From Gary Strauss at USA Today comes this quite shocking story about how some employers are preserving gold-plated health insurance plans for top CEOs just as millions of workers “face rising health insurance costs and dwindling benefits“:

Though millions of workers face rising health insurance costs and dwindling benefits in 2011, many CEOs will retain employer-paid medical plans and health benefits worth thousands of dollars.

Hundreds of top corporate managers get medical benefits and supplemental coverage far beyond what’s offered to rank-and-file employees. Benefits include “executive” physicals and reimbursements for out-of-pocket costs, deductibles and co-payments, according to corporate filings.

As one source told Strauss, “[t]he great hypocrisy is this is going to the people best able to pay for this stuff.” “Executives should pay for this on their own or be covered by the same plan as everyone else at the company,” Nell Minow of The Corporate Library said. Fortunately, the Affordable Care Act would do just that, prohibiting employers that provide health coverage from limiting eligibility for coverage to highly compensated individuals. (Sec. 2716 of the law or pages 38-39 in this version.) Group plans will not be able to limit eligibility to highly compensated individuals or discriminate through the benefits offered.

All of these bloated packages and perks only increase health care costs and by 2018 they will face the new excise tax and will likely be far less numerous. But for now, companies seem content on offering the policies while most of the workforce is struggling with risking costs.

It’s worth considering Sarah Palin’s new claim that the Independent Payment Advisory Board (IPAB) — one of the few cost control mechanisms in the Affordable Care Act — will lead to “death panel”-like rationing, if only to bury it once and for all for the absurdity that it is. First, look at how Palin described the IPAB in today’s Wall Street Journal editorial:

[The deficit commission] also implicitly endorses the use of “death panel”-like rationing by way of the new Independent Payments Advisory Board—making bureaucrats, not medical professionals, the ultimate arbiters of what types of treatment will (and especially will not) be reimbursed under Medicare.

In actuality, the board is something different. Beginning in 2014 the 15-member board that will offer Congress a comprehensive proposal to reduce excess cost growth in Medicare. As Section 3403 (page 409) of the law stipulates, the proposal cannot “include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums…increase Medicare beneficiary cost- sharing (including deductibles, coinsurance, and co- payments), or otherwise restrict benefits or modify eligibility criteria.” When Medicare costs are projected to be unsustainable, the proposal will take effect unless Congress passes an alternative measure that achieves the same level of savings. The deficit commission expands IPAB by allowing it to “make recommendations for cost-sharing and benefit design and to look beyond Medicare.”

But what’s ironic about Palin’s claim is that she makes it in the course of endorsing Rep. Paul Ryan’s ‘Roadmap’. By Palin’s standards, that proposal would have a far more significant effect on denying seniors access to care than anything in the health law. Briefly, under the Roadmap individuals who are age 65 or older in 2020 would continue in the current Medicare program, while those who will become eligible for Medicare after 2020 would be given a voucher with which to purchase private health insurance. Here is how the Congressional Budget Office (CBO) describes the consequences of that policy (pg. 10):

Under the Roadmap, the value of the voucher would be less than expected Medicare spending per enrollee in 2021, when the voucher program would begin. In addition, Medicare’s current payment rates for providers are lower than those paid by commercial insurers, and the program’s administrative costs are lower than those for individually purchased insurance. Beneficiaries would therefore face higher premiums in the private market for a package of benefits similar to that currently provided by Medicare. Moreover, the value of the voucher would grow significantly more slowly than CBO expects that Medicare spending per enrollee would grow under current law. Beneficiaries would therefore be likely to purchase less comprehensive health plans or plans more heavily managed than traditional Medicare, resulting in some combination of less use of health care services and less use of technologically advanced treatments than under current law. Beneficiaries would also bear the financial risk for the cost of buying insurance policies or the cost of obtaining health care services beyond what would be covered by their insurance.

U.S. Court of Appeals Judges and FREE Board Members Edith Clement, Alice Batchelder and Danny Boggs

Yesterday, ThinkProgress reported that three U.S. Court of Appeals judges serve on the board of the Foundation for Research on Economics & the Environment (FREE), an organization that “routinely hosts free junkets for federal judges where they can ride horses, bunk with industry attorneys, and learn how to decide environmental cases in ways that benefit FREE’s corporate funders.” Moreover, these three judges, Edith Clement of the Fifth Circuit and Alice Batchelder and Danny Boggs, both of the Sixth Circuit, have remained on the board despite an ethics opinion from a committee of federal judges which unequivocally states that belonging to this board violates these judges’ ethically obligations under federal law.  As the opinion explains, by serving on the board the judges “personally advocate FREE’s values and positions” and thus could create the impression that their “impartiality may be impaired as to certain issues likely to arise in federal court.”

Although FREE’s name suggest that its primary interest is in environmental law, the organization has hosted junkets and published a number of articles on other topics that are likely to arise in pending litigation.  Indeed, some of the views which Judges Batchelder, Boggs and Clement “personally advocate” by serving on FREE’s board raise serious questions about whether their “impartiality may be impaired” in the highest-profile cases in decades — the many lawsuits challenging the Affordable Care Act.

In addition to hosting at least one junket on health reform, FREE has published a number of articles questioning the wisdom of the Affordable Care Act — often telling stories more suited to Glenn Beck’s show than to an organization targeting federal judges.  One of these articles, for example, consists largely of FREE’s board chair reminiscing about the time when “[Saul] Alinsky and his acolyte, Bill Ayers, were mobilizing Chicago through ACORN, the Woodlawn and Gamaliel Foundations, the Weather Underground.”

But what FREE’s articles on the Affordable Care Act lack in coherence they make up for in disdain for “Obama Care.”  One article parrots the claims of Ken Cuccinelli and other anti-health reform plaintiffs who warn that upholding the Affordable Care Act could lead to an unlimited expansion of the federal government — in FREE’s words “[t]hose with an unconstrained vision of the good that government can do see health care reform as an opportunity to increase government’s scope and power.”  Another article mocked the Affordable Care Act’s supporters as “naïve”:

I have intelligent, generally well-informed friends who initially favored various versions of Obama Care. They put hopes and expectations in the same basket. I am hopeful that our impending experiences will change their naïve beliefs in centralized approaches to such complex social systems as health care.

Presently, a Michigan judge’s decision upholding the Affordable Care Act is pending in Judges Batchelder and Boggs’ court, and a similar case could easily arise in Judge Clement’s Fifth Circuit.  If these three judges insist upon remaining on FREE’s board, they should think very hard about the impression of partiality they would create if they are selected to hear these cases.

This Ben Smith post really ties together the two arguments I made yesterday, namely that health insurers are extremely effective in shaping public opinion and that Fox News began referring to the public option as the government option to help sink reform, not offer a better explanation of the provision. As it turns out, that phrase first originated not with Fox or Frank Luntz, but AHIP — the insurance lobby powerhouse that shaped much of the law to its liking:

A former Republican Hill staffer closely involved in the battle over the health care plan — and concerned that credit go where it’s due — e-mails that the case for the linguistic shift first emerged in February in research provided the GOP by the health insurance industry group America’s Health Insurance Plans (AHIP).

AHIP focus groups from late February (whose findings appear in this document, provided by the former aide) found that voters like the idea of a “public” plan, and that the most negative term is a “government-run health insurance plan.”

A round of polling from AHIP in February and March confirmed that argument. “It is clear the most negative language to use when describing a ‘public plan’ is ‘a government-run health insurance plan,’” reads a presentation the group distributed, starting in March, to allies, Republican staff and opinion leaders and to conservative media, according to the former aide.

Sen. John Ensign was the first to pick up the talking point in a March 24 release blasting a “Government-Run ‘Public’ Health Insurance Plan.”

This is fairly significant because it once again reaffirms the existence of a messaging pipeline which stretches from the industry to the lobbyist to the lawmaker and to Fox — and not necessarily in that order. The effectiveness of this communication system was on full display during the health care debate, when Republicans went to the floor and literally read from the industry-sponsored critique of the health law and then again echoed their arguments about the causes of premium increases after the law passed. None of this happened through some coincidence or a meeting of the minds. More likely than not, Republicans and their friends in the media were reading from talking points they received directly from the industry.

But the industry’s influence stretched far beyond the phrase “government option.” Insurers went to great lengths to develop messages that shifted public perceptions against the provision. As this AHIP presentation demonstrates, almost all of the following phrases became standard Republican talking points against reform — and they came straight out of the industry’s polling:

In his book Deadly Spin, Wendell Potter explains how this process works through the help of public relations firms and a mass distribution of information to friendly news outlets (read: Fox News) and conservative think tanks who then place favorable editorials in the country’s leading newspapers. This example deserves a prime spot in the book’s second edition, which, with some more investigative work, could contain whole treasure trove of anti-reform phrases and talking points that originated with AHIP.

Read AHIP’s research on the ‘public option’ here and see their presentation here.