard Foster, has said that overpayments shorten the life of Medicare trust funds by two years and raise premiums that all beneficiaries pay for doctor and outpatient services. MedPAC has recommended giving all Medicare Advantage plans no more than it costs the government to provide benefits under the traditional program. “I don’t see any possible defense for the overpayments,” says Robert Berenson, MD, a senior fellow at the Urban Institute. “Managed care has been ineffective at controlling costs in the commercial sector. Why would we want to turn Medicare over to private plans and abandon traditional Medicare, where if we wanted to, we could actually manage costs?” For example, Congress could lift the MMA prohibition on negotiating lower drug prices with pharmaceutical companies. But earlier this year the Senate refused to do that, bowing to lobbying pressure from Big Pharma, which believes government negotiations will lead to the dreaded price controls.
Some HMOs have not been particularly good at improving care. A 2005 study by The Commonwealth Fund found that beneficiaries enrolled in for-profit health plans received significantly lower-quality care than those belonging to not-for-profit plans when it came to certain procedures like giving patients appropriate medications after heart attacks. (Most Medicare beneficiaries belong to for-profit HMOs.)
[NOTE FROM TRUDE: Here's the AHIP involvement commentary referenced in Item #1. There's more AHIP and HR-676, and more acidly written, in Item #6.]
Despite convincing evidence for cutting payments, America’s Health Insurance Plans (AHIP), a trade association of insurance companies and HMOs, has managed to marshal strong support in Congress for continuing them; many legislators see nothing wrong with seniors reaping extra benefits from private fee-for-service plans, which they argue bring more choice to constituents, especially in rural areas without managed care. “It’s absolutely brilliant how this has been orchestrated,” says Bonnie Burns, a training and policy specialist with California Health Advocates. AHIP has turned the usual industry/consumer lobbying dynamic on its head, casting legitimate consumer groups like California Health Advocates and the Medicare Rights Center as bad guys for wanting cuts and the insurance industry as good guys for wanting more money poured into the program. Consumer groups generally advocate more money for social programs, but in this case they see the overpayments as a strategy to destroy Medicare.
To confuse legislators even more, the industry has called on its own sham “consumer” group, the Coalition for Medicare Choices, to push its agenda on the Hill. AHIP founded the group back in 1999 and still provides administrative support, according to spokesman Mohit Ghose. The address on the coalition’s website turns out to be the same one as Democracy & Data Communications, a public relations counseling firm whose clients include AHIP, Humana and United Healthcare, another carrier riding the Part D gravy train with lucrative deals to sell plans to members of AARP, the retirees’ organization. The coalition now has 400,000 members, in every state; and the group has gained 140,000 new members in the past sixty days. Its main purpose seems to be ginning up letters and calls to members of Congress “to protect choices and additional benefits provided through the Medicare Advantage program.” Sterling Life’s website, for instance, tells visitors about the Coalition for Medicare Choices and urges them to send letters-sample included. Nowhere does it say that the coalition is a creature of the industry’s trade association.
6. The Corporate Crime of Selling Private Health Insurance
Source: http://www.pnhp.org/news/2007/march/the_corporate_crime_.php
Physicians for a National Health Program
Posted on March 28, 2007
by The Corporate Crime Reporter
On Saturday, the Center for American Progress Action Fund and Service Employees International Union (SEIU) sponsored a forum in Las Vegas for presidential candidates to discuss health care.
No Republicans accepted.
Seven Democrats accepted.
All the candidates at the forum agreed that universal health care was the goal. (Even the Business Roundtable and the insurance industry now say they want “universal health care.”)
But only one — Congressman Dennis Kucinich (D-Ohio) — accepts the only answer that will work, single payer.
Medicare for all.
The rest — including Barack Obama, Hillary Clinton, Chris Dodd, Bill Richardson, Mike Gravel, and John Edwards — want some mixture of public and private health insurance.
They know this public/private mix won’t work — the healthy wealthy will buy private insurance, the sick poor will sign on with the government — and the government program will be crippled.
But they don’t have the guts to stand up to the private insurance industry and say, get out.”
[NOTE FROM TRUDE: Further AHIP exposé re HR-676. Click here to return to Item 5.]
Kucinich has introduced single payer legislation (HR 676) in Congress that would make it unlawful to sell private health insurance for benefits that are medically necessary.
Last week, we entered the belly of the beast — the American Health Insurance Plans (AHIP) 2007 National Policy Forum at the Capital Hilton in Washington, D.C.
AHIP is the trade association for the companies that will be sacked if single payer becomes law.
We walked into a session titled Coverage for All Americans: Putting Access at the Top of the National Agenda.
The session was moderated by AHIP President Karen Ignagni.
Not once during the 90-minute session was single payer mentioned.
Universal coverage, yes.
Single payer, no.
But during the discussion, the geography of nowhere was laid out.
On one side, Ron Pollack, executive director of Families USA had teamed up with AHIP’s Ignagni.
On the other, Bill Novelli, CEO of AARP and John Catsellani, president of the Business Roundtable.
AARP and the Business Roundtable have joined with SEIU to form something called Divided We Fail.
Divided We Fail is a corporate liberal answer to single payer.
All Americans should have access to affordable quality health care.
All Americans should have peace of mind about their future long-term financial security.
Families USA and AHIP do a separate dance but mouth similar platitudes.
But both Divided We Fail and Families USA/AHIP dismiss single payer as unworkable.
On the single payer side is Kucinich, about 60 members of the House of Representatives, the California Nurses Association, Physicians for a National Health Program, and Health Care Now.
Kucinich is now the single payer champion.
The problem with Kucinich, of course, is that if he doesn’t get the nomination, he will take the stage at the Democratic Convention in 2008 in Denver, as he did in 2004 in Boston, raise the hand of the corporate nominee and endorse the corporate platform.
Then where will we be?
Nowhere.
Again.
7. Health care: The best won’t be the easiest
Source: http://www.pnhp.org/news/2007/april/health_care_the_bes.php - reprinted from Newsday
Saul Friedman
Newsday
April 21, 2007
Most of the more pragmatic proposals reject the single-payer approach, fearing it would run afoul of lobbying campaigns against centralized government control of health care. The latest proposal, called AmeriCare, comes from one of the most liberal members of Congress, Rep. Pete Stark (D-Calif.). Like most others, it would depend on private, for-profit insurance companies to provide health care for the non-elderly.
Even AARP, which earned $379 million in royalties in 2005, mostly from health insurance sales, appears to favor universal public and private health care coverage. AARP endorsed and makes millions from Part D, which is based wholly on private coverage. Last month’s AARP Bulletin reported on various state schemes for universal private coverage, but made only passing mention of the Medicare for All proposals in Congress.
The most comprehensive public-private proposal favored by some liberal groups has come from Yale political scientist Jacob S. Hacker. Writing for the liberal Economic Policy Institute, Hacker said he seeks “to avoid the dismal fate of previous reform campaigns” that ran afoul of budget problems, public resistance to change and “the embedded realities of the present system.”
His proposal, Health Care for America, would “extend insurance to all non-elderly Americans through a new Medicare-like program and workplace health insurance…. Every legal resident of the U.S. who lacks access to Medicare or good workplace coverage would be able to buy into the ‘Health Care for America Plan,’ a new public insurance pool modeled after Medicare….Employers would be asked to either provide coverage as good as this new plan or make a relatively modest payroll-based contribution to Health Care for America.
“It would not eliminate private employment-based insurance….It is not single-payer - a vision that, for both political and budgetary reasons, is unlikely to be achieved in the near future. Nonetheless, Health Care for America does embody many of the key virtues of a universal Medicare-like program.”
Hacker’s plan would put private insurance in competition with a Medicare-type plan to provide coverage that would be guaranteed. “Health Care for America,” he writes, would provide “a generous package of benefits…greater choice.” (See epi.org for the full text of Hacker’s proposal.)
Diane Archer, former president of the New York-based Medicare Rights Center, applauded the proposal as a way to create competition between public and private insurers, and predicted that for-profit insurers would not compete because “they would still try as hard as possible to avoid insuring the people with the costliest conditions.”
8. AARP Says It Will Become Major Medicare Insurer While Remaining a Consumer Lobby
[NOTE FROM TRUDE: If you jumped here from my note above item #5, you can return by clicking here. The "counseling service" is mentioned on the next page. This article is the best summary of AARP hidden agenda - just "follow the money" logic, really. To return to Item 1, click here.]
Source: http://www.pnhp.org/news/2007/april/aarp_says_it_will_be.php - reprinted from NYT
By ROBERT PEAR
The New York Times
April 17, 2007
WASHINGTON, April 16 - AARP, the lobby for older Americans, announced Monday that it would become a major participant in the nation’s health insurance market, offering a health maintenance organization to Medicare recipients and several other products to people 50 to 64 years old.
The products for people under 65 include a managed care plan, known as a preferred provider organization, and a high-deductible insurance policy that could be used with a health savings account.
When the new coverage becomes available next year, AARP will be the largest provider of private insurance to Medicare recipients. In addition to the new H.M.O., AARP will continue providing prescription drug coverage and policies to supplement Medicare, known as Medigap coverage.
William D. Novelli, the chief executive of AARP, said, “In launching these initiatives, we are driven by our mission to create a healthier America.”
The group also said it would use its leverage to reshape the health insurance market. The organization has 38 million members, and Mr. Novelli said it hoped to have 50 million by 2011.
The new Medicare product will be marketed with UnitedHealth Group. Policies for people under 65 will carry the AARP name and will be marketed with Aetna.
Revenues and royalties from the sale of goods and services have, for many years, accounted for a substantial part of AARP’s income. AARP officials insisted that its financial interests do not affect the positions it takes on Medicare, Medicaid, Social Security and dozens of other issues on which it lobbies and litigates.
Judith A. Stein, director of the Center for Medicare Advocacy, a nonprofit group that counsels people on Medicare, said, “The new arrangements with insurance companies create a tremendous number of potential conflicts for AARP, which is a powerhouse, perceived as the most important voice for older people.”
The role of private insurers in Medicare is one of the most hotly debated issues in American health policy. In general, Republicans want to expand the role of private insurers like UnitedHealth and Aetna, while Democrats want to limit the role of private entities.
Ms. Stein and her organization work closely with AARP.
“AARP will not be perceived as a truly independent advocate on Medicare if it’s making hefty profits by selling insurance products that provide Medicare coverage,” Ms. Stein said. “AARP’s role in this market could give a big boost to the privatization of Medicare.”
AARP has opposed efforts to privatize Medicare or Social Security.
Dawn M. Sweeney, president of AARP Services Inc., the tax-paying business unit of AARP, said, “We will use our collective market power to negotiate” competitive prices for the new health insurance products.
AARP also said it would use $500 million of insurance sales revenue over the next decade to help people navigate the health care system, with a new counseling service.
Payments to UnitedHealth and Aetna will be linked to their performance in improving the health of subscribers, including members of minorities, Mr. Novelli said. The new plans will coordinate care for people with chronic conditions and will develop special programs to treat people with depression. AARP will measure how frequently the companies deliver recommended treatments to people with diabetes, hip fractures and other conditions.
People ages 50 to 64 often find that health insurance is unavailable or unaffordable when they try to buy it on their own. AARP said its underwriting practices would be less stringent than those of many commercial insurers, but it reserved the right to deny coverage to some sick people ages 50 to 64.
To guarantee issuance of a policy to every applicant in that age group is “just not economically feasible,” Ms. Sweeney said.
About seven million people currently have health insurance of various types, mainly drug coverage or Medigap policies, carrying the AARP brand name. With the new products, Ms. Sweeney estimated, the number will double to 14 million by 2014.
