I listened in on a conference call earlier this evening hosted by Healthcare-Now to discuss the health insurance reform passed last night. For anyone interested, a recording of the call will be posted to the Healthcare-Now website by tomorrow night.

These people are real policy wonks and my notes do not do justice to the conversation, but Michael Lighty, Policy Director for National Nurses United made some quick points about some of the failings of the plan that stuck with me, including:

  • The insurers will control the initial appeals board for claim denials and there will be no federal standard
  • Insurers remain in full control of what they will offer and what specific treatments they will cover
  • There are huge loop holes in premium pricing. For example, for those who fail the wellness tests(say because they have diabetes) they can have their premiums doubled
  • Also, while they can not deny you for a pre-existing treatment, they can charge 4 times more for premiums for certain conditions
  • They can continue to rescind insurance for fraud and misrepresentation with little oversight

Those were just a few of the plans short comings Micheal mentioned. He did speak to some of the bills better provisions, the Medicaid expansion, and the provision that allows younger people to enroll in their parents coverage plans. His central point was while this legislation does involve a federal regulatory regime, that regime does not regulate what insurers can charge and what care they must cover.

The host, and her name escapes me, brought up the Grayson buy-in, calling it "opportunistic", but noting how popular Medicare is and that it is something people should refer to when they talk about a fully public insurance program. The panel felt in it’s present form individuals buying into Medicare would yield little results because it would be prohibitively expensive, and not yet comprehensive. Michael suggested it was a good tool for starting the discussion of if they are going to force us to buy health insurance anyway, why not give us Medicare, at least enroll those 55-64? Others thought the focus on Medicare for All, without distractions, was a better approach. They all think the campaign to improve Medicare for its beneficiaries goes on, and is instrumental to expanding it in the future. None of the panelists think the policy approved last night will yield the results Americans want in the health care system.

Ajamu Sankofa, Esq., founder of Private Health Insurance Must Go! made perhaps the most striking point of the night when she argued Obama had "demonized" Medicare in the debate, that he always brought cost curve problems back to Medicare when we know it is private insurance and other health care costs, like the Federal government not using it’s market size to negotiate drug prices, are actually at the root of rising costs. Michael also chipped in saying in essence to expect more of this. That the next year will require an effort to protect Medicare. He brought up Obama’s pick to co-chair his National Commission of Fiscal Responsibility and Reform, noted Medicare and Social Security hater, Alan Simpson. I think this last bit was the biggest eye opener to me, Obama may have more plans to chip away and Medicare and Social security, so be prepared.

Oh, one final point, Ajamu Sankofa suggested that some reform supporters gave deference to the political process and it didn’t work. That reformers should note it was the single payer movement that got the robust public option into the debate. So Obama may say Medicare for All is "off the table", politically it is not.