PNHP

2009 Milliman Medical Index

2009 Milliman Medical Index

2009 Milliman Medical Index

Milliman, Inc.
May 2009
The fifth annual Milliman Medical Index (MMI) measures average annual medical spending for a typical American family of four covered by an employer-sponsored preferred provider organization (PPO) program.
The total 2009 medical cost for a typical American family of four is $16,771.
http://www.milliman.com/expertise/healthcare/products-tools/mmi/pdfs/milliman-medical-index-2009.pdf

The Milliman Medical Index (MMI) provides us with a very important measure of health care spending in the United States. For 2009, average annual medical spending for a typical American family of four covered by an employer-sponsored preferred provider organization (PPO) program is $16,771. That number should be front and center in our national dialogue on reform. It is important that we understand what it means.
Over 160 million of us receive our health care coverage through an employer. This sector is the healthy workforce and their young healthy families. This is the largest and least expensive sector to insure. It is the sector that we have presented to the private insurance industry either to insure risk or to provide administrative services for self-insured employers.
Group insurance wastes less on non-medical services than does insurance for individuals or small employers. So between the greater efficiency of employer-sponsored plans, and the low-cost, healthy status of the population insured, the spending on this group (represented by the MMI) shows us the best value that we can expect under our current multi-payer system of financing care.
The MMI is nominally broken down into an employer contribution ($9,947), an employee contribution ($4,004), and employee out-of-pocket costs ($2,820). But virtually all economists agree that the employer contribution is paid by the employee in the form of forgone wage increases. So the entire $16,771 represents the average health care costs for a family of four covered by an employer-sponsored PPO. That is what the average family is actually paying today.
Since this is average, those families with greater medical expenses are actually paying more in out-of-pocket costs. So reform proposals need to take into consideration not only the average $16,771 per family, but also the additional costs for those families with greater health care needs.
It is also important to understand that that the combined employer and employee contributions ($9,947 + $4,004 = $13,951) do not represent the premiums paid. Although the average family is defined as a family with an employer-sponsored PPO, the PPO reflects only the fact that the health care system provided discounts for the care provided. The employer and employee contributions represent the actual payments made for health care (minus the out-of-pocket spending). The MMI specifically excludes the non-medical administrative component of health plan premiums.
Read that again. The MMI ($16,771) represents the actual payments to the health care delivery system and excludes the funds retained by the insurance industry for administrative costs and profits.
Many in the policy community believe that health care costs that exceed 10 percent of family income create a financial hardship for that family. Based on the MMI, the average family with an employer-sponsored PPO would have to have an income of $167,710, though adding the administrative costs of private plans plus any additional out-of-pocket spending that might be required would drive that income threshold further upward.
The 2007 median household income was $50,233. Although that does not represent precisely the family of four with employer-sponsored coverage, it does give us a rough perspective of why the numbers no longer work. Any effective reform proposal based on private plans would have to provide taxpayer-financed subsidies for a typical family with an income below $167,000, plus additional subsidies for administrative costs, and even more subsidies for larger than average health care spending. That means that almost the entire workforce would require subsidies.
So what does the MMI tell us? Only an idiot would isolate the largest and healthiest sector of society into the collective employer-sponsored risk pools, assign a package of benefits to each family, assess contributions to be paid based on that package, shift all non-benefit costs to that family, add a hidden charge for wasteful administrative services, and still leave many families exposed to financial hardship. What does that say for those members of Congress who are hashing out this model of health care reform behind those closed doors?
We need a health care financing system that is funded equitably, based on ability to pay, and that uses the power of our own public monopsony to be certain that each of us receives the care that we need. The MMI tells us that it’s time to enact a single payer national health program.

2009 Milliman Medical Index

2009 Milliman Medical Index

Milliman, Inc.
May 2009

The fifth annual Milliman Medical Index (MMI) measures average annual medical spending for a typical American family of four covered by an employer-sponsored preferred provider organization (PPO) program.

The total 2009 medical cost for a typical American family of four is $16,771.

http://www.milliman.com/expertise/healthcare/products-tools/mmi/pdfs/milliman-medical-index-2009.pdf

Comment:

By Don McCanne, MD

The Milliman Medical Index (MMI) provides us with a very important measure of health care spending in the United States. For 2009, average annual medical spending for a typical American family of four covered by an employer-sponsored preferred provider organization (PPO) program is $16,771. That number should be front and center in our national dialogue on reform. It is important that we understand what it means.

Over 160 million of us receive our health care coverage through an employer. This sector is the healthy workforce and their young healthy families. This is the largest and least expensive sector to insure. It is the sector that we have presented to the private insurance industry either to insure risk or to provide administrative services for self-insured employers.

Group insurance wastes less on non-medical services than does insurance for individuals or small employers. So between the greater efficiency of employer-sponsored plans, and the low-cost, healthy status of the population insured, the spending on this group (represented by the MMI) shows us the best value that we can expect under our current multi-payer system of financing care.

The MMI is nominally broken down into an employer contribution ($9,947), an employee contribution ($4,004), and employee out-of-pocket costs ($2,820). But virtually all economists agree that the employer contribution is paid by the employee in the form of forgone wage increases. So the entire $16,771 represents the average health care costs for a family of four covered by an employer-sponsored PPO. That is what the average family is actually paying today.

Since this is average, those families with greater medical expenses are actually paying more in out-of-pocket costs. So reform proposals need to take into consideration not only the average $16,771 per family, but also the additional costs for those families with greater health care needs.

It is also important to understand that that the combined employer and employee contributions ($9,947 + $4,004 = $13,951) do not represent the premiums paid. Although the average family is defined as a family with an employer-sponsored PPO, the PPO reflects only the fact that the health care system provided discounts for the care provided. The employer and employee contributions represent the actual payments made for health care (minus the out-of-pocket spending). The MMI specifically excludes the non-medical administrative component of health plan premiums.

Read that again. The MMI ($16,771) represents the actual payments to the health care delivery system and excludes the funds retained by the insurance industry for administrative costs and profits.

Many in the policy community believe that health care costs that exceed 10 percent of family income create a financial hardship for that family. Based on the MMI, the average family with an employer-sponsored PPO would have to have an income of $167,710, though adding the administrative costs of private plans plus any additional out-of-pocket spending that might be required would drive that income threshold further upward.

The 2007 median household income was $50,233. Although that does not represent precisely the family of four with employer-sponsored coverage, it does give us a rough perspective of why the numbers no longer work. Any effective reform proposal based on private plans would have to provide taxpayer-financed subsidies for a typical family with an income below $167,000, plus additional subsidies for administrative costs, and even more subsidies for larger than average health care spending. That means that almost the entire workforce would require subsidies.

So what does the MMI tell us? Only an idiot would isolate the largest and healthiest sector of society into the collective employer-sponsored risk pools, assign a package of benefits to each family, assess contributions to be paid based on that package, shift all non-benefit costs to that family, add a hidden charge for wasteful administrative services, and still leave many families exposed to financial hardship. What does that say for those members of Congress who are hashing out this model of health care reform behind those closed doors?

We need a health care financing system that is funded equitably, based on ability to pay, and that uses the power of our own public monopsony to be certain that each of us receives the care that we need. The MMI tells us that it’s time to enact a single payer national health program.

Remind Baucus who he works for

Letters
Missoulian (Mont.)
May 13, 2009

Upton Sinclair once wrote: “It is difficult to get a man to understand something when his salary depends upon his not understanding it.”

I am reminded of this quote every time Sen. Max Baucus speaks about health care or banking issues. Baucus is a wholly owned subsidiary of the insurance and banking industries, having received more than $6 million from these industries in the last five years. Minding his masters, Baucus joined every Republican senator in voting against a bill to allow bankruptcy judges to amend mortgages to keep unsophisticated consumers from losing their homes. The bill’s sponsor, Sen. Richard Durbin, was so disgusted by the bill’s defeat he said, “At some point, the senators in this chamber will decide the bankers shouldn’t set the agenda for the United States Senate.”

Baucus is resolute in his opposition to publicly financed health care, insisting he wants a “uniquely American solution” to the health care crisis. His “unique” solution is to continue to rely upon health insurance corporations.

Baucus just can’t seem to understand that banks and health insurance companies haven’t exactly been working for the public good the last several years. Senators make $162,000 per year to supposedly represent the people of their state. Obviously, that salary isn’t enough for Baucus.

We, the little people of Montana, have been outbid for Baucus’ services. The only way Baucus will vote for Montanans is if enough voters call him and insist that he work for them instead of the highest bidder. Until then, he will continue to not understand the problems of the people he only nominally represents.

Richard Buley
Missoula

Poems to the Editor

By Don Stechschulte

Health care, Health care is it something you’ve got?
For 45 million Americans, the answer’s, NOT!

Forty-five million is a number that’s hard to see,
It equals the population of 26 states and Washington, DC.

You say we have a system, a system that’s the best
Why is it we’re so far behind so many of the rest?

Among developed countries, in Europe and the East,
You’d think we’d rank much higher, in the top 10 at least!

But when WHO takes a closer look, our system’s not too sporty
We rank somewhere at the bottom, close to number 40.

Our citizens don’t live as long as European friends
We spend more than twice as much, for lives that too soon end.

Obama wants to fix the system, bring everyone to the table
The one option’s not included, is the only one that’s able

To cover everyone, meet everybody’s needs,
It’s the single payer option, but the powerful don’t heed.

What most Americans truly want is when no one is left out,
A system that works for all, that’s what it’s all about.

In times gone by, when change was wanted, it never came from those in power;
It came as a result of gathered voices of those who refused to cower.

Senate committees now disrupted by those who want to state
It’s not fair when only the “entrenched” get the chance to debate.

What the people want is not considered a worthy option today
They don’t give us the opportunity, at least to have our say.

It’s time to stand and raise a ruckus, so that all may see the light.
Health care first and foremost is a basic human right!

Chants for the Senate sub-committee and other opportunities for protest

Hey Hey, shine the light, health care’s a basic human right!
Hey Hey, Ho, Ho, for-profit health insurance has to go!

Fax-for-Single-Payer Campaign Approaches 50,000 Faxes – Send Yours Today

HealthJustice Pushing Hard

What You Have Accomplished

Dear All,

This has been an extraordinarily busy couple of days for HealthJustice and for single payer advocates. It has been a turning point for single payer as an idea. We are finally getting the message across to the public and even (imagine that) to Congress.

Read what has happened and what you can do to keep up the momentum. Now is a crucial time because we are at the turning point. Congress will go our way or not in the next couple of weeks. Don’t let it be the NOT way.

After ordering the arrest of five more single payer speakers on May 12, Baucus said “I will personally meet with anyone.” OK Max, you know what that means. We are invited to your party and we are going to RSVP big time. Send your request for a personal meeting with Max to his scheduler. This free e-fax also goes to the White House and the Senate Finance and Health Committees. Let’s give Max the meeting requests he says he will honor. And just for fun, let’s suggest a meeting in the National Stadium, where Max can charge admission so he won’t have to keep taking insurance money. Win-win, wouldn’t you agree? Max gets the money and we get to give him an earful.

To top it off, you can stay (cheap, $35/day) with Medea Benjamin of Code Pink at theCode Pink House. Fill out the form here to stay with fellow activists while you are keeping your appointment with Max.

Health Insurance Horror Stories

Congressmen Conyers and Kucinich need your health insurance horror story. They particularly need stories that show “keeping the health insurance you have ” and the “Massachusetts plan” are bogus solutions. So if you are from Massachusetts or if you got screwed even though you were insured, write your story here. It will become a free fax to the White House but will also be used by single payer supporters in Congress to illustrate why the insurance companies do not belong in health care.

It’s easy. Write your story. Fill out a little contact information. Click send. Your fax is on its way.

The Ruckus We Are Making (Donate to Keep It Going)

As of today, you have sent 44 thousand faxes. About 5900 are still queued up for receipt. We have five lines going.

As of today, you have sent about 2000 individually recorded phone calls to Sen. Baucus and the White House. At two to three calls per minute, you are sending a couple of hours worth of calls each morning. The voice messages are also transcribed and faxed to the White House and to key legislators. You are on your 11th set of transcribed voicemails, each with about thirty pages of closely typed messages totalling 200-300 messages per day.

As of today, all five Mike Farrell ads are running. They have been on with Hardball, with MASH, with Larry King Live, with Campbell Brown and several others. Each time they run, there are five to twenty more phone calls in support of single payer. Altogether, an estimated 6.5 million people have seen the ads at an average cost of $3.50 per thousand and a total cost of $22,675.30. See the ads here: http://www.youtube.com/user/1PayerHealth

As of today, you have donated a little over $18,000. As you can see, donations have not quite kept up with costs for the TV ads. That of course does not even consider the cost of the faxes ($350/month currently), the phone services ($600/month) or the cost of health coverage and care($50-90/day.) Yes this is expensive. Is it worth it? Only you can make that decision.

Donate today if you think it is worth it.

The reform proposal of the conservative Republicans

Senators Coburn, Burr and Representatives Ryan, Nunes Offer A Better Path Forward on Health Care Reform

Senator Tom Coburn, M.D.
May 20, 2009
Earlier today, U.S. Senators Tom Coburn, M.D. (R-OK) and Richard Burr (R-NC) and U.S. Representatives Paul Ryan (R-WI) and Devin Nunes (R-CA) introduced health care reform legislation that delivers on the shared principles of promoting universal access to quality, affordable health care, and does so without adding billions of dollars in new debt or taxes.
“The Patients’ Choice Act of 2009,” transforms health care in America by strengthening the relationship between the patient and the doctor; using choice and competition rather than rationing and restrictions to contain costs; and ensuring universal, affordable health care for all Americans. “The Patients’ Choice Act” promotes innovative, State-based solutions, along with fundamental reforms in the tax code, to give every American, regardless of employment status, age, or health condition, the ability and the resources to purchase health insurance. The comprehensive legislation includes concrete prevention and transparency initiatives, long overdue reforms to Medicare and Medicaid, investments in wellness programs and health IT, and more.
http://coburn.senate.gov/public/index.cfm?FuseAction=HealthCareReform.Home&ContentRecord_id=5e3b30a4-802a-23ad-4b44-14f0219114c6

And…

The Patients’ Choice Act

May 2009
The Patients’ Choice Act transforms health care in America: strengthening the relationship between the patient and the doctor; using the forces of choice and competition rather than rationing and restrictions to contain costs; and ensuring universal, affordable health care for all Americans.
The Patient’s Choice Act of 2009 would encourage states to establish rational and reasonable consumer protections, including the following:
* Creates State Health Insurance Exchanges to give Americans a one-stop marketplace to compare different health insurance policies and select the one that meets their unique needs
* Gives Americans the same standard health benefits as Members of Congress, so all Americans have a wide range of choices
* Protects the most vulnerable Americans to ensure that no individual would be turned down by a participating Exchange insurers based on age or health
* Creates a non-profit, independent board to risk adjust among participating insurance companies to penalize companies that “cherry pick” health patients and reward insurers that encourage prevention/wellness and cover patients with pre-existing conditions
* Expands coverage through auto-enrollment at state and medical points of service, for individuals who do not select a plan at the beginning of the year
* Gives states the ability to band together in regional pooling arrangements, as well as the creation of robust high risk pools, reinsurance markets, or risk adjustment mechanisms to cover those deemed ‘uninsurable’
The Patients’ Choice Act of 2009 would restore fairness in the tax code and give every American, regardless of employment status, the ability to purchase health insurance by:
* Providing an advanceable and refundable tax credit of $2,300 per individual or $5,700 per family
Brief summary:
http://coburn.senate.gov/public/index.cfm?FuseAction=Files.View&FileStore_id=b8876db7-2be0-4c84-b833-3d77dc4afa83
“Comprehensive” summary:
http://coburn.senate.gov/public/index.cfm?FuseAction=Files.View&FileStore_id=d4eab376-d507-4fb9-9f17-8b479a10affc

“The Patients’ Choice Act of 2009” is one of two Republican proposals for health care reform being released today and is considered to be the more conservative version. (The other, “The Medical Rights Act,” is being introduced by the “Tuesday Group” of centrist Republicans in the House, though their report has not been released as of this moment.)
So what do the conservative Republicans propose? They recommend state health insurance exchanges that offer the same benefits as members of Congress receive, with guaranteed issue, with risk adjustment between participating insurance companies, and with auto-enrollment but with the ability to opt out (not unlike an individual mandate with a process to opt out because of a lack of affordability).
There is something more than just vaguely familiar here. Of course! It’s the Democrats’ plan!
In the ultimate of ironies, the Democrats abandoned any consideration of the golden standard for reform, a single payer national health program, and sat down to begin negotiations right in the middle of the conservative wing of the Republican members of Congress. That might provide us with a piece of legislation, but it will never provide us with the health care reform that we desperately need.
(But tread lightly. According to Roll Call this morning, “Top aides to Senate Finance Chairman Max Baucus ( D-Mont.) held a private meeting on Monday with a bloc of prominent Democratic lobbyists, warning them to hold their fire or be left out of negotiations on President Barack Obama’s No. 1 legislative priority.”)
Update: The centrist “Medical Rights Act” has now been released. Rather than being a centrist reform proposal, it is merely worthless libertarian rhetoric:
http://www.house.gov/list/press/il10_kirk/healthcare_release.html

The reform proposal of the conservative Republicans

Senators Coburn, Burr and Representatives Ryan, Nunes Offer A Better Path Forward on Health Care Reform

Senator Tom Coburn, M.D.
May 20, 2009

Earlier today, U.S. Senators Tom Coburn, M.D. (R-OK) and Richard Burr (R-NC) and U.S. Representatives Paul Ryan (R-WI) and Devin Nunes (R-CA) introduced health care reform legislation that delivers on the shared principles of promoting universal access to quality, affordable health care, and does so without adding billions of dollars in new debt or taxes.

“The Patients’ Choice Act of 2009,” transforms health care in America by strengthening the relationship between the patient and the doctor; using choice and competition rather than rationing and restrictions to contain costs; and ensuring universal, affordable health care for all Americans. “The Patients’ Choice Act” promotes innovative, State-based solutions, along with fundamental reforms in the tax code, to give every American, regardless of employment status, age, or health condition, the ability and the resources to purchase health insurance. The comprehensive legislation includes concrete prevention and transparency initiatives, long overdue reforms to Medicare and Medicaid, investments in wellness programs and health IT, and more.

http://coburn.senate.gov/public/index.cfm?FuseAction=HealthCareReform.Home&ContentRecord_id=5e3b30a4-802a-23ad-4b44-14f0219114c6

And…

The Patients’ Choice Act

May 2009

The Patients’ Choice Act transforms health care in America: strengthening the relationship between the patient and the doctor; using the forces of choice and competition rather than rationing and restrictions to contain costs; and ensuring universal, affordable health care for all Americans.

The Patient’s Choice Act of 2009 would encourage states to establish rational and reasonable consumer protections, including the following:

* Creates State Health Insurance Exchanges to give Americans a one-stop marketplace to compare different health insurance policies and select the one that meets their unique needs

* Gives Americans the same standard health benefits as Members of Congress, so all Americans have a wide range of choices

* Protects the most vulnerable Americans to ensure that no individual would be turned down by a participating Exchange insurers based on age or health

* Creates a non-profit, independent board to risk adjust among participating insurance companies to penalize companies that “cherry pick” health patients and reward insurers that encourage prevention/wellness and cover patients with pre-existing conditions

* Expands coverage through auto-enrollment at state and medical points of service, for individuals who do not select a plan at the beginning of the year

* Gives states the ability to band together in regional pooling arrangements, as well as the creation of robust high risk pools, reinsurance markets, or risk adjustment mechanisms to cover those deemed ‘uninsurable’

The Patients’ Choice Act of 2009 would restore fairness in the tax code and give every American, regardless of employment status, the ability to purchase health insurance by:

* Providing an advanceable and refundable tax credit of $2,300 per individual or $5,700 per family

Brief summary:
http://coburn.senate.gov/public/index.cfm?FuseAction=Files.View&FileStore_id=b8876db7-2be0-4c84-b833-3d77dc4afa83

“Comprehensive” summary:
http://coburn.senate.gov/public/index.cfm?FuseAction=Files.View&FileStore_id=d4eab376-d507-4fb9-9f17-8b479a10affc

Comment:

By Don McCanne, MD

“The Patients’ Choice Act of 2009” is one of two Republican proposals for health care reform being released today and is considered to be the more conservative version. (The other, “The Medical Rights Act,” is being introduced by the “Tuesday Group” of centrist Republicans in the House, though their report has not been released as of this moment.)

So what do the conservative Republicans propose? They recommend state health insurance exchanges that offer the same benefits as members of Congress receive, with guaranteed issue, with risk adjustment between participating insurance companies, and with auto-enrollment but with the ability to opt out (not unlike an individual mandate with a process to opt out because of a lack of affordability).

There is something more than just vaguely familiar here. Of course! It’s the Democrats’ plan!

In the ultimate of ironies, the Democrats abandoned any consideration of the golden standard for reform, a single payer national health program, and sat down to begin negotiations right in the middle of the conservative wing of the Republican members of Congress. That might provide us with a piece of legislation, but it will never provide us with the health care reform that we desperately need.

(But tread lightly. According to Roll Call this morning, “Top aides to Senate Finance Chairman Max Baucus ( D-Mont.) held a private meeting on Monday with a bloc of prominent Democratic lobbyists, warning them to hold their fire or be left out of negotiations on President Barack Obama’s No. 1 legislative priority.”)

Update: The centrist “Medical Rights Act” has now been released. Rather than being a centrist reform proposal, it is merely worthless libertarian rhetoric:
http://www.house.gov/list/press/il10_kirk/healthcare_release.html

Protesters in Cranberry pressure Altmire to support single-payer health care

By Diana Nelson Jones
Pittsburgh Post-Gazette
Sunday, May 10, 2009

About 60 people formed parentheses around the back entrance of the Cranberry Municipal Building, chanting their support for single-payer health care as U.S. Rep. Jason Altmire approached for a town hall meeting yesterday.

Surrounded by signs touting legislation aimed at creating a national health care system, Mr. Altmire, D-McCandless, stopped to shake hands on his way into the meeting. Several people accused him of reneging on early support of the bill, which would expand on Medicare as the national model of payment.

But Mr. Altmire said he determined after polling his constituents that most do not support a single-payer system, in which one government or government-related agency would distribute tax dollars to pay doctors chosen by patients. The system would eliminate private insurance companies.

Supporters said a single-payer system would assure health care for all Americans, including those who cannot afford insurance.

“We don’t need insurance companies to provide medical care,” said Sandy Fox, president of the Western Pennsylvania Coalition for Single-Payer Health Care. “We need health care providers to provide medical care.”
Critics use the term “socialized medicine” to describe a single-payer system, but Mary Pat Donegan, Western Pennsylvania’s coordinator of Health Care 4 All PA, said that would not be the case.

“It is competitive, the best quality of capitalism,” said Ms. Donegan, who also was among the protesters yesterday. “People choose the providers they want.”

Dr. Scott Tyson, a pediatrician, practices in Mt. Lebanon and Peters, “but I live in Jason’s district,” he said.

“I can’t notsupport” a single-payer system,” said Dr. Tyson. “My disappointment is that there aren’t 10,000 physicians out here protesting. Fifty million people uninsured is criminal. I went into medicine to take care of people. If I have to think about whether someone can pay me, I can’t do my job.”

So why aren’t more physicians protesting?

“Because we’re comfortable,” said Dr. Joe Talarico, an anesthesiologist who practices at UPMC Presbyterian and who also attended yesterday’s protest. “We make six figures and get the best health care there is. It is unconscionable that the have-nots are left out in the cold.”

Rep. John Conyers, D-Mich. and Rep. Dennis Kucinich, D-Ohio, co-sponsored H.R. 676 — the U.S. National Health Insurance Act — in 2007. Similar state legislation also has addressed the issue.

Advocates of the legislation who attended yesterday’s protest said they believe Mr. Altmire is influenced by campaign contributions.

OpenSecrets.org, a Web site launched by the Center for Responsive Politics, reported that two of Mr. Altmire’s top five contributors in 2007-08 were UPMC Health System, with total contributions of $34,650, and the American Hospital Association, $18,375.

But Mr. Altmire said he does not support government-run health care.

“We are going to do health care reform; I just don’t agree with this approach. I favor paying doctors and hospitals for quality over quantity and allowing people under 65 to buy their way into Medicare.”

For 150 million people now privately insured, he said he supports changing provisions that deny coverage or change rates for pre-existing conditions.

“I support private insurance for people who like it,” he said. “We just have to find a way to get health care to the 47 million Americans who are not insured.”

Diana Nelson Jones can be reached at djones@post-gazette.com or 412-263-1626.
First published on May 10, 2009 at 12:00 am

Health care reform advocates get arrested while protesting

By MIKE DENNISON
Gazette State Bureau
Thursday, May 14, 2009.

HELENA – Physicians, nurses and other advocates of a national single-payer health system are protesting their exclusion from high-level reform talks at the committee chaired by Sen. Max Baucus – and getting arrested while doing it.

“If you asked me a few weeks ago if I’d be arrested, I never would have dreamed that,” said Dr. Margaret Flowers of Sparks, Md. “But it became clear that (Baucus and his colleagues) wouldn’t give us a seat at the table, no matter what we did, so we had to have our voice heard somehow.”

Flowers was among eight people arrested last week as they protested before the Senate Finance Committee, which is preparing to craft major health reform legislation.

On Tuesday, five more people were arrested at a Finance Committee meeting in Washington, D.C., as they demanded that a single-payer system be considered as a possible reform.

“We’re advocating on behalf of our patients, and we’re not going to go away,” Flowers said in a telephone interview with the Gazette State Bureau.

Baucus, D-Mont., wouldn’t make himself available for an interview this week. However, his spokesman Ty Matsdorf said Baucus has had meetings with single-payer advocates and that they’ve been involved in other discussions.

“Sen. Baucus feels that everyone should be heard on health care reform, and that is why he invited people to submit comments into the congressional record or organize meetings with the senator and his staff,” Matsdorf said.

At the same time, Baucus has said single-payer will not be considered as a possible reform of America’s health-care system.

Under a single-payer system, the government would act as the primary health insurer, providing health coverage for all citizens, paid for by tax revenue.

Flowers, a pediatrician, heads the Maryland chapter of Physicians for a National Health Program, a doctors group pushing for a single-payer system. Since the election of President Barack Obama, the group has been contacting legislators, asking that single-payer be considered alongside other possible health reforms.

“What we’ve been finding is that the harder our movement pushes, the more they try to exclude us,” she said.

Flowers said the group asked Baucus to include its president, Dr. Oliver Fein, at a May 5 round table before the Finance Committee, as it discussed reforms to expand affordable coverage. That request was rejected, she said, while the round table had 15 people representing health insurers, business, retirees and others.

As the meeting began at the Everett Dirksen building in Washington, D.C., Flowers and others shouted from the audience, asking why the round table included no one for a single-payer system.

“The comments from the audience are inappropriate and out of order,” Baucus responded. “Any further disturbance will cause the committee to recess so the police can restore order.”

Capitol Police arrested each person as they spoke out, and they were taken to a Homeland Security Department building nearby, Flowers said.

Flowers said she was charged with unlawful conduct and disruption of Congress and held for seven hours before being released. An arraignment is scheduled May 26.

Baucus later attempted to address some of the protesters, saying he “deeply, deeply respect(s) the views of all members of the audience and all Americans who feel deeply about health-care reform.”

“I hear what you say; I talk to a lot of people in my home state of Montana who have the exact same views,” Baucus said. “But we aren’t going to get the best result here (unless) we can have an orderly discussion as to how we should best reform our health care system.”

Flowers dismissed Baucus’ statement as “political talk that doesn’t mean anything.”

“If he really respected our views, he would allow us to be there and present our views equally with others,” she said.

http://www.billingsgazette.net/articles/2009/05/14/news/state/20-health.txt?rating=true

Health care's enigma in chief

David Sirota
San Francisco Chronicle
Friday, May 15, 2009

The most stunning and least reported news about President Obama’s press conference with health industry executives this week wasn’t those executives’ willingness to negotiate with a Democrat. It was that Democrat’s eagerness to involve those executives in a discussion about health care reform even as they revealed their previous plans to pilfer $2 trillion from Americans.

That was the little-noticed message from the made-for-TV spectacle administration officials called a health care “game changer”: In saying they can voluntarily slash $200 billion a year from the country’s medical bills over the next decade and still preserve their profits, health care companies implicitly acknowledged they were plotting to fleece consumers, and have been fleecing them for years. With that acknowledgment came the tacit admission that the industry’s business is based not on respectable returns but on grotesque profiteering and waste – the kind that can give up $2 trillion and still guarantee huge margins.

Chief among the profiteers at the White House event were insurance companies, which have raised premiums by 119 percent since 1999, and one obvious question is why – why would Obama engage those particular thieves?

It’s a difficult query to answer, because Obama is a health care mystery, struggling to muster consistent positions on the issue.

Listening to a 2003 Obama speech, it’s hard to believe he has become such an enigma. Back then, he declared himself “a proponent of a single-payer universal health care program” – i.e., one eliminating private insurers and their overhead costs by having government finance health care. Obama’s position was as controversial then as today – which is to say, controversial among political elites, but not among the public. ABC’s 2003 poll showed almost two-thirds of Americans desiring a single-payer system “run by the government and financed by taxpayers,” just as CBS’ 2009 poll shows roughly the same percentage today.

In that speech six years ago, Obama said the only reason single-payer proponents should tolerate delay is “because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.”

This might explain why when Illinois contemplated a 2004 health care proposal raising insurance lobbyists’ “fears that it would result in a single-payer system,” those lobbyists “found a sympathetic ear in Obama, who amended (read: gutted) the bill more to their liking,” according to the Boston Globe. Maybe Obama didn’t think single payer was achievable without a Democratic Washington. And when, in a 2006 interview, he told me he was “not convinced that (single payer) is the best way to achieve universal health care,” perhaps he was following the same rationale, considering his insistence that he must “take into account what is possible.”

Of course, even as a senator aiming for the “possible” in a Republican Congress, Obama promised to never “shy away from a debate about single payer.” And after the 2008 election fulfilled his single-payer precondition of Democratic dominance, it was only logical to expect him to initiate that debate.

That’s why the White House’s current posture is so puzzling. As the Associated Press reports, Obama aides are trying to squelch any single-payer discussion, deploying their health care point-person, Sen. Max Baucus, D-Mont., to announce that “everything is on the table with the single exception of single-payer.”

So it’s back to why – why Obama’s insurance industry-coddling inconsistency? Is it a pol’s payback for campaign cash? Is it an overly cautious lawmaker’s paralysis? Is it a conciliator’s desire to appease powerful interests? Or is it something else?

For a president who spends so much time on camera answering questions, these have become the biggest unanswered questions.

David Sirota is a fellow at the Campaign for America’s Future. Find his blog at OpenLeft.com or e-mail him at ds@davidsirota.com.

This article appeared on page A – 13 of the San Francisco Chronicle
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/05/14/EDMF17KIVP.DTL

Health-care status quo pushing out single-payer advocates in nation's capital

By Amy Goodman
Syndicated columnist
The Seattle Times
Thursday, May 14, 2009

Barack Obama appeared this week with health-industry bigwigs, proclaiming light at the end of the health-care tunnel. Among those gathered were executives from HMO giants Kaiser Foundation Health Plan and Health Net Inc., and the health-insurance lobbying group America’s Health Insurance Plans; from the American Hospital Association and the American Medical Association; from medical-device companies; and from the pharmaceutical industry, including the president and CEO of Merck and former Rep. Billy Tauzin, now president and CEO of PhRMA, the massive industry lobbying group. They have pledged to voluntarily shave some $2 trillion off U.S. health-care costs over 10 years. But these groups, which are heavily invested in the U.S. health-care status quo, have little incentive to actually make good on their promises.

This is beginning to look like a replay of the failed 1993 health-care reform efforts led by then-first lady Hillary Rodham Clinton. Back then, the business interests took a hard line and waged a PR campaign, headlined by a fictitious middle-class couple, Harry and Louise, who feared a government-run health-care bureaucracy.

Still absent from the debate are advocates for single-payer, often referred to as “Canadian-style” health care. Single-payer health care is not “socialized medicine.” According to Physicians for a National Health Program, single-payer means “the government pays for care that is delivered in the private (mostly not-for-profit) sector.”

A February CBS News poll found that 59 percent in the U.S. say the government should provide national health insurance.

Single-payer advocates have been protesting in Senate Finance Committee hearings, chaired by Democratic Montana Sen. Max Baucus. Last week, at a committee hearing with 15 industry speakers, not one represented the single-payer perspective. A group of single-payer advocates, including doctors and lawyers, filled the hearing room and, one by one, interrupted the proceedings.

Protester Adam Schneider yelled: “We need to have single-payer at the table. I have friends who have died, who don’t have health care, whose health care did not withstand their personal health emergencies. … Single-payer now!”

Baucus gaveled for order, guffawing, “We need more police.” The single-payer movement has taken his words as a rallying cry. At a hearing Tuesday, five more were arrested. They call themselves the “Baucus 13.”

One of the Baucus 13, Kevin Zeese, recently summarized Baucus’ career campaign contributions:

“… from the insurance industry, $1,170,313; from health professionals, $1,016,276; pharmaceuticals/health-products industry, $734,605; hospitals/nursing homes, $541,891; health services/HMOs, $439,700.”

That’s almost $4 million from the very industries that have the most to gain or lose from health-care reform.

Another of the Baucus 13, Russell Mokhiber, co-founder of SinglePayerAction.org, has been charged with “disruption of Congress.”

He was quick to respond: “I charge Baucus with disrupting Congress. It once was a democratic institution; now it’s corrupt, because of people like him. He takes money from the industry and does their bidding. He won’t even diffuse the situation by seating a single-payer advocate at the table.”

As I traveled through Montana recently, from Missoula to Helena to Bozeman, health-care activists kept referring to Baucus as the “money man.” Montana state Sen. Christine Kaufmann sponsored an amendment to the Montana Constitution, granting everyone in Montana “the right to quality health care regardless of ability to pay,” or health care as a human right. It died in committee.

Wisconsin Sen. Russ Feingold, a single-payer advocate, said his position will not likely prevail in Washington: “I don’t think there’s any possibility that that will come out of this Congress.” That’s if things remain business as usual.

Mario Savio led the Free Speech Movement on the UC Berkeley campus. In 1964, he said: “There comes a time when the operation of the machine becomes so odious, makes you so sick at heart, that you can’t take part, you can’t even passively take part, and you’ve got to put your bodies upon the gears and upon the wheels, upon all the apparatus, and you’ve got to make it stop. And you’ve got to indicate to the people who run it, the people who own it, that unless you’re free, the machine will be prevented from working at all.”

“Unless you’re free,” the Baucus 13 might add, “to speak.” The current official debate has locked single-payer options out of the discussion, but also escalated the movement — from Healthcare-NOW! to Single Payer Action — to shut down the orderly functioning of the debate, until single-payer gets a seat at the table.

Amy Goodman is the host of “Democracy Now!,” a daily international TV/radio news hour airing on more than 750 stations in North America. Denis Moynihan contributed research to this column.

Single-payer health insurance is way to go

By Don Terry
Chicago Sun-Times
May 14, 2009

An army of lawyers and lobbyists is gathering along the Potomac.

The upcoming battle in Washington over national health care reform is going to be fierce.

Billions of dollars are at stake.

There will be blood.

So, I called a doctor.

About 70 percent of the patients who Dr. Claudia Fegan treats at her South Side clinic don’t have health insurance — like the housekeeper whose breasts were purple and rock-hard from cancer.

“She was just waiting at home to die,” Fegan says. “She didn’t have insurance. She didn’t know what to do. Her daughter finally brought her in.”

Fegan, past president of Physicians for a National Health Program, has seen cases like that again and again. A parade of preventable misery. That’s why she supports a single-payer system that would essentially expand Medicare coverage to include every American, regardless of age.

Under such a plan, the government would pay the health-care bills of all Americans. Advocates say the somewhat higher taxes that result would be offset by massive savings in administrative costs rung up by the scores of private insurance companies that dominate the current system.

Yet health-care services would remain private. People would still get their choice of doctors and hospitals — which isn’t always permitted under some of today’s insurance plans.

A single-payer system is not socialism, as its wackier opponents contend. But the S-word has become the far right’s boogey- man of the moment.

No wonder. Big money is at stake. America spends more on health care than any country in the world, about $7,200 a year for every man, woman and child.

France, Germany and Switzerland rank higher than the U.S. in overall health care yet spend only about $3,400 per capita. Like most of the developed world, those countries have single-payer health-care systems.

Under a single-payer system, the private insurance industry would be largely out of the health-care business. That’s what’s keeping them up at night — and at the White House just the other day, when they made sketchy promises to help cut costs.

A single-payer system would do it for them. Fegan says the program would save the country $400 billion a year in administrative costs and other waste. That’s a lot of foreclosed homes and jobs that could be saved.

“The current system,” she says, “allows insurance companies to dictate who gets care and what kind of care they get. We shouldn’t allow the insurance companies to practice medicine without a license.”

Before Barack Obama went to Washington, he supported a single-payer system. He has since backed off that position.

He has proposed a somewhat vague public/private system that would keep the insurance companies in the game — and in the money. That’s the most politically feasible option, he contends.

He barely gives single-payer advocates the time of day and begrudgingly included them at a recent White House health-care reform conference.

“I’m sorry to say, like many before him, Obama is worried about the awesome clout of the insurance industry,” says Dr. Quentin Young, a Hyde Park neighbor of Obama and a physician for more than 50 years. “The fix is in.”

“The economy can’t tolerate this market-based system. There’s a growing awareness that single-payer is the way to go,” says Young, national coordinator for Physicians for a National Health Program.

Fegan says more pressure has to be put on Obama and other officials to support a single-payer plan. “We have to create a movement. . . . He’s still making politically feasible arguments instead of doing what he knows to be right. Issues of social justice are never politically feasible.”

Fegan makes a lot of sense.

Remember, electing a black man from the South Side of Chicago president wasn’t politically feasible, either.

http://www.suntimes.com/news/terry/1573936,CST-EDT-terry14.article