Health Insurance Industry Wins: All Americans Must Buy Insurance under Obama Plan

Uncle Sam Single PayerBy Rady Ananda

Tonight, President Obama unveiled before Congress and the public his health insurance plan. Congress gave him a 5-minute standing ovation.

He said he was determined to be the last president to take up the cause of healthcare, but his plan insulates the health insurance industry by requiring all citizens to buy health insurance.

By his own definition, those on the Right won half of what they wanted: Require personal insurance for all Americans. The Left won nothing: Single payer is dead under this Administration.

As a consolation to the Left, I suppose, Obama explained that the insurance industry can no longer deny coverage based on past medical history. Now, they can no longer drop you if you get sick. If you sign up, they must cover all your illnesses.

Or, that’s how it sounded in plainspeak. His plan summary is at the end.

On the public option, Obama promised to create a market (allowing for Wall Street speculation?) where small employers can opt in at more affordable rates than if they applied directly to insurance companies.

On the poverty option, Obama promised that those of us who still cannot afford insurance coverage, the government will provide it thru tax relief.

Not quite sure how he plans to require me to pay for something I can’t afford even with a tax break. Even if I paid zero taxes, I cannot afford health care in the US. I currently earn less than 2/3 of a living wage in Ft. Lauderdale. At $10 an hour, I cannot afford healthcare. The only way I acquire needed healthcare is to go where they’ll provide it and bill me, which I then don’t pay.

He said he was interested in protecting physicians from malpractice lawsuits, but nothing about improving the quality of care. The World Health Organization ranked the US 37 in quality of care.

Anita Dunn, white hose spooksperson, explained that Medicare will be cleaned up of fraud, and this savings will cover us po’ folk. She said the pharmaceutical industry agreed to cut $50 billion from Medicare drug costs, and Obama said Big Pharma agreed to donate $80 billion.

How about a maximum cap on fees? I just paid $600 to have a tiny, benign cyst removed. Due to negligent treatment, I acquired a staph infection that required me to buy a single pill for $135 to kill the staph – that was on top of the other drug and medical paraphernalia costs I incurred.

He spoke at length about the disinformation campaign, but offered no cogent argument against single payer. FDR he is not.

The plan summary is as follows:


“It will provide more security and stability to those who have health insurance. It will provide insurance to those who don’t. And it will lower the cost of health care for our families, our businesses, and our government.”
– President Barack Obama

If You Have Health Insurance

More Stability and Security

· Ends discrimination against people with pre-existing conditions. Over the last three years, 12 million people were denied coverage directly or indirectly through high premiums due to a pre-existing condition. Under the President’s plan, it will be against the law for insurance companies to deny coverage for health reasons or risks.

· Limits premium discrimination based on gender and age. The President’s plan will end insurers’ practice of charging different premiums or denying coverage based on gender, and will limit premium variation based on age.

· Prevents insurance companies from dropping coverage when people are sick and need it most. The President’s plan prohibits insurance companies from rescinding coverage that has already been purchased except in cases of fraud. In most states, insurance companies can cancel a policy if any medical condition was not listed on the application – even one not related to a current illness or one the patient didn’t even know about. A recent Congressional investigation found that over five years, three large insurance companies cancelled coverage for 20,000 people, saving them from paying $300 million in medical claims – $300 million that became either an obligation for the patient’s family or bad debt for doctors and hospitals.

· Caps out-of pocket expenses so people don’t go broke when they get sick. The President’s plan will cap out-of-pocket expenses and will prohibit insurance companies from imposing annual or lifetime caps on benefit payments. A middle-class family purchasing health insurance directly from the individual insurance market today could spend up to 50 percent of household income on health care costs because there is no limit on out-of-pocket expenses.

· Eliminates extra charges for preventive care like mammograms, flu shots and diabetes tests to improve health and save money. The President’s plan ensures that all Americans have access to free preventive services under their health insurance plans. Too many Americans forgo needed preventive care, in part because of the cost of check-ups and screenings that can identify health problems early when they can be most effectively treated. For example, 24 percent of women age 40 and over have not received a mammogram in the past two years, and 38 percent of adults age 50 and over have never had a colon cancer screening.

· Protects Medicare for seniors. The President’s plan will extend new protections for Medicare beneficiaries that improve quality, coordinate care and reduce beneficiary and program costs. These protections will extend the life of the Medicare Trust Fund to pay for care for future generations.

· Eliminates the “donut-hole” gap in coverage for prescription drugs. The President’s plan begins immediately to close the Medicare “donut hole” – a current gap in its drug benefit – by providing a 50 percent discount on brand-name prescription drugs for seniors who fall into it. In 2007, over 8 million seniors hit this coverage gap in the standard Medicare drug benefit. By 2019, the President’s plan will completely close the “donut hole”. The average out-of-pocket spending for such beneficiaries who lack another source of insurance is $4,080.

If You Don’t Have Insurance

Quality, Affordable Choices for All Americans

· Creates a new insurance marketplace – the Exchange – that allows people without insurance and small businesses to compare plans and buy insurance at competitive prices. The President’s plan allows Americans who have health insurance and like it to keep it. But for those who lose their jobs, change jobs or move, new high quality, affordable options will be available in the exchange. Beginning in 2013, the Exchange will give Americans without access to affordable insurance on the job, and small businesses one-stop shopping for insurance where they can easily compare options based on price, benefits, and quality.

· Provides new tax credits to help people buy insurance. The President’s plan will provide new tax credits on a sliding scale to individuals and families that will limit how much of their income can be spent on premiums. There will also be greater protection for cost-sharing for out-of-pocket expenses.

· Provides small businesses tax credits and affordable options for covering employees. The President’s plan will also provide small businesses with tax credits to offset costs of providing coverage for their workers. Small businesses who for too long have faced higher prices than larger businesses, will now be eligible to enter the exchange so that they have lower costs and more choices for covering their workers.

· Offers a public health insurance option to provide the uninsured and those who can’t find affordable coverage with a real choice. The President believes this option will promote competition, hold insurance companies accountable and assure affordable choices. It is completely voluntary. The President believes the public option must operate like any private insurance company – it must be self-sufficient and rely on the premiums it collects.

· Immediately offers new, low-cost coverage through a national “high risk” pool to protect people with preexisting conditions from financial ruin until the new Exchange is created. For those Americans who cannot get insurance coverage today because of a pre-existing condition, the President’s plan will immediately make available coverage without a mark-up due to their health condition. This policy will offer protection against financial ruin until a wider array of choices become available in the new exchange in 2013.

For All Americans

Reins In the Cost of Health Care for Our Families, Our Businesses, and Our Government

· Won’t add a dime to the deficit and is paid for upfront. The President’s plan will not add one dime to the deficit today or in the future and is paid for in a fiscally responsible way. It begins the process of reforming the health care system so that we can further curb health care cost growth over the long term, and invests in quality improvements, consumer protections, prevention, and premium assistance. The plan fully pays for this investment through health system savings and new revenue including a fee on insurance companies that sell very expensive plans.

· Requires additional cuts if savings are not realized. Under the plan, if the savings promised at the time of enactment don’t materialize, the President will be required to put forth additional savings to ensure that the plan does not add to the deficit.

· Implements a number of delivery system reforms that begin to rein in health care costs and align incentives for hospitals, physicians, and others to improve quality. The President’s plan includes proposals that will improve the way care is delivered to emphasize quality over quantity, including: incentives for hospitals to prevent avoidable readmissions, pilots for new “bundled” payments in Medicare, and support for new models of delivering care through medical homes and accountable care organizations that focus on a coordinated approach to care and outcomes.

· Creates an independent commission of doctors and medical experts to identify waste, fraud and abuse in the health care system. The President’s plan will create an independent Commission, made up of doctors and medical experts, to make recommendations to Congress each year on how to promote greater efficiency and higher quality in Medicare. The Commission will not be authorized to propose or implement Medicare changes that ration care or affect benefits, eligibility or beneficiary access to care. It will ensure that your tax dollars go directly to caring for seniors.

· Orders immediate medical malpractice reform projects that could help doctors focus on putting their patients first, not on practicing defensive medicine. The President’s plan instructs the Secretary of Health and Human Services to move forward on awarding medical malpractice demonstration grants to states funded by the Agency for Healthcare Research and Quality as soon as possible.

· Requires large employers to cover their employees and individuals who can afford it to buy insurance so everyone shares in the responsibility of reform. Under the President’s plan, large businesses – those with more than 50 workers – will be required to offer their workers coverage or pay a fee to help cover the cost of making coverage affordable in the exchange. This will ensure that workers in firms not offering coverage will have affordable coverage options for themselves and their families. Individuals who can afford it will have a responsibility to purchase coverage – but there will be a “hardship exemption” for those who cannot.

6 responses to “Health Insurance Industry Wins: All Americans Must Buy Insurance under Obama Plan

  1. Dearest Rady . . .

    I too have serious problems with the plan. I submitted a comment on the White House facebook site and offer what you may enjoy and what physicians prefer. . .
    for me is the only authentic alternative was dismissed without ever be presented. I offer . . .

    Open Letter to President Obama to Support Single-Payer Health Care

    Dear President Obama:

    We are physicians from across the spectrum of our profession; primary care doctors and specialists, public health experts and administrators. We work in hospitals and clinics, private practices and universities, corporations and public agencies. Some of us are young, still in training; others are greatly experienced, and some have held senior positions in American medicine.

    We applaud you for reopening the national discussion of health care reform, and enthusiastically endorse your call for reform that would assure universal, comprehensive coverage at an affordable price, while improving the quality of care. Yet we are dismayed by recent developments in Washington. The single payer reform that could achieve our shared goals has been dismissed from consideration in favor of proposals that will neither fulfill your promises nor meet our patients’ urgent needs.

    Like most of our colleagues and the majority of the general public, we believe that single-payer reform is the standard against which other health reforms should be measured. Sound single payer proposals have been introduced in both the House of Representatives (H.R. 676, The U.S National Health Care Act) and the Senate (S. 703, The American Health Security Act of 2009).

    Single payer reform, as embodied in these bills, would eliminate the bewildering patchwork of private insurance plans with their exorbitant overhead and profits, as well as the costly paperwork burdens they impose on providers. These savings on bureaucracy – nearly $400 billion annually – are sufficient to cover all of the uninsured and to provide first dollar coverage for all Americans. No other approach can provide comparable coverage at a cost our nation can afford.

    Mr. President, you once embraced a single payer reform that would threaten private insurers, and foresaw its passage if Democrats regained control of the House, the Senate and the White House. These conditions have been met. Yet now Democrats propose diverting additional billions to private insurers by requiring middle class Americans to purchase defective policies from these firms – policies with so many gaps and loopholes that they currently leave millions of our insured patients vulnerable to financial ruin.

    Moreover, a “public plan option” would do little to mitigate the damage of a reform that perpetuates private insurers’ dominant role. Even a robust public option would forego 90% of the bureaucratic savings achievable under single payer. And a kinder, gentler public option would quickly fail in a health care marketplace where competition involves a race to the bottom, not the top, where insurers compete by NOT paying for care. But HHS Secretary Sebelius has made clear that any public option will be far worse than that, specifically crafted to prevent it from evolving to a single payer. This kind of public option would amount to a government-run clone of private insurance, reproducing the worst features of private plans.

    Mr. President, we ask that you join us in endorsing single payer reform as the only practicable means to reach our shared goals, and H.R. 676 and S. 703 as the appropriate starting point for debate in the House and Senate.


    I wish to sign AND support the movement for real reform by joining or contributing today! Please click here.
    I wish to sign but do not wish to join or contribute to PNHP today. Please click here.

  2. Dearest Rady . . .

    For those of us with less medical coverage, credibility, or prominence, may I present . . .

    A New Movement: Health Care as a Civil Right

    Dear Friends,

    There is only one true health care public option: Single payer. It covers everyone, all basic health care needs, with doctor of choice. No more premiums, co-pays or deductibles. All health care assets in America would become not-for-profit. The bill already exists. It is HR 676. Congressman John Conyers and I wrote the bill. Our bill has the support of 85 co-sponsors in the House. And it is backed by a growing national movement of labor, doctors, and nurses. The movement needs you. Please join me for tomorrow’s national conference call at 10:00pm EDT. Please call toll-free 1-800-230-1096.

    The hour has arrived to begin anew the Civil Rights Movement, this time for Health Care for All. I am calling upon you to become a force in this movement. Go to Health Care as A Civil Right at to learn how you can circulate a single-payer petition and organize in your community. Please help fund this effort. Go to now, contribute.

    The Preamble to the United States Constitution and Article One, Section 8 of the U.S. Constitution both describe an originating purpose of our United States: to promote the general welfare. Health care is a legitimate function of our government. Health care is a basic right in a Democratic society. It is no more a privilege based on ability to pay than is the right to vote, which was once accorded only to property owners.

    Health care is also a moral imperative. Forty seven million Americans are uninsured. Fifty million Americans are underinsured. People are losing their homes, their jobs, their life’s savings, their retirement security and their financial health because they cannot pay medical bills, and despite this calamity Washington looks another way. We must not avert our eyes to this human suffering and this economic injustice.

    Let’s prepare a response which Washington will long remember as the time when the people reclaimed their government from the insurance and pharmaceutical companies. Join us. Contribute. Together, we can initiate an action plan to intervene and provide health care for all.

    A National Health Care for All Conference Call from Washington, DC, at 10 pm EDT, Thursday, September 10th at 1-800-230-1096. Join us, so that we can discuss our new beginning and ways in which we can all help. Pre-registration is necessary in order to reserve sufficient phone lines. Please RSVP here. When you call in and the operator asks, “what conference call?” tell the operator, “Health Care for All.”

    On-line petition. Please contact your lists, your family and friends. Please sign the petition for a single payer system. I will deliver the petitions directly to your Congressperson.

    Petition to download, print and circulate among friends and neighbors – including an instruction sheet.

    Health Care Meet-Ups. Coming Thursday September 10 2009.

    Tell A Friend. Every email forwarded will make a difference? Please use the “Forward Email” link below to circulate up to 5 emails at a time to your friends.

    I need your help to initiate this action. If you believe, as I do, that we can and must begin a new long-term state-by-state grassroots effort to create a single-payer, not-for-profit health care system, please contribute now at
    Thank you.


  3. Dearest Rady . . .

    I thank you! it is always a pleasure to share with one who cares and advances awareness!

  4. Pingback: COTO Report Tops 100,000 Visitors « COTO Report

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