News

Despite Booming Economy, Number Uninsured Rises 1.5 Million

Cambridge, MA -- The number of Americans without health insurance climbed to 43.2 million last year, nearly one in every six persons. The number of uninsured was up 1.5 million from 41.7 million in 1996, equivalent to 125,000 people losing coverage every month, according to an analysis of raw data posted on the internet by the Census Bureau yesterday.
The 1998 Current Population Survey (CPS) data was analyzed by researchers at Harvard Medical School and Columbia University College of Physicians and Surgeons last night, and reported by Physicians for a National Health Program today.

"Sixteen percent of Americans are without insurance, a higher proportion than at any time since the passage of Medicare of Medicaid," according to Dr. Steffie Woolhandler, Associate Professor of Medicine at Harvard and a co-founder of Physicians for a National Health Program. "What's startling is the magnitude of the increase when the economy was booming."

California experienced the largest jump in uninsured, up 575,000 to 7.1 million people without coverage. Other states with large increases in the number of uninsured include Michigan (up 276,000 to 1.1 million), Illinois (up 169,000 to 1.5 million), Alabama (up 108,000 to 660,000), Florida (up 96,000 to 2.8 million), Maryland (up 96,000 to 680,000), and Pennsylvania (up 76,000 to 1.2 million).

In six states, more than one out of every five persons is uninsured: Texas (24.5%), Arkansas (24.4%), Arizona (23.8%), California (21.5%), New Mexico (20.2%), and Mississippi (20.1%). The number of states with less than 10% of the population uninsured dwindled from eight in 1996 to just five in 1997. Hawaii (7.5%) and Wisconsin (7.9%) had the lowest percentages of uninsured in 1997.

"We see the terrible consequences of patients lacking insurance in my clinic every day," said Dr. Bob LeBow, Medical Director of the Terry Reilly Health Center in Nampa Idaho and President of Physicians for a National Health Program.

"Hispanic Americans had the highest rates of uninsurance," noted Dr. Olveen Carrasquillo of Columbia University. "Millions of middle and upper income families also were uninsured."

Nearly 11 million people in families with incomes between $30,000 and $60,000 were uninsured in 1997, as well as 5.8 million in families with incomes over $60,000. The uninsurance rate for Hispanics climbed from 33.6% to 34.2%.

Uninsurance rates increased both for men (from 17.1% to 17.5%) and for women (from 14.2% to 14.7%). While the number of uninsured children was stable at 10.6 million, there were increases for young and middle-aged adults; 23.8% of people 18-39 were uninsured in 1997 (up from 22.7% in 1996), as were 14.6% of those between 40 and 65 (up from 14.4%).

Medicaid enrollment fell by approximately 1.8 million, apparently as a result of welfare cutbacks. Meanwhile, despite rising employment, the proportion of Americans with private coverage actually fell slightly from 70.2% to 70.0%. Medicare coverage rose slightly.

"These may be the best of times for the economy, but they are the worst of times for health care," noted Dr. David Himmelstein of Harvard. "Uninsurance is rising, even people with coverage often can't get the care they need, and costs will double in the next decade. It's time to reopen debate over national health insurance."

Posted by pnhp at 03:31 PM | Permalink | Comments (0)

Physicians for a National Health Program is a national organization with over 8,000 physician members across the United States. Our members represent every state and medical specialty, and include national experts in geriatrics, psychiatry, chronic illness, public health, women's health and long-term care as well as health care policy and financing.
We are pleased to be invited to testify on a panel before the Medicare Commission on health system reform, as that is PNHP's primary focus. PNHP was founded in 1987, and for over 10 years has performed nationally recognized research and education on the need for and the way to achieve system reform to address the fundamental problems plaguing the American health system.

Medicare is critical to the health and security of American seniors and the disabled, but despite this, Medicare is inadequate protection for many. On average, seniors now spend over 20% of their incomes for health care. Deductibles and co-payments are a barrier to access. Medications and nursing home care are not covered; home care services are limited and subject to fraud and abuse. With decreasing lengths of hospital stays and more out-patient procedures, the burden of care is being shifted from trained physicians and nurses to frail and untrained seniors and their family members.

The privatization of the Medicare program, shifting seniors into for-profit HMOs, has led to a new series of problems, notably increasing costs (6% higher per beneficiary in an HMO) and bureaucracy in the Medicare program, and a troubling rise in quality and access problems.

According to the Health Care Financing Administration, Medicare lost $2 billion on HMOs in 1996 alone due to selective enrollment of healthier seniors. A 1996 Physician Payment Review Commission Study of Medicare HMO enrollees between 1989 and 1994 confirmed previous studies showing selective enrollment, finding that HMOs enroll healthy seniors with only 63% of average Medicare costs prior to enrollment. The study also found that patients who disenrolled from Medicare HMOs had 60% higher health care costs -- a sign of the Medicare HMO "revolving door," where the "healthy go in, and the sick go out."

Other disturbing evidence from privatization is the rise in bureaucracy. The latest HCFA data show that administrative costs for beneficiaries in HMOs have skyrocketed to 9.1% while traditional Medicare's administrative costs are 2%.

Research also shows that the elderly, chronically ill, and poor do worse under managed care. A four year study of 2,235 patients in three cities with hypertension, diabetes, recent MI, congestive heart failure, or depression published in the Journal of the American Medical Association found that patients who were elderly were almost twice as likely to decline in physical health in an HMO than in traditional Medicare.

Medicare HMO enrollees are also, according to the Physician Payment Review Commission, three times more likely to report access to care problems as those in fee-for-service.

MSA's and other forms of privatization and fragmentation of the Medicare risk pool (e.g. the proposed Kyl amendment to allow physicians to charge Medicare patients higher fees) also would raise Medicare's costs and increase the risk of fraud and abuse within the Medicare program.

Although cost containment has not been successful in the U.S., other industrialized countries have done a far better job at controlling costs than the U.S. while also providing universal coverage. Between 1980 and 1994, national health expenditures as a share of GDP in France, Canada, Western Germany and the U.K. rose an average of 1.30% annually. In the U.S., the average was 3.15% or more than double this rate. During this period, Canada also experienced a rapid aging of the population. Between 1980 and 1990, the share of Canadians age 65 or above rose from 9.5% to 11.5%, an increase of 21%. This is only moderately below the 25% growth the trustees of the Social Security trust fund project will occur between 2010 and 2020, the decade of peak growth in the elderly in the U.S. (Economic Policy Institute study).

In 1996, the U.S. spent 13.6% of its total GDP on health care ($3,759 per capita), even though 43 million were left uninsured. Costs continue to rise and an additional 100,000 people lose coverage every month. Our neighbor to the north covered all residents for $2,002, about 10% of (her lower per capita) GDP in 1996. Canadians also continue to have free choice of physician and have much lower spending on bureaucracy (2% on insurance administration).

A study by the U.S. General Accounting Office concluded that the U.S. could save enough simply on administrative costs with a single payer national health program to cover all uninsured Americans. In addition, with more the more effective cost-containment mechanisms possible under single payer (negotiated fees, global hospital budgets, capital planning and budgeting), the U.S. Congressional Budget Office found that the U.S. could save $224 billion by 2004.

The advantages to seniors, and to Americans as a whole, of a single payer national health program would not include just affordable health care throughout their lifetimes. These advantages include: being able to choose their physicians, hospitals, clinics and other care settings; enough savings on bureaucracy to cover prescription medications and long-term care; an end to hospital, doctor and insurance bills; and a preservation of the doctor patient relationship with care based on clinical decisions by chosen caregivers.

Despite its magnificence, Medicare since 1965 has been an incomplete universal single payer insurance program for the elderly. Opponents of universal care for all people have cynically pointed to the limitations of Medicare which were imposed by the marketeers who profit from the present systems as an argument against guaranteed care for everyone. The Commission must not fall into this trap.

For more details, we submit to the Medicare Commission the following proposals: "A National Health Program for the U.S." (New England Journal of Medicine, January 12, 1989); "A National Long-term Care Program for the United States: A Caring Vision" (JAMA, December 4, 1991); "A Better Quality Alternative: Single Payer National Health System Reform" (JAMA, September 14, 1994); "Liberal Benefits, Conservative Spending: The Physicians for a National Health Program Proposal" (JAMA, May 15, 1991).

Posted by pnhp at 03:31 PM | Permalink | Comments (0)

My name is Douglas Robins. I am a practicing physician in Washington, D.C. and I am representing Physicians for a National Health Program, an organization with over 8,000 physicians across the United States representing every specialty. Our primary goal is to promote a universal health care system that would provide health care benefits to all Americans. It would eliminate for-profit health insurance and substitute a single payer system funded through a payroll deduction in place of the health insurance premiums which are now being paid. It would eliminate for-profit managed care and allow free choice of physician and hospital for all. We believe that as a result of the enormous savings that could be realized by eliminating the present insurance system, that with these same health care dollars that we're now spending, we could cover all of the 43 million Americans who now lack health care coverage, and expand benefits for those of us who are already covered. In fact, the GAO estimated a 10 percent administrative savings with a single payer system which would amount to more than 100 billion dollars a year in savings.

We, too, share your concerns about the future of Medicare as it now exists. We feel that it is a good system, although it could be improved by expanding pharmaceutical coverage, mental health benefits and long-term care support. Because it is such an integral part of our health care system, it simply cannot be dealt with in isolation, and the Medicare population would be best served by integrating with the remaining population into a universal single payer system.

I would like to highlight two of the major concerns in our health care system that would be eliminated by our single payer approach. The first concern is the myth that managed care saves money. When managed care first became prevalent a few years ago, it was able to slow down the runaway health care inflation which was occurring at that time by significantly reducing fees to physicians and hospital and by controlling utilization. In recent years managed care has failed to achieve further savings, and health care costs are again on the rise. At the same time, there has been a tremendous public backlash against many of the restrictive practices of managed care, and as the public and the political process tries to reform some of those restrictive practices, it will ultimately raise costs even further. What is often forgotten, however, is the huge administrative costs that managed care generates. In contrast to Medicare, which runs on a 2 percent administrative cost basis, managed care insurance companies routinely take 15% to 20% of health care premiums for their administrative costs and profits. In addition, because of the excessive paperwork requirements in the present system, physicians are often spending 10% or more of their gross incomes on billing costs. It doesn't take an advanced degree in health economics to determine that a health care system that is spending 25% to 30% of its dollars on administrative costs, is an extremely dysfunctional system. A well run single payer system would take the savings which managed care was previously able to achieve, and by eliminating much of the bloated bureaucracy, marketings costs and sales commissions, excessive executive compensation packages and shareholder profits, would be able to function far more economically. Most of the restrictive practices and expensive micro-management of managed care would be eliminated, Instead, quality and utilization control mechanisms would include practice guidelines, outcomes research and practice profiling to identify "outliers."

The second concern is the number of uninsured Americans which now stands about 43 million and is growing at the rate of 1 million a year in spite of a booming economy. Much of the large safety net which once existed in our health care system has now been eliminated because of the financial pressures of managed care, so that these increasing numbers of uninsured have far less access to health care than they had previously. I believe that most Americans feel that access to health care is a basic human right, and they are sympathetic to the plight of the uninsured. However, there is another aspect to this problem which is the significant public health implications, which of course, will affect the insured, as well as the uninsured population. The spread of infectious disease, as well as the closure of vital clinics, emergency rooms, and hospitals are examples of these public health issues; and, of course, the failure to diagnose and treat illness early in its course, rather than late, will ultimately lead to a far more expensive outcome for society as a whole. In spite of the fact that there has been extensive public and political debate on how to solve the uninsured problem, no other viable solution has yet been brought forth, other than using the savings achieved by converting our health care system to single payer and eliminating the insurance companies.

Let me close on an optimistic note. "Free market competition" is the mantra that is repeated so frequently in relation to our current economic prosperity. I would submit to you that when it comes to health care, almost all Americans would prefer not to have that competition between multi-billion dollar conglomerates competing on the basis of stock price and shareholder profits - but instead would rather see their physicians, hospitals, and other health care providers competing on the basis of competence, compassion, and cost-effectiveness. The good news is that we can have that kind of a system, one in which all Americans are included, for a much smaller price than what we are paying for now.

Posted by pnhp at 03:31 PM | Permalink | Comments (0)

Uninsured & Underinsured

Only 68.4% of Americans report having a "regular source of care," a strong predictor of access to health care services. People without a regular source of care are more like to be uninsured, young, male, Hispanic, and low-income. Only 44.6% of uninsured adults in Arizona have a regular source of care, the lowest among 10 states survey by the Centers for Disease Control (MMWR, 4/17/98).

14.8% of all children are uninsured, with the rate varying dramatically by race. 28.9% of Hispanic children are uninsured, compared to 18.8% of black children and 13.9% of white children (U.S. Census Bureau, 1998).

Uninsured kids in Alabama, Mississippi, and Texas, which are home to one out of six uninsured children in the country, are unlikely to be helped by the new children's health plan. According to a study by the Children's Defense Fund, these states are expanding coverage only minimally, e.g. to "poor teens with family incomes up to $13,650 for a family of three." In addition, nine states are charging premiums of $200 a year or more for coverage, and one (Wyoming) has declined to expand coverage altogether (CDF, 5/12/98).

Almost 3.4 million of the nation's 10.6 million uninsured children are eligible for Medicaid but are not enrolled. 64.4% of the eligible but uninsured children in California are Hispanic (USA Today, 4/27/98).

Among poor children under six years of age, 21% of those without health insurance lack a usual source of care, compared with 4% of those with health insurance (National Center for Health Statistics study, HHS release, 7/30/98).

14% of near-elderly people (aged 55 to 64) are uninsured. The near-elderly spend 45% more on health care services than do individuals between 45 and 54, and their median family income is 25% lower (GAO report 98-133).

The Decline of Employer-Sponsored Health Insurance

According to a study of employer-sponsored health plans, between 1988 and 1997, mental health benefits have been cut by 54%, while general health benefits have been cut by 7%. Total employer-paid health benefits per covered individual fell from $2,237 in 1988 to $2,156 in 1997, while mental health benefits plummeted from $154 to $69 per person, and from 6.2% to 3.1% of overall benefit packages. Both outpatient and inpatient treatment benefits were cut (Health Care Plan Design and Cost Trends: 1988 through 1997, Hay Group, American Health Line, 5/8/98).

Costs

Many employers are facing double-digit increases in health insurance costs this year. Benefits consultants estimate that the increases will average 7 percent nationally, five times the 1.4 percent inflation rate, but could be higher as HMOs try to make up for huge losses in 1997. Higher premiums are cheering investors, who have bid up shares of WellPoint Health Networks, PacifiCare, and United by one-third (New York Times, 4/27/98).

Minnesota is facing a 13% hike in health insurance costs for state employees in 1999. The state government is the largest employer in Minnesota, and the increases it faces make it a "bellwether" for other employers. One of the largest HMOs in the state, Medica, is increasing premiums 25% (Minneapolis Star and Tribune, 6/25/98).

The Real Drug Lords: Pharmaceuticals, Inc.

Eight medications used in the treatment of mental illness cost up to six times more in the U.S. than in Europe. A study by the consumer group Public Citizen found that the cost of five antidepressants and three antipsychotic drugs to pharmacists in the U.S., Mexico, Canada, and 14 European nations was always highest in the U.S., often by a wide margin. A month's supply of fluoxetine was $72.16 in the U.S. versus $25.93 in Spain. A month's supply of the antipsychotic clozapine was $317.03 in the U.S. compared to $51.94 in Spain. The cost differential persisted even when the medications were developed in Europe, as in the case of clozapine and risperidone. Drug firms are able to extract large profit margins in the U.S. because of the lack of a national health system to negotiate price discounts for consumers (Public Citizen Health Research Group, 7/15/98).

Five FDA-approved drugs have been pulled off the market since January 1996. The number of drugs approved annually by the FDA has climbed from 26 in the 1980's and early 1990's to 39 in 1997 (USA Today, 7/10/98).

Women's Health, Inc.

HMOs tailor their marketing to women because women make 75% of family decisions on health care, and 90% of physician-referral and health information calls. Indianapolis-based Anthem insurance company's latest advertising campaign is targeted at women. Dr. Bernardine Healy, former NIH director under President Bush, is kicking off Anthem's "Healthy Women" campaign with a speaking tour (Anthem release, 6/19/98).

Medical and Socio-economical Inequality

Metropolitan areas with high income inequality and low average income have 140 more deaths per 100,000 people each year than cities with more equitable distribution of wealth. According to University of Michigan epidemiologist John Lynch, 140 excess deaths per 100,000 is equivalent to the combined loss of life from lung cancer, diabetes, motor vehicle accidents, HIV infections, suicides, and homicides. The study was based on a review of mortality and income data from 282 metropolitan areas (Lynch, American Journal of Public Health, July 1998).
16 communities on the south and west sides of Chicago average less than 2 doctors per 10,000 population, compared with 15 communities along the "gold coast" that averages 16.8 doctors per 10,000 population (Chicago Reporter, July 1998).

Nursing Homes, Inc.

Most U.S. nursing homes are investor-owned, making the nursing home industry an important case study of the impact of for-profit ownership on quality of care.
The General Accounting Office (GAO) just completed a nine-month investigation into nursing homes in California. They found that 30% of the homes had committed violations "that caused death or life-threatening harm to patients." Another 33% had violations that "harmed patients without threatening their lives," and 35% had "deficiencies that could harm patients if not corrected." Only 2% of the homes had no violations or minimal deficiencies. The GAO reviewed inspection reports on 1,370 California nursing homes inspected between 1995 and 1998. Clinical researchers also reviewed medical records of a small sample of cases involving resident deaths. They found that more than half (34 of 62) of the suspicious deaths studied "were probably caused by poor care." Charlene Harrington, R.N., Ph.D. noted that "California is symptomatic of all the states," and that it is actually better than many other states in detecting substandard care (New York Times, 7/29/98).

Vencor, the nation's fourth-largest for-profit nursing home chain, illegally evicted Medicaid patients in Florida and Kentucky. Florida fined the firm $260,000 (the maximum $5,000 for each of 52 patients illegally sent 30-day eviction notices) and required Vencor to allow 10 evicted patients to return. Florida is also asking the federal government to levy an additonal $100,000 fine against the company. In Kentucky, Vencor illegally evicted 11 Medicaid patients from the Hermitage Manor nursing home in Owensboro, Kentucy in February, telling the patients they had to "pay privately or move out." The firm is also facing government scrutiny in California, Colorado, and Georgia (AP/Owensboro Messenger, 6/22/98, St. Petersburg Times, 4/11/98).

Corporate Money and Care

Milliman & Robertson (M & R), the actuarial and consulting firm that teaches HMOs how to skimp on care, is issuing a $500 volume of pediatric guidelines this fall. According to the Wall Street Journal, the guidelines recommend treating bone infections with as little as two nights in the hospital, followed by IV or oral antibiotics at home. For endocarditis, children would be allowed a three-night stay, followed by IV antibiotics at home--a dictate that makes pediatricians "shudder". Insurers use the M & R guidelines to refuse to pay for treatments that take longer than the book says they should (Wall Street Journal, 6/15/98).
The M & R guidelines for hospital stays for adults following major surgery are also skimpy. The firm suggests a 3- to 4-day stay for aortic valve repair, CABG, and partial colectomy, while the average LOS for such procedures performed at 157 North Carolina hospitals in 1996 was between 8 to 10 days ("Milliman and Robertson Fail Surgeons' Reality Check", Physicians Weekly, 6/98).

In response to an inquiry regarding their guidelines, M & R admitted that "we do not base our guidelines on any randomized clinical trials or other controlled studies, nor do we study outcomes before sharing the evidence of most efficient practices with colleagues." (Wall Street Journal, 7/1/98).

Harris Methodist Health Plan in Texas was fined $800,000 for illegally encouraging its physicians to limit medically-necessary treatment. Under the HMO's policy, physicians received bonuses or fines based on the amount they spent on pharmacy costs. Judge Bonnie Sudderth said the policy led to "denial of medically-necessary care to Harris HMO members", "cherry-picking, patient dumping...and outright denials of treatment, referrals and prescriptions" (Dallas Morning News, 5/12/98).

Galloping Towards Oligopoly

The conversion of non-profits to for-profits has spawned the creation of about 70 foundations with nearly $9 billion in assets. However, there is little oversight of these foundations and enormous potential for personal and corporate gain at public expense. According to the New York Times, "in at least a half a dozen hospital conversion cases, the hospital official who arranged the deal ended up running the new foundation--drawing a substantial salary and controlling millions of dollars. And usually, hospital board members who approve the deal get many of the seats on the new charity's board." In addition, foundation funds are not all going to charity care or even health care. For example, the Jackson Foundation in Tennessee, whose two officers are partners in a small airplane business, spent $170,000 on airplanes for flying lessons for high school students (New York Times, 4/27/97).

Medicare HMOs: The Next Frontier

Medicare HMOs target their marketing at healthy seniors, and not towards the sick or towards disabled Medicare patients under 65, according to a study of 169 newspaper ads, ads on 129 TV stations, and 21 HMO marketing seminars in four U.S. cities. Over 50% of the TV ads featured seniors running, biking, playing with grandchildren, etc. None of the TV or print ads showed people in hospitals or using walkers, and one-third of the seminars were not wheelchair-accessible. Important information about benefits restrictions was in fine print too small for many seniors to read, and the information often confused even trained researchers. Only one ad was in Spanish, despite large Spanish-speaking populations in three of the four cities studied (Los Angeles, Miami, New York, and Cleveland). Eight ads erroneously claimed that the Medicare beneficiary had to be 65 to qualify for the HMO. For copies, call the Kaiser Medical Policy Project at 1-800-656-4533 and ask for report #1417.

Congress Watch: Bipartisan Failure on Health Care

None of the "patient protection" bills in Congress includes the right to health care, which is Article XXV of the Universal Declaration of Human Rights. 1998 is the 50th anniversary of the U.N.'s Declaration, which has never been ratified by the United States.

The GOP apparently wants to end employer contributions to health coverage, including Medicare. House Ways and Means Health Subcommittee Chair Bill Thomas (R-CA) said the President's Medicare Commission should consider "radical" approaches. Thomas is pushing a proposal that would eliminate the tax break employers receive for purchasing health care for their workers and give individuals a "refundable tax credit" for purchasing their own insurance (Health Legislation, 6/3/98). Representative Newt Gingrich (R-GA) is "enthusiastic" about the Thomas Plan. Gingrich proposed examining the "wisdom of having employers provide health insurance" at a conference of HMO executives earlier this year (Boston Globe, 2/25/98). Phil Gramm (R-TX) "proposes replacing the existing payroll-funded Medicare program with a mandatory savings plan requiring all Americans to maintain [MSAs]" (Washington Times, 3/6/98).

AMA

The AMA's new health policy fits well with the GOP's pitch to cut business' responsibility for providing health insurance to workers. The AMA decided at their last meeting to make "an all-out effort" to make individuals responsible for buying their health insurance with defined contributions from employers, much like the federal employees health benefits plans (FEHBP) (New York Times, 6/18/98). Under the AMA's proposal, most workers are likely to be pushed into cut-rate HMOs with only the highest-paid employees able to afford better coverage. The AMA is also pushing MSA's (medical savings accounts) as a way of creating a new funding stream for care from affluent patients.

The AMA gave $4.1 million to candidates in the 1996 election, with most of the money going to pro-tobacco congressmen. The AMA contributed an average of $5,382 per pro-tobacco representative, and $2,103 to anti-tobacco members. Pro-tobacco candidates almost always endorse malpractice caps, hence attracting more AMA donations (Sharfstein, AJPH, 8/98).
The cigarette industry spent $40 million on the final three months of its campaign against the tobacco bill (Los Angeles Times, 6/19/98). The House Commerce Committee posted about 39,000 once-secret tobacco industry documents online at http://www.house.gov/commerce/TobaccoDocs/documents.html. How long before we see a similar site for proprietary medical and utilization review guidelines and insurance company documents?

Public Opinion

A survey of 600 Americans on President Clinton's policy stances found that only 26% were able to correctly identify that Clinton "favored adjustments to the existing system of private insurance in order to give more people access to the system." A much higher percentage (59%) erroneously thought Clinton "promoted a universal system of national health insurance," a position he never advocated. Similar misunderstandings of Clinton's policies were evident in other areas (e.g., only 13% knew he signed the Republican Welfare Reform Bill). The study found that the public consistently perceives Clinton as being more liberal than the positions he actually takes, perhaps explaining his enduring popularity in the face of ongoing scandals (Extra, May/June 1998).

An NBC/Wall Street Journal poll of 2,006 adults in June found that "the most important health care issue at the present time" is "people without health insurance" (37%), which was ranked first more frequently than the other two choices of "the cost of health care" (29%) and "the quality of health care" (23%).

Overall, twice as many people thought HMOs were "generally" a "change for the worse" (40%) than thought HMOs were a "change for the better" (20%). An even higher margin reported that HMOs made the "quality of health care services worse" (41%) versus "improved the quality of health care" (16%).

The survey also found that more than two-thirds of Americans say the government should guarantee everyone the best and most advanced health care that technology can supply, and that "everyone should have access to health care services." There was about an "equal split" over whether the federal government should guarantee access to everyone, even if it means an extra $2,000 in annual taxes for Americans. Democrats, women, and minorities were more in favor, while Republicans, men and whites were less in favor of the increase in taxes (which is substantially higher than what would be required by single payer). A sizable majority believe that "the amount of money people pay for health care should be based on their ability to pay" (Wall Street Journal, 6/25/98).

Posted by pnhp at 03:31 PM | Permalink | Comments (0)

Medicare patients under 65, according to a study of 169 newspaper ads, ads on 129 TV stations, and 21 HMO marketing seminars in four U.S. cities. Over 50% of the TV ads featured seniors running, biking, playing with grandchildren, etc. None of the TV or print ads showed people in hospitals or using walkers, and one-third of the seminars were not wheelchair-accessible. Important information
about benefits restrictions was in fine print too small for many seniors to read, and the information often confused even trained researchers. Only one ad was in Spanish, despite large Spanish-speaking populations in three of the four cities studied (Los Angeles, Miami, New York, and Cleveland). Eight ads erroneously claimed that the Medicare beneficiary had to be 65 to qualify for the HMO. For copies, call the Kaiser Medical Policy Project at 1-800-656-4533
and ask for report #1417.

Congress Watch: Bipartisan Failure on Health Care