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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 07:42 PM
Original message
Nation’s Largest RN Organization Says Healthcare Bill Cedes Too Much to Insurance Industry
Edited on Mon Dec-21-09 07:43 PM by depakid
I think I'll stand with the nurses on this one:

The 150,000 member National Nurses United, the nation’s largest union and professional organization of registered nurses in the U.S., today criticized the healthcare bill now advancing in the U.S. Senate saying it is deeply flawed and grants too much power to the giant insurers.

“It is tragic to see the promise from Washington this year for genuine, comprehensive reform ground down to a seriously flawed bill that could actually exacerbate the healthcare crisis and financial insecurity for American families, and that cedes far too much additional power to the tyranny of a callous insurance industry,” said NNU co-president Karen Higgins, RN.

NNU Co-president Deborah Burger, RN challenged arguments of legislation proponents that the bill should still be passed because of expanded coverage, new regulations on insurers, and the hope that it will be improved in the House-Senate conference committee or future years.

“Those wishful statements ignore the reality that much of the expanded coverage is based on forced purchase of private insurance without effective controls on industry pricing practices or real competition and gaping loopholes in the insurance reforms,” said Burger.

Further, said NNU Co-president Jean Ross, RN, “the bill seems more likely to be eroded, not improved, in future years due to the unchecked influence of the healthcare industry lobbyists and the lessons of this year in which all the compromises have been made to the right.”

“Sadly, we have ended up with legislation that fails to meet the test of true healthcare reform, guaranteeing high quality, cost effective care for all Americans, and instead are further locking into place a system that entrenches the chokehold of the profit-making insurance giants on our health. If this bill passes, the industry will become more powerful and could be beyond the reach of reform for generations,” Higgins said.


NNU cited ten significant problems in the legislation, noting many of the same flaws also exist in the House version and are likely to remain in the bill that emerges from the House-Senate reconciliation process:

1. The individual mandate forcing all those without coverage to buy private insurance, with insufficient cost controls on skyrocketing premiums and other insurance costs.

2. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate, severely limiting choice and competition.

3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.

4. The excise tax on comprehensive insurance plans which will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of high-deductible plans, and lead to more self-rationing of care and medical bankruptcies, especially as more plans are subject to the tax every year due to the lack of adequate price controls. A Towers-Perrin survey in September found 30 percent of employers said they would reduce employment if their health costs go up, 86 percent said they’d pass the higher costs to their employees.

5. Major loopholes in the insurance reforms that promise bans on exclusion for pre-existing conditions, and no cancellations for sickness. The loopholes include:


* Provisions permitting insurers and companies to more than double charges to employees who fail “wellness” programs because they have diabetes, high blood pressure, high cholesterol readings, or other medical conditions.

* Insurers are permitted to sell policies “across state lines”, exempting patient protections passed in other states. Insurers will thus set up in the least regulated states in a race to the bottom threatening public protections won by consumers in various states.

* Insurers can charge four times more based on age plus more for certain conditions, and continue to use marketing techniques to cherry-pick healthier, less costly enrollees.

* Insurers may continue to rescind policies for “fraud or intentional misrepresentation” – the main pretext insurance companies now use to cancel coverage.

6. Minimal oversight on insurance denials of care; a report by the California Nurses Association/NNOC in September found that six of California’s largest insurers have rejected more than one-fifth of all claims since 2002.

7. Inadequate limits on drug prices, especially after Senate rejection of an amendment, to protect a White House deal with pharmaceutical giants, allowing pharmacies and wholesalers to import lower-cost drugs.

8. New burdens for our public safety net. With a shortage of primary care physicians and a continuing fiscal crisis at the state and local level, public hospitals and clinics will be a dumping ground for those the private system doesn’t want.

9. Reduced reproductive rights for women.

10. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay. Nothing changes in basic structure of the system; healthcare remains a privilege, not a right.

“Desperation to pass a bill, regardless of its flaws, has made the White House and Congress subject to the worst political extortion and new, crippling concessions every day,” Burger said.

More: http://www.calnurses.org/media-center/in-the-news/2009/december/nation-s-largest-rn-organization-says-healthcare-bill-cedes-too-much-to-insurance-industry.html
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golddigger Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 07:45 PM
Response to Original message
1. K&R
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JDPriestly Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 07:50 PM
Response to Original message
2. So, we finally hear from them. Where have they been all this time?
I was looking for their views on healthcare reform in the past couple of months and could not find them.
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 07:57 PM
Response to Reply #2
4. Cut out of the process-
due to their longstanding advocacy of medicare for all.

Nevertheless, CNA has been active and put out a number of press releases over the past 8 months.
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kelly1mm Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 07:57 PM
Response to Original message
3. HATERS! Nurses hate Obama, poor people and puppies! nt
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 07:58 PM
Response to Original message
5. That's OK, they hated all the bills, including the public option. n/t
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vaberella Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 06:44 AM
Response to Reply #5
34. They hated the public option?! Ugh...well forget it then. n/t
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jeanpalmer Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 07:13 AM
Response to Reply #5
37. “NNU and nurses will continue to work
with the thousands of grassroots activists across the nation to campaign for the best reform, which would be to expand Medicare to cover everyone, the same type of system working more effectively in every other industrial country."
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treestar Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 07:59 PM
Response to Original message
6. Not to be rude but why would nurses know that much about the
overall system? They don't do billing. They do their job and collect their paycheck. I admire them. But I don't see how they get into the payment end of it.
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:00 PM
Response to Reply #6
7. Apparrently, you don't know much about nursing
or that there are advanced degrees called MPH's that nurses often pursue.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:03 PM
Response to Reply #7
8. Oh please.
The CNA has been against every measure this entire debate.

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LooseWilly Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:11 PM
Response to Reply #8
10. And that invalidates the points enumerated in the OP?
How about addressing those points?
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:12 PM
Response to Reply #8
11. The bullet points are persuasive, eh?
Edited on Mon Dec-21-09 08:15 PM by depakid
Particularly coming from people who actually do the brunt of the actual health care work in this country -and who haven't been too timid (or corrupted) to stand up and FIGHT for the best interests of their patients.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:18 PM
Response to Reply #11
12. No they're not. The are biased opinions.
Edited on Mon Dec-21-09 08:18 PM by ProSense
3. An affordability mirage. Congressional Budget Office estimates say a family of four with a household income of $54,000 would be expected to pay 17 percent of their income, $9,000, on healthcare exposing too many families to grave financial risk.


Extremely disingenuous since that more than $3,000 less than the current premiums, and the CBO specifically states that their numbers do not take the subsidies into account. A family at that income would realize significant savings




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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:32 PM
Response to Reply #12
14. Yep- the nurses who do the hands on work are bias and we can all trust political hacks
Edited on Mon Dec-21-09 08:35 PM by depakid
Those insurers are going to transform themselves into philanthropists and keep premiums, deductibles, copays and coverage restrictions down out of the goodness of their hearts.
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ProSense Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:37 PM
Response to Reply #14
16. Yes, the CNA is biased. And if you value the opinions of nurses so much, here:
Dear Senator Reid:

On behalf of the American Nurses Association (ANA), the only full-service professional organization representing the interests of the nation’s 2.9 million Registered Nurses through its 51 constituent member associations, I am writing to urge you to keep the democratic process moving in the Senate by voting to end debate on H.R. 3590, the Patient Protection and Affordable Care Act.

Nurses across this country have waited decades for this historic moment and the time is at hand. While political maneuvering delays reform, our patient’s needs are not on hold. The uninsured and underinsured continue to delay or forgo much-needed care; they continue to arrive in the emergency rooms across the country for conditions that could have been easily prevented with access to primary care—we are paying a high price for inaction. Quality health care for all should not be a partisan or political issue.

While we realize that no piece of legislation is perfect, we also realize that doing nothing is not an option. We know that passage of H.R. 3590 represents our only hope for much-needed, comprehensive, and meaningful reform of our nation’s healthcare system. America’s nurses understand the cost of inaction—we cannot afford to wait—it must be done before the end of the year.

Once again, the need for fundamental reform of the U.S. health care system is critical. ANA and nurses around the country are ready to work with you. We are almost there. Please vote YES to end the debate on H.R. 3590, the Patient Protection and Affordable Care Act and move the process forward towards a final vote of passage.

Sincerely,
Rebecca M. Patton, MSN, RN, CNOR
President


PDF


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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 09:07 PM
Response to Reply #16
19. Mighty vague, that- a far cry from any rebuttal or anything to do with the current travesty
Like Dean, one surmises that they hope that the House may yet stand up and fight for responsible policy- since it's clear that the administration and the Senate (or their various acolytes) have no intention of doing so.

Sad really, as few things would have given Republicans a better shot at taking back the majority in Congress than standing with the health insurers- and against the interests of ordinary working Americans.



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jeanpalmer Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 07:16 AM
Response to Reply #8
38. Nice try
“NNU and nurses will continue to work with the thousands of grassroots activists across the nation to campaign for the best reform, which would be to expand Medicare to cover everyone, the same type of system working more effectively in every other industrial country."

http://www.calnurses.org/media-center/in-the-news/2009/december/nation-s-largest-rn-organization-says-healthcare-bill-cedes-too-much-to-insurance-industry.html
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treestar Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:32 PM
Response to Reply #7
13. No I don't
But what would it have to do with where payment comes from?
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LooseWilly Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:10 PM
Response to Reply #6
9. Wow... I was going to post that sarcastically... you seem to mean it seriously.
Why would nurses know about the system?

I can't imagine everyone in the "system" doesn't know about the "system", as I'm sure the paperwork required at every step of the process in order to present justifications for billing eventually sent on to insurance companies is... onerous at best.

:+
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treestar Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:34 PM
Response to Reply #9
15. I would hate to think that nurses have to do billing paperwork
Maybe in a small old fashioned doctor's office, but in modern times why should an RN waste time on that?
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LooseWilly Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 10:19 PM
Response to Reply #15
23. Why does anyone waste time on paperwork?
So that they have information in order for billing purposes.

I would bet nurses fill out paperwork which then goes to an accounts receivable office for processing and then distribution of bills to insurance companies (just as I'm sure doctors, anaesthesiologists, and what all else professionals who perform any services in a hospital which someone will later be billed for also have to do). I've talked to doctors who say that insurance companies then routinely decide to challenge certain billable items/procedures, and outright refuse to pay others. Presumably, with that being the rule rather than the exception, the nurses who handle some of the procedures would then be called upon by the accounts receivable administrator to account for the procedure, as the hospital tries to decide whether or not to contest the insurance company's challenge of the billing for a procedure, or outright refusal to pay.

This is the manner in which billing by procedure or by job is handled in any company, large or small. The nurses would get to know the procedures that they handle, and would quickly become familiar with the billing procedures that a hospital's billing/account receivable administrators want them to follow in order to streamline the paperwork process and thusly facilitate the hospitals billing and collection of outstanding charges. The hospital would demand it. If the nurses are lucky, the hospital will provide paid time to fill out paperwork... if not, they're liable to expect the nurses to fill out the paperwork after they're "off the clock". Nurses are overworked and underpaid, and I've seen several strikes as a result.

I'm sure that nurses would also be called upon to elaborate on their previous paperwork in any unclear case when an insurance company challenges/refuses to cover a charge.

I'm sure that nurses get to know many aspects of the billing process far more intimately than they'd like to think about.

If any nurses would care to set me straight though... I'm all ears. I can't imagine administration of medications, drawing of blood, provision of kleenex... I can't imagine that the billing process is substantially different from any other work-order based job system.

And, while we're at it, what is the system you envision? Do you think there are administrators following the nurses and doctors around a hospital in order to do the paperwork and free the nurses and doctors up to only handle the "medicine"? That's ludicrous (and I've spelunked around hospitals and can guarantee you it's not true)... the HMOs that run hospitals would far prefer to cut costs by making the doctors and nurses do the paperwork, so that they can save the "expense" of an administrator.
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tavalon Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 09:04 PM
Response to Reply #6
18. Alas, wasn't it Ben Franklin who once said
Better to stay quiet and be thought a fool than to open your mouth and erase all doubt.

20 years as a nurse. I see people cut out of the system all of the time. Even writing system next to medical or health care is a morbid joke. 15 years ago, I worked as a home health nurse and had to fight directly with the insurance "companies". They were death dealers even then. They are much better at it now.
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Aramchek Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 08:49 PM
Response to Original message
17. it's still going to pass. enjoy!
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 09:16 PM
Response to Reply #17
20. Health policy wonks like Oregone and I already do enjoy
He has Canadian Medicare- I have Australian Medicare and private cover (a two tiered system like you might have been on track for if your President and Senators hadn't sold you out).

Private cover for us is $50 per fortnight (every two weeks) with a $250.00 excess (deductible) for hospital care. Very minor fees with Medicare and a very generous drug subsidy (generally about 3/4's of the cost on already lower priced drugs).

You and other Americans we left behind are the ones we worry (and still care) about- which is why we've been writing here.

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Aramchek Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 10:33 PM
Response to Reply #20
25. so a Canuck and an Aussie are here daily to tell us how bad things are here?
Thanks for letting me know that your opinion carries absolutely no weight.

Why don't you just let us take care of our own business?

It really says something that you spend more time trying to effect American policy than you do for your own country.

You ran away, yet you just can't let go, huh?

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ima_sinnic Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 06:54 AM
Response to Reply #20
35. you can see in #25 what we're up against here
the disinformation and smug approval of unregulated corporate greed disguised as somehow "beneficial" to our health and well-being is stunning. but the cards are stacked by the ones with the money (sucked out of poor saps all over the world, at gunpoint if necessary), who spend mightily to ensure that the disinformation and propaganda are well injected into the system, so all we can do is hope that a few principled people in power put a check on the worst aspects of the reaming.

and heaven forbid that anyone in a sane, truly beneficial and not-for-profit program could have anything to teach Americans about a better way to do things, or even give insights.
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 02:40 PM
Response to Reply #20
40. Some of us really appreciate it, believe me. n/t
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chill_wind Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 09:23 PM
Response to Original message
21. There it is. From the front lines and the trenches every living day.
K & R.
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chill_wind Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 09:23 PM
Response to Original message
22.  delete dupe
Edited on Mon Dec-21-09 09:24 PM by chill_wind
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Vidar Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-21-09 10:31 PM
Response to Original message
24. K&R.
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Garam_Masala Donating Member (711 posts) Send PM | Profile | Ignore Mon Dec-21-09 10:40 PM
Response to Original message
26. Yes...this bill is a Big win for Big Pharma and Big Insurance
No Single Payer.
This system is true HCR. Everything else is hodge podge.
With SP, every living person is in the same pool, and paying
on their ability to pay based on income.

P.O missing.
Not as good as SP, but the ONLY way to make sure there is competition
to the for profit private health insurance industry.

No re-import of Drugs.
This is missing from both bills as far as I know. Are you aware Big Pharma
passed on to us 11% increase this year? If this bill is not a bonanza for
Big Pharma with mandates and subsidized additional customers then I have
a bridge in Minnesota I can sell you.

No limits on insurance premiums.
Sure they can't drop you or refuse you. But they can jack up premiums
for all their customers until there is enough profit to pay big bonuses.
Why no limits on CEO pay when the TARP recipients and Bailout recipients
are subjected to restrictions?

To sum up, I don't see much cost reduction to health care in these bills.
Big Pharma and Big Insurance are the Big winners. If you don't believe me,
please check their stock performance on Wall Street.
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 02:12 AM
Response to Reply #26
27. Kick
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boppers Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 02:40 AM
Response to Original message
28. WTF?
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depakid Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 03:35 AM
Response to Reply #28
29. Compare the two pieces and make of your mind which is more credible
which one says what- and why.

Nurses DO NOT support the insurance lobbyist's legislation for the reasons outline succinctly above. Neither should you.

Read 'em for yourself, and you'll see why.
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jonnyblitz Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 03:48 AM
Response to Reply #29
30. i would never believe or trust anything that one posts.
I would feel confident taking your word for it without even reading either article.
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boppers Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 05:40 AM
Response to Reply #30
31. Am I "that one"?
Regardless, I would feel confident that reading multiple sources is more effective than only reading one opinion. Even better than two sources is 20 sources.

I'm not big on hero worship.
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jonnyblitz Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 05:42 AM
Response to Reply #31
32. oh hell no , not you.
i am talking about the cut and paste queen.
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vaberella Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 06:42 AM
Response to Reply #30
33. Ahhh....you just called yourself a lemming. Understood. n/t
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Wardoc Donating Member (204 posts) Send PM | Profile | Ignore Tue Dec-22-09 07:01 AM
Response to Original message
36. Funny how this supposedly "great bill" has all the traditional blocs bailing as fast as possible.
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jeanpalmer Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-22-09 08:02 AM
Response to Original message
39. Great posting
This response really lays out all the problems with the Senate bill. And shows why it should not be passed. Good job, nurses.
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