Health Care Talking Points

Here are highlights from two new reports - one underscoring high costs of health care, the other demonstrating doctors' support for public option - as well as background information on Medicare Advantage.

Talking Points: New Reports Underscore Need for President’s Health Insurance Reform Plan

  • Two new reports – one from the Kaiser Family Foundation and the Health Research and Educational Trust, and another from the New England Journal of Medicine – indicate that the experts agree: the status quo is unsustainable and it’s time for the kind of health insurance reform President Obama has proposed.

Health Insurance Premiums Continue to Skyrocket

  • American families and businesses are being crushed by the high cost of health care. Anew report from the Kaiser Family Foundation and Health Research and Educational Trust found that premiums for employer-sponsored health insurance are still rising.
  • Highlights from the Foundation’s Employer Health Benefits survey:
    • The average cost of a family policy in 2009 increased to $13,375: on average, employees pay $3,515 and employers pay $9,860.
    • In the past 10 years, health insurance premiums have increased by 131 percent, rising much faster than wages or inflation, which have risen 38 percent and 28 percent respectively.
  • The report also underscores what effect high costs and the recession have had on the insurance employers are able to offer their workers. More than a fifth (21 percent) of firms reported that they had either reduced benefits or increased cost sharing, while 15 percent reported charging their employees more for insurance.
  • More workers are also paying for insurance at work and being asked to pay again at the doctor’s office. 22 percent of insured workers contribute to their health care premiums and pay a minimum of $1,000 for health care out of their own pocket.
  • You can read the full report by visiting
  • President Obama’s health insurance reform will bring down the cost of health care for all Americans. His plan includes the best ideas from Democrats and Republicans.
  • President Obama’s health insurance reform plan addresses three simple goals: If you have health insurance, it will give you more security and stability. If you don’t have insurance it will give you quality, affordable options. And it will lower the cost of health care for our families, our businesses, and our government.
  • The President’s plan will cut costs by:
    • Cutting waste and fraud in the system.
    • Tackling the insurance bureaucracy by streamlining the payment system to save time and money that is currently processing claims and navigating the Byzantine insurance system.
    • Computerizing medical records that will reduce medical errors and make sure your doctor knows know what medicines and treatments other medical professionals have prescribed for you.
    • Changing the way we manage hospitalizations, to prevent mistakes and unnecessary readmissions.
    • Prioritizing primary care by changing the payment scale for primary care providers and building up the workforce.
    • Prioritizing prevention and rewarding care that focuses on treating the whole patient, rather than each episode of sickness.

Doctors Favor the Public Option

  • A new study published in the New England Journal of Medicine found that 60+% of doctors agree with President Obama that health insurance reform should include a public option which would operate alongside private plans, bringing more choice and competition to the insurance market.
    • Fewer than 3 in 10 doctors believe reform should not include any type of public health insurance option. (Background Note: the remaining 10% of doctors surveyed favor an entirely public system.)
  • Despite the claims by defenders of the status quo, the public option is not a “government takeover” of health care. President Obama has no interest in putting private insurers out of business.
    • The public option would be an option for Americans who don’t have insurance. Nobody would be forced to choose it and it would not affect those who already have insurance.
    • The public option would not be subsidized by taxpayers -- it would stand on the premiums it collects.
  • By avoiding some of the overhead that is currently sucked up by profits, excessive administrative costs and executive salaries, a public option could provide consumers a good deal and keep pressure on private insurances to offer affordable policies and treat their customers better.
  • A strong majority of Americans also favor the type of public option President Obama has proposed.

AHIP Report on Medicare Advantage

  • It is disappointing but not surprising that AHIP would defend private insurance companies whose profits are dependent on the hard-earned money of taxpayers.
  • President Obama is committed to making sure that that the Medicare trust fund goes toward improving the quality of care patients receive, rather than going to support the operations of private insurance companies.
  • By eliminating unwarranted subsidies to private Medicare plans – which cost 14% more on average than traditional Medicare - we will be able to reduce waste and extend the solvency of the Medicare Trust Fund.

The Facts on Medicare Advantage

  • Medicare Advantage allows beneficiaries to receive services via private plans. Private plans that participate in Medicare Advantage receive significant taxpayer subsidies from the federal government.
  • Unfortunately, Medicare overpays private plans by an average of 14 percent. Overpayments are as high as 20 percent in certain parts of the country.
  • All taxpayers – whether you are enrolled in a Medicare Advantage plan or not – pay for this program. In 2010, Medicare Advantage subsidies will add $3.60 per month to premiums for all Medicare beneficiaries. What does that mean? An older couple in traditional Medicare will pay almost $90 next year to subsidize private insurance companies who don’t actually provide their health benefits.
  • There is no evidence that this extra payment leads to better quality for Medicare beneficiaries. We aren’t getting what we pay for.
  • Medicare Advantage programs give insurance companies all the advantages while taxpayers get stuck with the bill.
  • President Obama’s health insurance reform plan will help to eliminate these over payments, which could save the Federal government, taxpayers, and Medicare beneficiaries more than $100 billion over the next 10 years

    The Cost of Inaction

    • As the debate continues over what the final version of health insurance reform will look like, it is critical to remember one thing: inaction is not an option. The cost of doing nothing is too high.
    • The Robert Wood Johnson foundation released a new report underscoring that cost.
    • The report found: “if federal reform efforts fail, over the next decade in every state, the number of uninsured will increase, employer-sponsored coverage will continue to erode, spending on public programs will balloon and individual and family out-of-pocket costs could increase by more than 35 percent.”
    • Even under the best case scenario, the Foundation’s analysis predicts an incredible economic strain on individuals and businesses in every state and the District of Columbia if reform is not enacted.
    • Under the worst case scenario, the results would be devastating. If we fail to enact reform:
      • In 29 states, the number of uninsured would increase by more than 30 percent.
      • The number of people without insurance could increase by at least 10 percent in every state. The number of uninsured Americans would reach 65.7 million.
      • The cost to individuals and families would increase significantly over the next 10 years - from $326.4 billion this year to $548.4 billion in 2019.
      • Out-of-pocket costs for families and individuals would increase by 35 percent in every state.
      • Rising costs would also continue to hurt businesses – their premiums would continue to increase, more than doubling in 27 states.
      • In the very best case, employers would see premium costs increase by more than 60 percent in nearly every state.
      • Employer-based coverage would continue to erode in every state. In half the country, employer-based coverage would fall by more than 10 percent.