Next On GOP Agenda: ‘Curing’ Medicare — With Help From Corporate Flacks And Lobbyists

Now that Congress has passed the GOP’s $1.5 trillion tax bill, the Senate will soon vote on President Trump’s nomination of former drug company CEO Alex Azar to be Secretary of Health and Human Services. Republicans will be eager to get him confirmed and on the job. Considering Azar’s background, they have good reason to believe he’ll be a reliable ally when they get to work on their next big goal: slashing spending on health care programs, Medicare in particular. If confirmed, Azar will be the first pharmaceutical industry executive to head HHS. During his tenure at Eli Lilly & Company, he oversaw big increases in the price of a number of the company’s drugs. But his corporate job is not the only reason to...

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Medicare And Drug Coverage: Some Good News, Some Bad

One of the benefits of the Affordable Care Act to Medicare beneficiaries has been the gradual closing of a big and costly gap called the “doughnut hole” in the prescription drug (Medicare Part D) program. By the end of 2020 — if the ACA is not repealed or altered substantially by Congress — the doughnut hole will be completely closed. In 2010, people hit the doughnut hole coverage gap when the total amount they and their plan had paid for prescription drugs reached $2,800 in a coverage year. At that point, people had to pay the full cost of their prescription drugs until they had reached the out-of-pocket spending limit established by the law. In 2010 that limit was $4,550. After someone paid that much,...

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Unlike Some Politicians, I Don’t Want You Going Naked Come January

People, I’m begging you: If you’re uninsured and don’t have the option of getting health insurance through your employer, please go to healthcare.gov right now to enroll in a health plan. You have until Dec. 15 to enroll—or pick another plan if you’re already enrolled—but getting it done and over with is better than waiting until the last minute. Or just forgetting. You do not want to forget because you do not want to gamble, with your life and your bank account, by “going naked.” (That’s insurance company lingo for what someone is doing when they decide to stay uninsured.) A lot of folks assume they’ll have another year of good health, that they won’t come down with some awful disease because they’re young or...

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Why Donald Trump Hates Michael Moore — And Why I Used To Hate Him, Too

A week after Michael Moore’s one-man Broadway show closed — as scheduled — President Trump took to Twitter over the weekend to do what so many men in high places have done for years: malign Moore in an effort to make people believe that Moore hates America and its business and political leaders most of all. While not at all presidential I must point out that the Sloppy Michael Moore Show on Broadway was a TOTAL BOMB and was forced to close. Sad! — Donald J. Trump (@realDonaldTrump) October 28, 2017 To which Moore replied: 1) You must have my smash hit of a Broadway show confused with your presidency-- which IS a total bomb and WILL indeed close early. NOT SAD https://t.co/URgXgzWWVk — Michael Moore (@MMFlint) October 29, 2017...

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Why We Need ‘Pull-No-Punches Reporting’ That Holds Big Corporations And Moneyed Interests Accountable

Nataline Sarkisyan might be alive today had I not been such a team player when she was so sick. Had I not been so focused on helping my company “win in the marketplace” and “enhance shareholder value,” had health insurance companies been held more accountable by lawmakers, the media and the public, Nataline, who died at the age of 17 nine years and 310 days ago, might have received the liver transplant she needed. I know about Nataline because of the role I played in her struggle to live—I was writing talking points to try to justify a colleague’s decision to deny coverage for the surgery her doctors were pleading for—but there are an untold number of other Americans who are no longer with us because...

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Study Refutes a Big Health Care Special Interest’s Talking Points

One of the most prevalent talking points used by an entrenched special interest to keep a new clinical profession from flourishing in the United States has been shown to be unfounded: The use of mid-level providers in dentistry can make a big difference in the oral health of people who live in communities where dentists are few and far between. A recently completed study by researchers at the University of Washington shows that children and adults in Alaska Native communities served by dental therapists—comparable to a nurse practitioner or physician assistant— had significantly better oral health outcomes than people in communities not served by them. Why does this matter? The current dental delivery system isn’t meeting the needs of many people in this country. A third of...

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Desperate for Dental Care in America’s Heartland

Imagine going online to make an appointment with your dentist and finding this message, in bold letters, at the top of the website: - The patient parking lot will open no later than midnight. - Numbered patient admission tickets will be given out beginning at 3 AM, one ticket per patient. - Clinic doors will open at 6 AM. Patients will be admitted in numerical order by ticket # and a ticket is required for admission. - Services are provided on a first-come, first-serve basis. If you have good health insurance and decent dental benefits, you probably can’t imagine that anyone in the U.S. needing care would ever encounter a message like that. After all, we have the best health care system in the world,...

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Conservatives and Liberals Agree on at Least One Health Care Fix

If you’re following the heated debate over whether the Affordable Care Act should be repealed and replaced, you might conclude that expanding access to health care is a goal that’s inconsistent with controlling government spending. You might also conclude that finding common ground is impossible because, it seems, right-leaning organizations want to talk only about cutting taxes while left-leaning organizations want to talk only about reducing the number of people without health care benefits. That’s the conventional wisdom in DC, but it doesn’t apply to what’s going on in the states in one important but underreported issue: the growing number of Americans without access to dental care. Finding ways to alleviate the crisis caused by a lack of access to dental care in the US...

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How America’s Dental Health Crisis Created Mexico’s “Molar City”

Immigration and the Mexican border have been in the news for months. But all the stories have been about people coming to the United States. The untold story is how many Americans are leaving the U.S. for Mexico. Not to stay but to get dental care. So many Americans are making the trip across the border to see a dentist that one small border town, Los Algodones, is now better known by its nickname: Molar City. The demand has become so great that a website has been created to help Americans make appointments with Mexican dentists before they leave home. If you’re like me and are able to see a dentist regularly, you’ve probably never heard of Molar City. I hadn’t until I read about...

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The new plan to cut out the heart of Obamacare

Community rating: the defining feature of the earliest health insurance – and the one thing that keeps carriers from gouging customers. Community rating is the one thing that keeps insurance companies from gouging most of their customers. It’s the thing that helps makes the health insurance marketplace even remotely fair. Continue reading

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A Major Health Care Victory in Indian Country

Almost exactly a year ago, I wrote about how an American Indian tribe in Washington state defied a powerful special interest that was making it difficult for members of the tribe to get the dental care they needed. It was a big gamble, but it paid off. What tribal leaders did was hire the equivalent of a nurse practitioner in dentistry—a dental therapist—to practice on the Swinomish Reservation, despite opposition from the state dental association and the fact that the state had not yet granted tribes the authority to use dental therapists. In the year that has passed, members of the Swinomish tribe are not having to wait nearly as long as before to get a dental appointment. The wait time has shrunk dramatically, from...

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Bipartisan Agreement On Health Care? On Dental Care, Absolutely

Dentist tools are photographed in the surgery room of dentist Sevan Arzuyan in Hanau near Frankfurt, Germany, March 7, 2016. REUTERS/Kai Pfaffenbach If you think Democrats and Republicans can’t agree on anything related to health care, you’d be wrong. A remarkable bipartisan effort is taking shape at the state level that could result in millions of Americans having better access to care in a way barely addressed by federal lawmakers. I’m talking about better access to dental care. Recent poll results and comments by policy advisors on both sides of the political divide show that there is growing bipartisan agreement on ways to improve the oral health of Americans. While the Affordable Care Act helped increase access to dental care for...

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‘Obamacare Saved My Life, Too.’

Donald Trump says everyone will be 'beautifully covered' after repeal. Why this Philly demonstrator isn't buying it, and why you shouldn't either.   You’ve been told for years that Obamacare has been bad for the middle class. That’s it’s the reason premiums are increasing and why more people are in high deductible plans. You’ve been told that once it’s repealed everybody will be “beautifully covered."That would be great. But Kristin Wolf isn’t buying it. And neither should you. Continue Reading 

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Adam Bruckner’s “Bully Back” – an elementary school adaptation of our election reality

In recent weeks, parents all across the country have been afraid to let their kids watch news coverage of the presidential candidates. My Nation on the Take co-author, Nick Penniman, posted this on Facebook shortly before the second Clinton-Trump debate: I couldn’t agree more. But all is not lost, thanks to a good friend of mine, Adam Bruckner. Adam—with a little help from a few of his little friends—has come up with the perfect way for parents and teachers to explain to kids what’s going on in this election year. Not only is it funny as heck, it’s G-rated and brilliantly illustrated. Angel [Left] and Bruckner [Right] on the front stairs of the Helping Hand Rescue Mission. The Mission was founded in...

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Introduction to Em’s Square

  Emily Potter poses for Head Shot assignment outside of checkout on the Ventura Campus of Brooks Institute in Ventura Calif., Wednesday afternoon, Jan. 29 2014. (© Rebekah A Romero 2014) In a New York Times op-ed this summer, author and columnist David Brooks wrote about how a series of portraits of 19th century abolitionist Frederick Douglass influenced attitudes toward slavery. A photograph, Brooks wrote, “is powerful, even in the age of video, because of its ability to ingrain a single truth.” Emily Jacqueline Potter (Em, as her friends called her) understood that intuitively. The photographs she took were poignant and powerful. Tragically, Emily passed away in 2014. She was just 27. You’ll learn more about Em, who was my and...

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History (of health carrier greed) repeats itself

It doesn't take a psychic to predict that health insurance carriers will return to the Obamacare fold in 2017 with dollar signs in their eyes. On a Friday afternoon 16 years and four months ago, after the close of trading at the New York Stock Exchange, my staff and I at Cigna disseminated a press release we knew would lead to a lot of angst in Washington, on Wall Street and around the country.  Continue reading

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Why Health Insurance Industry Consolidation Is Bad For Your Health

You undoubtedly have heard that some of the country’s biggest health insurers have decided to leave several Obamacare markets, which means that tens of thousands of us will be affected next year. You probably haven’t heard — at least not lately — that some of the biggest health insurers are moving full steam ahead to merge with each other, which means that tens of millions of us — yes, millions — will be affected next year. And not in a good way. If the consolidation happens as planned, many of us will find ourselves in health plans with much worse patient satisfaction and customer complaint scores. Here’s some context: Executives of UnitedHealthcare, Aetna and Humana made headlines this summer when they announced plans to quit...

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Cry me a river, Aetna.

Retreating carriers whine that exchanges bruised their bottom lines; meanwhile, their profits are off the charts, thanks to ... Obamacare. You might be thinking, based on what insurance company CEOs have been saying over the past few weeks, that carriers are awash in red ink because of Obamacare and would surely go bust if they had to keep paying the medical claims of their Obamacare customers for even one more year. You might even be shedding a tear or two for their poor shareholders. Here, for example, is the grim news Aetna’s CEO, Mark Bertolini, delivered to Wall Street financial analysts a few days ago: In light of a second-quarter pretax loss of $200 million and total pretax losses of more than $430 million since...

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The Insurance Empire Strikes Back

Read between the lines: Industry's message is clear that obstruction of carrier mergers will mean a grim future for Obamacare's exchanges. If federal officials fall for Anthem’s and Aetna’s latest PR ploy to win approval of their plans to buy the companies I used to work for, I’ll offer to sell President Obama a bridge or two. During a call with Wall Street financial analysts last week – as Anthem announced Second Quarter 2016 profits – Anthem’s CEO, Joseph Swedish, indicated that the future success of the Obamacare exchanges hinges on whether his company’s $54 billion offer to buy Cigna can be completed. This is an abstract of an article Wendell first published on healthinsurance.org.  The full text is available here.

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It’s Way Past Time For Us To Stop Deluding Ourselves About Private Health Insurers

I didn’t think it was possible for me to get more disgusted with the industry I used to be a cheerleader for, but I was wrong. Health insurers—more specifically, the big for-profit health insurers that want to get even bigger through two pending mega-mergers (Anthem wants to buy Cigna and Aetna wants to buy Humana)—once again are demonstrating that nothing—absolutely nothing—is more important to them than making their rich shareholders even richer. If that means making it more difficult for low- and middle-income Americans to get the medical care they need, so be it. “Too bad, so sad,” to use a phrase one of my former colleagues used to say when people complained about the way health insurers routinely screw their customers. What turned my...

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Who Cares About Wasserman Schultz When Americans Are Still Getting Medical Care In Animal Stalls?

MARK MAKELA / REUTERS While the media — and Democratic party leaders — obsess about whether Debbie Wasserman Schultz should be allowed to “gavel in” the Democratic National Convention here today, hundreds of doctors and dentists are returning to their day jobs after spending three days a few miles from where I grew up treating patients — human patients — in animal stalls. Frankly, I suspect the Democrats would rather deal with the Wasserman Schultz debacle than acknowledge that the Affordable Care Act, which will be praised many times this week, justifiably to a large extent, nevertheless falls so far short of making care either accessible or affordable to millions of Americans that many are willing to suffer the indignity of being examined in a...

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Seriously: Is the Public Option really an option?

Hillary Clinton, and now President Obama, have 'Public Option Fever.' But is it contagious enough to overcome the power of Big Money? Well, well, well. It seems as if the Democrats have once again come down with Public Option Fever. Forgive me for being cynical, but folks, until we address the democracy-stifling and status-quo protecting influence of Big Money in politics in this country, the Public Option – which the health insurance industry vehemently opposes – is not going to become a reality anytime soon. And the Democrats know it. This is an abstract of an article Wendell first published on healthinsurance.org.  The full text is available here.  

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Organized Dentistry Loses Big In Another State As Propaganda Stops Working

  In health care public policy fights, it’s very hard for an underdog to overcome a massively funded lobbying and propaganda campaign. Today, though, the underdog is celebrating a huge win. One so big, in fact, that it most certainly will embolden groups in other states to take on the same adversary—organized dentistry. The victory was made official this morning when Vermont Gov. Peter Shumlin signed a bill that will greatly expand access to dental care in the Green Mountain State by expanding the dental workforce. It will do so by enabling mid-level providers—called dental therapists—to practice in the state. With Shumlin’s signature, Vermont becomes the sixth state in which dental therapists—similar to nurse practitioners and physician assistants in medicine—can treat patients (under the supervision of...

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America’s Silent Epidemic Will End When Public Officials Stop Kowtowing to a Single Special Interest

  A new report by Surgeon General Vivek Murthy and the Department of Health and Human Services makes clear that the United States is still in the grip of a decades-long epidemic, albeit one that many Americans scarcely know exists. What this and previous reports do not make clear, however, is that the epidemic continues to cause lasting harm to millions of men, women and children in part because of the influence of a very powerful special interest. To a large extent, this epidemic is as “silent” as when one of Murthy’s predecessors, David Satcher, brought it to the nation’s attention 16 years ago. In “Oral Health in America: A Report of the Surgeon General,” Satcher wrote that: In spite of the safe and effective...

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The Lobbyist Who Made You Pay More at the Drugstore

Here's how the pharmaceutical industry keeps America's drug prices among the highest in the world. The following is excerpted from Wendell Potter and Nick Penniman’s new book, Nation On the Take: How Big Money Corrupts Our Democracy and What We Can Do About It. You can also listen to an interview with the authors. Bill and Faith Wildrick have never heard of Billy Tauzin, but they’re paying dearly for Tauzin’s tireless work for the pharmaceuticbal industry. So are Faith’s employer and all of her co-workers. We all are. And in the future, so will our children and grandchildren. Thanks in large part to Tauzin and Washington’s infamous revolving door, the Wildricks are paying so much to fill Bill’s prescriptions every month — even with their...

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Potter and Penniman: “The System Is Rigged Against Regular People”

In their new book, Nation on the Take, Wendell Potter and Nick Penniman portray a government and politics polluted by big corporate dollars. But the authors also offer solutions. By Michael Winship | March 18, 2016 Few are as qualified to tackle the massive topic of money in politics as Wendell Potter and Nick Penniman. Their new book, Nation on the Take: How Big Money Corrupts Our Democracy (read an excerpt), is a comprehensive and important examination of the many ways our lives are affected by the stranglehold corporations have on our government and society. And it’s a look at how we can fight back. Wendell Potter is senior analyst at the Center for Public Integrity, an ex-newspaperman and a former executive with the health insurance...

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Is America a ‘Nation on the Take’?

America stands at a historic crossroads. One path leads to a renewal of our Democratic ideal, the other to government by the few, the rich and the powerful. So argue Wendell Potter and Nick Penniman in their new book, “Nation on the Take: How Big Money Corrupts our Democracy and What We Can do About It” (Bloomsbury). Potter will be familiar to Center for Public Integrity readers as a former health insurance executive turned critic, Center columnist and author. His previous book “Deadly Spin” won the 2011 Ridenhour Book Prize. Penniman is executive director of the organization Issue One, which is dedicated to reducing the influence of money in politics; he was previously publisher of the Washington Monthly and director of the Huffington Post Investigative...

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On Super Tuesday, a Battle Plan to Save Democracy

Nick Penniman Executive Director, Issue One and Wendell Potter Author of Nation on the Take, to be published March 1, 2016 Tens of millions of political dollars have been injected into the 13 states holding their primaries this Super Tuesday as the presidential candidates angle for the 1,639 delegates that are up for grabs. Because of such massive outlays, political spending in 2016 will likely reach $10 billion, blowing the roof off all previous records. Yet, amidst the blinding blizzard of campaign cash, many people might wonder whether money really has that much of an impact on elections. When Jeb Bush recently pulled out of the campaign, Donald Trump cynically quipped about Bush's lackluster performance: "It shows you, you can't buy elections anymore. It's really...

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Trump Pledge to Repeal Obamacare Will Trigger Insurance Marketplace Chaos and Political Backlash

Listen to Scott Harris and Wendell Potter's conversation on Between the Lines. Check out the full post here. Ever since the passage of the Affordable Care Act in 2010, known widely as Obamacare, the Republican party has staged continuous rhetorical attacks on the health care law – and held more than 60 votes to repeal the legislation. Now with the election of Donald Trump to the White House, and Republicans maintaining control of both the House and Senate, the party will now be in position to destroy the legislation, that for all its flaws, has brought health insurance to more than 20 million Americans, many of them for the first time.

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Repeal Obamacare? GOP Should Be Careful What They Wish For

Now that they'll control the White House and Congress, Republicans still haven't got a clue what to do about health care. Felue Chang (right), who obtained health insurance through the Affordable Care Act, receives a checkup from Dr. Peria Del Pino-White at the South Broward Community Health Services clinic on April 15, 2014 in Hollywood, Florida. (Photo by Joe Raedle/Getty Images) For years, Republicans have been condemning Obamacare and vowing to repeal and replace it. Now that they’ll soon be able to do that, they’re like the dog that caught the car: Now what? I’d be willing to bet a month’s worth of premiums that this is what’s happening right now: The best PR pros money can buy are quietly developing...

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