Friday, November 8, 2013

Fwd: qotd: Editorial: Who first said, “You can keep the insurance you have”?

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-------- Original Message --------
Subject: qotd: Editorial: Who first said, "You can keep the insurance
you have"?
Date: Fri, 8 Nov 2013 11:53:35 -0800
From: Don McCanne <>
To: Quote-of-the-Day <>

November 8, 2013
Editorial: Who first said, "You can keep the insurance you have"?
By Don McCanne

Considering our national health expenditures, our health care financing
and delivery systems are a disaster. It is fully apparent that the
Affordable Care Act will fall woefully short of what is needed, and even
offset some of the minimal gains with changes that will make many of us
worse off by passing more costs directly onto us when we become ill
(higher deductibles and other cost sharing), and by further limiting our
choices of physicians and hospitals (shifting to narrow provider networks).

At a time that it is imperative that we address policy issues to try to
straighten up our system, we abandon reason and propel forward with
politics as usual.

President Obama's political enemies, well supported by the media -
including editorialists - are now expressing shock, shock that he lied
to us when he told us that we could keep the insurance we have, if we
like it. He was not the author of this sound bite provided to him for
political campaigning, so where did it come from?

Let's go back five years, beginning before Sen. Obama was even the
Democratic nominee for president, and look at some of our Quote of the
Day messages beginning then:

February 6, 2008
Is "keeping the insurance you have" your choice?
By Don McCanne

How many of you, under age 85, have the same health insurance plan that
you had twenty years ago? None?

Why did you change? (Several possibilities listed.)

What is the obvious conclusion? Health insurance coverage on a continual
basis is practically non-existent in the private insurance market. In
almost all of the instances listed, the insured individual was not
granted the option of "keeping the insurance you have."

Most polls on health care reform continue to ask many of the same
questions as they have over the past couple of decades, but there is one
new question. The pollsters are now asking if you support reform that
would allow you "to keep the insurance you have." For healthier
individuals who believe that they have good insurance, this concept
polls very well. In fact, the other questions in the polls are now
tailored to reinforce this simple concept.

Health Care for America Now!
(Undated, but referenced in 2008)
Statement of Common Purpose

A choice of a private insurance plan, including keeping the insurance
you have if you like it…

July 11, 2008
"Keeping the insurance you have" - Don't believe it!
By Don McCanne

Pause for a minute. Think back to the insurance you had twenty years
ago. Remember? Now do you still have precisely that same coverage?
Unless you are over 85 and have been in the traditional Medicare program
for the past twenty years, it is highly likely that you do not.

So why do you no longer have the better coverage that you had twenty
years ago? You may have changed jobs, likely more than once, and lost
the coverage that your prior employer provided. Your employer may have
changed plans because of ever-increasing insurance premiums. Frequently
your insurer introduces plan innovations such as larger deductibles, a
change from fixed-dollar co-payments to higher coinsurance percentages,
tiering of your cost sharing for services and products, reduction in the
benefits covered, dollar caps on payouts, and other innovations all
designed to keep premiums competitive in a market of rapidly rising
health care costs. You may have lost coverage when your age disqualified
you from participating in your parents' plan. You may have found that
health benefit programs have been declining as an incentive offered by
new employers. Your children may have lost coverage under the Children's
Health Insurance Program when your income, though modest, disqualified
your family from the program. Your union may not have been able to
negotiate the continuation of the high-quality coverage that you
previously held. Your employer may have reduced or eliminated the
retirement coverage that you were promised but not guaranteed. Your
employer may have filed for bankruptcy without setting aside the legacy
costs of their pensions and retiree health benefit programs. You may
have decided to start your own small business and found that you could
not qualify for coverage because of your medical history, even if
relatively benign, or maybe your small business margins are so narrow
that you can't afford the premiums. You may have been covered previously
by a small business owner whose entire group plan was cancelled at
renewal because one employee developed diabetes, or another became HIV
infected. Your COBRA coverage may have lapsed and you found that the
individual insurance market offered you no realistic options. You may
have retired before Medicare eligibility, only to find that premiums
were truly unaffordable or coverage was not even available because of
preexisting medical problems.

June 23, 2010
Will grandfathering save our current private plans?
By Don McCanne

The opponents of reform, especially the Republicans in Congress, are
making a big deal out of the fact that the Affordable Care Act breaks
President Obama's promise that you will be able to keep the insurance
plan you have. The Obama administration is countering by publicizing the
new regulations that will allow plans in place on March 23, 2010 to be
grandfathered, supposedly assuring that you will be able to keep your
plan if you had it on that date.

Actually, this is a silly debate. As explained in my comment two years
ago, except for those individuals on Medicare or other fiscally sound
retiree programs, almost no one gets to keep the insurance he or she
has. Rather than stabilizing existing coverage, the regulations that
would grandfather plans make it less likely, in an environment of
increasing health care costs, that existing plans would continue to be
offered without significant changes.

In an effort to make the insurance plans more affordable, further
adjustments in deductibles and coinsurance are almost inevitable, and
the ever-changing insurance marketplace will surely result in changes in
insurance companies selected. Insurance price shoppers, who are mostly
healthy, will be much more sensitive to size of the premiums than they
would be to cost sharing; this is precisely what has happened throughout
the individual market. These pressures would accelerate the decline in
grandfathered plans.

"Keeping the insurance you have" was only a slogan used to market the
reform proposal. It wasn't a serious long term strategy. Instead of
wasting time in another political dogfight - this time over
grandfathering - we should move forward with supporting policies that
will work for everyone - like a single payer national health program.

Comment, November 8, 2013:


Is that the best lesson that we can learn from President Obama's
decision to accept the recommendation of his political advisers to use
the sound bite, "You can keep the insurance you have, if that's what you

The fact that this is the framing of the current
keep-the-insurance-you-have discourse demonstrates not only how
acrimonious the Washington political environment has become, it also
shows the ineptitude of the media. Not only do they buy this framing
when there is a far more compelling message in this mess, they also
serve as dupes, propagating the biting, counter-productive message of
the Obama opponents.

Repeating my comment from 2010, "Instead of wasting time in another
political dogfight… we should move forward with supporting policies that
will work for everyone - like a single payer national health program."
That's the lesson we should learn.

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