“Wheel of misfortune” by Pat Bagley
Marcia Angell's testimony before Senate Finance
“Financing Comprehensive Health Care Reform”
Committee on Finance
United States Senate
May 12, 2009
Testimony of Marcia Angell, M.D.
(file does not exist)
http://finance.senate.gov/sitepages/hearing051209.html
It didn’t happen.
After nurses and physicians supporting single payer were removed from the audience, single payer was mentioned once only parenthetically.
During a discussion on the tax deductibility of employer-sponsored health plans, Sen. Max Baucus indicated that we should retain the tax preference, perhaps with modifications, since we should work with what we have and not make a radical change.
In response, considering that eliminating the tax preference would be a radical change especially impacting workers, Gerald Shea of AFL-CIO stated, “If we’re going to do a radical change, I think that single payer is really the way to go.”
Marcia Angell's testimony before Senate Finance
"Financing Comprehensive Health Care Reform"
Committee on Finance
United States Senate
May 12, 2009
Testimony of Marcia Angell, M.D.
(file does not exist)
http://finance.senate.gov/sitepages/hearing051209.html
Comment:
By Don McCanne, MD
It didn’t happen.
After nurses and physicians supporting single payer were removed from the audience, single payer was mentioned once only parenthetically.
During a discussion on the tax deductibility of employer-sponsored health plans, Sen. Max Baucus indicated that we should retain the tax preference, perhaps with modifications, since we should work with what we have and not make a radical change.
In response, considering that eliminating the tax preference would be a radical change especially impacting workers, Gerald Shea of AFL-CIO stated, “If we’re going to do a radical change, I think that single payer is really the way to go.”
A Doctor's Letter to Senator Baucus
Why We Need a Single-Payer Health Care System
By ANA M. MALINOW, MD
Counterpunch
May 7, 2009
Honorable Senator Baucus:
Last week, in the public clinic where I work, I treated a 6-year-old girl who had visited the emergency room for cellulitis, an infection of the skin, over her hand. Usually a relatively minor condition that is easily treated with a 10-day course of antibiotics, cellulitis can sometimes cause severe consequences, including life-threatening sepsis, if not treated promptly.
The reason this patient was notable was because she was uninsured and had been sent home with a prescription that her mother tried to fill but was unable to afford. How much did the antibiotic suspension cost? $500.
When I saw her three days after her ER visit, her hand was swollen twice the normal size, purple, tender and warm to the touch, with a red streak (signifying an extension of the infection from the skin to the bloodstream) up to her elbow. I took one look at her and quickly made the decision to admit her for IV antibiotics, including a consultation with pediatric surgery to ensure that the infection had not spread between the deep layers of her skin.
What struck me most about this visit, other than the child’s deformed hand, was the mother’s shame at not being able to afford her child’s medication. I assured her that I did not blame her, that our health care system was unconscionable, and that we needed a health care system where everyone was included and everyone paid according to his or her ability to pay. She agreed.
I’m not surprised she agreed. From 1943 to today, opinion polls consistently show that a stable majority of Americans favor a government role in the financing of health care. In the lead-up to President Truman’s national health care proposal, 82 percent of Americans agreed that something needed to be done to make health bills easier to afford.
Today, 65 percent of Americans, including 59 percent of U.S. physicians, support a tax-financed national health insurance plan. Why wouldn’t my patient’s mother support national health care?
What she probably doesn’t know is how much she already pays for the health care her child does not get, or gets late. Her uninsured family pays an extra 10 percent out of its paycheck in taxes to pay for our health care system. Her daughter’s hospitalization will be covered by emergency Medicaid, for which she pays through her sales taxes, income taxes, property taxes and other hidden taxes. She will still have many out-of-pocket costs, of course.
I was struck by your remarks this week during the Senate Finance Committee hearings as physicians were carted away. “We need more police.” No, Mr. Senator, we need true health care reform.
Referring to the difference between Washington insiders and most polls over the stimulus package, President Obama’s advisor, David Axelrod said, “This town talks to itself and whips itself into a frenzy with its own theories that are completely at odds with what the rest of America is thinking.” The moral, he said, is “not just that Washington is too insular but that the American people are a lot smarter than people in Washington think.”
I agree. As I talk about a single-payer national health program across Texas (yes, Texas!) and other states, I am repeatedly amazed by the ability of Americans to understand the complex issues of health reform if it is adequately explained to them. People quickly understand that a sustainable solution will come only when we contain costs and eliminate fragmentation.
The more I listen, the more I hear that all Americans want a health care system that is affordable, accountable, accessible, comprehensive, universal and just – not another Band-Aid that will condemn thousands of us to unnecessary pain, suffering, bankruptcy and death. Listen for yourself, and you will hear Americans clamoring for true health care reform.
By Washington standards, single payer is politically unfeasible. But step outside the beltway and you will be surprised by the genuine support that exists for a publicly funded, privately delivered, expanded and improved Medicare for all.
This mother should not be made to feel ashamed. Nor should her child be relegated to suffer like a Third World beggar. Your compromise plan that keeps the private, for-profit insurance industry in the game will perpetuate the shame and the begging. Already, there is a grassroots movement building against private health insurance and for single payer. It will reach Washington, whether Washington is ready or not.
Sincerely yours,
Ana M. Malinow, MD
Pediatrician in Houston, Texas
Past president, Physicians for a National Health Program
Co-founder, Health Care for All Texas
Health Coalition attacks American TV ad in open letter to Barack Obama:
"Listen to Canadians, not Brian Day and his for-profit friends"
MEDIA RELEASE
FOR IMMEDIATE RELEASE
May 8, 2009
(Ottawa, ON) In a tough open letter to President Barack Obama, the Canadian Health Coalition (CHC) is taking on Dr. Brian Day, current past president of the Canadian Medical Association (CMA), and an American conservative group running TV ads against health care reform.
“We are urging President Obama to listen to the overwhelming number of Canadians who value and depend on our public health care, not to Brian Day and his for-profit friends,” said Michael McBane, national coordinator of the Canadian Health Coalition. “Medicare has been good to Canadians since the 1960s when we parted from the American model.”
Dr. Day, whose private surgical clinic in British Columbia is currently under investigation by the B.C. government for illegal billing practices, appears in an ad running on American TV for Conservatives for Patient’s Rights (CPR). (http://www.cpractionfund.org/) The ad is part of a million dollar campaign attacking President Obama’s plan to overhaul the nation’s health care system. In the ad, Dr. Day — a strong proponent of privatizing Canada’s public health system — sides with those who would privatize the system, sharing horror stories of government-run health care programs.
The campaign sponsor, CPR, is a conservative organization founded by Rick Scott, the discredited former owner of Columbia/HCA, one of the largest private health care companies in the world. In 1997, his board of directors removed him from office during the largest health care fraud scandal in the United States. The company was forced to pay $1.7 billion in fines for overbilling state and federal government health plans.
This campaign slogan- ‘Putting Patients First’ – is borrowed from the drug industry and really means ‘Putting Profits First’.
“Dr. Day and Rick Scott should not be allowed to speak for people who need and deserve quality health care,” said Mr. McBane. “We want President Obama to understand the benefits of Canada’s public health system.”
In the open letter, Mr. McBane points out several critical differences between Canadian and American health care.
“Mr. President, we know that you are deeply concerned about the 46 million Americans who have no medical coverage. We’re proud to say that Canada covers every Canadian citizen. Canadians live three years longer than Americans, and our infant mortality rate is 20% lower. Canada spends 10% of its GDP on health care, compared to 15.3% in the United States, yet we generally get more services. Economically, Canada’s public health system dramatically reduces costs for business, particularly the hard-hit manufacturing sectors, because of higher prices and administrative costs in the primarily private U.S. system.”
Mr. McBane urged the President to look at the consistent level of support among Canadians for the public health care system. “Canadians recognize our system can always be improved, but they overwhelmingly want public sector improvements, not for-profit private companies taking our scarce health care dollars. Our two countries need to stand together to strengthen public health care across the border and to protect the right to public health care from financially motivated doctors and insurance companies.”
“It remains shocking to us that Dr. Day, a past president of the CMA, is participating in a campaign to de-rail the efforts of the American people to secure their right to health care by misrepresenting the facts about Canada. This is a breach of fundamental ethical obligations of the medical profession, namely, a commitment to best evidence and avoidance of conflict of interest.
“Canadians and Americans both need more public health care not less. Private markets and commercial competition will make things worse, not better.”
The Canadian Health Coalition is a not-for-profit, non-partisan organization dedicated to protecting and expanding Canada’s public health system for the benefit of all Canadians. It includes organizations representing seniors, women, churches, nurses, health care workers and anti-poverty activists from across Canada.
-30-
Michael McBane
National Coordinator
Canadian Health Coalition
Ottawa, Canada
(613) 277-6295
www.medicare.ca
Single payer system subject of debate at health care roundtable
By RTT Staff Writer
RTTNews
May 12, 2009
The Senate Finance Committee held its third and final Health Care Roundtable Discussion Tuesday, focusing on how to finance comprehensive health care reform. The roundtable concluded the series aimed at helping the committee offer health care reform legislation by June.
Experts and lawmakers discussed the cost of the proposals that they have considered in recent weeks, with committee chairman Max Baucus, D-Mont noting that they “are not cheap.”
However, the cost of inaction is also high, he added, noting that Americans spend $4.5 million on health care every minute of every day, leading to $2.5 trillion a year – or $33 trillion over the next 10 years.
Monday, President Barack Obama announced that he had reached an agreement with various organizations to cut health care spending by 1.5 percent each year for the next 10 years, saving over $2 trillion.
Baucus noted that, along the lines of the reform promoted by President Obama, the first place to cut spending is within the health care industry itself.
In addition, experts discussed the tax treatment of health care.
“We should look at ways to modify the current tax exclusion so that it provides the right incentives,” Baucus said. “And we should look at ways to make it fairer and more equitable for everyone.”
Protestors once again marked the opening of the hearing, with many in favor of a single-payer system.
“This is a sham – all of you are special interest groups up there?” one yelled before police escorted them from the meeting room.
“Why aren’t single payer activists at the table?” another asked, before being similarly removed from the room.
The single-payer system provides only one source of money for paying health care providers, and can be on a national scope, like Canada, or smaller like statewide or community-based.
The payer may be a governmental unit or other entity such as an insurance company. Advocates say that single payer supports the patient by reducing costs and simplifying administrative work.
Gerald Shea, Assistant to the President for Governmental affairs of the AFL-CIO, added his support for the single-payer system.
“If you’re going to do it the right way, I think that single-payer is the way to go,” Shea said.
However, Baucus called the proposal unrealistic.
“Some want to go to single payer,” Baucus said. “I don’t think that’s going to work in this country.”
Rather, he supported other tax benefits for health care.
“Among these are tax-preferred health accounts and the itemized deduction for health expenses,” Baucus said. “We should try to make sure that those benefits are structured fairly and efficiently.”
Ranking member, Chuck Grassley, R-Iowa, noted that the hardest part of health care reform is figuring out how to pay for it. However, he noted that no matter what the reform, President Obama will be a “key player” in crafting the new health care system.
Last week, lawmakers heard from a panel of experts on the best ways to overhaul the individual health care system. Financing was not discussed, although all participants agreed that an increase in cost would be needed.
Approximately 87 million people — one in three Americans — went without health insurance for some period during 2007 and 2008.
Marcia Angell’s testimony before Senate Finance
“Financing Comprehensive Health Care Reform”
Committee on Finance
United States Senate
May 12, 2009
Testimony of Marcia Angell, M.D.
(file does not exist)
http://finance.senate.gov/sitepages/hearing051209.html
Comment:
By Don McCanne, MD
It didn’t happen.
After nurses and physicians supporting single payer were removed from the audience, single payer was mentioned once only parenthetically.
During a discussion on the tax deductibility of employer-sponsored health plans, Sen. Max Baucus indicated that we should retain the tax preference, perhaps with modifications, since we should work with what we have and not make a radical change.
In response, considering that eliminating the tax preference would be a radical change especially impacting workers, Gerald Shea of AFL-CIO stated, “If we’re going to do a radical change, I think that single payer is really the way to go.”
A Doctor’s Letter to Senator Baucus
Why We Need a Single-Payer Health Care System
By ANA M. MALINOW, MD
Counterpunch
May 7, 2009
Honorable Senator Baucus:
Last week, in the public clinic where I work, I treated a 6-year-old girl who had visited the emergency room for cellulitis, an infection of the skin, over her hand. Usually a relatively minor condition that is easily treated with a 10-day course of antibiotics, cellulitis can sometimes cause severe consequences, including life-threatening sepsis, if not treated promptly.
The reason this patient was notable was because she was uninsured and had been sent home with a prescription that her mother tried to fill but was unable to afford. How much did the antibiotic suspension cost? $500.
When I saw her three days after her ER visit, her hand was swollen twice the normal size, purple, tender and warm to the touch, with a red streak (signifying an extension of the infection from the skin to the bloodstream) up to her elbow. I took one look at her and quickly made the decision to admit her for IV antibiotics, including a consultation with pediatric surgery to ensure that the infection had not spread between the deep layers of her skin.
What struck me most about this visit, other than the child’s deformed hand, was the mother’s shame at not being able to afford her child’s medication. I assured her that I did not blame her, that our health care system was unconscionable, and that we needed a health care system where everyone was included and everyone paid according to his or her ability to pay. She agreed.
I’m not surprised she agreed. From 1943 to today, opinion polls consistently show that a stable majority of Americans favor a government role in the financing of health care. In the lead-up to President Truman’s national health care proposal, 82 percent of Americans agreed that something needed to be done to make health bills easier to afford.
Today, 65 percent of Americans, including 59 percent of U.S. physicians, support a tax-financed national health insurance plan. Why wouldn’t my patient’s mother support national health care?
What she probably doesn’t know is how much she already pays for the health care her child does not get, or gets late. Her uninsured family pays an extra 10 percent out of its paycheck in taxes to pay for our health care system. Her daughter’s hospitalization will be covered by emergency Medicaid, for which she pays through her sales taxes, income taxes, property taxes and other hidden taxes. She will still have many out-of-pocket costs, of course.
I was struck by your remarks this week during the Senate Finance Committee hearings as physicians were carted away. “We need more police.” No, Mr. Senator, we need true health care reform.
Referring to the difference between Washington insiders and most polls over the stimulus package, President Obama’s advisor, David Axelrod said, “This town talks to itself and whips itself into a frenzy with its own theories that are completely at odds with what the rest of America is thinking.” The moral, he said, is “not just that Washington is too insular but that the American people are a lot smarter than people in Washington think.”
I agree. As I talk about a single-payer national health program across Texas (yes, Texas!) and other states, I am repeatedly amazed by the ability of Americans to understand the complex issues of health reform if it is adequately explained to them. People quickly understand that a sustainable solution will come only when we contain costs and eliminate fragmentation.
The more I listen, the more I hear that all Americans want a health care system that is affordable, accountable, accessible, comprehensive, universal and just – not another Band-Aid that will condemn thousands of us to unnecessary pain, suffering, bankruptcy and death. Listen for yourself, and you will hear Americans clamoring for true health care reform.
By Washington standards, single payer is politically unfeasible. But step outside the beltway and you will be surprised by the genuine support that exists for a publicly funded, privately delivered, expanded and improved Medicare for all.
This mother should not be made to feel ashamed. Nor should her child be relegated to suffer like a Third World beggar. Your compromise plan that keeps the private, for-profit insurance industry in the game will perpetuate the shame and the begging. Already, there is a grassroots movement building against private health insurance and for single payer. It will reach Washington, whether Washington is ready or not.
Sincerely yours,
Ana M. Malinow, MD
Pediatrician in Houston, Texas
Past president, Physicians for a National Health Program
Co-founder, Health Care for All Texas
"At home with the uninsured" by Chan Lowe
“At home with the uninsured” by Chan Lowe
Finance Committee member assignments
Exclusive: Max Baucus’s Health Care Team
by Ezra Klein
The American Prospect Blog
May 6, 2009
I mentioned yesterday that Chuck Schumer’s public plan compromise wasn’t a freelance effort: Max Baucus had deputized him to work through the options on the public plan. But he’s not the only Finance Committee member that received some homework from Baucus. In fact, Baucus has given every Democrat on the committee a different piece of health reform to focus in on.
This is the list:
Jay Rockefeller: Medicaid Expansion, Premium Subsidies, Quality Improvements
Kent Conrad: Comparative Effectiveness, Chronic Care Management
Jeff Bingaman: Pay-for-Performance, Bundled Payments, IHS
John Kerry: Health Information Technology, Exchange, Small Business Tax Credit
Blanche Lincoln: Small-Group Rating Reforms, Small Business Tax Credit
Ron Wyden: Tax Exclusion, Non-Group Rating Reform
Chuck Schumer: Public Plan
Debbie Stabenow: Employer Pay-or-Play, Medicare Buy-in, HIT
Maria Cantwell: Long-Term Care Reform, Workforce Issues
Bill Nelson: Graduate Medical Education, Medicare Part D
Bob Menendez: Disparities, Individual Requirement
Tom Carper: Fraud and Abuse, Prevention and Wellness, Transparency
http://www.prospect.org/csnc/blogs/ezraklein_archive?month=05&year=2009&base_name=exclusive_max_baucuss_health_c
Sen. Max Baucus has set an agenda to send a comprehensive health care reform bill to President Obama within the next few months. The significance of the assignments given to each of the Democratic members of the Senate Finance Committee is that they provide considerable insight as to the policies that are likely to be included in the legislative package.
Many of these categories involve significant increases in costs, especially through additional and more complex administrative functions. Potential cost savings here are merely wishes not supported by any solid policy studies. The quest to slow the rate of health care cost increases has been one of the most important driving forces for reform, yet these measures will only add more to the cost burden.
Providing health care for everyone seems to be elusive, and these measures would hardly budge the numbers. Perhaps that is why they changed the goal of universal coverage to a goal of “aim for” universal coverage.
Much of the demand for reform stems from public dissatisfaction with the waste and abuses of the private insurance industry. In response, we were promised much greater regulatory oversight of the private insurers. But where is it? Is that what the “Exchange” is? If so, can you imagine John Kerry crafting legislation that would convert our private insurers into a system of social insurance? Do you think that his conservative approach based on a foundation of sloth might be the reason that he received this important assignment?
The senators have some busy work to do. It’s too bad that it’s not on health care reform.