The Securities and Exchange Commission took a bold step in considering new rules that would require publicly traded companies to disclose political donations. This is a good idea because since the Citizens United decision, corporate entities have moved away from disclosed campaign committees, and instead have begun funneling cash into secret campaign funds, mostly 501c nonprofits.
Last year, The Nation published an investigation that debunked the idea that corporate money has flowed mostly to so-called Super PACs in the wake of Citizens United. Rather, big business has embraced nonprofit trade associations and issue advocacy groups to pour hundreds of millions into direct campaign advocacy. The distinction is important because Super PACs, for all their problems, at least disclose their donors and spending records; trade associations and issue advocacy groups do not.
To the credit of reformers, particularly the Center for Political Accountability and several investor groups, many large corporations have voluntarily adopted transparency measures. While we should applaud corporations that go beyond the letter of the law in disclosing these funds, a system based on voluntary participation does not come close to solving the problem of secret political slush funds. In some cases, voluntary disclosure actually obscures the truth.
Take health insurance companies. Aetna, Aflac and WellPoint are among several that have adopted voluntary disclose rules to provide the public and shareholders with a window into their giving patterns. There’s one problem: they aren’t truthful.
In 2009, the major health insurers, including the aforementioned companies, secretly funneled over $86.2 million to the US Chamber of Commerce, a trade association, using another trade association as a proxy to move the money, to run television and radio advertisements against health reform. Aetna’s disclosures that year only revealed $100,000 to the Chamber. WellPoint and Aflac failed to report those donations, as well. The following year, during the midterm elections, Aetna again secretly provided $7 million to “American Action Network,” a social welfare nonprofit used to run partisan attack ads against Democrats, along with the Chamber, which spent over $50 million on a partisan campaign to elect mostly Republicans that year. Again, Aetna’s voluntary disclosure report made no mention of the money, which became public through an inadvertent regulatory filing.
Similarly, several major oil companies have adopted voluntary disclosure guidelines that are fairly useless. ExxonMobil and Valero Energy are two examples: Both firms proudly produce annual reports on which candidates and political parties they fund. The problem? That data can be found already on the Federal Elections Commission website and related state-level disclosure websites, so there’s nothing new. As The Nation has reported, oil companies often work through secretive trade associations like the American Petroleum Institute, which has become more active in financing campaign-related advertisements and grants to other dark money groups.
As Senator John McCain and others have noted, the hundreds of millions slushing in secret money is bound to lead to another major scandal. And that scandal will likely to produce a lot of liability for the corporations involved. Moreover, as attorney Jerry Goldfeder noted in a letter to the New York Times this week, the I.R.S. has sent a questionnaire to 1,300 nonprofit groups questioning their tax exempt status. The increased scrutiny could lead to new questions that could increase liability for corporations: Are these groups being used to violate the Foreign Corrupt Practices Act, by funneling cash to foreign governments? Are consumer brands secretly funding ads that could harm the perception of their product (as was the case with Target and their donations to an anti-gay politician in Minnesota)?
Under the current system, only corporate executives, their lobbyists, and certain politicians really understand where the money is flowing. Shareholders, the public, and reporters have a right to know, too.
By: Lee Fang, The Nation, March 29, 2013
According to a study released today by the Kaiser Family Foundation, 2011 health insurance premiums for employer-sponsored family healthcare benefits rose 9 percent over last year’s prices, leaving employees to pay, on average, $4,129 and employer contributions at $10,944. The number represents a surprising rise given that increases experienced in 2010 were just 3 percent.
So, why the sudden increase?
We know that Americans are using fewer medical services since the economy took a dive as people are staying away from the doctor and putting off non-life saving surgeries, such as knee and hip replacements, until they have more confidence that they will have the money required to pay deductibles and co-pays. We also know that fewer medical services are being utilized as a result of the increased popularity of Health Safety Accounts which require deductibles in excess of $2,000 per family, and employer provided policies that have increasingly large deductibles and co-pays.
As a result, can it possibly make sense that medical costs are increasing by the 9 percent reflected in the hefty premium hikes? In a word, no.
That will not stop the anti-Obamacare forces, of course, from putting the blame squarely on healthcare reform. In a sense, I suppose the Affordable Care Act does bear some of the responsibility—if you can consider motivating the health insurers to falsely inflate their prices, by forcing them to do the right thing, to be a blamable offense.
Beginning next year, health insurers will be required to justify any increases in premium rates above 10 percent. They will further be obligated to refund money to customers if an insurer is found to have spent less than 85 percent of their premium income on medical expenses. Thus, it is hardly a stretch to conclude that the insurers are simply taking their last chance to raise premium rates before they find themselves having to be more accountable to the government, particularly when they are pretty much admitting to as much.
Republican Member of Congress, Phil Gingrey (GA), has decided that the moment has arrived to get back on offense in the debate for the future of Medicare.
At a press conference earlier this week, Gingrey returned to one of the GOP’s favorite ‘boogeymen’ in an effort to make us forget just how much we hate the Republican approach to reforming Medicare. He went after the fifteen-member panel of medical experts established by the Affordable Care Act who go by the name the Independent Payment Advisory Board (IPAB).
According to Gingrey-
“Democrats like to picture us as pushing grandmother over the cliff or throwing someone under the bus. In either one of those scenarios, at least the senior has a chance to survive.
But under this IPAB we described that the Democrats put in Obamacare, where a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy, I guarantee you when you withdraw that the patient is going to die. It’s rationing.” (Via Politico)
Wow…that does sound scary! In fact, it sounds an awful lot like a …..Death Panel.
Thank goodness that absolutely nothing Gingrey said at his press conference beyond “My name is Phil Gingrey” has even the slightest connection to the truth.
Like it or not, here are the facts –
In order to keep Medicare spending under control, the Affordable Care Act, aka “Obamacare”, established specific target growth rates for the government program that cares for our seniors.
To ensure that these targets are met, the reform law created the IPAB for the purpose of monitoring the growth of Medicare spending and to make recommendations to cut the same in those years where it looks like we are going to blow past the targets – and only in those years.
So, if the growth in Medicare costs is staying within the boundaries set by law, the IPAB has no authority to propose any changes whatsoever.
Why was it necessary to create this panel of experts?
Prior to creation of the IPAB, it was left to Congress to make decisions about who and what should be covered by Medicare.
While Congress has long had their own board of experts to rely on (“Medipac”), the profound influence of special interests combined with a general lack of understanding of the world of medicine – and the economics that rule that world – made it fairly obvious that Congress was not the best place to get the job done.
If you doubt this, simply look at how poorly Congress has managed the growth in Medicare costs to date. And before you blame this on whichever president you would like to put in the crosshairs, you should be very clear that it is, indeed, the job of Congress to make these decisions and manage this policy.
The IPAB was created to solve this problem.
As noted earlier, the board has no statutory impact whatsoever on Medicare payment rates and policy during the years when the spending targets are being met. Their powers only come into play in those years where Medicare actuarial reports suggest we are spending too much money per the restrictions established by Obamacare.
During those years when the board is required to come up with proposals to get spending under control, they will provide these proposals to the DHHS who must then implement them – unless Congress takes it upon itself to come up with their own proposals and pass them into law.
Thus, Congress retains the absolute ability and opportunity to effectuate its own program to bring Medicare costs back in line with the targets any time they wish. Maybe it was me, but I don’t recall Gingrey pointing out this little detail. And there is something else that Representative Gingrey forgot to mention during his tirade. There is an entire list of policy items contained in the ACA that are specifically prohibited to the IPAB.
And what would you imagine is at the top of that list?
What’s more, until 2020, the IPAB may not come up with proposals that place the rates being charged by primary hospitals and hospice programs in their sights. This prohibition was the result of the ACA already putting the moves on these organizations when it comes to what the government pays them. Thus, it seemed fair to give them some breathing room for the next eight years or so.
As a result of these inconvenient truths, it is rather difficult to concoct the scenario where Gingrey and friends see this insidious opportunity for the board to ration our health care.
The only argument I can imagine is to suggest that the board could recommend reducing the sums paid to physicians who provide Medicare services to patients. Were this to occur, more physicians might decide to drop out of Medicare, creating a longer waiting period for patients needing to see a doctor.
Of course, even this is not rationing.
Further, the SGR issue is about to become a thing of the past as Congress moves toward reaching a permanent solution to the problem created by an outdated formula that puts physicians in a position of taking major pay cuts from Medicare each year.
Once the physician payment issue is resolved, it becomes hard to see where the IPAB is going to exercise this health rationing Gingrey so fervently fears.
What should disturb each and every American is not only that Gingrey is willing to flat out lie in order to feather his political nest, he is using that lie to pull our attention away from the true health care rationers in our system – the private insurance companies.
Think this is a liberal red herring designed to distract you from the evil government plan to kill grandma?
Ask your physician about the hoops he or she must jump through to gain insurance company approval to do the job you hire them to do. Ask them how much of their time and money is wasted arguing with health insurance company representatives whose sole job is to turn down a requested procedure so that they will not have to pay for the same. Take a look at some of your statements from your insurer and see where they’ve denied payment on any number of technicalities resulting from a contract you signed that you could not possibly understand.
This is the true rationing problem in the United States today.
Still, polls continue to show that many Americans are deeply displeased with Obamacare.
I continue to believe that this is the direct result of so many of us not understanding what the legislation does – and does not – do.
But there is one thing we should all be able to understand.
If the opponents of health care reform and the current approach to Medicare are continuously left to base their arguments solely on lies, should it not occur to us all that maybe the law is better than what we’ve been led believe?
If not, why the lies instead of criticism based on the truth?
By: Rick Ungar, The Policy Page, Forbes, June 24, 2011
Every once in a while a politician comes up with an idea that’s so bad, so wrongheaded, that you’re almost grateful. For really bad ideas can help illustrate the extent to which policy discourse has gone off the rails.
And so it was with Senator Joseph Lieberman’s proposal, released last week, to raise the age for Medicare eligibility from 65 to 67.
Like Republicans who want to end Medicare as we know it and replace it with (grossly inadequate) insurance vouchers, Mr. Lieberman describes his proposal as a way to save Medicare. It wouldn’t actually do that. But more to the point, our goal shouldn’t be to “save Medicare,” whatever that means. It should be to ensure that Americans get the health care they need, at a cost the nation can afford.
And here’s what you need to know: Medicare actually saves money — a lot of money — compared with relying on private insurance companies. And this in turn means that pushing people out of Medicare, in addition to depriving many Americans of needed care, would almost surely end up increasing total health care costs.
The idea of Medicare as a money-saving program may seem hard to grasp. After all, hasn’t Medicare spending risen dramatically over time? Yes, it has: adjusting for overall inflation, Medicare spending per beneficiary rose more than 400 percent from 1969 to 2009.
But inflation-adjusted premiums on private health insurance rose more than 700 percent over the same period. So while it’s true that Medicare has done an inadequate job of controlling costs, the private sector has done much worse. And if we deny Medicare to 65- and 66-year-olds, we’ll be forcing them to get private insurance — if they can — that will cost much more than it would have cost to provide the same coverage through Medicare.
By the way, we have direct evidence about the higher costs of private insurance via the Medicare Advantage program, which allows Medicare beneficiaries to get their coverage through the private sector. This was supposed to save money; in fact, the program costs taxpayers substantially more per beneficiary than traditional Medicare.
And then there’s the international evidence. The United States has the most privatized health care system in the advanced world; it also has, by far, the most expensive care, without gaining any clear advantage in quality for all that spending. Health is one area in which the public sector consistently does a better job than the private sector at controlling costs.
Indeed, as the economist (and former Reagan adviser) Bruce Bartlett points out, high U.S. private spending on health care, compared with spending in other advanced countries, just about wipes out any benefit we might receive from our relatively low tax burden. So where’s the gain from pushing seniors out of an admittedly expensive system, Medicare, into even more expensive private health insurance?
Wait, it gets worse. Not every 65- or 66-year-old denied Medicare would be able to get private coverage — in fact, many would find themselves uninsured. So what would these seniors do?
Well, as the health economists Austin Frakt and Aaron Carroll document, right now Americans in their early 60s without health insurance routinely delay needed care, only to become very expensive Medicare recipients once they reach 65. This pattern would be even stronger and more destructive if Medicare eligibility were delayed. As a result, Mr. Frakt and Mr. Carroll suggest, Medicare spending might actually go up, not down, under Mr. Lieberman’s proposal.
O.K., the obvious question: If Medicare is so much better than private insurance, why didn’t the Affordable Care Act simply extend Medicare to cover everyone? The answer, of course, was interest-group politics: realistically, given the insurance industry’s power, Medicare for all wasn’t going to pass, so advocates of universal coverage, myself included, were willing to settle for half a loaf. But the fact that it seemed politically necessary to accept a second-best solution for younger Americans is no reason to start dismantling the superior system we already have for those 65 and over.
Now, none of what I have said should be taken as a reason to be complacent about rising health care costs. Both Medicare and private insurance will be unsustainable unless there are major cost-control efforts — the kind of efforts that are actually in the Affordable Care Act, and which Republicans demagogued with cries of “death panels.”
The point, however, is that privatizing health insurance for seniors, which is what Mr. Lieberman is in effect proposing — and which is the essence of the G.O.P. plan — hurts rather than helps the cause of cost control. If we really want to hold down costs, we should be seeking to offer Medicare-type programs to as many Americans as possible.
By: Paul Krugman, Op-Ed Columnist, The New York Times, June 12, 2011