Retiree Newsletter from the AFT - 3/5/10 edition

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March 5, 2010

President Creates Debt Commission To Examine Social Security, Medicare
White House Unveils Revamped Health Reform Plan
Supporters Rally To Protest Central Falls Mass Teacher Firings
Health Reform Update
Doctors Delay Talking About End-Of-Life Care
Get Ready for Spring with AFT+ Health Clubs
Quote of Note
Web Site of the Week: http://www.retiredamericans.org/ht/a/GetDocumentAction/id/15274



PRESIDENT CREATES DEBT COMMISSION TO EXAMINE SOCIAL SECURITY, MEDICARE

President Barack Obama signed an executive order Feb. 23 establishing a commission to tackle the federal debt. The commission's purpose is to reduce the federal budget deficit from 10 percent to 3 percent by 2015 and in the long run bring down the overall federal debt. The president said the commission can consider everything, including new taxes, spending cuts and changes to Medicare, Social Security and Medicaid, in order to meet its goals. Congress then will consider its recommendations. Six of the 18 members on the panel are appointed by the White House, with up to four from the same party. Leaders in Congress will choose the other 12 members, with three coming from each party in the U.S. House and Senate. Recent appointments include co-chairs of the commission, former Clinton White House chief of staff Erskine Bowles and former Republican Sen. Alan Simpson. Additional Obama nominees are former Clinton White House budget director Alice Rivlin; Service Employees International Union president Andy Stern; former Young & Rubicam Brands CEO Ann Fudge; and Honeywell CEO and chair David Cote. Democratic Senate appointees include majority whip Richard Durbin (D-Ill.), Budget Committee chair Kent Conrad (D-N.D.) and Finance Committee chair Max Baucus (D-Mont.). House Speaker Nancy Pelosi (D-Calif.) and Republican leaders in both the House and Senate have yet to make their appointments.

Co-chair Bowles, president of the University of North Carolina, worked with Republicans in Congress to pass the Balanced Budget Act of 1997 when he was White House chief of staff. He ran unsuccessfully for the U.S. Senate in 2002 and 2004. Simpson served as a U.S. senator from Wyoming (1979 to 1997) and as Senate GOP whip (1985 to 1995). Both Baucus and Conrad are noted centrists who have made debt and deficit issues a priority. While expressing willingness to work with the commission to reduce the budget deficit and federal debt, Alliance for Retired Americans leaders have expressed concern about Simpson, who as a senator tagged older Americans as "greedy geezers," battled advocacy groups for older Americans and supported cuts in the Social Security COLA.

WHITE HOUSE UNVEILS REVAMPED HEALTH REFORM PLAN

President Obama began a final surge to overhaul the nation's health system Feb. 22, unveiling a White House-drafted plan days before a scheduled meeting with Republicans. The president's proposal is heavily based on Senate Democrats' already-passed overhaul plan. The bill is intended to achieve the broad White House goals of expanding coverage to the uninsured while driving down health premiums and imposing tighter rules for insurers, including ending discrimination against people with pre-existing conditions. The proposal would provide more money to help cash-strapped states pay for Medicaid over the next four years and eliminate the “doughnut hole” coverage gap in the Medicare prescription drug program. It also boosts subsidies to help low- and moderate-income people buy insurance on the new state exchanges, a key demand of House Democrats. The plan includes a national exchange and would scale back the proposed tax on high-cost health plans. The new White House proposal would cost $950 billion over 10 years, more than the bill approved by the Senate but less than the House measure. Although Republican leaders complained loudly that the plan ignored their ideas, the White House said that 160 Republican amendments have been included in congressional versions of the legislation.

SUPPORTERS RALLY TO PROTEST CENTRAL FALLS MASS TEACHER FIRINGS

Teachers, parents and students as well as community, political and union leaders protested the firings of all 74 teachers at Central Falls (R.I.) High School at a Feb. 23 rally, saying there are proven, more promising ways to improve student achievement other than solely blaming the teachers. "The teachers have been unfairly targeted, and we will fight to have them reinstated," said Jane Sessums, president of the Central Falls Teachers Union, an AFT affiliate. "Instead of trying to fix the system with a successful model, the administration has decided to scapegoat the teachers. We want genuine reforms, not quick fixes that do nothing but create a wedge between teachers, our school and our community." The superintendent of schools in Central Falls dismissed all of the teachers at the city's high school when the union refused to sign on to a Race to the Top application that would, among other things, require that a number of teachers be fired, and increase the school day without additional compensation.

Central Falls teachers have agreed to numerous reforms since the 1991 state takeover of one of the poorest districts in Rhode Island. The staff have worked with the administration to develop a teacher evaluation system, schedule changes that benefit the students, create continuous common planning time throughout the year, and implement many research-based programs. Sessums called on the state education commissioner to bring the parties back to the table so they can work toward a solution together. AFT president Randi Weingarten expressed disappointment that district superintendent Frances Gallo and the state education commissioner both have rejected overtures to meet with her to discuss the Central Falls situation and also declined former U.S. Sen. Lincoln Chaffee's proposal for mediation. Weingarten criticized both U.S. Education Secretary Arne Duncan and President Obama for failing to get all the facts—or even speak with teachers—before weighing in on the mass firing. The Central Falls school board voted Feb. 23 to terminate all teachers at the end of the current school year despite a recent 21 percent increase in reading scores.

On March 3, district superintendent Gallo said she would return to the bargaining table.

HEALTH REFORM UPDATE

Obama's Latest Health Proposal to Focus on Cost: President Obama has begun a climactic push to rally restive congressional Democrats to pass major healthcare legislation by hammering home the argument that the costs of failure will be higher insurance premiums and lost coverage for individuals and businesses. At least nine of the 39 Democrats who voted “nay” when the House passed sweeping overhaul legislation by a 220-to-215 vote in November are now undecided or withholding judgment until they see Obama's final product, according to an Associated Press survey. The president sharpened his arguments contrasting Democratic proposals for expanding coverage and regulating insurance company practices with the shortcomings of the Republicans' incremental plans. Under rules of reconciliation (see below), the Senate can pass a bill affecting revenues by a simple majority. Senate McConnell (R-Ky.) said on CNN Feb. 28 that he expects all 41 members of the Republican Caucus to oppose the healthcare plan. The House bill drew just one Republican vote. The outcome in both chambers remains uncertain. Key to getting the House to pass a reconciliation bill aimed largely at modifying the Senate version of health reform are pro-life Democrats who want more restrictive language on abortion, Blue Dog Democrats concerned about the cost of the bill, freshmen Democrats in swing districts; and members of the liberal Progressive Caucus who want an expanded public role in healthcare.

Reconciliation: Established in 1974, reconciliation makes it easier for the Senate to pass bills to reduce the nation's debt. The procedure has been used 23 times, and every president beginning with Jimmy Carter has signed bills that were passed using the reconciliation process. If Democrats proceed with reconciliation, the House would have to act first. House Speaker Nancy Pelosi says she is confident she will be able to get the votes needed to pass healthcare reform. House Democrats are reluctant to take up the Senate bill, alone or in conjunction with the reconciliation package, fearing that the Senate will once again leave them hanging as it did with previous tries at health reform. Since 1981, Republican presidents have signed into law 17 of 23 reconciliation bills. In that time period, the process has been used nine times by Republicans and six by Democrats when the parties controlled both the House and the Senate. Landmark legislation passed under reconciliation includes the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) which allows terminated employees to continue to buy health coverage under employer plans; the 1993 budget; the Marriage Tax Relief Reconciliation Act of 2000; and the $1.3 trillion Bush tax cuts.

Health Costs Continue Steep Rise: The unrelenting rise in medical costs is likely to wreak havoc within the healthcare system and beyond it, according to an article in the Feb. 28 New York Times. Even families that enjoy generous insurance now are likely to see the cost of those benefits escalate. The typical price of family coverage now runs about $13,000 a year; premiums are expected to nearly double—to $24,000—by 2020, according to the Commonwealth Fund.

House Votes To Repeal Antitrust Exemption for Health Insurers: The House passed legislation Feb. 24 (by a 406-to-19 vote) to strip health insurers of their federal antitrust exemption. President Obama favors the idea of repealing the exemption, and House Democrats say doing so would add scrutiny to the practices of health insurers. In making their case for the bill, lawmakers have pointed out the near monopolies enjoyed by health insurance companies in many states. In 39 states, two health insurers control at least half the market, according to evidence presented in recent congressional hearings. In nine states, one insurer controls 75 percent of the market. Supporters portrayed the bill as a way to tamp down sharply rising health insurance costs, such as those from WellPoint, which raised rates up to 39 percent for Anthem Blue Cross customers in California.

Americans' Health Reform Fears Ease: Americans' concerns about health reform eased in January, according to a poll released by the Associated Press/MSNBC reports. The monthly poll from the nonpartisan Robert Wood Johnson Foundation also found that three-fourths of Americans still think it's important that President Obama include healthcare reform in addressing the nation's economic crisis. The proportion of Americans who said they feared that access to doctors and hospitals would get worse under the Democratic plans dropped to 29 percent, from 33 percent in December. A new tracking poll from the Kaiser Family Foundation finds opinion evenly split on overhaul legislation, with 43 percent of Americans in favor of passage and 43 percent opposed. But more than two-thirds of people favor most of the important planks in the administration's overhaul plan: reforming the way health insurance works, and 76 percent say it's "extremely" or "very important" to reform health insurance, including 64 percent of Republicans. Majorities of Americans say they're disappointed or frustrated by delays in the reform process. About six in 10 say they'd be "angry" (20 percent) or "disappointed" (38 percent) if Congress abandoned the reform effort.

MedPac Urges Feds To Cut MA Payments: The Medicare Payment Advisory Commission (MedPac) on March 1 recommended that Medicare cut U.S. government payments to private insurers and home healthcare providers. The panel, which is an independent body of experts set up to advise Congress on Medicare, repeated its earlier call for the federal government to pay private insurers offering coverage known as Medicare Advantage the same that it pays when Medicare reimburses providers directly. (Their current average reimbursement is 14 percent higher than traditional Medicare.) Congress is considering cuts to Medicare Advantage and other sectors as part of healthcare reform legislation.

DOCTORS DELAY TALKING ABOUT END-OF-LIFE CARE

A study published earlier this year finds doctors delay talking about end-of-life care, which often proves very costly. Most doctors don't talk about end-of-life issues with their cancer patients when those patients are feeling well. Physicians also tend to delay these conversations until treatments have been exhausted. Such delays mean that patients might not be able to make truly informed choices early in their treatment. Published online Jan. 11 in the journal Cancer, the study surveyed 4,188 doctors about how they would talk to a hypothetical cancer patient with four to six months to live. A majority of respondents (65 percent) said they would discuss prognosis, but only a minority said they would discuss do-not-resuscitate status (44 percent), hospice (26 percent) or preferred site of death (21 percent) at that time. Rather, they would wait until symptoms were present or until there were no more treatments to offer. The Centers for Medicare & Medicaid Services estimates that 5 percent of the Medicare recipients who die each year account for 30 percent of the $446-billion annual Medicare budget. About 80 percent of that money is spent during a patient’s final month, on mechanical ventilators, resuscitation and other aggressive life-sustaining care. Patients who plan in advance for end-of-life treatment have lower costs and often have higher quality of life in their final days.

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QUOTE OF NOTE

"Our kids have developed a bond with their teachers. They have great relationships with them and they trust them. To separate them from their teachers now, just as test scores and student performance are improving, is unconscionable. The entire process is devastating—not just to our kids, but to the entire Central Falls community."

Fausto Barbosa, parent
Central Falls High School
Feb. 23, 2010

WEB SITE OF THE WEEK:

http://www.retiredamericans.org/ht/a/GetDocumentAction/id/15274

Visit this site for an easy-to-understand snapshot of how President Obama’s health reform proposals compare with the House and Senate plans.

Contributors and sources: Bernadette Bailey, Bill Cunningham, Los Angeles Times, New York Times, Washington Post, USA Today, Denver Post, The Hill, Associated Press, Reuters, CNN, MSNBC, National Public Radio, Inside AFT, Alliance for Retired Americans Alert, BNA Healthcare Daily Report, Kaiser Health Policy Report. Frank Stella, editor; Laura Baker, copy editor; Janelle Bowe, design.

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