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June/July 2007 | Volume 6, Number 6
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I N T H I S I S S U E...
* President’s Message
* NOAHU Awards Health Underwriter of
the Year
* Meet the New NAHU President
* NOAHU Member Wins National Award
* NAHU House of Delegates Approves
Dues Increase
* Canadian Doctor Describes How Socialized
Medicine Doesn't Work
* NAHU Leads the Way on SCHIP
Reauthorization
* President Responds to Senate's Passage
of SCHIP Reauthorization Bill
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Welcome New Members!
Berline Broom
Humana
David Hanley
Fringe Benefit Mgmt Co.
Ron Hess
Ron Hess & Associates
Darlene Jones-Nasri
Humana
and THANK YOU to the
members who recruited them:
Dana Martin
Mike Mohr
Have you recruited a new member lately?
Click here for a Membership Application
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Congratulations to the new NOAHU Board of Directors!
President:
Jennifer Toups
Vice-President:
Mike Mohr
Secretary:
Carmen Waring
Treasurer:
Cabrini Granier
Immediate Past President:
Kenny Colins, Jr.
Awards Director:
Jay McGuire
Communications Director:
Stephanie Booth McGinnis
Education Director:
Bill Eastin
Legislation Director:
Dan Wagner
Media Relations Director:
Mortimore Kelly
Membership Director:
Lou Koster
Progams Director:
Rina Tikia
Public Relations Director:
Wayne Francingues, Jr.
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PRESIDENT'S MESSAGE
After returning from our Annual Convention in Denver, CO, I was more excited than ever about the position in which our organization finds ourselves. With our largest membership ever, both locally and nationally, NAHU has continued to make our voice heard in Washington and around the country. We heard an update of all of the things we have accomplished over the last year. You can view NAHU's Annual Report to its members by clicking here. It's quite remarkable that NAHU continues to be ranked among the Most Powerful People in Washington, DC.
Single Payer Health Care is at the forefront of a national debate. Ironically, as we met in Denver, Michael Moore was in Denver screening his movie "SiCKO" less than a mile away. We earned a small victory when during the local news coverage of the screening, NAHU Colorado's President was featured in the segment speaking out against Moore's movie. But that is just the first step. NAHU's Media Staff monitor the top 25 media markets on a daily basis and are responding to all pro-single-payer articles. Recently, NAHU CEO Janet Trautwein responded to an article in Time Magazine and her "Letter to the Editor" response was printed. (Janet says you wouldn't believe the amount of hate mail that Letter to the Editor has generated!)
In addition to responding to the media, NAHU is working to educate members, clients and more about the realities of a single-payer system- limited access, lower quality rationed health care.
As your Board of Directors and I start planning our goals for the year, we will be sure to host quality programs for our members. But as important, we will focusing on increasing our presence in the public and our eye on the media. If you see an article that is pro-single payer health care, pleas email me at jennifer@noahu.org or (504) 837-0110.
We are so excited about the year to come! But we can't to it without you! Each and every one of you are a valuable asset to our chapter and we plan to make sure that we are delivering value to you. If you have any ideas or suggestions, please do not hesitate to give me a call or drop me an email. We are always open to your opinions!
I look forward to serving you in the year to come!
Jennifer Toups
President
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Stephanie Booth McGinnis and Jennifer Toups awarded the Health Underwriter of the Year
At the June meeting, NOAHU awarded its highest honor to both Stephanie Booth McGinnis and Jennifer Toups for their unerring support of the organization.
Stephanie served as President of the chapter in 2004-2005. She has been currently elected back to the Board in the position of Communications Director. Jennifer Toups was elected as the President at the June meeting and has served on the Board since 2001. Both members have contributed in a multitude of ways to the betterment of the the New Orleans chapter and the industry. We are proud to have them as members of our chapter!
Congratulations Stephanie & Jennifer!!!
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Meet the New NAHU President
NAHU Elects Texan Beth Ashmore to Lead Organization
Beth Ashmore was sworn in as the new president of the National Association of Health Underwriters (NAHU) at its 77th Annual Convention, held in Denver, CO. After accepting the gavel from outgoing president David Fear, Mrs. Ashmore vowed to enhance efforts by NAHU to help lawmakers enact responsible reforms so more Americans have access to affordable health care and to preserve choice and competition in the marketplace.Under the banner “Get the Edge”, Mrs. Ashmore pledged to reinforce NAHU’s mission: to educate consumers and lawmakers about the value that health insurance agents and brokers bring to the health care system and, through education and association involvement, to increase NAHU members' ability to better serve consumers.“We live in challenging times,” stated Ashmore. “We’ve seen a tightening of budgets, continually escalating health benefits costs, and product offerings being reviewed more closely for value. At the same time, our customers expect greater choice and flexibility. Our membership faces these quandaries every day and I look forward to working together to help overcome these challenges.”Mrs. Ashmore began her career in the industry more than twenty five years ago with her husband Will as owners of an employee benefits agency. They also own a property casualty agency. Beth and Will reside in Lubbock, Texas and they have two daughters, two son-in-laws and four grandchildren.
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NOAHU Member Jennifer Toups Wins National Award
President Jennifer Toups was honored at the NAHU Annual Convention in Denver with one of NAHU's highest individual honors.
The Distinguished Service Award honors NAHU members who have contributed significantly above and beyond what is normally called for in connection with association volunteer service at the local, state, and/or national level over an extended period of time. The award can be presented to up to 12 members each year. This year, only 6 awards were given. Other NOAHU members who have won this award in the past are Christine Buras, Linda Ray & Ray Cumpsten.
Congratulations, Jennifer!
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NAHU House of Delegates Approves a Dues Increase
The NAHU House of Delegates approved a national dues increase of $50 per year. The increase will begin for renewals beginning January 1, 2008. Members on monthly draft will see their increase in January 1, 2008. This increase is targeted to hire additional national staff, incease public relations programs and more. This increase will bring our local dues to $325 per year or $27.08 per month.
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A Canadian Doctor Describes How Socialized Medicine Doesn't Work
I was once a believer in socialized medicine. As a Canadian, I had soaked up the belief that government-run health care was truly compassionate. What I knew about American health care was unappealing: high expenses and lots of uninsured people.
My health care prejudices crumbled on the way to a medical school class.
On a subzero Winnipeg morning in 1997, I cut across the hospital emergency room to shave a few minutes off my frigid commute.Swinging open the door, I stepped into a nightmare: the ER overflowed with elderly people on stretchers, waiting for admission. Some, it turned out, had waited five days. The air stank with sweat and urine. Right then, I began to reconsider everything that I thought I knew about Canadian health care.
I soon discovered that the problems went well beyond overcrowded ERs. Patients had to wait for practically any diagnostic test or procedure, such as the man with persistent pain from a hernia operation whom we referred to a pain clinic — with a three-year wait list; or the woman with breast cancer who needed to wait four months for radiation therapy, when the standard of care was four weeks.Government researchers now note that more than 1.5 million Ontarians (or 12% of that province's population) can't find family physicians.
Health officials in one Nova Scotia community actually resorted to a lottery to determine who'd get a doctor's appointment. These problems are not unique to Canada — they characterize all government-run health care systems.
Consider the recent British controversy over a cancer patient who tried to get an appointment with a specialist, only to have it canceled — 48 times. More than 1 million Britons must wait for some type of care, with 200,000 in line for longer than six months. In France, the supply of doctors is so limited that during an August 2003 heat wave — when many doctors were on vacation and hospitals were stretched beyond capacity — 15,000 elderly citizens died. Across Europe, state-of-the-art drugs aren't available. And so on.
Single-payer systems — confronting dirty hospitals, long waiting lists and substandard treatment — are starting to crack, however. Canadian newspapers are filled with stories of people frustrated by long delays for care. Many Canadians, determined to get the care they need, have begun looking not to lotteries — but to markets.
Dr. Jacques Chaoulli is at the center of this changing health care scene. In the 1990s, he organized a private Quebec practice — patients called him, he made house calls and then he directly billed his patients. The local health board cried foul and began fining him. The legal status of private practice in Canada remained murky, but billing patients, rather than the government, was certainly illegal, and so was private insurance.
Eventually, Chaoulli took on the government in a case that went all the way to the Supreme Court. Representing an elderly Montrealer who had waited almost a year for a hip replacement, Chaoulli maintained that the patient should have the right to pay for private health insurance and get treatment sooner. A majority of the court agreed that Quebec's charter did implicitly recognize such a right. The monumental ruling, which shocked the government, opened the way to more private medicine in Quebec.
Though the prohibition against private insurance holds in the rest of Canada for now, at least two people outside Quebec, armed with Chaoulli's case as precedent, are taking their demand for private insurance to court.Consider, too, Rick Baker. He isn't a neurosurgeon or even a doctor. He's a medical broker — one member of a private sector that is rushing in to address the inadequacies of Canada's government care. Canadians pay him to set up surgical procedures, diagnostic tests and specialist consultations, privately and quickly.
Baker describes a man who had a seizure and received a diagnosis of epilepsy. Dissatisfied with the opinion — he had no family history of epilepsy, but he did have constant headaches and nausea, which aren't usually seen in the disorder — he requested an MRI.The government told him that the wait would be 4 1/2 months. So he went to Baker, who arranged to have the MRI done within 24 hours — and who, after the test revealed a brain tumor, arranged surgery within a few weeks. Some services that Baker brokers almost certainly contravene Canadian law, but governments are loath to stop him.
Other private-sector health options are blossoming across Canada, and the government is increasingly turning a blind eye to them, too, despite their often uncertain legal status. Private clinics are opening at a rate of about one a week. Canadian doctors, long silent on the health care system's problems, are starting to speak up.
Last August, they voted Brian Day president of their national association. Day has become perhaps the most vocal critic of Canadian public health care, having opened his own private surgery center and challenging the government to shut him down. And now even Canadian governments are looking to the private sector to shrink the waiting lists. In British Columbia, private clinics perform roughly 80% of government-funded diagnostic testing.
This privatizing trend is reaching Europe, too. Britain's Labour Party — which originally created the National Health Service — now openly favors privatization. Sweden's government, after the completion of the latest round of privatizations, will be contracting out some 80% of Stockholm's primary care and 40% of its total health services.Since the fall of communism, Slovakia has looked to liberalize its state-run system, introducing co-payments and privatizations. And modest market reforms have begun in Germany.
Yet even as Stockholm and Saskatoon are percolating with the ideas of Adam Smith, a growing number of prominent Americans are arguing that socialized health care still provides better results for less money. Politicians like Hillary Clinton are on board; Michael Moore's new documentary, "Sicko," celebrates the virtues of Canada's socialized health care; the National Coalition on Health Care, which includes big businesses like AT&T, recently endorsed a scheme to centralize major health decisions to a government committee; and big unions are questioning the tenets of employer-sponsored health insurance.
One often-heard argument, voiced by the New York Times' Paul Krugman and others, is that America lags behind other countries in crude health outcomes. But such outcomes reflect a mosaic of factors, such as diet, lifestyle, drug use and cultural values. It pains me as a doctor to say this, but health care is just one factor in health.Americans live 75.3 years on average, fewer than Canadians (77.3) or the French (76.6) or the citizens of any Western European nation save Portugal. Health care influences life expectancy, of course. But a life can end because of a murder, a fall or a car accident. Such factors aren't academic — homicide rates in the U.S. are much higher than in other countries.
In The Business of Health, Robert Ohsfeldt and John Schneider factor out intentional and unintentional injuries from life-expectancy statistics and find that Americans who don't die in car crashes or homicides outlive people in any other Western country.And if we measure a health care system by how well it serves its sick citizens, American medicine excels. Five-year cancer survival rates bear this out. For leukemia, the American survival rate is almost 50%; the European rate is just 35%. Esophageal carcinoma: 12% in the U.S., 6% in Europe. The survival rate for prostate cancer is 81.2% here, yet 61.7% in France and down to 44.3% in England — a striking variation.
Like many critics of American health care, though, Krugman argues that the costs are just too high: health care spending in Canada and Britain, he notes, is a small fraction of what Americans pay. Again, the picture isn't quite as clear as he suggests. Because the U.S. is so much wealthier than other countries, it isn't unreasonable for it to spend more on health care. Take America's high spending on research and development. M.D. Anderson in Texas, a prominent cancer center, spends more on research than Canada does.That said, American health care is expensive.
And Americans aren't always getting a good deal. In the coming years, with health expenses spiraling up, it will be easy for some to give in to the temptation of socialized medicine. In Washington, there are plenty of old pieces of legislation that like-minded politicians could take off the shelf, dust off and promote: expanding Medicare to Americans 55 and older, say, or covering all children in Medicaid. But such initiatives would push the U.S. further down the path to a government-run system and make things much, much worse.
True, government bureaucrats would be able to cut costs — but only by shrinking access to health care, as in Canada, and engendering a Canadian-style nightmare of overflowing emergency rooms and yearlong waits for treatment.America is right to seek a model for delivering good health care at good prices, but we should be looking not to Canada, but close to home — in the other four-fifths or so of our economy.
From telecommunications to retail, deregulation and market competition have driven prices down and quality and productivity up. Health care is long overdue for the same prescription.
Gratzer, a physician, is a senior fellow at the Manhattan Institute. This article is adapted from the forthcoming issue of City Journal.
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NAHU Leads the Way on Reauthorization of SCHIP
The State Children's Health Insurance Program (SCHIP) began in 1997. CHIP represents the most comprehensive federal effort to ensure health insurance coverage of children since the creation of Medicaid. Since the states have several options as to how they can develop programs to provide coverage to the children in their states, different parts of the country have been more successful than others in reaching out to low-income kids.
SCHIP will expire on September 30, 2007 unless it is reauthorized by Congress. The program enjoys wide bipartisan support but there are differences of opinion regarding the reauthorization. Some members of Congress would like to expand the program. Among the policy changes under consideration include formally allowing adults into the program, changing the program from a block grant to an entitlement and raising the eligibility criteria.
NAHU has been actively monitoring the progress of SCHIP in the states and we have provided comments to both Congress and CMS on ways to improve the success of the program. NAHU has testified on this subject before the Committee on Education and Labor Subcommittee on Health, Labor and Pensions Regarding Examining Innovative Approaches to Covering the Uninsured Through Employer-Provided Health Benefits and the United State Senate Committee on Finance Regarding The Children's Health Insurance Program in Action: A State's Perspective on CHIP .
The Senate version of the bill echoes many of the conditions that NAHU has promoted. The House Committees on Energy and Commerce and Ways and Means will be "marking-up" the SCHIP Reauthorization bill this week. The full House is expected to vote on the bill THIS WEEK.
NAHU has been working with members of Congress to strengthen SCHIP by eliminating obstacles in current law and policy that have hindered many states from interacting with existing private sector coverage.
If you haven't responded to the Operation Shout, please click here and click "Take Action" to send a note to your legislator. This process takes just a few seconds.
For more detailed information about the SCHIP and NAHU's activities including communications with Congress and more, click here.
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President Responds to Senate's Passage of SCHIP Reauthorization Bill
STATEMENT OF ADMINISTRATION POLICY
S. 1893 – Children’s Health Insurance Reauthorization Act of 2007
(Sen. Baucus (D) MT)
The Administration strongly supports reauthorization of the State Children’s Health Insurance Program (SCHIP). The Administration is committed to making sure that poor children have health insurance and to that end, supports focusing resources on providing coverage for low-income children. It is urgent that Congress complete its work and send the President a bill he can sign before the program expires September 30, 2007. In fact, the President would sign reasonable legislation to reauthorize SCHIP today. The President’s Budget includes a proposed $5 billion expansion, a 20 percent increase in funding. However, the President has several concerns about S. 1893 and the Senate approach to SCHIP Reauthorization. If S. 1893 were presented to the President in its current form, he would veto the bill.
S. 1893 expands the SCHIP program and changes the focus from those who cannot afford coverage to include families with incomes of up to $83,000 per year or even more. This bill essentially extends a welfare benefit to middleclass households. The funding levels provided in the first five years under S. 1893 are far more than necessary to accomplish the goal of covering low-income children.
At the same time, S. 1893 sets SCHIP on an unsustainable course by expanding and then drastically underfunding the program in the future by at least $60 billion. The legislation balloons the allotments to $16 billion in 2012 and then reduces the allotments to $3.5 billion in 2013. Such a dramatic decline in allotments is highly unlikely and nothing more than an irresponsible budgetary gimmick. In the period 2013-2017, according to the Congressional Budget Office, SCHIP funding and enrollment under the bill would be lower than under current law, which could cause millions of children to lose coverage over the long-term.
The bill discourages States from efficiently managing their allotments by increasing SCHIP allotments at a growth rate well above their projected spending and by creating new funding sources in addition to State allotments. The legislation would create two new funds that appear to encourage States to overspend their budgets. The legislation purposefully sets excessive and unnecessary allotment levels that are designed to spill over into the new “Incentive Fund.”
The bill is inconsistent with the principle of choice for American consumers and instead goes too far in federalizing health care. A competitive private market for health insurance is better policy than a government-run system that would mean lower quality, longer lines, and fewer options for patients and their doctors. S. 1893 would cause millions of individuals to drop their private insurance in order to be involved with a government insurance plan. Many of the gains in SCHIP under this legislation will be offset by losses in private health insurance coverage because the proposed SCHIP expansion targets families at income levels where most children already have private health insurance coverage. As a result, the true net increase in coverage for children is estimated to be between 40 and 50 percent of the increase in enrollment levels under SCHIP. As a result, the cost per each newly insured individual under the bill would be $3,950 in 2012 in combined Federal and State spending. The Administration is deeply concerned that S. 1893 will result in the expenditure of billions of dollars that will merely replace what otherwise would have been spent by families meeting their own obligations to care for their children. The “crowd out” effect weakens the private health insurance system and creates new inequities among families who continue to pay for their own health care and those at the same income level who do not.
The Administration is also concerned that S. 1893 will delay the Administration’s efforts to transition adults out of SCHIP and into Medicaid. By October 1, 2007, the Department of Health and Human Services will have moved half of the adults covered by SCHIP through demonstration projects out of Title XXI and into Medicaid, but S. 1893 would reverse this progress.
The Administration believes this legislation needs dramatic changes in three major areas—funding, coverage of adults, and coverage of children in higher income levels.
The Administration strongly objects to the provision in S. 1893 that wrongly weakens the current option available to States to cover unborn children and their mothers. The new option would exclude coverage for certain unborn children and their mothers who would be eligible under the existing regulations. The Administration believes every human life has value, and every child should be welcomed into life.
The Administration also strongly opposes the proposed tax increases contained in the legislation. The use of tax increases to fund spending increases is undesirable and inadvisable. The Administration is concerned about the negative impact on State budgets from the loss of direct revenue and the uncertain impact this may have on States and bondholders in relation to the tobacco Master Settlement Agreements.
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