The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Health Care Reform Is Coming. Don’t Panic.

Posted by Alan on June 22, 2009


The legislative process is like Kabuki Theater. Very stylized. Clear-cut characters. Starts off slow, proceeds through several acts, ends fast and furious. The Congressional tussle over health care reform is no exception. We have the champions of the left and right pounding across the stage, striking poses, shouting out their predictable lines, scaring the bejeebies (whatever they are) out of the audience (otherwise known as constituents) and generally creating high drama. This is important work as it gives the 24 hour news stations something to talk about and this, in turn, keeps the commercials from running together in an endless loop of paid messages for help fighting the IRS, encouragement to ask your doctor about the benefits of an unhealthy number of medications, easy ways to get low cost loans and willing buyers of your excess gold jewelry.

At the same time we have numerous audience members who are quickly losing whatever bejeebies they might possess. If you are among the 470,000 Americans employed by the health insurance industry, for instance or among the tens of thousands of health insurance brokers in this country, you might feel like people are out to get you. Good catch because people are out to get you. Don’t feel too bad, though, you’re not alone. They’re also out to get doctors, hospitals, pharmaceutical companies and a host of others. 

Every health care reform idea on the table is scary to someone. Government-run plans, exchanges, mandates to sell coverage, mandates to buy coverage, taxes, cost containment. The list of proposals go on endlessly. Everybody with a stake in health care (which is everybody) has something to lose from some these reforms and someone is out there working hard to make sure these stakeholders lose it. In the health care reform everyone is an archer and everyone is a target.

So as someone with a stake in the system, but who has also spent more time than sane people should involved in politics and the legislative process, I would like to offer some simple advice to my fellow targets:

         Don’t Panic.

Don’t get comfortable, but don’t panic.

The good news is the health care reform most likely to emerge from Congress will be far more moderate than the proposals whipping around the Capital hallways today imply. This is theater — and it’s politics. Everyone in Washington is busy staking out negotiating positions, trying to score points, and auditioning for an appearance on CNN, Fox or MSNBC. Which means what they say matters, but not as much as they’d like to think it does.

In negotiations you expect to compromise so you start off asking for more than you expect to get. Every eight year old discussing bed time knows this. So do politicians. What we’re seeing at this point is primarily Democrats and Republicans anchoring their positions. In Kabuki Theater, actors will strike stances that identify their role in the story. In Congressional theater, this role is played by lawmakers. 

Which leads us to the effort of scoring points. Nothing revs up the base like lambasting opponents. The number of people who make a living by keeping a significant portion of the American population seething is significant and appalling. These people (and I use the term loosely) paint the world in terms of good and evil, black and white, us and them. Anyone who disagrees with “us” is a traitor, a fool, a liar or all of the above. They care less about moving the country forward than in adding to their power or their bank account. (Have you ever noticed how often their diatribes are followed by an appeal for cash or an advertisement?) These blowhards replace bombast for thought. They have honed the cheap shot and the stiletto implication into art forms. Fortunately there’s a cozy spot in Hell reserved for them where they’ll have to listen to themselves blather for eternity. Until then, we’re the ones stuck in their noisy hurricanes of malicious hot air. 

The subset of these sub-humans who hold public office will be especially prominent during this portion of the legislative process. Ignore them. Like the extreme positions taken by negotiators, the extreme rhetoric spouting from these Katrinas of politics are designed to rile you up, get your money and generate news clippings, not educate or move the debate forward.

The real action on health care reform is taking place in the nooks and crannies of Washington where moderates dwell. For example, keep your eye on the Senate Finance Committee. They seem to be trying to find solutions the nation can afford and that might actually work. Track the movements of moderates in the Senate, too. Senators Olympia Snow and Susan Collins are the two trendsetters on the amazing-shrinking-group of GOP moderates. On the Democratic side of the Senate moderates gather weekly in a self-described  Working Group. (Insert your own snide comment here).

The fact is, in Washington moderates win. The system is designed this way. It may not seem like it, but that’s the way it usually goes. This is the point articulately made by Jay Cost in his HorseRaceBlog over at RealClearPolitics.com. In two postings (Part 1 and Part 2) he lays out the pivot points in the legislative process and applies them specifically to the current health care reform debate. (My thanks to John Nelson for sending these my way). What he shows is that the true partisans are merely the fodder necessary to get to the number of votes needed to turn legislation into law. These pivot points vary depending on the political context.

Need to overcome a filibuster? The most powerful Senator is not the true believers who immediately vote yes or no, but the Senator who represents the 60th vote for cloture. Only that Senator can move the bill forward. The rest simply set the stage. When it comes to health care reform, watch the moderates. They are the key actors in this play because it is from among their group, along with critical  negotiators like Senators Max Baucus and Charles Grassley, from which the decisive votes will come. 

With 17 votes (maybe 18 now that Senator Arlen Specter is a Democrat) the moderate Democrats in the Senate will determine the final shape of healthcare reform. They are the ones the partisans on both sides are already seeking to persuade or, failing that, threaten (good news for television and radio stations in their states looking to sell advertising time). If these partisans are serious about passing something, however, that something will need to earn the votes of these moderates. Keep in mind, Democrats have a large majority in both chambers of Congress, but they got it by appealing broadly to the electorate. Democrats rarely are genetically incapable of group thought even when there’s just a few of them. Put 60 into one room (say, the floor of the Senate) and the chances of agreement on anything controversial is reduced to a theoretical nil.

What all this means is that the partisan posturing of the current debate is simply sound and fury signifying the hopes and aspirations of sincere partisans and cynical pot stirrers (which is which is sometimes hard to tell, but there is a difference — only the latter are despicable). Eventually the play will reach its final act. At this point the moderates take center stage and with their arrival the odds of disappointed extremists on both sides  increases(disappointing extremists is, after all, what moderates d0).

This doesn’t mean they will come up with the perfect health care reform plan. If you care about the issue you need to make your voice heard. Moderates are capable of making bad policy — and whether the truck that runs you over is driven by a true partisan or a moderate doesn’t really matter, it still hurts. Moderates are more likely, however to produce reforms that are closer to something reasonable than might seem possible appear today.

In the meantime, let the loud and boisterous actors strike their poses. It’s all part of the play.

22 Responses to “Health Care Reform Is Coming. Don’t Panic.”

  1. Calcined Clay said

    It is a good news not to be panic. Because it will make benefit to us not a way to wastage to money. So take it positively and be happy. I really appreciate to meat to this blog and read to this pretty awesome article.Cheers!
    calcined clay

  2. […] If no common ground emerges – whether because Democrats refuse to listen to Republicans or the GOP refuses to truly negotiate – the majority party is likely to move forward on their own. Whether liberals in the Democratic caucus have learned the lesson of the past year would be interesting to watch. That lesson, that it is Democrats who have a majority in Congress, not liberals and that the two are not the same, is a major reason Democrats are in danger of losing the opportunity to pass health care reform in the first place. If the Administration and Democratic leaders had focused on a moderate bill that could gain the support of their more conservative caucus members from the beginning, they would have passed a bill long before they lost their 60th vote. By hewing to the left, they delayed the inevitable: whatever health care reform bill, if any, emerges from Congress will disappoint true believers among…. […]

  3. Layton Lang said

    I am a National Healthcare Consultant who possesses years of experience with health policy reform. Based upon the past and current conduct of the key stakeholders, I am convinced that the primary participants are not prepared for the onerous and labyrinthine journey that lies ahead to meet Mr. Obama’s three health reform policy objectives. I maintain that we will have to experience a catastrophic event to compel all parties to the figurative table for substantive cooperation. I define such an event to be similar to the recent General Motor’s bankruptcy that brought the American auto industry to its knees. Here is an industry that has been aware of its internal problems for years, but had not been able to resolve the issues because the stakeholders’ desires were diametrically opposed. Once, GM emerges from the bankruptcy, I anticipate it will be a leaner company focusing on designing automobiles that travel over 100 miles per gallon, that cut emissions by 60% , and even reshape our American foreign policy. We will no longer amalgamate with regimes and foreign powers based upon potential oil reserves, but, instead, affiliate with countries that pledge an allegiance to our ideals and people. In sum, the health care industry needs to experience a symbolic bankruptcy to bring it to its bottom, which would rescind all parties’ hidden agendas and allow healthcare reform to flourish.

  4. Alison said

    I have seen more proactive action come accross my desk from NAHU directed toward preserving the role of agents than most. Letters put together that give you the ablitiy to get everyone involved. Designed so that the person need only sign their name and links have been provided to take the difficulty out of getting the letters where they need to go. You tell two friends and they tell two friends and so on and so on. Its alot more than alot of people I know who are talking about it endlessly with tons of ideas and no participation in the action. DO SOMETHING.

    • Al said

      Email form letters as well as faxed form letters are not taken all that seriously by legislators. They don’t hurt your cause, but they don’t do a whole lot to help it.

      In my experience of working with and around government (I was once a registered lobbyist in California) I can only surmise that decisions at the federal level are made the same way they are on the state level… by who gives how much money to whom and when.

      The carriers have a whole lot more money than agents do. So when it comes down to “brass tacks” (an expression that came from buying cloth) those who can pay are those who will play. The rest of us, no matter how many letters we send, are just going to be spectators.

      This is why I tell agents “Don’t worry, be happy.” There is nothing we can do to change anything… so why get all worked up over it? We do not have our own seat at the table… and NO, NAHU is first and foremost the voice of their carrier patrons. I don’t think NANU is anti-agent in all of this, but if it comes down to a choice of a government paid system, no private carriers, where agents contract directly with CMS or something similar for a 5% commission, vs. private insurance companies selling product without agents (they will sell via online exchanges or connectors) NAHU is going to throw us agents under the bus.

  5. Marie said

    I just came from a meeting of one of the few major players left in group health. They were unveiling their next new plan, and the experienced agents in the room were confused. Does anyone making these plans think about the consumer at the end? All the consumers know is that they have to jump through extra hoops to get covered procedures paid for, and if they do “A” it’s paid at one level, if they do “B” the same service is paid at another level. It’s beyond comprehension, and it just drives the consumers into the arms of those who say the government should take over. From their perspective, how could it get any worse? It takes months to get in as a new patient with a doctor, so the complaint that the Canadian plan has a wait list is meaningless. We have a wait list with private insurance.

    If the health insurance companies would clean up their act by making plans understandable, and stop paying the top brass more than the the cost of a hospital wing, the consumers might stop begging their representatives to change things.

  6. Ted said

    Well, a lot of interesting thoughts here about who is representing who. I have read most of the proposed Senate Bill and find many points ambiguous (and thereby quite disconcerting). The recent Congresional Budget Office estimates are based on tremendous amount of SWAG. See (http://www.mccarthystevenot.com/2009/06/24/proposed-senate-health-care-bill-leaves-30-million-uninsured-adds-1-042-trillion-in-deficits/). Few seem to note that – while covering the some 46 million uninsured people in America was one of the primary reasons for health care reform in the first place – the proposed bill still leaves 30 million uncovered! Further, the subsidies extended to low income people are so expansive, it will provide a disincentive for many families to move forward economically.

    Yes, health care affects me – but if I’m to be steam rolled over – at least pass legislation that: (1) trully impacts cost efficiency and not just rearranges the deck chairs on the Titanic, (2) actually helps cover the uninsured, and (3) is sold and delivered at the promised price.

    One of my concerns is that we continue to see more and more overhead being bolted on to our economy, thus making it harder for us to compete on a global scale – like the reality Europe now lives in. If we are not careful, we’ll become just like the Europeans and the emerging markets will clean our clocks! Further, it is bothersome this notion that the “rich” will pay for these Progressive plans. It’s not the rich who will end up paying – it’s college educated, professional, and small business owner types that will end up footing this bill (See:http://www.mccarthystevenot.com/2009/06/19/who-pays-in-the-senate-health-care-bill/).

    I appreciate the advice not to panic, but based on the mountain of mush in this proposed legislation, it is really hard not to panic. The kid is negotiating for a bedtime of a week from next Thursday. Except for a few small parts, there is very little in this proposed legislation that moderates should find worth picking up at all. This proposal is completely unworkable in its current form. Thanks.

  7. Mark Goodman said

    “But why would we want more Medicare? Isn’t Medicare a mess? Well, yes and no. The fabulously popular free health-insurance program for the elderly is running out of money, thanks to exploding costs. But the administration of Medicare is a miracle of low overhead and a model, despite all the fraud and abuse, of what government can do right. Three percent of Medicare’s premiums go for administrative costs. By contrast, 10 to 20 percent of private-insurance premiums go for administrative costs. Roll that figure around on your tongue. When you swallow and digest it, you’ll understand that any hope of significantly reducing health-care costs depends on a public option.”

    Above is a comment from Newsweek’s Johnathan Alter on June 20,2009. This is what makes the discussion so difficult. The issue is difficult enough with the correct facts but the above shows how much misconception is working its way into the public psyche.

    In the Presidents press conference yesterday he commented about people being able to buy into a public plan and/or connector without any pre-existing conditions. Great idea! Only if coverage is mandated is it a good idea. It is the place people need to go if they can’t get credible coverage elsewhere. The President had previously stated he didn’t want to make coverage mandatory and that is a shame and essentially should be a deal breaker on the Hill.

    The idea floating around the public and the Hill is that insurance isn’t competitive. If it’s not then where is the charge of price-fixing? No one in the brokerage side or the HR side can reasonably make that allegation. What those in Washington and the uniformed public have been unable to come to grips with is medicine is expensive.

    In an earlier post Alan has stated the situation clearly. It’s cost and universality; you can’t cover everyone effectively until you figure out how to reign in costs.

  8. Ann said

    Nope, I’m still going to panic.

    The reason is this: I’m really afraid that the pressure to pass something but still cater to lobbyists will result in expansion of access without serious cost controls – as in Medicare Part D. The middle ground just doesn’t cut it for cost control, and lack of cost controls will bankrupt both the country and individuals. Only the far left or the far right would succeed in controlling costs. Both would end the link with employment. Single payer could bring a global budget, and “free market competition” could bring health plans that don’t cover much of anything, creating huge gaps in coverage, and bringing down prices because no one would be able to afford to buy all those tests, procedures, and treatments anymore.

    Is anyone talking about Daschle’s “Federal Health Board”? I like the idea because I really think we need to take Congress out of managing the details.

  9. George Fulmore said

    If the Republican administration under George W. Bush could spend about $7 trillion or so in its eight years ($5.5 trillion to $12.5 by October 1, 2009?), mostly under the cover of announcements of moderate or “better than expected” annual deficits, why not give the Democrats a turn to spend a like amount? At that point, who would we blame for the bankrupting of the federal government? Bush? Obama? Both? Or would it matter? The federal government could be technically bankrupted, but if the totality of the population of the U.S. is not bankrupted, then things could be fixed. The problem is that George W. left us with a federal debt of about $40K per American resident. Doubling that would make it $80K? Not everyone is going to be able to come up with that tidy sum. But if we had a national health care system, maybe we could get back on the path to annual federal surpluses. That would be a start.

  10. Ronald W Masters, RHU said

    Alan,
    Brilliant post. Of all you wrote, “Don’t Panic. Don’t get comfortable, but don’t panic.”, I think is advice for all to follow. The don’t get comfortable is good counsel as well. Become evangelical about why the agent needs to be kept in the system.

    Now for Al,
    It is dissappoiting when I read a statement from one that is obviously misinformed.

    NAHU is not now nor has it ever been bought and paid for by carriers. Nor is Alan a mouthpiece for a middle of the road viewpoint, but has the political wisdom most of us could only hope to have. I have known him for over 20 years and we have had many a spirited debate but at the end of the day, he has the wisdom to rule the debate but not necessarily my view.

    Does NAHU accept sponsorships or donations from carriers? You bet. Has NAHU ever felt “obligated” to any carrier to promote their views or products? Not to my knowledge. Why would I know? I am a past president of the California Association of Health Underwriters, Orange County Association of Health Underwriters, past member of the NAHU Board, served as a Trustee for the NAHU, and was the Adhoc Committee Chairman Against Kennedy Waxman, and the first NAHU Legislative Council Chairman,,a position in which I served for 3 ½ years
    During that time, and since NAHU has represented the agent role in the health care system in America, and at the same time, the interests of the consumer.

    Maybe to you, Al, that is moderate, but based upon what has come forth as Health Care Reform in the past two weeks, the agent role is and the interests of Americans are under attack. And supporting the agent is a role that is anything but “moderate”.

    So, Al, if you have a bigger megaphone that can attend literally hundreds of meetings, in Washington DC and State Capitals, for several committees for numerous health insurance issues that will affect that agent’s livelihood, then grab it and speak out. Otherwise, join a local HU organization and join the 21,000+ (an increase of about 300% in recent years due to their effectiveness) who know who serves the agents’ role.

    NAHU is the known voice for health insurance brokers in Washington DC. There are other organizations who work hard too. If they are active in this fight, get involved, but know that NAHU has the biggest dog in this fight.

    Sorry, Alan, but I dislike misinformation.

    Regards,
    Ron
    r

    • Al said

      Ron, show me just one instance…just one where NAHU has come to the aid of the agent vs. the carrier.

      What about when Aetna cut IFP commissions for agents in CA a couple of years ago? Where was NAHU on that? Nowhere.

      When Anthem and others have threatened to “attack” the brokers who suggest to a client how they can indemnify a group HDHP plan, by suspending said agent’s commission, where was/is NAHU on that? Nowhere.

      When the state of CA came up with the silly IFP attestation procedure which in essence makes agents liable to a large penalty, where were they on that issue? Nowhere? (Notice that it isn’t the carriers who are liable to a $20,000 fine, but agents!)

      Today, when CMS is in cahoots with several carriers refusing to pay full commissions to agents for MAPD, where is NAHU on that? Nowhere?

      Why? Because when it comes to agents, carriers always have and always will come first with NAHU. As I say, show me where and when in the past five years that NAUH has dared to stand up for the agent against any or all carriers? It’s not done. Follow the money!

      So you want us to believe that Mr. Katz and NAHU really gives a damn about agents? Why would you think that given the past history of both?

      As for Mr. Katz, there is no doubt that he is knowledgeable on legislative subjects, but keep in perspective that he makes his living from consulting to the large carriers as well as speaking for them. He is also the major NAHU fanboy… which is tantamount to being bought and paid for by the large carriers. He was on the Blue Shield of CA stage this past spring and a few months before that he gave the same presentation to NAHU on their spring CE day.

      I have no problem with you or Mr. Katz eating the food of the large carriers, drinking their booze, or even sleeping with their women. All I ask is that those who purport that NAHU somehow is THE voice for independent agents, get a clue and not assume that we are as stupid as we seem to be (by paying the inflated dues of the organization.)

      If the past is prologue, NAHU and Mr. Katz as their spokesperson will indeed throw agents under the bus if and when the negotiations get hard. As I say, I don’t know of one instance when NAHU and Mr. Katz has stood for agents against a carrier. They talk the talk, but I’ve not seen either walk the walk.

      If I am wrong, I have no doubt that there are those here who can make that case.

      Al

      • Dennis said

        Al,

        I wonder if you are mistaking NAHU for a union? You see, NAHU is an industry trade association that is comprised of agents and those that make their living through the work of agents. When NAHU “fights” for its members it does so in a manner reflective of an industry trade association. This typically manifests itself in the legislative arena. If you look at any trade association made up of independent business owners and vendors looking to do business with (or through) those business owners I don’t think you’ll find that the trade association usually picks up the battle axe when it comes to disputes between its primary members and similarly aligned industry colleagues.

        Yes, many carrier representatives are members of their local NAHU chapter but if you actually look at which carrier representatives are members at any given chapter around the country you’ll find that they are primarily sales reps, sales reps who make their living from the work of agents. I’m not sure if you are an agent, but I am and I know that my interests and my carrier reps’ interests are closely aligned.

        The insurance carriers have their own very large and powerful trade association, AHIP. I think your frustration with NAHU is a bit misguided. Have you familiarized yourself with NAHU’s mission? Is there anything in that mission that leads you to believe that NAHU will stand up for your rights against carriers that most of us consider to be industry colleagues? You seem to be expecting something from NAHU that doesn’t actually align with their mission. Were you promised that NAHU would fight the carriers when those carriers made a business decision like Aetna did to reduce IFP commission in California for new and low performing producers? As an agent, I had no issue with this. I do the same thing with my client base. I have clients that range in size from individuals to small businesses with up to 200 employees. I can assure you that I don’t provide the same services to my individuals and two life groups that I give my larger clients. It is a business decision and one that no business person would fault me for. Aetna has made a similar decision. They know that an agent that only submits one or two cases a year in general can be a bigger challenge (incomplete apps, service issues, misrepresentation of policies to a client) so they pay those agents less than they do a higher performing agent. I don’t see where NAHU would have a place to come to the aid of the agent in that instance.

        I can’t comment on the MAPD commission cuts as I don’t sell Medicare and am not familiar with that situation. But bringing up the IFP attestation form or the HDHP statements of understanding as “proof” that NAHU (actually in this case CAHU) doesn’t have the best interest of the broker in mind is a bit ridiculous. When you look at the constant lobbying efforts of NAHU and CAHU and the anti-agent legislation that has been defeated over the years how can you point to two issues like these as “proof”.

        In a free market I expect my trade association to flex it’s muscle where we need it, with the legislators. Have you attended Capitol Conference in DC or Day at the Capitol in Sacramento? If you did, I think you would find that it is all about the agent. I’ve been on many appointments in legislator’s offices with insurance carrier reps and they do not represent themselves as advocating for the insurance companies, but for the brokers.

        But Al,
        Let’s say you are right and that NAHU is in the back pocket of the insurance carriers and that NAHU’s 20,000 members are wrong and there is no trade association looking out for us. We can both agree that as agents we’re in a critical time. So, now what?

        Sincerely,

        Dennis

        • Al said

          We will have to agree to disagree on what we see as the role of NAHU and its state and local chapters. While I’m a member, I can’t say that I believe that the organization does anything specifically for me as an agent.

          Perhaps you are right in that NAHU only represents the interests of agents when they conform to the interests of the carriers. Otherwise they keep their beak out of commission politics, and other agent-carrier issues. That is good for the carriers… not so good for the agents.

          Unlike you, my practice is about a 40% group and IFP health, the other 60% is split between life, DI and LTC. Thus, I don’t have as much skin in the game as you and others do.

          I have no idea what the final outcome of health reform will be, but I am pessimistic that agents will be part of it. My guess is that IF there is still a private sector participation, the Feds will force the carriers to do something similar to what Shelia Kuhl advocated by “allowing” the carriers only a 15% admin-overhead… meaning our commissions would be about 3%. Perhaps in a GI environment we could still make a sustainable living at 3%. I don’t know.

          I saw a lot of this coming with the popularity of the Sicko movie and it was then that I started to concentrate far more on my non-health products. Thus, if we agents are thrown under the health reform bus, I’m sure it won’t take more more than a year or two to replace the 40% of my income from health with income from life products, etc. Indeed, I think every agent should begin the process of diversification.

          I remember when ERISA and TEFRA wiped out an entire sector of financial advisors and consultants. I believe that NAHU, AHIP, the AMA and all the angels in heaven singing the praises of private insurance will not be nearly enough to stop what looks like an idea whose time has surely (or finally… depending on which side you are on) come.

          And maybe it won’t be such a bad thing. I’m old enough to remember the Alan Katz’s of the world saying that the sky would fall if Medicare was passed… but it was in 1963 (I was in college) and I don’t hear him or anyone else seeking its repeal. And in the end, Medicare was good for agents. So perhaps whatever reform we get will also be good for us.

          The point I’m making is that I don’t believe my best interests as an agent are necessarily tied to those of the large carriers who have NAHU by its privates. If the government will contract with me to sell US government health insurance or perhaps GI supplements for a government provided health plan at a 6% commission (isn’t that what they pay realtors to sell HUD homes?) tell me why I need an Aetna or an Anthem?

          I’m glad you trust NAHU to look out after your best interests. If it brings you comfort, by all means continue in what I call a state of denial. As I said, if the past is prologue, I don’t see a commitment by NAHU on the part of agents over that of the carriers should in the end it becomes a “them” vs. “us” issue. I have zero doubt that if preserving the place and profit of the carriers in the new system requires the end of independent agency, I know with whom NAHU will stand beside.

          Al

        • Ronald W Masters, RHU said

          Dennis

          Thoughful post. Your points are not only well made but on the mark.

          Al, as I said in my initial post, the number of times, over the many years, that NAHU has come to the aid of agents are so numerous that listing them here would take up Alan’s entire page.

          Additionally, Dennis is right on in stating that NAHU has chosed not to act as an attorney-in-fact for agent-carrier issues. That has never been their charge. In my experienced, profitable producers generally have little need for such assitance.

          As for me, I am now retired and have not directly benefited from carrier entertainment in some years now.

          Whether you will ever try to look at NAHU or any agents trade association to represent your interests is, of course, up to you. But regardless, this may be the most pivotal point in time in the history of agent representation and all voices need to be heard.

          How will you make yours heard?

          I wish you well

          Ron

  11. Ed Harris said

    I hope you’re right. I have always said that the combination of HSAs and well-placed tax incentives would solve most of our health care problems.

  12. Al said

    Those of you who believe from reading Alan’s blog, that there are calm seas and following winds ahead for agents could not be more mistaken.

    What Alan has not told you is that NAHU and the other moderates out there could care less about agents. NAHU makes a lot of noise about looking after our interests, but at the end of the day… follow the money. Agents have no interest group. NAHU is bought and paid for by the large carriers and when push comes to shove, it will be the agents whom these so-called “moderates” will throw under the bus.

    • Ron said

      So Al, what are you doing about it? Or what are you suggesting be done? Do you know Alan? I do, and call me naive, but I don’t believe he wouldn’t fight for the role of agents. He is right about how things get done in Washington. Read you American history. Making laws in Washington has always been like watching sausages get made.

    • Alan said

      Al, you have a right to your opinions, but you couldn’t be more wrong. NAHU is fighting on behalf of agents. The staff and volunteer members have spent countless hours educating lawmakers and their staffs on the value we bring to the system. They have suggested legislative language and policies that would lower health care costs, increase the number of Americans covered, and make health care reform effective, responsible and meaningful. Some of their positions are aligned with those of the carriers; some are not. To say NAHU has been bought by the carriers indicates the level of your anger more than your insight, but again, you have a right to your opinions.

      Whether NAHU will be successful or not is unknown. We are, after all, only one voice among many. Nor do I know what kind of reforms will result from the influence of moderates. That was one of the points of my post: it’s too early to know where this is headed. For now we’re going to see a lot of posturing and hear a lot of extreme rhetoric. People should expect this and not overreact. Nor should they be complacent. If people took from my post that there are “calm seas and following winds ahead for agents” (nicely put, by the way) then they misread the post. There’s rough seas ahead and all hands need to be on deck. We’re months away from a resolution and those who care about the outcome need to be engaged through the entire process.

  13. Alison said

    Ditto to Mark. Alan is the best.

  14. Mark Goodman said

    Your post this morning was better then a cabinet full of prescribed medication from our health care system! Many thanks for your continued vigilance as this unfolds.

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