Guest post by Jean Ross, RN and Co-President for National Nurses United
The fight in Wisconsin continues to be an ongoing an inspiration to the entire nation. As a registered nurse for 37 years, I have been part of a proud tradition of protest as well. My number one priority, as it is for all nurses, is to advocate for my patients. This is a daily struggle we must wage against corporate insurance and hospitals that care more about the bottom line than patient care. As nurses we fight every day for our patients -- by marching on our administrators, disrupting our halls of government, and protesting in the streets.
Of the many supporters of a single-payer health care system in the United States, some of the most ardent are small business owners who have struggled to continue offering coverage to their workers.
Among them are David Steil, a small business owner and former Republican state legislator in Pennsylvania who earlier this year became president of the advocacy group Health Care 4 All PA.
Another supporter is Vermont Governor Peter Shumlin, who last Thursday signed a bill that sets the stage for the country's first single-payer plan. If all goes as Shumlin and the bill's many backers hope, all 620,000 Vermonters will eventually be enrolled in a state-run plan to replace Blue Cross, CIGNA and other private insurers whose business practices have contributed to the number of Vermonters without coverage -- approximately 60,000 and growing.
The reaction of health insurers to the Obama administration's requirement that they start justifying rate increases of 10 percent or more was quick and predictable: "Not fair!"
The PR and lobbying group America's Health Insurance Plans (AHIP) absolved the industry of any responsibility for constantly rising premiums and pointed the finger of blame at just about everyone else. The real culprits, AHIP president Karen Ignagni insisted, are greedy doctors and hospitals, state legislators who make insurers provide coverage for an overly broad range of illnesses, and, of course, irresponsible American citizens, especially healthy young people who decide not to buy insurance.
I turned 43 a couple of weeks after I joined CIGNA in 1993. One of the birthday gifts from my new colleagues was a framed, three-word quote by E. B. White: "Be obscure clearly."
We laughed and laughed. It was an inside joke -- and a perfect present for an HMO PR guy who more than a few times had to be obscure when responding to media inquiries. Reporters always wanted more information than I dared give them, but I had to give them something. Hence the need to follow White's sage advice.
That quote, by the way, was in Elements of Style, the classic 1959 book on writing that White co-authored with William Strunk, Jr. White was not actually recommending obscure writing. He was just saying that if for some reason you felt you could not tell the whole truth, if there was no choice but to be obscure, at least use the active voice and proper grammar while doing it.
You might not realize it, but this is National Small Business Week. I'm betting many small business owners aren't aware of it, either. Perhaps that's because most small business owners are far more likely to be worrying about whether they'll be able to offer health insurance to their employees for another year.
Or is this the year they join the ever-growing list of small businesses that have been "purged" by their insurance carrier?
For several years now, insurance companies have been "purging" small business accounts they no longer consider profitable enough or that their underwriters believe pose too much risk. I became familiar with"purging" (yes, that's the actual word insurance executives use internally) toward the end of my career as an industry PR man.
Like many others, I've heard President Obama talk about his mother's insurance problems during her final months in 1995. The memory of his mother having to devote precious time and energy pleading with her insurer to pay her mounting medical bills fueled Obama's determination to focus on passing health care reform.
But I didn't realize until reading a new book about the president's mother that the insurer she was pleading with was CIGNA, the one I used to work for. I wish I had known at the time. In my role as PR man for the company, I might have been able to help.
For a non-actress surrounded by movie stars, Debbie Levin, President of the Environmental Media Association (EMA) -- an organization founded by Norman Lear -- is putting on quite a performance of her own. Too bad it's more likely to win her a fraud charge than an Oscar, based on her May 6, 2011 letter to her Board provided to the Food Rights Network by a source inside EMA.
Over the past month, Levin has been confronted with ample evidence that the group she runs exposed school children (not to mention the Hollywood celebrities that serve on the group's board) to toxic sewage sludge. In 2009, EMA began a partnership with several Los Angeles schools, securing the donation of thousands of dollars in compost and soil amendment products from Kellogg Garden Products for the schools' organic gardens soon thereafter. In a sworn affidavit, former L.A. Unified School District garden advisor, Mud Baron, said that he informed Levin early on and repeatedly that Kellogg uses sewage sludge in many of its products, and sewage sludge is illegal for use in organic gardens.
While several states are suing the federal government to block health care reform and dragging their feet on implementing any part of it, Vermont this week will be taking a giant leap in the other direction -- toward universal coverage and greater cost control -- when Governor Peter Shumlin signs legislation putting the state on the path toward a single-payer health care system.
The Vermont House last week voted 94-49 to approve legislation that has been years in the making. The Senate approved the measure a few days earlier. While it will not establish a government-run system right away, work will begin almost immediately to lay the groundwork to create a state health plan -- called Green Mountain Care -- that could be up and running as early as 2014.
A recent study of tobacco industry documents reveals that cigarette makers added appetite-suppressing substances to cigarettes and strategized on how to enhance the appetite-suppressing and weight-reducing effects of smoking. In the 1960s, Philip Morris (PM) added tartaric acid to its cigarettes to reduce smokers' appetite. British American Tobacco (BAT) added the same substance to its cigarettes. Another known tobacco additive with appetite-reducing characteristics, 2-acetylepyridine, was referred to in industry documents using code-names and was used as a cigarette ingredient by PM, Brown & Williamson, R.J. Reynolds and BAT. The companies also considered adding ephedrine and amphetamine to cigarettes, but these chemicals were not found in their ingredients lists. Cigarette makers strategized that they could get away with adding appetite-suppressing chemicals to cigarettes as long as they made no overt health claims about their effects to the public. In a 1969 memo, Helmut Wakeham, PM's scientific director, in response to a question about introducing specific substances into cigarettes, explained that "FDA [has] no requirements until a health claim is made. Then there must be studies on safety, efficacy, mechanism of action, metabolism, etc. If a substance is simply added to a product and no claims are made there is not need for FDA approval.
One of the reasons I wanted to return to journalism after a long career as an insurance company PR man was to keep an eye on the implementation of the new health reform law. Many journalists who covered the reform debate have moved on, and some consider the writing of regulations to implement the legislation boring and of little interest to the public.
But insurance company lobbyists know the media are not paying much attention. And so they are able to influence what the regulations actually look like -- and how the law will be enforced -- with little scrutiny, much less awareness.