Ray Bellamy
Tallahassee Democrat
My View
April 29, 2009

No to offshore drilling in a state that depends on pristine beaches and an attractive environment to attract a vibrant tourist industry. No to Seminole gaming, which would siphon money from those least able to afford it and create a number of other social problems.

What to do? Say yes to single-payer national health insurance. How would this help, you ask? The single largest expenditure in Florida’s budget is the $16 billion for Medicaid. And this Medicaid cost goes up annually at an unsustainable rate. That item, the entire Medicaid budget, would disappear if we had single payer national health insurance, such as HR 676 in the U.S. House, or S703 in the U.S. Senate. Since everyone would have comprehensive health coverage, including long-term care, dental, pharmacy and mental health — think a very comprehensive “Medicare for All” from the day of birth — state Medicaid expenditures would vanish from the budget. Also eliminated would be Leon County’s costs for providing employee and retiree health care, the same costs for the city of Tallahassee, and also for state employees and state retirees. Now this is sustainable improvement for our state’s budget number-crunchers to love.

Single payer is the only health care reform proposal that is revenue neutral in our $2.4 trillion national health care cost equation. It achieves universal coverage by saving an estimated $380 billion a year in wasted profit for the insurance industry and counter-productive administrative excess caused by that industry. These savings would go toward covering all of us with comprehensive coverage, free choice of physician and free choice of hospital, just as Medicare would be if it were much better funded.

Single payer is the only proposal for covering the uninsured that is fiscally responsible, the only proposal that covers all citizens, and the only proposal that utilizes a successful business model: Medicare. Australia, Canada, Taiwan and other countries with better-rated health care quality at half the per-capita costs of the U.S. patchwork system have greater success with the single payer model at far less cost than we. There is no successful model in the world experience for a private, for-profit insurance system such as proposed by those opposed to single payer.

We have a unique opportunity to achieve this needed reform in health care and solve our Florida budget crisis. Our own congressman, Allen Boyd, has stated his support for “universal health coverage.” But if the Obama administration is successful in shepherding through the Obama plan, Boyd is likely to be presented with a bill that will subsidize the health coverage for the uninsured at an additional national cost of $150 billion to $200 billion, but leave in place the 31-percent overhead and excessive insurance company profits within the present system. In fact, additional administrative costs would be added.

Boyd, as a leader of the Blue Dog caucus in Congress, is in a position to lead the redirection of health care reform toward single payer and take a true leadership role in Congress. The more than $18 billion saved from our state budget would go a long way toward helping our education, law enforcement, state worker salaries and other pressing social needs. Let Congressman Boyd know how you feel.

ABOUT THE AUTHOR: Ray Bellamy is a physician practicing in Tallahassee. Contact him at ray.bellamy@med.fsu.edu.

By DEAN CALBREATH
San Diego Union Tribune
April 26, 2009

It’s been nearly three decades since White House Chief of Staff John Ehrlichman floated the idea of creating a health care system based on health maintenance organizations.

President Richard Nixon at first balked at the idea. “You know, I’m not too keen on any of these damn medical programs,” he said on June 17, 1971, as recorded by his secret White House taping system.

Ehrlichman, who would later serve jail time for his role in the Watergate affair, patiently explained that privately run HMOs could be profitable, since “all of the incentives are for less medical care. Because the less care they give, the more money they make.”

“Not bad,” Nixon replied. The next day, he proposed “a new national health strategy” based on HMOs, saying that “the purpose of this program is simply this: I want Americans to have the finest health care in the world.”

In the years since, it’s an open question whether the United States has created the world’s finest health care system, but it’s definitely the costliest. In 2006, the United States spent $6,714 per person on health care.

In comparison, Japan — which, like most other industrialized countries, offers a largely socialized health care system — spent $2,474; the United Kingdom, $2,760; Sweden, $3,202; Germany, $3,371; and France, $3,449. We devote more than 15 percent of our gross domestic product to health care, while most other industrialized countries spend less than 10 percent.

What has that bought us? There are few areas where we do noticeably better than other countries — our hospital waiting times, for instance, are shorter than in other countries, and we provide greater access to advanced technologies.

But over the past decade, the United States has consistently ranked last on patient access, safety, efficiency and equity when compared with countries such as Germany, Australia, Canada, New Zealand and the United Kingdom in a biannual survey of the Commonwealth Fund, a New York-based health advocacy group.

By a number of other measures, such as infant mortality and life span, we lag behind most industrialized nations. And we still are a nation where nearly one out of four residents is uninsured. In fact, the number of uninsured is rising each day as more employees get laid off. Every 1 percent increase in the jobless rate translates into more than 1 million people losing health coverage nationwide, according to the Kaiser Family Foundation.

Why are our health care costs so high? Why aren’t we getting broader coverage, considering the amount of money we’re putting into the system?

There are a number of reasons, ranging from our fondness for CT scans and MRIs to the high profits of the drug industry. But some critics recently have focused on two other major factors: profits — as Nixon alluded to — and paperwork.

In testimony on Capitol Hill last week, David Himmelstein, national spokesman for Physicians for a National Health Program, argued that one reason for the high cost of health care in the United States is that American hospitals and clinics spend much more money on administrative services than other countries do, partly because U.S. doctors have to devote such a large portion of their time responding to questions and challenges from insurers.

Himmelstein, an associate professor at Harvard and doctor at Cambridge Hospital, said 31 cents out of every dollar that Americans spend on health care goes for administrative expenses. That compares with less than 17 cents in neighboring Canada, which uses a single-payer system.

“If we cut our bureaucratic costs to Canadian levels, we’d save nearly $400 billion annually — more than enough to cover the uninsured and to eliminate co-payments and deductibles for all Americans,” Himmelstein told the House Subcommittee on Health, Employment, Labor and Pensions.

Jim G. Kahn, health economist at the Institute for Health Policy Studies at the University of California San Francisco, found a similar pattern during a study of California hospitals, clinics and doctors’ groups. He found the doctors’ groups were spending an average of 14 cents per dollar related to legal, accounting and processing costs involved with health insurance.

“You have to have teams of lawyers and accountants to negotiate contracts and to figure out who pays for what,” Kahn said. “You have to have whole teams in place to figure out what errors there are (in the paperwork) and how to fix them.”

Kahn said that in a single-payer system like Canada’s, the data are centralized, resulting in less time, money and effort being spent on administrative tasks. “And then you could apply that savings to provide better health coverage,” he said.

Critics of a single-payer concept worry that a government-run system would end up being too costly and too bureaucratic, without providing the benefits of innovation and cost-cutting that competition is supposed to bring. But if that were true, why does our system cost more than those abroad?

The entities that seem to benefit most from the current system are the major pharmaceuticals, which are among the nation’s most profitable companies, and the life insurers, which have also done well.

Donald Cohen, executive director of San Diego’s Center for Policy Initiatives, a liberal think tank, said the top seven for-profit health insurers made a combined $12.6 billion in 2007, an increase of more than 170 percent from 2003. Part of those profits go toward paying high salaries for the top executives. The seven chief executives received an average compensation of $14.3 million in 2007, with pay packages ranging from $3.7 million to $25.8 million.

Cohen suggested that one way of lowering costs would be to create more competition, by having a government health plan competing with the private insurers. Government-run programs, he said, typically run with low administrative expenses, often with overhead running at 1 percent to 3 percent of their expenses. In contrast, the privately run insurance firms have overhead costs as high as 20 percent, partly because of their high salaries.

As Cohen noted, conservative think tanks like the Reason Foundation, Heritage Foundation and others have argued that allowing the private sector to compete with the public sector can benefit the taxpayer. Why shouldn’t the reverse be true?

“Public-private competition in health insurance will squeeze overhead and profits from the middlemen in the system so we can put more money into actual health care,” Cohen said.

Dean Calbreath: (619) 293-1891; dean.calbreath@uniontrib.com

By DEAN CALBREATH
San Diego Union Tribune
April 26, 2009

It’s been nearly three decades since White House Chief of Staff John Ehrlichman floated the idea of creating a health care system based on health maintenance organizations.

President Richard Nixon at first balked at the idea. “You know, I’m not too keen on any of these damn medical programs,” he said on June 17, 1971, as recorded by his secret White House taping system.

Ehrlichman, who would later serve jail time for his role in the Watergate affair, patiently explained that privately run HMOs could be profitable, since “all of the incentives are for less medical care. Because the less care they give, the more money they make.”

“Not bad,” Nixon replied. The next day, he proposed “a new national health strategy” based on HMOs, saying that “the purpose of this program is simply this: I want Americans to have the finest health care in the world.”

In the years since, it’s an open question whether the United States has created the world’s finest health care system, but it’s definitely the costliest. In 2006, the United States spent $6,714 per person on health care.

In comparison, Japan — which, like most other industrialized countries, offers a largely socialized health care system — spent $2,474; the United Kingdom, $2,760; Sweden, $3,202; Germany, $3,371; and France, $3,449. We devote more than 15 percent of our gross domestic product to health care, while most other industrialized countries spend less than 10 percent.

What has that bought us? There are few areas where we do noticeably better than other countries — our hospital waiting times, for instance, are shorter than in other countries, and we provide greater access to advanced technologies.

But over the past decade, the United States has consistently ranked last on patient access, safety, efficiency and equity when compared with countries such as Germany, Australia, Canada, New Zealand and the United Kingdom in a biannual survey of the Commonwealth Fund, a New York-based health advocacy group.

By a number of other measures, such as infant mortality and life span, we lag behind most industrialized nations. And we still are a nation where nearly one out of four residents is uninsured. In fact, the number of uninsured is rising each day as more employees get laid off. Every 1 percent increase in the jobless rate translates into more than 1 million people losing health coverage nationwide, according to the Kaiser Family Foundation.

Why are our health care costs so high? Why aren’t we getting broader coverage, considering the amount of money we’re putting into the system?

There are a number of reasons, ranging from our fondness for CT scans and MRIs to the high profits of the drug industry. But some critics recently have focused on two other major factors: profits — as Nixon alluded to — and paperwork.

In testimony on Capitol Hill last week, David Himmelstein, national spokesman for Physicians for a National Health Program, argued that one reason for the high cost of health care in the United States is that American hospitals and clinics spend much more money on administrative services than other countries do, partly because U.S. doctors have to devote such a large portion of their time responding to questions and challenges from insurers.

Himmelstein, an associate professor at Harvard and doctor at Cambridge Hospital, said 31 cents out of every dollar that Americans spend on health care goes for administrative expenses. That compares with less than 17 cents in neighboring Canada, which uses a single-payer system.

“If we cut our bureaucratic costs to Canadian levels, we’d save nearly $400 billion annually — more than enough to cover the uninsured and to eliminate co-payments and deductibles for all Americans,” Himmelstein told the House Subcommittee on Health, Employment, Labor and Pensions.

Jim G. Kahn, health economist at the Institute for Health Policy Studies at the University of California San Francisco, found a similar pattern during a study of California hospitals, clinics and doctors’ groups. He found the doctors’ groups were spending an average of 14 cents per dollar related to legal, accounting and processing costs involved with health insurance.

“You have to have teams of lawyers and accountants to negotiate contracts and to figure out who pays for what,” Kahn said. “You have to have whole teams in place to figure out what errors there are (in the paperwork) and how to fix them.”

Kahn said that in a single-payer system like Canada’s, the data are centralized, resulting in less time, money and effort being spent on administrative tasks. “And then you could apply that savings to provide better health coverage,” he said.

Critics of a single-payer concept worry that a government-run system would end up being too costly and too bureaucratic, without providing the benefits of innovation and cost-cutting that competition is supposed to bring. But if that were true, why does our system cost more than those abroad?

The entities that seem to benefit most from the current system are the major pharmaceuticals, which are among the nation’s most profitable companies, and the life insurers, which have also done well.

Donald Cohen, executive director of San Diego’s Center for Policy Initiatives, a liberal think tank, said the top seven for-profit health insurers made a combined $12.6 billion in 2007, an increase of more than 170 percent from 2003. Part of those profits go toward paying high salaries for the top executives. The seven chief executives received an average compensation of $14.3 million in 2007, with pay packages ranging from $3.7 million to $25.8 million.

Cohen suggested that one way of lowering costs would be to create more competition, by having a government health plan competing with the private insurers. Government-run programs, he said, typically run with low administrative expenses, often with overhead running at 1 percent to 3 percent of their expenses. In contrast, the privately run insurance firms have overhead costs as high as 20 percent, partly because of their high salaries.

As Cohen noted, conservative think tanks like the Reason Foundation, Heritage Foundation and others have argued that allowing the private sector to compete with the public sector can benefit the taxpayer. Why shouldn’t the reverse be true?

“Public-private competition in health insurance will squeeze overhead and profits from the middlemen in the system so we can put more money into actual health care,” Cohen said.

Dean Calbreath: (619) 293-1891; dean.calbreath@uniontrib.com

By Michael Carano
PDA OH State Coordinator
April 28, 2009, Columbus, OH

On April 25, 2009, over one hundred and twenty-five Ohio healthcare advocates converged at the Ramada Plaza Hotel in the State’s capital for the Sixth Annual Single-Payer Action Network of Ohio conference (SPAN Ohio). SPAN Ohio is a single-payer coalition working to enact “The Health Care For All Ohioans Act” in the Ohio legislature and, should that fail, through a petition initiative to put the single-payer bill on the Ohio ballot.

The conference attendees, a mix of new and long-time activists, came to elect officers for the coming year, to participate in workshops, and to hear an address by one of the leading, long-time proponents of a national single-payer healthcare plan, keynote speaker Oliver Fein, M.D., president of Physicians for a National Health Program (PNHP).

The purpose of the annual conference is to bring together supporters of healthcare for all–unions, healthcare providers, faith groups, community groups, women’s organizations, businesses and others–to discuss how best to build the campaign to win publicly-funded, privately-provided, not-for-profit universal healthcare guaranteeing coverage for all Ohioans. The conference also serves as the time when SPAN democratically elects its board, regional coordinators, and constituency leadership.

Dr. Fein eloquently laid out how agents for change must work to move single-payer health care forward in the new political environment brought about by the election of Barack Obama. As recently reported in the national press, Dr. Fein, along with Congressman John Conyers, author of the single-payer resolution in Congress, both received invitations to the White House for the Stakeholders Conference convened by the president only hours before the meeting in Washington was to take place. Dr. Fein said their late inclusion in the D.C. meeting was made possible by the efforts of the grassroots, groups like the Leadership Conference for Guaranteed Health Care. With a smile on his face, he also stated that the threat of direct action by PNHP doctors had some small effect. It seems the Obama Administration did not like the idea of having doctors in white coats picketing outside the White House for the initial kickoff of his healthcare campaign.

In his explanation of what is being discussed and considered by the powers that be in Washington, Fein pointed out the deficiencies of the much-touted “public plan.” Dr. Fein
explained that 10-15% of public employees cannot afford the coverage. It is a menu of premium-based rather than income-based private insurance plans. An office clerk pays the same as a senator–one more example as to why single-payer healthcare is the answer.

Dr. Fein also noted the contingent of members of Progressive Democrats of America activists in the crowd, commending them for their work in the Leadership Conference and their focused effort on the part of single-payer healthcare. He suggested that the movement must begin to engage in direct actions to raise the pressure on Congress to the next level to ensure healthcare reform results in a single-payer plan–sooner rather than later. Dr. Fein encouraged those in attendance to lobby their members of Congress to gain support for HR 676.

Dr. Fein’s activism dates back to his college days while attending medical school in Cleveland, Ohio. He was an organizer of the Cleveland Community Project (CCP), one of the more successful endeavors of Students for Democratic Society’s Economic Research and Action Project. (Coincidentally, SPAN Ohio’s own Bob Smiddie, a social justice activist from Athens, Ohio, was also involved in the community theater component of the CCP at the time of Dr. Fein’s leadership.)

Attendees swelled the breakout sessions, which focused on ways to move true health care reform forward. John Ross, a Toledo, Ohio physician and a founding member of SPAN, spoke to those interested in learning more about the Health Care for All Ohioans Act in a session heavily attended by those relatively new to the cause. Dr. Fein’s breakout session centered on the methods his group has used in PNHP chapter-building efforts in New York. Nuts and bolts organizing tools, which will be useful in promoting SPAN’s efforts in the coming year, were presented. Mary Nichols-Rhodes, Summit County SPAN member and PDA Ohio’s Congressional District Organizer, held a workshop on lobbying at both the state and federal levels. All the workshops produced enthusiastic interactions and discussions by fuly engaged participants.

Deb Silverstein, founder of the Portage County SPAN chapter and an activist from the Steering Committee of Portage County’s PDA chapter, the Portage Democratic Coalition, was elected SPAN’s Region 6 Coordinator. Her thirteen-county area includes the major cities of Akron, Canton, and Youngstown.

Kurt Bateman, retired UAW worker and an effective organizer for the recent Sick Days Ohio campaign, was elected as SPAN Coordinator of Region 5, the Columbus and surrounding areas. Kurt is also part of PDA’s lobby efforts in the Columbus region.

Members of labor, healthcare workers, faith-based organizers, and community groups met after lunch in groups to discuss expanding their reach to other members of their constituency groups so that the single-payer movement will continue to strengthen and grow.

Single-payer is not off the table, regardless of Senator Baucus’s insistence that it is. Judging from the energy of those present in the Columbus Ramada that day, those seeking the best option for health care reform–HR 676–will not cease their work until a system is established that finds everyone in, and nobody out–nobody except the blood-sucking healthcare corporations, the main impediment to real reform.

Progressive Democrats of America continues to work for a single-payer system on both the national (HR676) and state levels. If you are interested in joining the movement, please contact pdaohio@gmail.com.