Uniquely American Solution - What is it ? Why is it being pushed?

[slipslidingaway]

Is the goal of the "uniquely American solution" to keep the private health care companies in business and protect their profits? It is not just the Democrats that are using the phrase, Karen Ignagni of AHIP wrote an article in April.


Some talking points from the Herndon Alliance and published on the Third Way site...

http://www.thirdway.org/data/product/file/235/Talking_Points_-_Responding_to_Attacks.pdf

2. Tap into key values the public places on reform:

» Stability and peace of mind
» The middle class
» Choice and control
» Quality
» Continuity—keeping your current plan and doctor
» Value—paying less and getting more
» Affordability
» Patriotism—“uniquely American solution”


http://www.thirdway.org/data/product/file/234/Messaging_Health_Reform.pdf

Phrases That Don’t Work

• Politically polarizing language such as talking about the Republicans’ failure to
address the health care crisis or using phrases like “unregulated greed” to
describe insurance companies (references to “excessive profits” are better).

• Don’t say “universal” health care. Talk about “quality, affordable health care for
all.” (But remember—quality, affordable health care for all is largely a message
about access.)

• Don’t compare the U.S. to other countries, or assert that America does not
provide quality health care. (i.e. Do not cite statistics that say the U.S. is 37th in
the world in health outcomes).


Uniquely American Solution: Collaboration, Leadership Required to Bring Change

Commentary on The Commonwealth Fund/Modern Healthcare Health Care Opinion Leaders Survey on Priorities for the Obama Administration by Karen Ignagni, CEO of America's Health Insurance Plans

April 27, 2009

Author(s): Karen Ignagni

http://www.commonwealthfund.org/Content/Publications/Commentaries/2009/Apr/Uniquely-American-Solution.aspx

"Significant consensus has emerged that health care reform, which has eluded our nation for almost a century, should be enacted this year, and that bold changes are necessary to ensure high-quality, affordable health care for all Americans...

In moving to pass legislation this year, Congress can create a uniquely American solution by encouraging and expecting uniquely American stakeholder responsibility."


Americans Support Single payer. Why Doesn't Celinda Lake?

http://www.pnhp.org/news/2008/december/americans_support_si.php

"...Similar strong support for Medicare for All was found the last time health reform was on the top of the nation’s agenda, during the Clinton administration. In 1993, a citizen jury sat for 8 hours a day for five days in Washington, DC before making their choice among the then-leading options for health reform: managed competition (supported by Clinton), medical savings accounts, and single payer. Single payer received 17 out of 24 votes (70 percent). There were 5 votes for Clinton’s plan, and none for medical savings accounts. Focus groups conducted that year by Democratic pollster Celinda Lake reported the same strong support for single payer. “After conducting extensive focus groups on health care, pollster Celinda Lake discovered that the more people are told about the Canadian system, “the higher the support goes.” In contrast, according to Lake, working Americans found the managed competition idea “laughable.” (“It’s Time for a Real Debate on National Health Insurance”)

So, how come Democratic pollster Celinda Lake now claims Americans won’t support single payer, and instead favor a plan that is a variant of managed competition? Because her latest research was brazenly biased. Kip Sullivan explains how and why..."



What Journalists Can Learn from Celinda Lake

http://www.cjr.org/campaign_desk/what_journalists_can_learn_fro_1.php

"First there was Frank Luntz. Now, Celinda Lake is trying to do for the Dems what Luntz did for the GOP. Lake, a longtime Democratic strategist, has been hard at work crafting the right words and phrases to persuade the public that Dems really do have their best health care interests in mind. For months, politicians, advocates, and especially the president have talked about “affordable, quality” health care—a Lake-fashioned phrase that has caught on big time. Reporters have repeated these words without providing any context about what they mean—that is, if they mean anything...


In early June, a memo circulated from the Herndon Alliance and Lake Research Partners telling advocacy groups and other interested parties precisely what words they should use to counter Republican messages as health reform’s verbal war begins. The Herndon Alliance, which calls itself a non-partisan coalition, has partnered with some 200 organizations, including former single-payer advocates, think tanks, foundations, advocacy groups, businesses, and health care providers. The Alliance claims to “provide value-added services to partner organizations”—i.e., helping them develop communications strategies. Lake has worked closely with the Alliance in crafting messages its partners can use. She has counseled the Alliance’s partners against using the term “universal coverage.” Maybe that’s why it’s not talked about much anymore. Similarly, she tells activists never to say “Medicare for all.” Instead, they should say “choice of public and private plans.”

...Lake says that frame is “so effective” because it taps into the public’s key expectations for health reform, such as the choice of keeping your current plan and doctor—the president uses that one; affordability (paying less and getting more)—lots of groups are using that one; and finding a uniquely American solution—insurance companies and Sen. Max Baucus have used that one. But wait a minute. Didn’t the phrase “uniquely American solution” surface with Bill Clinton? In the early 1990s, as Clinton began to craft his plan based on managed competition, he framed it as his “uniquely American plan.” How many uniquely American plans can there be? ..."


Reply to critics of “Bait and switch: How the ‘public option’ was sold”

http://pnhp.org/blog/2009/08/08/reply-to-critics-of-%e2%80%9cbait-and-switch-how-the-%e2%80%98public-option%e2%80%99-was-sold%e2%80%9d/

The Herndon Alliance was founded in 2005 by many of the same groups that would create HCAN in 2008. The Herndon Alliance paved the way for HCAN’s promotion of the “public option” with some laughable “research” claiming to find that Americans want a “public-private-plan choice” approach and don’t want a single-payer system. I have written elsewhere about the bogus “research” conducted by the Herndon Alliance. Suffice it to say here the Herndon Alliance cooked up a new and more insidious version of the “political feasibility” argument.

Until about 2007, when the Herndon Alliance first began publishing its “research,” there was only one variant of the “political feasibility” argument, the one that said the insurance industry is too powerful to beat. The Herndon Alliance variant claimed single-payer is not feasible because Americans don’t want it. According to this variant, American “values,” not the insurance industry, are actually the greatest impediment to single-payer. According to the Herndon Alliance, Americans “value choice of insurance company” and “they like the insurance they have and want to keep it.” HCAN and Hacker picked up these refrains and promoted them vigorously to the public and to members of Congress. This inexcusable attack on single-payer no doubt helped key committee chairs in Congress (Kennedy, Baucus, Waxman, Rangel and Miller) feel more comfortable taking single-payer off the table and concentrating on the “public option.”

By early 2009, it was clear the Hacker-HCAN-Herndon Alliance propaganda for the “public option” and against single-payer had worked with the Democratic leadership, and that the Democratic leadership would fall once again for a market-based alternative and remove single-payer from the table. The removal of single-payer legislation took place without the firing of a single shot in public by the insurance industry and the right wing. It took place at the request of the “yes but” wing..."

[slipslidingaway]

1. The Doctors' Revolt

http://www.prospect.org/cs/articles?article=the_doctors_revolt

July 1, 2008

"Doctors have historically been the watchdogs of the U.S. medical system, with the American Medical Association scaring New Dealers into dropping national health coverage from the Social Security Act and then the AMA shredding Harry Truman's reform efforts in the late 1940s. But a new poll and other significant indicators suggest that doctors are turning against the health-insurance firms that increasingly dominate American health care.

The latest sign is a poll published recently in the Annals of Internal Medicine showing that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers. Most industrial societies -- including nations as diverse as Taiwan, France, and Canada -- have adopted universal health systems that provide health care to all citizens and permit them free choice of their doctors and hospitals. These plans are typically funded by a mix of general tax revenues and payroll taxes, and essential health-care is administered by nonprofit government agencies rather than private insurers.

The new poll, conducted by Indiana University's Center for Health Policy and Professionalism Research, shows a sharp 10 percent spike in the number of doctors supporting national insurance: 59 percent in 2007 compared to 49 percent five years earlier. This indicates that more physicians are eager for systematic changes, said Toledo physician Dr. Johnathon Ross, past president of Physicians for a National Health Program.

"What this means is the usual bloc of anti-reform is breaking up," he told The Toledo Blade. "These doctors are looking in the eyes of sick patients every day." ...


Poll...

http://www.pnhp.org/docsurvey/annals_physician_support.pdf

[slipslidingaway]

2. Thanks for the recs! n/t

[slipslidingaway]

3. kick nt

[slipslidingaway]

4. Uniquely American solution is a new code phrase...

http://www.cjr.org/campaign_desk/one_step_forward_one_step_back.php

"...It turns out that Obama’s plan for universal access seems similar to principles advocated by Health Care for America Now (HCAN), a coalition that includes the AFSCME and SEIU unions, Moveon.org, Planned Parenthood, and the National Women’s Law Center. In its statement of common purpose, HCAN says that it stands for a truly inclusive system that gives people a choice of buying a policy from a private insurance company, keeping what they have now (usually also from a private insurance company), or buying from a public plan that guarantees affordable coverage without a private insurer middleman. Does that mean it won’t be like the federal employees program? The devil, remember, is always in the details.

HCAN’s ad sends a bit of a mixed message. Even though the group does not oppose private insurance policies, the ad also offers this rhetoric: “Will health insurance companies ever put your health before their profits? We can’t trust insurance companies to fix the health care mess.”

If that’s not puzzling enough, some of the same language found in coverage of the HCAN campaign is identical to the language used by America’s Health Insurance Plans (AHIP), the industry’s trade association. In an ABC News story this week, HCAN’s campaign director Richard Kirsch said: “We are looking for a uniquely American solution.” When the campaign was announced this week in Maine, Alison Vander Zanden, of the Maine People’s Alliance, said: “We’re looking for a uniquely American solution to the health care crisis that is truly affordable, that provides quality care, that controls costs and that is available to all.”

Gosh, that’s the same thing that AHIP said in a press release issued after the ad campaign launched. AHIP president Karen Ignani said that her group intended to make a significant contribution to the debate over blending public and private strategies “to achieve a uniquely American solution that can work and be enacted.” Those words—uniquely American solution— have shown up before. This spring, in an interview with Lee Newspapers, Montana Sen. Max Baucus, chair of the Senate Finance Committee (though which health care legislation must pass), said: “We will have insurance companies in America. We’ll have uniquely American solutions….” Uniquely American solution is a new code phrase, intended to prod the public into approving this vague and unspecified “solution” without really understanding what the words really mean..."

[slipslidingaway]

5. “American Values” — A Smoke Screen in the Debate on Health Care Reform

http://healthcarereform.nejm.org/?p=1245

"Amid all the rhetoric about health care reform, one claim has emerged as a trump card designed to preserve the current patchwork of private and public insurance and to stop discussion of a government-sponsored single-payer system in its tracks: the claim that single-payer health care — a Canadian-style Medicare-for-all system — is antithetical to “American values.” The idea that American values dictate a particular approach to health care reform is often stated explicitly, and it is implicit in the generalization that “Americans want” a particular system. The underlying premise is that an identifiable set of American values point incontrovertibly to a health care system anchored by the private insurance industry. Remarkably, this premise has received very little scrutiny.

Two related assumptions are buried in the language of “American values.” The first is that there are archetypical Americans — that if we know someone fits the category “American,” it should be possible to predict his or her general worldview accurately. However, we have good reason to doubt that assumption. In nearly all respects — ethnically, culturally, religiously, politically, and socioeconomically — Americans are increasingly diverse. The recent presidential campaign provides evidence that a monolithic conception of what it means to be “American” is problematic and outdated: those who championed the idea of “real” Americans (as distinct from Americans who are somehow less representative of American ideals) were precisely those whose candidate lost the election.


Suppose that “freedom to choose” is indeed the paramount American value relevant to health care. For many people, it would surely imply choice of physician, hospital, or clinic. For such choice, a single-payer system beats the competition hands down. Incremental reforms preserving the private insurance industry and employer-based insurance would probably perpetuate the restricted choice of health care providers that many Americans already encounter: private plans typically limit access to certain physicians or hospitals, and physicians often refuse to accept certain plans. In contrast, single-payer proposals eliminate those restrictions.

...In their book Benchmarks of Fairness for Health Care Reform, Norman Daniels and colleagues reject these “ungenerous” views of our values, arguing that past failures to reform health care are better explained by the influence of interest groups whose wealth and power are threatened by reform.5 The authors propose that fair equality of opportunity is a more promising and relevant American value. Opinion polls support this proposal: in multiple surveys of randomly selected Americans during the past decade, more than 60% of respondents have favored government-guaranteed health care for all. Although these responses don’t necessarily specify a single-payer system as the only model for government-guaranteed insurance, they surely do not exclude it.

Policymakers debating health care reform should stop hiding behind the smoke screen of “American values.” Discussions dominated by references to uniquely American individualism, uniquely American solutions, or narrowly defined conceptions of choice tell us more about the political and economic interests of the discussants than about the interests of the Americans they claim to represent. In an increasingly diverse country that has a widening gap between rich and poor, a more promising approach is to start with the questions that matter to everyone: Will the system care for us when we’re sick and help prevent illness when we’re well? Will we have access to medical care throughout our lives without risking financial ruin? Will we be able to navigate the system easily, without jumping through unnecessary hoops or encountering excessive red tape? Will health care spending be managed wisely? Health care reformers owe Americans a system that best addresses these questions — not one that merely pays lip service to ill-defined “American values.”

[slipslidingaway]

6. 2006 AHIP Proposal...

http://www.ahipresearch.org/PDFs/vision_of_reform.pdf

"...We envision and advocate enactment of federal legislation aimed at achieving
HEALTH INSURANCE COVERAGE FOR ALL AMERICANS
by providing financial incentives to states to meet this goal, with an emphasis on
providing coverage for all children first and covering adults in stages.


...We believe that the nation needs to develop a plan to achieve
health insurance coverage for all Americans in stages. We
propose a federal framework to reward states that make rapid
progress in advancing health insurance coverage for children
first and then adults in a fiscally responsible way. Our approach
is intended to foster an efficient and effective allocation of
public and private resources and encourage individuals to work
with their health care professionals to take responsibility for
maintaining their health.

We believe that these goals can best be met by drawing upon
the innovation of the private health care system partnering
with the public sector. Moreover, we believe that federal and
state resources can be combined to create incentives to build
upon the employer-based insurance system and encourage
individuals to purchase coverage. However, to achieve a
sustainable system and minimize cost-shifting, federal and
state policymakers must ensure that reimbursement mechanisms
are adequate and that the nation prioritizes prevention,
which will improve health outcomes.

Our proposal to expand access to health insurance coverage is
built upon five principles that are designed to clearly delineate
the responsibilities of the private and public sectors, avoiding
duplication, providing a framework for complementary
strategies, and maximizing the effectiveness of a system-wide
effort to improve quality and reduce costs..."

[earth mom]

7. The "Uniquely American Solution" is nothing more than about protecting the Status Quo aka

the insurance companies and pharma giants.

FUCK THEM!

:puke:

[slipslidingaway]

9. Yes and thanks for the reply....

but you did interrupt my conversation with myself.

:yourock:

[earth mom]

14. Thanks...but...

:blush:

But actually you are the one who ROCKS because you went to a lot of trouble to post this thread-it needed to be said!

:yourock:

[slipslidingaway]

17. Maybe we'll have a little more information on how this plan came

about...thanks.

:)

[slipslidingaway]

8. Health Reform and Obama’s Consumer Protections

http://www.cjr.org/campaign_desk/obamas_consumer_protections.php

"...To help journalists and the public understand all this, I contacted Mila Kofman, the insurance superintendent for the state of Maine, who knows insurance regulation as well as anyone. A few takeaways: while some of Obama’s eight protections may be a real benefit to policyholders, others already exist, and reporters need to keep a careful eye on what happens to all of them as Congress and the special interests start fiddling with legislative language. Herewith is my consumer protection primer:

No discrimination for preexisting conditions. That’s a good thing, and insurers have agreed to eliminate health status as a factor for granting coverage in the individual market if every American is required to carry insurance one way or another. Right now, a few states restrict preexisting conditions clauses; the Health Insurance Portability and Accountability Act (HIPAA), passed in 1996, gives people the right to buy a policy in the individual market without regard to health problems if they do so within sixty-three days of losing coverage and if they have used up all their COBRA benefits. HIPAA, though, didn’t say anything about premiums, and so insurers in most states charge higher rates to discourage people with preexisting medical needs from signing up.

What to watch for: Lobbyists inserting language that limits insurers’ risks, like the restrictions in the HIPAA law that still make it difficult for sick people to obtain coverage. President Obama has been silent on the question of age rating, which serves as a proxy for using health as a factor in charging higher rates. Older people are likely to present more health risks and cost the insurers money. “As long as they can rate people up for age, that’s a proxy for health rating,” Kofman says..."



What Insurers Are Trying to Get Out of Health Reform - Over 50 Age Ratings

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=6267263&mesg_id=6267263

Affordable Premiums

Health insurers will no longer be able to deny coverage to people based on pre-existing conditions or to charge them more based on health care conditions, health care usage, or gender. These system reforms will allow more Americans to purchase the health insurance they need.

Insurance companies will, however, be allowed to charge higher premiums based on age (age rating). Unfortunately, age rating may be a proxy for pricing insurance premiums based on health status, especially on chronic conditions. The House of Representatives Tri-Committee draft bill allows insurance companies to charge older people twice as much as younger people. The Senate Finance Committee is contemplating letting insurance companies charge up to five times as much based on age. In other words, under the Senate proposal, the health plan that costs someone in his/her twenties $100/month or $1,200/year could cost someone in his/her fifties/sixties $500/month or $6,000/year..."

[robinlynne]

10. I'm going to throw up.

[slipslidingaway]

11. Does that mean I should stop posting or that the marketing of the

public option plan is making you sick?

[robinlynne]

29. It's a great post. The content is sickening.

[slipslidingaway]

30. You never know at DU, thanks :) n/t

[stranger81]

12. Didn't realize this was an official talking point, but someone parroted it to me yesterday.

My response was that we already have a "uniquely American system" amongst industrialized nations, anyway -- one that hands health care over in its entirety to private industry and lets millions of citizens die every year from lack of access to care. That "uniquely American system" is a massive failure. It's clearly time for something else.

[slipslidingaway]

15. Excellent reply - why build on a bad foundation, we've been doing

that for decades.

[nadinbrzezinski]

13. I jsut finished readhing a good part of the bill

and you know what I am reminded off... not Canada, but Mexico

That hybrid system is a mess... and I fear this hybrid system will be a mess too.

Tomorrow I will be calling my congress critter and my senators and give them a piece of my mind...

[slipslidingaway]

16. Thanks n/t

[Turborama]

18. K&R Thanks for all the material. n/t

[slipslidingaway]

23. You're welcome and thank you, link is in the OP but a bit buried...

http://www.pnhp.org/news/2008/december/americans_support_si.php

An analysis of Celinda Lake’s slide show, “How to talk to voters about health care”
By Kip Sullivan
November 29, 2008

"Summary of Lake’s conclusions

Did you know that the most effective way to promote universal health insurance is not to say “universal health insurance”? Did you know that when you feel the urge to say “universal health insurance” or “universal coverage,” you should check yourself and instead say, “quality, affordable health care”? That is just one of numerous controversial recommendations made by Celinda Lake, a pollster who now tours the country with a slide show entitled, “How to talk to voters about health care.”

You might think this advice comes from Sen. John McCain or other conservatives who don’t support universal health insurance..."

[nightrain]

19. knr Thanks. Saved for later...

[slipslidingaway]

24. thanks for the knr nt

[dorkulon]

20. Uniquely corrupt and ineffective. nt

[slipslidingaway]

25. A more acurate description n/t

[eridani]

21. Single payer proposals ARE uniquely American

State or national, they propose separate trust funds for health care, as opposed to competing with other budget priorities at budget time, as is the case for Canada (single payer) and Britain (socialized medicine). Also, you can add all the extra bells and whistles you want that are not covered in the comprehensive package on your own dime or with private insurance.

[slipslidingaway]

26. Thanks :) n/t

[Echo In Light]

22. K&R And the answer to the 1st question: yes, it's to ensure corporate profit$

[slipslidingaway]

27. Yes, what else could it be...if americans want choice then let us

pick the doctors instead of the insurance companies.

Also...divide and conquer.

[Orsino]

28. Among insdustrialized nations, our religious devotion to corporate profits seems to be unique.

We will proudly refuse to adopt universal/single-payer health care, because we're all mavericky and American, and stuff. Also.

[slipslidingaway]

31. Amazing that we do not want to interfere with companies who make

money denying claims.

:(

[ipaint]

32. Thanks for gathering all this info in one place

I'll be doing some reading tonight. :hi:

[slipslidingaway]

33. You're welcome and thank you, I'm sure there must be more

others can add, but it did help cement my belief that this was a coordinated effort to marginalize SP and force this public option idea on people... the power of marketing.

:hi:

[slipslidingaway]

34. Saturday kick ....

polls have consistently showed support for a national insurance system that will cover everyone, 59% of doctors support a national system.

Our politicians say we cannot discuss the idea, we need to build on a flawed foundation.

:(

[slipslidingaway]

35. delete - dup nt

[SoCalDem]

36. Uniquely American *translation

Costs 10 times more than necessary
Marginally effective
Difficult to get
Duplicitous/incomprehensible rules

[slipslidingaway]

37. Nice translation :) n/t