Toronto Star
Sep. 26, 2003
Ottawa, provinces agree to national health council

The federal government and provinces have reached agreement on the creation
of a 27-member national health council, a key source said today.

The council, which would monitor health policy and accountability, would be comprised of a chairperson, 13 government representatives and 13 people
from outside government.

Roy Romanow recommended the council last year in his royal commission
report on the future of health care.

click here to view the article

Comment: Imagine a national health council in the United States monitoring
health policy and accountability. Just to begin with, what would such a commission have to say about our very high costs in the face of the profound
deficiencies and inequities in our system?

Such a council would be invaluable to help fine tune a comprehensive health
care system such as Canada’s. But, in the United States, we don’t need to
fine tune a system. We need to establish a system. The sooner the better.

Sat, 27 Sep 2003 11:06:15 -0700
Subject: qotd: Federal regulations produce a return on our investment

The White House
Office of Management and Budget
Informing Regulatory Decisions: 2003 Report to Congress on the Costs and Benefits of Federal Regulations and Unfunded Mandates on State, Local, and
Tribal Entities.

OMB reviewed 107 major Federal rulemakings finalized over the previous ten
years (October 1, 1992 to September 30, 2002). The estimated total annual
quantified benefits of these rules range from $146 billion to $230 billion, while the estimated total annual quantified costs range from $36 billion to $42 billion.

Table 2: Estimates of the Total Annual Benefits and Costs of Major Federal Rules, October 1, 1992 to September 30, 2002 (millions of 2001 dollars):

Health & Human Services
Benefits: 9,129 to 11,710
Costs: 3,165 to 3,334

Environmental Protection Agency
Benefits: 120,753 to 193,163
Costs: 23,359 to 26,604

(six other agencies are listed, and each shows a significantly greater benefit than cost.) http://www.whitehouse.gov/omb/inforeg/2003_cost-ben_final_rpt.pdf

Comment: One of the most common objections to the role of government is the cost of regulatory requirements. Although the social benefits of many regulations may be priceless, it is very reassuring to know that President Bush’s OMB has provided a report that demonstrates that the regulations of each agency also produce a significantly greater dollar value in benefits than are the costs of fulfilling the regulations.

Although the greatest return has been through EPA regulations, agencies such as HHS have also produced a positive dollar return on the regulatory requirements.

The benefits of regulatory oversight are further evidence that our government is not our enemy. And we could benefit even more if we would begin to use a Universal, “government-run,” social insurance program to improve the value of our health care investment.

Toronto Star
Sep. 26, 2003
Ottawa, provinces agree to national health council

The federal government and provinces have reached agreement on the creation
of a 27-member national health council, a key source said today.

The council, which would monitor health policy and accountability, would be comprised of a chairperson, 13 government representatives and 13 people
from outside government.

Roy Romanow recommended the council last year in his royal commission
report on the future of health care.

click here to view the article

Comment: Imagine a national health council in the United States monitoring
health policy and accountability. Just to begin with, what would such a commission have to say about our very high costs in the face of the profound
deficiencies and inequities in our system?

Such a council would be invaluable to help fine tune a comprehensive health
care system such as Canada’s. But, in the United States, we don’t need to
fine tune a system. We need to establish a system. The sooner the better.

Sat, 27 Sep 2003 11:06:15 -0700
Subject: qotd: Federal regulations produce a return on our investment

The White House
Office of Management and Budget
Informing Regulatory Decisions: 2003 Report to Congress on the Costs and Benefits of Federal Regulations and Unfunded Mandates on State, Local, and
Tribal Entities.

OMB reviewed 107 major Federal rulemakings finalized over the previous ten
years (October 1, 1992 to September 30, 2002). The estimated total annual
quantified benefits of these rules range from $146 billion to $230 billion, while the estimated total annual quantified costs range from $36 billion to $42 billion.

Table 2: Estimates of the Total Annual Benefits and Costs of Major Federal Rules, October 1, 1992 to September 30, 2002 (millions of 2001 dollars):

Health & Human Services
Benefits: 9,129 to 11,710
Costs: 3,165 to 3,334

Environmental Protection Agency
Benefits: 120,753 to 193,163
Costs: 23,359 to 26,604

(six other agencies are listed, and each shows a significantly greater benefit than cost.) http://www.whitehouse.gov/omb/inforeg/2003_cost-ben_final_rpt.pdf

Comment: One of the most common objections to the role of government is the cost of regulatory requirements. Although the social benefits of many regulations may be priceless, it is very reassuring to know that President Bush’s OMB has provided a report that demonstrates that the regulations of each agency also produce a significantly greater dollar value in benefits than are the costs of fulfilling the regulations.

Although the greatest return has been through EPA regulations, agencies such as HHS have also produced a positive dollar return on the regulatory requirements.

The benefits of regulatory oversight are further evidence that our government is not our enemy. And we could benefit even more if we would begin to use a Universal, “government-run,” social insurance program to improve the value of our health care investment.

Canada Newswire
Sept. 24, 2003
Release from Canadian Institute for Health Information (CIHI)
CIHI report shows dramatic increase in MRI, CT scans and scanners

A new national report on medical imaging by the Canadian Institute for Health Information (CIHI) shows the supply of MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) scanners and the number of scans performed have risen dramatically in the past decade, and that the distribution of major imaging equipment varies across the country.

A recent Statistics Canada survey found that 6.7% of Canadians age 15 and
over – a total of 1.7 million people – had a non-emergency MRI, CT, or angiography in 2001. Provincial data show volumes have risen sharply in
recent years.

Canada had a total of 147 MRI scanners in January 2003 compared to 30 in
1993, an increase of nearly 400%. The number of CT scanners rose by about
50% over the same period, from 216 in 1993 to 326 in January 2003. The country also had 594 nuclear medicine cameras, 165 angiography suites,
94 Catheterization labs, and 14 PET scanners in January 2003. Canada’s MRI and CT machines are, on average, newer than those in Europe.

Waiting for Care: The 2001 Statistics Canada Health Services Access Survey
found that about half of Canadians aged 15 and older who reported receiving
a non-emergency CT, MRI, or angiography waited three weeks or less. Most
(55%) waited less than a month; about 5% waited six months or more. One-quarter of those who were tested felt their wait was unacceptable; about
one in six (16%) said the wait affected their lives. Most (68%) of those who
said the wait affected them said it caused worry, anxiety, or stress.

http://www.newswire.ca/releases/September2003/25/c4564.html

Comment: One of the most common arguments presented against the adoption of a single payer system in the United States is that there are unacceptable
queues or delays for services in any universal, government funded program.
Perhaps the most frequent example given is the unacceptable delays in diagnostic imaging in Canada due to the fact that they do not have enough CT or MRI scanners to meet their needs. This report reveals that, in the past decade, great progress has been made by Canada in addressing this problem.

Emergency imaging is always available without delay. And, by 2001, three-fourths of Canadians who had elective scans do not believe that they were subjected to unacceptable delays. Since the release of the Romanow report, an even greater effort has been made to ensure adequate capacity.

Canada’s access to imaging is not bad and is improving dramatically. Contrast that to imaging in the United States. We have the capacity, but the uninsured and many of the under-insured cannot afford CT or MRI scans. Tens of millions of Americans are not even allowed a place in the queue.

Which system is better: a lower cost system that recognizes a capacity problem and takes measures to resolve that, or a higher cost system that has adequate capacity but nevertheless engages in wholesale rationing based on ability to pay?

Canada Newswire
Sept. 24, 2003
Release from Canadian Institute for Health Information (CIHI)
CIHI report shows dramatic increase in MRI, CT scans and scanners

A new national report on medical imaging by the Canadian Institute for Health Information (CIHI) shows the supply of MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) scanners and the number of scans performed have risen dramatically in the past decade, and that the distribution of major imaging equipment varies across the country.

A recent Statistics Canada survey found that 6.7% of Canadians age 15 and
over – a total of 1.7 million people – had a non-emergency MRI, CT, or angiography in 2001. Provincial data show volumes have risen sharply in
recent years.

Canada had a total of 147 MRI scanners in January 2003 compared to 30 in
1993, an increase of nearly 400%. The number of CT scanners rose by about
50% over the same period, from 216 in 1993 to 326 in January 2003. The country also had 594 nuclear medicine cameras, 165 angiography suites,
94 Catheterization labs, and 14 PET scanners in January 2003. Canada’s MRI and CT machines are, on average, newer than those in Europe.

Waiting for Care: The 2001 Statistics Canada Health Services Access Survey
found that about half of Canadians aged 15 and older who reported receiving
a non-emergency CT, MRI, or angiography waited three weeks or less. Most
(55%) waited less than a month; about 5% waited six months or more. One-quarter of those who were tested felt their wait was unacceptable; about
one in six (16%) said the wait affected their lives. Most (68%) of those who
said the wait affected them said it caused worry, anxiety, or stress.

http://www.newswire.ca/releases/September2003/25/c4564.html

Comment: One of the most common arguments presented against the adoption of a single payer system in the United States is that there are unacceptable
queues or delays for services in any universal, government funded program.
Perhaps the most frequent example given is the unacceptable delays in diagnostic imaging in Canada due to the fact that they do not have enough CT or MRI scanners to meet their needs. This report reveals that, in the past decade, great progress has been made by Canada in addressing this problem.

Emergency imaging is always available without delay. And, by 2001, three-fourths of Canadians who had elective scans do not believe that they were subjected to unacceptable delays. Since the release of the Romanow report, an even greater effort has been made to ensure adequate capacity.

Canada’s access to imaging is not bad and is improving dramatically. Contrast that to imaging in the United States. We have the capacity, but the uninsured and many of the under-insured cannot afford CT or MRI scans. Tens of millions of Americans are not even allowed a place in the queue.

Which system is better: a lower cost system that recognizes a capacity problem and takes measures to resolve that, or a higher cost system that has adequate capacity but nevertheless engages in wholesale rationing based on ability to pay?

Beth Capell, Ph.D. responds on the AAHP/HIAA merger and the importance
of lobbying:

The budgets listed (in yesterday’s message on the AAHP/HIAA merger) probably do NOT include campaign contributions as your comment implies.Instead, these budgets are devoted to lobbying, providing information and “research” that supports lobbying, and activating grassroots presence (though perhaps not that either: it would depend on how these associations structure what they do: the overhead on grassroots could be modest and most of the cost of that effort could be buried within the budgets of individual companies).

Woody Allen says that 90% of life is just showing up. The same is true for moving an idea through the political process. Showing up counts. A lot. The insurers are ubiquitous on health issues–not just universal coverage, but Medicare prescription drugs and probably a dozen other key issues. And they are omnipresent: that’s what $30-$40 million in lobbying presence means: it means that every member of Congress who thinks a thought about health care knows who the insurance lobbyists are and probably what they will think about an issue.

PNHP has a plan for affordable health care for all—but members of Congress won’t know about it or take it seriously without an effective lobbying presence and without grassroots capacity to back that up. An occasional appearance on public television or an article in a medical journal (not widely read on Capitol Hill) are good but not sufficient. It is not a matter of matching the insurance industry dollar for dollar: after all, we beat them on HMO reform in California with far less capacity than that–but we (you, me, lots of other people and a number of key organizations) were there day after day for five years to win that fight. A fight at the national level requires commensurately greater capacity.

Good ideas are important but not sufficient. Just showing up counts for a lot in advocacy. Creating that presence, that showing up is what organizing is about.

Beth Capell, Ph.D., political science, lobbyist for California Physicians Alliance, Health Access California and others.

The Hill
September 23, 2003
Insurance trade groups OK merger
AAHP and HIAA consolidates Hill lobbying efforts
By Michael S. Gerber

Washington, D.C.’s two largest health insurance trade groups (The American
Association of Health Plans (AAHP) and Health Insurance Association of America (HIAA)) announced Monday that their boards of directors had approved a merger…

Leading the new association in its efforts on Capitol Hill to promote
private insurers will be Karen Ignagni, who currently serves as president
and CEO of AAHP.

The two associations’ similar agendas in Washington make it easy to merge
the policy shops. Both have been pressing for a larger role for private insurers in the Medicare prescription drug package as well as increased
payments to HMOs.

AAHP and HIAA spent a combined $9.3 million on lobbying last year,according
to records filed with the Senate.Each group’s budget is around $20 million, according to the Government Affairs Yellow Book published by Leadership Directories.

AAHP currently employs a staff of 120 and HIAA 80, Ignagni said.(AAHP Chairman William) McCallum said the new organization’s budget would be about 40 percent greater than AAHP’s.

http://www.hillnews.com/business/092303_merger.aspx

Comment: So what? Well, AAHP/HIAA and its membership owns a controlling
interest in Congress. That’s what.

When our goal is to try to provide everyone with health insurance, why should we be concerned that this industry has a favored position with Congress? It’s because our current fragmented system of funding care through private and public programs has resulted in unacceptable waste, deficiencies and inequities in our system. Congress continues to perpetuate policies that protect and enhance private health plans at the cost of health care equity for all of us.

AAHP/HIAA’s $40 million budget can secure its position quite solidly in the
hallways and lobby rooms of Congress. In contrast, we have no significant
sources of funds. All we can offer is a plan to provide affordable, comprehensive health care for everyone. Unfortunately, policy position papers don’t have the color and smell of fresh U.S. Treasury ink that serves as an effective attractant to too many of the creatures of Congress.

The Providence Journal
September 21, 2003
There’s no shelter from this storm
By John Kostrzewa

Employees used to contribute about 15 percent of the cost of health care. Now, the contribution has risen to 25 percent to 35 percent. And health-care consultants forecast it will grow to 50 percent at some companies.

Some workers are cutting back on health care and elective Surgeries, deciding to live with the bad knee rather than get a replacement. Or they are deciding to postpone the eye exam to avoid the copay. Or they are going without health insurance.
No relief is on the horizon.

http://www.projo.com/business/content/projo_20030921_jk21x.777bd.html

Comment: Current health care reform efforts continue down this path of shifting costs to patients. But is this really reform? Reform is defined as a change for the better. Reducing affordable access to beneficial health care services is a change for the worse.

Let’s dump this movement to shift costs to patients and get on with the process of real reform!

The Washington Post
September 17, 2003
Health Plan Costs Up 10.6%
By Christopher Lee

Health insurance premiums for federal employees and retirees (under the Federal Employees Health Benefits Program) will rise an average of 10.6 percent next year, the fourth consecutive year of double-digit increases, the Bush administration said yesterday.

Kay Cole James, director of the Office of Personnel Management:”This is great news for the federal employees, and we’re excited today on their behalf.”

Alwyn Cassil, spokeswoman for the Center for Studying Health System Change:Although federal workers’ premium increases have been comparatively
smaller,10.6 percent “is still a very high rate of growth. It’s growing much faster than increases in wages, increases in growth of the economy and increases in inflation. That means that more and more money will be coming out of people’s pockets to pay for health care.”

The administration also announced that, for the first time in five years,the government will expand the number of health plan choices under the Federal Employees Health Benefits Program. The program will offer 205 plans nationwide next year, up from 188 in this year.

http://www.washingtonpost.com/wp-dyn/articles/A21909-2003Sep16.html Comment: The largest purchaser of health care coverage, the Federal Employees Health Benefits Program, has not been able to slow the rise in health care costs to anywhere near the rate of inflation. That is not good news.

The fact that more plans wish to participate in the program indicates that our national policies are designed to enhance the business model of private health plans at the cost of higher health care expenses for the employees and their families.

Should we continue with national policies that are designed to protect the health plans of the members of Congress, or should we change to policies that are designed to ensure access to affordable care for everyone?