(This post is part of Brave New Films’ 16 Deaths Per Day campaign, for which I am a blogger fellow.)
Steven Greenhouse reports in the New York Times that employers are routinely underreporting illnesses and injuries to their workers.
The report, by the G.A.O., the auditing arm of Congress, said many employers did not report workplace injuries and illnesses for fear of increasing their workers’ compensation costs or hurting their chances of winning contracts.
The report also said workers did not report job-related injuries because they feared being fired or disciplined and worried that their co-workers might lose rewards, like bonuses or steak dinners, as part of safety-based incentive programs.
“The widespread underreporting so clearly documented in this report is undermining the health and safety of American workers,” said Senator Tom Harkin, Democrat of Iowa and chairman of the Health, Education, Labor and Pensions Committee. “If we don’t know the full extent of the workplace hazards workers face, we cannot fully address these risks.”
Mr. Harkin was one of the Congressional leaders who requested the report.
It’s hard to even determine the problems with workplace safety when employers are systematically undermining the data. And it’s impossible for industry to take credit for declines in workplace injuries and even fatalities if the official data cannot be trusted (that decline can also be attributed to the overall decline in the workforce due to the recession, too, as well as the decline in staffing at the agencies that keep the records). In fact, the GAO report concluded that OSHA may have failed to account for “up to two-thirds of all workplace injuries and illnesses.”
See, OSHA relies on data from employers for a bulk of its surveying about workplace safety. That’s right, the foxes write up the reports about the henhouse. When you start talking to people other than the site managers, some interesting statistics crop up:
The accountability office also found that more than a third of the occupational health practitioners it surveyed said that employers or workers had pressured them to provide insufficient medical treatment to hide or play down work-related injuries or illnesses.
The safety and health administration requires employers with more than 10 workers to record every work-related injury or illness that results in lost work time or medical treatment other than first aid. Some occupational health practitioners say that to avoid recording an injury, some employers will try to limit treatment for a serious injury to just first aid.
In other cases, the practitioners said, employers might seek alternative diagnoses if the initial diagnosis would result in a recordable injury or illness.
They want to avoid OSHA site inspections, which they know the agency is only equipped to perform on the most egregious violators. If you stay out of sight, you’ll be out of OSHA’s mind, in all likelihood.
When you read the independent reports, outside of OSHA, you begin to get the true picture of what American workplaces look like. In the low-wage market, there are all kinds of systematic violations, forcing employees to work longer hours for less pay – and these violations extend to health and safety. This stress and strain may account for the shocking rise in workplace suicides over the last year.
“This report confirms that when it comes to the documenting of workplace injuries, we can’t just take employers at their word,” said Senator Patty Murray, Democrat of Washington and chairwoman of the Subcommittee on Employment and Workplace Safety. “The system, to this point, has been all too easy to game.”
You may know Andy Cobb from the series of humorous video sketches he’s done about Republicans, the media, and assorted inanities. But he works by day as an actor. And a few years ago, he was a commercial spokesman for Blue Cross Blue Shield of Florida. Now, he’s speaking out about the insurance industry in a new video produced by Brave New Films for their Sick For Profit campaign.
Andy, who lives in Los Angeles, describes himself as a “spokesjerk” put in front of the cameras by the industry to deliberately stand in the way of reform and maintain the status quo. He asks for solidarity from spokesjerks like him – the Sham-wow guy, for example – to stop pitching products that rip off Americans.
Senate Democrats are trying to extract some embarrassing information from the insurance industry about their deceptive practices.
First, Tom Harkin, who is seeking to subpoena insurers for failing to provide information requested by his committee.
Harkin, the chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, said his committee may demand information from health insurance companies about the reasoning for steep increases in premiums faced by small businesses.
“I’ve been inundated with letters and information about the exorbitant increases in premiums for small businesses in this country,” Harkin said during an appearance on MSNBC. “I asked them to come and testify at a hearing I had yesterday. They refused.”
“So now I’m asking them to give us information on which we can make some decisions on why these premiums are going up so much for small businesses,” he added.
Jay Rockefeller also wants some information about the industry’s “medical loss ratio,” and how they cook the books to pretend that they spend a substantial amount of premium money on treatment and care.
The New York Times reports: “The health insurance industry likes to cite figures showing that 87 cents of every dollar in premiums is spent on medical claims. But a new Senate analysis suggests that for-profit insurance companies are spending much less than that, especially for policies sold to individuals and small businesses. Instead, as little as 66 cents of each dollar paid in premiums goes toward doctor and hospital bills, while the rest covers administrative expenses, marketing and company profits, according to the analysis. …. The [health reform] legislation that may reach the House floor later this week would initially require insurers to spend at least 85 cents of every dollar in premiums on medical claims.”
A long-standing complaint from individuals and small businesses is that they get less for their money. “But insurance companies generally do not disclose how much they spend in different segments of the market. The Senate analysis of the figures does not include information from California, because that state’s filings are not available through the National Association of Insurance Commissioners. … The insurance industry’s trade group, America’s Health Insurance Plans, said Monday that the 87-cent figure it cited as the industry average was based on information collected by the federal government and was an accurate reflection of how much of each dollar in premiums was spent on medical claims.” (Abelson, 11/2).
This comes at a time when the Senate is about to unveil their health care bill. This information could be crucial to massing public opinion against the industry and keeping the entire Democratic caucus on board with reform.
The House and Senate will be voting on health care bills in a matter of weeks. But the forces behind the status quo have not quit in their efforts to derail the bill or at least get as many goodies out of it as they can.
The lobbying expenses of the top 13 health insurers and their industry association, America’s Health Insurance Plans (AHIP), spent nearly $8.2 million in the third quarter of 2009 to influence Congress on upcoming health care legislation, according to analysis released today by the nonpartisan campaign finance watchdog Public Campaign Action Fund (PCAF). The total marks an 11 percent increase over the pace of their spending in the first half of the year.
“Congress is marching toward passing landmark legislation to overhaul the health care system, and the health insurance industry is fighting them every step of the way,” said David Donnelly, national campaigns director of Public Campaign Action Fund. “These insurance giants may be running out of time, but clearly they haven’t run out of political cash.”
This brings the total in lobbying to nearly $23 million this year, including $6.3 million from AHIP, $3.5 million from WellPoint, $3.5 million from UnitedHealth and $2 million from Aetna. Humana, which has spent $1.85 million in lobbying fees this year, saw their earnings rise 65% in the third quarter, a lot of it off the wasteful Medicare Advantage program, which represents a corporate handout and which is earmarked for scale-backs in the health care bills. Majority Leader Reid’s office released this statement in response:
“It’s no wonder why Humana has been misleading seniors about health insurance reform — they saw their profits rise 65 percent last quarter and want to make sure the gravy train doesn’t end. The insurance industry is making billions by gaming the Medicare Advantage system, at the expense of seniors’ traditional Medicare coverage, and taxpayers are footing the bill.
“The American people have had enough, but unfortunately Senate Republicans have sided with insurers like Humana and are working to protect insurance industry profits over Americans’ health care needs. When we pass health insurance reform this year, this will all come to an end. Our seniors deserve better and American taxpayers should not be asked to pad the profits of the insurance industry.”
Insurers like Humana are ready to pounce on this legislation when it hits the floor in both Chambers, particularly in the Senate, where they will use the amendments process to try and cripple reform and the cloture process to outright kill it. But the insurance industry isn’t just fighting for their own self-preservation, they’re fighting the interests of the people.
Ryan Grim reported yesterday that Harry Reid decided to leave out the repeal of the insurance industry’s anti-trust exemption from the Senate health care bill, preferring to include it as an amendment on the floor. However, the House bill does include repeal, albeit the partial one that passed the Judiciary Committee and not the full repeal of the exemption that some Democrats sought. The narrow-cast repeal in the House bill refers specifically to “price fixing, market allocation, or monopolization.” This would enable the Justice Department to go after monopolistic practices in the health insurance or the medical malpractice insurance market in the states. While CBO basically said that this would have a minimal effect, it would put those engaged in corrupt practices either in jail or out of business, which is preferable to the alternative.
The fact that the House will embed, and probably pass, this repeal makes its ultimate survival in conference pretty good, since we know Harry Reid, who testified in its favor, is a supporter. He may not have wanted to introduce something in the blend of the bills that didn’t appear in either of them, but that won’t be the case in the conference committee.
After today’s announcement from Harry Reid, adding a public option to the Senate health care bill, some might think that a great victory has been achieved. And it’s a significant accomplishment to this point. But we’re at the beginning of the end, not the end. And now that this public option, with a state opt-out, represents the lower bound of health care reform, you can bet that the insurance industry will redouble their efforts to kill the bill and retain the status quo. In fact, they’ve already started. Blue Cross/Blue Shield of North Carolina has begun to lobby their customers to work against the bill, asking them to contact Senator Kay Hagan (D-NC). Not a front group, or some ad hoc organization funded by BC/BS. No, just the company itself.
(The mailer) reads:
Public option?
Government Cooperatives?
Community plan?
Single payer?
No matter what you call it, if the federal government intervenes in the private health insurance market, it’s a slippery slope to a single payer system.
Who wants that?
The enclosed postcard to Hagan reads:
Senator Hagan,
Please oppose government-run health insurance. We can meet our health care challenges without the government unfairly competing with the private sector. Tell Senate leaders that North Carolina doesn’t need government-run insurance.
They’ve also deployed lobbyists and shills to Capitol Hill to make completely dubious arguments. At a hearing about the insurance industry’s anti-trust exemption, this amazing exchange occurred:
University of Arkansas business professor Lawrence Powell, who testified on behalf of the medical malpractice insurance industry.
“The best possible outcome from repealing McCarran is continuation of the status quo,” he said. “However, it is also likely that repealing McCarran would have negative consequences for consumers, by decreasing competition and accuracy in insurance pricing.”
Rhode Island Democrat Sheldon Whitehouse pointed out that the professor was relying on outdated information.
“You cite for the proposition that insurance markets are highly competitive an article by Paul Joskow. Do I have the date of that article correct, it’s 1973?” he asked Powell. “I believe so,” came the answer.
And, they’ve started to push their message out to media, getting an AP reporter to buy the canard that poor, henpecked insurance companies just don’t make a lot of money.
WASHINGTON – Quick quiz: What do these enterprises have in common? Farm and construction machinery, Tupperware, the railroads, Hershey sweets, Yum food brands and Yahoo? Answer: They’re all more profitable than the health insurance industry.
The missing ingredient here is scale. Tupperware is more profitable than health insurance on a percentage basis, but 1/6 of the US economy doesn’t go through Tupperware. In real dollars, the insurance industry makes a mint. And remember, “profit” doesn’t count salaries, not even what’s given to CEOs.
The truth is that, even with this public option, insurers will do just fine in the health care bill. They get millions of new customers, with competition that is limited (not everyone can get the public plan, under even the most expansive version). But it’s just not good enough for them. The notion that they might have to offer coverage with actual benefits, and not cherry-pick the healthy to pay their premiums, which would cut into those profits, is just distasteful to them. So they will fight. And we will be ready.
Here’s some amusing video from the group “Billionaires for Wealthcare” as they crashed the AHIP (America’s Health Insurance Plans) conference today. Pollster Bill McInturf initially took their mocking “thank you for all the good work you do” as a compliment, and then the group broke into song, a parody of “Tomorrow” from the musical Annie, with lyrics like “the option, the option, the public wants options, without it it’s a giveaway!”
In other creative anti-insurance company activism, Americans United For Change has released a video highlighting this peculiar tendency from insurers of late to deny babies health coverage because of their weight, whether they be too skinny or too fat. The video features “Patriot Baby,” a talking prodigy, hitting the industry for their tactics.
The White House just released a video first lady Michelle Obama, focusing on health care and gender disparity. She tells a personal story about her daughter and a bout with meningitis, and what that might have looked like if the family didn’t have insurance. She includes a story of medical bankruptcy and a woman denied health insurance for a pre-existing condition. HHS Secretary Kathleen Sebelius also appears in the piece, explaining that insurance companies can charge women substantially more than men, can choose not to cover services women need, and can even deny coverage over things like domestic violence.
This new layer of the health care debate is undeniably compelling. Insurance industry discrimination against women ought to be completely intolerable.
The video premiered on the site iVillage.com. The site is also taking questions for the White House on health reform.
This was known for a while, but Sam Stein nails it down:
A top lobbyist for the major private insurance industry trade group, America’s Health Insurance Plans (AHIP), urged Congressional Republicans to not even consider helping Democrats pass health care reform lest they aid an “enemy who is down.”
Steve Champlin, a lobbyist for the Duberstein Group who represents AHIP, declared that the road to a bipartisan health care reform bill was, essentially, dead. And he urged GOP members to keep it that way.
“There is absolutely no interest, no reason Republicans should ever vote for this thing. They have gone from a party that got killed 11 months ago to a party that is rising today. And they are rising up on the turmoil of health care,” said Champlin. “So when they vote for a health care reform bill, whatever it is, they are giving comfort to the enemy who is down.”
“Long before the Republicans discovered that the House bill was a strategy to kill seniors and all that kind of stuff the plan was already unpopular,” he added, underscoring why Republicans shouldn’t attach themselves to the legislation.
Champlin got $400,000 from AHIP this year, so you can be pretty sure he speaks for them.
This has been a year in the making, as Jason Rosenbaum points out. The insurance industry has always offered a fig leaf of support, while in actuality spending their millions lobbying against anything that wouldn’t set up a profit bonanza for them, using astroturf campaigns, debunked reports, and even scare-seniors ads. All the while, they claimed to oppose things like rescission and denying coverage for pre-existing condition while continuing to employ them for the most frivolous and even offensive reasons. For example, denying children coverage based on their weight:
First, a Colorado baby was turned down for health insurance for being too big. Now, another Colorado child has been turned down for health insurance for being too small.
Just a week after TODAY highlighted the story of 4-month-old Alex Lange, who at 17 pounds was considered obese, the show presented Wednesday the equally curious case of 2-year-old Aislin Bates, who at 22 pounds was turned down for health insurance for not meeting a proposed insurer’s height and weight standards.
Christina Turner feared that she might have been sexually assaulted after two men slipped her a knockout drug. She thought she was taking proper precautions when her doctor prescribed a month’s worth of anti-AIDS medicine.
Only later did she learn that she had made herself all but uninsurable [...]
Turner, 45, who used to be a health insurance underwriter herself, said the insurance companies examined her health records. Even after she explained the assault, the insurers would not sell her a policy because the HIV medication raised too many health questions. They told her they might reconsider in three or more years if she could prove that she was still AIDS-free.
I don’t think advocates of reform should worry too much, though. As Paul Waldman points out in a great piece, this year, the insurance industry has been their own worst enemy.
Rattled by their failed effort to kill health care reform, Karen Ignagni, the head of the health insurance lobby, took to the Washington Post today to claim, no, really, we love reform, trust us!
Let me be clear and direct: Health plans continue to strongly support reform. In fact, last year we proposed new insurance market rules and consumer protections to achieve universal coverage, remove restrictions on preexisting conditions and end the practice of basing premiums on health status or gender. We firmly believe that all the cost concerns the report raised can be resolved.
Practically every option Ignagni brings up to “resolve” those cost concerns, like killing the excise tax on high-end insurance plans, would only exacerbate them by draining the system of resources and eliminating cost controls.
Furthermore, the entire notion that the industry supports health care reform is ludicrous on its face. They are the cause of most of the practices that need reforming. If they supported reform they wouldn’t sustain a system that led to outcomes like this:
Jenny Fritts was 24 years old. Jenny lived with her husband Sean for the past five years, and together they had a little girl named Kylee, 2. Jenny was seven-and-a-half months pregnant with her second child – a beautiful, baby girl.
Jenny is dead. Jenny’s unborn baby is dead. They died because they were turned away for appropriate care at a for-profit hospital because they did not have health insurance. Sean rushed Jenny back to another hospital when her symptoms became even more severe, and he lied about having insurance to get her in the door. She was placed on a respirator in intensive care, but she didn’t make it. She died. And so did her baby.
They become two more of the more than 45,000 Americans who die preventable deaths due to our broken healthcare system every year. Two more. Mother and child.
It’s completely outrageous for someone like Ignagni to even open her mouth about reform. The entire premise should be rejected. The industry has lost their right to speak on the issue.
