Dear Reader,

Michael Moore’s new movie Sicko hit me hard. I found heartbreaking the unnecessary suffering our heath care system causes so many Americans. But I also felt this powerful film could change public opinion about U.S. health care the way An Inconvenient Truth changed the public view on global warming.

Real change, however, doesn’t come just from watching a film. It will happen only if a great many ordinary citizens seize the moment. Here are six suggestions for how you can stir the public dialogue and help get our lawmakers to fix the U.S. health care system.

See Sicko. No matter how you feel about Michael Moore, bring friends and encourage everyone you know to see this film. See the film in your local theater or contact Sicko producers to show it in your church, union, workplace, or community group.

Talk with others. Share your own health care experiences and ask your friends about theirs. Most of us know someone who’s had problems with the health care system. Learn about others’ experience and use those stories to push for change.

Learn the facts so you can counter arguments against changing the system. Did you know that the U.S. is the only major industrialized country without universal health care coverage? Do you know how we compare to other countries on costs and outcomes? Here are some important facts.

Choose a solution. Moore has a three-point proposal for fixing the U.S. healthcare system:

i) Provide free health care to all U.S. residents;

ii) Abolish the health insurance companies;

iii) Regulate the pharmaceuticals industry.

As an immediate step, he supports HR 676, a bill in the House of Representatives that would extend Medicare to everyone. Those are his views. What are yours? You may find helpful a chart we prepared at YES! that compares eight coverage models. We also outlined basic principles that should underlie a good health care system, and compared the U.S. with Canada. See more YES! health care articles.

Let your views be known. Tell your lawmakers in simple, heartfelt language what you think. Your voice gives your representatives cover to fight the lobbyists and do what’s right. Don’t forget your state legislators–there are many state initiatives pending. You can find state initiatives at the Physicians for a National Health Program. Write letters to your newspaper and call in to radio talk shows. Making your views public gives others courage to speak out.

Forward this email and invite friends and colleagues to discuss it with you. With elections on the horizon and discontent about the U.S. health care system running deep, we have a special window of opportunity to improve the system. You can be part of it.

Thanks for reading this. Together, we can bring the U.S. into the 21st century with a responsible and inclusive health care system.

Fran Korten
Publisher, YES! Magazine

by Leonard Rodberg & Don McCanne

Private health insurance was an idea that worked during part of the last century; it will not succeed through the 21st Century. With jobs increasingly service-based and short-term, the large employment-based risk pools that made this insurance system possible no longer exist. Medical care has become more effective and more essential to the ordinary person, but also more costly and capital-intensive. The multiple private insurance carriers that emerged during the last century can no longer provide a sound basis for financing our modern health care system.

Alone among the nations of the world, the U.S. has relied upon private insurance to cover the majority of its population. In the mid-20th Century, when medical care accounted for barely 1% of our gross national product, medical technology was limited, and jobs lasted for a lifetime, health care could be financed through such employment-based, premium-financed health insurance. But the time for private insurance has passed.

Health care has now become a major part of our national expenditures. The premium for an individual now averages more than $4,000 per year, while a good family policy averages more than $10,000 per year, comparable to the minimum wage and nearly one-fourth of the median family income. As a consequence, though the US spends far more on health care than any other nation, we leave millions of our people without any coverage at all. And those who do have coverage increasingly find that their plans are inadequate, exposing them to financial hardship and even bankruptcy when illness strikes.

If we believe that everyone should have health care coverage, and that financial barriers should not prevent us from accessing health care when we need it, then it has become clear that the private health insurance system cannot meet our needs. Health care has simply become too expensive to be financed through private insurance premiums.

Supporters of insurance companies claim that they create efficiency through competition. However, the truth is that insurance industry is increasingly concentrated, with three national firms, United Health, Wellpoint, and Aetna, dominating the industry. And the high and rising cost of health care shows that whatever competition there was in the past has not worked to hold down costs.

Supporters of private insurance also claim that it expands consumer choice. However, the choice of plans that these companies offer is not what consumers want; it is the choice of their physician and hospital, exactly the choice that private insurance plans, in the guise of managed care, increasingly deny us.

What has been the response of the health insurance industry to this situation? To protect their markets and try to make premiums affordable, they have reduced the protection afforded by insurance by shifting more of the cost to patients, especially through high-deductible plans. They have also targeted their marketing more narrowly to the healthy portion of the population, so as to avoid covering individuals with known needs for health care. Yet premiums continue to rise each year, increasing by nearly 70% above inflation in just the last six years.

The so-called “universal health care” proposals being put forward by mainstream politicians would simply expand the current system without addressing any of its problems. They would simply mandate that either our employers provide us with coverage or we, as individuals, purchase our own coverage in the private insurance market. These plans cannot work in the face of the high cost of premium-based coverage for even the average person. (Some proposals would offer the option of buying a competing public plan, under the theory that the public program would be more efficient and effective. The flaw here is that the public plan would attract those who are unable to afford private coverage or who are paying high premiums or have no insurance because of pre-existing conditions. Placing these high-cost individuals in a separate government pool would make it unaffordable for most other people. This “death spiral” would cause the public plan to fail.)

The main impetus for renewed interest in health care reform has been the rapid rise in costs over the last few years. Yet, while most of these proposals give lip service to the need to control costs, none actually addresses the problem in a serious way. (The introduction of health information technology and “disease management”, which some of them urge, are mere placebos; they may make politicians feel better, but studies have shown they will do little to reduce costs and may actually increase them.)

Everyone acknowledges that coverage for low-income individuals must be subsidized. But what about the average-income individual and family? If they must now be subsidized as well, we might as well throw in the towel and recognize that a more efficient, more equitable financing system has to be adopted if it has any chance of providing coverage while being affordable to the society. An individual mandate to purchase private insurance cannot provide good coverage while remaining affordable, while employer-provided coverage also can no longer be sustained as the premium costs to the employer become increasingly unaffordable.

The private insurance industry spends about 20 percent of its revenue on administration, marketing, and profits. Further, this industry imposes on physicians and hospitals an administrative burden in billing and insurance-related functions that consumes another 12 percent of insurance premiums. Thus, about one-third of private insurance premiums are absorbed in administrative services that could be drastically reduced if we were to finance health care through a single non-profit or public fund. Indeed, studies have shown that replacing the multiplicity of public and private payers with a single national health insurance program would eliminate $350 billion in wasteful expenditures, enough to pay for the care that the uninsured and the underinsured are not currently receiving.

Such a single payer plan would make possible a set of mechanisms, including public budgeting and investment planning, that would allow us to address the real sources of cost increases and allow us to rationalize our health care investments. The drivers of high cost such as administrative waste, deterioration of our primary care infrastructure, excessive prices, and use of non-beneficial or detrimental high-tech services and products could all be addressed within such a rationalized system.

In sum, we will not be able to control health care costs until we reform our method of financing health care. We simply have to give up the fantasy that the private insurance industry can provide us with comprehensive coverage when this requires premiums that average-income individuals cannot afford. Instead, the U.S. already has a successful program that covers more than forty million people, gives free choice of doctors and hospitals, and has only three percent administrative expense. It is Medicare, and an expanded and improved Medicare for All (Medicare 2.0) program would cover everyone comprehensively within our current expenditures and eliminate the need for private insurance. This is the direction we must go.

Leonard Rodberg is Research Director of the New York Metro Chapter, and Don McCanne, Senior Policy Fellow, of Physicians for a National Health Program. www.pnhp.org

By PAUL KRUGMAN
New York Times
Published: July 16, 2007

Being without health insurance is no big deal. Just ask President Bush. “I mean, people have access to health care in America,” he said last week. “After all, you just go to an emergency room.”
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This is what you might call callousness with consequences. The White House has announced that Mr. Bush will veto a bipartisan plan that would extend health insurance, and with it such essentials as regular checkups and preventive medical care, to an estimated 4.1 million currently uninsured children. After all, it’s not as if those kids really need insurance — they can just go to emergency rooms, right?

O.K., it’s not news that Mr. Bush has no empathy for people less fortunate than himself. But his willful ignorance here is part of a larger picture: by and large, opponents of universal health care paint a glowing portrait of the American system that bears as little resemblance to reality as the scare stories they tell about health care in France, Britain, and Canada.

The claim that the uninsured can get all the care they need in emergency rooms is just the beginning. Beyond that is the myth that Americans who are lucky enough to have insurance never face long waits for medical care.

Actually, the persistence of that myth puzzles me. I can understand how people like Mr. Bush or Fred Thompson, who declared recently that “the poorest Americans are getting far better service” than Canadians or the British, can wave away the desperation of uninsured Americans, who are often poor and voiceless. But how can they get away with pretending that insured Americans always get prompt care, when most of us can testify otherwise?

A recent article in Business Week put it bluntly: “In reality, both data and anecdotes show that the American people are already waiting as long or longer than patients living with universal health-care systems.”

A cross-national survey conducted by the Commonwealth Fund found that America ranks near the bottom among advanced countries in terms of how hard it is to get medical attention on short notice (although Canada was slightly worse), and that America is the worst place in the advanced world if you need care after hours or on a weekend.

We look better when it comes to seeing a specialist or receiving elective surgery. But Germany outperforms us even on those measures — and I suspect that France, which wasn’t included in the study, matches Germany’s performance.

Besides, not all medical delays are created equal. In Canada and Britain, delays are caused by doctors trying to devote limited medical resources to the most urgent cases. In the United States, they’re often caused by insurance companies trying to save money.

This can lead to ordeals like the one recently described by Mark Kleiman, a professor at U.C.L.A., who nearly died of cancer because his insurer kept delaying approval for a necessary biopsy. “It was only later,” writes Mr. Kleiman on his blog, “that I discovered why the insurance company was stalling; I had an option, which I didn’t know I had, to avoid all the approvals by going to ‘Tier II,’ which would have meant higher co-payments.”

He adds, “I don’t know how many people my insurance company waited to death that year, but I’m certain the number wasn’t zero.”

To be fair, Mr. Kleiman is only surmising that his insurance company risked his life in an attempt to get him to pay more of his treatment costs. But there’s no question that some Americans who seemingly have good insurance nonetheless die because insurers are trying to hold down their “medical losses” — the industry term for actually having to pay for care.

On the other hand, it’s true that Americans get hip replacements faster than Canadians. But there’s a funny thing about that example, which is used constantly as an argument for the superiority of private health insurance over a government-run system: the large majority of hip replacements in the United States are paid for by, um, Medicare.

That’s right: the hip-replacement gap is actually a comparison of two government health insurance systems. American Medicare has shorter waits than Canadian Medicare (yes, that’s what they call their system) because it has more lavish funding — end of story. The alleged virtues of private insurance have nothing to do with it.

The bottom line is that the opponents of universal health care appear to have run out of honest arguments. All they have left are fantasies: horror fiction about health care in other countries, and fairy tales about health care here in America.

Shifting to public funding of campaigns could be a big first step toward health care coverage for everyone.

By Jack E. Lohman
COMMENTARY | July 16, 2007
jlohman@execpc.com

Health care is looming as a major issue in the 2008 elections, but a root cause of soaring health care costs is being ignored both by the public and the press, at least until now. I’m referring to a very conflicted system of political campaign financing.

Think about it. Had the insurance industry not been a major contributor, we’d have fixed our health care system years ago. Its biggest single problem is the huge portion of total health care costs — about 31 percent, according to a group called Physicians for a National Health Program and others — that are consumed by the insurance and billing bureaucracy without ever providing direct patient care. Costs for marketing, broker sales commissions, actuarial costs, gatekeepers, high executive salaries, increasing shareholder profits, even the high costs of their lobbying and campaign contributions are passed on to the patient (and in most cases employers, who have been taking their jobs offshore to avoid the costs).

Eliminate that waste and we could expand health care coverage to 100 percent of our people for the same dollars we spend to cover just 85 percent today.

But that means eliminating the very profitable yet wasteful insurance component, and the insurance industry will have nothing of that. So its executives are sending big cash dollars to the very state and federal politicians that can block or approve progress. They are bribing my representatives and yours to guard their own profits.

The media must not allow this process to go unchecked. When there is a political fight, it’s usually because money is involved on one side or the other. And when it affects the public, that side generally has a lot of citizen volunteers with little cash fighting a goliath industry with lots of cash going to the politicians that pass the laws. The public’s only equalizer is the press, and it too often ignores the driving force: money.

Politicians get offended when they hear charges of corruption. They seem to think they can continue representing “us” while receiving money from “them.” Robert Kennedy, Jr., calls it political treason, and he’s not far off base.

As a former CEO, had I allowed my employees to accept money from vendors while giving away company assets, my company would have crashed and my employees put out of jobs. So how can our state and nation survive under this same kind of corruption?

It can’t, and it is only a matter of time before Americans begin migrating to other countries to escape it. We are in a slow-motion spiral downward. Jobs are being outsourced daily and Americans will eventually follow them. We cannot survive as a consumer-only nation.

Health care is just one of many issues that are robbing our population of its resources. Whatever your issue — energy, environment, high taxes or whatever — follow the money and you’ll find politicians at the other end with their hands out, all while claiming a purity we could only hope for.

The only reasonable solution is to have the electoral system financed by the people the politicians should be beholden to, the taxpayers. Private interests are currently funding our public electoral system, the last place you would expect privatization and the free market to exist.

Full public funding of political campaigns, like the system promoted by Public Campaign and Wisconsin Clean Elections Coalition, would cost $10 per taxpayer per year at the federal level and would eliminate the $300 billion per year the Feds give away to the special interests that currently fund the elections. Subsidies, tax breaks, no bid contracts and local pork are all on the long list of government handouts. If we paid a hundred times the $10 per taxpayer, it would be a bargain.

For the system to be constitutional it must be optional, thus politicians can opt in or opt out of the public system. Those opting in would receive a sufficient amount of money to run a credible campaign. Those opting for private cash should be allowed to prostitute themselves to the fullest extent possible; but with full disclosure of their money source.

Then let the voters decide whom they want representing them. In the states that have adopted this system, Arizona and Maine, the voters have selected the public candidate for over 65 percent of their elected seats.

The Democrats have promised reform, but it apparently is not high on their list. They must now deliver. And if they don’t it is up to the voters to oust those in 2008 who fail to fix the system. And that includes the candidates in both parties who oppose reform. We must give our democracy back to the people.

Jack Lohman, a free-lance writer, is a retired business owner in Wisconsin with 35 years in the health care industry.

By Susanne L. King
Berkshire Eagle
Friday, July 13

A MAN sews up the gaping wound in his own leg because he has no health insurance. Another decides whether to save his ring finger for $12,000, or his middle finger for $60,000, since he can’t afford reconstructive surgery for both fingers.

So begins “Sicko,” Michael Moore’s new documentary on the failures and travesties of the United States’ health care system, which leaves almost 50 million people uninsured and many more underinsured.

These stories are only two of the 25,000 that Moore received when he sent an e-mail request for reports from patients who have experienced difficulties with the health care system. With these stories of shattered lives, Moore masterfully weaves a powerful narrative that is an indictment of our health care system. He shows us people who suffer unnecessary pain, chaos, indignity and death because of their lack of access to health care.

Moore details the failures of our system by focusing on working adults who can’t get insurance because of pre-existing conditions, who have insurance but can’t afford their co-payments and deductibles, or who have been denied coverage by their insurance companies when they develop a health problem.

The people around me cried as we watched a middle-aged couple move into a small room in their daughter’s house after declaring medical bankruptcy. The husband had survived three heart attacks and his wife had developed cancer. Even though both had been gainfully employed and had insurance, they went bankrupt in their retirement years because of “cost-sharing,” the term insurance companies use for sticking patients with high deductibles and co-payments.

By showing how having insurance does not guarantee access to health care in America, Moore highlights the underhanded practices of insurance companies. A devastated mother describes her child’s death, which occurred because the family’s managed care insurance company would not pay for treatment at the closest hospital emergency department.

A former medical reviewer, Dr. Linda Peeno, cries as she testifies in a government hearing about the practices she implemented to deny care to patients insured by Humana before she quit her job in protest. .

Moore not only details the problems of our current health care system, he also shows us the solution. He supports a national health care plan, similar to that of every other industrialized country in the world. He goes to Canada, Great Britain, France, and, yes, to Cuba, to highlight the benefits of a single-payer plan funded and administered by the government.

He also debunks the myths and distortions about a national health plan, which are promulgated by the insurance companies, including the specter of “waiting lines,” and the bogeyman of “socialized medicine.” As he points out, we have “socialized” education, “socialized” police and fire departments, and a “socialized” postal service.

The truth is that a national health plan would not be “socialized medicine,” as doctors and hospitals that are now private would remain so. The change would be in the administration of the health care funds. Rather than a system with multiple insurance companies that drains health care coffers of 31 percent of the health care dollars, the government would be the “single payer” and administer the funds. (The administrative costs for Medicare are 3.6 percent, and Canadian costs are 1.3 percent). A similar system in the United States would save $300 billion annually.

In addition, patients would be able to choose their own doctors and hospitals, without intrusion into their health care decisions by faceless bureaucrats.

Moore raises the moral issue of denying patients access to health care in our country. A wonderful moment in the film occurs when he talks with a conservative party member in Canada who strongly supports his national health care system. The Canadian conservative believes that society should support equal access to health care for each person, regardless of means, even though that might affect his own pocketbook. This is not a partisan movie: This documentary is about social values and the right of everyone to have adequate and affordable health care.

While there is humor in this movie, the stories elicit raw emotions of sadness and rage. Unlike his previous movies, Moore is not confrontational; he just lets people tell their gripping stories. “Sicko” will help you better understand the problems of our health care system, and it makes a strong case for a national health plan as the obvious solution.

See this movie, and then call your legislators and ask them to sponsor the current national health care legislation in Congress, H. R. 676.

By Susanne L. King
Berkshire Eagle
Friday, July 13

A MAN sews up the gaping wound in his own leg because he has no health insurance. Another decides whether to save his ring finger for $12,000, or his middle finger for $60,000, since he can’t afford reconstructive surgery for both fingers.

So begins “Sicko,” Michael Moore’s new documentary on the failures and travesties of the United States’ health care system, which leaves almost 50 million people uninsured and many more underinsured.

These stories are only two of the 25,000 that Moore received when he sent an e-mail request for reports from patients who have experienced difficulties with the health care system. With these stories of shattered lives, Moore masterfully weaves a powerful narrative that is an indictment of our health care system. He shows us people who suffer unnecessary pain, chaos, indignity and death because of their lack of access to health care.

Moore details the failures of our system by focusing on working adults who can’t get insurance because of pre-existing conditions, who have insurance but can’t afford their co-payments and deductibles, or who have been denied coverage by their insurance companies when they develop a health problem.

The people around me cried as we watched a middle-aged couple move into a small room in their daughter’s house after declaring medical bankruptcy. The husband had survived three heart attacks and his wife had developed cancer. Even though both had been gainfully employed and had insurance, they went bankrupt in their retirement years because of “cost-sharing,” the term insurance companies use for sticking patients with high deductibles and co-payments.

By showing how having insurance does not guarantee access to health care in America, Moore highlights the underhanded practices of insurance companies. A devastated mother describes her child’s death, which occurred because the family’s managed care insurance company would not pay for treatment at the closest hospital emergency department.

A former medical reviewer, Dr. Linda Peeno, cries as she testifies in a government hearing about the practices she implemented to deny care to patients insured by Humana before she quit her job in protest. .

Moore not only details the problems of our current health care system, he also shows us the solution. He supports a national health care plan, similar to that of every other industrialized country in the world. He goes to Canada, Great Britain, France, and, yes, to Cuba, to highlight the benefits of a single-payer plan funded and administered by the government.

He also debunks the myths and distortions about a national health plan, which are promulgated by the insurance companies, including the specter of “waiting lines,” and the bogeyman of “socialized medicine.” As he points out, we have “socialized” education, “socialized” police and fire departments, and a “socialized” postal service.

The truth is that a national health plan would not be “socialized medicine,” as doctors and hospitals that are now private would remain so. The change would be in the administration of the health care funds. Rather than a system with multiple insurance companies that drains health care coffers of 31 percent of the health care dollars, the government would be the “single payer” and administer the funds. (The administrative costs for Medicare are 3.6 percent, and Canadian costs are 1.3 percent). A similar system in the United States would save $300 billion annually.

In addition, patients would be able to choose their own doctors and hospitals, without intrusion into their health care decisions by faceless bureaucrats.

Moore raises the moral issue of denying patients access to health care in our country. A wonderful moment in the film occurs when he talks with a conservative party member in Canada who strongly supports his national health care system. The Canadian conservative believes that society should support equal access to health care for each person, regardless of means, even though that might affect his own pocketbook. This is not a partisan movie: This documentary is about social values and the right of everyone to have adequate and affordable health care.

While there is humor in this movie, the stories elicit raw emotions of sadness and rage. Unlike his previous movies, Moore is not confrontational; he just lets people tell their gripping stories. “Sicko” will help you better understand the problems of our health care system, and it makes a strong case for a national health plan as the obvious solution.

See this movie, and then call your legislators and ask them to sponsor the current national health care legislation in Congress, H. R. 676.