National Nurses United statement on Healthcare Reform

[Chico David, BSN, RN]

i think this gives a fairly balanced perspective on what the newly passed law does and does not do. being an optimist, i tend to think of it as a partial step in the right direction. we've heard plenty of the critique from the right, think of this as the critique from the left:

diary of a wimpy healthcare bill

passage of president obama's healthcare bill proves that congress can enact comprehensive social legislation in the face of virulent rightwing opposition. now that we have an insurance bill, can we move on to healthcare reform?...

as an organization of registered nurses, we have an obligation to provide an honest assessment, as nurses must do every hour of every day. the legislation fails to deliver on the promise of a single standard of excellence in care for all and instead makes piecemeal adjustments to the current privatized, for-profit healthcare behemoth.

when all the boasts fade, comparing the bill to social security and medicare, probably intended to mollify liberal supporters following repeated concessions to the healthcare industry and conservative democrats, a sobering reality will probably set in.

what the bill does provide

-expansion of government-funded medicaid to cover 16 million additional low income people, though the program remains significantly under funded which limits access to its enrollees as its reimbursement rates are lower than either medicare or private insurance with the result some providers find it impossible to participate. though the federal government will provide additional subsidies to states, those expire in 2016, leaving the program a top target to budget cutting governors and legislatures.

-increased funding for community health centers, thanks to an amendment by sen. bernie sanders, that will open their doors to nearly double their current patient volume.

-reducing but not eliminating the infamous "donut hole" gap in prescription drug coverage for which medicare enrollees have to pay the costs fully out of pocket.

-insurance regulations covering members' dependent children until age 26, and new restrictions on limits on annual and lifetime on lifetime insurance coverage, and exclusion of policies for children with pre-existing conditions.

-permission for individual states - though weakened from the version sponsored by rep. dennis kucinich -- to waive some federal regulations to adopt innovative state programs like an expanded medicare.

all of these reforms could, and should, have been enacted on their own without the poison pills that accompanied them.

where the bill falls short

-the mandate forcing people without coverage to buy insurance. coupled with the subsidies for other moderate income working people not eligible for medicare or medicaid, the result is a gift worth hundreds of billions of dollars to reward the very insurance industry that created the present crisis through price gouging, care denials, and other abuses.

-inadequate healthcare cost controls for individuals and families.

1. insurance premiums will continue to climb. proponents touted a "robust" public option to keep the insurers "honest," but that proposal was scuttled. after anthem blue cross of california announced 39 percent premium hikes, the administration promised to crack down with a federal rate insurance authority, an idea also dropped from the bill.

2. there is no standard benefits package, only a circumspect reference that benefits should be "comparable to" current employer provided plans.

3. an illusory limit on out-of-pocket medical expenses. but even in the regulated state exchanges, insurers remain in control of what they offer and what will be a covered service. insurers are likely to design plans to attract healthier customers, and many enrollees will likely find the federal guarantees do not protect them for medical treatments they actually need.

-no meaningful restrictions on claims denials insurers don't want to pay for. proponents cite a review process on denials, but the "internal review process" remains in the hands of the insurers, and the "external" review will be up to the states, many of which have systems now in place that are dominated by the insurance industry with little enforcement mechanism....

[elkpark]

The statement does a good job of listing all the things wrong with the bill. It's basically a giant giveaway to the for-profit insurance industry, just as Medicare Part D was a giant giveaway to the insurance and pharaceutical industries. When we will finally wake up and quit letting them run the country? The final bill could just as easily have been written by the Republicans -- I don't see what they're complaining about, other than the fact the Obama and the centrist Democratic caucus support it.

It sickens me to think that we're going to hand huge amounts of taxpayer dollars to the for-profit insurance companies for them to pocket as profits, while they laugh all the way to the bank.