PNHP

They Said They Would Push Me "Off a Cliff"

They Said They Would Push Me "Off a Cliff"

By Michael Moore
Open Mike Blog, 17 November 10

Yesterday, on the TV and radio show “Democracy Now” hosted by Amy Goodman, the former Vice President of CIGNA, one of the nation’s largest health insurance companies, revealed that CIGNA met with the other big health insurers to hatch a plan to “push” yours truly “off a cliff.”

The interview contains new revelations about just how frightened the health industry was that “Sicko” might ignite a public wave of support for “socialized medicine.” So the large health insurance companies came together over a common cause: Stop the American people from going to see “Sicko” – and the way to do that was to cause some form of harm to me (either personally, professionally or … physically?).

Take a look at this stunning section of the interview with Wendell Potter:

WENDELL POTTER [former executive, CIGNA]: … We were concerned that the movie [“Sicko”] would be as successful as “Fahrenheit 9/11” had been. And we knew that if it were, it really would change public opinion about our health care system in ways that would be harmful to the profits of health insurers. So, it was very important for this [attack] campaign to succeed. At one point during a strategy meeting, one of the people from [the insurance companies’ public relations firm] APCO said that if our efforts, our initial efforts, were not successful, then we’d have to move to an element of the campaign to push Michael Moore off a cliff. And not meaning to do that literally, but to –

AMY GOODMAN: Are you sure?

WENDELL POTTER: Well, I’m not sure. To tell you the truth, when I started doing what I’m doing [as a whistleblower], I was concerned about my own health and well-being, maybe just from paranoia. But these companies play to win. And we’re talking about some big bucks at stake here – billions and billions and billions of dollars.

AMY GOODMAN: So what were they talking about when they said, “If this doesn’t work, we’re going to push him off the cliff”?

WENDELL POTTER: Well, it would be just an incredibly intense PR effort, if necessary, to spend more premium dollars to defame Michael Moore, to discredit him even more as a filmmaker.

AMY GOODMAN: So, were you doing research on him?

WENDELL POTTER: Oh, yeah. Oh, yeah.

AMY GOODMAN: You were going – personally?

WENDELL POTTER: Well, I was a part of the effort. I didn’t – that was part of the reason for hiring APCO and to work with a trade association, is that it relieved me of the responsibility of doing that kind of work. You paid for it to be done by people who were experts in doing that kind of research.

AMY GOODMAN: But they were doing an investigation into him personally?

WENDELL POTTER: Well, absolutely. We knew as much about him probably as he knows about himself.

AMY GOODMAN: About his wife, about his kid, about –

WENDELL POTTER: Oh, yeah. You know, it’s important to know everything that you might be able to use in some kind of a campaign against someone, to discredit them professionally and often personally.

AMY GOODMAN: And did you use that?

WENDELL POTTER: You use it if necessary.

The interview goes on as Potter reveals how his front group was able to get its talking points and smears into stories in the New York Times and CNN. It is a chilling look inside how easy it is to manipulate our mainstream media – and just how worried the health insurance companies were that the American people might demand a true universal health care system.

In particular, Potter talks about how they may have succeeded in influencing CNN to run a factually untrue story about “Sicko” by its reporter, Sanjay Gupta (which led to my infamous encounter with Wolf Blitzer and later, an apology from CNN for getting their facts wrong).

Potter believes his work to defame “Sicko” succeeded, as the film didn’t end up posting “Fahrenheit 9/11” grosses. To be clear, “Sicko” went on to become the 3rd largest grossing documentary of all time at that point. And as the release of “Sicko” in June of 2007 was the first time since the defeat of Hillary Clinton’s healthcare bill in 1994 that the issue of health insurance was brought to the forefront of the national media, I believe it helped to reignite the issue during the 2008 election year by exposing millions of Americans to the truth about the health insurance industry. More than one person on Capitol Hill will admit that “Sicko” was a big help in rallying public support for the compromise bill that eventually passed earlier this year. But I agree, their smear campaign was effective and did create the dent they were hoping for – single payer and the public option never even made it into the real discussion on the floor of Congress.

(There was really only one reason “Sicko” didn’t sell as many tickets as “Fahrenheit” and that was because of a felony that was committed – a felony that I will discuss for the first time on this site in the coming weeks or months ahead. Stay tuned.)

Please read or watch the entire interview with Wendell Potter. It’s a fascinating peek behind the curtain of how corporate America really runs this country. And how if any of us get in their way, then those people must be stopped. It begs the question: Seeing how there’s more of us than there are of them, how long will we let their takeover of our democracy continue?

God Bless the Ruling Class,
Michael Moore

P.S. Over the next few days I will continue this examination of the Wendell Potter revelations on “Democracy Now” and in his new book. Please check in here on MichaelMoore.com.

They Said They Would Push Me “Off a Cliff”

By Michael Moore
Open Mike Blog, 17 November 10

Yesterday, on the TV and radio show “Democracy Now” hosted by Amy Goodman, the former Vice President of CIGNA, one of the nation’s largest health insurance companies, revealed that CIGNA met with the other big health insurers to hatch a plan to “push” yours truly “off a cliff.”

The interview contains new revelations about just how frightened the health industry was that “Sicko” might ignite a public wave of support for “socialized medicine.” So the large health insurance companies came together over a common cause: Stop the American people from going to see “Sicko” – and the way to do that was to cause some form of harm to me (either personally, professionally or … physically?).

Take a look at this stunning section of the interview with Wendell Potter:

WENDELL POTTER [former executive, CIGNA]: … We were concerned that the movie [“Sicko”] would be as successful as “Fahrenheit 9/11” had been. And we knew that if it were, it really would change public opinion about our health care system in ways that would be harmful to the profits of health insurers. So, it was very important for this [attack] campaign to succeed. At one point during a strategy meeting, one of the people from [the insurance companies’ public relations firm] APCO said that if our efforts, our initial efforts, were not successful, then we’d have to move to an element of the campaign to push Michael Moore off a cliff. And not meaning to do that literally, but to –

AMY GOODMAN: Are you sure?

WENDELL POTTER: Well, I’m not sure. To tell you the truth, when I started doing what I’m doing [as a whistleblower], I was concerned about my own health and well-being, maybe just from paranoia. But these companies play to win. And we’re talking about some big bucks at stake here – billions and billions and billions of dollars.

AMY GOODMAN: So what were they talking about when they said, “If this doesn’t work, we’re going to push him off the cliff”?

WENDELL POTTER: Well, it would be just an incredibly intense PR effort, if necessary, to spend more premium dollars to defame Michael Moore, to discredit him even more as a filmmaker.

AMY GOODMAN: So, were you doing research on him?

WENDELL POTTER: Oh, yeah. Oh, yeah.

AMY GOODMAN: You were going – personally?

WENDELL POTTER: Well, I was a part of the effort. I didn’t – that was part of the reason for hiring APCO and to work with a trade association, is that it relieved me of the responsibility of doing that kind of work. You paid for it to be done by people who were experts in doing that kind of research.

AMY GOODMAN: But they were doing an investigation into him personally?

WENDELL POTTER: Well, absolutely. We knew as much about him probably as he knows about himself.

AMY GOODMAN: About his wife, about his kid, about –

WENDELL POTTER: Oh, yeah. You know, it’s important to know everything that you might be able to use in some kind of a campaign against someone, to discredit them professionally and often personally.

AMY GOODMAN: And did you use that?

WENDELL POTTER: You use it if necessary.

The interview goes on as Potter reveals how his front group was able to get its talking points and smears into stories in the New York Times and CNN. It is a chilling look inside how easy it is to manipulate our mainstream media – and just how worried the health insurance companies were that the American people might demand a true universal health care system.

In particular, Potter talks about how they may have succeeded in influencing CNN to run a factually untrue story about “Sicko” by its reporter, Sanjay Gupta (which led to my infamous encounter with Wolf Blitzer and later, an apology from CNN for getting their facts wrong).

Potter believes his work to defame “Sicko” succeeded, as the film didn’t end up posting “Fahrenheit 9/11” grosses. To be clear, “Sicko” went on to become the 3rd largest grossing documentary of all time at that point. And as the release of “Sicko” in June of 2007 was the first time since the defeat of Hillary Clinton’s healthcare bill in 1994 that the issue of health insurance was brought to the forefront of the national media, I believe it helped to reignite the issue during the 2008 election year by exposing millions of Americans to the truth about the health insurance industry. More than one person on Capitol Hill will admit that “Sicko” was a big help in rallying public support for the compromise bill that eventually passed earlier this year. But I agree, their smear campaign was effective and did create the dent they were hoping for – single payer and the public option never even made it into the real discussion on the floor of Congress.

(There was really only one reason “Sicko” didn’t sell as many tickets as “Fahrenheit” and that was because of a felony that was committed – a felony that I will discuss for the first time on this site in the coming weeks or months ahead. Stay tuned.)

Please read or watch the entire interview with Wendell Potter. It’s a fascinating peek behind the curtain of how corporate America really runs this country. And how if any of us get in their way, then those people must be stopped. It begs the question: Seeing how there’s more of us than there are of them, how long will we let their takeover of our democracy continue?

God Bless the Ruling Class,
Michael Moore

P.S. Over the next few days I will continue this examination of the Wendell Potter revelations on “Democracy Now” and in his new book. Please check in here on MichaelMoore.com.

Listen to Dr. Flowers on health care

By JOHN NICHOLS
The Cap Times
November 18, 2010

If the Obama White House and congressional Democrats had listened to Dr. Margaret Flowers, they would have produced a single-payer “Medicare for All” health reform that would have excited the party’s progressive base. That base would have waded into the 2010 election campaign to defend real reform, closing the “enthusiasm gap” and changing the course of political history.

Unfortunately, instead of listening to Dr. Flowers, top Democrats had her arrested, and forcibly removed one of the nation’s top experts on health care from Senate hearings on the issue.

The Democrats who did that were fools, and they got their comeuppance Nov. 2, to their own and the republic’s disservice.

Now it’s time to listen to Dr. Flowers, a genuine hero in the struggle to reform our broken health care system.

No one did a better job than she when it came to challenging the Obama administration and compromise-prone Democrats during a health care debate that ended up creating a weak and dysfunctional “reform” rather than the “Medicare for All” system that would care for all Americans, cut costs and break the stranglehold of the big insurance companies.

I’ve been writing about Flowers and the fight for single-payer health care for years and I am a huge fan of the group she works with, Physicians for a National Health Program.

That group, with which the beloved Madison-area physician Dr. Linda Farley was closely associated before her death (and with which Linda’s husband, Dr. Eugene Farley, remains active), will be holding a fundraising event Friday night with Dr. Flowers, state Sen. Mark Miller, D-Monona, and state Rep. Chuck Benedict, D-Beloit. It will run from 6 p.m. to 9 p.m. at the EVP Coffee House at 3809 Mineral Point Road. Anyone who wants to get up to speed on the ongoing fight to achieve real reform should make a point of being there.

Flowers has been in the thick of the fight and she is not giving up.

She has some “war stories” to tell about battling not just Republicans but misguided Democrats.

Here’s part of a piece I wrote about her in the spring of 2009, when she and other doctors and nurses tried to force senators to open the debate that was needed:

“Senate Finance Committee chairman Max Baucus, the insurance industry-friendly Democrat who is managing show hearings on health care reform, has come up with a novel way to express his commitment to care for the almost 50 million Americans who have no health care and roughly equal number who have inadequate care.

“The senior senator from Montana is ordering the arrest of doctors and nurses.

“Medical practitioners who have shown up at Baucus-chaired ‘roundtable discussions’ to demand consideration of a real fix — the single-payer, genuinely public reform that assures all Americans will have health care while at the same time holding down costs — are being taken into custody and removed from the hearing rooms.

“At the first Finance Committee session last week, Dr. Margaret Flowers and seven others were taken into custody when they urged Baucus to include witnesses who support single-payer.

“Dr. Flowers discussed her arrest on Ed Schultz’s MSNBC show, explaining that physicians, nurses and reform groups representing more than 20 million Americans wanted to give voice to the more than 60 percent of Americans who in polls have repeatedly expressed support for a single-payer reform.

“But the answer from Baucus, who has been charged by the Obama administration with shaping a health care plan, has been to call in the cops.

“ ‘They just don’t want to hear from single-payer,’ explained Dr. Flowers, a pediatrician from Maryland. ‘We’ve been trying for months now, meeting with members of Congress, to be included in the hearings, at the events that they are holding, and they keep excluding us.’

“After reviewing the details of the Baucus overreaction, Schultz asked: ‘President Obama: Do you support excluding people from the discussion?’

“Obama has not responded.

“But Baucus has.

“On Tuesday, at the second Finance Committee session, dozens of California Nurses Association/National Nurses Organizing Committee members and their allies showed up to protest the heavy-handed tactics. At the opening of the hearing, roughly 30 of them rose and turned their backs to Baucus. On their backs were signs reading: ‘Pass Single-Payer’ and ‘Nurses Say: Patients First.’ Other signs, reading ‘Stop AHIP,’ protested the collaboration by the Obama administration and Baucus with the country’s most powerful industry lobby, the America’s Health Insurance Plans group.

“While the health insurance lobby has been welcomed to the roundtable discussions organized by Baucus, the nurses and their allies were told to leave. When five objected to their exclusion from the hearing, and to the exclusion of single-payer from the debate about how to fix a broken private health care system, they were arrested. Among those taken into custody were Dr. Judy Dasovich, Dr. Steven Fenichel and California nurses DeAnn McEwen and Sue Cannon.

“Their crime? As health care professionals, they dared to dissent from the Baucus-led attempt to impose an insurance company approved plan under the guise of ‘reform.’

“Dr. Dasovich, a physician from Springfield, Mo., dared to say, ‘We request that single-payer advocates be allowed at the table. Health care should be for patients, not for profits.’ Nurse Cannon said, ‘People at the table have failed Americans for 30 years. We want single-payer at the table. We want guaranteed health care so we can give the care we need, when we need to give it.’

“When the doctors, nurses and their allies left the Capitol, activist David Swanson reported, members of the CNA/NNOC, Progressive Democrats of American, Code Pink and allied single-payer advocates chanted: ‘Lock Up Baucus!’ and hoisted a sign reading: ‘Most Physicians Want a Single-Payer National Health System.’

“At the White House, reporter Helen Thomas asked Obama administration spokesman Robert Gibbs: ‘Did anyone represent single-payer at this meeting today?’

“Gibbs tried to spin it.

“ ‘Well, I don’t think it was a full meeting of those that might be at the table,’ the scrambling spokesman said. ‘I believe that people of varying opinions have been here for different meetings, have been part of the larger health care reform summit that was done earlier this year, and I don’t doubt that in the coming days differing viewpoints about how to achieve cost savings in increased coverage will be part of that discussion.’

“If that sounded like a dodge, it was.

“But single-payer advocates weren’t fooled.

“They’re raising the banner of real reform higher. …”

John Nichols is the associate editor of The Capital Times. jnichols@madison.com

International comparisons: It’s the insurance, stupid!

Consumers and Insurance: Experiences In Eleven Countries

By Chris Fleming
Health Affairs Blog
November 18, 2010

As the United States begins implementing health reform, how does the U.S. experience compare with that of other high-income countries? To answer that question, The Commonwealth Fund conducted its thirteenth annual health policy survey, this year focusing on access, cost, and care experiences. The survey findings were published today in a Health Affairs Web First article by Commonwealth Fund Senior Vice President Cathy Schoen and coauthors.

Overall, the survey identified significant differences between countries and found that US adults — even when insured — were the most likely to incur high medical expenses, spend more time on paperwork, and have more claims denied.

The countries surveyed were Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States.

Key findings include the following:

*  Twenty percent of US adults surveyed said they had had serious problems paying medical bills in the previous year. Responses to the same question from the other ten countries were in the single digits. US respondents were also significantly more likely than adults in other countries to have gone without care because of cost.

*  Thirty-five percent of US adults had out-of-pocket medical spending of $1,000 during the previous year, a far higher percentage than in any other country.

*  A lower proportion of adults in the United States (70 percent) than in all other countries except Sweden (67 percent) and Norway (70 percent) were confident that they would receive the most effective treatment when needed.

*  When asked about access to prompt medical care, 57 percent of US adults said they had seen a doctor or nurse the same or next day the last time they were sick and needed care. Switzerland had the most rapid access (93 percent). Adults in three other countries (Canada, Norway, and Sweden) reported longer waits than US adults.

*  Nearly one third of US adults (31 percent) reported either denial of payments by insurers or time-consuming interactions with insurers, a higher rate than in all other countries. Twenty-five percent of US respondents reported that their insurance company denied payment or did not pay as much as expected; 17 percent said they spent a lot of time on paperwork or disputes for medical bills or insurance — the highest rates in the survey.

*  The United States had the widest and most pervasive differences in access and affordability by income of the eleven countries. The United Kingdom had the least.

http://healthaffairs.org/blog/2010/11/18/consumers-and-insurance-experiences-in-eleven-countries/

And…

How Health Insurance Design Affects Access To Care And Costs, By Income, In Eleven Countries

By Cathy Schoen, Robin Osborn, David Squires, Michelle M. Doty, Roz Pierson and Sandra Applebaum
Health Affairs
November 18, 2010

US Insurance Reforms: Challenges Ahead

Concerns expressed by US respondents were concentrated in the working-age population that is the target of insurance reforms. In this age group, wide disparities by income for those insured throughout the year underscore the importance of the Affordable Care Act’s emphasis on benefits with income-related provisions. The law will expand eligibility for Medicaid to those earning 133 percent of the federal poverty level. It will also provide subsidies for premiums for people up to 400 percent of poverty and for cost sharing for people up to 250 percent of poverty.

However, by international standards, the United States will remain an outlier for cost sharing. The annual limits for the least expensive benefit option will range from $2,000 per person ($4,000 per family) for those with incomes just above 133 percent of poverty, to $6,000 per person above subsidy thresholds. Families can opt for lower cost exposure, but only if they can pay higher premiums.

As US reforms unfold, it will be important to monitor access and affordability. The Affordable Care Act will provide billions of dollars in subsidies for premiums and cost sharing to address affordability for individuals and families with low or modest incomes. Even so, it is still possible that some of the insured will remain at substantial financial risk for care they cannot afford when sick and bills they cannot pay.

Even after the enactment of health reform, the United States will also remain unique among countries in that it covers low-income people in a separate program. This poses the dual challenge of promoting equity across programs and ensuring continuity of insurance. In the other ten countries in our survey, providers were typically paid the same amount regardless of patients’ incomes, which is not currently the case in the United States. Nor is it likely to be the case after full implementation of health reform. Avoiding coverage gaps as patients’ circumstances change will require creative efforts to enable single portals of entry for people to enroll in publicly sponsored and private insurance, and smooth transitions as families gain or lose eligibility for insurance. To the extent that provider networks also differ for those low-income insurance programs, continuity of care as well as insurance will remain at risk after reforms take effect.

http://content.healthaffairs.org/cgi/content/full/hlthaff.2010.0862v1

Compared to other high-income nations, the health care financing system in the United States does not perform well. We pay more; we have greater problems paying medical bills; we have excessive out-of-pocket spending; we have greater hassles with insurers; and we have the greatest disparities in access and affordability based on income levels.

We clearly needed reform, but will the Patient Protection and Affordable Care Act (PPACA) correct these deficiencies? It looks grim. The law has perpetuated the flawed system that we already have, one based on the U.S. version of dysfunctional private insurance plans plus a welfare program – Medicaid.

PPACA does include some important insurance regulations such as guaranteed issue and removal of annual and life-time spending caps, but it doesn’t do much to end the administrative hassles that are designed to protect the insurers from loss (i.e., protect them from having to pay medical bills). In fact, by making plans with low actuarial values the new standard, patients will face even greater out-of-pocket expenses and administrative hassles when they access health care. The government subsidies are not adequate to reduce the problems that patients already have with paying their medical bills.

Although other countries have special provisions for low-income individuals, Medicaid is unique in that beneficiaries are enrolled in an entirely different program that generally pays much lower rates than do private insurers. Thus the Medicaid networks of willing providers can be quite different from the networks for the private insurers, which in themselves also can vary greatly from plan to plan. Care can be very disruptive as individuals move in and out of the Medicaid program because of fluctuations in their eligibility, or move between various private plans based on such factors as employment, place of residence, or premium affordability. Such disruptions can aggravate the access problems noted in this study.

Another important observation in this study is the protection that is afforded by Medicare. Quoting from Schoen et al, “US adults under age sixty-five were significantly more likely to report insurance paperwork, disputes, or insurance surprises than were those sixty-five and older and covered by Medicare (35 percent compared to 16 percent). The high rates of insurance concerns among younger adults may stem from unstable coverage as well as complex benefit designs.”

What we needed was a program that includes everyone, funds care equitably, eliminates financial barriers to care, provides automatic life-long enrollment, provides choice of any health care professionals and facilities, and has public funding that would ensure adequate capacity in the system. A single payer, improved Medicare for all would have those goals.

Instead, we’ll be pouring even more money into the system we have, and still compare unfavorably to these other high-income nations, that is unless we are willing to do something about it. We need to tell our policy makers, “It’s the insurance, stupid!”

Election moves Vermont closer to single payer, plus new challenges

November 18, 2010

Dear PNHP colleagues and friends,

Fresh from PNHP’s Annual Meeting in Denver, we have much to report! 

Surprisingly, the Nov. 2 election included some bright spots for single payer.  Vermont is now poised to be the first state to pass single payer (see below).  At the same time, advocates for an improved Medicare for All face new challenges, including from the Deficit Commission and the powerful interests opposing reform. 

Your help – by donating to support efforts in Vermont and elsewhere, opposing cuts to Medicare, and speaking out in support of single payer – is needed now more than ever.

1. PNHP hosts “spectacular” Annual Meeting in Denver

Amy Goodman

First, if you weren’t able to get to Denver, you missed a terrific program and exchange among 250 physicians, medical students, and activists from all over the country about the way forward for single payer. The mood was decidedly upbeat, particularly in view of developments in Vermont and elsewhere (see below).

As a small taste of what transpired last weekend, you can watch the remarks of Democracy Now’s Amy Goodman here. In addition, some photos of the participants can be viewed here.

An interview with PNHP’s incoming President Dr. Garrett Adams appeared in this month’s Louisville Medicine.

2. Vermont is closer to winning single payer

Former PNHP President Dr. Deb Richter reports that Peter Shumlin, a strong advocate for single-payer health reform, won his race for governor. Since the election he has reaffirmed his commitment to implementing a single-payer plan in Vermont and has already spoken to President Obama and Kathleen Sebelius, the head of Health and Human Services, about getting the required federal waivers.

Shumlin’s win, combined with (1) the support of other pro-single-payer lawmakers in the state, (2) an impending report to the state Legislature by Harvard health economist William Hsiao about the merits of three health reform models, one of which is single payer, and (3) the existence of a vibrant movement for single payer in the Green Mountain State, has laid the basis for a historic breakthrough there.

You can help by making a tax-deductible donation to PNHP and designating that it be used for organizing in Vermont. Dr. Richter’s goal is to raise $50,000 by December 1.  Help us meet or exceed that goal!

3. More single-payer election news

  • All but one of the 88 congressional sponsors of H.R. 676, Rep. John Conyers’ single-payer bill, were re-elected to office on Nov. 2, often by hefty margins.

  • Pro-single-payer gubernatorial candidates were also elected in California (Jerry Brown), where single payer legislation has twice passed the state’s legislature, and in Hawaii (Neil Abercrombie), where single-payer also enjoys substantial support.  Brown supported single payer in his 1992 primary race for the presidency against Bill Clinton.

  • In Massachusetts, in 14 of 14 legislative districts a ballot question for single payer in Massachusetts won a majority vote, including in some of the most conservative districts in the state and several that went for Republican Sen. Scott Brown last year. This follows a similar referendum in 2008 that swept 10 other districts.  Needless to say, coming from Massachusetts, the incubator of the new health law, this resounding vote of support for a single-payer Medicare-for-all program packs a wallop. So, too, does a new survey of the state’s physicians by the Massachusetts Medical Society. The MMS survey shows a plurality of the state’s doctors, 34 percent, favor a single-payer system, with only 14 percent supporting the Massachusetts plan as a model for reform.

  • PNHP National Coordinator Dr. Quentin Young’s latest Huffington Post article with a full election roundup is below.

4. Deficit Commission urges cuts to Medicare  

On Nov. 11, the co-chairs of the president’s National Commission on Fiscal Responsibility and Reform, businessman Erskine Bowles and former Sen. Alan Simpson, issued a draft document calling for an increase in the eligibility age for Social Security benefits to 69, cuts in Medicare payments to providers, an increase in cost-sharing by Medicare beneficiaries, and increased powers for the Independent Payment Advisory Board created under the new health law.  Since then another group of lawmakers has issued similar recommendations.

All of these measures (and more) move in a bad direction, as this assessment by Dr. Don McCanne and this testimony by Dr. Margaret Flowers point out.  PNHP hosted a Congressional briefing opposing the cuts featuring economist Tsung-Mei Cheng in late September.

5. Insurance industry whistleblower Wendell Potter speaks out

The former head of PR for Cigna, Wendell Potter, revealed new details about the insurance industry’s campaign to keep single payer “off the table” in the health reform debate, including their coordinated attack to discredit the film “Sicko” by Michael Moore.

Potter appeared on Democracy Now with Amy Goodman to discuss his new book, “Deadly Spin.”  A transcript of his interview is here.

On a lighter note, a tongue-in-cheek critique of the insurance industry by Dr. Carol Paris, “Private Insurance Induced Stress Disorder” or “PIISD,” appeared in Psychiatric Times.

6. What You Can Do

  • Donate – A victory for single payer in Vermont would reverberate nationwide. Help us raise funds for an educational and organizing campaign in Vermont.  Donors of $250 or more also renew their membership for 2011.  Donors of $100 or more receive a free copy of “Hijacked: The Road to Single Payer in the Aftermath of Stolen Health Care Reform” by former PNHP president Dr. John Geyman.

    If you can, please consider an end-of-year donation of $1,000 or more. You know more than anyone how important PNHP’s work is.  We’ll put your gift to immediate good use in Vermont and elsewhere where the needs and opportunities for single payer organizing are greatest. 

  • Stop the Deficit Commission – Call the Senate – PNHP activists are encouraged to ask their senators to vote against any attempt to privatize Social Security or Medicare, in whole or in part; any proposals to raise the eligibility ages for Social Security or Medicare; any recommendations for means-testing for these programs; and any proposal for benefit cuts for current and future beneficiaries.  The Capitol Switchboard number is 202-224-3121.

  • Speak out – Please join the growing number of physicians who have given talks or published op-eds in support of single payer, Medicare for All.  PNHP Congressional Fellow Dr. Margaret Flowers is giving several talks this week in Wisconsin (organized by chapter leaders and PNHP national organizer Ali Thebert); Flowers’ latest op-ed just appeared in the Charlotte (N.C.) Observer.

7. One more thought: if you missed this year’s meeting, just think of all the money you saved in airfare and other travel expenses. Then think about what you can contribute to PNHP’s next steps forward! 

Cordially,

Quentin Young Signature
Quentin Young, M.D.
National Coordinator

Ida Hellander Signature
Ida Hellander, M.D.
Executive Director

Mark Almberg Signature
Mark Almberg
Communications Director

They Said They Would Push Me “Off a Cliff”

By Michael Moore, Open Mike Blog
17 November 2010

Michael Moore

Yesterday, on the TV and radio show “Democracy Now” hosted by Amy Goodman, the former Vice President of CIGNA, one of the nation’s largest health insurance companies, revealed that CIGNA met with the other big health insurers to hatch a plan to “push” yours truly “off a cliff.”

The interview contains new revelations about just how frightened the health industry was that “Sicko” might ignite a public wave of support for “socialized medicine.” So the large health insurance companies came together over a common cause: Stop the American people from going to see “Sicko” – and the way to do that was to cause some form of harm to me (either personally, professionally or … physically?).

Take a look at this stunning section of the interview with Wendell Potter:

WENDELL POTTER [former executive, CIGNA]: … We were concerned that the movie [“Sicko”] would be as successful as “Fahrenheit 9/11” had been. And we knew that if it were, it really would change public opinion about our health care system in ways that would be harmful to the profits of health insurers. So, it was very important for this [attack] campaign to succeed. At one point during a strategy meeting, one of the people from [the insurance companies’ public relations firm] APCO said that if our efforts, our initial efforts, were not successful, then we’d have to move to an element of the campaign to push Michael Moore off a cliff. And not meaning to do that literally, but to –

AMY GOODMAN: Are you sure?

WENDELL POTTER: Well, I’m not sure. To tell you the truth, when I started doing what I’m doing [as a whistleblower], I was concerned about my own health and well-being, maybe just from paranoia. But these companies play to win. And we’re talking about some big bucks at stake here – billions and billions and billions of dollars.

AMY GOODMAN: So what were they talking about when they said, “If this doesn’t work, we’re going to push him off the cliff”?

WENDELL POTTER: Well, it would be just an incredibly intense PR effort, if necessary, to spend more premium dollars to defame Michael Moore, to discredit him even more as a filmmaker.

AMY GOODMAN: So, were you doing research on him?

WENDELL POTTER: Oh, yeah. Oh, yeah.

AMY GOODMAN: You were going – personally?

WENDELL POTTER: Well, I was a part of the effort. I didn’t – that was part of the reason for hiring APCO and to work with a trade association, is that it relieved me of the responsibility of doing that kind of work. You paid for it to be done by people who were experts in doing that kind of research.

AMY GOODMAN: But they were doing an investigation into him personally?

WENDELL POTTER: Well, absolutely. We knew as much about him probably as he knows about himself.

AMY GOODMAN: About his wife, about his kid, about –

WENDELL POTTER: Oh, yeah. You know, it’s important to know everything that you might be able to use in some kind of a campaign against someone, to discredit them professionally and often personally.

AMY GOODMAN: And did you use that?

WENDELL POTTER: You use it if necessary.

The interview goes on as Potter reveals how his front group was able to get its talking points and smears into stories in the New York Times and CNN. It is a chilling look inside how easy it is to manipulate our mainstream media – and just how worried the health insurance companies were that the American people might demand a true universal health care system.

In particular, Potter talks about how they may have succeeded in influencing CNN to run a factually untrue story about “Sicko” by its reporter, Sanjay Gupta (which led to my infamous encounter w
ith Wolf Blitzer and later, an apology from CNN for getting their facts wrong).

 Potter believes his work to defame “Sicko” succeeded, as the film didn’t end up posting “Fahrenheit 9/11” grosses. To be clear, “Sicko” went on to become the 3rd largest grossing documentary of all time at that point. And as the release of “Sicko” in June of 2007 was the first time since the defeat of Hillary Clinton’s healthcare bill in 1994 that the issue of health insurance was brought to the forefront of the national media, I believe it helped to reignite the issue during the 2008 election year by exposing millions of Americans to the truth about the health insurance industry. More than one person on Capitol Hill will admit that “Sicko” was a big help in rallying public support for the compromise bill that eventually passed earlier this year. But I agree, their smear campaign was effective and did create the dent they were hoping for – single payer and the public option never even made it into the real discussion on the floor of Congress.

(There was really only one reason “Sicko” didn’t sell as many tickets as “Fahrenheit” and that was because of a felony that was committed – a felony that I will discuss for the first time on this site in the coming weeks or months ahead. Stay tuned.)

Please read or watch the entire interview with Wendell Potter. It’s a fascinating peek behind the curtain of how corporate America really runs this country. And how if any of us get in their way, then those people must be stopped. It begs the question: Seeing how there’s more of us than there are of them, how long will we let their takeover of our democracy continue?

God Bless the Ruling Class,

Michael Moore

P.S. Over the next few days I will continue this examination of the Wendell Potter revelations on “Democracy Now” and in his new book. Please check in here on MichaelMoore.com.

Single Payer after the Midterm Elections

By Quentin Young, M.D.
The Huffington Post
November 17, 2010

While it’s clear from post-election surveys that having voted for “health care reform” was not a major cause of the Democrats’ defeats, the new health law didn’t help. What should have been a feather in the administration’s cap – i.e. a genuine reform that guaranteed truly universal, comprehensive care – instead became an albatross.

Many Democrats, sensing the electorate’s unease with the new health law’s mandates to buy private insurance, its lack of cost controls, and its limited reach – e.g. 23 million will remain uninsured in 2019 – found it difficult to defend. Some even boasted they voted against it.

In a fundamental sense, health care reform was botched by Congress. People wanted serious reform and didn’t get it. The big insurance and drug companies got their way, making a few concessions that they are already trying to wriggle out of.

As a result, what was adopted last March was so defective that ultra-conservatives were actually able use it against the president’s party.

Yet those who might interpret the election results as a repudiation of any health care reform should pause for a moment and consider these developments:

In Vermont, Peter Shumlin, an outspoken supporter of single-payer health reform who defeated four opponents (some of whom also supported single payer) in the primary, went on to win the governor’s race.

Shumlin reports that he has already spoken with President Obama and Health and Human Services Secretary Kathleen Sebelius about getting the necessary federal waivers to implement a single-payer system in the state of Vermont.

Besides Shumlin, four other political heavyweights in the state also support single payer: former governor Howard Dean, Senators Bernie Sanders and Patrick Leahy, and Rep. Peter Welch.

Dr. Deb Richter, a family physician in the Green Mountain State, says, “Peter Shumlin’s election shows Vermonters want a single-payer health care system. We’re going to get this done.”

In California, Jerry Brown won the governorship, defeating Meg Whitman, who spent $141 million of her own money in her failed campaign. In his 1992 presidential primary bid, Brown declared his support for single-payer health reform, and California activists hope he will sign a single-payer bill in 2011 when it comes to his desk. (The Legislature there has twice passed a single-payer bill, only to have it vetoed both times by Gov. Arnold Schwarzenegger.)

In Hawaii, former congressman Neil Abercrombie, a co-sponsor of Rep. John Conyers’ single-payer bill, H.R. 676, was also elected governor. He, too, takes office in a state where many lawmakers have signaled their openness to the single-payer alternative.

Significantly, in the House races, only one of 88 co-sponsors of H.R. 676, Rep. Phil Hare, D-Ill., was defeated in the general election by a Republican. Seven other co-sponsors were lost due to death, resignation, defeat in the primary or retirement. Just one of those went to a Republican, Tom Reed, who won Rep. Eric Massa’s old seat in New York.

The Congressional Progressive Caucus also did well, losing only three of its 69 members. In contrast, over half of the 54-member conservative Blue Dog Democrats went down to defeat.

In Massachusetts, voters in 14 of 14 legislative districts affirmed their support for single-payer health reform by turning in a majority of “Yes” votes (overall, around 2 to 1) for the following ballot question: “Shall the representative from this district be instructed to support legislation that would establish health care as a human right regardless of age, state of health or employment status, by creating a single payer health insurance system like Medicare that is comprehensive, cost effective, and publicly provided to all residents of Massachusetts?”

Benjamin Day, executive director of MassCare, writes: “The ballots spanned 80 different cities and towns in a state of 351 municipalities, winning in every city and town reporting results so far [as of Nov. 3] except two. Five of the districts backing single-payer reform voted for Scott Brown in last year’s special Senate election, whi
ch was largely seen as a referendum on national health reform, showing that the goal of improved and expanded Medicare for All is supported by a diverse range of communities across the state.”

A similar referendum in 2008 swept 10 of 10 different legislative districts in Massachusetts, refuting the Republican boast that single-payer health care reform is unpopular.

Apparently, whenever people are given serious choices, single payer’s popularity is sustained, even in the face of scurrilous attacks from the right claiming it is “socialistic” or “un-American.”

There were also setbacks to the single-payer cause, too.

The defeat of Sen. Russ Feingold of Wisconsin was a very heavy loss. Just last February, Feingold had reaffirmed his longtime support for single payer. He should be sought out to help lead the movement for single payer in this new phase.

One of the most egregious results was the election of former hospital company executive Rick Scott to the governor’s mansion in Florida. In 1997, Scott was forced to resign his post as CEO of Columbia/HCA, a giant hospital chain, amid a scandal pointing to massive Medicare fraud and other improper billing practices. The company ultimately admitted to 14 felonies and agreed to pay the federal government over $1.7 billion in fines. Scott spent at least $73 million of his own money to get elected to Florida’s top office.

In Arizona and Oklahoma, ballot initiatives purporting to uphold “freedom of choice” in health care passed. Couched in anti-mandate language, these initiatives are in fact intended to keep patients prisoner of their insurance company networks and are really directed against enactment of single-payer systems.

So what to do going forward?

Aside from the very promising prospects for fundamental reform in Vermont, one of the immediate tasks of single-payer supporters is to block the proposals from the co-chairs of the Deficit Commission to reduce Social Security and Medicare benefits. The commission is set to make its recommendations to Congress by Dec. 1.

As my colleague Dr. Margaret Flowers has testified, the best way to safeguard Medicare is to improve its benefits and to expand it to cover everyone.

Otherwise the battle for fundamental health reform remains front and center, on both the state and national levels. The Medicare-for-all proposal is simple, clear, legitimate and compelling in its logic. The destructive role of private corporations in our health system is also plainly evident.

Just as women’s suffrage and civil rights laws were widely seen as unattainable – sometimes just a few years before they were enacted – single payer is an idea whose time has come. It is unstoppable.

http://www.huffingtonpost.com/dr-quentin-young/single-payer-after-the-mi_b_784961.html

New health law falls short

By Margaret Flowers
The Charlotte Observer
Thursday, Nov. 18, 2010

It’s been said that a society can be judged by how it treats its most vulnerable. If that’s the case, what can we say about today’s United States?

I recently toured several cities in North Carolina to speak about national health insurance. I had the pleasure of meeting with physicians, health advocates and citizens from all walks of life.

Many of the physicians I met are working in health centers that treat the uninsured. While such efforts are important and commendable, the doctors are saying that they are unable to meet the growing need.

The Census Bureau reports that the number of uninsured in the U.S. jumped 10 percent to 51 million people in 2009. In North Carolina, about 1.7 million – nearly 1 in 5 residents – lacked coverage last year. That’s 300,000 more than the year before. Much of the increase, of course, can be chalked up to job losses.

Lack of insurance fatal for many

We know that people who lack insurance suffer much more than their insured counterparts. They also more frequently die of preventable causes. A recent study in the American Journal of Public Health, for example, shows about 45,000 deaths annually can be linked to lack of health insurance. That’s about 120 preventable deaths a day.

And then there’s the problem of underinsurance – people having poor-quality insurance policies that require high co-pays, deductibles and other out-of-pocket expenses. These onerous “cost sharing” measures are obstacles to getting care. The gaps in such policies can easily lead to personal bankruptcy in the event of serious illness.

Sadly, the new federal health law falls short of the remedy we need.

Most of the provisions in the legislation do not take effect until 2014. Thus, for the foreseeable future, literally tens of millions of Americans will remain uninsured. In fact, the Congressional Budget Office estimates that about 23 million people will still lack coverage in 2019. That’s a deadly scenario.

I’m a pediatrician, so I was particularly interested in two provisions in the federal bill relating to children that kicked in last month. One measure allows children under 26 to remain on their parents’ policies. While beneficial, this provision will expand coverage to only about 20 percent of the young adults who need it.

Insurors screen out the sick

Another measure would prevent health insurers from denying new policies to children with pre-existing conditions. However, just before it went into effect, insurers like WellPoint, UnitedHealth Group, Aetna, Cigna and Humana announced that they would no longer offer new policies to individual children.

What can we conclude from these and similar episodes? As long as private insurers occupy a commanding role in our health system, we will never be able to achieve truly universal or affordable care. The insurers make money by enrolling the healthy, screening out the sick, denying claims and raising premiums. They do not put patients’ interests first; they do not provide care.

And yet the new health law keeps the big insurers – the main obstacle to care – at the heart of our system.

There is a better alternative: a national health insurance program that is publicly financed and privately delivered. This solution is commonly referred to as improved Medicare for all. It’s supported by about two-thirds of the population and a solid majority of physicians, according to national surveys.

Make it Medicare for all

Improved Medicare for all would be truly universal – every person living in the United States would be guaranteed high-quality care from birth to death. People would no longer worry about losing coverage if they changed jobs or became unemployed. Coverage would be comprehensive, including dental care, vision care, mental health services and prescriptions.

Patients would be able to go to any physician and any health facility of their choice, and decisions about treatment would be made by patients and their health professionals without inte
rference by insurance company administrators.

By replacing our inefficient, dysfunctional patchwork of private insurers with a streamlined, single payer of all medical bills, much like Medicare operates today, our nation would save about $400 billion annually in reduced administrative costs.

That’s enough to cover everyone, with no co-pays or deductibles. We’d also acquire very strong cost-control tools like the ability to negotiate fees and purchase medications in bulk.

I urge you to learn more about the improved-Medicare-for-all approach to health care. Let’s be the great society that we have the potential to be.

Margaret Flowers, M.D., lives in Baltimore and is congressional fellow for Physicians for a National Health Program ( www.pnhp.org). She is also a board member of Healthcare-Now ( www.healthcare-now.org).

http://www.charlotteobserver.com/2010/11/18/1845659/new-health-law-falls-short.html

New health law falls short

By Margaret Flowers
The Charlotte Observer
Thursday, Nov. 18, 2010

It’s been said that a society can be judged by how it treats its most vulnerable. If that’s the case, what can we say about today’s United States?

I recently toured several cities in North Carolina to speak about national health insurance. I had the pleasure of meeting with physicians, health advocates and citizens from all walks of life.

Many of the physicians I met are working in health centers that treat the uninsured. While such efforts are important and commendable, the doctors are saying that they are unable to meet the growing need.

The Census Bureau reports that the number of uninsured in the U.S. jumped 10 percent to 51 million people in 2009. In North Carolina, about 1.7 million – nearly 1 in 5 residents – lacked coverage last year. That’s 300,000 more than the year before. Much of the increase, of course, can be chalked up to job losses.

Lack of insurance fatal for many

We know that people who lack insurance suffer much more than their insured counterparts. They also more frequently die of preventable causes. A recent study in the American Journal of Public Health, for example, shows about 45,000 deaths annually can be linked to lack of health insurance. That’s about 120 preventable deaths a day.

And then there’s the problem of underinsurance – people having poor-quality insurance policies that require high co-pays, deductibles and other out-of-pocket expenses. These onerous “cost sharing” measures are obstacles to getting care. The gaps in such policies can easily lead to personal bankruptcy in the event of serious illness.

Sadly, the new federal health law falls short of the remedy we need.

Most of the provisions in the legislation do not take effect until 2014. Thus, for the foreseeable future, literally tens of millions of Americans will remain uninsured. In fact, the Congressional Budget Office estimates that about 23 million people will still lack coverage in 2019. That’s a deadly scenario.

I’m a pediatrician, so I was particularly interested in two provisions in the federal bill relating to children that kicked in last month. One measure allows children under 26 to remain on their parents’ policies. While beneficial, this provision will expand coverage to only about 20 percent of the young adults who need it.

Insurors screen out the sick

Another measure would prevent health insurers from denying new policies to children with pre-existing conditions. However, just before it went into effect, insurers like WellPoint, UnitedHealth Group, Aetna, Cigna and Humana announced that they would no longer offer new policies to individual children.

What can we conclude from these and similar episodes? As long as private insurers occupy a commanding role in our health system, we will never be able to achieve truly universal or affordable care. The insurers make money by enrolling the healthy, screening out the sick, denying claims and raising premiums. They do not put patients’ interests first; they do not provide care.

And yet the new health law keeps the big insurers – the main obstacle to care – at the heart of our system.

There is a better alternative: a national health insurance program that is publicly financed and privately delivered. This solution is commonly referred to as improved Medicare for all. It’s supported by about two-thirds of the population and a solid majority of physicians, according to national surveys.

Make it Medicare for all

Improved Medicare for all would be truly universal – every person living in the United States would be guaranteed high-quality care from birth to death. People would no longer worry about losing coverage if they changed jobs or became unemployed. Coverage would be comprehensive, including dental care, vision care, mental health services and prescriptions.

Patients would be able to go to any physician and any health facility of their choice, and decisions about treatment would be made by patients and their health professionals without interference by insurance company administrators.

By replacing our inefficient, dysfunctional patchwork of private insurers with a streamlined, single payer of all medical bills, much like Medicare operates today, our nation would save about $400 billion annually in reduced administrative costs.

That’s enough to cover everyone, with no co-pays or deductibles. We’d also acquire very strong cost-control tools like the ability to negotiate fees and purchase medications in bulk.

I urge you to learn more about the improved-Medicare-for-all approach to health care. Let’s be the great society that we have the potential to be.

Margaret Flowers, M.D., lives in Baltimore and is congressional fellow for Physicians for a National Health Program ( www.pnhp.org). She is also a board member of Healthcare-Now ( www.healthcare-now.org).

http://www.charlotteobserver.com/2010/11/18/1845659/new-health-law-falls-short.html

Jan Schakowsky and Rivlin/Domenici on the deficit

Schakowsky Alternative to Simpson-Bowles Deficit Reduction Plan

Congresswoman Jan Schakowsky
November 16, 2010

Today Rep. Jan Schakowsky (D-IL), a member of the bipartisan National Commission on Fiscal Responsibility and Reform, offered a comprehensive proposal to reduce the federal deficit without making middle class Americans foot the bill.  Schakowsky’s plan is an alternative to the Simpson-Bowles plan and would reduce the deficit by $427.75 billion in 2015, surpassing President Obama’s $250 billion target. Critically, the Schakowsky plan accomplishes deficit reduction without making cuts to essential federal expenditures that benefit the middle class.

http://schakowsky.house.gov/index.php?option=com_content&view=article&id=2777:schakowsky-alternative-to-simpson-bowles-deficit-reduction-plan&catid=21:2010-press-releases&Itemid=58

And…

Reviving the Economy, Cutting Spending and Debt, and Creating a Simple, Pro-Growth Tax System

By The Debt Reduction Task Force, Senator Pete Domenici and Dr. Alice Rivlin, Co-Chairs
Bipartisan Policy Center
November 2010

Strengthen Medicare for the Long Term: Transition to a Premium Support Option

Like today, Medicare enrollees will be in the traditional fee-for-service program unless they choose a private plan. However, if federal spending per enrollee for the benefits specified in legislation rises faster than GDP growth plus one percent, beneficiaries will have to pay an additional premium to cover the difference. They can avoid that additional premium, however, and potentially get higher quality health care, if they choose a private health plan offered on a new Medicare Exchange. The expectation is that increased competition among plans fostered by the Medicare Exchange, and increased beneficiary interest in these plans, will keep costs from rising rapidly and result in higher quality, more cost-effective health care.

This proposal will limit growth in federal support for Medicare per beneficiary to one percentage point per year higher than a five-year moving average of GDP growth. If Medicare spending per enrollee for the benefits specified in legislation rises at a faster rate, enrollees will have the option of paying an additional premium to cover the difference and remaining in the traditional Medicare program, or selecting a private insurance plan from the Medicare Exchange.

While the proposed premium support option resembles the current structure of Medicare Advantage, there are differences. Competition among plans will be enhanced by creating a federal Medicare Exchange, which will facilitate beneficiary choice and enrollment and increase the competitiveness of the market, leading to lower premiums.

This proposal will provide incentives for Medicare Exchange plans to develop products that will save beneficiaries money. Today, if a Medicare Advantage plan has very low costs, it cannot pay a rebate to enrollees; instead, it must increase benefits. Under this proposal, Medicare Exchange plans can offer beneficiaries relief from rising Medicare premiums. The Task Force plan might also increase political support – by Medicare beneficiaries, their children, and those approaching Medicare eligibility – for federal policies that promote cost containment in health care.

Asking beneficiaries to pay more for their Medicare coverage (or shift to a lower-cost plan) mirrors what has happened in private insurance over the past decade, with increases in patient cost-sharing to keep premium growth from exceeding income growth by too large a margin. Employers have generally opted to increase patient cost-sharing rather than increase the percentage of the premium that employees contribute. The former keeps employees enrolled in the plan and encourages more judicious use of health services.

http://bipartisanpolicy.org/system/assets/drupal/FINAL%20DRTF%20REPORT%2011.16.10.pdf

Comment: 

By Don McCanne, MD

The co-chairmen of President Obama’s deficit commission advanced a proposal that disappointed those of us who believe that the government has an important role in promoting a healthy and secure future for all of us. Erskine Bowles and Alan Simpson recommend reducing the deficit by cutting back on important social programs such as Medicare and Social Security, while failing to recommend tapping obvious potential revenue sources in our upside-down economy. Two members of their committee, Jan Schakowsky and Alice Rivlin, have now released alternative proposals.

Alice Rivlin is also co-chair, along with Pete Dominici, of The Debt Reduction Task Force from the Bipartisan Policy Center (BPC), an organization founded by Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. Frankly, their report is also disappointing for basically the same reasons. It is very heavy on program reductions (though some are appropriate) and very light on seeking new revenues.

Discussed here is only one feature of the BPC recommendation: converting Medicare to a premium support program. This had been mentioned only cryptically in the Bowles/Simpson report, but more details are provided in the Rivlin/Domenici report (excepts above).

Premium support was a proposal advanced a dozen years ago by John Breaux, Bill Thomas, Bill Frist, and Bobby Jindal that barely failed to receive a super-majority vote in their Bipartisan Medicare Commission, and is now being trotted out again. It is a proposal to convert Medicare from a defined benefit to a defined contribution.

Premium support places a limit on the amount that the government contributes toward the Medicare beneficiaries’ premiums, exposing individuals to the increasing costs of health care. It then uses the leverage of higher individual premiums to encourage “voluntary” purchase of less expensive private plans in the marketplace.

Since private plans have much higher administrative costs, they can achieve lower premiums only by reducing benefits or increasing out-of-pocket costs for the beneficiaries, making coverage worse than under the traditional Medicare program. Instead of overpaying private plans as with the current Medicare Advantage program, the premium support underpays the private plans but allows them to obtain the balance from the Medicare beneficiaries. It is a plan to privatize Medicare that can have only disastrous consequences for Medicare beneficiaries.

In sharp contrast is the proposal of Jan Schakowsky. She would balance revenues and expenditures with the goal of reducing the deficit, as opposed to the unstated goals of Bowles/Simpson and Rivlin/Domenici to reduce government. Her recommended reductions in spending are carefully targeted to programs that many in America believe should be reduced anyway. Her proposed increased revenues not only would help wipe out the deficit, but they also would provide corrections to the current massive income transfer from middle-income workers to the very wealthy – one of the greatest social injustices in modern history.

Other than improving the way we would purchase pharmaceuticals, she has little to say about Medicare. Her position is that of protecting what we do have. We can go her one better on that. We can improve Medicare and then provide it for everyone. That frankly won’t reduce the deficit much, but it would provide us with much greater value for our health care taxes.

What more could we ask for out of our government than sustainable budgets that provide us with real value?

ACTION ALERT:  The heavy hitters are out in force, and they intend to dismantle as much of government as they can, in the name of “fiscally responsible hard choices.” It is imperative that President Obama and members of the Senate receive our clear and unrelenting message that we must both protect and improve our public programs dedicated to social justice. The House alone cannot take those away from us if we have the President and the Senate on our side.

Single Payer after the Midterm Elections

By Quentin Young, M.D.
The Huffington Post
November 17, 2010

While it’s clear from post-election surveys that having voted for “health care reform” was not a major cause of the Democrats’ defeats, the new health law didn’t help. What should have been a feather in the administration’s cap – i.e. a genuine reform that guaranteed truly universal, comprehensive care – instead became an albatross.

Many Democrats, sensing the electorate’s unease with the new health law’s mandates to buy private insurance, its lack of cost controls, and its limited reach – e.g. 23 million will remain uninsured in 2019 – found it difficult to defend. Some even boasted they voted against it.

In a fundamental sense, health care reform was botched by Congress. People wanted serious reform and didn’t get it. The big insurance and drug companies got their way, making a few concessions that they are already trying to wriggle out of.

As a result, what was adopted last March was so defective that ultra-conservatives were actually able use it against the president’s party.

Yet those who might interpret the election results as a repudiation of any health care reform should pause for a moment and consider these developments:

In Vermont, Peter Shumlin, an outspoken supporter of single-payer health reform who defeated four opponents (some of whom also supported single payer) in the primary, went on to win the governor’s race.

Shumlin reports that he has already spoken with President Obama and Health and Human Services Secretary Kathleen Sebelius about getting the necessary federal waivers to implement a single-payer system in the state of Vermont.

Besides Shumlin, four other political heavyweights in the state also support single payer: former governor Howard Dean, Senators Bernie Sanders and Patrick Leahy, and Rep. Peter Welch.

Dr. Deb Richter, a family physician in the Green Mountain State, says, “Peter Shumlin’s election shows Vermonters want a single-payer health care system. We’re going to get this done.”

In California, Jerry Brown won the governorship, defeating Meg Whitman, who spent $141 million of her own money in her failed campaign. In his 1992 presidential primary bid, Brown declared his support for single-payer health reform, and California activists hope he will sign a single-payer bill in 2011 when it comes to his desk. (The Legislature there has twice passed a single-payer bill, only to have it vetoed both times by Gov. Arnold Schwarzenegger.)

In Hawaii, former congressman Neil Abercrombie, a co-sponsor of Rep. John Conyers’ single-payer bill, H.R. 676, was also elected governor. He, too, takes office in a state where many lawmakers have signaled their openness to the single-payer alternative.

Significantly, in the House races, only one of 88 co-sponsors of H.R. 676, Rep. Phil Hare, D-Ill., was defeated in the general election by a Republican. Seven other co-sponsors were lost due to death, resignation, defeat in the primary or retirement. Just one of those went to a Republican, Tom Reed, who won Rep. Eric Massa’s old seat in New York.

The Congressional Progressive Caucus also did well, losing only three of its 69 members. In contrast, over half of the 54-member conservative Blue Dog Democrats went down to defeat.

In Massachusetts, voters in 14 of 14 legislative districts affirmed their support for single-payer health reform by turning in a majority of “Yes” votes (overall, around 2 to 1) for the following ballot question: “Shall the representative from this district be instructed to support legislation that would establish health care as a human right regardless of age, state of health or employment status, by creating a single payer health insurance system like Medicare that is comprehensive, cost effective, and publicly provided to all residents of Massachusetts?”

Benjamin Day, executive director of MassCare, writes: “The ballots spanned 80 different cities and towns in a state of 351 municipalities, winning in every city and town reporting results so far [as of Nov. 3] except two. Five of the districts backing single-payer reform voted for Scott Brown in last year’s special Senate election, which was largely seen as a referendum on national health reform, showing that the goal of improved and expanded Medicare for All is supported by a diverse range of communities across the state.”

A similar referendum in 2008 swept 10 of 10 different legislative districts in Massachusetts, refuting the Republican boast that single-payer health care reform is unpopular.

Apparently, whenever people are given serious choices, single payer’s popularity is sustained, even in the face of scurrilous attacks from the right claiming it is “socialistic” or “un-American.”

There were also setbacks to the single-payer cause, too.

The defeat of Sen. Russ Feingold of Wisconsin was a very heavy loss. Just last February, Feingold had reaffirmed his longtime support for single payer. He should be sought out to help lead the movement for single payer in this new phase.

One of the most egregious results was the election of former hospital company executive Rick Scott to the governor’s mansion in Florida. In 1997, Scott was forced to resign his post as CEO of Columbia/HCA, a giant hospital chain, amid a scandal pointing to massive Medicare fraud and other improper billing practices. The company ultimately admitted to 14 felonies and agreed to pay the federal government over $1.7 billion in fines. Scott spent at least $73 million of his own money to get elected to Florida’s top office.

In Arizona and Oklahoma, ballot initiatives purporting to uphold “freedom of choice” in health care passed. Couched in anti-mandate language, these initiatives are in fact intended to keep patients prisoner of their insurance company networks and are really directed against enactment of single-payer systems.

So what to do going forward?

Aside from the very promising prospects for fundamental reform in Vermont, one of the immediate tasks of single-payer supporters is to block the proposals from the co-chairs of the Deficit Commission to reduce Social Security and Medicare benefits. The commission is set to make its recommendations to Congress by Dec. 1.

As my colleague Dr. Margaret Flowers has testified, the best way to safeguard Medicare is to improve its benefits and to expand it to cover everyone.

Otherwise the battle for fundamental health reform remains front and center, on both the state and national levels. The Medicare-for-all proposal is simple, clear, legitimate and compelling in its logic. The destructive role of private corporations in our health system is also plainly evident.

Just as women’s suffrage and civil rights laws were widely seen as unattainable – sometimes just a few years before they were enacted – single payer is an idea whose time has come. It is unstoppable.

http://www.huffingtonpost.com/dr-quentin-young/single-payer-after-the-mi_b_784961.html

Healthcare For All Ohioans Would Promote Economic Prosperity

by Margaret Brinich
The Lakewood (Ohio) Observer, Nov. 16, 2010

Charles Shaughnessy interviewed April Stoltz on the Health Care For All Ohioans Act (HCFAOA)

Q. April, your picture was on the front page of the Huffington Post last week. What were you protesting so soon after the mid-term elections? Your sign read “Healthcare …” but it was cut off in the picture.

A. Actually, that was an AP image from a “Medicare for All” protest that occurred in Cleveland in October of 2009. The sign said “Healthcare is a Human Right”. The picture is old, but the debate continues. There are nineteen states with single payer healthcare initiatives at various stages. The non-profit organization SPAN Ohio is working to promote a Medicare-for-All style plan known as the Health Care for All Ohioans Act (HCFAOA). SPAN stands for Single-Payer Action Network.

Q. Most people have health insurance and they’re generally satisfied with it. Why rock the boat?

A. Premiums will continue to rise. More and more Ohioans will be priced out of the health care market. It’s not only a health care crisis, but a major contributor to the economic crisis. Lack of health insurance leads to lack of health care and a less-healthy working population. Ohio needs jobs. If Ohio had a comprehensive health care plan covering all citizens and the costs were known, prospective employers would be encouraged to start up new businesses or move businesses into Ohio. It’s in our economic self-interest.

Q. Is it possible to extend health care to everyone without raising the collective cost?

A. Absolutely. The premiums being paid today by individuals, employers, and taxpayers, and the co-pays being paid for medical service could pay for comparable coverage for all. The savings would come from a number of efficiencies. Administrative costs would decline significantly if there were one Medicare-type system in place of a number of private insurance carriers. There would be no need for multi-million dollar executive salaries. No shareholder dividends to pay out quarterly. No marketing budget. Equipment costs for million-dollar imaging machines would be reduced. Today there are too many MRI machines in some areas, sitting idle, while other parts of the state have a shortage. Emergency departments would no longer be a substitute for a doctor’s office. Ohio’s population of about 13 million would mean prescription prices could be negotiated downward significantly. As a local example, health insurance savings for the Lakewood School System would exceed $7 million annually with the passage of the Health Care for All Ohioans Act. Elimination of waste is not possible with the Federal plan, as insurance companies are left to their own devices with no caps on premiums.

Access to medical care for all, including preventive care programs, would lead to a healthier, more productive population. Aside from a better quality of life for all, employees could choose a job or profession based on true interest rather than availability of employer-provided health care coverage. It’s been shown for many years that European and Asian countries have enjoyed a higher level of medical care for less cost than in the United States. SPAN Ohio is showing the PBS special “Sick Around the World ” Thursday November 18th at 7:00 p.m. at the Shaker Heights Community Bldg. at 3450 Lee Rd. It’s free and parking is free.

Q. What about all the workers engaged in claims processing at doctor’s offices and insurance companies who would lose their jobs?

A. Fewer workers would be needed to process claims in a Medicare-type single-payer system, but extending coverage would increase the number of workers needed to run the state plan. Those who wouldn’t be needed would be protected by a provision of Ohio’s proposed plan. They would be paid their previous income, up to $60,000 annually, for up to two years, while training for new jobs or until they took other jobs.

Q. It seems that many people get upset over discussions of health care issues. Can you explain that?

A. I don’t know what others are thinking, but poling show 85% of the population is in favor of no pre-existing condition restrictions and in favor of extending coverage for children and young adults up to age 26. The biggest complaint about the Federal plan is that many provisions don’t take effect until 2014 and that it still leaves the insurance companies in the drivers seat raising costs and cutting coverage.

Q. You have said health care access has become especially important due to the current economic crisis. Please explain.

A. Ohioans know we must have attractive conditions to bring in new job opportunities and that includes having a healthier work force and known health care costs for employers. Ohio is a leader in agricultural production, manufacturing, exports to other countries, and the development and manufacture of climate-friendly sources of energy, yet we’re suffering in a few measures, notably high unemployment. Fiscal responsibility is not a partisan issue. The Healthcare for All Ohioans Act (HCFAOA) could make an impact on our state budget and would promote economic prosperity by creating an entrepreneur-friendly environment.

Q. What local entities support this effort?

A. Endorsers of the campaign sponsored by the Single-Payer Action Network Ohio (SPAN Ohio) to pass the Health Care For All Ohioans Act (HCFAOA) include health care professionals, unions, faith-based organizations, businesses, and government bodies throughout the state.  Local support comes from Ohio Senator Michael Skindell, Ohio State Reps. Nickie Antonio and Michael Foley, Cleveland City Council and Lakewood City Council.

April Stoltz retired early from the U.S. Post Office and has good health insurance coverage, but works for health care for all, as a “civilized and responsible” access solution. She volunteers for Single-Payer Action Network Ohio (SPAN Ohio).  www.spanohio.org

Charles Shaughnessy is a long-time resident of Lakewood, Ohio and currently serves as Treasurer of the Lakewood Democratic Club. www.lakewooddemocrats.com

http://lakewoodobserver.com/read/6/23/healthcare-for-all-ohioans-would-promote-economic-prosperity

Jan Schakowsky and Rivlin/Domenici on the deficit

Schakowsky Alternative to Simpson-Bowles Deficit Reduction Plan

Congresswoman Jan Schakowsky
November 16, 2010

Today Rep. Jan Schakowsky (D-IL), a member of the bipartisan National Commission on Fiscal Responsibility and Reform, offered a comprehensive proposal to reduce the federal deficit without making middle class Americans foot the bill.  Schakowsky’s plan is an alternative to the Simpson-Bowles plan and would reduce the deficit by $427.75 billion in 2015, surpassing President Obama’s $250 billion target. Critically, the Schakowsky plan accomplishes deficit reduction without making cuts to essential federal expenditures that benefit the middle class.

http://schakowsky.house.gov/index.php?option=com_content&view=article&id=2777:schakowsky-alternative-to-simpson-bowles-deficit-reduction-plan&catid=21:2010-press-releases&Itemid=58

And…

Reviving the Economy, Cutting Spending and Debt, and Creating a Simple, Pro-Growth Tax System

By The Debt Reduction Task Force, Senator Pete Domenici and Dr. Alice Rivlin, Co-Chairs
Bipartisan Policy Center
November 2010

Strengthen Medicare for the Long Term: Transition to a Premium Support Option

Like today, Medicare enrollees will be in the traditional fee-for-service program unless they choose a private plan. However, if federal spending per enrollee for the benefits specified in legislation rises faster than GDP growth plus one percent, beneficiaries will have to pay an additional premium to cover the difference. They can avoid that additional premium, however, and potentially get higher quality health care, if they choose a private health plan offered on a new Medicare Exchange. The expectation is that increased competition among plans fostered by the Medicare Exchange, and increased beneficiary interest in these plans, will keep costs from rising rapidly and result in higher quality, more cost-effective health care.

This proposal will limit growth in federal support for Medicare per beneficiary to one percentage point per year higher than a five-year moving average of GDP growth. If Medicare spending per enrollee for the benefits specified in legislation rises at a faster rate, enrollees will have the option of paying an additional premium to cover the difference and remaining in the traditional Medicare program, or selecting a private insurance plan from the Medicare Exchange.

While the proposed premium support option resembles the current structure of Medicare Advantage, there are differences. Competition among plans will be enhanced by creating a federal Medicare Exchange, which will facilitate beneficiary choice and enrollment and increase the competitiveness of the market, leading to lower premiums.

This proposal will provide incentives for Medicare Exchange plans to develop products that will save beneficiaries money. Today, if a Medicare Advantage plan has very low costs, it cannot pay a rebate to enrollees; instead, it must increase benefits. Under this proposal, Medicare Exchange plans can offer beneficiaries relief from rising Medicare premiums. The Task Force plan might also increase political support – by Medicare beneficiaries, their children, and those approaching Medicare eligibility – for federal policies that promote cost containment in health care.

Asking beneficiaries to pay more for their Medicare coverage (or shift to a lower-cost plan) mirrors what has happened in private insurance over the past decade, with increases in patient cost-sharing to keep premium growth from exceeding income growth by too large a margin. Employers have generally opted to increase patient cost-sharing rather than increase the percentage of the premium that employees contribute. The former keeps employees enrolled in the plan and encourages more judicious use of health services.

http://bipartisanpolicy.org/system/assets/drupal/FINAL%20DRTF%20REPORT%2011.16.10.pdf

The co-chairmen of President Obama’s deficit commission advanced a proposal that disappointed those of us who believe that the government has an important role in promoting a healthy and secure future for all of us. Erskine Bowles and Alan Simpson recommend reducing the deficit by cutting back on important social programs such as Medicare and Social Security, while failing to recommend tapping obvious potential revenue sources in our upside-down economy. Two members of their committee, Jan Schakowsky and Alice Rivlin, have now released alternative proposals.

Alice Rivlin is also co-chair, along with Pete Dominici, of The Debt Reduction Task Force from the Bipartisan Policy Center (BPC), an organization founded by Howard Baker, Tom Daschle, Bob Dole, and George Mitchell. Frankly, their report is also disappointing for basically the same reasons. It is very heavy on program reductions (though some are appropriate) and very light on seeking new revenues.

Discussed here is only one feature of the BPC recommendation: converting Medicare to a premium support program. This had been mentioned only cryptically in the Bowles/Simpson report, but more details are provided in the Rivlin/Domenici report (excepts above).

Premium support was a proposal advanced a dozen years ago by John Breaux, Bill Thomas, Bill Frist, and Bobby Jindal that barely failed to receive a super-majority vote in their Bipartisan Medicare Commission, and is now being trotted out again. It is a proposal to convert Medicare from a defined benefit to a defined contribution.

Premium support places a limit on the amount that the government contributes toward the Medicare beneficiaries’ premiums, exposing individuals to the increasing costs of health care. It then uses the leverage of higher individual premiums to encourage “voluntary” purchase of less expensive private plans in the marketplace.

Since private plans have much higher administrative costs, they can achieve lower premiums only by reducing benefits or increasing out-of-pocket costs for the beneficiaries, making coverage worse than under the traditional Medicare program. Instead of overpaying private plans as with the current Medicare Advantage program, the premium support underpays the private plans but allows them to obtain the balance from the Medicare beneficiaries. It is a plan to privatize Medicare that can have only disastrous consequences for Medicare beneficiaries.

In sharp contrast is the proposal of Jan Schakowsky. She would balance revenues and expenditures with the goal of reducing the deficit, as opposed to the unstated goals of Bowles/Simpson and Rivlin/Domenici to reduce government. Her recommended reductions in spending are carefully targeted to programs that many in America believe should be reduced anyway. Her proposed increased revenues not only would help wipe out the deficit, but they also would provide corrections to the current massive income transfer from middle-income workers to the very wealthy – one of the greatest social injustices in modern history.

Other than improving the way we would purchase pharmaceuticals, she has little to say about Medicare. Her position is that of protecting what we do have. We can go her one better on that. We can improve Medicare and then provide it for everyone. That frankly won’t reduce the deficit much, but it would provide us with much greater value for our health care taxes.

What more could we ask for out of our government than sustainable budgets that provide us with real value?

ACTION ALERT: The heavy hitters are out in force, and they intend to dismantle as much of government as they can, in the name of “fiscally responsible hard choices.” It is imperative that President Obama and members of the Senate receive our clear and unrelenting message that we must both protect and improve our public programs dedicated to social justice. The House alone cannot take those away from us if we have the President and the Senate on our side.

Physician-Congressman Andy Harris wants his health care, but forget yours

GOP frosh: Where's my health care?

By Glenn Thrush
Politico
November 16, 2010

A conservative Maryland physician elected to Congress on an anti-Obamacare platform surprised fellow freshmen at a Monday orientation session by demanding to know why his government-subsidized health care plan takes a month to kick in.

Republican Andy Harris, an anesthesiologist who defeated freshman Democrat Frank Kratovil on Maryland’s Eastern Shore, reacted incredulously when informed that federal law mandated that his government-subsidized health care policy would take effect on Feb. 1 – 28 days after his Jan. 3rd swearing-in.

Harris, a Maryland state senator who works at Johns Hopkins in Baltimore and several hospitals on the Eastern Shore, also told the audience, “This is the only employer I’ve ever worked for where you don’t get coverage the first day you are employed,” his spokeswoman Anna Nix told Politico.

Harris said in an Oct. 30 statement, “In Washington, I will never vote to raise taxes, I will fight to repeal health-care reform, and I will work to balance the budget.”

http://www.politico.com/news/stories/1110/45181.html

Comment:

By Don McCanne, MD

Freshman Congressman Andy Harris, a physician, certainly understands the importance of health insurance. He is incensed that the government would make him wait until the month following the onset of his employment for his insurance benefits to begin, even though that is standard in both the public and private sectors. Actually he does not have to face a lapse in insurance coverage since another government program, COBRA, guarantees that he will be able to extend his previous insurance through the month of January.

But what about our citizens who are uninsured? The 30 million or so who would become insured under the Patient Protection and Affordable Care Act? He says he will “fight to repeal health care reform.” And we already know that the proposals that he and his Republican colleagues support instead would insure only about 3 million people.

He, a physician, demands his taxpayer-financed health care at the same time that he fought to become a government steward and will use that position to deny tens of millions of Americans their health care. A physician!

No. A real politically-empowered physician would use that power to see that financial barriers to health care would be removed for everyone.

Our medical school admissions committees need to set the bar higher. All applicants accepted should meet the standard of possessing common decency. Too bad Andy Harris snuck through.

Progressive Groups: Salem to See Single-Payer Health Care Bill in 2011

By James Pitkin
Willamette Week, November 15th, 2010

After President Obama and Democrats in Congess failed to even put universal single-payer health care on the table, progressive groups say they’ll bring a bill to the Oregon Legislature in 2011 that would establish that option in the state.

The announcement from Health Care for All-Oregon, Jobs with Justice, Physicians for a National Health Program and the Oregon League of Women Voters says state Rep. Michael Dembrow (D-Northeast Portland) will introduce the bill.

Dembrow has yet to return a phone call seeking comment. And the measure would be a tough sell in a a House evenly split and a Senate where Democrats have only a 16-14 advantage. But the groups that drafted the bill say it would provide comprehensive health benefits for every Oregon resident without co-payments or deductibles. Insurance companies would be forbidden from competing directly but could still provide benefits not covered under the plan.

Critics have blasted the national health-care bill because it lacks any meaningful cost controls and does not cover all Americans. But states have been encouraged by the feds to experiment with their own programs. And any state that passes single-payer health care has the potential to see a huge economic revival once businesses realize they’ll no longer be saddled with paying for employees’ spiraling health costs.

Read a draft of the proposed bill here.

http://blogs.wweek.com/news/2010/11/15/progressive-groups-salem-to-see-single-payer-bill-in-2011/