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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

December 11th, 2009 11:27 AM

Senate Tweaks Away Your Healthcare

As my grandmother used to say, “I was born on a weekend but not last weekend.” The latest insult to Americans hungry for a bit of healthcare justice for all comes from the news that the Senate health bill now allows insurance companies to place annual limits on payments for some catastrophic illnesses, like cancer.

Surprise, surprise, surprise.  Another day. Another lie uncovered in the process. Another piece of this reform bill that favors the for-profit health insurance industry.

Associated Press' Ricardo Alonso-Zaldivar:

Health care loophole would allow coverage limits

A loophole in the Senate health care bill would let insurers place annual dollar limits on medical care for people struggling with costly illnesses such as cancer, prompting a rebuke from patient advocates.

The legislation that originally passed the Senate health committee last summer would have banned such limits, but a tweak to that provision weakened it in the bill now moving toward a Senate vote.

As currently written, the Senate Democratic health care bill would permit insurance companies to place annual limits on the dollar value of medical care, as long as those limits are not "unreasonable." The bill does not define what level of limits would be allowable, delegating that task to administration officials.

Read that passage again folks.  The bill was “tweaked.”  No official or legal amendment required when the insurance industry needs a tweak they damn well get a tweak.  And this is quite a tweak.

Just hours ago, I continued to read reports that claimed our healthcare reformers in Congress were doing away with pre-existing condition clauses and also ending lifetime caps on coverage.  Some patients and families were thrilled with this change alone, and most especially those people struggling with serious illnesses.

This summer, a friend of mine in Colorado was asked to introduce President Obama at a forum in Grand Junction.  Nathan Wilkes was selected to do so because he could speak clearly and passionately about his family’s troubles keeping enough insurance coverage for his son, Thomas, who has a serious blood disorder.  My friend has been and is a supporter of Medicare for all, single-payer type reform, but this opportunity to introduce the President and weigh in about eliminating lifetime benefit caps was a powerful pull.   Nathan gave an intelligent and emotional intro for the President, and he was later invited to Washington to watch Obama’s address to Congress on healthcare reform.

Well, the joke’s on you Nathan and on a lot of others who trusted the details of reform being sold by members of Congress and President Obama.   Only this is not at all funny.  Families like the Wilkes family will go broke trying to keep kids like Thomas alive.  And kids like Thomas will die without the care they need.
Nathan responded to the latest news out of the Senate with the clarity of a father who has fought hard to support reform that would make our system better not more problematic, “Now it looks like such plans will have a floor before they start covering (beyond the deductible/out-of-pocket) and a ceiling at which they stop (no "unreasonable annual limits").  That is the sweet spot for profiteering health insurers.  They avoid paying the common and the catastrophic, while soaking up premiums from all of us.”
The death panels allowed by this legislation are those set up and protected by the insurance industry – and tweaked into law by Congress and the President.

You simply cannot do this sort of tweaking and not have people notice.  Did you think the Wilkes family wouldn’t notice when the annual cap is reached for Thomas and they have to start paying out of pocket or stop treatment? 

This process has been fraught with disclosures of the misleading marketing of various details in the reform legislation from all involved.  Who can the American public trust on this?  Anybody?

As we sit on the verge of 2010, we citizens have some more political work of our own to do.  We need to do some tweaking in the streets and at the polls.  Because we surely are not going to get healthcare as a basic human right from this Congress and this administration.  Neither the Republicans nor the Democrats seem to get it.

When we do the math for ourselves and when we watch you all play a deadly game of push-me, pull-me with our healthcare reform legislation, we know for certain you are only maneuvering for political advantage while we are out here fighting for our lives, our health and for our financial security.  You didn’t hear us loudly enough at the polls in 2008, apparently.

Let me get this straight.  You will force us to buy private insurance products that will not guarantee approval of treatment or payment for treatment.  You will tax our insurance benefits if our employers offer those deemed as “Cadillac coverage” regardless of whether or not we make less than $250,000 a year.  You cannot guarantee that employers will keep our current insurance plans and provider networks or that insurance companies will keep benefits and providers the same – therefore we cannot keep what we’ve got if we like it.  You’ve crumbled on the notion of any real public option for coverage at all much less a “robust” option – whatever that squishy word ever meant.  And now insurance companies will decide when we’ve had enough treatment for serious illness each year.

Wow.  Sweet tweaking indeed for the profit-takers -- and without so much as a debate or airing on the floor of the Senate.  It seems only the things that would benefit real people require an appropriate following of legal process in Congress and full debate – amendments like Senator Bernie Sanders’ single-payer amendment aimed at strengthening real reform haven’t even gotten a hearing.  We’re still fighting for that.

Please don’t insult us any more by selling this legislation as healthcare reform or even health insurance reform.  This seems more and more like health industry protection and less like anything at all to do with providing what President Obama declared as a basic human right during the campaign.  Even he said the only way to get to full coverage is a single-payer plan.  And that’s a tweak too far from profit protection, it seems.

Hang on, fellow citizens.  This healthcare mess is about to get messier and make you wonder if anyone told us the truth at all.  Then we’ll have some serious tweaking of our own to do in 2010 and 2012.  We will not forget this.

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