How Did We Get Here?

How did the U.S. get to 46 million people without health insurance? How is the solution everyone buying their own health insurance as employers and government bail on their commitments?

Did people in power implement changes to address the problems and they just not work? I looked over an agenda from the National Health Policy Conference in 2003 and found some familiar names.

Tom Scully, CMS Chief

In his speech Tom talked about the Bush administration’s plans to cut the number of uninsured by 5-6 million. Since his 2003 talk, the number has not declined but grown by some 6 million (an 11-12 million swing between promise and reality). Mr. Scully would serve 11 more months before leaving to work for Alston & Bird, a D.C. law firm/lobbying house. Tom jumped back in bed with for-profit healthcare via his appointment as Senior Advisor to Welsh, Carson, Anderson & Stowe, an investment firm with a strong healthcare niche. He serves on the Board of a number of WCAS affiliates including Select Medical, SHPS Inc., and MemberHealth, while lobbying for another U.S. Oncology.

Uwe Reinhardt, Ph.D, Health Economist

Uwe moderated a panel concerned about the cost of government regulation on hospitals. During lunch his topic was “Concierge Health Care: Using Economic Theory to Peek Deeply into America's Soul”. There is no record of his presentation but his history of serving on boards of for-profit health insurers, hospitals, and medical device makers is clear. As he advised thought and government leaders how did his personal portfolio play into the strategies Uwe recommended?

A 2005 presentation at Princeton sheds light on this question. The longtime economic advisor to government leaders states the growing burden of health care on the U.S. economy, employer moves to cut or eliminate the health insurance benefit, and government’s inability to pick up the slack. His program ends with a bird feeding analogy with citizens being birds and health care the feed. Many will have the money to buy oats and dine nicely in the future. Others without resources will have to scrounge for food. For them to get oats it will have to be second hand, from the back end of a horse. Uwe’s two tiered healthcare vision already exists, and he is positioned to make great money off the birds who can afford oats. Watch his AMERIGROUP Corp, Triad Hospitals and Boston Scientific stock soar.

Senator Max Baucus-D, Montana

As a member of the Senate Finance Committee Max benefits from health care companies largesse. Eight for-profit healthcare companies with no (as in zero) facilities in Montana donated to his 2006 campaign.

In his 2003 talk Sen. Baucus stated his willingness to go down the private insurance road for Medicare Prescription Drugs. He spoke of current reform proposals that wouldn’t extend Medicare solvency into the future but increase private plan participation in Medicare (which he opposed). Has Max flip-flopped since then?

Senator John Breaux-D, Louisiana

John unveiled a Universal Coverage Plan at the 2003 event. Since then Mr. Breaux left the Senate to work for Patton Boggs, another D.C. legal/lobbying firm. The uninsured are still waiting. Since then John landed a spot on the CSX Board of Directors, a company with its own political intrigue. Muddying the bayou water further, John is the managing director of Riverstone Holdings, a private investment firm that struck several deals with the Carlyle Group. While Mr. Breaux grew his personal portfolio, the uninsured just grew in number.

Leonard Schaeffer, Chairman & CEO of WellPoint Health Networks

Also speaking at the meeting was large health insurer Wellpoint’s CEO. He failed to mention in his speech that President Bush’s Uncle Bucky serves on his Board of Directors. WellPoint had a banner third quarter, in part due to their Medicare Prescription Drug plan offerings. Search the list of insiders for other big political last names, Bayh, Boxer, & Bush. While the Boxer isn't politically connected, the other two are. Both Senator Evan Bayh’s wife and the Wellpoint Director share the first name of Susan. Both live in Indianapolis. The wife of future Presidential candidate Evan Bayh serves on 5 corporate boards, 4 of which are in healthcare.

Today a new “Universal Coverage” plan was introduced. Somehow Democrats allowed employers to slip off the yoke of health insurance benefits between Senator John Breaux’s 2003 effort and Senator Ron Wyden’s 2006 unveiling of “Universal coverage”. My guess is they’re most grateful. If all the previous latest and greatest ideas didn’t work to contain healthcare costs, why should the public believe the Wyden plan will? If it fails, each citizen will be the bagholder.