Rationing And Restricting Health Care?

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RACHEL MADDOW, HOST: We begin tonight with a new campaign to terrify you about health care reform.

Within Congress where what’s going to happen is actually being worked out, the action is all among Democrats — and, frankly, things are happening really fast now. Pressure from the left for major reforms is heavy and it is starting to change the range of what’s possible.

Conservative Democratic Senator Max Baucus saying in an interview with "The New York Times" late today that because of pressure from the left, he will make more generous the subsidies in his bill to help people afford health insurance.

Over in the House, the lead conservative blue dog Democrat on health care, Mike Ross of Arkansas, was hit at the end of last week with ads that threatened a Democratic primary challenger against him if he didn’t support real reform including the public option.

Well, now, Congressman Ross has been hit with devastating poll results, highlighting the risks of his stance against the public option to compete with private health insurance. This poll was commissioned by the liberal Web site "Daily Kos," but it was carried out not by a liberal group but by the nonpartisan traditional polling firm called Research 2000. The poll found that in Mike Ross’ Arkansas district, voters in general are in favor of the public option. Independent voters in the district specifically are in favor of the public option.

And among Democrats in Mike Ross’ district? Democrats were in favor of the public option by a walloping 74 percent. That’s the hardball context in which the specifics of what our new health care system is going to be like are being worked out. It’s being worked out among Democrats.

Republicans are just not a big part of the legislative process right now, as evidence by the fact that even a senior Republican senator like Orrin Hatch today offered an amendment to the Baucus health care bill singling out — and I quote — "any state with a name that begins with the letter ‘U’ to get special federal health care assistance." When your policy suggestions could double as skits about the alphabet on "Sesame Street" it may be fair to say that you’re not doing the real heavy-lifting in developing legislation.

But even as Republicans become more and more irrelevant to the content of any nhealth reform bill, they are launching new attacks on the whole idea of reform itself.


MADDOW: And they’re scary.

After promoting the idea that health care was a secret plot to kill old people and a secret plot to take away veterans health care, and a secret plot to kill women with breast cancer, and a secret plot to deny health care specifically to Republicans, and even a secret plot to deny care to disabled children — that one was particularly classy — just when you thought they might be running out of groups of Americans to scare about what secret plot lurks within health care reform, they found a new one. A new survey being sent out by the National Republican Senatorial Committee says that health care reform is actually a plot to deprive you of health care on the basis of your race.

And, you know, the president is black. So, we don’t want to give you any ideas, but guess which race will be discriminated against?

Yes. Under the heading "Rationing and Restricting Health Care" on this fund-raising fake survey from the Republican Party appears this question, quote, "Are you concerned about health care rationing could lead to a quota system which would determine who would get treatments on the basis of race or age?" We’re not saying that`s going to happen, but hypothetically, would that sort of thing concern you?

Although they have been among the worst offenders in terms of scaring Americans by making stuff up about health reform, the Republican Party is not exactly alone here. Consider this letter that has been sent out from the health insurance company Humana to its older customers, quote, "Millions of seniors and disabled individuals could lose many important benefits and services."

In addition to that not being proposed by anyone in any of the health care bills under consideration, that sort of disingenuous health reform fearmongering might also be illegal. Humana is being investigated by the Department of Health and Human Services because the government pays Humana to provide Medicare Advantage coverage to Medicare patients, and by virtue of that, Humana has agreed to abide by some marketing rules — marketing rules that are basically in place so Medicare patients won`t be confused about who`s sending them information about their benefits, confused between their insurance company and the government.

Now, in this case, Humana says they don’t think they broke the rules but they are cooperating with the investigation nonetheless.

Meanwhile, an advocacy group called Consumer Watchdog on Friday released a sheet of internal underwriting guidelines from the industry that may clear just how sweet the deal has been for companies in the current system and how bad that system has been for those of us trying to use it to get our health care needs met. BlueCross of California guidelines from 2004, for example, said you could be disqualified from health coverage in certain circumstances if you had varicose veins.

Health Net guidelines from 2006 said that you could be denied coverage or charged higher premiums if you ever had treatment for toenail fungus or allergies. Health Net said you could be rejected from coverage if you were pregnant or if you were an expectant father. Yes, who could ever be expected to cover a high risk freak like that?

A company called PacifiCare in 2003 not only said that pregnancy or being an expectant father were grounds for automatic rejection of health coverage, they also refused coverage to police officers and firefighters as a class.

What’s actually scary about health care is what passes for a health system in this country now. Why again does anyone in Congress fighting to preserve the industry that brought us the genius idea that police officers don’t deserve health insurance in America? Why is it so important to preserve that system?

Joining us now is Wendell Potter. He’s a former health insurance executive-turned-whistleblower. He was head of public relations for CIGNA, one of the nation`s largest insurers. He’s now a senior fellow on health care at the Center for Media and Democracy.

Mr. Potter, thanks very much for joining us again tonight.

WENDELL POTTER, FORMER INSURANCE EXECUTIVE: Thank you, Rachel. And also, I was at Humana for a few years, too.

MADDOW: Which makes it all the more relevant to have you here. Thank you.

I have to say that I was upset, I was sort of shaken up by these industry documents that were made public this weekend. Internal rules that say you can’t cover police officers. You can’t cover firefighters. Don’t cover anyone who’s going to have a baby.

This pre-existing condition system was created by the industry. What was the purpose of it and how has it worked out for them?

POTTER: Well, it’s worked out great for them. They’ve been able to avoid paying out billions of dollars in claims through the years because of the system that the industry created. And they did this primarily to be able to avoid anyone who might need health insurance. They’ve been — they had such a sweet deal over many years by avoiding or not having to accept anyone who applied for coverage who might have some kind of illness in the past.

In fact, there are some professions in the industry that in the past they’ve actually written do not quote. So, it’s something — and, in fact, health care workers are among those that health insurance companies would rather not have to cover if they had a choice.

MADDOW: What about when someone already has coverage? Do pre- existing condition clauses factor after somebody’s already been granted coverage in order to avoid paying specific claims or in order to drop them?

POTTER: Absolutely, it does. And this is in the individual market where someone doesn’t have access to health insurance through the workplace. You have to fill out an application. And you are expected to try to remember everything that you can throughout your medical history, throughout your life. If you miss something or if you forget something, then if you do get sick, if you do have medical claims, the insurance company will go back and look at application, and they will have better memory — they`ll have better records than you will have memory, and they’re very — very often, they will cancel your coverage even though you paid premiums year in and year out every month on time even if you had acne or something like that.

MADDOW: When we look at the prospects for reform right now, the idea of getting rid of pre-existing conditions is something that pretty much everyone seems to be on board with even the health insurance industry. They’re willing to let — they’re willing to let the pre-existing condition thing go.

If you put yourself in the mindset of yourself when you worked back in the industry, or executives who are there now, surveying these reform prospects right now, how are they feeling about what may happening to their industry?

POTTER: Well, they would be willing to give up pre-existing conditions as a condition to deny coverage because they see this as a potential bonanza for them. If — and they’ve already gotten the president to go along or change his course and agree that everyone should be forced to get coverage and that would mean that if there’s no public option, they would have billions of dollars in new revenue that would come from new policyholders and for those who can’t afford to pay their overpriced premiums, taxpayer dollars that would go into these companies. And a lot of it would come out in the other end in terms profits for the shareholders. So, it’s a sweet deal for them.

They have said in the past, by the way, that they would — they’d be willing to give up pre-existing conditions. They said this in congressional testimony back in 1993. It`s empty rhetoric. But they would be willing to go along with it, first of all, because I don’t think they can’t avoid it this time. And secondly, in exchange for getting all of these new customers, you betcha, they’ll go along with it.

MADDOW: When I think about my own health insurance coverage and my own family’s experience, my friend’s experience with health insurance coverage, I have been through a long period of life when I was uninsured. A lot of people in my family, my friends, have been through time where we’re uninsured. But I also know, a lot of people who have health insurance right now but still feel that we are underinsured, still feel that we’re being given unaffordable costs even
after paying unaffordable premiums.

Do you feel like the sort of new regulations for industries — including getting rid of pre-existing conditions but all the other things that are being proposed — would actually make our insurance less bad if we’re all going to be required to have it?

POTTER: No, I think it will make it even more bad. Pre-existing conditions could be eliminated. I think they should be. It should be made illegal a long time ago. But a lot of the legislation would still enable – – in fact, it would sanction or enable companies to continue shifting more and more of the cost of health care to us. The so-called premiums might be more affordable comparatively, but on the other end of that is that we would make us pay more out of our own pocket for coverage.

So, the goal of making sure that no one has to file for bankruptcy because of medical bills is a pipe dream with the kind of legislation we see right now.

MADDOW: And that is the argument for the public option to compete with private system.

POTTER: Right. Exactly.

MADDOW: Wendell Potter, former head of public relations for CIGNA, also formerly with Humana — thank you very much for coming on the show tonight, sir.

POTTER: Thank you, Rachel.

Consumer Watchdog
Consumer Watchdoghttps://consumerwatchdog.org
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