Thursday, January 31, 2013

Big Pharma Buys Off The Senate

An eleventh-hour loophole in the “fiscal cliff” deal confirms our worst suspicions about how Congress operates.

The inauguration of a president is one of those spectacles of democracy that can make us remember we�re part of something big and enduring. So for a few hours this past Monday, the pomp and circumstance inspired us to think that government of, by, and for the people really is just that, despite the predatory threats that stalk it.

But the mood didn�t last. Every now and then, as the cameras panned upward, the Capitol dome towering over the ceremony was a reminder of something the good feeling of the moment couldn�t erase. It�s the journalist�s curse to have a good time spoiled by the reality beyond the pageantry. Just a couple of days before the inaugural festivities, The New York Times published some superb investigative reporting by the team of Eric Lipton and Kevin Sack, and their revelations were hard to forget, even at a time of celebration.

The story told us of a pharmaceutical giant called Amgen and three senators so close to it they might be entries on its balance sheet: Republican Minority Leader Mitch McConnell, Democratic Senator Max Baucus, chair of the Senate Finance Committee, and that powerful committee�s ranking Republican, Orrin Hatch. A trio of perpetrators who treat the United States treasury as if it were a cash-and-carry annex of corporate America.

The Times story described how Amgen got a huge hidden gift from unnamed members of Congress and their staffers. They slipped an eleventh-hour loophole into the New Year�s Eve deal that kept the government from going over the fiscal cliff. When the sun rose in the morning, there it was, a richly embroidered loophole for Amgen that will cost taxpayers a cool half a billion dollars.

Amgen is the world�s largest biotechnology firm, a drug maker that sells a variety of medications. The little clause they secretly sneaked into the fiscal cliff bill gives the company two more years of relief from Medicare cost controls for certain drugs used by patients who are on kidney dialysis, including a pill called Sensipar, manufactured by Amgen.

The provision didn�t mention Amgen by name, but according to reporters Lipton and Sack, the news that it had been tucked into the fiscal cliff deal �was so welcome that the company�s chief executive quickly relayed it to investment analysts.� Tipping them off, it would seem, to a jackpot in the making.

Amgen has 74 lobbyists on its team in Washington and lobbied hard for that loophole, currying favor with friends at the White House and on Capitol Hill. The Times reporters traced its �deep financial and political ties� to Baucus, McConnell and Hatch, �who hold heavy sway over Medicare payment policy.�

All three have received hefty campaign donations from the company whose bottom line mysteriously just got padded at taxpayer expense. Since 2007, Amgen employees and its political action committee have contributed nearly $68,000 to Senator Baucus, $73,000 to Senator McConnell�s campaigns, and $59,000 to Senator Hatch.

And lo and behold, among those 74 Amgen lobbyists are the former chief of staff to Senator Baucus and the former chief of staff to Senator McConnell. You get the picture: Two guys nurtured at public expense, paid as public servants, disappear through the gold-plated revolving door of Congress and presto, return as money changers in the temple of crony capitalism.

Inside to welcome them is a current top aide to Senator Hatch, one who helped weave this lucrative loophole. He used to work as a health policy analyst for � you guessed it � Amgen.

So the trail winds deeper into the sordid swamp beneath that great Capitol dome, a sinkhole where shame has all but disappeared. As reporters Lipton and Sack remind us, just weeks before this backroom betrayal of the public interest by elected officials and the mercenaries they have mentored, Amgen pleaded guilty to fraud. Look it up: fraud means trickery, cheating and duplicity. Amgen agreed to pay $762 million in criminal and civil penalties; the company had been caught illegally marketing another one of its drugs.

The fact that their puppet master had been the subject of fines and a massive federal investigation mattered not to its servile pawns in the Senate, where pomp and circumstance are but masks for the brute power of money.

Peter Welch, Vermont�s Democratic congressman, has just introduced bipartisan legislation to repeal the half billion�dollar giveaway to Amgen. Its co-sponsors include Republican Richard Hanna of New York and Democrats Jim Cooper of Tennessee and Bruce Braley of Iowa.

The Amgen deal �confirms the American public�s worst suspicions of how Congress operates,� Representative Welch told us this week. �As the nation�s economy teetered on the edge of a Congressional-created fiscal cliff, lobbyists for a private, for-profit company seized an opportunity to feed at the public trough. It�s no wonder cockroaches and root canals are more popular than Congress.�

In his inaugural address, Barack Obama said the commitments we make to each other through Medicare, Medicaid and Social Security don�t make us a nation of takers. But the actions of Amgen and its cronies under the dome on Capitol Hill show who the real takers are � not those who look to government for support in old age and hard times but the ones at the top whose avarice and lust for profit compel them to take as much as they can from that government at the expense of everyone else.

Wednesday, January 30, 2013

Hey, Kid, You Could Be A 'Disaster Hero'

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Sunday, January 27, 2013

Barring Insurance Discrimination Based on Pre-Existing Health Conditions

Too often, I�ve heard from people worried that they couldn�t leave a job because they had diabetes or breast cancer and they wouldn�t be able to get health insurance on their own because of their pre-existing condition.

Thanks to the health care law, those fears will soon be a thing of the past. As part of the Affordable Care Act, HHS today proposed a rule that would prohibit some of the worst insurance industry practices that have kept affordable health coverage out of reach for millions of Americans.

Under this new rule, starting in 2014, families and individuals would see new protections from egregious insurance company practices, including higher premiums or the denial of health coverage because of a pre-existing condition.

No longer would women like Myrna Rodriguez Previte, a breast cancer survivor, have to struggle to find health coverage because insurance companies refused to cover her because she had cancer previously.

No longer would young adults like Abby Schanfield, who has a rare genetic parasitic disease that has required multiple surgeries, and Steven Giallourakis, a two-time cancer survivor with chronic health conditions, have to worry about being refused coverage or charged more because of their medical history.

The proposed rule that HHS is issuing today would guarantee that being sick will not keep you, your family, or your employees from getting affordable health coverage.

This rule builds off earlier successes of the Affordable Care Act, which prohibited health plans from denying children health coverage because they had a pre-existing condition.

To learn more about how this proposed rule would create a better health insurance market for consumers, please see this page.

The Obama Administration today also issued the following:

A proposed rule outlining policies and standards for coverage of �essential health benefits,� while giving states flexibility to implement the Affordable Care Act. Essential health benefits are a core set of critical benefits that would give consumers a consistent way to compare health plans in the individual and small group markets. For more information regarding this rule, visit this page.A proposed rule implementing and expanding employment-based wellness programs to promote health and help control health care spending, while also ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status. For more information regarding this rule, visit this page.

Saturday, January 26, 2013

Pennsylvania Cuts Medicaid Coverage For Dental Care

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Jill-Care: Pre-Existing Condition Insurance Plan Keeps Her Running

Jill from North Carolina is a writer and a tutor, but she�s also a runner. A few years ago, she was even training for the Olympic trials in the marathon. But one day, she suddenly passed out in a parking lot. She was diagnosed with a heart condition, atrioventricular nodal reentrant tachycardia (AVNRT).

The good news was that the condition could be remedied with a surgical procedure.

The bad news was that Jill could not afford the surgery.

For years following her diagnosis, she lived within reach of a cell phone just in case she had to call 911. Her condition worsened. �I did stop running; I stopped exercising completely because any kind of exertion would trigger an episode. So I went from running marathons competitively to doing nothing,� Jill says.

She applied for insurance that might cover her surgery, but was turned down due to her pre-existing condition. Her appeal was denied.

There didn�t seem to be a place in the health care system for her situation.

In 2011, Jill heard about the Pre-Existing Condition Insurance Plan (PCIP). PCIP is a program created by the health care law. It is designed to provide affordable health coverage for people who were otherwise locked out of the private system. It also serves as a bridge to 2014, when insurance companies are prohibited from refusing to sell coverage based on someone�s pre-existing condition.�

Jill applied for PCIP. �It took about about 10 minutes to fill out the online application. I received a [approval] letter two weeks later,� Jill says. �In another two weeks, she had her surgery. It�s been over a year since her surgery and Jill hasn�t had another episode. She�s running every single day again.

�The Affordable Care Act---and PCIP program in particular--allows me to pursue what I love to do and have medical coverage and have the comfort of having that medical coverage,� Jill says. �So I don�t have to worry if I have an injury, or an illness, or an accident, that I�m going to go bankrupt; I�m going to lose everything.�

Jill-Care in Action: Coverage for Pre-Existing ConditionsVisit PCIP.gov to learn more about this programSee Myrna's story about trying to find insurance with a pre-existing conditionSee all MyCare stories ?

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Comments   You must be logged in to leave a comment. Login / Register

Please keep your community civil. All comments must follow the NPR.org Community rules and terms of use, and will be moderated prior to posting. NPR reserves the right to use the comments we receive, in whole or in part, and to use the commenter's name and location, in any medium. See also the Terms of Use, Privacy Policy and Community FAQ.

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