October 20, 2009

Our response to Obama re: Health Care Reform

Thank you for your reply. I appreciate the respect you showed me by responding. However, you have not actually addressed the question I posed in my email. I asked how my family would be affected by the bill due to the fact that private insurance is our livelihood and has done a great job at giving me the quality of life I have while I deal with a very rare condition.

I agree with the theory that all Americans should have free Healthcare. Forcing people to acquire this care through the government is not a viable road and is taking away my choice. Americans should not be fined if they choose to not have healthcare.

Although in the past some insurance companies have been underhanded they do take a great risk when insuring someone with a pre-existing condition. We pay 16 thousand a year for our insurance due to my disability. However, the insurance has spent more on me than I have had to pay. You can not guarantee my quality of life if I am forced into a cookie cutter plan. Just to be clear I spent many years with out insurance and many before that on military benefits and the private insurance has given me much more than the government. Insurance companies have the right to protect themselves and to make some profit.

SCHIP has existed for years and to continue and even build on this program is not you doing something new. As for doing more let’s do what is right and fix the actual issues not just make more government. As for the Recovery….Act that has not helped at all. Most of this happens years down the road and interestingly enough at election times.

Also stop with this inherited stuff. I’m in no way stating that the previous administration was great but you promised to move forward and you are not!

As for getting this done this year I want it right not fast. You are doing yourself and America a disservice by rushing this bill and not assuring we are fixing the actual root problems.

I firmly agree that we need to support our veterans. We have a personal stake in this. Having military family with PTSD we have seen no change in these military members being allowed care. This is truly something your administration is failing at and you need to work on it before trying to tell us you fixed this issue. By the way killing them off with toxic drug combinations and pulling the doctors that are actually helping them is not the answer.

Looking forward I agree that tough choices do need to be made but patients need to come first not political parties. It is the American people who need to be allowed to come together to make healthcare correct.

Trust me we know the forms and the struggles of insurance but we also know how personal accountability and engagement can mitigate that paperwork. We would also stress that often that paperwork is generated by the doctor, hospital and the government not the insurance company. There are now due to the Recovery…Act over 4 privacy laws on the books that insurance, doctors, hospitals etc. have to comply to that add extreme costs to healthcare. If you want to start helping costs get these off the books and state simply that anyone sharing patient information with someone besides the patient or the legal representative of the patient will be punished. The end no book of words to state one sentence!

Given all this my original question has not been addressed which is how can you guarantee my current quality of life. Please don’t try to tell me I have to sacrifice for others because my family has spent our life serving others but we do not accept the concept that government can dictate what and when and how we give. I am sick of the rhetoric and politics. Take the politics out and stop the one-upmanship and lets do it right.

HC response from CO U.S. Senator Mark Udall

Once again a response that does not actually answer my question or address my concerns

Dear ----,

Thank you for contacting me with your concerns regarding health care reform.  I appreciate your taking the time to express your specific views on this important topic facing our nation.
As you know, many proposals have been put on the table for reforming our health care system to make it work for all Americans.  I recognize there are many, often competing, philosophies and ideas on the best way to move forward.  As your Senator, it is my job to listen closely to the various stakeholders involved in this process as well as actively seek out input from across the state to help inform my understanding of what is best for Colorado.  One thing I firmly believe, however, is that the status quo is unacceptable and unsustainable.
While we move forward in this debate, there are a number of key requirements which will guide my consideration.  Any health reform must: 1) allow people who like the coverage they currently have to keep it; 2) bring costs down so that all Coloradans are able to cover their families while staying within their means; 3) preserve the critical doctor-patient relationship, ensuring that decisions about treatment are made by those who know the patient the best; 4) call for insurers to provide coverage regardless of pre-existing conditions or medical history; and 5) be fiscally responsible.  By ensuring that these pieces are part of reform, we can provide the stability in health care that is currently lacking for hard working Coloradans - stable costs, stable coverage, and stable quality.  As Congress continues looking for the best ways to meet our nation's health care challenges, please know that I will always keep the best interests of Coloradans in mind.  Along the way, I will certainly remember your particular thoughts and concerns.
I will continue to listen closely to what you and other Coloradans have to say about matters before Congress, the concerns of our communities, and the issues facing Colorado and the nation.  My job is not about merely supporting or opposing legislation; it is also about bridging the divide that has paralyzed our nation's politics.  For more information about my positions and to learn how my office can assist you, please visit my website at www.markudall.senate.gov.

Warm Regards,
Mark Udall
United States Senator, Colorado

HC response from Obama

 Just a note this response did not address my question in any way. It also states that military are receiving better treatment for PTSD and I know many military not getting any help in anyway. I would also state that H.R. 2 was a continuation of an existing program.


From: The White House - Presidential Correspondence
Subject: Thank you for your message
To: -------------
Date: Monday, October 19, 2009, 11:41 AM

Dear Friend:

      Thank you for sharing your thoughts with me.  I have heard
from countless Americans struggling to afford health insurance and
health professionals striving to provide care.  I appreciate your
      There is broad consensus among the American people on
the need for affordable, high-quality health care.  The rising cost of
health care is the most pressing financial challenge for families and
for our Nation, and controlling this cost is essential to bringing
down the Federal deficits we inherited.  We must end unfair
insurance practices that leave millions of Americans without
coverage, denying them access to care, and exposing them to
extraordinary burdens.  And we should ensure that all small
business employees have access to affordable, high-quality health
plans so that we can make our economy--and our small businesses-
-more competitive.  Now is the time to move forward, and I am
working to get health insurance reform done this year. 

      Since I took office, we have done more to improve health
care than we have in the previous decade.  In February, I signed
H.R. 2 to provide coverage for millions of children through the
Children's Health Insurance Program, and I signed the American
Recovery and Reinvestment Act to make key investments in
computerized medical records and preventive services.
      Still, more must be done to lower costs, expand coverage,
and improve the quality of health care.  My 2010 Budget makes a
major down payment on health insurance reform by implementing
efficiencies in government health care spending while improving
the quality of care.  To help fulfill the debt we owe to our service
men and women, it includes the largest proposed single-year
increase in veterans funding in 30 years.  It expands health care
to an additional 500,000 veterans by 2013, implements
technology that eases the transition from military care to veterans'
care, and enhances screening and treatment services for those
suffering from Post-Traumatic Stress Disorder and Traumatic
Brain Injury

      Looking forward, there are tough choices to be made, and I
will seek to bring employers and workers, health care providers
and patients, and Democrats and Republicans together to create a
system that delivers better care and puts the Nation on a
sustainable, long-term fiscal path.  To learn more about my agenda
or to share a personal story, please join me online at: 
www.healthreform.gov.  For further information on health care and
assistance that may be available to you, you may call 1-800-
FEDINFO or visit:  www.usa.gov.

I share the sense of urgency that millions of Americans have
voiced.  I watched as my ailing mother struggled with stacks of
insurance forms in the last moments of her life.  This is not who
we are as a Nation; together, we will fix it.


Barack Obama

To be a part of our agenda for change, join us at www.WhiteHouse.gov

August 22, 2009

Health Care Administrative Costs

Earlier this year (2009) the Commonwelth Fund Commission issued multiple reports asserting a goverment-run health care plan could cut insurance premiums approximatly 20%. It asserts that private insurance spends 40% of claims costs on administrative expenses. The Sherlock Company was commissioned to do a study of private insurance costs in 2009 (the study most frequently quoted in the debate today dates from 1988).

The full report can be found at http://tinyurl.com/kjo9hq

I. Executive Summary
Health plan administrative expenses often are cited as consuming a significant share of health insurance premiums. Proponents of a public health insurance plan often state that Medicare is more efficient than private insurance companies. However, these statements are based on outdated data and misconceptions about private administrative expenses, especially in the small group and individual markets.

Recent reports claim that health plan administrative expenses in the individual and small employer markets can exceed 30%. However, these estimates are based on data from Hay-Huggins that is more than 20 years old (1988) — a time when most claims were paper-based and many electronic processes were in their infancy — and based on estimated, rather than actual, administrative costs for companies that no longer provide health insurance.
An independent analysis by Sherlock Company of health plan administrative costs finds that prior estimates do not reflect the actual administrative costs for Blue Cross and Blue Shield Plans and other major health plans. Based on our review of actual health plan administrative expenses, we find that:

• Private health plan administrative expenses are grossly overstated in previous reports.
Based on combined data from 36 health plans participating in our performance benchmarking studies in 2008 (2007 data) and other data, administrative expenses for all commercial products represented 9.18% of premiums. Administrative costs are 11.12% of premiums for the small group market and 16.35% of the individual market, amounts that are nearly one-half and in some cases nearly one-third of other estimates.

• Traditional Medicare performs only a fraction of the administrative functions of private health plans because it retains its original fee-for-service design and is, therefore, not comparable.
Private plans use their administrative costs to promote care coordination and wellness, reduce unnecessary utilization and aggressively combat fraud and abuse. No precise, generally accepted measure of Medicare administrative expenses exists that is comparable to private plans. Moreover, Medicare does not need to market its coverage, develop provider networks, negotiate provider rates or maintain capital. If the government were to create a public health option to compete with private plans in a health insurance exchange, it would have to take on many additional functions that are not part of Medicare’s administrative costs today, resulting in increased administrative costs.

• Private plans perform those administrative functions that Medicare performs at lower costs.
In comparing only those administrative functions that Medicare performs, private administrative costs are actually lower — $12.51 per member per month, compared to a $13.19 per member per month in traditional Medicare. Many of Medicare’s administrative functions are, in fact, performed by private administrative contractors.

• Comparing administrative expenses between Medicare beneficiaries and people under age 65 should consider the unique healthcare needs of seniors.
Medicare beneficiaries have higher costs per claim compared to private plan enrollees. This means that the service requirements are less per dollar of health benefit, and administrative expenses are less for Medicare simply by virtue of the higher cost per claim.

• Comparing administrative costs as a percentage of claims overstates the difference
between plans for small groups or individuals and large groups.
Instead of calculating administrative expenses as a percentage of premiums, which is the most conventional metric used for comparing administrative costs, Hay-Huggins and subsequent reports have expressed the values as a percentage of claims, which is very misleading. Because health insurance premiums pay for both health claim costs and administrative expenses, the Hay-Huggins approach, repeated by Lewin, of dividing administrative expenses by claims costs unrealistically magnifies the differences between administrative expense ratios.