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Staying active for Medicare for All throughout the summer: Parades, town halls, texting, and more!
On August 21, 2019, Health Care Justice - NC members advocated for Medicare for All by having a texting party at Queens University! We partnered with National Nurses United to contact constituents in targeted congressional districts who need to contact their reps to hold hearings on Medicare for All.
Health Care Justice - NC members marched in the annual Pride Parade on August 18, 2019, and staffed an information table at the weekend festival. We collected over 500 new signers in support of improved Medicare for All!
On August 13, 2019, Health Care Justice - NC members packed the house at a Health Care for All town hall organized by Congresswoman Alma Adams. A special thanks to health care advocates Nazim Uddin, Margie Storch, Michael Merenstein, Tera Long, Dimple Desai, Steven Phillips, Zach Thomas, Sally Okoniewski, Tom Moore, Janice Valder Offerman, and many more who stood in solidarity for improved Medicare for All.
Also on August 13, the Health Care Justice - NC Cornwell team participated in a showing of Fix It! with apanel discussion at Friendship Missionary Baptist Church in Charlotte. Great discussion! We were pleased to help organize this event.
Board members met on August 7, 2019, to review M4A strategies now through the Republican National Convention in Charlotte in August 2020.
A press conference and celebration on July 30, 2019, highlighted the 54th anniversary of Medicare (for seniors) and Medicaid (for some) outside the Mecklenburg County Health Dept. Action NC, Health Care Justice - NC, and others joined to demand NC legislators Expand Medicaid NOW! Mecklenburg County Commissioner Pat Cotham pointed out that President Harry Truman first pushed for a universal national health insurance program in 1945! It’s past time for improved Medicare for All.
Health Care Justice - NC showed support for Medicare for All by marching in the Fourth of July parade and hosting an info table at the celebration afterwards.
Health Care Justice – NC Joins Allies in Call for Medicaid Expansion
On June 5, 2019, more than 20 "Health Care Can’t Wait!" vigils were held across North Carolina to remember the people who have tragically died or who are still suffering because they have fallen into the Medicaid coverage gap.
Health Care Justice – NC organized the Vigil in Charlotte at Elmwood Cemetery with over a dozen local supporting organizations. NC Justice Center coordinated the statewide action. See a video summary of the event here.
May 9 rally for health care reform
Health Care Justice - NC members and others rallied in support of health care reform (Medicaid expansion, Medicare for All, protecting care for pre-existing conditions) outside of a Sen. Thom Tillis fundraiser in Charlotte on May 9, 2019. About 50 people turned out. We displayed both of our Health Care Justice - NC banners and chanted messages in support of health care for all.
Wendell Potter, nationally known author of "Deadly Spin," speaks to HCJ-NC members in Charlotte!
Over 200 people attended the Wendell Potter "Medicare for All" Charlotte events on April 12, 2019. Wendell Potter is president of the Business Initiative for Health Policy. He spent 20 years working as a public relations executive for health insurers, before leaving his position as the Vice President of Communications for CIGNA to become an advocate for meaningful health care reform.
Thanks to all who participated and volunteered to make these events in Charlotte and across North Carolina a success. Special thanks to Wendell - keep up the great work!
Presenting to NC House and Senate members
Tera Long, HCJ-NC Legislative Co-Chair, made a presentation to the Mecklenburg Co. members of NC House and Senate at their March 16, 2019 Listening Session. HCJ-NC members attended to show support and also had a great turnout at the March 9 session in Charlotte.
"Fix It" screening in Charlotte
Tom Bowers arranged a Medicare for All Teach-In at the Unitarian Universalist Church of Charlotte on March 14, 2019 featuring Physicians and the film Fix It: Health Care at the Tipping Point.
Dr. Jessica Schorr Saxe at the Democratic Women of Mecklenburg County meeting
HCJ-NC Board Chair Jessica Schorr Saxe, MD, presented info on the Medicare for All Act of 2019 at the March 13, 2019 Democratic Women of Mecklenburg County meeting. The DWMC passed a resolution supporting supporting the Medicare for All Act of 2019 by acclamation that evening.
"Fix It" screening at Faith and Community Leaders Luncheon
The HCJ-NC Cornwell Team organized a Faith and Community Leaders Luncheon about Medicare for All on Feb. 27, 2019 featuring a panel of medical professionals and the film Fix It.
Advocating for Medicaid Expansion in Raleigh
HCJ-NC members Margie Storch and Ann Newman joined other Charlotteans in Raleigh on Feb. 27, 2019 to advocate for Medicaid Expansion - a short term fix to cover more North Carolinians. The long term fix, HR 1384 Medicare for All Act of 2019, was introduced in Washington DC the same day!
"Power to Heal" screening at St. Paul Baptist Church
HCJ-NC partnered with St. Paul Baptist Church, Caldwell Presbyterian Church, and Greenspon Center for Social Justice to present a documentary film: "Power to Heal," documenting a little known feature of the 1960s civil rights movement — how Medicare forced the dramatic desegregation of every hospital in America practically overnight.
Rev. de'Angelo Día moderated the Feb. 26, 2019 event.
Medicare-for-All teach-in at Queens University
HCJ-NC partnered with Queens University student group Health Care Justice and 9 other activist organizations to present a Medicare for All Teach In and Reception on Feb. 10, 2019.
Drs. Jessica Schorr Saxe and Carol Paris rally in Raleigh
HCJ-NC Chair Jessica Schorr Saxe spoke at the HJonK People's Assembly Moral March in Raleigh on Feb. 9, 2019. She joined Carol Paris, MD, (former Pres. of PNHP) and other MFA supporters in the fusion campaign for social justice.
Town hall meeting with Rep. Alma Adams
HCJ-NC members attended US Rep. Alma Adams' (co-sponsor of MFA HR 1384) State of the District Meeting / Town Hall on Jan. 27, 2019 with Medicare for All signs and questions.
HCJ-NC at Women's United March
HCJ-NC members marched in the Women's United March on Jan. 26, 2019. HCJ-NC Chair Jessica Schorr Saxe, MD, was a featured speaker at the rally.
Marching in Charlotte's MLK Day Parade
HCJ-NC members marched in the Martin Luther King Jr. Parade on Jan. 19, 2019.
HCJ-NC general membership meeting (Jan. 2019)
Health Care Justice – NC's general membership meeting on Jan. 17, 2019 featured presentations by board members George Bohmfalk, MD ("Talking to Conservatives") and Jessica Schorr Saxe, MD ("Beware of Medicare Look-A-Like Proposals").
Health Care for All: Dollars and Sense
On October 29, 2018, HCJ--NC organized with five churches in Charlotte to hear retired neurosurgeon Dr. George Bohmfalk speak. Gathered at Caldwell Presbyterian Church, 85 attendees learned how Medicare actually improves length of life.
On a graph comparing health statistics of 17 developed countries, Dr. Bohmfalk showed that Americans rank near or at the bottom in death rates at every age under 65. However, after 65 and with every passing decade, Americans rank increasingly higher. Those of us in our 80s and 90s rank near or at the top in life expectancy.
The reason: Medicare! That’s a compelling demonstration of what happens when people have unfettered access to health care.
“Partnering” with faith communities gave HCJ--NC a positive experience to build upon for future gatherings, as these parties have common goals for justice and a healthier society.
Quick Facts Handout
HCJ-NC has created a one-page handout of facts on improved Medicare for all. Click here to open/print the document in your web browser. (Or right-click to save as a PDF document.)
Charlotte Pride Parade 2018
Health Care Justice - NC had the honor of marching in the Charlotte Pride parade and hosting a booth Aug. 18-19 that netted over 300 new members.
Talking to festival participants both confirmed the great need and the great support in the community for Improved Medicare for All!
Medicare is turning 53. Here's how to celebrate.
HCJ-NC member Dr. Goerge Bohmfalk urges Congress to improve and expand Medicare on the occasion of its 53rd birthday. Click here to read his op-ed in the Charlotte Observer.
The profound link between poverty and health
HCJ-NC chair Dr. Jessica Schorr Saxe writes about the health risks associated with low income and low wealth, and what we can do to address them. Click here to read her op-ed in the Charlotte Observer.
White Coat Brigade at the Poor People's Campaign
Health Care Justice - NC members attended the Poor People's Campaign rally in Raleigh on June 4, 2018 to support health care for all.
About a dozen persons from Charlotte participated, including the "white coat brigade" of medical providers. HCJ-NC members spoke at the rally in support of Medicaid expansion in N.C. and single-payer health care for all Americans.
Dr. Ed Weisbart speaks to HCJ-NC members
Dr. Ed Weisbart, chair of PNHP Missouri, made Charlotte his first stop in a weeklong spring trip to North Carolina.
A group of activists learned how to make more effective presentations during his April 29, 2018 seminar, followed by a master's level course in making better PowerPoint slides.
The next evening, Dr. Weisbart elaborated on improved Medicare for all at a public gathering, including a discussion of the recent "lookalike" plans being proposed by a variety of groups.
He also worked in a very informative lunch with the Health Care Justice - NC board. His visit attracted several new members to our group and further energized all of us to spread the word about the best path to true health care reform.
Video: "Make American Healthcare for All"
Thanks to HCJ-NC member Zach Thomas for writing this song and to Brian Kasher for producing it. Please view, enjoy, and share!
Cornwell Center group advocates Medicare for all
Health Care Justice has spun off a satellite! Our newest Board member, Jacki Marshall, organized a group at the Cornwell Center, a wellness and fitness center affiliated with a church where she and many of her friends do yoga and other activities.
After being inspired by seeing FixIt there last fall, she organized a group of like-minded folk to further the mission of HCJ-NC with a series of three screenings. Over 150 people came to the presentations, each followed by a spirited Q&A led by panels of physicians.
At the podium (above) is PNHP member Dr. John Clarkson, retired ophthalmologist and dean emeritus of the University of Miami Miller School of Medicine.
Panel: National Health Plans Around the World
HCJ - NC hosted a spirited discussion October 19, 2017 in Charlotte. Emily Paterson described how efficiently and kindly the Canadian system handled her kids' ear infections, Hazel Tapp described her positive experiences with England's socialized medicine, Majda Garrity-Smith reviewed her Caesarean sections in both France and the U.S., and Elena Platanova spoke on Germany's system.
All of the speakers, as well as several in the audience, emphasized that the benefits of universal coverage far outweigh any disadvantages. The care they received in other countries was as good as (cancer treatments) or superior to (C-section aftercare) what they have experienced in the U.S.
The discussion was preceded by the audience singing Board member Zach Thomas III's new song, "Make American Healthcare for All," seen in a beautiful studio recording below. Several of the 100 or so attendees became new members of HCJ-NC by signing our Chapter Resolution, which you can do by clicking here.
Dr. Robert Zarr Draws Large Crowd to Charlotte Forum on Single Payer
If you did not attend the Health Care Justice - NC meeting on Thursday evening, March 9, 2017 at the Midwood Cultural Center in Charlotte, then you missed a fantastic presentation given by Dr. Robert Zarr. Dr. Zarr, a pediatrician in Washington D.C., is the past president of the Physicians for a National Health Program. There were almost 100 attendees and the crowd was engaged with questions and comments.
Polls indicate that the American public and physicians favor a health program referred to as "single payer." It's the basis of the popular Medicare program initiated in the mid 1960's. And many developed countries have similar health plans, including Taiwan, Sweden, and Canada with superior health indicators and lower cost.
Comparisons were made to other developed countries with single payer health care systems and the deficiencies of our current system (with the exception of Medicare). Relevant slides included the a graph of the huge increase in health care administrative costs for physicians and hospitals due to inefficient payment models and contracts.
A summary was also presented of the changes that are being made to eliminate the ACA provisions that will cause the loss of insurance for millions. Potentially 10 million Americans will become uninsured resulting in 10,000 deaths! (documented 1,000 deaths per 1 million people who lose coverage). Did you know that there are still over 31 million people underinsured and 27 uninsured!
HCJ-NC Members Told that Progress Made by ACA is Being Challenged
Remember what health care was like before the Affordable Care Act (ACA)? Rising health inequality. Increasing out-of-pocket expenses. Fifty million uninsured. Many more underinsured.
The ACA has clearly made progress toward greater coverage and equal benefits, Dr. Jessica Schorr Saxe, Board Chair of Health Care Justice - NC, told an audience of over 50 members on January 26. However, any progress made is threatened by the current move to "repeal and replace" the law.
She also reminded the group that Congress is considering block grants to states to cover Medicaid programs, which would mean less federal money and changes in eligibility to limit enrollment. They are also considering changes to Medicare such as vouchers to purchase health insurance.
Dr. Saxe urged the group to contact their elected officials to oppose repealing the ACA without replacing it with a plan that is at least as good, block grants for Medicaid, and changing Medicare to "premium support" (also known as "defined contribution" or voucher program.)
Dr. Saxe said that in the midst of this chaos, she sees an opportunity for single payer to succeed.
The meeting also included the following highlights on the work of committees:
- Membership is currently at 500 and increasing membership through participation in community events and speaking to community groups is a primary goal of the Board.
- Legislative committee reported that Gov. Roy Cooper has proposed expanding Medicaid to cover more North Carolinians.
- Communication committee recommended, and the Board adopted, a new logo with the tag line, "Advocating Health Care for All." Future goals include improving the website and assuring that Health Care Justice - NC has a presence at appropriate community events.
Dr. Saxe reminded the audience to put March 9th on their calendars. Dr. Robert Zarr, immediate past president of Physicians for a National Health Program, will be in Charlotte to speak to the membership.
Health Care is a Right, Not a Privilege: Stories of Health Care Injustice, Resolution & Solution
Update: For more details on this meeting, click here.
Hear compelling stories of how the American Health Care System is failing many individuals and join a discussion focused on solutions.
When:
October 6th at 6:00pm
Where:
Midwood International and Cultural Center
1817 Central Avenue, Charlotte 28205
Event Moderators:
Karen Bean, League of Women Voters & NC Chair, Close the Gap NC Campaign
Dr. Jessica Schorr Saxe, Chair, Health Care Justice-NC
For more information or to RSVP, contact Denise Finck-Rothman at DeniseFinck@hotmail.com.
Health Care Justice NC Participates in Day of Advocacy to Close the Medicaid Gap
On May 25, members of Health Care Justice North Carolina joined other advocacy groups at the General Assembly to raise awareness of the need for North Carolina to close our Medicaid gap. Half a million of our fellow North Carolinians--70% of them working poor--lack access to health care.
At a press conference in the state legislative building, Dr. Stephen Luking and Dr. Charlie van der Horst told impassioned stories of their own patients and Sonya Taylor spoke about her personal situation in the gap. There are hundreds of thousands like her across the state.
Expanding Medicaid would bring good-paying jobs to the state, bolster county economies, strengthen the finances of rural hospitals, return NC tax dollars to our state, and most of all, would provide health care to 500,000 North Carolinians in the gap.
For further information on the Medicaid gap see:
The Economic and Employment Costs of Not Expanding Medicaid in North Carolina
A county-by-county analysis of closing the Medicaid coverage gap
May 25 Day of Advocacy to Close the Gap in Raleigh
Please join us in the Week of Advocacy. If you would like to carpool from the Charlotte area please let Karen Bean (karenb@lssp.org) know by noon Thursday, May 12, so we can make more definitive travel plans.
Join members of the North Carolina Medicaid Expansion Coalition for
Close the Medicaid Gap - Week of Advocacy
Patients, healthcare providers, individuals in the coverage gap, and advocates are planning a Week of Advocacy to raise public awareness about the need for North Carolina to close our Medicaid gap. Closing the gap would provide health coverage for half a million North Carolinians and create tens of thousands of jobs. Please join us for any or all of the events below!
Day of Advocacy at NC General Assembly
Wednesday, May 25th, 8:00 a.m. - 3:00 p.m.
Phonebanking at NC Justice Center
Monday, May 23rd from 6:00 p.m. - 8:00 p.m.
Location: 224 South Dawson Street in downtown Raleigh
Help make calls to turn out folks to Advocacy Day and contact legislators on closing the gap. RSVP to Ciara Zachary at ciara@ncjustice.org. Dinner will be provided!
Twitter Town Hall hosted by Young Invincibles
Tuesday, May 24th from 2:00 p.m. - 3:00 p.m.
Young Invincibles (@YoungInvincible) and NC Justice Center's Health Access Coalition (@nchealthaccess), will host a twitter chat to promote Closing the Coverage Gap and the upcoming Advocacy Day. For information about the Twitter event, please contact krieg.rajaram@younginvincibles.org.
For more information on any of these events, contact Lee Storrow at lee@ncaan.org or Nicole Dozier at nicole@ncjustice.org.
See "Fix it" Thursday, May 19, at 6:00pm
You are invited to a meeting of Health Care Justice. Bring a friend!
Thursday, May 19, 2016, at 6:00pm
Morrison Regional Library, 7015 Morrison Blvd, Charlotte, NC 28211
First floor meeting room
Fix It: Health Care at the Tipping Point, produced by CEO Richard Master, is "...a powerful new documentary that reaches across the political and ideological divide to expand support for major healthcare reform."
Discussion will follow.
Questions?
DeniseFinck@hotmail.com
Luis Lang case sparks wrong questions
Lang has garnered a lot of attention, but his case just points to the need for a better approach to health care in the U.S.
By Jessica Schorr Saxe
Charlotte Observer, June 6, 2015
Have you weighed in on Luis Lang, the diabetic smoker who put off getting health insurance until he was about to go blind from complications of diabetes, only to find it was too late to enroll in an Affordable Care Act policy and that he wasn’t eligible for Medicaid in South Carolina? Since his story was reported in the Observer, it has unleashed a torrent of comments and has been widely disseminated through social media. Lang has raised more than $25,000 for eye surgery through the original story and his GoFundMe site – and is now an advocate for the ACA.
Apparently everyone has a position. Many are punitive, as in “he made his bed, so he must lie in it.” One suggested that he go blind: “Learn to read Braille. Sell pencils on the street.” Some remark on the value of his house, his “immaculate lawn and gardens,” and his “fine furniture.” Some wonder why, if they had the foresight to invest in their own health insurance, they should now pay for his health care. Others note that, if he does not get help and goes blind, he will actually cost the public more in various ways. Many who have contributed to his surgery are self-described liberals, provoking a separate stream of criticism as expressed by Keith Larson in a column titled “Go ahead and gamble: the liberals will rescue you.”
Since there are millions in similar situations, this could prompt other discussions. If he didn’t smoke, would he attract more sympathy? What if we knew his wife really couldn’t work, which he suggests but doesn’t explain?
The problem is that this is the wrong discussion.
What’s the best model?
The questions we should be asking are these:
Who needs health care?
Who benefits if everyone has health care?
Do we really want people to have better health habits? If so, is blaming them and excluding them from health care the way to accomplish that?
Is crowdfunding the way to finance needed medical care, or are there better models?
We all benefit from coverage
And the answers are:
Everyone needs health care. Some need it more than others, but we all need it at some point, and we all need to know it’s available when we do.
We all benefit if everyone has health care. Infectious diseases are an obvious example. If our neighbor or food server has whooping cough, we are better off if they are not deterred by expense and get treated before starting an epidemic. We are better off if our employees or colleagues have their diabetes or asthma treated so their work is not impaired. We are also better served if our neighbors can get needed care and are not beset by anxiety about illness or mounting medical bills.
Many have expressed reservations about Lang’s health habits and decisions. Yet, most of us do not have exemplary lifestyles. Like Lang, 18 percent of U.S. adults smoke. And two-thirds are overweight or obese. A doctor’s words can affect detrimental lifestyle habits. Even brief smoking cessation counseling by a physician boosts success. In medical practice, I helped many patients stop smoking, eat better and be more active. But I could do that only if they were able to see me.
Crowdfunding is interesting because it taps compassion, a quality sorely needed in this discussion. But crowdfunding is an inefficient and arbitrary mechanism for distribution of resources, directing funds to those with savvy and communications skills rather than those with the greatest need.
Much spending is wasted
We must ask the right questions in order to direct our energies toward a compassionate solution to the health care plight of so many and away from the impulse to nitpick our neighbors’ lives and second-guess their decisions.
Asking the right questions will lead to the right solution. The ACA is a step in the right direction in providing more people with insurance, but it will not solve the problem. We must move forward to provide everyone with needed health care. We can look to the example of other developed nations which all provide universal health care at considerably lower costs than ours by administering it through a unified system instead of our fragmented, complex non-system. The Institute of Medicine estimated that 30 percent of our health care spending is wasted, much on administrative complexity and unnecessary care. Harnessing that wasteful spending and putting it to use would provide more than enough resources to provide care for all.
If we have the vision to ask the right questions and exert our political will, we can save costs and move toward a kinder, gentler system in which Luis Lang won’t have to crowdfund his sight.
Jessica Schorr Saxe is a Charlotte family physician and chair of Health Care Justice – N.C.
http://www.charlotteobserver.com/opinion/op-ed/article23220168.html#stor...
Medicare is worthy model to provide health care for all
By Jessica Schorr Saxe, M.D.
Special to the Charlotte Observer, July 30, 2014
On July 30, 1965, President Lyndon Johnson signed Medicare into law, making 19 million Americans aged 65 and over eligible for health care coverage.
Given what you know about the federal government, how long do you think it took to implement?
Keep in mind that implementation involved identifying everyone over 65 for automatic enrollment in Medicare Part A (hospitalization) and identifying who would opt to enroll in (and pay for) Medicare Part B (office visits); enrolling the providers for Part A and the doctors and insurance companies for Part B; coordinating various government agencies; and developing policy.
Since there was no Internet, enrollment was accomplished by a quaint process using punch cards sent through the U.S. mail, supplemented by door-knocking.
Medicare was fully implemented on July 1, 1966 - 11 months after enactment - with 95 percent of eligible individuals signed up.
As we watch the cumbersome, protracted enactment of the Affordable Care Act, we should be aware that much of the problem is not the government, but the complications of dealing with insurance companies with their varying coverage, premiums, co-pays and networks, as well as their concerns about losing profits by paying for medical expenses.
While we laud the ACA for insuring the previously uninsured (and sometimes desperate), we should keep in mind those left behind: those still uninsured and often still desperate. As a doctor who sees low-income patients, I know many.
I recently saw a woman in her 40s who had had a stroke three months earlier. Her diabetes and blood pressure were seriously out of control. Because she had no insurance, she had not kept the primary care and neurology appointments made for her at her discharge from the hospital. She easily could have died waiting to seek medical care.
Another patient had suffered for years with a serious, yet treatable, skin condition. Why? After he lost his job, he lost his health insurance, and thus his dermatologist.
The public must look beyond the ACA to a system that will not leave so many locked out and suffering.
And when we do, we should start with Medicare as a framework, recognizing that:
- Medicare operates more efficiently than private insurance, spending less than 2 percent on administration and overhead, whereas private insurance companies typically spend more than 12 percent, sometimes considerably more.
- Participants in Medicare report greater health-care satisfaction than the privately insured.
- Medicare costs have a slower rate of growth than costs under private insurance.
- Medicare pays providers more quickly than private insurance.
- Medicare has decreased poverty among the elderly.
And it achieves these successes while covering the aged and disabled - the sickest among us.
Is Medicare perfect? Hardly. But it is the best model the U.S. has, and it can be improved. Expanding Medicare to cover everyone - thus dispensing with the wasteful middleman, i.e. the insurance companies - would provide many benefits. It would save hundreds of billions of dollars a year in reduced administrative costs. It would have negotiating clout to rein in medical supply prices. It would give us the choice we want - not the choice of convoluted insurance plans, but the choice of doctors and hospitals.
And the issues agonizingly debated in Burwell v. Hobby Lobby of whether employers should have a say in the contraceptive decisions of their employees? Poof! The discussion would disappear because employers would no longer be involved in health insurance. That alone would save the nation from lawsuits and endless public debate.
Furthermore, letting employers out of the health care business would free them to spend their time on their own businesses and spare them worrying about whether their workforce can get needed health care. And it will make their businesses more competitive in the international marketplace.
We should celebrate the anniversary of Medicare’s enactment this year by moving toward improved and expanded Medicare for all, which will give us the access, quality, cost-control and choice that we deserve - and that our wealthy country can easily provide. Wouldn’t achieving that be cause to celebrate in its golden anniversary year of 2015?
Jessica Schorr Saxe is a family physician in Charlotte.
http://www.pnhp.org/news/2014/july/medicare-is-worthy-model-to-provide-health-care-for-all
Americans underuse healthcare
By Jessica Schorr Saxe, M.D.
Special to the Charlotte Observer
Are we a nation of people waiting to have medical insurance so that we can spend our time seeking unnecessary medical care? Really?
The true problem is that many of us don’t get needed care.
Yet the myth of overuse reverberates throughout health care discussions. The myth is applied across socioeconomic classes – though differently. For the poor, it is argued that Medicaid will lead to unnecessary utilization and increased cost. For the privately insured, the myth suggests that people need high deductible health plans (HDHPs) to deter them from using medical care frivolously.
A recent study showed increased emergency department (ED) use for non-urgent conditions in Oregon patients who had recently gotten Medicaid through a lottery. It looked at short-term results of a largely white urban population. Much discussed in the media, it has been used as a warning against Medicaid expansion. It was not suggested that the care was unnecessary – just that much of it could have been provided in an outpatient setting.
Not as publicized was the recent national study of thousands of patients, examining their ED use by health insurance type. It found that Medicaid and privately insured patients used EDs similarly for acute problems, but Medicaid patients were more likely to use the ED for less serious conditions because they lacked other sources of health care. One might infer that the solution is to ensure that Medicaid patients have access to primary care, which is better and more cost-effective for non-urgent conditions.
For the privately insured, it is argued that, with HDHPs, consumers will be more conscious of their expenditures, use less care, and thus save money – largely for employers and insurers. If people have lower premiums and aren’t sick, they may also save money. But those who actually need health care may find themselves with large out-of-pocket expenses. According to the nonpartisan Kaiser Family Foundation, about one third of non-elderly adults had difficulty paying medical bills in 2012. Of people with medical debt, 70 percent are insured, mostly with employer-sponsored insurance – and more likely to have HDHPs.
And what about health, which health insurance is supposed to promote? The nonpartisan Robert Wood Johnson Foundation notes that cost-sharing (deductibles, co-pays and coinsurance) indeed cuts down on use of services, but that patients are as likely to forgo necessary as unnecessary care. Increases in cost-sharing have the worst impact on vulnerable populations, such as the poor, elderly and chronically ill.
Why isn’t anyone talking about the real American epidemic: the underuse of necessary care? A 2012 survey showed that 58 percent of Americans deferred medical care due to cost.
As a family physician, I live with this reality. I think of a patient who had rectal bleeding and one with life-threatening high blood pressure, who avoided the ED because of expense. I see patients who “stretch” their medications to make them last or miss needed visits for lack of co-pays.
Here’s another clue to possible underuse. Though we spend more per person than other countries, we actually use less health care. For example, Americans average 4 doctor visits a year compared to 7 in France and Canada, countries with better health outcomes than ours.
Whether others have health care matters to all of us. We all benefit when our colleagues aren’t working with chronic untreated conditions and our food servers don’t have coughs they can’t afford to have evaluated.
While many of us might have a story about someone who goes to the doctor more than necessary, the evidence asserts that lack of care is a much bigger problem. Even when insured, Americans have better things to do than wait in doctor’s offices when they don’t need to. But many who need health care don’t get it.
We should expand Medicaid, increase availability of primary care, and give access to our disproportionately sick population. Then we should move beyond Obamacare to improved health care for everyone. Other industrialized countries provide access to all, with lower costs and better health outcomes. Like them, we should eliminate insurance companies and for-profit medicine and expand health care to all.
Jessica Schorr Saxe is a family physician in Charlotte and chair of Health Care Justice –NC. Email: HCJusticeNC@gmail.com
HCJ Joins NC Legislators and Progressive Groups in Rally to Expand Medicaid
Health Care Justice and a coalition of progressive N.C. organizations joined with the Mecklenburg County (Charlotte, NC) Democratic state legislative delegation to urge Governor Pat McCrory to expand Medicaid to cover a half-million working poor adults in N.C.
The estimated crowd of 80 (WBTV) at the October 31 Charlotte press conference included not only the legislators but also medical professionals, clergy, representatives from the Medicaid Expansion Now coalition and individuals who are facing difficulties due to the lack of health insurance.
Health Care Justice is a member of a coalition which includes the N.C. NAACP/Moral Monday, Action NC, Progress NC, Protect Your Health NC and other groups.
Health Care Justice advocates for universal quality health care that is privately delivered and publicly funded. Although we believe the Affordable Care Act does not offer the best approach to solving the health care crisis in our country, we do support the increased coverage for hundreds of thousands of N.C. citizens that the expansion of Medicaid would provide.
Health Care Justice NC Successfully Advocated for the Resolution from Mecklenburg County Commissioners to Expand Medicaid in N.C.
Health Care Justice NC led a coalition of groups on October 15 to advocate successfully for 
the passage by the Mecklenburg County (Charlotte) Commission of a resolution calling on state government to expand Medicaid. The Resolution, introduced by Commissioner Dumont Clarke, was passed by a vote of 6 to 3.
HCJ Chair Dr. Jessica Shorr Saxe and member John Clark spoke at a news conference and again during the Commissioners session. The other participating groups were Protect your Care NC and Action NC. HCJ member Madison Hodges and Joel Segal, Charlotte resident and former senior staffer for Congressman John Conyers, also addressed the Commission meeting.
Last February, the Republican-controlled Legislature in N.C. refused to expand Medicaid to a half-million uninsured, low-income working adults. The costs of the program, which is part of the Affordable Care Act, would be covered by the Federal Government: 100% the first three years and about 90% thereafter. Estimates are that 25,000 jobs could be created by the expansion.
The primary mission of HCJ is to advocate for universal, quality healthcare which would be privately delivered and publicly funded. HCJ, however, considers Medicaid expansion to be vital to the health and well-being of 500,000 North Carolinians, including the 70,000 in Mecklenburg County who would qualify under the expansion.
You may view the speeches delivered to the Commissioners by Dr. Jessica Saxe, John Clark, Madison Hodges and Joel Segal here:
http://mecklenburg.granicus.com/MediaPlayer.php?view_id=2&clip_id=2509
Scroll down the meeting agenda on the left side of the webpage and select Medicaid Expansion to view that portion of the meeting.
HCJ Chair asks "What was the Legislature Thinking?"
Dr. Jessica Schorr Saxe, Chairperson of Health Care Justice, was the lead off speaker at the Moral Monday gathering in Charlotte, NC on August 19. Officials estimated the turnout to be at 2,000. Dr. Saxe addressed the failure of the N.C. Legislature and Governor Pat McCrory to expand Medicaid and cover a half million working-poor North Carolinians.
The Moral Monday protests began last spring to protest legislative actions from abortion restrictions, voting obstacles and a tax plan that benefits the wealthy and big business in the state. Initiated by the state's NAACP, the campaign attracted thousands each week and gained national attention.
Following are Dr. Saxe's remarks:
Does having medical care matter?
What was our legislature thinking when they turned down the opportunity to expand Medicaid - which would have covered about 1/2 million more North Carolinians?
Does having medical care matter?
Martin Luther King thought so. He said "Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
Let me tell you some reasons why we should all care about expanding Medicaid.
First of all, Medicaid saves lives. If we were to expand Medicaid, we would save the lives of almost 3000 North Carolinians every year.
It would also improve lives. Let me tell you about some of them. I'm a family doctor. In just one morning last week, I saw several patients who would be helped by Medicaid.
I saw an elderly woman with several medical conditions who apologized for not coming in for months. Her son who has kidney failure and heart failure, and she says she can't afford for both of them to go to the doctor, so she pays for his doctor visits - when she can.
The Medicaid expansion would matter to them: If her son had Medicaid, he could get the medical care he needs - and she would then be afford the care she needs.
Another patient has a bad hip that is very painful and he needs a hip replacement. He can barely walk, so he can't work. He is homeless because he has no income. He can't get his hip replacement because he has no insurance.
The Medicaid expansion would matter to him: if he had Medicaid, he could get his surgery. And then he could work - which is what he wants to do.
Do you think our legislature and governor were thinking of these people - and the thousands like them when they rejected the Medicaid expansion?
But expanding Medicaid will not only save lives and relieve suffering, it will save money: $65.4 million over the first 8 years.
Expanding Medicaid is a win for people who would be covered, it's a win for other North Carolinians who don't like to see people suffer, it's a win for doctors who want our patients taken care of, for hospitals that need to be paid, and it's a win for the state budget.
So what was our legislature thinking?
I'd like to know if they think medical care matters. And, if they don't: Would they be willing to give up their health insurance?
And, if they do think medical care matters, they should take care of their fellow North Carolinians and accept the Medicaid expansion.
-EndNote: To learn more about a just solution to health care and to join Health Care Justice NC, click here: http://www.pnhphcjnc.org/sign-resolution.php.
Let’s celebrate Medicare
By Jessica Schorr Saxe, M.D.
The Charlotte (N.C.) Observer, July 29, 2013
Just after her 65th birthday, a patient limped into my office and apologized for not having shown up in months. She had not been able to afford a visit. Now on Medicare, she was able to address her medical problems. Within a month, she had seen her kidney doctor and an orthopedist. Within a few more weeks, she would have the knee replacement that had been recommended years before. A previously “noncompliant patient,” she was keeping all her appointments – now that she could afford them.
As the nation notes the 48th birthday of Medicare today, let us celebrate what we have achieved. But let us ponder this as well: This patient – and my many other pre-senior citizen patients with medical needs – would have been better off with coverage earlier. Maybe her kidney failure would not have progressed. She was lucky to have a job she could do while “hobbling around,” she says. Others can’t work due to pain and can’t get surgery because they are unemployed and uninsured.
Access to health care for all
The real celebration of this important milestone would be to improve Medicare and extend it, providing access to health care for all.
Consider these facts:
• According to a study by the Commonwealth Fund, elderly individuals on Medicare were more satisfied than people with private insurance. (Only 8 percent rated their Medicare as fair or poor compared to 20 percent for employer-sponsored insurance and 33 percent for individual policies).
• Medicare patients were less likely to have access problems due to cost (23 percent as compared to 37-39 percent for private insurance) and had fewer medical bill problems (21 percent and 39 percent respectively).
• Traditional Medicare is more efficient with its 1.4 percent overhead (according to the Centers for Medicare and Medicaid Services) as compared to 12-25 percent for private insurance.
• Lack of health insurance accounts for 45,000 deaths annually in the United States. Behind these statistics are 45,000 human beings whose lives might have been saved had they received medical care.
• While the Affordable Care Act will reduce the number of uninsured, a recent survey showed that in 2016 about 30 million people, 80 percent of whom are U.S. citizens, would still be uninsured. In North Carolina, that number will be 1,268,000 (which could drop to 790,000, if N.C. lawmakers were to accept the Medicaid expansion).
Improved Medicare for all would be financed by a single-payer system in which one public entity would pay the bills, while the delivery of medical care would remain largely private. The program would eliminate all co-pays and deductibles, and be funded by equitable taxes amounting to less than what most people pay today for insurance premiums and out-of-pocket expenses. The billions of dollars in savings in administrative costs and negotiated drug costs would be more than adequate to provide universal coverage as well as improved services.
Do you think that extending Medicare to all is a liberal fantasy?
GOP doctor pushes ‘single payer’
Dr. David May, the gun-toting Republican chair of the Board of Governors of the American College of Cardiology, recently wrote an article advocating a single-payer system. He notes that it would save money, promote choice, provide transparency in costs, capture data that would allow to us improve outcomes, and allow physicians – rather than insurance companies – to be in charge of health care. He concludes that our current system is un-American and that his proposal is “quite Republican.”
This is a month to celebrate freedom. July 4 marked the anniversary of freedom for Americans from tyranny. Let’s end the month celebrating the freedoms that Medicare gives our seniors: the ability get needed medical care with less risk of financial devastation.
How much better it would be if we extended that freedom to all!
Jessica Schorr Saxe is a Charlotte physician and chair of Health Care Justice, the local chapter of Physicians for a National Health Program. hcjusticenc@gmail. com
Thank You Health Care for All North Carolina
Health Care for all North Carolina (HCFANC) is the North Carolina state Chapter of PNHP. Through our association and support from HCFANC, our organization Health Care Justice evolved. HCJ is an affiliate of PNHP and a chapter of HCFANC. It is our hope that HCJ, just like HCFANC, can encourage other groups to form and advocate for single-payer health care.
The banner for a single-payer health care system can only grow as more and more people hear about single-payer and how it can be the solution to the crisis of our health care system.
North Carolina Rejects Medicaid Expansion
Governor Pat McCrory and the NC General Assembly rejected both Medicaid Expansion and the Insurance Exchange provided under the Affordable Care Act. Of 1.5 million people not insured in NC, 500,000 would have been eligible for Medicaid. The General Assembly at any time can vote to accept Medicaid Expansion. The Federal Government will plan and implement the Insurance Exchange.
We at HCJ encourage the General Assembly to accept the Medicaid Expansion so more of our citizens can have access to health care in a health care home. The uninsured patient often postpones medical visits and ends up at an emergency room where care is more expensive and often the patient is sicker due to the delay.
Rep. John Conyers, Jr. honored by Health Care Justiceduring National Democratic Convention
U.S. Representative John Conyers, Jr. (D. Mich.) was honored by Health Care Justice at a special reception during the National Democratic Convention in Charlotte last September for his passionate advocacy over many years for a universal, single-payer healthcare program.
As the key sponsor of HR bill 676, Rep. Conyers along with other House members has introduced this bill annually since 2003. It is often described as “Expanded and Improved
Medicare For All Act” which would provide for comprehensive health insurance coverage for all United States residents.
During his remarks, Conyers thanked members of Health Care Justice for their local efforts to educate citizens about this important issue. Dr. Jessica Schorr Saxe, Health Care Justice Chairwoman, was also recognized by the organization for her excellent leadership in advocating for a universal, single payer health care system.