By Harry Kelber
Labor’s Voice for Change (31)
April 30, 2009

An AFL-CIO-sponsored on line health care survey of 26,419 respondents, more than half of them union members, reveals a widespread discontent with the cost, benefits and operating procedures of current health insurance plans. The survey, taken between Jan. 14 and March 3, shows that “ninety-four percent of the insured say the health care system needs fundamental change or to be rebuilt.”

Curiously, the survey makes no mention of the Single Payer (H.R. 676) health care system or Medicare as possible options that the respondents were never asked. Those questions were left out, says Amaya Smith, survey director, “for no particular reason.”

H.R. 676, introduced in Congress by Representative John Conyers (Dem.-Mich, has been gathering sensational support from unions across the country. It has already been endorsed by 512 union organizations in 49 states. That includes 39 AFL-CIO-affiliated State Federations and 125 Central Labor Councils. The Service Employees International Union and other Change to Win internationals have also endorsed it.

Surely, Single Payer is worth at least an occasional story on the AFL-CIO’s Web, but none has appeared. Instead, it has been totally ignored. The health care advantages that H.R, 676 has to offer have been given only limited coverage in the labor media, despite the strong record of union endorsements. Why? The short answer is that AFL-CIO President John Sweeney and his close associates are supporting a universal health care plan that would include profit-making insurance companies and HMOs.

Under H.R. 676, a single public payer would replace the many hundreds of private, for profit insurance companies, each with an expensive bureaucracy and a different set of rules, that is focused on making money for the company rather than the health of their customers. The billions that could be saved from the continuing increases in premiums, co-payments and deductibles could be used to cut costs or improve health care services.

For those who are unfamiliar with Single Payer, H.R. 676 would provide every resident in the United States with an expanded and greatly improved Medicare system. It would cover every person for all necessary medical care, including prescription drugs, hospital, surgical, outpatient services, as well as dental, substance abuse, mental and other health problems. No insurance company bureaucrat would come between you and your doctor.

Let’s Have an Open Dialogue on the AFL-CIO’s Web Site

Health care insurance, particularly for the tens of millions of people who don’t have any, is one of the most important issues worrying working families. It is a good sign that there is general agreement among our unions that our current health care system needs to be reformed. There is also consensus that some form of universal health care insurance is necessary, but which plan?

The Sweeney camp believes that Congress won’t pass a bill for universal coverage without a clear role for the powerful insurance companies. On the other hand, the Single Payer advocates say that the insurance companies are part of the problem, not the solution. Letting them participate in any eventual health care plan would retain the abuses and shortcomings that working families currently encounter in protecting their health.

It will be interesting to see how the health care issue is debated and voted upon at the AFL-CIO’s 2009 convention in Pittsburgh, less than five months away.. The odds are that there will be a general resolution of support for universal health care insurance, but it will stop short of making a specific recommendation..

Strange things have happened before at AFL-CIO conventions, where a vote called for at a critical time on a particular issue can decide the outcome of an election of officers… It will be worth watching how the health care issue is played out at this convention.

By Alex Wayne, CQ Staff
CQ TODAY ONLINE NEWS — HEALTH
April 23, 2009

A Massachusetts doctor and health policy expert told Congress on Thursday that he believes his state’s 2006 overhaul of its health system — legislation that may be a model for a national overhaul — “will fail.”

The physician, David Himmelstein, told the House Education and Labor panel’s health subcommittee that based on his experience working in the Cambridge Health Alliance, Harvard University’s hospital system, Massachusetts’ health overhaul won’t work in the long term because it is too expensive.

“I think it’s economically not viable and I see from my patients it’s not viable,” Himmelstein said after Rep. Dennis J. Kucinich, D-Ohio, asked him if he thought the overhaul would fail.

“I think it will fail,” said Himmelstein, who is an associate professor of medicine at Harvard and a well known advocate for a single-payer health system, in which the government would provide everyone health care.

His observations might be important as lawmakers in Washington move toward a Massachusetts-style overhaul of the nation’s health system. Many Democrats have expressed admiration for the Massachusetts system, in which a government agency called the Commonwealth Connector helps state residents obtain private health insurance if they can’t get it through their employers or government programs such as Medicare.

The overhaul has greatly boosted insurance coverage in Massachusetts; the state says that less than 3 percent of its residents lack insurance, and the U.S. Census says the state has the lowest rate of uninsurance in the country.

But the overhaul has also been more expensive than expected. Massachusetts legislators have been criticized for doing little, when the overhaul was written, to try to control health care costs.

State legislators predicted when the law was written that the new system would cost the state $400 million in fiscal 2008; it actually cost $628 million. Fiscal 2009 spending was forecasted to be $725 million; the budget for the system is $869 million this year, though the state expects to spend less.

Long-term cost problems in the state are even worse, according to the Urban Institute, which published a study on the Massachusetts overhaul in January. Massachusetts has some of the highest health costs in the nation, in part because its hospital, physician and insurance markets are all highly concentrated and lack serious competition, according to the Urban Institute. For those and other reasons, premiums for insurance offered through the Connector are often unaffordable if residents make too much money to qualify for subsidies, the Urban Institute says.

“The way we’re increasing coverage is by buying additional insurance from [private insurers] on top of already high costs,” Himmelstein said. “We’ve had no means of cost containment.”

Kucinich, a single-payer advocate himself, thinks Congress is too concerned about preserving a role for private insurers within the health care system.

“Our efforts in Congress should be about health care, not insurance care,” Kucinich said. “What we know, and what Dr. Himmelstein was talking about is, the insurance companies make money not providing health care.”

But a single-payer system is not supported by President Obama or many Democratic leaders. That is because previous efforts at health care overhauls, particularly former President Bill Clinton’s effort in 1993-94, failed after people with insurance became worried they would lose their coverage and be forced into a government-run system.

“As we go forward, we need be mindful of those 160 million people getting insurance from their employers and we not pull that string unless and until we’re ready to replace the paradigm,” warned Rep. John Kline, R-Minn.

Source: CQ Today Online News
Round-the-clock coverage of news from Capitol Hill.
(c) 2009 Congressional Quarterly Inc. All Rights Reserved.

By John Sammon
The Herald, Monterey County (Calif.)
April 27, 2009

National health care for all Americans is an idea whose time has come, a visiting lawmaker said Sunday at CSU- Monterey Bay.

“It’s in our face,” Rep. Jim McDermott, D-Wash., said. “We can’t avoid it. That’s why something is going to happen.”

A physician serving his 11th term in the House, McDermott has long championed health care reform and supports “single-payer” legislation guaranteeing affordable coverage to all Americans.

McDermott said the election of Barack Obama is among the most fundamental change in the effort to get all Americans health care.

“The first thing that has to happen, is that you have to have a president who will lead,” he said.

McDermott spoke to about 100 people in the CSUMB University Center at an event sponsored by the Compassionate Care Alliance.

He said 45 million Americans do not have medical insurance, while another 30 million are underinsured. But, he said, several influential groups, including doctors and unions, recognize the need for national health coverage.

“Industry also wants a national health plan,” he said. “They want to divest themselves of health costs. Health care costs are the number one cause of bankruptcies.”

McDermott predicted that drug and insurance companies will resist change.

“People never had a problem with taking care of roads and schools,” he explained. “But some of them still have the idea that when it comes to health care, it’s your private responsibility.”

An earlier attempt to institute national coverage bogged down when the Clinton administration tried to sponsor a 1,600-page plan, he said.

“The president (Obama) is saying this time, if you’ve got good coverage, if you like it, it’s OK, there won’t be any change in your system,” he said. “But the problem is, we’ve got too many people today who have no coverage at all, and they’re just crossing their fingers hoping nothing happens to them until they can find a job.”

McDermott described a dysfunctional health care system beset by soaring costs. As an example, he noted a patient who during a one-day visit, had an MRI and two CAT scans costing $11,000. The reading of a couple of X-rays generated another $1,500 charge.

“You can’t tolerate a system that operates that way,” he said.

Added to high costs is the often bewildering array of separate payment plans, resulting in a mountain of wasteful, time-consuming paperwork, McDermott said

New doctors, McDermott said, face a make-big-money-or- else quandary.

“You’ve got a medical student who comes out of college $150,000 in debt, maybe $250,000. This doctor has a family with children and says to himself, ‘I’ve got to make a lot of money.’ … You don’t go into primary care in an underserved (poor) area because it isn’t sufficient to pay off the debt.”

He said a possible solution would be to give free or low-cost tuition to medical students if they agreed to provide primary care in an underserved area for four years.

McDermott indicated that part of the problem is America’s reverence for the free-market system: It’s hard for us to visualize a national system.

He cited France as an example of an effective health care system. “The French are rated the best in the world, and we’re No. 18,” he said. “In this country, it depends on who you are and what plastic (credit card) you have. The idea of us learning from other countries is a hard concept for the U.S. We say to ourselves, ‘how could they know more.'”

Nevertheless, McDermott said single-payer national health care will be adopted here.

“There will be a campaign to support this from the grass roots. You need to place pressure on your congressman. They will react to people asking them, why don’t you do something? There’s no question people can make a real impact.”

http://www.montereyherald.com/local/ci_12236288

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.