Rx Health Reform Tanc Final

8/14/2019 Rx Health Reform Tanc Final

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Copyright 2009, Trans-American Alliance for a National Consensus (TANC) ALL RIGHTS RESERVED

By Michael A. FreemanExecutive Director, TANCIts right under the noses of President Obama and members from both majorparties of Congress, and they may not even know it or have simply over-looked it: There is a practical, self-sustainable model and ready-made solution for

the reform of Americas teetering healthcare system. And the federal Medicare sys-

tem helped create it.

It is a little-known federally-funded Medicare program that has successfully covereda segment of the Senior Citizen population for nearly a quarter-century in an innova-

tive partnership with NON-PROFIT health insurance organizations. And it is one ofthe best kept secrets and a relatively tiny sliver of American healthcare.

Operating under the Medicare Advantage Prescription Drug Program (MA-PD),which are standard Part D Medicare payments from senior citizens accounts typi-cally dedicated for prescription drug plans, is a special classification of Social Man-

aged Care an entire suite of extensivehealthcare services. These so-called Social

HMOs stand to serve as shining models for anational non-profit health insurance system

and offer broader applications for the general (under-65) American population aninnovative, new paradigm to potentially convert and reform our cost-spiraling FOR-PROFIT/PRIVATE Health Insurance system.

As this position paper attempts to illustrate, themodel for Social HMOs set an outstanding

template for what low- to no-cost, NOT-FORPROFIT health insurance can do to alleviate andreverse the ever-escalating costs and gaps incoverage for an estimated 47 million uninsured

Americans. The more altruistic and humaneprinciples that are the basic tenets of theseNON-PROFIT, senior-based Social HMOs, ifadapted and broadened out for the generalunder-65 population, could bring badly neededrelief to the many millions of other insuredAmericans who live in dire fear of their FOR-PROFIT/PRIVATE carriers raising their deducti-ble payments, co-pays on hospital stays, issuing

outright DENIALS on critical life-saving medical procedures, and routine policy revo-cations for discovering preexisting conditions all of which can have a devastat-ing economic impact on American families.

Trans-American Alliance for a National Consensus (TANC)

www.transamericanalliance.org

Rx for U.S. Healthcare Reform

A Self-Sustaining, Ready-Made NON-PROFIT Model for

Universal Healthcare is Achievable at Little Cost

Of all forms ofinequality,injustice inhealthcare is themost shockingand inhumane.Rev. Dr. MartinLuther King, Jr.

(1966)

Remote Area Medical (RAM), a Nashville-based non-profit medical relieforganization, stands at the vanguard of providing mobilized treatmentevents across the country attracting tens of thousands of Americanswho cant obtain or afford FOR-PROFIT/PRIVATE health insurance cover-age.
http://www.transamericanalliance.org/http://www.transamericanalliance.org/http://www.transamericanalliance.org/http://www.ramusa.org/http://www.transamericanalliance.org/


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Under proposals from President Obama and Sen. Max Baucus (D-MT),

chairman of the Senate Finance Committee sharing half of Congress loadon healthcare reform, both have laid out plans for some kind of national or

state Insurance Exchanges in which FOR-PROFIT/PRIVATE health insurancecarriers would be placed into competitive, low-cost pools for consumers to

choose which plans best fit their needs and what they can afford. But, the Presi-dent and Congress would find a much more affordable, minimally governmentbudgeted and much lower cost solution in fostering the creation of a NON-PROFIThealth insurance pool, which is already an operational, more justifiable SocialHMOmodel for future healthcare reform than long-standing FOR-PROFIT insurancemodels.

The hallmark of these non-profit Social HMOs,originally authorized by Congress

enactment of the Deficit Reduction Act of 1984 and the federal governments ex-pansion under the Omnibus Reconciliation Act of 1990, feature minimal to no out-of-pocket cost health insurance premiums guaranteeing affordable, equitable andhumane access to healthcare services.

Originally constructed to serve as an alternative nursing care system that keepssenior citizens from being prematurely forced into nursing home facilities, theseNON-PROFIT health insurers formally operate under the banner of being SocialManaged Care Plans; an organization that provides the full range of Medicarebenefits offered by standard Managed Care Plans plus additional services whichinclude care coordination, prescription drug benefits, chronic care benefits coveringshort term nursing home care, a full range of home and community based services

such as homemaker, personal care services, adult day care, respite care, and medi-cal transportation. Other services that may be provided include eyeglasses, hearingaids, and dental benefits. These plans offer the full range of medical benefits thatare offered by standard Managed Care Plans plus chronic care/ extended care ser-vices. Membership offers other health benefits that are not provided through Medi-care alone or most other FOR-PROFIT/PRIVATE-SECTOR senior health plans.

There are four NOT-FOR-PROFIT, Social Managed Care Plan organizations SCANHealth Plan of Southern California, Elderplan of Brooklyn, New York, Kaiser HealthFoundation of the Northwest (Portland-Vancouver metropolitan area, Salem, Ore.,and Longview, Wash.), and Health Plan of Nevada of Las Vegas that secured MA-PD funding from Medicare in servicing several hundred thousand Seniors withbroad inpatient/outpatient and preventive health insurance coverage in their re-

spective regions.

The longest running of these Social HMOs is the not-for-profit SCAN Health Plan (www.scanhealthplan.com),otherwise known as the Senior Care Action Network,founded in 1977 by a group of Long Beach, Calif. areaseniors angered about some short-comings in the elderhealthcare sector. With the backing and help of areadoctors and other medical/caregiver practitioners join-

ing their management staff, SCAN secured its first MA-PD funding from Medicare tooffers health insurance and seniors-based healthcare services in 1985.

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Rx for U.S. Healthcare ReformA Proven Model for NON-PROFIT Universal

Healthcare Provides a Solution for Enactment

"One of the centralpublic policy ques-tions for U.S. citizenstoday is whether therichest nation onearth will continue toallow millions of poorpeople to exist with-out health insurance.To do so violates bibli-cal justice. How canany Christian readwhat the Bible saysabout the poor andwhat Jesus saysabout the sick with-out hearing a divinecall to demand thatevery person in thisnation, starting withthe poor, have accessto health insurance?"from "Just Generos-ity" by Ronald Sider,

founder of Evangeli-

cals for Social Action
http://www.scanhealthplan.com/http://www.scanhealthplan.com/http://www.transamericanalliance.org/http://www.scanhealthplan.org/http://www.transamericanalliance.org/http://www.transamericanalliance.org/http://www.scanhealthplan.com/


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Today,SCAN provides insurance coverage and other wellness/preventivehealthcare services to over 110,000 seniors in seven Southern California

counties. Over the last year or so, SCAN has expanded its non-profit ser-vices to senior residents of Maricopa County (Phoenix) in Arizona and has

drawn up plans to launch shortly in Northern California potentially doublingits number of Senior subscribers within the next year or two.

A key ingredient of SCANs success is its broad Southern California-area roster of17,000-plus registered in-network doctors and specialistsand over 150 hospital choices. SCANs remaining care menuis quite broad and impressive to include other inpatient hospi-

tal care; outpatient doctor/hospital care; at-home care; emer-gency admittance and transportation services coverage; a pre-

scription brand/generic drug program; vision services; dentalcoverage; hearing; other no- to low-cost co-pays on a variety ofscreenings and exams; and a wide array of preventive andhealth-and-wellness services features necessary for seniorcare but MUCH GREATER than what could be found in eitherstandard Medicare and so-called Cadillac Plans from PRI-VATE/FOR-PROFIT insurance carriers for the general under-65population.

Most notably, out-of-pocket costs, or so-called co-pay ex-penses to senior subscribers, come at mere fractions in the

two SCAN Health Plan choices Classic and Option plans.For example, an in-hospital stay of 1 day to 150 days incursout-of-pocket costs of up to $2,300 under the standard Medi-care plan while SCANsClassic plan has a maximum co-paydeductible of $400 and the Options plan has a $0 co-paydeductible In fact, if you peruse either ofSCANs two plans(on both facing pages), most of the benefit categories feature$0 co-pays/deductibles and hit a maximum of $100 for selectcare services.

Adding frosting to the NON-PROFIT case, my next-doorneighbors, a senior-aged married couple and long-time SCANpolicy holders, both sing its praises by exclaiming that theyhave guaranteed emergency care/hospital coverage on aworldwide basis if they go travelling abroad. Additionally, myneighbors boast that they have an individual Personal CareRepresentative who has been assigned to each of them for

the duration of the SCAN memberships. They also empha-sized they have never had to deal with a disputed or deniedclaim from SCAN, and their Personal Care Representativealways handled outside billing issues that either arose fromhospital or doctor/specialist procedures.

Perhaps the most intriguing figure comes from a Wikipedia.org estimate that SCANearns $1.3 billion in revenue from its direct billings to Medicare, which translates to

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A Proven Model for NON-PROFIT UniversalHealthcare Provides a Solution for Enactment
http://www.transamericanalliance.org/http://www.scanhealthplan.org/http://www.transamericanalliance.org/


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a premium cost of roughly $98 per month for each of its 110,000 sub-scribers or $1,181 per year for its full array of covered services al-

though Medicares database factors in the potential additional surchargeof up to $56 per month for SCANs Special Needs Plan (SNP) subscribersand other options-based premium charges. Still, the no-out-of-pocket-cost premiums SCAN offers translate to little more than $2.00 above the

minimum base $96 per month Medicare deducts from seniors accounts (about$1,157 for all of 2009).

Better yet, the most startling fact in this is that SCAN andthe three other major NON-PROFIT health insurance carriersparticipating in the MA-PD program provide much higherlevels of premium coverage and at lower co-pay/deductiblecosts and in-Medicare monthly premium fees ($96 per

month) at about one-fifth (20%) to one-quarter (25%) ofthe cost of an average $400 to $500 per month (or $4,800per-year premium average) of what FOR-PROFIT/PRIVATEhealth insurance carrier charges on a premium for an indi-vidual policyholder in the general under-65 population, ac-cording to World Health Organization data.

If FOR-PROFIT/PRIVATE health insurance carriers label theirso-called top-of-the-line plans as Cadillac Premiums, thanseveral Social HMOs including SCANs Medicare-basedplans for seniors should be coined the Rolls-Royce Premi-ums of health insurance. It just proves that a greatly ex-

panded menu of benefits and lower deductibles and co-paysare very achievable at a fraction of the monthly/yearly costsof what FOR-PROFIT/PRIVATE health insurers offer.

An online trip to Medicares state-by-state and plan-specificwebsite (http://www.medicare.gov/MPPF/Include/DataSection/ComparePlans/BenefitsAtAGlance.asp ) revealsa convenient database for searching out a wide array ofmostly FOR-PROFIT/PRIVATE health insurance carriers thatoffer senior option plans. Some of the plans are spon-sored by theAmerican Association of Retired People (AARP),but they originate from FOR-PROFIT, pay subscription plans

(outside of standard Medicare-provided health insurance) typically featuring considerably higher co-pays/deductiblesand far fewer coverage areas.

If you really want to get a true gauge of how seniors inSouthern California value their SCAN health plans, just givea read of a May 2001 article in The Christian Science Moni-tor. At the time, TCSM reported that SCAN garnered highlyfavorable ratings from Consumer Reports, which found that96 percent of SCAN subscribers would never leave the

plan and 98 percent said they would recommend it to their senior friends. Basi-cally, these NON-PROFIT Social HMOs like SCAN offer as great or greater selection

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http://www.medicare.gov/MPPF/Include/DataSection/ComparePlans/BenefitsAtAGlance.asphttp://www.medicare.gov/MPPF/Include/DataSection/ComparePlans/BenefitsAtAGlance.asphttp://www.medicare.gov/MPPF/Include/DataSection/ComparePlans/BenefitsAtAGlance.asphttp://www.transamericanalliance.org/http://www.scanhealthplan.org/http://www.transamericanalliance.org/http://www.transamericanalliance.org/http://www.medicare.gov/MPPF/Include/DataSection/ComparePlans/BenefitsAtAGlance.asphttp://www.medicare.gov/MPPF/Include/DataSection/ComparePlans/BenefitsAtAGlance.asp


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of in-network doctors, specialists and hospitals than what FOR-PROFIT/PRIVATE insurers comparably offer.

Ratings from Medicares own online database typically rank both SCANHealth Plans Classic and Options each with scores of 4 out of 5 stars

when it comes to handling member complaints and those staying with the pro-gram. The same numbers of stars are accorded to SCANfor the prescription drug

pricing and patient safety category as well. Similarly high ratings were attributed toother NON-PROFIT Social HMOs like Elderplan and Kai-ser Foundation Health Plan of the Northwest.The lone Social HMO on the East Coast is Elderplan(http://www.elderplan.org), a Brooklyn-based non-profitfounded 23 years ago and operating under the auspices

of the Metropolitan Jewish Health System, serving justover 15,000 seniors in the five boroughs of New YorkCity. Although it operates on a much smaller scale thanSCAN, Elderplans five plan options similarly offer $0 co-pay and deductible features across the board to a nearlyidentical menu of in-network inpatient, outpatient andat-home services.

Kaiser Health Foundation of the Northwest offers a pairof HMO plans, Senior Advantage Basic and Senior Ad-vantage, but each have respective $39 and $99monthly add-on premium charges and generally higherco-pays and deductibles than what SCAN and Elderplanoffer as Medicare-minimum premium values. Theslightly higher co-pay/deductible levels and additional

premium charges are somewhat in keeping with other FOR-PROFIT/PRIVATE carri-ers offering Medicare exchange plans. Kaiser HealthFoundation of the Northwest is a non-profit organiza-

tion that is a MA-PD spinoff from the other FOR-PROFITKaiser Permanente healthcare subsidiaries.

Health Plan of Nevada also offers Medicare mini-mum, no outside monthly cost premiums, but doescharge a low- to higher-range of co-pays/deductiblesand offers fewer coverage areas to about 25,000 sen-

ior members in the southern and northern regions of the state. However, FOR-PROFIT insurance giant Unit-edHealth Group acquired Health Plan of Nevadas over-all under-65 health insurance business (serving close

to 500,000 subscribers overall) in early 2008, but wasrequired by the U.S. Justice Department to divest own-ership of the NOT-FOR-PROFIT Social HMO seniorcare arm of the company to be fall into compliance with

the deal. It is not immediately known if the SocialHMO has yet been fully divested from the UnitedHealthGroup-owned parent company or discontinued entirely.

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Allowing FOR-PROFIT, free-market forces to go unregulated has proveddisastrous while government incentivized NON-PROFIT ventures likeMedicare-based Social HMOs have proved hugely beneficial to SeniorCitizens.

Non-profit Social HMOs offer coverage at Public Medicare-minimumrates, so its likely the savings would be greater than the 25% in the fur-thest right-hand bar if it would be operated as a Non-Profit Insurance

Exchange not solely as For-Profit/Private Exchanges proposed byCongress and the White House.
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That is why it is so vitally important for any true healthcare reform to

take place in this country, our government needs to step up and use theweight of its legal authority to untangle FOR-PROFIT/PRIVATE health insur-

ance carriers from a future Universal Healthcare system. Given the ongo-ing criminality of FOR-PROFIT/PRIVATE health insurance practices, where

Americans are either DYING or currently suffering from GROWING TERMINAL ILL-NESSES due to DENIED CLAIMS, there is NO constitutionally justifiable reason why

American lives are being weighted or balanced ver-sus the model of MAXIMIZING AND MINIMIZINGRISKS so entrenched into our long-standing FOR-PROFIT/PRIVATE system up to today.

In his speech to a joint session of Congress on

September 8, Pres. Obama reiterated a verbal-onlyproposal to create a non-profit insurance ex-change, conceivably featuring a pool of FOR-PROFIT/PRIVATE health insurance carriers for con-sumers to pick the most competitively pricedplan that fits their needs. On September 16, Sen.Baucus then released his Chairmans Report, an$856 billion, 10-year plan, that would similarly fea-

ture a State Insurance Exchange program andFOR-PROFIT/PRIVATE-based healthcare cooperatives. This is just pouring more

taxpayer money into the pockets of cor-rupt FOR-PROFIT/PRIVATE carriers, whowere the same $4 million contributors toSen. Baucus latest fundraising dinnerlast May.

While sounding and appearing like potentially attractive, reasoned proposalsboth the Presidents and Baucus plansstill fundamentally fail to address how

the FOR-PROFIT/PRIVATE health insurance industry has been artificially inflat-ing the prices of premiums (most likelydue to covering excessive executive com-pensation, bloated administrative over-

head and an overstated emphasis onmaximizing earnings and profit margins)while increasingly chipping away at cov-erage options and placing higher co-payand deductible burdens on the backs ofconsumers. Essentially, it is amiddleman system where the consum-ers pay more but get less in return.

Medicare already runs an exchange-like system where senior consumers can choose from a pooled menu of largely

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UnderThe Commonwealth Funds study offering three different healthcare plan scenarios, it isan inescapable fact that offering up a Public Plan based on Medicare rates such as thatthe long-term projected savings of up to $56 billion by 2020 would be most ideally maxi-mized under a nonprofit-based Health Insurance Organizational proposed by TANC.

Both the Presidents and Baucus plans still

fundamentally fail to address how the FOR-PROFIT/

PRIVATE health insurance industry has been

artificially inflating the prices of premiums (most

likely due to covering excessive executive

compensation, bloated administrative overhead andan overstated emphasis on maximizing earnings and

profit margins) while increasingly chipping away at

coverage options and placing higher co-pay and

deductible burdens on the backs of consumers.

Essentially, it is a middleman system where the

consumers pay more but get less in return.
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FOR-PRIVATE/FOR-PROFIT coverage plans, with the American Associationof Retired People (AARP) even serving as a clearinghouse/sponsor forlower-cost Medicare Health Plans. But many of these exchange option

plans coming from such Big Health Insurance companies as UnitedHealthGroup, CIGNA, Aetna, Coventry, Wellpoint, Anthem Blue Cross/BlueShieldand Humana are still priced considerably higher, with additional out-of-

pocket monthly premium charges and other higher Medicare estimated costscompared to what the handful of NON-PROFIT Social HMOs charge in most cases

to be Medicare-minimum base rates. (The most noticeable differences in Medi-cares customizable/comparable database comes from what FOR-PROFIT/PRIVATEinsurance carriers typically charge in additional out-of-pocket monthly premium

fees, higher co-pays and deductiblecosts, and generally offer consid-erably smaller menus of covered

care services.)

Plain and simple, the excessivelyhigh levels of executive compensa-

tion for PRIVATE/FOR-PROFIT insur-ance, bloated administrative over-head costs and the 20%-plus profitmargins of the Big Insurance Carri-ers (please refer to the accompany-ing charts), truly reflect the inordi-nate disparity of what they chargeversus what NON-PROFIT carriers

can charge on a much lowered-priced, feature-rich basis. It is also an accurate re-flection of the grossly inequitable, unethical and often CRIMINAL business practicesof FOR-PROFIT insurance and why Americans are literally paying through their

teeth for less healthcare.

Additionally taking into account theoutright DENIALS of medical proce-dure claims for at-riskpatients and

the often arbitrary revocations ofpremium holders for have what BigInsurance deems are preexistingconditions to meet the businessmodel of MAXIMIZING PROFITAND MINIMIZING RISKS commonwith Big Health insurance, arewholly UNETHICAL and frequentlyMORALLY CRIMINALpurely on aConstitutional Law basis.

In these proposed exchange systems, where some lower-income/disadvantagedAmericans will conceivably have the ability price out low-cost insurance premiumsbut may actually face paying penalties for not having coverage under Baucusoriginal plan, there are still massive inequities in what being laid out in both theCongressional and White House proposals. Even the President has not elaborated

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on how to get the Big Health Insurance Carriers to seriously modify andreform their business practices away from their historical strategies of

monopolizing/consolidating the marketplace with exploitive and punitiveactions directed at American consumers.

In fact, I am not even sure if the President realizes it yet, but his marginal-ized, verbal-only vision of a non-profit insurance exchange carries merit, but it ac-

tually should be broadened out to mandate that Health Insurance Carriers can onlyreform their CRIMINAL business practices bydropping their exploitive and predatory PRI-VATE/FOR-PROFIT status and instead adoptingNON-PROFIT roles going forward. And thatNON-PROFIT organizational model, which onceflourished when religious hospitals and family

clinics were founded in America during the18th to early 20th centuries, is something thatcould have broader applications beneficial toother segments of healthcare in America to-day.

For those reasons, our non-profit citizens ad-vocacy and Direct Democracy-based organi-zation, Trans-American Alliance for a NationalConsensus (TANC), is proposing that the Presi-dent and Congress crafts healthcare reformlegislation that 1) funds and fosters the crea-

tion of NON-PROFIT health insurance carriersin structures similar to Medicares Social HMO organizational architecture; and 2)presents FOR-PROFIT/PRIVATE BigInsurance carriers the opportunity

to convert to NON-PROFIT status orface the consequences of not par-

ticipating in the exchange program and facing the specter ofU.S. Justice Department and Con-gressional criminal investigationsinto DENIAL-based patient deaths,

the alarming rise of terminal illnesses, debilitation, and otherneedless suffering in other cases.

This is a time when Congress, theWhite House and other federal in-vestigatory agencies need to liveup to their Constitutional oaths touphold the law and end this long-standing corrupt pattern of busi-ness practices in the healthcareindustries the only thing BigHealth Insurance will yield to is if

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know the federal government is going to use its full weight of its authorityto uphold laws and enact serious reform to re-regulate their business prac-

tices. Given that total healthcare costs currently eat up to 17% of theUnited States Gross Domestic Product (GDP), or roughly $2.5 trillion of

nearly $15 trillion in total GDP for 2009 (according to World Health Organiza- tion estimates), the worlds most expensive healthcare system will eventually

implode under the sheer weight of its excesses and lead to an even greater publichealth crisis/catastrophe in the near future.

On that front, TANC has formed a pair of Facebook Cause Groups, themost critical being a Petition for the Federal Government to Open CRIMI-NAL INVESTIGATIONS into DENIED Patient Deaths (http://apps.facebook.com/causes/340854/54103574?m=611088da) to compelour government not to let this long-standing pattern of criminality in the

health insurance industry go unpunished.

Secondly, TANC ideally hopes the proposals laid out in this position papercan be used as springboard for our Facebook Cause Group initiative to

Petition for a CITIZENS SUMMIT on U.S. Healthcare Reform (http://apps.facebook.com/causes/332619/54103574) to lay to out a set of proposals

for a truly OPEN PUBLIC-FORUM debate a draft bill-making process for Americancitizens to offer as template and blueprint for our elected representatives to pos-sibly follow as THE WILL OF THE AMERICAN PEOPLE. Even if our federal gov-ernment chooses to dismiss this summit and draft bill, it will forever be on-the-record where American citizens decided the future direction of Healthcare Reformshould go!

If the health insurance industry does concede that its business practices needdrastic reform and it abides by new government regulatory actions, TANC has setforth detailed recommendations for the Congress and the White House at thevery least to SET MINIMUM PROFIT MARGIN CAPS and LIMITS ON EXECUTIVECOMPENSATION AND BONUSES for the PRIVATE/FOR-PROFIT Health InsuranceCarriers. The other major option the federal government can present is that afunding program based on new, minimal corporate taxes and a special tax assess-ment on companies producing and distributing unhealthy/addictive consumableproducts be used to help fund their conversion into NON-PROFIT Health InsuranceOrganizations (HIOs).

To accomplish steps necessary for the NON-PROFIT conversion of Private/For-Profit

Health Insurance, TANC is proposing the following preliminary scenarios:1) De-list FOR-PROFIT/PRIVATE-SECTOR Insurance Companies fromstock exchanges and Re-File under Non-Profit Articles of Incorpo-ration Much in the same way the federal and state government

issue interest-bearing bonds, the federal government can serve toguarantee bond funds to participating Private-Sector InsuranceCarriers an exchange in expediting the buyback of shares fromlarge institutional investors, hedge funds and individual share-holders in these publicly-held corporations. By unlocking them-selves from the control of large shareholders, some of whom own

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"Every person has theright to adequatehealth care. This rightflows from the sanctityof human life and thedignity that belongs toall persons, who aremade in the image ofGod... Our call forhealth care reform isrooted in the biblicalcall to heal the sick andto serve 'the least ofthese,' the priorities ofjustice and the princi-ple of the commongood. The existing pat-terns of health care inthe United States do nomeet the minimal stan-dard of social justiceand the common good." Resolution on Health

Care Reform, U.S. Catho-

lic Bishops, 1993, com-

ing before the Clinton

Administration's failed

efforts at achieving U.S.

healthcare reform.


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large blocks of stock and exercise considerable control ofvoting shares and seats on the Board of Directors for these Big

Insurance corporations, the government is effectively alleviating the health insurance carrier of typical outside marketplace pres-sures to meet certain per-share earnings and profit projections in addition to eliminating conflicting agendas and hostile take-over scenarios, sometimes those arising internally from their own

Board of Directors and/or large-block shareholders.

2) The federal government forms the temporary FEDERAL NON-PROFIT HEALTHCARE CONVERSION ASSISTANCE CORPORATIONwith the mandate of helping Health Insurance Companies andpotentially other FOR-PROFIT Healthcare entities un-tether them-selves from outside investors and other marketplace-driven forces The mission of this federal program will be solely to assist participating FOR-PROFIT Health Insurance Carriers with bond-issuefunding to buyback the publicly-traded shares from major institu-

tional investors and individual shareholders. Once buyers of these bonds (including investors and non-profit foundations, etc.)reach maturity and can be paid off (within the next 5 to 10 years),

the government can effectively liquidate/disband the FEDERALNON-PROFIT HEALTHCARE CONVERSION ASSISTANCE CORPORA-TION once all the conversions are completed.

3) The buyback of publicly-traded shares, with the assistance of gov-ernment-backed bonds can be timed to mature in 5 years to 10years, or less This would allow the once-publicly traded/for-profit Health Insurance Carrier to recoup all costs related to thebuyback share plan as well as covering any other debts incurredby the organization before converting to NON-PROFIT status. Mon-ies from the government bond issues will also allow for a slidingscale of a 5% to 25% premium to be paid over the Health Insur-ance Carriers current per-share stock market price, which willbe based on any potential negative short-falls some shareholdersmay still incur from what they originally paid on a per-share basis.This is to make sure both the investor/shareholders, lien holders

and the company are reimbursed and properly covered ator slightly above their original investments so it effec-

tively un-encumbers Health Insurance Carriers from any

outside FOR-PROFIT interests and outside marketplaceforces.

4) Upon their incorporation as NON-PROFIT Health Insur-ance Organizations (HIOs), participating insurance carrierswill still be able to service their roster of current premium-holding customers on their existing levels of premium cov-erage but able to do it closer in line with lower cost Medi-care-based rate structures The maintaining of premiumsubscriptions with the HIOs current roster of customers willalso address concerns some consumers have about being

forced into universal access Public-Option plans offered to low-

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"To be without healthinsurance in this coun-try means to be with-out access to medicalcare. But health is nota luxury, nor should itbe the sole possessionof a privileged few. Weare all created b'tzelemelohim in the imageof God and thismakes each human lifeas precious as the next.By 'pricing out' a por-tion of this country'spopulation from healthcare coverage, we mockthe image of God anddestroy the vessels ofGod's work." Rabbi Alexander

Schindler, Past Presi-

dent, Union of American

Hebrew Congregations

(1992)


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income individuals and families. Moreover, current policy-holderswill benefit from LOWER MONTHLY/ANNUAL PREMIUM COSTS due

to the NON-PROFIT restructuring of health insurance, in additionto likely seeing their DEDUCTIBLE and CO-PAYMENT cost contributions greatly reduced or eliminated. Employer-compensated willalso great benefit from lower individual and family plan premium

costs, much as described above.

5) Universal Access will also be a mandatory requirement as a re-sult of a Health Insurance Organizations NON-PROFIT, TAX-EXEMPT STATUS, meaning a PublicOption program will be made availableto low-/no-income Americans whocant afford to obtain coverage on areviewed, as-needed basis By tap-ping into a special 1% or 2% generalU.S. Corporate Healthcare Tax levy,which could bring in anywhere from$140 to $280 billion annually in an-nual revenues (depending on the stateof the economy and final dollar-generation figures from annual GrossDomestic Product totals) to help covernon-profit HIOs offering the same kindof individual and family premiums offer

to its regular customers. Currently, cor-porations pay the equivalent of 2.5% of

the Gross National Product, or roughly$378 billion in corporate taxes in 2008while individual American taxpayers

paid roughly 8% of the GDP or roughly $1.2 trillion in individualtaxes. So, if corporations pay an additional 1% to 2% corporate tax

(rather than individual taxes), they willstill realize much larger immediate sav-ings to their bottom-line expenses

through a drastically reduced NON-PROFIT health insurance system. Addi-

tionally, due to the disproportionatelylarge burdens placed on the healthcare

system byunhealthy/addictive consum-ables tobacco, alcohol, fast foods,sweetened beverages, candy/confectionery products, and packagedsnack foods could be assessed a spe-cial 5% to 10% corporate tax based on

their gross sales revenue volume, possi-bly raising between $25 billion to $50billion in new tax revenue to help subsi-

dize a Public Option program (see the accompanying chart).These unhealthy/addictive consumables account for the greatest

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burdens and biggest public health risks that require inordinatelylarger public/private expenditures from Americas healthcare

system budgets. So, the producers and distributors of these un-healthy/addictive consumables should shoulder an additional taxlevy as part of social responsibility to help assist in funding aPublic Option system, which originates from a 10% Reformhealthcare reform tax proposal submitted by Facebook Friend,Andy Freeman (no relation). Currently, it is estimated that thereare 47 million uninsured American citizens, so on a cost-level

comparable to Medicare-minimum base rates (forSenior Citizens), the full rolls of uninsured beingextended Public Option premiums could come toa total cost of $188 billion annually with an averagenon-profit premium adjusted to a cost of $2,500

to $3,000 per year in reverse of the ongoingtrend of $4,800 to $6,000 annual costs for individ-ual premiums and upwards of $12,000 to $14,000annually for family premiums that are UNATTAIN-ABLE for low-income families on an out-of-pocket

basis.

6) Limits on senior management/executivesalaries and bonuses One of the key drivingforces for the escalating costs of healthcare in thiscountry is the ever-escalating rise in senior manage-ment executive pay and administrative overheadcosts. Currently, the top Chief Executive Officers

(CEOs) of the Big 6 of Health Insurance CIGNA, UnitedHealthGroup, Aetna, Humana, Wellpoint and Coventry take home anaverage of $11 million in pay annually (see chart on page 8), butstock options typically carry overall compensation into the HUN-DREDS OF MILLIONS OF DOLLARS once shares are exercised forsale. For example, UnitedHealth CEO Steve Hemsley took home$3.2 million in pay for 2008 but his unexercised stock options arevalued at $744 million, translating to roughly $700 out of eachUnitedHealth customers monthly bill paid on a premium for oneyear, according to SickforProfit.com. Despite the groundswell ofpublic criticism over excessive CEO pay in this country (especiallyin light of the federal government bailouts of corporate institutions

failing to immediately address excessive executive pay and bo-nuses), the average CEO across all U.S. industries took home$10.8 million in total compensation annually about 364 times

the pay of the average American worker ($29,670 per year), ac-cording to an Associated Press survey of 386 of the top Fortune500 companies. All of this points to why healthcare costs are ris-ing faster in the United States than in any other countries in theworld largely due to excessive, undue executive costs, bloatedadministrative overhead and investor/marketplace pressures tomaintain fat profit margins. Under a new NON-PROFIT Health In-surance structure, executive compensation should be capped at

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"The health of a society istruly measured by thequality of its concernand care for the healthof its members... Theright of every individualto adequate health careflows from the sanctityof human life and thatdignity belongs to all hu-man beings... We believethat health is a funda-mental human rightwhich has as its prereq-uisites social justice andequality and that itshould be equally avail-able and accessible toall."- Imam Sa'dullah Khan,

The Islamic Center of

Southern California


14/23


3% to 10% of their current average, or about $300,000 to $1 mil-lion per year, and maybe at 3% to 6% of current levels for other

senior-level management below CEO.

7) Each of these freshly converted NON-PROFIT Health InsuranceOrganizations (HIOs) will begin search processes for a new,independent Board of Directors, inclusive of medical practitio-ners, caregivers, first-responders and other non-profit hospital/family clinic administrators The proposed composition of theseBoards will effectively help guide newly-converted NON-PROFITHealth Insurance Organizations to gather input and direction of

how to better interact in a more responsiveand efficient manner by observing a newly-created UNIFORM HEALTH INSURANCE IN-

DUSTRY STANDARDS for the processing ofmedical billings and claims with hospital andfamily clinic administrators, in addition to at-home caregiver and rehab services. Uniformstandards for the claims and billing proc-esses will greatly cut down on the red-tapeand hassles many hospitals and family clinicphysician centers deal with currently in apatchwork, haphazard and non-uniform PRI-VATE/FOR-PROFIT system insurance carriersundertake in states across the country ef-

fectively reducing hourly manpower costs in trying reconcile bill-

paying claims procedures.

8) To insure and maintain compliance on a newly structured nationalUNIFORM INSURANCE INDUSTRY STANDARDS, it would be advis-able to form independent HEALTH SER-VICES PROVIDER AND PEER REVIEWBOARDS to regularly review Health Insur-ance Organizations compliance withvarious claims and billings reconciliationprocesses These kind of board re-views, which can be conducted on anopen hearing basis, can also allow anypolicy subscribers (either paid or

publicly-subsidized subscribers) to reg-ister any complaints and concerns to anombudsman-like panel regarding is-sues that need to be addressed and cor-rected with these new NON-PROFIT

Health Insurance Organizations.

Some partisans within the PRIVATE/FOR-PROFITHealth Insurance industry will likely be reticent

and clearly reluctant to consider a NON-PROFTIT organizational model, but given the roughly 75-year history of their resistance and lobbying efforts against Health-

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care Reform (dating back to the World War II efforts of the Franklin D.Roosevelt Administration), more vigorous publicly-generated petition and

legislative efforts need to be taken today.

Somewhere lost in the hysterics and vitriol that has marked the nationalHealthcare Reform debate in America is a serious, reasoned and sane explora-

tion of how to craft a Universal Healthcare system that somehow answers andassuages fears from some corners about a Government -run, Socialist Healthcare

System. It may surprise some congressional Re-publicans, most of whom think Big Governmentand Socialized Healthcare are the inevitable re-sults of a reformed healthcare system, that TANCsnon-profit proposal is similarly based on the premise

that the federal government should NOT be involved

in the day-to-day operational management of healthinsurance and healthcare services in this country.

Given the growing divisions and rancorous allegations being tossed within the halls of Congress and the White House in this largely CLOSED-DOOR/CLOSED-FORUM debate and legislative proposalprocess, it is particularly understandable why thevarious political factions and BIG HEALTHCARE LOB-BIES and other well-funded special interest groupshave disseminated a head-dizzying array of MISIN-FORMATION, PROPAGANDIZING, STIGMATIZING and

DEMONIZING about Universal, Single-Payer and so-called Public Optionhealthcare systems particularly against those already being practiced in over 50

countries around the world today.

Recent proposed compromise plans for institutingsome form of national Healthcare Reform have pro-duced what many Americans and the media havederided as either watered-down half-measure solu-

tions or have just been flatly rejected for injectingany kind of government-/taxpayer-financed PublicOption.

It has been estimated that roughly 22,000 Americancitizens unnecessarily die annually due to eitherinadequate health insurance coverage, denied/delayed claim payouts for treatment or being unem-ployed and unable to afford PRIVATE health insur-ance coverage, according to Institute for Medicineresearch. A recently release Harvard Universitystudy found that up to 45,000 patient die annually(one every 12 minutes) due to a lack of insurance

coverage and quality healthcare services. However, the National Center of PolicyAnalysis, a Washington-based think tank backing a free-market/private-sector ap-

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proach to healthcare, countered that the Harvard study overstated thedeath risk and did not track for how long the subjects were uninsured.

On top of the current, nearly three-year-old economic recession, the mostdramatic, darkly illustrative byproduct of growing unemployment (more than

doubling from 4.7% at the beginning of 2006 to 9.7% in August 2009), the num-ber of UNINSURED Americans has risen to an estimated 47 million American citi-zens, according to U.S. Bureau of Labor and U.S. Department of Commerce statis-

tics. This growing number of the UNINSURED Americans has created a rising, fes- tering public healthcare crisis nearly universally decried by medical practitioners,caregivers, first-responders and hospital administrators that our elected repre-sentatives cant ignore any longereven with the roughly $2.3 billion in politicalcontributions by the INSURANCE LOBBY from 1998-2006 (source: OpenSecrets.org)

to maintain thestatus quoof Americas Have or Have-Not, FOR-PROFIT HEALTH

INSURANCE SYSTEM.

Given the poor economic climate and the alarming rise in unemployed and unin-sured Americans, other immense public pressure if coming down on the FOR-PROFIT/PRIVATE health insurance over its burgeoning DENIALS-BASED businesspractices and other allegations of manipulating the marketplace, artificially inflatingpricing and shifting the costs of deductibles and co-pay charges to consumers, evenwith employer-based premiums.

Over the last few months, the California Nurses Association successfully lobbiedstate Attorney General Jerry Brown Jr. to mount a full investigation into what thegroup claimed were 45 million suspect denied claims for medical treatment of

patients unlawfully carried about by major FOR-PROFIT/PRIVATE-SECTOR healthinsurance companies in the state. SmartMoney.com re-cently reported that out of 1 billion medical claims filednationally with PRIVATE/FOR-PROFIT insurers, as many as75 million claims annually are rejected outright, leavingpatents unable to get treatment or stuck with medical bills

that add up to at least $50 billion annually.

Furthermore, Sen. Patrick Leahy (D-VT) is leading thecharge on a pair of Congressional bills (S. 1681 and H.R.3596) under the Health Insurance Industry Antitrust En-forcement Act banner to bring an end to the 64-year-old

exemption that the health insurance industry has beenallowed to operate outside the federal Sherman Antitrust

laws rules that protect consumers from anti-competitive practices like price fixing, Leahy wrote in hisemail blast to the American public.

They can pick and choose their customers and deny cov-erage to anyone with any sort of pre-existing condition --even acne. They can get away with dropping your coveragewhen you get sick, Leahy wrote. Passing health care re-form with an effective public option is one key way to pro-

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Please click the hyperlink

with this photo for one of

the most revealing, infor-

mative interviews PBSs

Bill Moyers had with for-

mer CIGNA executiveWendell Potter, a whistle-

blower who speaks in de-

tail of insurance industry

practices and with insider

knowledge ofCIGNAs foot-dragging claims DENIALS

involved in the death of

Nataline Sarkisyan.
http://www.transamericanalliance.org/http://www.pbs.org/moyers/journal/07102009/watch2.htmlhttp://www.transamericanalliance.org/


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mote competition in the health insurance marketplace, but we mustalso eliminate the unjustified and unnecessary antitrust exemption cur-

rently enjoyed by insurance companies.

Sen. Leahy went on cite an unnamed recent study that when one or two of the handful of major FOR-PROFIT Big Insurance Carriers control found 94% of

the American health insurance markets across the country, it means every yearconsumers are paying more for less coverage.

When insurance companies know they dont have to compete, they dont, Leahyadded. When they know they can get away with raising your premiums every year,

they do. And when they know they can deny you coverage without consequence,they'll leave you high and dry. The Health Insurance Industry Antitrust EnforcementAct, which I introduced in the Senate in [mid-September 2009], is not the be all and

end all of necessary reform, but it is akey way we can give consumers morechoice in the health insurance market-place.

As the result of this DENIAL-BASEDprivate health insurance system, millionsof Americans either live in dire fear ofever using their PRIVATE health insur-ance plans (and risking higher premiumcosts, higher deductibles or outright pol-icy cancellations for having preexisting conditions) or having no coverage at all

and risking going into bankruptcy due to a mountain of incoming medical bills.Wikipedia.org cited an un-sourced recent study that found uninsured and uncov-ered, denial-based medical expenses played a significant factor in 60% of all per-sonal bankruptcies filed in the United States.

Even those who thought they had goodinsurance coverage took pause at thestory of Nataline Sarkisyan, a 17-year-oldLos Angeles girl who died while her healthinsurance carrier, CIGNA, hemmed andhawed over whether to pay for her live-saving liver transplant surgery. CIGNAdeemed Sarkisyans badly-needed anddelayed liver transplant surgery anexploratory procedure and this camedespite UCLA Medical specialists citing instances where they had performed the

transplant surgery successfully before. Nataline passed away while awaiting the

transplant in December 2007 although CIGNA finally relented in approving herclaim (after massive public outcry against the insurer) just a day before she died.

Sarkisyans story is one that rings familiar in denial-based cases where other Ameri-cans have died while awaiting critical life-saving surgeries and can be found, alongwith other stories about prolonged, growing terminal illnesses and other suffering at

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Nataline Sarkisyan

"Health security is an issuethat affects all of us. Everyperson has a fundamentalhuman right to qualityhealthcare healthcarethat is affordable, accessi-ble, and compassionate. Asthe nation begins to trans-form the healthcare systemto one that is sustainable,it will be important thatwe, as a society, ensurethat healthcare in the U.S.respects the dignity ofevery person and deliversthe quality, compassionatecare we expect and de-serve. Meaningful reformwill require dialogue, theacceptance of diverse viewsand above all, compromise.With the human right ofhealthcare at stake, all ofus must work together tomake sure future genera-tions inherit a healthcaresystem that embraces qual-ity and compassion." Catholic Healthcare West's

Perspective, as printed in

their Health Security Index,

Spring 2007
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-risk patients have endured, at film documentarian Robert Greenwalds

healthcare advocacy site, www.SickforProfit.com.If all or some of the Big Health Insurance carriers reject the NON-PROFIT

conversion program model TANC is proposing here, then this federally-fundedprogram should be entirely focused on fostering the creation of new NON-PROFIT

Health Insurance Organizations and/or expanding the ex-isting Medicare-based Social HMOs, such as SCAN andElderplan, into the general under-65 marketplace. Allow-ing greater NON-PROFIT participation will generate lowerpricing competition in the marketplace that could similarlycreate new market-driven forces to drive down the artifi-cially inflated pricing from FOR-PROFIT/PRIVATE insurance

carriers.

The benefits of creating and fostering the growth of NON-

PROFIT carriers are many:

Larger, feature-rich menus of inpatient and outpatient coverage areas and prescription drug assistanceon a low- to no-cost basis available to all American

consumers.

All medical procedures, doctor visits, preventative/at-home care andscreening exam tests are completely coveredwith no chance of DENIALS or REVOCATIONSof premiums if someone is identified with a

preexisting condition.

A large selection of in-network Primary CarePhysicians (PCPs), specialists, hospitals, emer-gency care, family clinics, outpatient treatmentfacilities, at-home caregiver services and low-

to no-cost prescription drug services.

Even if corporations pay a 1 to 2 percentspecial corporate tax to fund NON-PROFIThealthcare, these companies will quickly real-ize greater overhead savings with lower

group coverage policy costs realizing thata current individual employee premium willdrop more than half in cost from about $6,000annually while a typical family-of-four pre-mium will similarly drop by more than half from

its annual $12,000 to $18,000 range today.

There will be NO day-to-day, invasive in-volvement of the federal government in managing a NON-PROFIT

healthcare system, only badly-needed regulatory and legal oversight.

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Under the 3 scenarios proposed by The Commonwealth Fund (with research fromthe Lewin Group), the Public Plan based on setting rates at Medicare-minimum levels offers most optimal long-term reduction in federal outlays (atnearly $3 trillion) over the next 10 years. But, imagine how much higher the sav-ings would be in all-nonprofit organizational health insurance system.
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Non-profit HIO carriers will be able to charge middle- to upper-

income consumers directly for their premiums, incrementally lower-ing the amounts of special federal startup and long-term funding.

Low- to no-income Americans get Public Option coverage throughthe general and special corporate taxes on unhealthy/addictive prod-

uct categories on a reviewed, as-needed basis.

People who choose stay with their FOR-PROFIT/PRIVATE carriers canstay with their option plans, but will likely also realize a considerablelowering in monthly/yearly premium costs because of the new-foundcompetition from an emerging and expanding offering of NON-PROFIT

Health Insurance Organizations entering into the marketplace.

Adoption of new UNIFORM INSURANCE INDUSTRY STANDARDS willgreatly reduce or eliminate red-tape hassles that medical practitioners,hospitals, family clinics and other caregiver services must deal with infrequently arbitrary DENIALS on billings/pay-out claims thus having asnowball-effect on greatly lowering hourly administrative and outside

collection agency costs to reconcile billing statements.

The emergence of a flourishing, growing NON-PROFIT health insurancemarket could also have the domino effect of leading to the de-listingof other FOR-PROFIT/PRIVATE healthcare companies rekindling thefounding spirit of social contract non-profit, religious- and publicly-

funded hospitals and other caregiver services.

Jobs in the health insurance and other healthcare sectors will be morestable and secure in a NON-PROFIT organizational model a much

more professionally and person-ally rewarding experience wouldawait those who currently toil in

the FOR-PROFIT/PRIVATE arenaand switch to NON-PROFIT rolesin fulfilling a vital Social Con-

tract dedicated to aiding thehealth and well-being of Ameri-

cans.

Hopefully, more than anything, thispotential reinvigoration of NON-PROFIT health insurance can get top-

to middle-level executives, administrators and highly-skilled medicapractitioners to look inside at ahealthcare system badly in need ofreform when it comes to overheadcosts and compensation. Reform of

the health insurance industry, like allother sectors of healthcare, has to

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"Science mayhave found acure for mostevils, but it hasfound noremedy for theworst of themall theapathy ofhuman beings."

Helen Keller


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do with amending internal business practices and renewing governmentsrole as a regulatory/legislative oversight body not just pouring in $856

billion dollars over the next 10 years (as Sen. Baucus proposes) without aclear mandate and plan to truly end the unjustified FOR-PROFIT inequities

of a long-running Have or Have-Not healthcare system.

If this country can manage to return to the Spirit of Collectivism that was a hall-mark and fixture in the founding of religious-based hospitals and family-based prac-

tices from a variety of Christian faiths and other denominations originally settling inAmerica during the 18th to early 20th centuries, then we truly have a chance to cre-ate an American healthcare system that will be uniquely self-reliant/self-sustainable, just, equitable and accessible for this and future generations of Ameri-

cans.

In 2003, of the roughly 3,900 nonfederal, short-term, acute care general hospitals

in the United States, the majority about 62 percent were NON-PROFIT, accord-ing to Wikipedia.org. The rest included government hospitals (20 percent) and for-profit hospitals (18 percent). Still, it has been widely reported that even not-for-profit hospitals are being racked with higher executive and administrative costs, soeven NON-PROFIT religious- and government-backed hospitals need to address andconform with lower, more equitable compensation structures to fulfill their social

contracts with the American public.

In other key areas of U.S. healthcare reform, TANC is additionally proposing the fol-lowing measures to reform Americas healthcare system:

Medical Malpractice Liability and Tort Reform State and federalstatutes have to be legislatively amended to mandate a set structurefor the limitation of jury rewards on malpractice suits against hospitals

and medical practitioners. This will alsohelp to drive down the cost of malpracticeinsurance for doctors and hospitals, bothof which pass those costs back to consum-

ers in what they charge for services.

Pharmaceutical Pricing and Practices Prescription drug prices in the UnitedStates are the highest in the world, accord-ing to Wikipedia.org. The prices Americanspay for prescription drugs, which are far

higher than those paid by citizens of anyother developed country, help explain why

the pharmaceutical industry is and hasbeen for years the most profitable of allbusinesses in the U.S. In the annual For-tune 500 survey, the pharmaceutical in-dustry topped the list of the most profit-able industries, with a return of 17% onrevenue and 30% operating profit margins.

The high price of prescription drugs has been typically one of the mostcontentious areas of discussion in the U.S. healthcare reform de-

Page 20




"When will ourconsciences growso tender that wewill act toprevent humanmisery ratherthan avenge it?" Eleanor Roosevelt


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bates, especially given the complexities of trying to regulate bigpharmaceutical conglomerates with operations spread across the

world internationally. Areas of consideration have been tougherfederal government regulation of the pharma industry to the adoptionof a Medicare- type Part-D prescription drug subsidization programalready offered to seniors and possibly expanded to the general under-65 population. Coming up with an equitable solution in the public

interest could be tough, though, with thousands of lobbyistsfrom the pharma lobby funneling their influence and contribu-

tions through halls of Congress and the White House in Washing- ton, D.C. The pharmaceutical industry spent $855 million, more than any other industry category, on lobbying activities from1998 to 2006, according to the non-partisan Center for Public

Integrity.

Strengthening/Financially Reinforcing Medicare Havingcreated the model for NON-PROFIT, Social Managed Care pro-grams, it would seem logical that the expansion of its MedicareAdvantage Prescription Drug program is a highly attractive andseamless solution for relieving federal budgetary burdens on thesenior-care agency. The budget for the U.S. Department ofHealth and Human Services, which encompasses budgetary/operational oversight of Medicare, is the largest federal budgetcategory at $707.8 billion in 2008, according to the White HouseOffice of Management and Budget. Total budget outlays forMedicare (Parts A, B & D) are expected to top $506.8 billion for

2009, a near doubling (97% increase) over its $256.8 billionbudget in 2002. According to a report by the board of trusteesfor Medicare and Social Security, Medicare spent more than it

brought in from taxes in 2008, with predictions that the Medicare hos-pital insurance trust fund will become insolvent by 2019. However, if

the federal government acts more aggressively in mandat-ing an expansion of its successful Medicare Advantage(Part D) prescription drug program for Social HMOs, itcould be possible that more of the budgetary shortfall inmeeting the needs of nearly 45 million seniors in thiscountry could be alleviated and shifted toward direct pre-mium contributions to innovative non-profits, such as

SCAN,Elderplan and others, outlined in this paper.Profit should not be the overriding motivating, driving force ofAmerican healthcare and if we can get this right, I truly believeother American business categories rocked by scandals, corrup-

tion and other forms of mismanagement such as banking, realestate/housing and the automotive sectors will have a modelfor conducting business on a more sound and ethical basis go-ing-forward. The independence and innovation of these SocialHMOs feature the best of what NON-PROFIT, altruistic organiza-

tions offer, along with the innovations of what had once been considered sole pro-

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prietorship of FOR-PROFIT, private enterprise.

However, somewhere in this CLOSED-DOOR debate on Healthcare Reformin Washington, DC, the President and Congress seem to have shut off any

further PUBLIC EXPLORATION of new proposals, although Pres. Obama stillinsists he is keeping an open door policy on ideas from his friends in Con-

gress. But that is where the President doesnt even realize there are other ideas that can be explored and derived from a truly OPEN-PUBLIC FORUMsummit on healthcare that TANCis proposing. And that may be why thePresident doesnt realize that he lacks much of any kind of PUBLIC CON-SENSUS MANDATE FROM THE PEOPLE to give him leverage he needs inCongress.

Its time for all Americans to look inward, question, propose and work

together on how we can do better to help each other, rather than feed-ing off a dated laissez fairetheory of a free-market, predatory health-care system based on the survival of the fittest this is intolerableand unacceptable when it comes to balancing out the lives and well-

being of Americans.

Most notably, Americas arcane, haphazard Have orHave-Not system of private healthcare appears to bebuilt on a self-fulfilling prophecy of ethical and moralcriminality, all of which has already been rejected by the50 or so other nations of the world practicing variousforms of Universal Healthcare. Coming on the heels of

massive, nearly TRILLION-DOLLAR bailouts of corporatebanking, insurance and automotive institutions in thiscountry, it is critical our representative federal govern-ment proves it can still produce Healthcare Reform in thePublic Interest not just in Corporate Interests.

Delivering on a NON-PROFIT-BASED, Universal Health-care system would be a triumphant, epic accomplish-ment after 75-plus years of mostly futile struggles to at-

tain any kind of meaningful reform. It is time for Americato regain its reputation for humanity, equality and innova-tion as an advanced society atop the world stage.

# # #

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Advocates of a Single Payer and Universal Healthcare had tomake their feelings known quickly as Sen. Max Baucus (D-MT),chairman of Senate Finance Subcommittee holding hearings onHealthcare Reform, had security officers quickly escort them outdue to the CLOSED-DOOR nature of the HCR debate. Pleaseclick the hyperlink to watch the YouTube video as Baucus and

other committee members scoff and laugh as the advocates arerushed out the door.

If all or some of the Big Health Insurance carriers reject the NON-PROFIT conversion programmodel TANC is proposing here, then this federally-funded program should be entirely focused onfostering the creation of new NON-PROFIT Health Insurance Organizations and/or expanding theexisting Medicare-based Social HMOs, such as SCAN and Elderplan, into the general under-65marketplace. Allowing greater NON-PROFIT participation will generate lower pricing competitionin the marketplace that could similarly create new market-driven forces to drive down theartificially inflated pricing from FOR-PROFIT/PRIVATE insurance carriers.
http://www.transamericanalliance.org/http://www.youtube.com/watch?v=pwrudYlwxqEhttp://www.youtube.com/watch?v=pwrudYlwxqEhttp://www.transamericanalliance.org/


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About TANCTrans-American Alliance for a National Consensus (TANC) is a Califor-nia-based nonprofit 501[c][3] public advocacy organization dedi-

cated to establishing a national Electorate Legislative Consortium as partof a nonpartisan, citizen-based assembly bringing together all key segments ofsociety to author and enact consensus federal legislation. The primary mis-sion ofTANCis to act as a complementary but binding fourth branch arbiterbetween the established Legislative, Executive and Judicial branches of the

U.S. government.

To convene on a local, regional and national basis through a representational

number of universities and colleges in the United States, TANC is empoweredto bring badly-needed consistency, accountability and transparency to policy-and law-making from the federal government. Also referred to as The Alliance,the overriding goal is to establish TANCas a nonpartisan ethical conscienceof democracy, effectively seeking to contradict or mitigate the influence somewell-funded lobbyists, special interest groups and political action committees

hold on politicians throughout the corridors of power in Washington, D.C.

For more information and how you can participate to make Citizens Over-sight a potential fixture of future federal governance, please visit us at

www.transamericanalliance.org.

You can also make a huge difference by mailing or emailing this position pa-per, Rx for U.S. Healthcare Reform, to your elected congressional Senate andHouse representatives by searching for their email addresses at http://www.congress.org/congressorg/directory/congdir.tt. Emails, with the PDF ver-sion of the position paper attached, can be forwarded to the President([email protected]), Vice President ([email protected])and other members of executive branch-level cabinet departments can besent to [email protected]; and snail mail to The White House, 1600Pennsylvania Avenue NW, Washington, DC 20500. If you have any inquiries,suggestions or thoughts, please share them with us at Think-

[email protected].

# # #


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You can also find moreinformation, position pa-pers, presentations, ourdraft bill for anElectorate Branch ofgovernment and otherresearch and how you

are welcome to join inTANC membership at ourWeb site (listed above) orwith our two social net-work site portals: OurFacebook TANC CauseGroup at http://apps.facebook.com/causes/249715/54103574?m=1 and TANCLinkedIn.com Group por-tal at http://www.linkedin.com/

OrganizationMichael A. Freeman

Executive DirectorCo-Founder

Jaimie J. KeaneAssistant DirectorCo-Founder

If FOR-PROFIT/PRIVATE health insurance carriers label their so-called top-of-the-line plansas Cadillac Premiums, than several Social HMOs including SCANs Medicare-based plansfor seniors should be coined the Rolls-Royce Premiums of health insurance. It just provesthat a greatly expanded menu of benefits and lower deductibles and co-pays are veryachievable at a fraction of the monthly/yearly costs of what FOR-PROFIT/PRIVATE healthinsurers offer.
http://www.transamericanalliance.org/http://www.transamericanalliance.org/http://www.congress.org/congressorg/directory/congdir.tthttp://www.congress.org/congressorg/directory/congdir.tthttp://www.congress.org/congressorg/directory/congdir.ttmailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]://www.transamericanalliance.org/http://apps.facebook.com/causes/249715/54103574?m=1http://apps.facebook.com/causes/249715/54103574?m=1http://apps.facebook.com/causes/249715/54103574?m=1http://apps.facebook.com/causes/249715/54103574?m=1http://apps.facebook.com/causes/249715/54103574?m=1http://www.linkedin.com/groups?gid=129546&trk=hb_side_ghttp://www.linkedin.com/groups?gid=129546&trk=hb_side_ghttp://www.linkedin.com/groups?gid=129546&trk=hb_side_ghttp://www.linkedin.com/groups?gid=129546&trk=hb_side_ghttp://apps.facebook.com/causes/249715/54103574?m=1http://apps.facebook.com/causes/249715/54103574?m=1http://apps.facebook.com/causes/249715/54103574?m=1http://apps.facebook.com/causes/249715/54103574?m=1http://www.transamericanalliance.org/http://www.transamericanalliance.org/mailto:[email protected]:[email protected]:[email protected]:[email protected]:[email protected]://www.congress.org/congressorg/directory/congdir.tthttp://www.congress.org/congressorg/directory/congdir.tthttp://www.transamericanalliance.org/

Documents

Rx Health Reform Tanc Final