In case anyone missed a 14 page detailed Health cost saving proposal by Hillary - here are

[papau]

clippings (I am amazed at the lack of press/air time this has gotten)

plan also is available online. http://www.hillaryclinton.com/news/speech/view/?id=1789

=====================================================
http://www.latimes.com/news/politics/la-na-hillary25may25,0,7754092.story?coll=la-home-center

From the Los Angeles Times
Clinton offers health proposal
The topic is fraught for the Democratic presidential candidate, who stumbled famously in the 1990s.
By Jill Zuckman Chicago Tribune

May 25, 2007

WASHINGTON — <snip>Clinton offered a proposal Thursday focused on reining in healthcare costs. Two other proposals are expected — one seeking to improve the quality of healthcare and the other to insure all Americans. She has already introduced legislation in Congress to expand healthcare coverage to all children.<snip>

A rival for the Democratic presidential nomination, Sen. Barack Obama of Illinois, is expected to lay out his own vision Tuesday for bringing down healthcare costs and expanding coverage. Former Sen. John Edwards (D-N.C.) has already proposed insuring all Americans by 2012. Currently 45 million are uninsured.

On Thursday, Clinton argued that healthcare costs were out of control. Among the evidence she cited: Premiums have almost doubled since 2000; the nation spends 16% of its gross domestic product on healthcare; 30% of the cost increase is related to the doubling of obesity among adults during the last two decades; and administrative costs are the highest in the world.

"If we spend so much, why does the World Health Organization rank the United States 31st in life expectancy and 40th in child mortality, worse than Cuba and Croatia?" she asked.<snip>

"The whole point of insurance, lest we forget, is to spread risk across a group of enrollees," she said. "It's one of the reasons that the administrative costs of Medicare are so much lower — because they are actually insuring everyone."

=======================================================================

May 25, 2007
Clinton Plan Would Trim Health Spending by $120 Billion a Year
By CQ Staff, CONGRESSIONAL QUARTERLY
By John Reichard, CQ HealthBeat Editor

Sen. Hillary Rodham Clinton announced a health cost control plan Thursday she said would trim at least $120 billion a year from national health care spending. A key feature of the seven-point plan calls for a “National Prevention Initiative” that would require insurers doing business with the federal government to cover “high priority” preventive services as well as wellness programs to maintain health, the New York Democrat said.<snip>

Under her cost control proposal, insurers would have to follow the recommendations of the U.S. Preventive Services Task Force on what preventive care to cover. The federal advisory panel consists of academic researchers who sift through medical literature to determine which preventive services actually are effective in warding off disease and issue reports on their findings.<snip>

Other elements of the proposal would aim to:

• improve health information technology. To help hospitals and doctors upgrade, “I would invest $3 billion a year in grants to help ramp up the system,” Clinton said.

• streamline care for the chronically ill. “Americans with chronic disease such as heart disease and diabetes account for an astonishing” 75 percent of national health care expenditures, she said. Clinton would require that Americans with such conditions have access under Medicare and other federally funded plans to “chronic care coordination” plans providing a “medical home”— a provider or team of providers who would work together to avoid treatment complications or duplicative services.

• end insurance company “discrimination.” As part of a plan for universal coverage Clinton said she will detail in coming months, she said, “We would create large insurance pools that lower administrative costs for small businesses and individuals by spreading the risk.” She also said the plan would “end insurance company discrimination against people with pre-existing conditions.” Insurers would be required to allow anyone who wishes to join a plan to do so and bar insurers from charging higher rates to people with health problems.

• drive down costs with “best practices.” Clinton said she would start a public-private “Best Practices Institute” to finance research comparing the effectiveness of various forms of treatment. Based on its findings, the institute would issue practice protocols.

• control prescription drug costs. Clinton would give Medicare the authority to negotiate for lower drug prices, allow the importation of low-cost drugs from abroad and bring lower-cost generic versions of biotech drugs on the market.

• revise the medical malpractice system. She called for an approach that would encourage health systems to give liability protection to doctors who disclose medical errors to patients. Health systems that disclose these errors and move quickly to provide compensation are much less likely to be sued, she said.<snip>

=================================================================


WASHINGTON (MarketWatch) -- <snip>On the technology front, Clinton's plan calls for the creation of a "paperless" health information-technology system.

The 14-page plan also outlined proposals to improve outcomes of the chronically ill, who usually incur catastrophic expenses and are a key driver of rising health-care costs.

Clinton criticized health insurers for steering clear of Americans with expensive, pre-existing conditions, and called for ending insurance discrimination. Under the plan, a "guarantee-issue" system would allow anyone to join an insurance plan and would bar insurers from carving out benefits or charging higher rates to people with health problems.

Wider coverage would reduce administrative costs by forcing insurers to compete on lowering costs and improving quality, the Clinton outline said.

The plan also calls for some medical malpractice reforms, including a program that would provide liability protections for physicians who disclose medical errors to patients and offer to enter into negotiations for fair compensation.

[JTFrog]

1. Not interested in anything

that includes insurance companies. It's not about health INSURANCE for all, it's about health CARE for all.

[Tandalayo_Scheisskopf]

3. Yup.

Single Payer seems to me to be the only way out of the morass. Peripheral fixes, tacking things on the outside of a corrupt and broken system, only tarts up a corrupt and broken system. Lipstick on a pig and all that.

[papau]

5. Buried in the details' premiums can't consider "pre-existing condition" - that's "single payer" in

all but name.

In any single payer the insurance companies would continue to exist but only as claim processors - in just the same way they exist in the single payer program "Medicare" (Part B).

What Hillary has done is to take them out of the insurance role and put them in that claim paying role while letting them be the folks that decide what benefits are covered, thereby letting the citizen be the person who by choice of the insurance decides what benefit is covered.

The complaint has always been about National Health Plans covering my illness but not yours - government being unfair. This is a move to kill that complaint!

Damn she is smart!

[napi21]

6. I understand a lot of us would love to see a universal HC plan, BUT

I don't think that has a remote chance of happening in the foreseeable future. I honestly think we need to look at the plans that at least stand a CHANCE of enacting now.

What a lot of people who keep saying they want plans like they have in Canada and Europe don't seem to understand is that THOSE PLANS ARE NOT FREE! The only place I can actually speak to is Italy because my son lives there. The Italians pay very high taxes for their "free" health care. Taxes in Italy are about 50% of your earnings. Not all of the 50% goes to pay for HC. Some goes to retirement benefits and some other services too, but if ANYoNE mentioned a 50% income tax in the US, they'd be run out of town!

The only thing I've heard about Hillary's HC plan is what I read in the above post, but so far, her ideas sound pretty good.

[papau]

9. I agree - if the are "no pre-existing" they can't weasel out of paying for covered needs -

they can only limit what is covered - and that would be done by any plan - single payer or not - coverage must be limited in some way or we get cosmetic surgery/unneeded treatment driving us bankrupt.

So you choose what you want covered, and pay that amount of premium. But the premium for a policy for the mandated benefits only should turn out to be cheap. So perhaps the universal plan will/may be be a simple mandate of the minimum things that must be covered by any policy, plus a government determined medical procedure/process/bed scheduled cost list showing what is "customary" as to payment in your region (just as Medicare does now) for those mandated procedures, plus a reinsurance pool that moves all risk into "single payer" risk that is shared out for that simple list of mandated coverage. It allows the insurance company profiteering to continue but only as to the benefits above that mandated list of coverages - which is what single payer would also do.

The drop in cost occurs because claim payment is a 15% to 20% return on capital business that requires little to start, but adds only 3 to 4% to the health care cost bill above what the medical people charge.

The "risk taking" mega profits and mega overhead is dead as to the mandated benefits.

If insurance companies do not compete at that 4% mark up level, we will no doubt have India hiring U.S. employees (US processing of claims would be required) and taking away that business.

Of course this stuff I've written above is all my WAG (wild ass guess) based on the single statement that she would end the pre-existing condition nonsense! :-)

[papau]

13. Richardson's Medicare 55+/Federal Plan coverage below 55 is no pre-existing also

Re Richardsons federal plan - that plan has a rule that pre-existing conditions can not be considered from enrollment or cost:

No FEHB plan may refuse to provide benefits for any condition you or a covered family
member may have solely on the basis that it was a condition that existed before you enrolled
in a plan under the FEHB Program except as stated in any cosmetic surgery or dental
benefits description in this brochure.

[midnight]

23. That should be the whole point in the reform that is needed

for people to obtain health care, and not health insurance. My current experience to obtain care being prescribed by doctors is being denied via insurance co.

[Honeycombe8]

2. Who pays for it?

I read this post and her particulars quickly, but I didn't see where she says who pays for this.

[papau]

7. This first of 3 - the last will be universal coverage and who pays - this's cost savings n/t

n/t

[Telly Savalas]

17. Nobody ever asked that question about funding the Iraq war.

Why should it matter here?

[Sukie1941]

4. Airtime

"clippings (I am amazed at the lack of press/air time this has gotten)"

This is probably not the best weekend for a politician to put out new material for consumption.

Most everyone I know is away from home camping, going to parades, etc. this weekend.

[papau]

8. True - the clipings are Friday (yesterday) before a long weekend - so it may

innocent and just a function of the calendar that this has gotten no press.

[sandnsea]

10. Typical middle class pandering

Ignore the poor. How politically astute of her. If it doesn't acknowledge that the vast majority of Americans are paying premiums for coverage that often isn't there, or leaves them with gaps in the tens of thousands, then it's just a pile of trash. If she's going to keep insurance, the first thing she has to do is have a subsidized plan that everybody can join. The second thing she has to do is make sure the plan covers 100%. The third thing she needs to acknowledge is that there's an intentional shortage of medical schools. Then we can get on to feel-good do-nothing bullshit like malpractice reform.

I also love that she's astonished that sick people make up the bulk of those using health services, but I'm sure she didn't mean for it to come out that way.

[rucky]

11. Why'd she give up on her original plan?

I know it took a beating, but maybe its time has come?

[napi21]

12. I think because it was too agressive a change from what people are

used to. Most people are VERY skeptical of change, and simply won't go along with dramatic change...i suppose because they're afraid of the unknown. What if it doesn't work like you say it will?

[draft_mario_cuomo]

14. How will HRC pay for it? By repealing Bush's tax hike for the rich or with larger deficits?

[doggyboy]

19. Read the plan...nt

.

[Czolgosz]

22. I read the plan; there is less there than meets the eye.

[avrdream]

15. The Devil will be in the details....

however, I am pleased with ANY candidate who makes a decent attempt at addressing this problem.

I'm in the health care system and came down to Australia to work because I saw no help on the horizon from the Bush administration - they won't even TALK about it.

Regarding these changes not being enough: I, too, believe that no president will be able to go directly to the national health care system that many want. Americans need to change some of their thinking first (like how things are going to be paid for) so change in the health care system will have to take place in steps. Clinton and Edwards have put out specific plans and I'll listen to any other candidates who put out specifics as well.

Any candidate, from any party, who DOESN'T address this, isn't worth the paper we use to vote for him/her on (oh, wait, what paper?)

[eridani]

16. Didn't she learn anything in 1994?

"Leave the private insurers in the game, bring them to the table, and they'll screw you anyway" is the name of the lesson.

[Vinca]

18. It's as if the insurance companies are god. Get rid of the damn

insurance companies!!! If they were ordered not to discriminate against people in issuing policies and setting rates, they'd just up the rates for everybody. It's a profit-driven business and they've got to keep the megabucks rolling in.

[LWolf]

20. Why would you be surprised?

It's not like the much better HR 676 is getting any press, and it's been out there a lot longer.

http://kucinich.us/issues/universalhealth.php

[Czolgosz]

21. Here's a load of crap:

The final point that I would make today about lowering costs is to reduce costs through medical malpractice reform. While some have overstated the role that malpractice insurance plays in the health care crisis, I think we can all agree that we need reform that works for doctors and patients alike.

I have offered one solution that has been used successfully at the University of Michigan Hospital system. It's called the National Medical Error Disclosure and Compensation (MEDiC) Act as I have borrowed it from the University of Michigan to put it into law. It's a novel approach to improving patient safety and the quality of health care while protecting patients' rights, reducing medical errors and lowering malpractice costs. This Act would encourage physicians, hospitals and health systems to provide liability protections for physicians who disclose medical errors to patients and offer to enter into negotiations for fair compensation. At the University of Michigan, these policies have already resulted in greater patient trust and satisfaction, more patients being compensated for injuries, fewer malpractice suits, significantly reduced administrative costs and between one and three million dollars in litigation cost savings.

The rise in malpractice rates has spurred states like Texas and Nevada to allow doctors to create their own risk retention companies as an alternative to traditional liability insurance. Because a large percentage of actual malpractice is committed by a very small percentage of doctors who won't be included in insurance groups that other doctors control, thereby lowering malpractice rates for all.

HillaryCare: http://www.hillaryclinton.com/news/speech/view/?id=1789

In Texas, this boondoggle for insurance companies, hospital corporations, and HMOs has been a catastrophe:

Two years ago, rich and powerful Texans said lawsuits were ruining the state’s economy and needed to be fairer. Today, thanks to tort reform, they are fairer for business. Ordinary people are out of luck.

LIKE A LOT OF OLD-FASHIONED TEXANS, Alvin Berry is the kind of man who bears the pain and indignities of life with good grace. At 73, Alvin has never been a rich man, but in his youth he managed to maneuver himself from the rolling plains of Central Texas to the industrialized eastern corner of the state, where he worked his way up to maintenance superintendent at a chemical plant in Texas City. After he retired, he moved to a small ranch near Izoro, in Lampasas County, on property inherited by his wife of almost fifty years, Carla Jean. ... But Alvin also has, in common with many Texans, a keenly developed sense of fairness, and something happened two years ago that struck him as just plain wrong. He had endured several surgeries: a hip replacement in 1999, which required additional surgery in 2000, and in 2002, a triple bypass, after which he experienced uncontrolled bleeding and heart failure; the doctors had to open him up again right on his hospital bed. Alvin made no complaint; as Carla Jean pointed out, those doctors had saved his life. But then, in 2003, Alvin got some lab tests with disturbing results. He’d been having kidney stones, and now his prostate-specific antigen test showed an elevated score. He didn’t like that; the nurse at the chemical plant had been a stickler for this test, so he knew that a high score could indicate cancer. His family doctor was worried enough to send him to a urologist, and that is when the trouble started. Don’t worry, Alvin recalls the doctor telling him. Kidney stones can elevate your PSA. Go home. Relax. But five months later, in September, Alvin still had stones, and when he took Carla Jean in for her physical, he asked a nurse to check his PSA. It was up again, to 86 from 12.6. He called his urologist, who, a little more brusquely, told him not to worry. But Alvin couldn’t stop worrying. In November he got it checked again; now his level was 166. “Then he got all excited,” Alvin says of his doctor, who immediately ordered a biopsy. ... Alvin had prostate cancer, and it had already spread to his bones in twenty places. Right away the doctor put him on daily medication and a $4,000 injection three times a year. The money wasn’t a big problem—Alvin had insurance—but he couldn’t help stewing about his predicament. “If he’d caught it earlier, it wouldn’t have been in my bones,” Alvin says. It bothered him too that the doctor hadn’t looked him in the eye when he’d delivered the bad news and that he’d never said he was sorry, even as he gave Alvin, at best, five years to live. “I’ll tell you what upset me so much,” he says today. “Other than that, I was in pretty good health. We had a ranch out in the country, goats and cattle.” Because Alvin didn’t want his wife to be left alone in the middle of nowhere, they sold the house and part of the ranch and moved into a modest brick home atop a hill in Copperas Cove, outside Killeen. He tried to control his anger, but he felt his final years had been stolen from him: “That doctor thought he was right and the world was wrong. He didn’t give me the opportunity to make the decision of what to do with my life.”

Personally, Alvin had always been against lawsuits. He thought there were too many of them, and he didn’t think people should be able to win multimillion-dollar awards for situations they could have prevented, like the smokers who sued tobacco companies. Alvin had voted for Proposition 12 back in 2003, which amended the Texas constitution to limit noneconomic damages (usually pain and suffering) in medical malpractice cases to $250,000. “I think there are too many frivolous lawsuits,” he says. “But you ought to have the right to sue if you’ve been wronged.” Alvin sure didn’t think what had happened to him was frivolous, and he didn’t want to give his doctor the chance to be so arrogantly dismissive of anyone else. So on a sunny Saturday in April 2004, he found himself in a Hillsboro coffee shop with a pretty auburn-haired lawyer named Kelly Reddell.

Kelly had good news and bad news. The good news was, in her opinion, that Alvin had definitely been the victim of malpractice. The bad news was that it would probably take up to two years to litigate, and if he won the case, Alvin would take home substantially less than the maximum of $250,000 the state of Texas had decided an injury like his could be worth. “Is this something you are ready to sign on for?” she asked.

Full article: http://www.hobb.org/index.php?option=com_content&task=view&id=575&Itemid=159

[doggyboy]

24. Apples and lizards

Clinton's proposal has nothing to do with Texas' "limits on noneconomic damages...to $250,000." Nor does it have anything to do with “frivolous lawsuits”. Clinton mentions Texas only to praise how it "allows doctors to create their own risk retention companies", a policy your post does nothing to criticize.

Bottom line, you use texas policies that Clinton does not support (in fact, she opposes both limits on damages and texas-style tort reform) in order to criticize Clinton. Nice work

[bread_and_roses]

25. She's still protecting the Insurance Co.s, I see

why am I not surprised? I'm sure they are big donors. Why is it so hard for some to understand that the only reason insurance companies are in the business is to make a profit, and that profit comes out of our hides?