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May 31, 2001

Medical Costs Surge as Hospitals Force Insurers to Raise Payments


The New York Times
May 25, 2001

By Milt Freudenheim

"As costs rise, some economists said, the growing unhappiness could stoke popular demand for political solutions, and even revive interest in a national single-payer health system like Canada's.

"'In 1991 and 1992, the last time a business slowdown coincided with double-digit inflation in health costs, people started to talk about universal health coverage,' recalled Uwe Reinhardt, a Princeton university economist. Instead, employers placed their faith in managed care."

http://www.nytimes.com/2001/05/25/business/25COST.html

Comment: Managed care is losing its clout, and the plans are resembling the indemnity coverage of years past. This quasi-indemnity model is returning us to double digit inflation in health care. The current movement toward "enabling empowered consumers" will compound the problems of of impaired access due to the inevitability of inadequate, flawed coverage. All other paths create so many problems that we are left solely with the logic of a universal health program to solve our problems in health care. We've been in denial long enough. Let's now move forward with rational reform.

May 24, 2001

The End of Managed Care


** PLEASE READ THIS ONE ** This is an important quote about the direction in which our health care system is headed.

JAMA May 23/30, 2001

By James C. Robinson, Ph.D., Associate Professor of Health Care Economics, University of California, Berkeley

"The consumer era in health care is emerging due to the rejection of governmental, corporate, and professional dominance rather than due to a judicious evaluation of the alternative."

"Four problems will plague a consumer-driven health care system. First, despite the widespread dissemination of information, consumers will face significant obstacles in understanding the quality and even the true price of health insurance and health care services. Variations in utilization, cost, and outcomes challenge the analytical capabilities of governmental, corporate, insurer, and physician organizations and are daunting even for the most sophisticated and Internet-enabled consumer. Second, consumers vary enormously in their financial, cognitive, and cultural preparedness to navigate the complex health care system. The new paradigm fits most comfortably the educated, assertive and prosperous and least comfortably the impoverished, meek, and poorly educated. Third, the consumer era will complicate the pooling of insurance risk between consistently healthy citizens and those who are chronically ill. Risk-adjusted subsidies by government and employers can foster risk-spreading, but the requisite actuarial methods are only embryonic. Finally, the emerging era will make transparent and render difficult the redistribution of income from rich to poor that otherwise results from the collective purchasing and administration of health insurance. The proliferation of insurance products and physician networks likely will accentuate the contemporary allocation of care based on ability to pay, partially mitigated through tax exemptions and refundable tax credits."

Comment: Perhaps the most appropriate comment is that of the author, James Robinson, in a May 23 Reuters release, "If all the good people got together and designed a health care system, they wouldn't design the health care system that we're heading towards."

May 23, 2001

Buyers Health Care Action Group National BHCAG Symposium


April 19, 2001
Keynote Address by Professor Regina Herzlinger, Harvard Business School
"A Force for Innovation, Consumers Taking Charge of Their Health Care"

"Harvard University Professor Regina Herzlinger, the author of 'Consumer-Driven Health Care' and other books on America's health care marketplace, predicts consumers exercising personal choice - not employers or managed care companies - will create dramatic change in the health care marketplace of the future."

Audience Question:

"With a consumer driven model, a lot of people are concerned that folks who are healthy will elect into the lower cost options leaving the cost of care to the folks with the most chronic conditions and sometimes to the people who can afford it the least."

Professor Regina Herzlinger:

".... What happens in the individual market in a risk adjusted... the community rating systems end up in a death spiral. It there's a community rated system there's a great incentive for anybody whose costs are lower than the community average to get the hell out of that system. So ultimately it becomes a very expensive system because the people who are left in it are only the very sick. Doesn't it make more sense to price the sick accurately and to price the well accurately right from the start and to provide more subsidies for the sick and fewer subsidies for the well and to get the incentives lined up the right way?"

http://www.bhcag.com/herzlinger_speech.pdf

Comment: The Buyers Health Care Action Group (BHCAG) has become the glamour boy of advocates that support utilizing "empowered consumers" in the marketplace to control costs and improve quality in health care. Although we share their goals of cost containment and quality improvement, their methods can only be disastrous for those with the greatest health care needs. Individuals active in the health care reform movement should be aware of this organization, and be prepared to respond to their defective proposals (www.bhcag.com). (Also, some of their concepts on quality improvement and improving efficiency may have some merit, although they are flawed in assuming that solutions should be limited to control by market forces.)

The extent to which marketplace advocates manipulate policy theory for the purpose of preserving our very sick system of pseudo-free market medicine is astonishing, considering that we could solve most of the problems of access, coverage, quality, and cost containment, by adopting the moral imperative, a publicly-administered risk pool with everybody in and nobody out.

May 22, 2001

Hands-on leader: Incoming AMA President Richard F. Corlin, M.D.


amednews.com
May 28, 2001


Richard Corlin, M.D., President-elect of the American Medical Association:

"First, last and always is dealing with the 43 million uninsured. That is simply a stain on our national fabric, if you will, that we have got to erase."

http://www.ama-assn.org/sci-pubs/amnews/pick_01/prsa0528.htm

Comment: Now if the AMA can only get the policy right.

May 21, 2001

Hearing on the Nation's Uninsured


United States House of Representatives Committee on Ways and Means Subcommittee on Health April 4, 2001
Testimony of Sara J. Singer, Executive Director, Center for Health Policy, Stanford University:

"Our plan would provide near-universal coverage among the non-Medicare population by making private plans more affordable. It would do so by using insurance exchanges to promote competition among plans."

http://waysandmeans.house.gov/health/107cong/4-4-01/4-4sing.htm

Comment: The proposal of Sara Singer and her colleagues, Alain Enthoven and Alan Garber, includes the following:

* Insurance exchanges (private or public) - would offer individuals a choice of at least two plans, one that "provides some coverage for treatment by most providers," and one that is a "low-priced alternative"

* U.S. Insurance Exchange (USIX) - like Federal Employees Health Benefits Program, for small employers in "areas in which private exchanges do not emerge"

* Refundable tax credits - for families who purchase insurance through an exchange, phased out with increasing income

* Default plan - automatic for lower income individuals who do not enroll in a health plan - federal funding at 50% of the tax credit - for financing of public hospitals and clinics and "open access" providers

* Phased in cap - limit amount of exclusion of premiums from taxable income to "encourage value-based purchasing"

* Independent Exchange Commission (IEC) - similar to the SEC, to "encourage smooth information flow and functioning of insurance exchange markets"

It is amazing how tenaciously Singer, Enthoven and Garber adhere to the doctrine that the solution to our health care problems is to promote competition between health plans, in spite of the overwhelming evidence that the private bureaucracies of health plans continue to waste a tremendous amount of valuable resources, while failing to provide for the unmet needs of the uninsured and underinsured. It is also ironic that, in recognizing that this model has not worked, they now are proposing government bureaucracies, including the USIX and IEC, along with tax subsidization. Yet this very expensive program will enable only "some coverage," or a "low-priced alternative," or additional funding of public facilities as a default (doctrinaire multi-tiered health care). To allow the "market" to function, they are recommending more government involvement and more taxpayer funds, while doing virtually nothing to correct the excesses of the industry, and failing to propose a satisfactory level of assured coverage.

What is even more amazing to me is that Sara Singer continues to reject the brilliant proposal strongly supported by her cousin and our friend, Quentin Young. It is a proposal that would meet their goal of controlling health care costs, but on the supply side by utilizing health planning and global budgeting, a much more humane approach than making health care unaffordable for low and moderate income individuals by providing only inadequate, Spartan coverage. That proposal, of course, is universal, comprehensive, publicly-administered insurance, with everybody in and nobody out!

Don McCanne

May 20, 2001

Senate plan helps teachers without hurting others


The Austin American-Statesman May 18, 2001 Letters
Insurance for all
Re: May 13 editorial :

"Teachers and public school employees will get a state-supported health insurance plan. That is certain. What has yet to be decided is whether they will drive away in a Cadillac or a Chevrolet."

This leaves 5 million Texans driving Yugos, because they do not have any health insurance but are forced to pay for the health insurance of state employees.

"Health Care For All Texans" endorses a comprehensive health care system that would guarantee:

* Access to affordable, quality health care without regard to income, employment or health status.

* Freedom to choose their doctors and other health professionals.

* Participation in a comprehensive, age-specific, quality health benefits package.

To help, contact Health Care For All Texans, 206 W. Woodlawn, San Antonio, 78212 or send e-mail to makstool@earthlink.net.

Milton A. Braun Dallas

Comment: Milt Braun is a retired CPA and now a very dedicated health care reform activist. His e-mail address is: mrtex@webtv.net

May 19, 2001

On Ethics and Medicine


The University of California at San Diego Healthwise
May 2001


Lawrence Schneiderman, MD, Professor, Family and Preventive Medicine, UCSD:

"Every responsible ethicist agrees that we are violating our moral obligations to our citizens by not providing a decent minimum of universal health care.... We are proud to be a free enterprise, capitalist society that has produced many remarkable achievements, but we are trying to use that concept in health care. We are trying to build health care on the profit-based market model and it's failing miserably.... A fundamental duty of a just society is to all of the citizens. They all are owed a decent minimum standard of health care, and only the government can take that responsibility.... (E)very responsible ethicist I know who has thought about this issue has a similar opinion."

(Thanks to Jeoff Gordon for today's quote.)

May 18, 2001

Court Rules in Favor of Maine Rx Price Controls

As reported May 17 in the Kaiser Daily Health Policy Report, the 1st U.S. Circuit Court of Appeals in Boston on Wednesday struck down a challenge to a Maine law that would "impose price controls on prescription drugs if pharmaceutical companies refuse to provide a discount for thousands of uninsured residents." Enacted nearly one year ago, Maine's law allows the state to "leverage its buying clout -- $210 million in Medicaid drug purchases -- to negotiate discounted prices" for the 325,000 Maine residents not covered by private insurance or Medicaid. If drugmakers refuse to give the state discounts, the law allows Maine to impose price caps by 2003. The Pharmaceutical Research and Manufacturers of America initially brought a lawsuit against the state, saying that the law is unconstitutional because it violates laws regulating interstate commerce by interrupting relationships between drug manufacturers and distributors (Connolly, Washington Post, 5/18). Last October, a federal District Court judge agreed with the pharmaceutical industry and blocked the program's implementation ( Kaiser Daily Health Policy Report, 10/16/00). In overturning that ruling, the three-judge panel of the circuit court on Wednesday "praised Maine for tackling a vexing problem in a creative way," the Post reports. In a 75-page opinion, the court said, "It is one of the happy incidents of the federal system that a single courageous state may, if its citizens choose, serve as a laboratory; and try novel social and economic experiments without risk to the rest of the country" (Washington Post, 5/18).

Chellie Pingree, the Maine legislator who "spearheaded" Maine's law, said, "This is a big win. It makes clear that states should be creative and that Maine, specifically, acted appropriately on behalf of citizens who need this benefit." PhRMA spokesperson Jeff Trewhitt said that the organization would file an appeal, adding, "The last thing we need is a patchwork of different state laws. We agree that improved access is important. But this is the wrong way to go. The problem requires a national solution."

More State Action to Come? Twenty-six states are moving forward with plans to create programs similar to Maine's and have watched the Maine case "closely" (Silverman, Newark Star-Ledger, 5/18). Bernie Horn, policy director of the Center for Policy Alternatives, said, "Now that the appeals court has wiped away the stigma of unconstitutionality, we expect the Maine approach to move like wildfire across the country" (Center for Policy Alternatives release, 5/17). Peter Shumlin (D), president pro tem of Vermont's Senate, added, "A number of [states] were waiting for a court decision to see what the future would be for fair-pricing legislation. I'm incredibly happy about the court decision. It gives many of us the green light to move forward."

Alan Sager, a public health professor at Boston University, added that while the pharmaceutical industry has succeeded in "defusing the issue this year by moving it from the legislative arena to the courts," the "pressure is building up." Meanwhile, in Maine, the state is prepared to give cheaper drugs to uninsured state residents beginning next month (Ornstein, Dallas Morning News, 5/18).

Keeping Quality on the Policy Agenda


Health Affairs
May/June 2001

"How many more people have to die before we accept that quality is everyone's problem?" by Elizabeth A. McGlynn and Robert H. Brook

"The science that the nation spent so much public and private money developing could produce its promised results."

"We spend more money on health care than any country in the world; one of every seven dollars spent in this country goes to medical care. We have sophisticated physicians and social scientists. But we lack the will to reengineer our own health system."

"Leadership for this reengineering will have to come from both government and the private sector. The government role is particularly critical, something that has been recognized in all other Western nations except the United States."

"We must find a way to keep quality care at the top of the health policy agenda. After providing insurance to all Americans, there is no issue of equal importance."

http://www.healthaffairs.org/archives_library.htm

May 17, 2001

Organizations Find Big Changes in Bush's A-List


The Washington Post
May 17, 2001
"Professional Groups Lose International Delegation Spots" by Karen DeYoung

"The American Public Health Association assumed it would be invited to join the official U.S. delegation to this week's World Health Assembly in Geneva. As the nation's oldest and largest organization of public health professionals, the APHA has been a U.S. delegate to the annual meeting of the world's health ministers for many years..."

Instead, "... 'five private-sector advisors' are on the official team," along with Tommy Thompson and other government officials, that will discuss issues such as global strategies for infant and child feeding, the AIDS pandemic, strengthening health systems, and the health effects of depleted uranium.

Mohammad Akhter, executive director of the American Public Health Association:

"I think this is setting a bad precedent. This is not at all what America is about. It doesn't matter who the president is, we represent the people. That's what has put us above all the other countries in the world.... Now, we're the same as third world countries where they bring in their friends and make a mess of things."

http://www.washingtonpost.com/wp-dyn/articles/A36643-2001May16.html

Comment: Is the APHA is being punished for supporting health care for everyone?

May 16, 2001

Health plans' costs set to jump: CalPERS is ready to increase premiums by about 17 percent in its two self-insured care plans.


The Sacramento Bee
May 16, 2001
by Lisa Rapaport

Bert Clark, a retired enrollee: "A lot of people will gripe and say these rates are hard to take. What gets me is I pay Medicare, then I pay CalPERS, and then I pay for drugs."

David Thompson, a public agency representative: "We get a wonderful benefit structure that's all you could want -- it's just expensive. It's fair as long as we have a choice."

Comment: A choice? Making health care unaffordable gives many retired folks the choice of not eating or paying rent as the price of health care. Some choice!

May 15, 2001

American Medical Association Policy and Advocacy


H-165.960 Health Access America Refinements

Excerpts:

(11) The AMA should achieve the right to negotiate for physicians program payment and the other conditions in government health entitlement programs, where legislative and/or administrative restrictions are unilaterally applied to physicians' freedom to set their own fees. Any such fee restrictions should be limited to those patients who cannot reasonably afford to pay the difference between the physician fees and government reimbursement levels. In the private sector, where insurance arrangements for thousands of patients are increasingly controlled by single third party payers, physicians should have the ability to negotiate collectively on behalf of their patients and themselves.

(12) Single-payer systems are not in the best interests of the public, physicians or the health care of this nation and should be strenuously resisted.

http://www.ama-assn.org/apps/pf_online/pf_online (Check "House of Delegates" and enter "H-165.960")

Comment: It is unfortunate that the leadership of the American Medical Association continues to endorse official AMA policies that protect physicians' income while essentially neglecting the great, unmet, health care needs of the nation. As long as they continue to support grossly deficient policies such as tax credits and medical savings accounts, the AMA will have very limited legitimacy in the process of reforming health care in America.

Should the AMA ever take a strong advocacy role on behalf of physicians? The answer may be, "Yes." I'll explain.

Most of us engaged in compassionate reform activities firmly believe that our abundant health care resources can be allocated much more effectively, resulting in comprehensive, high quality care for everyone. But under our current sick structure, efforts to remove cost restraints for the purpose of embellishing physician wealth can only place additional stresses on our deficient mechanisms of delivering resources for care of the medically underserved. Physicians must advocate for structural reform that will improve resource allocation before they can legitimately advocate for their own financial interests.

Once we have in place an effective system that will assure comprehensive care for everyone, mechanisms of cost containment will be essential. At that time, physicians will need a strong and effective voice in negotiating rates and practice environment. Otherwise, those in control will divert physician resources into other sectors of the budget. Very soon medicine as an occupation would be appealing only to the Mother Teresas of this nation, and, frankly, there simply are not enough individuals that are so dedicated. So it is in the best interests of patients to be certain that physicians are rewarded at a level that will assure that prime candidates will continue to be attracted to the medical work force.

The AMA's position that it should "achieve the right to negotiate (collectively) for physicians" is a proper stance, but not within our current sick system. If the AMA actively participates in bringing about the ethical reforms that will cure the ills of our system, than it will have earned its position as negotiator on behalf of the medical profession.

Don McCanne

May 14, 2001

Physicians Promote Universal Health Care


May 21, 2001

"Several prominent physicians, fed up with 'market-based medicine' have banded together to advocate for single-payer national health insurance." by Amy Snow Landa

Quentin Young, M.D., commenting on a conversation he had with Rep. John Conyers Jr.:

"I represented to him that the leaders of medicine are no longer to be painted with one stripe as conservative, even reactionary obstacles to universal health care, but that leadership is taking quite a different tack, and he accepted my comments and challenged me to produce that group."

http://www.ama-assn.org/sci-pubs/amnews/pick_01/gvsb0521.htm

Comment: This is yet another article on the pivotal, landmark meeting of several Congressional caucuses and the Physicians' Working Group for Single-Payer National Health Insurance. The objectivity of this article is to be commended considering that this is a publication of the American Medical Association.

A picture of our Santa Barbara friends:

http://community.webshots.com/photo/14083539/14083762FJqxqmJZsP

Thanks to Robert Bernstein, Chair, Sierra Club - Santa Barbara Group

May 13, 2001

May 2001 Data Update

The May 2001 Data Update is now available here as an Adobe PDF.

May 11, 2001

Reforming Medicare's Benefit Package: Impact on Beneficiary Expenditures


The Commonwealth Fund
by Stephanie Maxwell, Marilyn Moon, and Matthew Storeygard
The Urban Institute
May 2001

"Expanding Medicare's benefit package would enhance equity of coverage among beneficiaries, who currently obtain coverage through a patchwork of sources at varying costs. Coordinating coverage under a single source would allow for greater overall efficiency in furnishing health insurance coverage to Medicare beneficiaries and society as a whole. Moreover, administrative costs for public insurance programs are lower than those for private insurance plans: a public program does not need to maintain reserves to protect against adverse risk, nor does it need to pay marketing or sales commissions."

"Expanded Medicare coverage would clearly result in decreased out-of-pocket costs for many beneficiaries, particularly those with the highest expenses."

The full report is available at: http://www.cmwf.org/programs/medfutur/maxwell_reforming_medbenefits_461.pdf

Comment: This study demonstrates that improving Medicare benefits can eliminate the need for expensive Medigap coverage, and result in the reduction of out-of-pocket spending. This is the type of Medicare reform that we should be supporting, rather than the severely flawed Breaux-Frist premium support proposal.

May 10, 2001

Income gap in California gets wider


The Orange County Register
May 10, 2001
by Michelle Quinn

According to a study conducted by the Public Policy Institute of California, inflation adjusted family income at the 10th percentile dropped 14 percent, from $15,810 in 1969 to $13,600 in 1999. (The 90th percentile increased 58 percent - from $86,140 to $135,850.)

Deborah Reed, an economist and co-author of the study:

"When we have families with disparate income, how do we offer equal opportunity to the children? Children of the rich are afforded better schools and health care."

Comment: Since our economic system supports and encourages the movement of capital from lower and middle income individuals to the wealthy, it becomes even more imperative that we have in place a system that will assure health care access and coverage for all of us, as health care is becoming less and less affordable.

May 09, 2001

'Superman' gives Canada super marks


The Province Vancouver, B.C.
May 7, 2001


Actor Christopher Reeve: "We look to Canada with the greatest respect and admiration. Clearly, in this country, there is a system in place which really takes into account what human suffering is."

Mr. Reeve was Honorary Chair this week of a symposium at the University of Montreal on "Spinal Cord Trauma: Neural Repair and Functional Recovery." He praised Canadian researchers for their leadership, over the past two decades, in studying ways to regenerate damaged spinal cords, noting that such research was held back in the United States.

http://www.crsn.umontreal.ca/XXIIIs/home.html

Comment: Critics of universal health programs often state that universal systems stifle innovation and research. On the contrary, universal systems direct their research resources to where they can achieve the greatest good, in both advancing basic knowledge and in clinical applications. Private systems direct their efforts to where they can achieve the greatest profit. These missions have some elements in common, but they are definitely not the same.

May 07, 2001

After Two Centuries, Washington Is Losing Its Only Public Hospital by

SHERYL GAY STOLBERGÊ

WASHINGTON, May 6 Ñ On the day that federal officials decided to put this city's first and only public hospital out of business, business continued there as usual. A woman, hugely pregnant and a week past her due date, received an ultrasound examination in the sweltering heat, the still air moved about by a fan because the air-conditioning had not yet been turned on.

On the maternity ward, a 14-year-old girl gave birth in a room of peeling wallpaper and cracked paint; the baby swallowed its own stool during the delivery and was rushed to the neonatal intensive care unit for oxygen. On the cancer ward, a nurse made her rounds with dollar bills stuffed in her pockets. She never knew, she explained, when a patient might need bus fare home.

So has it ever been at the District of Columbia General Hospital. Since its founding as an almshouse nearly two centuries ago, D.C. General, as it is known, has embraced this city's sick and poor, most of them African-Americans, when there was nowhere else for them to go. It has trained generations of black doctors; many, committed to serving the underserved, stayed on. But the hospital has also been sorely mismanaged, and it has bled red ink to the point of bankruptcy.

Last Monday, in a move that followed a nationwide trend, the federal control board that oversees the city's financial affairs contracted with a consortium of private health care providers to run the hospital and six separate city clinics. The hospital's own outpatient clinics and emergency room will remain open. But the inpatient and trauma wards Ñ in essence, the hospital itself Ñ will be shuttered.

"We are tossing public health into the trash," said Dr. Michal Young, a neonatologist and president of the hospital's medical and dental staff. "When you lose public health in the capital of the most powerful nation in the world, it is an indicator of what the rest of the country is going to do."

Indeed, it is an indicator of what the rest of the country is already doing. Over the last two decades, as competition has forced hospital mergers and acquisitions, the number of public hospitals has dwindled. In 1999, the last year for which figures are available, that number was 1,197, down from 1,778 in 1980, according to the American Hospital Association. By comparison, the number of private hospitals dropped to 3,759 from 4,052.

Public hospitals offer free care for the indigent, typically at greater levels than private hospitals, and at taxpayers' expense. Some, as in Boston and Baltimore, have been absorbed into nonprofit university hospitals, which remain committed to serving the poor. Others have become private entities; still others, as in St. Louis, have shut down.

And dozens, if not hundreds, of small rural public hospitals have closed, said Larry S. Gage, president of the National Association of Public Hospitals and Health Systems. "In cities and in rural areas, hospitals have an increasingly difficult time making it," Mr. Gage said, "and public hospitals are often the most vulnerable institutions."

Mr. Gage says he is not overly concerned about the privatization of government-run hospitals, so long as what he calls their "safety-net mission" is retained. And in many cases it has been, experts say. But others mourn the loss of the institutions that have historically been the nation's health care providers of last resort.

"These are a treasure and we shouldn't let them go," said Sandra Opdycke, author of "No One Was Turned Away" (Oxford University Press, 1999), about the New York City public hospital system. "They have never had the kind of care and respect that they deserve, and especially now, they are not getting it."

Alan Sager, a professor of public health at Boston University who consulted with the unions at D.C. General in an effort to keep the hospital open, said, "What is lost is a guaranteed open door, a room at the inn."

D.C. General sits in the city's depressed Southeast section, at the end of a forlorn stretch of Massachusetts Avenue, a street that in the prosperous Northwest area is home to the elegant mansions of Embassy Row. The hospital is a collection of mostly aging brick buildings, sprawled over a 68-acre riverfront site that includes the city morgue and jail. At its peak, after World War II, D.C. General had enough patients to fill 1,600 beds.

Last Monday, the patient count was 119, a reflection of staffing cuts, uncertainty about the hospital's future and the reality, faced by all hospitals, that patients today are sent home sooner and often not admitted at all.

The hospital had been in dire financial straits for more than a decade, as was the city, which is why the control board was established in 1995. Michael Barch, until last week the hospital's chief executive (he took that job just six months ago, after his predecessor was fired amid accusations of fraud), said the hospital's budget dance had been the same for several years. Each year, the city offered a $45 million subsidy. Each year, the hospital overspent it by many millions, with the city making up the difference.

Of Washington's 550,000 residents, an estimated 80,000 lack insurance. At the same time, the city's health statistics are abysmal.

"We have a life expectancy for African-American men that is 59, the lowest in the country," said Dr. Ivan C. A. Walks, the city's health commissioner. The infant mortality rate, 12.5 per 1,000 births, is nearly double the national average.

The city in 1996 put the hospital and the city clinics under the auspices of a new body, the Public Benefits Corporation, which was supposed to act like a business. That strategy worked in Denver. But it failed here.

The corporation "never integrated the clinics with the hospital," said Alice M. Rivlin, an economist at the Brookings Institution who is chairwoman of the federal control board. Some clinic doctors were not qualified to admit patients to the hospital. Nurses at the clinics and the hospital earned different salaries. Antiquated computers made it impossible to track patients.

The hospital's financial records were a mess. Sixty percent of D.C. General's patients were insured, Mr. Barch said, yet often they were not billed. "It was a culture that said, `We're here to serve patients, not to harass them about paying,' " he said.

In January 1999, a new mayor, Anthony A. Williams, took office. "We talked," Ms. Rivlin said, "and I urged him to get on top of the hospital problem."

Mr. Williams, previously the city's chief financial officer, is regarded here as something of a technocrat and politically na•ve. At a recent news conference, his press secretary had to remind him to look at the cameras. He did not expect the deep resentment he would engender by stepping into the hospital's affairs.

"Thank God for four-year terms," Mr. Williams said in a recent interview.

By last year, city auditors had warned that the hospital was about to run out of money and would soon be forced to shut down. "We were in a crisis," Ms. Rivlin said. The solution, the mayor and his staff concluded, was to get the city out of the health care business.

"We began looking around the country at other jurisdictions," said Dr. Walks, the health commissioner. "San Diego, Detroit, Tampa. What we found is that if you do these transitions correctly, you can expect three things: increased access, increased quality and cost savings."

According to a 1999 report by the Kaiser Family Foundation, for every 100 public hospitals in the United States, one closes and two convert to private ownership or management each year. But for Washington, finding a private partner was not easy. About 200 people turned out for a bidder's conference, Dr. Walks said. Two bids were submitted.

One came from a group led by Mr. Barch, who proposed building a smaller hospital on the site of D.C. General. That plan was rejected. The other came from a consortium led by Greater Southeast Community Hospital, a Washington hospital that went bankrupt in late 1999 but has been bought and turned around by an Arizona company.

For $90 million each year from taxpayers (the Public Benefits Corporation spent $120 million last year), Greater Southeast has promised to increase medical services Ñ including hospital admissions, surgeries and primary care Ñ for uninsured patients by 34 percent.

The big question, of course, is whether it can live up to that commitment. The company's financial history leaves many residents as well as the City Council, which voted unanimously to oppose the privatization, uneasy.

Mayor Williams is confident that the uninsured will get more, and better, care. "I'm going to sleep like a baby at night," he said, "because I've done the right thing."

But Dr. Sager, the Boston University professor, says the mayor underestimates the intimate relationship between patients and hospitals. When a hospital closes, he said, 30 percent of its patients simply cease seeking care for a time.

"Hospitals are not interchangeable parts in some health care machine," Dr. Sager said. "It takes a while to reweave a connection."

That connection is keenly felt at D.C. General, by both patients and doctors.

"I feel that I was led by the Lord to come here," said Dr. Steven Tucker, director of obstetrics and gynecology, who arrived three years ago. Once, he had dreams of renovating the maternity ward. "This institution," Dr. Tucker said, "has never been given a fair shake."

To whites in Washington, the hospital symbolized everything that was wrong with the city. But to blacks, it stood as a symbol of culture and history. With its privatization, conspiracy theories abound. Some blacks say they believe the mayor, who is himself African-American, wants the riverfront land for redevelopment.

"The eradication of D.C. General is a statement that there is no place for the black community, for the low-income residents, the people that have lived here through thick and thin, ups and downs," said the Rev. Graylan Hagler, pastor of the Ply mouth Congregational United Church of Christ. "Not only is the hospital being removed, but those populations are being removed."

But more than a symbol, D.C. General was a medical home for the disenfranchised. Last month, a homeless man became ill during a court hearing on misdemeanor charges and died a short while later in a holding cell. While he was still in court, gasping for breath, he begged of the judge, "Just take me to D.C. General."

Copyright 2001 The New York Times Company

May 06, 2001

Marcia Angell on PBS

http://www.pbs.org/newshour/bb/health/july-dec01/patients_7-2.html

Seniority: In the Middle on Medicare

The New York Times
May 6, 2001
by Fred Brock

"... Mr. Breaux hopes to use his negotiating skills to push Medicare legislation -including limited prescription coverage - through Congress this summer."

Sen. John Breaux:

"No one has a health plan as inadequate as the 40 million people on Medicare. Nobody has a health plan that does not cover 47 percent of their average costs."

"I'm trying to combine the best of what government can do and the best of what the private section can do. The best that government can do is pay for Medicare and help make sure that nobody tries to scam it. The best of what the private section can do is bring about the innovations and new technology quickly without having to get an act of Congress to cover something that's new. The private section can also bring about real competition to hopefully slow rising costs."

Comment: Sen. Breaux clearly understands that we need to add prescription coverage to Medicare and that we need to dramatically reduce out-of-pocket expenses. He also understands that Medicare will function best by properly balancing the roles of the government and the private sector. What he fails to acknowledge is the overwhelming evidence that competition, as a mechanism to control costs, has been a dismal failure. In fact, costs have actually increased through the excesses of the private bureaucracies of the "competing" health plans. There is a consensus that something must be done about the anticipated increases in the Medicare budget, and there is great risk that Sen. Breaux's plan may be enacted by default for "want of something better." We cannot allow this to happen. We must protect Medicare now, and then begin to enact the reforms that we really need.

An article on the flawed concept of containing Medicare costs through health plan competition is available at: http://www.pnhp.org/publications/competition_medicare2_29_00.htm

May 05, 2001

Proposal of the Physicians' Working for Single-Payer Health Insurance

Executive Summary

The United States spends more than twice as much on health care as the average of other developed nations, all of which boast universal coverage. Yet over 42 million Americans have no health insurance whatsoever, and most others are underinsured, in the sense that they lack adequate coverage for all contingencies (e.g., long-term care and prescription drug costs).

Why is the U. S. so different? The short answer is that we alone treat health care as a commodity distributed according to the ability to pay, rather than as a social service to be distributed according to medical need. In our market-driven system, investor-owned firms compete not so much by increasing quality or lowering costs, but by avoiding unprofitable patients and shifting costs back to patients or to other payers. This creates the paradox of a health care system based on avoiding the sick. It generates huge administrative costs, which, along with profits, divert resources from clinical care to the demands of business. In addition, burgeoning satellite businesses, such as consulting firms and marketing companies, consume an increasing fraction of the health care dollar.Ê

We endorse a fundamental change in America's health care - the creation of a comprehensive National Health Insurance (NHI) Program. Such a program - which in essence would be an expanded and improved version of Medicare - would cover every American for all necessary medical care. Most hospitals and clinics would remain privately owned and operated, receiving a budget from the NHI to cover all operating costs. Investor-owned facilities would be converted to not-for-profit status, and their former owners compensated for past investments. Physicians could continue to practice on a fee-for-service basis, or receive salaries from group practices, hospitals or clinics.

A National Health Insurance Program would save at least $150 billion annually by eliminating the high overhead and profits of the private, investor-owned insurance industry and reducing spending for marketing and other satellite services. Doctors and hospitals would be freed from the concomitant burdens and expenses of paperwork created by having to deal with multiple insurers with different rules - often rules designed to avoid payment. During the transition to an NHI, the savings on administration and profits would fully offset the costs of expanded and improved coverage. NHI would make it possible to set and enforce overall spending limits for the health care system, slowing cost growth over the long run.

A National Health Insurance Program is the only affordable option for universal, comprehensive coverage. Under the current system, expanding access to health care inevitably means increasing costs, and reducing costs inevitably means limiting access. But an NHI could both expand access and reduce costs. It would squeeze out bureaucratic waste and eliminate the perverse incentives that threaten the quality of care and the ethical foundations of medicine.

Marcia Angell, MD
Spokesperson
Past Editor
New England Journal of Medicine
Merlin Du Val, MD
Former Assistant Secretary for Health
Department of Health, Education and Welfare
Quentin Young, MD
Convener
National Coordinator
Physicians for a National Health Program
Past President
American Public Health Association
David Himmelstein, MD
Co-Founder
Physicians for a National Health Program
Joel Alpert, MD
Past President
American Academy of Pediatrics 
Rodney Hood, MD 
President
National Medical Association
Ron Anderson, MD
President and CEO
Parkland Health & Hospital System
Edith Rasell, MD, PhD
Director
Economic Analysis and Research Network
Economic Policy Institute
Peter Beilenson, MD, MPH
Commissioner
Department of Health, Baltimore City
Helen Rodriguez-Trias, MD
Past President
American Public Health Association
Olveen Carrasquillo, MD, MPH
Advisory Committee Member
National Hispanic Medical Association
Sindhu Srinivas, MD
National President
American Medical Student Association
Christine Cassell, MD
Past President
American College of Physicians
Gerald Thomson, MD
Past President
American College of Physicians
Elinor Christiansen, MD
President Elect
American Medical Women's Association
Walter Tsou, MD, MPH
Commissioner 
Department of Health, Philadelphia
Gary Dennis, MD
Past President
National Medical Association
Steffie Woolhandler, MD, MPH
Co-Director
Center for National Health Program Studies
The Cambridge Hospital/Harvard Medical School

*The participants hold a number of distinguished positions, which are not limited to those listed above. The participants' positions and affiliations listed here are provided for identification purposes only.

Rep. Stark and Sen. Rockefeller Introduce MediKids Health Insurance Act of 2001


News Release Congressman Pete Stark
May 3, 2001


Rep. Pete Stark:

"Children are the least expensive segment of our population to insure, and maintaining their health is integral to the future of our society. Providing health care coverage to children impacts more than just their health -- it impacts their ability to learn, their ability to thrive, and their ability to become productive members of society. MediKids simplifies the confusing array of health insurance assistance programs for children today and guarantees them coverage until adulthood."

Comment: Incremental expansions of the S-CHIP and Medicaid programs can never lead to universal coverage for children. The Stark-Rockefeller MediKids program is fundamentally different because it mandates that all children will have coverage. If parents do not provide coverage then, right from birth forward, they are automatically enrolled in the MediKids program, a Medicare program designed just for children. Although we must not let up on our efforts to attain a system of universal health care, covering all children by enacting MediKids would be a giant step towards our goal.

For a copy of the bill: http://thomas.loc.gov/ and type in the bill number: S827

May 04, 2001

Universal Health Care Briefing


Washington, DC
May 1, 2001
Congressional Progressive Caucus, Black Caucus and Hispanic Caucus

Secretary Robert Reich: "This is a terribly important hearing."

Dr. Quentin Young: "I'm confidant that when we get universal national health insurance, which will come a lot sooner than many of us in the room expect, this very hearing will be considered one of the launching pads of the beginning of that process in a fresh way."

Dr. Marcia Angell: "A fifth and final myth is that a single payer system is a good idea, but politically unrealistic. Now that is a self-fulfilling prophesy. In my opinion, the medical profession and the public would be enthusiastic about a single payer system if the facts were known and the myths dispelled."

Rep. John Conyers: "I just wanted to say that this is the best health care hearing that's ever been held in the United States' House of Representatives, and you should all be proud of yourselves."

Rep. Dennis Kucinich: "We really need to hold town hall meetings all across the country on this issue and wake the town, tell the people... "

The transcript of this landmark hearing is now available at: http://www.kaisernetwork.org/health_cast/uploaded_files/kff050101.pdf or available for download as Word document: Transcript.doc

May 03, 2001

Romanow pledges 'open mind' in health probe


The Globe and Mail
May 2, 2001
by Richard Mackie

"Mr. Romanow (Roy Romanow, head of the commission on the future of health care in Canada) also said he will look at the issues of funding the health-care system. This is a continuing irritant. The provinces complain that the federal government forced the start-up of medicare more than 30 years ago by promising to pay 50 percent of costs. That share has fallen to as low as 13 percent."

"Mr. Harris (Ontario Premier Mike Harris) said governments need to look at imposing user fees and means tests, and at increasing the use of private companies, including private run hospitals (and not excluding foreign-controlled companies)."

Comment: Advocates for a rational, humane health care system in the United States will not be able to relax once we have reform. Permanent vigilance and constructive maintenance will be required.

May 02, 2001

Sweeping Health Care Reform Proposed by Nation's Top Physicians

Former Editor of the New England Journal of Medicine is Leading Spokesperson for Effort

Washington, D.C. - A group of nearly two-dozen nationally prominent physicians -- including Dr. Marcia Angell, former editor of the New England Journal of Medicine, Dr. Rodney Hood, the President of the National Medical Association which represents African-American physicians, Dr. Elinor Christiansen, the President of the American Medical Women's Association, Dr. Merlin DuVal, President Nixon's Assistant Secretary for Health, Drs. Christine Cassel and Gerald Thompson, Past Presidents of the American College of Physicians, Dr. Sindhu Srinivas, President of the American Medical Student Association, and other physician leaders -- testify before Congress today that only comprehensive reform of America's ailing health system will address the nation's health care crisis. The hearing is sponsored by the Congressional Black Caucus, the Congressional Progressive Caucus, and the Congressional Hispanic Caucus.Ê

"We've engaged in a massive and failed experiment in market-based medicine in the U.S." said Dr. Marcia Angell. "Rhetoric about the benefits of competition and profit-driven health care can no longer hide the reality: Our health system is in shambles. Despite spending twice as much on average on health care per person as Sweden, Norway, Denmark, Canada, Australia, Japan and every other developed country, over 42 million Americans have no health care insurance at all, and tens of millions more are not covered for all their medical needs. The recession we all fear could easily push the number of uninsured to 60 million."Ê

Dr. Angell is the spokesperson for a collaboration by the nation's top physicians who believe that a national health program is needed to improve the quality of the U.S. health system - recently ranked 37th by the World Health Organization. The physicians' consensus proposal begins "Health care is an essential safeguard of human life and dignity and there is an obligation for society to ensure that every person be able to realize this right,"(Cardinal Joseph Bernardin). "

More than 60 years ago, the National Medical Association was the only physician organization that supported single-payer, national health insurance" said Dr. Rodney Hood, President of the NMA. "In a diverse country such as ours, full of resources and ingenuity to unravel the mysteries of the human genome, there is no acceptable reason for Americans of any race, ethnicity or economic background to be barred from accessing the health care services they need. It is clear that Americans want health coverage that is affordable, accountable, and equitable."Ê

The group of eminent physicians will testify that national health insurance - essentially, Medicare for all -- is the only way to control skyrocketing health costs while restoring choice of physician and the doctor-patient relationship. "We have the cruel paradox of rationing health care in the midst of plenty," said Dr. Quentin Young, National Coordinator of Physicians for a National Health Program (PNHP) and a Past President of the American Public Health Association. "With national health insurance we could reclaim the 25% of all health spending we currently squander on paperwork and use it to cover the uninsured."Ê

Tax credits, vouchers and medical savings accounts are failed strategies for reform, according to the Physicians' Working Group. They would mostly benefit healthy and well-off Americans. "We don't need any more piecemeal strategies that are, in effect, tactics by the drug and insurance industries to delay real reform," said Dr. Young. "We need a system in which we have 'everybody in, nobody out.'"Ê

Medicare + Choice: Lessons for Reform


House of Representatives
Committee on Ways and Means
Subcommittee on Health
May 1, 2001


Marilyn Moon, Ph.D., Senior Fellow, Urban Institute:

"In many ways, the Medicare + Choice benefit has been one of the less successful changes that have occurred in Medicare." "At present, the program is neither saving money for the federal government nor achieving good, stable care for many of its enrollees."

The entire testimony is available at: http://www.urban.org/TESTIMON/moon05-01-01.html

May 01, 2001

Congressional Progressive Caucus, Black Caucus and Hispanic Caucus

Secretary Robert Reich: "This is a terribly important hearing."

Dr. Quentin Young: "I'm confidant that when we get universal national health insurance, which will come a lot sooner than many of us in the room expect, this very hearing will be considered one of the launching pads of the beginning of that process in a fresh way."

Dr. Marcia Angell: "A fifth and final myth is that a single payer system is a good idea, but politically unrealistic. Now that is a self-fulfilling prophesy. In my opinion, the medical profession and the public would be enthusiastic about a single payer system if the facts were known and the myths dispelled."

Rep. John Conyers: "I just wanted to say that this is the best health care hearing that's ever been held in the United States' House of Representatives, and you should all be proud of yourselves."

Rep. Dennis Kucinich: "We really need to hold town hall meetings all across the country on this issue and wake the town, tell the people... "

The transcript of this landmark hearing is now available at: http://www.kaisernetwork.org/health_cast/uploaded_files/kff050101.pdf

Single Payer Health Care Hearings Mobilize Progressive Members of Congress, Key Constituencies

Summary by Ellen Schaffer, Ph.D., MPH, with Ida Hellander, MD

As many of you know, the Congressional Progressive Caucus, Black Caucus, Hispanic Caucus, and the Congressional Universal Health Care Task Force, sponsored a hearing on universal, single payer, national health insurance from 10 a.m. to 3 p.m. on May 1, 2001. An impressive array of speakers and members of Congress appeared, and at the end, Representative Conyers (D-MI) declared it was "best hearing on health care ever held in the Congress."

You can view the entire hearing on the web at the Kaiser Family Foundation website. The listed url is: www.kaisernetwork.org/healthcast/uhcb/may01. Alternatively, go to www.kaisernetwork.org/. Click on "view healthcasts," then "calendar," then look at the May 1 listing and click on "Progressive Caucus Universal Health Care." A transcript is also on-line there.

What happened: Three notable trends

1. There is strong and committed leadership from active, progressive members of Congress for advancing health care reform in this session.

2. Support for comprehensive reform is broadening among communities of color, doctors, union members, patients, providers, and advocates.

3. There is growing recognition that market-based solutions are failing, but the battle lines are being drawn between the current administration, which is determined to further privatize Medicare and other public programs, and advocates of effective, single payer reform.

The progressive House leadership signaled their serious commitment to universal, comprehensive single payer health care reform, by their statements and by their presence throughout the day. Progressive Caucus chair, Rep. Dennis Kucinich (OH), vice-chair Rep. Barbara Lee (CA), and Rep. John Conyers (MI) engaged the participants for nearly five hours, and Rep. Donna Christensen (Virgin Islands), chair of the Black Caucus health committee, stayed for most of the proceedings. Twelve members of Congress attended, and many stayed for several hours, a truly significant turnout.

The three panels

Robert Reich, former Secretary of Labor, led off the proceedings with a statement.

Dr. Marcia Angell, former editor of the New England Journal of Medicine, presented a White Paper prepared by the Physicians' Working Group for Single-Payer National Health Insurance, a group organized by PNHP National Coordinator and APHA Past-President Dr. Quentin Young. The paper is available at the web site of Physicians for a National Health Program at www.pnhp.org under "News and Updates." Dr. Angell's clear and compelling presentation that universal single payer national health insurance is both imperative and affordable received a standing ovation from the members and the audience.

In addition to Dr. Angell, members of the Physicians Working Group for Single-Payer National Health Insurance come from a wide array of physician organizations and backgrounds: Dr. Rodney Hood, the President of the National Medical Association which represents African-American physicians; Dr. Elinor Christiansen, the President of the American Medical Women's Association; Dr. Merlin DuVal, President Nixon's Assistant Secretary for Health; Drs. Christine Cassel and Gerald Thompson, Past Presidents of the American College of Physicians; Dr. Sindhu Srinivas, President of the American Medical Student Association; APHA Past President Dr. Quentin Young, Philadelphia Health Commissioner Dr. Walter Tsou, APHA Past-President, Dr. Helen Rodriguez-Trias, the Economic Policy Institute's Dr. Edith Rasell, Dr. Olveen Carasquillo, Universal Health Care Task Force of the National Hispanic Medical Association, Dr. Peter Beilenson, Baltimore City Health Commissioner, and PNHP co-founders Drs. David Himmelstein and Steffie Woolhandler.

During the second panel, members of Congress spoke about their own legislative proposals.

Reps. Kucinich and Conyers announced their intentions to work together to draft a new bill for single payer national health insurance.

Rep. Barbara Lee spoke eloquently about HR 3000, the U.S. Universal Health Service Act, which she will re-introduce, and its importance both for public health and for redressing health care inequalities.

Rep. Jesse Jackson Jr. (IL) made an impassioned presentation about his proposed resolution to make health care a constitutional right.

Other speakers included Reps. Ciro Rodriguez (TX), Tammy Baldwin (WI), John Tierney (MA), and Pete Stark, Hilda Solis, and Bob Filner (all CA).

The third panel included other supporters of universal health care, who presented their personal experiences as health care providers, patients, and analysts to dramatize the need for universal health care.

Ellen Shaffer, a founding member of the APHA Working Group on Universal Health Care, discussed the importance of a publicly accountable and public financed universal system to provide access and coordinated, high quality care for immigrant workers in California, women with breast cancer, and high-risk infants. APHA members Donald Light, Claudia Morrissey, Nancy Milio, Mary Villedrouin, Thelma Correll, Carmen Nevarez, Karyn Pomerantz, Mark Hannay, and Susan Reverby, and Barbara Brenner, contributed to her statement.

Other providers and patients represented the American Psychological Association, the Service Employees International Union, the Black Nurses Association, the League of Women Voters, the Massachusetts Nurses Association, the Black Health Care Brain Trust, people with sickle cell anemia and cancer. A doctor protested the recent closing of DC General Hospital. Frank Clemente of Public Citizen's Congress Watch presented a critique of the Breaux-Frist proposal to privatize Medicare.

The audience for the hearings were as impressive as the panelists, including among others: Bob Griss, Executive Director, Center on Disability and Health, and APHA Executive Director Mohammed Akhter; Kevin Lindamood of Health Care for the Homeless; Gail Shearer of Consumers Union; Madeleine Gold of SEIU; and many Congressional staff, including Cathy Hurwit, staff for Rep.Jan Schakowsky, and staff for Sen. Paul Wellstone. The hearing room was packed and enthusiastic.

Significance of the event

PNHP National Coordinator Dr. Quentin Young's extraordinary energy and vision, combined with excellent staffing by PNHP assistant Jackie Le, brought together a wide-ranging group of doctors in support of a single payer health care system, and gave our champions in Congress like Reps. Kucinich, Lee, Conyers and Christensen a platform for action on single payer national health insurance, which was endorsed before the hearing by both the Progressive and Black Caucuses. This diversity was reflected in the participation of the Black and Hispanic Caucuses, and the range of advocates for reform who spoke at and attended the hearing.

It was remarkable that these members of Congress devoted almost five hours on a working day to listening to moving and effective testimony. Thanks to Congressional staff Joel Segal, Allison Friedrich, and Danielle LeClair for their dedication to this project.

As the discussion on the Breaux-Frist Medicare proposal reminded all of us, our vision is not driving national policy, and in fact supporters of the failing market approach are pushing hard and fast to undermine public programs in the U.S. and to export privatization abroad. It is more critical than ever to show our support for those courageous and visionary members of Congress who are standing up to lead the way, by mobilizing our organizations, and encouraging our representatives to co-sponsor progressive legislation, including the upcoming new Conyer's bill for single payer national health insurance and to join the Universal Health Care Task Force.

A LANDMARK PAPER:


Physicians' Working Group on Single-Payer National Health Insurance Proposal for Health Care Reform
May 1, 2001
Presented to the Congressional Black Caucus, the Congressional Progressive Caucus, and the Congressional Hispanic Caucus

"A National Health Insurance Program is the only affordable option for universal, comprehensive coverage. Under the current system, expanding access to health care inevitably means increasing costs, and reducing costs inevitably means limiting access. But an NHI could both expand access and reduce costs. It would squeeze out bureaucratic waste and eliminate the perverse incentives that threaten the quality of care and the ethical foundations of medicine."

This landmark white paper is available at: http://www.kaisernetwork.org/health_cast/uploaded_files/whitepaper.pdf

The videocast of the entire hearing is available at: http://kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=202

Comment: Downloading this white paper is a must. Single payer national health insurance is now back on the agenda for health care reform.