PNHP

Speakers Bureau – Northeast

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Speakers Bureau – Northeast

To request a PNHP speaker, please contact us at info@pnhp.org or (312) 782-6006.

Philip Caper, MD, MS – internal medicine, Portland, ME

Dr. Phil Caper received his BA, MS and MD degrees at UCLA, and trained in internal medicine on the Harvard Medical Unit at Boston City Hospital. He has held professorships at Dartmouth Medical School and the University of Massachusetts Medical School, where he was also Vice-Chancellor for Health Affairs, chief of the medical staff, and hospital director. He has been an adjunct lecturer on health policy and management at the Harvard School of Public Health, a research associate at Harvard’s Kennedy School of Government and an associate in health policy and management at the Johns Hopkins School of Public Health. From 1971 to 1976, he was a professional staff member on the United States Senate Labor and Human Resources subcommittee on health, chaired by Senator Edward Kennedy (D-Mass.).

Dr. Caper was a charter member of the nation’s top health care advisory panel, the National Council on Health Planning and Development from 1977 to 1984, chairing the panel from 1980 to 1984. He was also founder and chairman of the Codman Group from 1986 to 2001, a health care software and consulting company with an international reputation and clientele. He is a founding member of the National Academy of Social Insurance and is a founding board member of Maine AllCare, the Maine chapter of Physicians for a National Health Program. He also serves on PNHP’s national board of directors. He has published numerous articles in professional journals and written many letters to the editor and op-ed articles advocating for a publicly run universal health care program.

Andrew D. Coates, MD, FACP – internal medicine, Albany, N.Y.

Dr. Andy Coates is a past president of Physicians for a National Health Program, chief of hospital medicine at Samaritan Hospital in Troy, New York, and an assistant professor of medicine and psychiatry at Albany Medical College. Board certified in internal medicine as well as hospice and palliative care medicine, Dr. Coates graduated from the Columbia University College of Physicians and Surgeons.

Dr. Coates is a co-founder of the Capital District chapter of PNHP and founder of Single Payer New York. He previously served on the statewide executive board of the Public Employees Federation, AFL-CIO. He provides commentary on WAMC Northeast Public Radio.

Sherif Emil, MD,CM, FRCSC, FACS, FAAP – pediatric surgery, Montreal

Dr. Sherif Emil is director of the division of pediatric general and thoracic surgery at the Montreal Children’s Hospital, associate chair for education and departmental citizenship in the Department of Pediatric Surgery, and professor of pediatric surgery, surgery, and pediatrics at McGill University. He also co-directs Canada’s first multidisciplinary Chest Wall Anomalies Clinic at the Shriners Hospital for Children.

Dr. Emil received his medical degree from McGill University and completed a residency in general surgery at Loma Linda University. During his residency he spent two years in laboratory research at Children’s Hospital Los Angeles. Following residency, he lectured at Loma Linda and completed a fellowship in pediatric surgery at McGill. Dr. Emil returned to California to join the surgical faculty at the University of California, Irvine, serving as chief of pediatric surgery until his move to Montreal Children’s.

Dr. Emil has published more than 90 manuscripts and several book chapters on many topics in pediatric surgery. He also has a passion for teaching and has been honored with several teaching awards. His article, “The Quest for Significance,” based on his 2010 School of Medicine commencement address at UC Irvine, was published in the Bulletin of the American College of Surgeons and gained wide traction within the surgical community.

Dr. Emil is active in numerous professional organizations and has served as program chair for the surgical section of the American Academy of Pediatrics and chair of the workforce committee of the Canadian Association of Pediatric Surgeons. His many accomplishments led to his selection as one of America’s Best Doctors in 2007 and one of Canada’s Best Doctors for the years 2009 to 2014. Dr. Emil also serves on the board of Mercy Ships Canada. In 2012, he was awarded the Queen Elizabeth II Diamond Jubilee Medal by the Governor General of Canada for his service to children around the world and his academic accomplishments in pediatric surgery.

Oliver T. Fein, MD, FACP – internal medicine, New York City

Dr. Oliver Fein is professor of clinical medicine and clinical public health at Weill Cornell Medical College, where he serves as associate dean responsible for the Office of Affiliations and the Office of Global Health Education. He is a general internist and active in clinical practice.

Dr. Fein is a past president of Physicians for a National Health Program and chair of the New York Metro Chapter of PNHP. He is a past vice president of the American Public Health Association, where he served four years on the executive board.

Much of Dr. Fein’s work has focused on health system delivery reform and access to care for vulnerable populations. His recent writings include a chapter (with Joanne Landy) on the feasibility of fundamental health reform in the new book “10 Excellent Reasons for National Health Care”; an article on ethical issues and global health in Academic Medicine; an editorial in Medical Care; and an article on U.S. health care reform and the presidential candidates in the Journal of Health Services Research and Policy. He has also published opinion pieces in the Philadelphia Inquirer and the Atlanta Journal-Constitution.

Dr. Fein received his medical degree from Western Reserve University in 1967 and completed his internship at Cleveland Metropolitan General Hospital and his residency at Lincoln Hospital in the Bronx. In 1977 he became director of general medicine outpatient services at the Columbia Presbyterian Medical Center and subsequently acting-director of the division of general medicine at the College of Physicians and Surgeons of Columbia University. He was a Robert Wood Johnson health policy fellow in 1993-1994, where he worked as a legislative assistant for the Senate Democratic Majority Leader, George Mitchell.

Dr. Fein received the Elnora M. Rhodes Service award from the Society of General Internal Medicine in 1999; the Haven Emerson Award from the Public Health Association of New York City in 2001; and the Lifetime Achievement Award from the Robert Wood Johnson Health Policy Fellowships Program in 2008.

Margaret Flowers, MD – pediatrics, Baltimore

Dr. Margaret Flowers is a pediatrician and currently serves as a national board adviser for Physicians for a National Health Program.

Dr. Flowers, a mother of three teens, graduated cum laude and AOA from the University of Maryland School of Medicine and completed residency training in pediatrics at Johns Hopkins Hospital.

She was director of the pediatric hospitalist program and chief of pediatrics at Carroll County General Hospital, a rural hospital in Maryland. While at CCGH, she oversaw the opening of a level II nursery. She has taught Pediatric Advanced Life Support for the Johns Hopkins H.O.P.E. program and served on the Fetus and Newborn Committee of the Maryland chapter of the American Academy of Pediatrics. Subsequently, she practiced primary pediatrics in a small community practice and then at an all-girl boarding high school.

Dr. Flowers left practice in May 2007 to work on health care reform full-time. In November 2008 she joined the steering committee of the Leadership Conference for Guaranteed Health Care. Dr. Flowers is a national board member of Healthcare Now, a national nonprofit organization dedicated to popularizing the single-payer perspective.

After multiple meetings with and requests to members of Congress to include single payer in the health care debate were unsuccessful, she joined seven other physicians and advocates in an action in the Senate Finance Committee in May 2009 and was arrested. She testified before the Senate Health, Education, Labor and Pensions Committee in June 2009.

Adam Gaffney, M.D.Adam Gaffney, MD – pulmonary and critical care medicine, Boston

Dr. Adam Gaffney is a national board member of Physicians for a National Health Program, chair of the Massachusetts chapter of PNHP, and a co-chair of the Working Group on Single-Payer Program Design, which developed the “Physicians’ Proposal for Single-Payer Health Care Reform,” recently published at the American Journal of Public Health. Dr. Gaffney is a prolific writer and blogger on health policy and also frequently appears on radio.

Dr. Gaffney is a pulmonary specialist at Cambridge Health Alliance / Harvard Medical School. He received his medical degree from the New York University School of Medicine and completed residency training at Columbia University Medical Center. He recently completed a clinical and research fellowship in pulmonary and critical care medicine at Massachusetts General Hospital.

David U. Himmelstein, MD, FACP – internal medicine, New York/Boston

Dr. David Himmelstein is a distinguished professor of public health and health policy in the CUNY School of Public Health at Hunter College, adjunct clinical professor at Albert Einstein College of Medicine, and lecturer in medicine at Harvard Medical School. He has served as chief of the division of social and community medicine at Cambridge Hospital.

Dr. Himmelstein has authored or co-authored more than 100 journal articles and three books, including widely cited studies of medical bankruptcy and the high administrative costs of the U.S. health care system. His 1984 study of patient dumping led to the enactment of EMTALA, the law that banned that practice.

A co-founder of Physicians for a National Health Program, Dr. Himmelstein co-edits PNHP’s newsletter and is a principal author of PNHP articles published in the JAMA and the New England Journal of Medicine in conjunction with Dr. Steffie Woolhandler. A sample of Dr. Himmelstein’s grand rounds at the University of Southern California Keek School of Medicine is available here.

Dr. Himmelstein received his medical degree from Columbia University and completed internal medicine training at Highland Hospital/University of California San Francisco and a fellowship in general internal medicine at Harvard.

Donald E. Moore, M.D., M.P.H.Donald E. Moore, MD, MPH – general medicine, New York City

Dr. Donald Moore runs a full-time general medicine practice in Brooklyn and has distinguished himself through service to his community and his profession. He is also an attending physician at New York Methodist Hospital and teaches medicine students at Weill Cornell Medical College and nurse practitioner students at NYU and Hunter College. He is a board member of the New York Metro chapter of Physicians for a National Health Program.

Dr. Moore has served as president of the Association of Yale Alumni in Medicine (AYAM) and president of the Medical Society of the County of Kings. He had received numerous awards including the Distinguished Alumni Service Award from AYAM and awards for teaching excellence from Weill Cornell. He has been recognized for his humanitarian efforts in health care delivery by the New York State Senate and U.S. Congress.

Mary E. O’Brien, MD – primary care, New York City

Dr. Mary O’Brien has been a practicing primary care physician in New York City for the past 35 years – first as associate director of an urban emergency department for 10 years and now as a primary care physician at Columbia. She is double-boarded in internal medicine and emergency medicine. For several summers she has volunteered at a rural clinic in the Mississippi while the medical director takes vacation time. She currently precepts fourth-year medical students at Columbia in their primary care rotation. A member of the board of directors of Physicians for a National Health Program, Dr. O’Brien is also a member of the New York Metro chapter’s executive committee.

Deborah Richter, MD – family medicine, Montpelier, Vt.

Dr. Deb Richter is a family practitioner in Montpelier, Vt. A former president of Physicians for a National Health Program, she is currently involved with Vermont Health Care for All and is an outspoken advocate and coalition-builder for universal access to health care.

Dr. Richter frequently appears in print and on television and radio to advocate for single-payer issues. Her years of experience caring for the uninsured and extensive knowledge of the Canadian health system make her an outstanding spokesperson, being described as “a force of nature” for her tremendous energy and organizing ability.

Elizabeth R. Rosenthal, M.D.Elizabeth R. Rosenthal, MD – dermatology, New York

Dr. Elizabeth Rosenthal is a retired dermatologist residing in Westchester County, where she practiced for 31 years. She continues to serve on the volunteer faculty of Albert Einstein College of Medicine, where she supervises residents and students in the pediatric dermatology clinic. Dr. Rosenthal comes from a family of doctors and graduated from NYU Medical School. She completed her postgraduate training in Syracuse, Detroit, and Boston. Dr. Rosenthal is a member of the executive committee of the New York Metro chapter of Physicians for a National Health Program.

Gordon Schiff, MD – internal medicine, Boston

Dr. Gordy Schiff is associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital in Boston and associate professor of medicine at Harvard Medical School. He is a founding member and past president of Physicians for a National Health Program, and he is author of PNHP’s JAMA paper on quality health care reform. He was previously professor of medicine at Rush University and a senior attending physician at Cook County Hospital, where he worked for more than 30 years as director of clinical quality research and improvement for the Department of Medicine.

Dr. Schiff is currently the clinical and research director of a 3-year AHRQ-funded Massachusetts statewide malpractice and patient safety improvement initiative. He is a member of the editorial boards of Medical Care and the Journal of Public Health Policy, and author of numerous articles on patient safety, diagnosis error, and medication quality improvement. He is past chair of the medical care section of the American Public Health Association (APHA), recipient of the 2005 Institute of Medicine Chicago (IOMC) Patient Safety Leader of the Year award, and the Institute for Safe Medical Practices (ISMP) 2006 Lifetime Achievement award. In 2006 he was selected by Modern Healthcare as one of the “30 People for the Future”—national leaders most “likely to continue to shape health care in the years and decades ahead,” and the 2010 Rx for Excellence in Quality Award from the Massachusetts Medical Law Report.

Diljeet K. Singh, MD, DrPH – gynecologic oncology, Washington, DC.

Dr. Diljeet Singh is a gynecologic oncologist with the Mid-Atlantic Permanante Medical Group in Washington, DC. She recently relocated from Phoenix, AZ, where she was the program director of gynecologic oncology and the program director of Cancer Prevention and Integrative Medicine at the Banner MD Anderson Cancer Center in Gilbert, Arizona.

Dr. Singh received her medical degree from Northwestern University and master’s degree from the Harvard School of Public Health. She completed an obstetrics and gynecology residency at the Johns Hopkins and a gynecologic oncology fellowship at the MD Anderson Cancer Center. She completed her doctoral degree in public health on cost analysis at the University of Texas School of Public Health and an associate fellowship in integrative medicine at the University of Arizona. She is a national board member of Physicians for a National Health Program.

Peter Steinglass, MD, DLFAPA, FAAAP – psychiatry, New York City

Dr. Peter Steinglass is president emeritus and director of the Ackerman Center for Substance Abuse and the Family. A graduate of Harvard Medical School, he is clinical professor of psychiatry at the Weill Medical College of Cornell University. He is also a member of the Physicians for a National Health Program New York Metro chapter’s board of directors.

Dr. Steinglass has received many honors for his work in academic psychiatry as well as for his clinical and research collaborations with medical and mental health institutions, including the American Association for Marriage and Family Therapy’s Cumulative Contribution to Family Therapy Research Award, and the Distinguished Contribution to Family Therapy Research Award from the American Family Therapy Academy. He is also a Distinguished Life Fellow of the American Psychiatric Association and a Fellow of the American Academy for Addiction Psychiatry.

Most recently, Dr. Steinglass was the recipient of the 2009 Mona Mansell Award from New York’s Freedom Institute, signifying his contributions to the substance abuse treatment field. His research on alcoholism and on chronic medical illness as they affect family life has provided vital information for the clinical community. Dr. Steinglass has written more than 90 articles, book chapters and books on these subjects.

Walter H. Tsou, MD, MPH – internal medicine/public health, Philadelphia

Dr. Walter Tsou is a past president of the American Public Health Association and former health commissioner of Philadelphia. He is a founding member of the National Board of Public Health Examiners and a board adviser to Physicians for a National Health Program. An expert on health reform and health care financing, he frequently briefs members of Congress on health care issues.

Dr. Tsou is a contributing editor of Physician’s News Digest and Pennsylvania Medicine. He is the recipient of numerous awards, including the Public Health Recognition Award from the College of Physicians of Philadelphia, the Leadership Award from the Delaware Valley Healthcare Council, and the Broad Street Pump Award from Physicians for Social Responsibility. He was named Practitioner of the Year by the Philadelphia County Medical Society in 2001.

Dr. Tsou received his medical degree from the University of Pennsylvania and his master’s degree from the Johns Hopkins School of Hygiene and Public Health. He holds an honorary doctorate in medical sciences from Drexel University.

Steffie Woolhandler, MD, MPH, FACP – internal medicine, New York/Boston

Dr. Steffie Woolhandler is a practicing primary care physician, distinguished professor of public health and health policy in the CUNY School of Public Health at Hunter College, adjunct clinical professor at Albert Einstein College of Medicine, and lecturer in medicine at Harvard Medical School, where she co-directed the general internal medicine fellowship program and practiced primary care internal medicine at Cambridge Hospital.

Dr. Woolhandler earned her bachelor’s degree from Stanford University; her medical degree from Louisiana State University; and her master’s degree from the University of California. She worked in 1990-1991 as a Robert Wood Johnson Foundation health policy fellow at the Institute of Medicine and the U.S. Congress.

Dr. Woolhandler is a frequent speaker and has written extensively on health policy, administrative overhead and the uninsured. She has authored more than 150 journal articles, reviews, chapters, and books on health policy. A sample of Dr. Woolhandler’s grand rounds at the University of Southern California Keek School of Medicine is available here.

A co-founder and board member of Physicians for a National Health Program, Dr. Woolhandler co-edits PNHP’s newsletter and is a principal author of PNHP articles published in the JAMA and the New England Journal of Medicine in conjunction with Dr. David Himmelstein.

Robert L. Zarr, MD, MPH, FAAP – pediatrics, Washington, D.C.

Dr. Robert Zarr is a board-certified pediatrician at Unity Health Care in Washington, DC, where he cares for a low-income and immigrant population. He is the immediate past president of Physicians for a National Health Program.

Dr. Zarr is a past president of the DC Chapter of the American Academy of Pediatrics, and he holds adjunct professorships at Children’s National Medical Center and George Washington University. He also co-directs the Washington, DC chapter of PNHP. He is “physician champion” of DC Park Rx, a community health initiative to prescribe nature to patients and families and encourage time in one of 350 parks and green spaces in Washington, DC.

Dr. Zarr is fluent and literate in Spanish and has worked in the U.S. and abroad with Spanish-speaking populations. He is active in Washington, DC, in a variety of quality improvement initiatives including asthma management, injury prevention, literacy promotion, breastfeeding awareness, youth advocacy, tuberculosis prevention, and compliance with early and periodic screening, diagnostic and treatment standards.

Dr. Zarr received his medical degree from Baylor College of Medicine and completed his pediatric residency at Texas Children’s Hospital in Houston. He also has a master’s degree in public health, specializing in international health, from the University of Texas School of Public Health.

EHealth moves in for the kill

EHealth Wins Approval to Sell Obamacare Health Plans

By Alex Wayne
Bloomberg, July 31, 2013

Online health insurance broker EHealth Inc. (EHTH) won permission from the U.S. government to enroll customers for subsidized plans offered under the federal health-care law.

EHealth will be able to tap into a government computer system allowing the company to determine whether people shopping for plans at its website are eligible for tax subsidies for their health insurance, the Mountain View, California company said today in a statement. The information will enable EHealth to offer customers subsidized plans available in their state.

The company has been lobbying the federal government for the agreement (for 36 states not electing to establish their own exchanges), as well as urging similar permission from 14 states that are building their own marketplaces called exchanges to sell insurance to people who don’t get it at work.

It won’t cost the government or customers anything extra when people enroll through EHealth, (Chief Executive Officer Gary) Lauer said in a May 14 conference call with reporters. The company will instead collect a commission from insurance companies such as UnitedHealth Group Inc. (UNH) when it enrolls people in their plans.

EHealth collects about 7 percent of monthly premiums as commission for the plans it sells now, Lauer said. Carriers will probably negotiate a lower commission for plans sold in government exchanges because “the risk is a little bit more unknown,” he said.

EHealth shares gained 28 percent to $30.74 at the close in New York, the biggest single-day increase since October 2006.

http://www.bloomberg.com/news/2013-07-31/ehealth-wins-agreement-to-sell-obamacare-health-insurance-plans.html

Comment:

By Don McCanne, M.D.

Today’s comment is a repeat of the Quote of the Day comment from November 9, 2009. It is more evidence that we have been trying to warn the nation about the intolerable flaws in the Affordable Care Act and that there is a far better alternative, but the people who can do something about it are not listening.

eHealth is ready to connect America
Quote of the Day, November 9, 2009

eHealth is ready to become the nation’s broker for private health insurance.

This is yet one more reason why the model of reform selected by Congress and the Obama administration is the most expensive of all. With all of the other wasteful administrative expenses, brokers’ fees are added on top, though often hidden in the premium as a commission rather than a fee.

Compare this to Medicare enrollment. The administrative costs for automatic enrollment in Medicare, at that only once in a lifetime, are negligible for the government and its taxpayers.

Imagine the simplicity and efficiency of automatic, lifetime Medicare enrollment at birth for everyone. But Congress won’t go there… not until the nation demands it.

https://pnhp.org/news/2009/november/ehealth-is-ready-to-connect-america

Study: Single-payer healthcare system would save billions

By Lara Seligman
The Hill, Healthwatch blog, July 31, 2013

Expanding the nation’s Medicare program to cover people of all ages would save the government billions of dollars, according to a new study released Wednesday.

The study found that a single-payer health care system based on the principles of legislation by Rep. John Conyers, Jr. (D-Mich.), the Expanded and Improved Medicare for All Act, would save the federal government about $592 billion in one year.

That’s more than enough to pay for comprehensive benefits for all Americans at a lower cost to the public, according to Physicians for a National Health Program, which circulated the study. The extra money would go to paying down the national debt.

The savings would come from slashing administrative waste and negotiating drug prices.

The study was conducted by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst.

“Paradoxically, by expanding Medicare to everyone we’d end up saving billions of dollars annually,” Friedman said. “We’d be safeguarding Medicare’s fiscal integrity while enhancing the nation’s health for the long term.”

The study comes as Republicans in Congress are pulling out all the stops to repeal President Obama’s health care overhaul. Tea Party Republicans have in recent weeks vowed to oppose any measures to keep the government running after the current funding bill runs out on Sept. 30 if it also means funding ObamaCare.

Republicans have generally opposed the idea of a single-payer health care system in the past.

http://thehill.com/blogs/healthwatch/medicare/314839-study-single-payer-health-care-system-would-save-billions

Demonstrators call for single-payer health care, Medicare for all

By Bill Lambdin
NewsChannel 13, wynt.com (Albany, N.Y.), July 31, 2013

ALBANY, N.Y. – Just today third year medical student Janice Lee told the crowd, she observed a case where doctors were debating not what care would work, but what treatment the uninsured patient could receive.

“We were talking about whether or not he should receive an operation because he would not be able to obtain the necessary post operative care and also the rehabilitation that he needs,” said Lee. “I feel like this is a real shame.”

Advocates argue treatment would be much more often based on medical need, not the quality of insurance available, if the Medicare system that now covers most medical expenses for people 65 and over was extended to everyone.

“It’s a right and we need to fight for it and we need to say that we’re paying for it already, we’re just doing it in ways that are unfair and that create pain and suffering in our families and it has to stop,” Albany City Treasurer and candidate for mayor Kathy Sheehan said.

In all the debate that continues to rage over implementing or repealing Obamacare, whether it will save money or drive up costs, only a few individuals like the demonstrators are looking beyond the current politically influenced dispute to argue for something more extensive, single-payer health coverage, Medicare for all.

http://wnyt.com/article/stories/S3115548.shtml?cat=300

To mark Medicare anniversary, lawmakers and advocates rally for expansion of program to include every American

U.S. Rep. John Conyers, U.S. Sen. Bernie Sanders, others push for single-payer health care system

By Public Citizen (news release)
July 31, 2013

WASHINGTON – To mark the 48th anniversary of Medicare, congressional lawmakers and consumer advocates today called for Medicare to be expanded to provide health insurance to all Americans and highlighted a new study showing that a Medicare-for-all, or single-payer, system would save enough money to cover all of the 44 to 50 million uninsured Americans.

Participants in a rally outside the U.S. Capitol included U.S. Rep. John Conyers (D-Mich.), U.S. Sen. Bernie Sanders (I-Vt.), other members of the Congressional Progressive Caucus and representatives from Public Citizen, Physicians for a National Health Program, Labor Campaign for Single Payer Healthcare, Kentuckians for Single Payer Healthcare, Health Care Now! and All Unions Committee for Single Payer Health Care–HR 676. The event was preceded by a congressional briefing about the cost savings of a Medicare-for-all system and followed by lobby visits.

Although the Affordable Care Act (ACA) is designed to ensure that many more Americans are covered by the time the plan is fully implemented, a single-payer system would achieve far greater savings than the ACA, which maintains the role of the costly and wasteful private insurance industry. It also would be less complicated to put into place because it is already in place for Americans over 65 in the form of Medicare.

“The solution to our nation’s health care crisis isn’t cutting Medicare,” said Robert Weissman, president of Public Citizen. “It’s strengthening Medicare and expanding it to cover everyone. A Medicare-for-all, single payer system will ensure that every American is covered as a matter of right, and will save hundreds of billions of dollars by eliminating costs imposed by the wasteful private insurance industry.”

The new study, done by Gerald Friedman, professor of economics at the University of Massachusetts Amherst and released today by Physicians for a National Health Program, shows that upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

Under the single-payer system envisioned by “The Expanded & Improved Medicare For All Act” (H.R. 676), the U.S. could save $592 billion – $476 billion by eliminating administrative waste associated with the private insurance industry and $116 billion by reducing drug prices – in 2014.

“The evidence is clear,” said Dr. Robert Zarr, a Washington pediatrician and national board member of Physicians for a National Health Program, “An improved Medicare-for-all program is the most equitable and cost-effective way to assure that everyone, without exception, gets high-quality care. As a doctor who sees hard-pressed patients every day, I can tell you that the need for fundamental health care reform has never been greater.”

Savings from a single-payer plan would be more than enough to fund $343 billion in improvements to the health system such as expanded coverage, improved benefits, enhanced reimbursement of providers serving indigent patients, and the elimination of co-payments and deductibles. The savings also would fund $51 billion in transition costs such as retraining displaced workers and phasing out investor-owned, for-profit delivery systems.

Medicare was signed into law on July 30, 1965. H.R. 676, introduced into the 113th Congress by Conyers and 37 initial co-sponsors, would establish a single authority responsible for paying for medically necessary health care for all residents of the United States.

“Access to quality, affordable health care is more than just a moral imperative,” said Conyers. “It is a basic human right. The Affordable Care Act was a first step in reforming our broken health care system, but it cannot be the last. Until our coverage is truly universal, I will continue to fight – alongside groups like Public Citizen – for single-payer health care that will deliver quality health care to all Americans.”

“It is long past time that we recognize health care is a right, not a privilege,” said Sanders. “It boggles the mind that today, in America, we do not guarantee high-quality, affordable health care for all of our people. I am proud that Vermont is leading the nation in working to establish a single-payer health care system to provide better care at less cost.”

“Medicare-for-all is the high road solution to the fiscal crisis impacting all levels of government,” said Mark Dudzic, national coordinator of the Labor Campaign for Single Payer Healthcare. “Instead of solving this crisis on the backs of working people, Dr. Friedman’s study shows how we can save hundreds of billions of dollars while making quality health care a birthright for everyone in America.”

www.citizen.org

http://yubanet.com/usa/To-Mark-Medicare-Anniversary-Lawmakers-and-Advocates-Rally-for-Expansion-of-Program-to-Include-Every-American.php#.UflbzazrIng

Study: Single-Payer Health System Feasible, Could Save $1.8 Trillion in 10 Years

By Bob Herman
Becker’s Hospital Review, July 31, 2013

A new study shows that expanding Medicare to every American citizen would not only achieve universal coverage and trillions in savings, but it’s also feasible to implement based on legislation that has already been proposed.

Gerald Friedman, PhD, a professor of economics at the University of Massachusetts at Amherst, released his study today in Washington, D.C., at a congressional briefing. The basis of Dr. Friedman’s research is HR 676 — the Expanded and Improved Medicare for All Act — which is a bill introduced by Rep. John Conyers Jr. (D-Mich.) in February that would establish a single-payer health care program. The bill has been proposed for 11 straight years.

In his study, Dr. Friedman said if Rep. Conyers’ bill were signed into law, the expansion of Medicare could “paradoxically” save the U.S. health care system $592 billion in 2014 alone. The main savings would come from slashing “administrative waste” in the private health insurance industry and using the government’s bargaining power to obtain cheaper pharmaceuticals, according to the report. Over the next decade, the study suggested savings could reach $1.8 trillion.

Under HR 676, a single-payer system would be financed through several factors: increasing the personal income tax on the top 5 percent of income earners, instituting a progressive tax on payroll and self-employment, taxing capital gains and other unearned income, instituting a 0.5 percent tax on stock trades and other “progressive tax” financing efforts, according to the study.

The results of implementing the legislation, Dr. Friedman said, would be “expanded coverage, improved benefits, enhanced reimbursement of providers serving indigent patients and the elimination of copayments and deductibles in 2014.” The savings would also go toward retraining displaced health care workers for new healthcare roles and converting investor-owned, for-profit healthcare organizations into nonprofit systems.

“This analysis shows that it is possible to reform the U.S. health financing system to make it more efficient and equitable,” the study concludes. “On top of the enormous administrative savings of single payer, the savings from effective cost-control would make it possible to provide universal coverage and comprehensive benefits to future generations at a sustainable cost.”

Single-payer health care bills have generally been opposed by Republicans and others in the past. According to a 2008 study in the Annals of Internal Medicine, 59 percent of physicians support legislation to establish a single-payer system. Several industrialized countries have also had established single-payer or universal healthcare systems for at least 30 years, including the United Kingdom, Canada, Australia, Sweden and Norway.

http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/study-single-payer-health-system-feasible-could-save-1-8-trillion-in-10-years.html

Fulfilling the Promise of Medicare

By Rep. John Conyers and Robert Weissman
The Huffington Post, July 30, 2013

“We can say this of Medicare: By honoring the fundamental humanity, which is the spirit of democracy, it is a triumph of rightness in America.”

Nearly five decades after President Lyndon Johnson spoke those words as he signed Medicare into law, it is time to honor the fundamental humanity of all Americans by ensuring that each and every one of us has a right to health care — irrespective of our wealth or income — by improving and expanding Medicare so that it covers all Americans.

The benefits that Medicare has brought to older Americans are almost boundless. Millions of Americans have lived longer, more productive, healthier lives because of the medical care they received under this program. Many would have incurred financial ruin, suffered needlessly, and died prematurely without Medicare.

Despite these incredible gains, there are those who want to end close to 50 years of progress in the name of ideological dogma. They oppose the thought of the federal government running anything so vehemently that they want to end Medicare as we know it. These zealots would turn Medicare into a voucher program, cutting benefits and effectively denying millions the medical care they need.

Others propose raising the Medicare eligibility age and similar measures to reduce the government’s Medicare bill — not by controlling health care costs, but by making the elderly pay more. Those proposals, too, are misguided.

Medicare does face cost pressures. The solution is not to take from older Americans, but to end the program’s subsidies and giveaways to Big Pharma and private insurance companies.

Nearly five decades after its enactment, here’s what we know: Medicare saves money by eliminating all the waste associated with the for-profit insurance industry. And Medicare provides coverage to everyone eligible. In stark contrast, the for-profit insurers condition care on ability to pay … and then still try to deny care to those who have paid.

That’s five decades of evidence that indicates the solution to our nation’s healthcare crisis isn’t cutting Medicare. It’s strengthening Medicare and expanding it to cover everyone.

However the Affordable Care Act ultimately plays out, we know two things for certain: Millions of Americans will remain uncovered and the for-profit insurance industry will remain in charge of prices and life-and-death treatment decisions. As President Obama once stated, the only way to ensure everyone is covered is with Medicare-for-All, a single-payer system.

Medicare-for-All would save $350 billion a year in administrative costs, waste and profits — savings would be used to cover everyone. Everyone would have free choice of a doctor. Americans would never have to fight with their insurance company ever again.

The richest country in the history of humanity has a moral obligation to cover all of its inhabitants with health care coverage. We believe health care is a right, and should not be treated as a benefit reserved for the privileged.

It’s past time for an American health care system that provides universal coverage of all medically necessary services at a fraction of the cost of our current fractured system. The way to do that is to enact H.R. 676, the “Expanded and Improved Medicare for All Act,” which will create a single-payer health care system similar to those in almost every other industrialized country.

Today, as we celebrate Medicare’s birthday, we urge Congress to fulfill Medicare’s promise and enact single-payer legislation and provide Medicare for All.

Representative John Conyers represents Michigan’s 13th Congressional District in the U.S. House of Representatives. Robert Weissman serves as the President of Public Citizen.

http://www.huffingtonpost.com/john-conyers/fulfilling-the-promise-of_b_3676992.html

Friedman analysis of HR 676: Medicare for All would save billions

‘Medicare for All’ would cover everyone, save billions in first year: new study

Physicians for a National Health Program
July 31, 2013

Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield over a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.

Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 44 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.

“No other plan can achieve this magnitude of savings on health care,” Friedman said.

His findings were released this morning [Wednesday, July 31] at a congressional briefing in the Cannon House Office Building hosted by Public Citizen and Physicians for a National Health Program, followed by a 1 p.m. news conference with Rep. Conyers and others in observance of Medicare’s 48th anniversary at the House Triangle near the Capitol steps.

https://pnhp.org/news/2013/july/%E2%80%98medicare-for-all%E2%80%99-would-cover-everyone-save-billions-in-first-year-new-study

Funding HR 676: The Expanded and Improved Medicare for All Act: How we can afford a national single-payer health plan

By Gerald Friedman, Ph.D.
July 31, 2013

Executive Summary

The Expanded and Improved Medicare for All Act, HR 676, introduced into the 113th Congress by Rep. John Conyers Jr. and 37 co-sponsors, would establish a single authority responsible for paying for medically necessary health care for all residents of the United States.

Under the single-payer system created by HR 676, the U.S. could save an estimated $592 billion annually by slashing the administrative waste associated with the private insurance industry ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion). In 2014, the savings would be enough to cover all 44 million uninsured and upgrade benefits for everyone else. No other plan can achieve this magnitude of savings on health care.

Specifically, the savings from a single-payer plan would be more than enough to fund $343 billion in improvements to the health system such as expanded coverage, improved benefits, enhanced reimbursement of providers serving indigent patients, and the elimination of co-payments and deductibles in 2014. The savings would also fund $51 billion in transition costs such as retraining displaced workers and phasing out investor- owned, for-profit delivery systems.

Health care financing in the U.S. is regressive, weighing heaviest on the poor, the working class, and the sick. With the progressive financing plan outlined for HR 676 (below), 95% of all U.S. households would save money.

HR 676 (Section 211, Appendix 2) specifies a financing plan for single-payer that includes
• Maintaining current federal financing for health care
• Increasing personal income taxes on the top 5% of income earners
• Instituting a modest tax on unearned income
• Instituting a modest and progressive tax on payroll, self-employment
• Instituting a small tax on stock and bond transactions

The following progressive financing plan would meet the specifications of HR 676:
• Existing sources of federal revenues for health care
• Tax of 0.5% on stock trades and 0.01% tax per year to maturity on transactions in bonds, swaps, and trades
• 6% high-income surtax (applies to households with incomes > $225,000)
• 6% tax on unearned income from capital gains, dividends, interest, profits, and rents
• 6% payroll tax on top 60% of income earners (applies to incomes over $53,000, tax paid by employers)
• 3% payroll tax on the bottom 40% of income earners (applies to incomes under $53,000, tax paid by employers)

HR 676 would also establish a system for future cost control using proven-effective methods such as negotiated fees, global budgets, and capital planning. Over time, reduced health cost inflation over the next decade (“bending the cost curve”) would save $1.8 trillion, making comprehensive health benefits sustainable for future generations.

https://pnhp.org/system/assets/drupal/Funding%20HR%20676_Friedman_7.31.13_proofed.pdf

Comment:

By Don McCanne, M.D.

This is the report that single payer advocates have been waiting for. Economics Professor Gerald Friedman of the University of Massachusetts at Amherst has provided us with an analysis of the financing of John Conyers’ HR 676: The Expanded and Improved Medicare for All Act. The results are quite impressive, especially considering the comprehensiveness of the HR 676 reforms. Dr. Friedman’s report will be invaluable in our advocacy for a single pager national health program.

The analysis shows that we really can provide everyone with comprehensive health care without causing a financial hardship for anyone. This is made possible by depending on progressive tax policies. Since it is likely that the opposition will become apoplectic when they see the proposed taxes, we should be prepared to explain why progressive tax policies to fund health care are a good thing rather than a bad thing.

Let’s begin with two fundamental principles: 1) All of us should have the health care that we need, and 2) Obtaining health care should not ever result in financial hardship. Having health problems is enough without adding the financial penalties of paying for health care simply because of having the misfortune of being sick or injured.

Our audience is not those who disagree with these principles. We will never be able to satisfy them. Rather we need to address those who agree but cringe and withdraw when they see a recommendation for TAXES!

We need to keep in mind that we are not working with the spending baseline that we had when we began to advocate for single payer a couple decades ago. (They should have listened to us then!) Health costs are now a much larger percentage of our economy. Health care costs for the average working family of four are now over $22,000, when median household income is about $50,000. It is now impossible to meet the goal of providing affordable health care for everyone without making the wealthy pay more than the rest of us. Financing must be progressive it we are to meet our goals.

The Affordable Care Act (ACA) has included several policies that do increase the progressivity of financing, but it depends on an administratively wasteful, fragmented system that is the source of many of the problems in health care today. Many who cannot afford their allocated share will still pay too much, and many more will not even receive the care that they should have merely because of the dysfunctional financing method perpetuated by ACA. In contrast, the administrative simplicity of progressive taxes ensures an equitable method of financing care, making it affordable for everyone.

For those who say that we can’t afford the taxes, remind them that the taxes displace much of our current spending for health care. Because of the efficiencies of the single payer model of financing, the amount that we would spend in increased taxes for health care is less than the amount we would s
ave in recovering the administrative and clinical waste of our current system. Not only will we be paying less in taxes than the excessive amount that we are currently paying for our dysfunctional system, the payment will become much more transparent so that we finally would know what health care really costs us. Much of the costs are hidden today.

People often think that health care costs are what they or their employers pay in private insurance premiums, plus out-of-pocket expenses. In fact, in 2012 we paid only about $884 billion in private insurance premiums, though our total national health expediters were about $2,831 billion. It is that other $1,947 billion of relatively hidden health care costs that we are already paying that will be more transparent under a public tax system. When you think of these numbers, you can better understand why the proposed taxes seem to be so high.

Rather than fixating on just the taxes proposed in HR 676, it is much more important to look at the change in income that each person faces as a result of these tax policies. Use the link above to access Professor Friedman’s report and go to Figure 2. The bar graph and its explanation in the note below should be studied carefully to understand the changes.

The four bars on the left represent the bottom four quintiles of household income – 80 percent of the population. The four bars on the right represent the top 20 percent. The fifth bar, representing those with incomes from the 80th to the 95th percentile have an average household income of $216,922. Yet they and also those with incomes below them – 95  percent of all households – will see an INCREASE in their net income in spite of what they may perceive to be onerous taxes. It is only the top 5 percent that will be paying more in taxes than they will be receiving in health care benefits.

Okay. That’s fair for most of us, but is it really fair for those with incomes of a half million dollars or more – especially for those with average incomes of $3 million or even $166 million? Remember that wealth has moved upwards with high income individuals benefiting from the increased productivity of the workers, while workers’ incomes have remained flat. This massive, unfair upward shift of income and wealth screams out for justice. Progressive tax policies are precisely what we need to correct this injustice. HR 676 does exactly that – not only ensuring health care for everyone, but finally making it affordable for everyone while establishing public policies to slow the financial drain that the wealthy have placed upon the rest of us.

The Koch brothers and the Walton family may not like this proposal, but it’s not like we’re taking away their mansions or their personal jets. They’ll never miss the money that HR 676 would divert to taxes. Even those with a current $500,000 after tax income will see their net income reduced to about $460,000. They may whine, but if they are honest with themselves, they would have to agree that they really won’t see any significant differences in their lifestyles either. Some of them will even think that it is worth it if it ensures that absolutely everyone finally has the right to affordable health care.

We can have an Expanded and Improved Medicare for All if we simply dispense with our irrational tax phobia.

‘Medicare for All’ would cover everyone, save billions in first year: new study

Economist says Canadian-style, single-payer health plan would reap huge savings from reduced paperwork and from negotiated drug prices, enough to pay for quality coverage for all – at less cost to families and businesses

FOR IMMEDIATE RELEASE
July 31, 2013

Contact:
Mark Almberg, communications director, (312) 782-6006, mark@pnhp.org

Upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

That’s the chief finding of a new fiscal study by Gerald Friedman, a professor of economics at the University of Massachusetts, Amherst. There would even be money left over to help pay down the national debt, he said.

Friedman says his analysis shows that a nonprofit single-payer system based on the principles of the Expanded and Improved Medicare for All Act, H.R. 676, introduced by Rep. John Conyers Jr., D-Mich., and co-sponsored by 45 other lawmakers, would save an estimated $592 billion in 2014. That would be more than enough to cover all 44 million people the government estimates will be uninsured in that year and to upgrade benefits for everyone else.

“No other plan can achieve this magnitude of savings on health care,” Friedman said.

His findings were released this morning [Wednesday, July 31, 11 a.m. EDT] at a congressional briefing in the Cannon House Office Building hosted by Public Citizen and Physicians for a National Health Program, followed by a 1 p.m. news conference with Rep. Conyers and others in observance of Medicare’s 48th anniversary at the House Triangle near the Capitol steps. A copy of Friedman’s full report, with tables and charts, is available here.

Friedman said the savings would come from slashing the administrative waste associated with today’s private health insurance industry ($476 billion) and using the new, public system’s bargaining muscle to negotiate pharmaceutical drug prices down to European levels ($116 billion).

“These savings would be more than enough to fund $343 billion in improvements to our health system, including the achievement of truly universal coverage, improved benefits, and the elimination of premiums, co-payments and deductibles, which are major barriers to people seeking care,” he said.

Friedman said the savings would also fund $51 billion in transition costs such as retraining displaced workers from the insurance industry and phasing out investor-owned, for-profit delivery systems.

Over the next decade, the system’s savings from reduced health inflation (“bending the cost curve”), thanks to cost-control methods such as negotiated fees, lump-sum payments to hospitals, and capital planning, would amount to an estimated $1.8 trillion.

“Paradoxically, by expanding Medicare to everyone we’d end up saving billions of dollars annually,” he said. “We’d be safeguarding Medicare’s fiscal integrity while enhancing the nation’s health for the long term.”

Friedman said the plan would be funded by maintaining current federal revenues for health care and imposing new, modest tax increases on very high income earners. It would also be funded by a small increase in payroll taxes on employers, who would no longer pay health insurance premiums, and a new, very small tax on stock and bond transactions.

“Such a financing scheme would vastly simplify how the nation pays for care, restore free choice of physician, guarantee all necessary medical care, improve patient health and, because it would be financed by a program of progressive taxation, result in 95 percent of all U.S. households saving money,” Friedman said.

Friedman’s findings are consistent with other research showing large savings from a single-payer plan. Single-payer fiscal studies by other economists, such as Kenneth E. Thorpe (2005), have arrived at similar conclusions, as have studies conducted by the Congressional Budget Office and the General Accountability Office in the early 1990s. Other studies have documented the administrative efficiency and other benefits of Canada’s single-payer system in comparison with the current U.S. system.

Friedman’s research was commissioned by Physicians for a National Health Program, a nonprofit research and educational organization of more than 18,000 doctors nationwide, which wanted to find out how much a single-payer system would cost today and how it could be financed.

“Funding H.R. 676:  The Expanded and Improved Medicare for All Act – How we can afford a national single-payer health plan in 2014,” by Gerald Friedman, Ph.D., Department of Economics, University of Massachusetts, Amherst.

Montana government clinic: Maybe single payer is aiming too low

Montana's State-Run Free Clinic Sees Early Success

By Dan Boyce
NPR, July 30,2013

A year ago, Montana opened the nation’s first clinic for free primary healthcare services to its state government employees. The Helena, Mont., clinic was pitched as a way to improve overall employee health.

A year later, the state says the clinic is already saving money.

(Government employees still have their) normal health insurance provided by the state. But at the clinic, (there are) no co-pays, no deductibles. It’s free.

That’s the case for the Helena area’s 11,000 state workers and their dependents. With an appointment, patients wait just a couple minutes to see a doctor.

“For goodness sakes, of course the employees and the retirees like it, it’s free,” says Republican State Sen. Dave Lewis.

He and others faulted then-Gov. Brian Schweitzer for moving ahead with the clinic last year without approval of the state legislature, although it was not needed.

Now, Lewis is a retired state employee himself. He says, personally, he does like going there, too.

The state contracts with a private company to run the facility and pays for everything — wages of the staff, total costs of all the visits. Those are all new expenses, and they all come from the budget for state employee healthcare.

Even so, division manager Russ Hill says it’s actually costing the state $1,500,000 less for healthcare than before the clinic opened.

“Because there’s no markup, our cost per visit is lower than in a private fee-for-service environment,” Hill says.

Physicians are paid by the hour, not by the number of procedures they prescribe like many in the private sector. The state is able to buy supplies at lower prices.

Bottom line: a patient’s visit to the employee health clinic costs the state about half what it would cost if that patient went to a private doctor. And because it’s free to patients, hundreds of people have come in who had not seen a doctor for at least two years.

Montana recently opened a second state employee health clinic in Billings, the state’s largest city. Others are in the works.

http://www.npr.org/2013/07/30/206654000/montanas-state-run-free-clinic-sees-early-success

Comment:

By Don McCanne, M.D.

Let’s see. This Montana state-run free clinic is government owned, the physicians are salaried, there are no deductibles or co-pays, employees and retirees including Republicans like it, and it costs the state “about half what it would cost if that patient went to a private doctor.” Wow!

The single payer model of social insurance usually calls for a government-run insurance program that pays for our largely private health care delivery system, with all of its inefficiencies and inequities. But what if it paid for a government owned and financed health care delivery system similar to this Montana clinic, but with government ownership expanded throughout the entire delivery system.

Instead of just aiming for the goal of a single payer social insurance program, we could have a program of socialized medicine – government ownership of the delivery system. Considering that it is a much lower cost system with which everyone is happy, is that such a bad idea?

Shumlin administration gears up for the nitty-gritty of single payer

By Andrew Stein
Vtdigger.org, July 29, 2013

Gov. Peter Shumlin put Vermont on a path to creating the nation’s first single payer health care system when he signed Act 48 in 2011. But since then, his administration has made little progress up that mountain, drawing questions and accusations from the far political left and right about the governor’s sincerity.

Now, Shumlin and his team are beginning to shift gears, planning the implementation of a publicly funded, universal health care system. In the past two months, the administration has moved two of its policy heavyweights to the fifth floor Office of Health Care Reform — right around the corner from where the governor sits.

Michael Costa, former policy director at the Tax Department, took the elevator up to his new office at the beginning of June. He is charged with figuring out how to finance a single payer system with tax dollars.

David Reynolds, a co-architect of the Affordable Care Act and a former health policy adviser to Sen. Bernie Sanders, joined the team in July. He is tasked with bringing the moving parts of a single payer system together.

Costa and Reynolds join Robin Lunge, director of Health Care Reform, who helped craft the single payer legislation and has overseen the administration’s health care policy initiatives since July 2011.

“This shows that we’re serious,” said Secretary of Administration Jeb Spaulding. “But that’s not why we’re doing this. We’re doing this because we are serious.”

Shumlin doesn’t flinch when questioned about the proposal’s vulnerable points, like shifting more than a billion dollars in health insurance dollars to the tax sector.

“I am bound and determined to pass the first sensible single payer health care system in the country, and that’s going to be the most ambitious policy lift in Vermont history,” Shumlin said on Monday. “So, obviously, we’re going to gear up our staff and engage Vermonters from all walks of life.”

For the past two years, Shumlin’s top health care team has been focused on creating and implementing a new web-based insurance market for more than 100,000 Vermonters. The exchange, called Vermont Health Connect, is slated to open Oct. 1. Then, on Jan. 1, 2014, Vermonters buying health insurance individually or through businesses with 50 or fewer employees will be legally required to purchase plans on this market.

The exchange is not the single payer system the administration has in mind. It is a market that is being created in accordance with the Affordable Care Act, aka Obamacare. To deviate from these federal regulations and implement a single payer health care system, Vermont will need a federal waiver from the secretary of Health and Human Services. But, under federal law, states are not eligible for the waiver until 2017.

This past legislative session, the administration was supposed to submit to the Legislature a financing plan for funding a universal health care system with public dollars. The plan was called for in Act 48, which became statute.

The financing plan, however, did not arrive on legislators’ desks. The administration said it would be premature to propose specific taxes and that the Legislature should focus on passing necessary laws for the imminent insurance exchange.

What did come was a road map of sorts for drawing up a financing plan. It was created by the University of Massachusetts, which estimated the state would need to raise roughly $1.6 billion in public dollars to finance a single payer system.

Some critics of the study say that it’s an underestimate of the overall cost to the public. But Costa says this study is crucial for developing a single-payer financing plan.

“I am developing a specific financing plan for Green Mountain Care, and we will have that to the Legislature in January 2015,” he said. “When I read Act 48 and the UMass report, I basically see who is covered, what is covered and how much this costs. For the next 18 months, my role is to take the ‘how much’ and design several different ways that you could pay for it and look at what are the impacts on employers, individuals and Vermont’s economy.”

Green Mountain Care

Green Mountain Care is the name of the publicly financed plan that is proposed in Act 48. To get there, Lunge says the administration had to cooperate with federal law.

“Our first step in moving towards Green Mountain Care and payment and delivery system reform was to start with the Affordable Care Act, and so a significant portion of our time and efforts and focus has had to be on the Affordable Care Act,” she said. “As we get closer to that being live and up and running, our focus is shifting to the bigger picture, long-term goals.”

Act 48 is explicit: Green Mountain Care would provide “affordable, high-quality, publicly financed health care coverage for all Vermont residents.”

Specifically, Lunge said, “It would provide coverage for doctor’s visits, hospital stays, preventative care, prescription drugs, all of the services that will be covered through all of the plans in Vermont Health Connect.” She added that Green Mountain Care would use a sliding scale for deductibles and co-pays based on residents’ incomes.

Shumlin says he is adamant that Green Mountain Care is applied universally — that includes teachers and state workers.

“Everybody in,” he said. “This is what we envision: No more health care premiums; public financing instead. Contracting out to one of our insurers to adjudicate the claims. We don’t want to be an insurance company. This means having a health care system where the health care follows the individual as a result of their residency in the state of Vermont, not where they work.”

One of the largest pieces to this puzzle is the business community. In 2011, Harvard economist William Hsiao recommended an 11 percent employer tax to fund a single payer system. The proposal was extremely unpopular among many of the state’s largest employers.

“Businesses are one of the many sectors that have so much to win if we get this right and so much to lose if we don’t,” Shumlin said. “One of the biggest challenges for businesses large and small is the unsustainable rise in costs of health care, which gobbles up our dollars faster than we can make them.”

Shumlin’s Business Council

In April, the governor organized a group of 20 business leaders from across the state to meet with him in off-the-record sessions about financing options for a single payer system.

The council’s representatives span the gamut of Vermont’s businesses, from IBM executive Janette Bombardier to Onion River Sports owner Andrew Brewer to Ken Perine, CEO of the National Bank of Middlebury.

David Coates is chair of the council. He heads the Vermont Long Term Disaster Recovery Group and is a former partner of
KPMG LLP, the auditing firm.

“It seems to me that business is extremely important for health care, and, as you know, businesses provide a lot of it,” Coates said. “At the end of the day, if this is going to have a very negative impact on businesses, then it will have a very negative impact on jobs and the economy.”

The group has met twice thus far and Coates says the members are waiting for the financing plan from Costa. He says his team won’t be devising financing mechanisms, but, rather, will react to the administration’s proposals.

“The hurdle in my opinion will be what is the cost and how will it impact these businesses’ bottom lines,” he said. “If those things come in in a positive way, then I don’t think there will be a hurdle whatsoever.”

But while thousands of Vermonters are keeping a close eye on the administration’s financing plan, one key official says he is focusing on how to make the rest of the system work.

David Reynolds

When David Reynolds founded Vermont’s first network of Federally Qualified Health Centers in 1976, he says insurance wasn’t the chief issue.

“Coverage alone does not equate to access,” Reynolds said. “Before I started Northern Counties, people in the Northeast Kingdom had health insurance, but they didn’t have a place to use it.”

Reynolds says a single payer system is about much more than financing, and it’s his task to make the system mesh. On the state government side of things, he is charged with greasing the wheels of state bureaucracies so that they work together.

“You need to have the workforce; you need to have integrated systems; you need to have more integration of mental and physical health; and those are the things I’m working on,” he said.

Reynolds left Northern Counties Health Care Inc. in 2007 to become U.S. Sen. Bernie Sanders’ senior policy adviser for health. When he said goodbye to Northern Counties, the network included six federally qualified health centers, two dental clinics and a home health and hospice division.

Working with Sanders, he pushed for progressive policies in Washington.

“David was the lead negotiator, researcher, and drafter of legislation to advance the senator’s priorities in health care,” Sanders’ spokesman Jeff Frank said. “He was involved in the drafting of the first national single payer bill introduced in the United States Senate.”

Reynolds says that one of his token achievements in Washington was helping to negotiate the creation of the 2017 waiver in the Affordable Care Act — the very waiver that would allow Vermont to deviate from the law to set up a single payer system.

“When the president gave up on not proposing single payer or a public option, that (waiver) was a compromise to get the votes of the more liberal members,” he said. “I call the Affordable Care Act the ‘private health insurance preservation act.’”

In 2011, he returned to Vermont to work on implementing Act 48.

“Having come from the dysfunctionality of Congress, working for Bernie Sanders, this is just remarkable to see,” he said. “People are really dedicated to this task.”

http://vtdigger.org/2013/07/29/shumlin-administration-gearing-up-for-the-nitty-gritty-of-single-payer/

Medicare has proved itself after 48 years

By Rob Stone, M.D.
The Herald-Times (Bloomington, Ind.), July 30, 2013

Who is the most popular health insurer in America? Not Anthem Blue Cross. It’s Medicare. And what insurer is the most efficient? Medicare again, operating at only 1.4 percent overhead, while the private insurers strain to meet the Affordable Care Act maximum overhead of 20 percent.

While the Affordable Care Act struggles to be born, it’s worth looking again at how well Medicare works. Last year the respected journal Health Affairs published a study showing how Medicare performs better than private health insurance plans.

According to the report, “Medicare beneficiaries are less likely to have cost-related access problems, high premium and out-of-pocket health care expenses as a share of income, and financial problems because of medical bills. And compared to non-elderly adults with employer-based coverage, Medicare beneficiaries are more likely to have access to a medical home – a primary care provider who knows their medical history well, is accessible, and helps coordinate their care,” and are “far more likely to report excellent quality of care.”

Medicare is not perfect and needs improvement, but it performs far better than the best of the private plans – the employer-sponsored health plans. Individual and small group plans have even worse performance. The Health Affairs article concluded, “Medicare is doing a better job than employer-sponsored plans at fulfilling the two main purposes of health insurance: ensuring access to care and providing financial protection.”

In my work as a physician I see it every day – patients under the Medicare eligibility age of 65 struggling to find affordable insurance, or fighting with their insurance company when they try to make a claim, or driven to bankruptcy by impossibly high deductible payments. But if they can hang on until they reach Medicare age, then they can finally get the care they need, without the hassles. “Pre-existing conditions” are not an issue. You can pick the hospital and doctor of your choice.

We need to celebrate and protect Medicare, a uniquely American approach to health care. Somehow Congress in their infinite wisdom decided 48 years ago that we should have a universal health care system for everyone over 65, but that the rest of us were on our own.

Don’t let the politicians privatize Medicare or raise the eligibility age. Some want to turn Medicare into a voucher program and shift more costs to seniors, a terrible idea. Medicare is the victim of skyrocketing health care costs, not the cause.

Medicare may not be perfect, but Americans with Medicare are far happier than those with private insurance. Medicare has been a leader in keeping costs down. Medicare already insures the people with the greatest health care needs: people over 65 and the disabled.

Happy Birthday, Medicare! It’s time for everyone to be able to see a doctor when they are sick, to have access to preventative care, and to not face financial ruin when they have to go to the hospital. We should improve and expand Medicare to cover everyone. Everybody In – Nobody Out. We all deserve health care.

Dr. Rob Stone is director of Hoosiers for a Commonsense Health Plan. He lives in Bloomington.

http://www.heraldtimesonline.com/news/opinion/medicare-has-proved-itself-after-years/article_0289bbec-3b3f-5e03-a45f-d47d60a88fc0.html