If Democrats own healthcare, we can own the Governor's Mansion in 2012

It's not often that Harry Reid and Alan Levine team up on anything, but they did today in laying out the path to Democratic success in Louisiana in the 2011 statewide elections.

That path will be healthcare. Specifically, it will be Governor Bobby Jindal's ideological rigidity on taxes in the face of what will be draconian (criminal?) cuts in healthcare in the state budget over the next two years. With healthcare and higher education still the only funding streams not constitutionally protected and the state facing a billion dollar revenue shortfall, Jindal will force the Legislature to make heavy cuts in both programs.

Last week, the Baton Rouge Advocate carried a story saying the higher education cuts will amount to 60 percent over the next two years. No mention of healthcare, but that's where the bulk of the cuts will be and for two reasons. First, that's where the money is (Medicaid is a $6 billion program). Secondly, no one in the Legislature is lobbying to protect the interests of the poor, the handicapped and those with special needs — the victims of these coming cuts. Oh, the hospitals, nursing homes and doctors will object, but you won't see anything resembling the "Intervention at the Mansion" earlier this year where all of the non-imprisoned former governors got together to tell the Boy Governor that he just could not cut $200 million-plus from higher education.

No notables stood up for Medicaid clients then. And none will do it in the coming session.

They are, in the current world of Louisiana politics, "expendable."

That's what happens when Democrats forget who they are and who they represent and buy into the conceit that they can get elected if they run as 'Republican-lite' candidates. Ultimately, they are not Democrats and their votes show it.

Today, Jindal's DHH Secretary Alan Levine dropped the first of what will be many shoes. According to The Advocate, he announced another round of Medicaid budget cuts made necessary because of rising enrollments in the program and the inability of the department to implement cuts fast enough. Poverty is up in Louisiana. Unemployment is up. The number of companies offering health insurance coverage is falling through the floor.

So, Levine, working within Jindal's "No Taxes for Any Reason" straight jacket, is ordering more cuts. This is, of course, a result of issues in the current fiscal year. This isn't even related to the even bigger cuts that will be needed next year.

Senator Harry Reid handed Louisiana Democrats a gift today by including the Public Option in the bill that the U.S. Senate will debate and vote on in a couple of weeks. Word is that the bill will include an "opt out" clause for states to leave the public option.

Is there any doubt as to which way the Jindal administration and Louisiana Republicans will lurch on this? Levine has been taking part in Louisiana Republican Party workshops talking against healthcare reform. Jindal's path to the national Republican stage requires he follow the party's rejectionist strategy, so he will clearly push to have the state opt out of the public option.

But, here's where it gets interesting.

Depending on the year, anywhere between 17 and 25 working age Louisiana adults are uninsured. In July, the Baton Rouge Business Report quoted a spokesman for BlueCross/BlueShield of Louisiana who said that only 30 percent of Louisiana small businesses offer health insurance to their employees and that the number is falling due to skyrocketing rates.

While no one will speak up for Medicaid patients, surely someone will speak up for the rights of the working uninsured and fight the Jindal administration's expected push to, in fact, opt out of the public option — the path to provide affordable coverage to those working age residents without coverage.

The 2011 statewide elections will be the battle ground where this fight takes place. Jindal, if he follows his current course, will have cut higher education by three-quarters of a billion dollars. He will have cut a billion in healthcare spending, eliminating services, shutting institutions, impacting the families of the disabled, the sick and the infirm.

This election will take place on a re-districted state Legislative map. Every district will be redrawn, and it will be pretty radically different due to post-2005/2008 storm induced population shifts.

Democrats should be easy to distinguish from Republicans. The Republicans will be the ones saying they are sorry for the pain, injury and even deaths their cuts inflicted, but that they had no choice. Democrats will be the candidates motivated by outrage at the callous, depraved disregard for the health and well-being of their fellow citizens.

Jindal will be vulnerable in 2011. He will have revealed that everything said about him in 2003 was true — that his knowledge of numbers is matched only by his inability to see the people behind the numbers in state budgets and programs. The healthcare ads that Kathleen Blanco ran against him in 2003 — those credited with sealing her victory then — will ring prophetic.

This man is devoid of compassion and is blinded by his ambition. Our state is paying — and will pay — a fearful price for his limitations.

But, elections are about changing course.

Harry Reid has just set up Louisiana Democrats to take our state back, to walk it back from the brink.

It will be a hard fight — beating incumbents always is. The Louisiana Committee for a Republican Majority (David Vitter's homage to Tom DeLay) did not quite succeed in taking over either house of the Legislature, but they succeeded just enough to give Jindal the ability to defeat tax increases that could stave off some of these cuts. They will also work to ensure that the re-districting process is skewed to favor Republicans.

They, too, are setting him up for defeat — and the members of the House and Senate they sent there to do their ideologically driven work.

The world has shifted. They have not changed. The opportunity to oust them is ripening.

(Blue) Dog Whistles

Dah-yum! Says here that the so-called Blue Dog Democrats are raking in political contributions from the pharmaceutical, health insurance and health insurance industries.

McClatchy's Washington news bureau has the shocking news:

As the Obama administration and Democrats wrangled over the timing, shape and cost of health care overhaul efforts during the first half of the year, more than half the $1.1 million in campaign contributions the Democratic Party's Blue Dog Coalition received came from the pharmaceutical, health care and health insurance industries, according to watchdog organizations.

The amount outstrips contributions to other congressional political action committees during the same period, according to an analysis by the Center for Public Integrity, a nonprofit watchdog organization. The Blue Dogs, a group of fiscally conservative lawmakers, successfully delayed the vote on health care overhaul proposals until the fall.

The article continues:

On average, Blue Dog Democrats net $62,650 more from the health sector than other Democrats, while hospitals and nursing homes also favor them, giving, respectively, $5,680 and $5,550 more, according to the Center for Responsive Politics, a nonprofit organization that tracks the influence of money in politics.

The contributions came at a time when health care and pharmaceutical companies were mounting a campaign against a government-run public health insurance option, fearing cost controls and an impact on business. The Blue Dogs' windfall also came at a time when the 52-member coalition flexed its muscle with both the White House and the Democratic leadership in the House of Representatives as an increasingly influential bloc in the health care overhaul debate.

With 'friends' like these, who needs Republicans?

Well, at least the those same interests view the Republicans as more reliable votes, based on the money they give them:

House Republicans, however, tend to collect more than Democrats — including Blue Dogs — from insurers, health professionals and the broader health sector, the Center for Responsive Politics found.

I consider myself a loyal Democrat, but I am sick and tired of supporting Democrats who go to Washington (and Baton Rouge) and vote like Republicans on issues that matter to me. Healthcare reform is a signature Democratic issue and has been since Harry Truman tried to pass universal healthcare back in the late 1940s.

If these Blue Dogs can't bring themselves to stand with their party and their president on this core issues of our party, the question that must be asked is this: "Why are they members of this party?"

If their loyalty is to their corporate fund-raisers and not to the hard working people in their states and districts who are struggling to afford health insurance and/or to avoid losing everything they have in order to pay medical bills, why don't they align themselves with the party that makes no pretense about their loyalty to the rich and the powerful?

There is a party that welcomes people who think and vote that way.

The Democratic Party is not it.

We have a party primary system in place for federal elections in Louisiana. Those primaries should be used to remind Democrats who have apparently gone soft headed running in open primaries that there is a loyal Democratic base that cannot be taken for granted or ignored.

We matter. We volunteer. We work in campaigns. And we vote.

Dear Senator Landrieu: Stand with us as we've stood with you

The following letter, signed/approved by 24 Louisiana supporters of Senator Mary Landrieu, was hand delivered to her office in Lake Charles today. The letter calls on the senator to support healthcare reform legislation that includes the public option.

• • •

Dear Senator Landrieu:

We write you today as friends, long-time supporters, and concerned Louisiana citizens regarding an issue of great national significance that is critical to the future well being of our state.

In a few days you will be asked to decide whether healthcare coverage will be extended to millions of Americans who do not now enjoy those benefits. As your votes in support of SCHIP and your efforts to support community healthcare demonstrate, you know that people who do not to have access to adequate health care are destined to die younger, suffer many more illnesses and to watch helplessly as their love ones are denied the care that could save their lives or relieve their discomfort. The high cost of health insurance is the main barrier preventing working families and small business owners from gaining access to that care.

Small businesses and large corporations alike are abandoning employer-based health care because of cost. In Louisiana, where the percentage of employers offering healthcare benefits has historically been low, the problem is even worse. Even where coverage is offered, workers frequently cannot afford the premiums to cover their families. The situation will only be made worse by recent cuts in services voted by the Louisiana Legislature.

In spite of the dishonest campaigns being waged to prevent comprehensive national health care from becoming a reality, the overwhelming majority of Americans support it. Surprisingly, over sixty percent of American physicians are also in support of these ends.

We realize the pressure being exerted on you to vote against this program.

The same stale arguments are being made today against the public option that have been made against every progressive endeavor for the last seventy-five years. Social Security was supposed to be the pinnacle of governmental intrusion into our lives. Where would we be today without Social Security? Medicare was another “Socialist” program that was supposed to destroy medical care in our nation. Where would our seniors be without Medicare? The same could be said for the Civil Rights Act and the Voting Rights Acts. All of these programs were passed under Democratic presidents and all of them have changed our nation and our lives profoundly for the better.

The vast majority of your political base in Louisiana is composed of people who stand to benefit directly from enactment of a national coverage plan, specifically the public option.

We believe that the public option — where adults can buy into a Medicare-like program — is the best way to control costs by bringing competition to the health insurance system. In Louisiana, the two largest health insurance providers control 74 percent of the health insurance market. The market has failed us by pricing coverage beyond the reach of too many Louisiana citizens.

A national consensus has emerged that the current system must be changed and that only federal government has the scale and reach to change it. If these efforts are not successful, it may be many years before we have a president who is willing to take the challenge and pay the political price to achieve these admirable ends.

We do not consider this to be an issue of politics or party. This is an issue of the basic right of every American to be able to access quality healthcare without the risk of financial ruin. Access to healthcare should not be a privilege available only to those who can afford private health insurance.

As friends and long-time supporters we ask you to please not ignore the people who have repeatedly voted you into office. We have stood with you; now, we are asking you to stand with us in support of the public option.

Sincerely yours,

Mike Stagg, Lafayette
Sally O. Donlon, Lafayette
Dr. Mike Robichaux, Raceland
Deborah Langhoff, New Orleans
Stephen Handwerk, Lafayette
Angelique LaCour, Covington
Barbara St. Romain, MSW, LCSW, Lafayette
John St. Julien, Lafayette
Edna D. St. Julien, Lafayette
Phillip Arleigh Lank, Lafayette
Mark Lastrapes, New Orleans
Michelle Vega, New Orleans
Robert J. Guercio, Lafayette
Anna K. Guercio, Lafayette
Charles St. Romain, LCSW, Lafayette
Rebecca Chaisson, Lake Charles
Joanne Pettit, Mandeville
Daryl Pettit, Mandeville
Adrienne LaCour, Covington
Karen E. Keller, MS, Lafayette
State Representative Juan LaFonta, New Orleans
Lauren Lastrapes, New Orleans
Dr. Douglas de Mahy, Lafayette
Marie de Mahy, Lafayette
Andrea Loewy, Lafayette

Speakout for the Public Option

AMA backs the Public Option. Why can't Mary?

The American Medical Association (AMA) — GASP!!! — has endorsed the healthcare reform legislation proposed by Democrats in the U.S. House of Representatives according to the Associated Press:

The American Medical Association on Thursday endorsed a liberal health overhaul bill that includes a public insurance option, a bold step for a traditionally conservative group with a checkered past on health reforms.

In its strongest action yet signaling support for President Barack Obama's vow to reform health care, the nation's largest doctors' group sent letters to three House committees behind the bill. The letters, signed by AMA's executive vice president, Dr. Michael Maves, said the AMA appreciates and supports what is being called America's Affordable Health Choices Act.

This is an historic shift. The AMA opposed the introduction of Medicare and Medicaid in the 1960s. It's conference of delegats gave President Obama a lukewarm reception when he addressed their convention earlier this summer.

The AMA's leader told the news organization that the fact that the Democratic proposal will bring healthcare coverage to the 50 million Americans now without health insurance was what won the organization's support:

Dr. J. James Rohack, AMA's president, told The Associated Press that the group's endorsement shouldn't be seen as the AMA turning more liberal.

"It's not blue or red, or Democratic or Republican. This is something that is the AMA's core values," Rohack said. "The status quo that is 50 million Americans not having health insurance, a system that has administrative waste and as a result drives up premiums so that it is unaffordable for many patients — that is just not acceptable."

The AMA has long believed any health system reform can be achieved by revamping private health insurance plans. It fought the creation of Medicare and succeeded in delaying its debut decades ago. That was when it had more clout; its membership has dwindled to include barely one-fourth of the nation's doctors.bama a lukewarm reception earlier this year when he addressed their convention.

So, the AMA has endorsed the House Democratic proposal with the Public Option — a provision that will allow working age Americans to buy into a Medicare-like public insurance program.

Wonder what is keeping Senator Mary Landrieu from seeing the light on this? Maybe this has something to do with it.

Healthcare Costs Bankrupt Even Those With Health Insurance

The New York Times reported on Tuesday that "an estimated three-quarters of people who are pushed into personal bankruptcy by medical problems actually had insurance when they got sick or were injured."

This is scary. Why?

Because more than half of all bankruptcies (prior to the current economic bust) were related to healthcare expenses. You can read the report on this fact here (PDF).

If you do the math (61% of all bankruptcies involve medical expenses; 75% of medical expense bankruptcies involve people who HAD health insurance), you'll find that somewhere around 40% of all bankruptcies involve medical expenses of people who had health insurance.

"Underinsurance is the great hidden risk of the American health care system," Elizabeth Warren told the Times. She co-authored the 2007 report on healthcare bankruptcies cited above. “People do not realize they are one diagnosis away from financial collapse.”

The Times reports:

Last week, a former Cigna executive warned at a Senate hearing on health insurance that lawmakers should be careful about the role they gave private insurers in any new system, saying the companies were too prone to “confuse their customers and dump the sick.”

“The number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance,” Wendell Potter, the former Cigna executive, testified.

To put a human face on the issue, the Times tells the medical tale of woe of Lawrence Yurdin, a 64-year old computer specialist living in Texas. To make a long story short, Mr. Yurdin faced tens of thousands of dollars of unexpected medical expenditures if he got necessary heart procedures, even though he had health insurance coverage.

Things turned out well for Mr. Yurdin, though, the Times reports:

But as of Wednesday, his future insurance problems are largely solved: he qualifies for Medicare because he turns 65.

The "public option" in President Obama's healthcare reform package would allow working age Americans (18-64) buy into a Medicare-like program that would provide medical coverage (as does Medicare) with affordable premiums.

This is the plan that the health insurance companies (you know, the ones who deny coverage and have overhead costs that consume about 30 percent of health insurance premiums) are opposing.

There are tens of thousands — if not millions — of stories like Mr. Yurdin in America today. There are tens of thousands — if not millions — of stories involving people who cannot even afford health insurance premiums.

Recent polls show something on the order of 70% support for the public option in the country, fueled in no small part by the direct experiences individuals, families and businesses have had dealing with private, for-profit health insurance providers.

Senator Mary Landrieu has not heard from enough Louisiana residents who want this public option as a path to affordable access to care. Call her office and tell her you support the public option!

Here's a list of her in-state offices:

New Orleans Hale Boggs Federal Building
500 Poydras Street
Room 1005
New Orleans, LA 70130
Voice: (504) 589-2427
Fax:(504) 589-4023

Baton Rouge Room 326, Federal Building
707 Florida Street
Baton Rouge, LA 70801
Voice: (225) 389-0395
Fax:(225) 389-0660

Shreveport U.S. Courthouse
300 Fannin Street
Room 2240
Shreveport, LA 71101
Voice: (318) 676-3085
Fax:(318) 676-3100

Lake Charles
Hibernia Tower
One Lakeshore Drive
Suite 1260
Lake Charles, LA 70629
Voice: (337) 436-6650
Fax:(337) 439-3762

She needs to hear from you!

Why Louisiana Needs Healthcare Reform

The debate on healthcare reform is intensifying in Washington and across the country. This is not a debate taking place in the abstract.

Louisiana stands to benefit greatly from reform — if the final package includes the so-called "Public Option." The public option is a proposal by President Obama to offer working-age Americans the opportunity to buy health insurance coverage similar to coverage currently available to those over 65 through Medicare.

Health insurance companies oppose this, saying that the government will ultimately drive them from the field; that they won't be able to compete. The public, according to polls, is not buying that argument. Various polls report public support for the public option to be running 70 percent and higher.

That probably has something to do with the experiences those with insurance have had with insurance companies over the years. The insurance companies have not endeared themselves to the American public through their arbitrary denials of coverage, refusal to pay claims, and general ripping off of consumers and businesses over the years.

The case for reform is becoming still more urgent in Louisiana coming on the heals of a disastrous (for providers and patients; analysts say the Governor did well) legislative session for healthcare. Medicaid is a big-ticket, unprotected item in the state's budget and the poor have no well-healed army of lobbyists to work the Capitol for them. As a result, the only opposition raised to a quarter billion dollars in Medicaid cuts were hospitals who will lose money through reduced reimbursements.

And, while the initial pain will fall squarely on the poor, ultimately those of us with health insurance will pay for these cuts, as hospitals and other providers shift costs onto those with coverage to recoup the lost dollars resulting from the state budget cuts. Oh, there is also the matter of the thousands of healthcare jobs that will be lost as a result of these cuts. But, it's all good because taxes were not raised and the Governor's presidential ambitions remain in tact.

Healthcare reform on the national level, specifically the public option, holds real promise for Louisiana. First, Louisiana has historically had a large percentage of working age people without health insurance coverage. The latest figures are that only 54 percent of employers offer any form of coverage. In many small communities across the state, local governments offer coverage for their workers but the workers can't afford to pay the premiums based on the small salaries they receive.

The public option will bring competition to insurance markets. In Louisiana, there is not much competition. Blue Cross has 61 percent of the market. Combine that with the second largest health insurer and 74 percent of the market is owned by those two companies. Introduction of the public option would immediately bring cost discipline to the health insurance markets that is sorely missing now.

You can find these and other great facts about the current state of healthcare in Louisiana here.

Any requirement to force companies to offer health insurance or to require individuals to buy health insurance coverage without the inclusion of a public option is nothing more than a gift to the very companies that have produced this financially ruinous system that is responsible for at least half of the bankruptcies in the U.S. each year.

The public option is the minimal requirement for any program worthy of the name healthcare reform.

Senator Mary Landrieu needs to know that Louisiana voters support the public option. So far, only her insurance company lobbying friends are getting through. Call her office. Remind her that you have stood with her and now you expect her to stand with you in support of the public option.

The public option will be good for us, good working Louisiana families, and good for our country.