Weekly Pulse: Profits, Premiums and Potassium

Ashley Ellis weighed just 87 pounds when she reported to the Northwest State Correctional Facility in Vermont to serve a 30-day sentence for “careless and negligent operation of a motor vehicle.” Two days later, she was dead. As Terry J. Allen reports for In These Times, Ashley suffered from severe anorexia and bulimia. She died because the understaffed, profit-driven prison health service contractor, Prison Health Services (PHS), failed to give her potassium supplements that kept her heart beating normally. Investigators later learned that staffers nicknamed Ashley "Potassium Girl" because she begged so frantically for her medicine. The only healthcare providers on duty were licensed practical nurses who are barred by law from assessing patients. Ellis's family is considering a civil suit. Critics say that PHS has already figured the costs of lawsuits into its business model. Unlike public institutions, corporations can just move on when the costs of their negligence become unsupportable. If Vermont fires PHS, it can move on to the next state. Allen writes that "Vermont’s serial contracts with for-profit prison health care corporations follow a nationwide pattern: Prisoners get inadequate care, contractors absorb lawsuits, states switch providers, and the conflict between profit-making and good care remains." In other health news, the proposed anti-abortion amendment to the Senate health bill was defeated last night. Ardent pro-choicer Barbara Boxer (D-CA) killed the Nelson-Hatch-Casey amendment by calling a vote to table, as Jodi Jacobson of RH Reality Check reports. The fight over abortion funding and health care reform is far from over. Anti-choice senators might still decide to join a filibuster over the issue. The fate of the public option is still up in the air as Democratic senators are negotiate furiously amongst themselves. James Ridgeway of Mother Jones is disappointed with the options on the table. At this rate, he predicts, the Senate will approve a public option that isn't public at all. One popular proposal is modeled on the Federal Employee Health Benefits Program (FEHBP), which allows beneficiaries to choose between different private insurance plans under the oversight of an independent regulatory board. Some federal employees already opt out of the FEHBP because they can't afford the premiums. "This is the Democrats' idea of a 'compromise'—not with the Republicans, but with the so-called moderates within their own party," Ridgeway fumes. At The American Prospect, Paul Starr floats a plan to minimize political backlash over the individual mandate. Under an individual mandate, everyone who doesn't have health insurance would be required to buy coverage or pay a fine. A mandate is an important part of bringing down the cost of insurance because it would force young healthy people who might otherwise be tempted to skip insurance to pay their share. But, Starr notes, health care reform is supposed to help the uninsured, not force them to buy coverage they can't afford. He proposes that those with low incomes should be exempted from the mandate if they sign a waiver that makes them ineligible for future federal subsidies for the next five years. This proposal might soften the political blow of the individual mandate, but it would seem to defeat the purpose of having a mandate in the first place. The whole point was to get people to sign up, not to make it easier for them to avoid buying insurance. Starr's approach seems backwards. We shouldn't have to figure out how to cajole people into buying coverage that costs too much and covers too little. Subsidies and waivers won't change the ground truth: People will be annoyed when the government forces them to buy more of the private health insurers' crappy product. We know that for-profit health insurance is structurally designed to charge more and cover less. We know that premiums will keep going up if insurers don't have to compete with a public plan. Yet Democrats are converging on a plan that puts the interests of health insurers first and those of the public a distant second. This post features links to the best independent, progressive reporting about health care by members of The Media Consortium. It is free to reprint. Visit the Pulse for a complete list of articles on health care reform, or follow us on Twitter. And for the best progressive reporting on critical economy, environment, health care and immigration issues, check out The Audit, The Mulch, and The Diaspora. This is a project of The Media Consortium, a network of leading independent media outlets.