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Single-payer health care pushed for Maryland

By Larry Carson
The Baltimore Sun, March 3, 2011

The idea of a single-payer health care system was lost in the debate over the much-amended national health care reform1 passed by Congress last year, but three Howard County delegates are co-sponsors of legislation in this year’s General Assembly that seeks to bring the idea to fruition in the Free State.

The concept involves having everyone in the state get health care through one single insurance pool to which everyone pays premiums. It eliminates the variety of insurance companies that now offer coverage only to those insured through an employer or who can pay.

The Senate version (SB388) of the Maryland Health Security Act is scheduled for a hearing March 9 at 1 p.m. in the Senate Finance Committee2 in Annapolis3, and backers are planning a free event to help boost support March 12 at 1 p.m. at the Central Library in Columbia.

Dels. Guy Guzzone, Frank Turner and Elizabeth Bobo, all Democrats, are all co-sponsors of the House bill (HB1035), and Democratic Del. Shane Pendergrass said she supports a single-payer system in concept, though she is not a co-sponsor because the bill would come before her subcommittee. Sponsors of the three-hour library event are Healthcare-Now! Maryland and Physicians for a National Health Program.

Organizers of the single-payer campaign, Stephen Dunbar and Dr. Eric G. Naumburg, say the bill has little chance of passage this year, but they believe that things may change in the future.

“The health system, the way it’s going, cannot survive long-term,” said Dunbar, 68, of Columbia. He’s an entrepreneur with a 43-year old son who was recently laid off from his job. His son, he said, had three open-heart surgeries as a child and needs continuous medical care that he may not be able to afford without employer-provided health insurance.

If the federal plan survives a Republican onslaught, it still leaves millions without coverage, and will be expensive. If Republicans succeed, Dunbar and Naumburg feel, the whole system will collapse, making single-payer the logical alternative.

Naumburg, 63, also of Columbia, is a former pediatrician who said he’s retired from active medical practice to devote his life to promoting a single-payer system.

To advocates, the advantages seem naturally appealing. Instead of having multiple insurance companies with a jungle of rules and paperwork, there would be one standard for everyone. That means no need for advertising, huge billing and administrative offices, far less confusion, and medical services dispensed as needed without a cost-driving fee-for-service system.

They are also aware that what they see as a logical solution to the still rising costs of health care is seen as “socialized medicine” to be opposed at all costs by others. “We know we need support from the grassroots,” said Naumburg.

Bobo said she never gives up on what she feels is a good idea, no matter the obstacles. “I think we need to get out there and just keep promoting it.” ….

http://www.baltimoresun.com/news/maryland/howard/bs-ho-politics-kittleman-health-20110228,0,3871231.story

Nurses Offer to Buy President's Shoes to March With Workers

By Rose Ann DeMoro
Executive Director, National Nurses United, AFL-CIO and California Nurses Association
The Huffington Post, February 28, 2011

The past two weeks have been a “Where’s Waldo” moment for President Obama.

He’s been largely a bystander while tens of thousands of American workers, joined by students, and community allies, marched in Madison’s snow and freezing temperatures, and slept on the floors of the capitol to defend their most fundamental right to freedom of assembly and a collective voice.

On Monday, the President told U.S. governors, “I don’t think it does anybody any good when public employees are denigrated or vilified or their rights are infringed upon.”

But the President never addresses the heart of the problem, a clear statement of who is responsible for the crisis — the corporate class and the right, aided by those like President Obama, who enable them. That’s the giant elephant in the room that remains missing in the ‘blame the workers’ paradigm so often repeated by politicians and mainstream media alike.

Many of us recall the pledge made by candidate Barack Obama in Spartanburg, S.C. on November 3, 2007 when he declared:

“Understand this. If American workers are being denied their right to organize and collectively bargain, when I’m in the White House, I’ll put on a comfortable pair of shoes myself. I’ll walk on that picket line with you as President of the United States because Americans deserve to know that somebody is standing in their corner.”

We’re waiting. Nurses, who have been on the ground every day in Madison and at support rallies across the country, will buy his shoes.

Standing with the embattled workers would be an important symbol (and might even get more of the media to show up). But we need far more from this administration — and for that matter from the Democratic leadership on Capitol Hill.

We need a clear message that public workers and union members in general did not cause the economic crisis or unbalanced budgets. Public pensions did not spark a meltdown on Wall Street. It wasn’t workers exploiting tax loopholes or off shoring their bank accounts that depleted public treasuries.

Over the past three decades there has been a massive shift of federal revenues. Individuals now account for nearly five times the federal tax receipts as do corporations, numbers that were roughly equal when Ronald Reagan took office.

The states are no better. Overall, taxes on individuals produce about four times the revenues for states that corporations do. In Wisconsin, the ratio is about five to one — and that was before Gov. Walker gave corporations $117 million in tax cuts in January to create his current “I need to break the unions” $137 million deficit.

It’s well and right for the President to criticize “an assault on unions,” as he did in an initial statement two weeks ago.

But he undercuts that message by conceding the Republican and tea party rhetoric about the “tough fiscal situation we are in” while calling for even lower corporate taxes, and making deals to extend tax cuts for the wealthy, and expressing sympathy for governors, like Walker, who want to put their entire burden on workers and the poor.

Every time you hear the President or any other politician call for “shared sacrifice,” think about this:

• Corporate taxes as a percent of the gross domestic product are at historical lows.
• Corporate profits per employee are the highest on record. At $1.6 trillion, third quarter corporate profits were the highest figure ever recorded since record keeping began 60 years ago.
• The top 1% of the population had 17.1% of total after tax income in 2009, the highest figure for at least 30 years.
• A one-time 14% surcharge on the super-rich would more than pay for the $1.6 trillion budget deficit projected for 2011 (according to the National Nurses United’s research arm, the Institute for Health and Socio-Economic Policy).
• And, finally, workers’ wages have been stagnant or falling for at least 30 years.

What more and more people are saying in Madison and elsewhere is that this is not about public workers. It’s about politicians funded by far right zealots like the Koch brothers who want to privatize all publicly owned institutions in the U.S. and shift even more resources to Wall Street.

Let’s recall it was the finance sector, especially the big banks, not workers, who created the economic crisis in the states and nationally through wild economic speculation concentrated in the mortgage industry.

The ‘Deficit Hawks’ on the far right are exploiting that crisis to push severe cuts in federal and state spending to ‘balance the budget’ on the backs of those that can least afford it — people of color, women, the long term unemployed and the millions caught in the mortgage debacle — when their real goal is to engage in a private sector hostile takeover of federal and state government. At the same time, they are pushing more tax breaks for corporations and the wealthy which adds to the debt.

The real issue is a responsibility crisis. Those responsible for the economic crisis are being rewarded and workers are being asked to sacrifice.

Here’s what we’d like to hear the President say:

Bringing the deficit into balance requires a just rebalancing of the responsibility of the corporate elite and the rich. As a start, corporate profits need to be fairly taxed. Taxes on the rich need to be increased not decreased, and wages should be raised to a living wage, which would raise tax revenues and workers’ ability to purchase goods and services in the long term.

Until then, we’ll continue to say this President is missing in action.

http://www.huffingtonpost.com/rose-ann-demoro/missing-in-madison–where_b_829457.html

A just system of health care insurance: improved Medicare for All

The following is a slightly edited translation of an interview with Edgar A. Lopez, M.D., F.A.C.S., which was conducted in Spanish by journalist Pablo Castelo of Al Día en América in early February. Dr. Lopez is a member of Physicians for a National Health Program and Kentuckians for Single Payer Health Care.

CASTELO: How do you explain to the common citizen what H.R. 676, the so-called single-payer bill, is?

LOPEZ: In English it is known as the “Expanded and Improved Medicare for All Act,” sometimes called the U.S. National Health Care Act. In Spanish the best translation would be “universal health insurance coverage,” financed by the government with payment for medical services going directly to the medical providers. This system would eliminate the intermediaries, or third-party payers, namely, the private health insurance companies.

CASTELO: Many people ask how much this kind of program would cost the average patient.

LOPEZ: Nothing. The patient doesn’t have to pay anything when they present themselves to the doctor or the hospital. Those who are working or employed are already contributing with taxes contributions that go to Social Security and the Medicare fund; along the same lines, a single-payer system would be financed largely by progressive taxation.

CASTELO: What would make us think that this system would actually work in the United States?

LOPEZ: We already have such a system for those who reach age 65; it is called Medicare. Hence the name for H.R. 676 – the Expanded and Improved Medicare for All Act. We also have the Medicaid system that helps those citizens who are in the lowest income levels and have the right to free or nearly free medical attention.

CASTELO: From the point of view of the patient, what are the advantages of eliminating the private health insurance companies as intermediaries?

LOPEZ: The new single-payer system would be a wonderful change because, first, it would eliminate the premiums that we have to pay to the insurers, and second, it would also eliminate co-pays, deductibles and additional out-of-pocket expenses. From the standpoint of physicians, within the current system, doctors are constantly struggling with the health insurance companies over payment issues, diminishing operational effectiveness, adding unnecessary overhead and curtailing proper medical care. For example, when I was in private practice, two of my employees would spend many hours of their working day dealing with the insurance companies.

CASTELO: I understand that statistics show that many people die because of the high cost of medical care under the present system. Is this true?

LOPEZ: According to an Institute of Medicine study in 2002, in the United States, the richest country in the world, approximately 55-60 persons die everyday because of lack of health insurance; that adds to about 20,000 preventable deaths a year. Many people wait until the last moment to go to see a physician or end up at a hospital emergency room. A more recent Harvard study in 2009, using similar methods as the IOM, found the number of deaths linked to lack of health insurance as more than twice that figure – roughly 45,000 deaths each year.

Another study in 2009 showed that over 60 percent of personal bankruptcies in the U.S. can be linked to illness and medical bills. What is rather amazing is that 75 percent of those who went bankrupt under these circumstances had health insurance when they first got sick. What happens is that when you are struck with a catastrophic illness, either you die or you fall into severe debt. Once you can no longer pay your bills, bankruptcy is the result. Hence, just because you have insurance with your employer, that doesn’t mean you are safe.

CASTELO: You and I come from countries where we grew up with the concept that health care is a right, like the right to vote as an expression of democracy. Why, in this country, which calls itself the paradigm of world democracy, is health care not a right?

LOPEZ: I believe this phenomenon is a symptom of a deformed or degenerated type of capitalism that is peculiar to the United States, because there are many industrialized countries in the world where health care is provided to everybody as a right, and yet those countries are not called communist or socialist.

CASTELO: By the way, why is H.R. 676 or the single-payer system frequently characterized as a path to socialism?

LOPEZ: Socialism is a scare word or label that the extreme right in the U.S. uses to attack the single-payer concept. They claim that an improved Medicare for All would be a form of “socialized medicine.” This is a lie. A single-payer system would simply change the way in which health care is financed; it would still continue to be delivered privately. You would go to the doctor of your choice. Hospitals wouldn’t become the property of the government. Through the years, the words communism and socialism have been used to scare people. And it’s ironic: many people who say they are against an improved Medicare for All are in fact supporters of Medicare, and some of them are enrolled in the program.

CASTELO: Any final comments?

LOPEZ: The Expanded and Improved Medicare for All Act, H.R. 676, has just been reintroduced in the Congress by Rep. John Conyers Jr. of Michigan. It embodies some of the key feature of a single-payer program:

1. Universal coverage. Everyone is covered automatically at birth.
2. Coverage for all medically necessary services – comprehensive care.
3. Redirects $400 billion in administrative waste back into patient care.
4. Patients will be allowed free choice of their doctor and hospital.
5. Premiums and out-of-pockets costs are replaced with a progressive structure of income taxation, resulting in almost everyone paying less in taxes than they currently pay for premiums, co-pays and deductibles.

The Spanish-language original was posted at Al Día en América on Feb. 10, 2011.

Wis. doctors' group opposes governor's budget bill

Warns of dangers posed to BadgerCare, other safety-net programs

FOR IMMEDIATE RELEASE
March 1, 2011

Contact:
Melissa Stiles, M.D., melstiles1@gmail.com
Laurel Mark, M.D., laurel.mark@gmail.com

The Wisconsin chapter of Physicians for a National Health Program joins countless organizations in Wisconsin in opposition to the governor’s budget repair bill. We particularly oppose the dramatic changes in policy regarding Medicaid. These changes would take decision-making authority away from our elected officials and into the hands of unelected, partisan appointees with oversight only by the Joint Finance Committee.

As proposed in the bill, the director of the Department of Human Services would control future rule-making and policy changes could take place without full legislative oversight or public input. These policy changes could include important decisions about program eligibility, covered services, patient cost-sharing, enrollment procedures and provider reimbursement.

PNHP Wisconsin believes that any changes in Medicaid and BadgerCare should be made in the public eye and with public debate. We feel the changes to oversight of these programs should not be included in a bill that claims to solve a fiscal crisis for the current budget year.

PNHP Wisconsin supports universal, comprehensive and affordable health care. Programs like BadgerCare, Medicaid and Medicare are critical safety-nets that must be defended and preserved until we have such a universal health care system. We recognize these programs are not the cause of our rising health care costs, but are just part of our irrational, fragmented and failed market-based model of health care financing.

If the governor and the Wisconsin Legislature want to control costs, PNHP suggests an improved Medicare for all – single-payer national health insurance – as the remedy for our health care cost woes. By replacing private insurers with a streamlined, publicly financed system of care, we’ll have enough resources to provide comprehensive, quality care for all.

The 350 physician-members of PNHP Wisconsin stand in solidarity with the many other groups opposing the budget repair bill. Wisconsin’s admirable record of health coverage, currently at 94 percent of the state population, is a record we’re proud of and hope to expand, so that we can truly achieve “Health Care for All!”

MEDIA ADVISORY: Dr. Margaret Flowers, congressional fellow of Physicians for a National Health Program, will be visiting Madison, Wis., from Wednesday, March 2, through Friday, March 4, for several speaking engagements and will be available for interview. To contact Dr. Flowers, call (410) 591-0892 or write margaret@pnhp.org.

PNHP’s national statement on the Wisconsin developments can be found here.

****

Physicians for a National Health Program (www.pnhp.org) is an organization of 18,000 doctors who advocate for single-payer national health insurance, an improved Medicare for all. To speak with a physician near you, visit www.pnhp.org/stateactions, or call (312) 782-6006.

Health care “unsustainability” a myth, report finds

Public sector care stable, though problems loom in private health care sector

Canadian Doctors for Medicare
Press release, Feb 28, 2011

Toronto ‐ A new report on health care financing demonstrates that the widely repeated concern about the sustainability of public health are is unsubstantiated. Despite comments by Prime Ministers, Premiers, bank presidents and newspaper reporters suggesting that we are in a public health care financing crisis, the facts show that Medicare and public sector health care spending in general has grown little over the last 30 years and shos no signs of rapid future growth. The report, “Neat, Plausible and Wrong”, was released today by Canadian Doctors for Medicare (CDM) and draws on the full range of health care statistics to put the myth to rest.

“It’s a classic case of Chicken Little,” said Dr. Danielle Martin, Board Chair of Canadian Doctors for Medicare. “Once people started saying it, and put bit of spin on the numbers, no one stopped to question the facts.”

The report shows that, contrary to some claims, core Medicare costs have grown little over the years, staying between 4% and 5% of GDP. Other public health care costs have grown slightly more but not markedly, keeping public spending on health care between 5% and 7% of GDP for over three decades.

However, the report shows reason for concern about growth in private sector costs. Canadians are paying more and more for health care, up from 7% of GDP in 1975 to 12% in 2009. But it’s the private sector, where governments aren’t managing costs, that was primarily responsible for that growth. Statistics show that expenditures on drugs are more than 3 times what they were 20 years ago and that private health insurance costs have increased sharply.

“It’s ironic that some politicians are calling for a larger private sector role to help sustain our health care system, when it is the private sector that has been
completely unable to control costs” said Dr. Irfan Dhalla, Board Treasurer of CDM.

The report, issued just days before the Canadian Medical Association’s town hall meeting in Toronto on Health Care Transformation and on te brink of a federal election, calls for changes to how we manage health care to address the rising private sector costs and improve our health care system, but cautions policy makers not to undermine the part of our system that is working: Medicare.

Click here for a copy of the report

Click here for a fact sheet

http://www.canadiandoctorsformedicare.ca

‐30‐

For more information, please contact CDM Executive Director Sean Meagher at 416‐820‐7889

ANALYSIS — A Canadian-Style Single-Payer Health System in Vermont?

By Wendell Potter
The Center for Public Integrity, March 01, 2011

MONTPELIER, Vt. — Chances are you’ve never heard of Peter Shumlin, who last month was sworn in as the 81st governor or Vermont. That’s about to change. If Shumlin makes good on a signature campaign promise, he might end up as well-known and beloved in the United States as Tommy Douglas is in Canada.

OK, maybe you’ve never heard of Tommy Douglas, either. A former Baptist preacher and member of the Canadian parliament, Douglas is considered the father of Canada’s popular government-run medical insurance program.

If you’re surprised to learn that Canadians like that system, it’s probably because you’ve been convinced otherwise by a years-long propaganda campaign from American insurers — a campaign I used to help carry out as an industry PR executive.

But according to 2008 Harris Interactive polls in ten developed countries, Canadians were among those most satisfied with their health care system — while Americans were the least satisfied. Speaking of polls, in 2004, 18 years after his death, Tommy Douglas was named “The Greatest Canadian” of all time in a national contest conducted by the Canadian Broadcasting Corporation (CBC).

Shumlin is hoping to do in Vermont what Douglas accomplished first as premier of Saskatchewan — implement a publicly financed system that guarantees universal access to medical care and controls costs better than private insurers. If Shumlin pulls it off, other states undoubtedly will attempt the same thing, just as other Canadian provinces followed Saskatchewan’s lead.

Toward the end of his nearly two decades in the Vermont General Assembly, Shumlin concluded that the uniquely American multi-payer system of private health insurance firms was actually fueling medical inflation and thwarting the state’s efforts to provide coverage for all of its citizens. It was an unsustainable system, he believed — one that would not only force more Vermonters into the ranks of the uninsured, but would ultimately bankrupt the state.

So Sumlin did something about it. As president of the Vermont Senate, he co-sponsored legislation last year that may eventually help reduce if not eliminate private health insurers in the Granite State, at least in providing coverage for basic medical care.

As a result of that groundwork, lawmakers were presented with three options in January that would radically change Vermont’s health care financing system. One of those options: a state-based, tax-supported single payer system, similar to the one Tommy Douglas pioneered in Saskatchewan in the 1960s.

A second option would create a public insurance plan to compete with private insurers. Such an idea was considered by Congress but never made it into the final reform bill in Washington because of intense opposition from the insurance industry.

Vermont’s third option would be a single-payer system with a twist. The state would create an independent public board to oversee the health care system, and the board would contract out the administration of claims. The claims administrator could be either a public or a private entity. Private insurers could compete for this largely clerical work, as they have done for years to administer the Medicare program.

The consultants hired by the state to develop the recommendations — led by Dr. William Hsiao of the Harvard School of Public Health — told lawmakers they favored option three in part because it was likely the most politically feasible. They estimated that option three could save the state at least $580 million yearly, though some have challenged the numbers.

As the state’s new governor, Shumlin last week presented his own health care reform plan to the legislature, based largely on that third option.

Insurers have urged lawmakers not to rush, but otherwise haven’t had much to say, opting instead to let their business allies lead the attack. Last week, John O’Kane, an IBM lobbyist, said in a letter to the House Health Care Committee that his company was opposed to any single-payer proposal. He said IBM planned to continue offering medical coverage to its Vermont employees and wasn’t interested in paying additional taxes to help the state achieve universal coverage.

The letter hinted that the company, the state’s largest private employer, might have to reduce its work force or even close its operations if a single-payer system was adopted.

Shumlin knows there are more attacks to come, but believes he was elected to implement the plan, which has broad support in the legislature. Among the Republican supporters: Rep. Francis “Topper” McFaun of Barre, who a few years ago sponsored a bill to provide public insurance for hospital care.

Late last week, Rutland Mayor Christopher Louras, also a Republican, surprised lawmakers in urging adoption of single-payer legislation, arguing that the current system was more than a little broken.

“The only way to fix the problem is to blow it up and start over,” he said, noting that Rutland’s health care costs would consume $3 million of his city’s $7 million payroll in 2011.

Back in Montpelier, Shumlin and the legislators know that implementing their plan won’t be easy — not just because of industry opposition, but also because they will need permission from the federal government to proceed. The health care reform act signed by President Obama last year contains a provision barring states from reform this radical before 2017 without Congressional approval. Obama announced Monday, however, that he supports amending the law to allow states more leeway to experiment by 2014 if they have reform proposals that can provide coverage for the same number of people at the same or lower cost.

Vermont’s entire Congressional delegation — Sens. Patrick Leahy and Bernie Sanders and Rep. Peter Welch — supports Shumlin’s efforts and they have already begun the process of requesting a waiver.

Considering the President’s willingness to cut states some slack and the hundreds of waivers the government already has granted to insurers and corporations from various provisions of the law, they might just get the waiver they’re seeking.

Vermonters were the first to abolish slavery in the United States. Many folks here, including the freshly minted governor, are determined to be the first to abolish private health insurers, just as Canada did under Tommy Douglas’s leadership several decades ago.

News analyst Wendell Potter, a former insurance company executive, is the author of Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans.

http://www.publicintegrity.org/articles/entry/2953/

'Wisconsin battle crucial for health and democracy': doctors group

FOR IMMEDIATE RELEASE
March 1, 2011

Contact:
Garrett Adams, M.D., president, Physicians for a National Health Program
Mark Almberg, communications director, PNHP, (312) 782-6006, mark@pnhp.org

The following statement was released today by Dr. Garrett Adams, president of Physicians for a National Health Program.

Physicians for a National Health Program extends its deep and unwavering solidarity with the workers and people of Wisconsin who are fighting to preserve their collective bargaining rights, save BadgerCare and other safety-net programs, and put a stop to further encroachments by corporate interests on the public’s health and democracy.

We stand shoulder-to-shoulder with the unions and people of Wisconsin in their momentous battle against the attempt by Gov. Scott Walker and his billionaire corporate backers who would turn the clock back to the 19th century. Their real goal is to prevent labor unions from continuing their advocacy of a better standard of living for all Americans, including the right to high quality health care. Labor has been critical to the achievement of truly universal health care systems in all the countries that have them.

Our members in Wisconsin have dedicated themselves to repulsing this attack on the public’s health and welfare – and on the elementary principles of social justice – and have been actively participating in the massive, inspiring demonstrations in Madison over the past two weeks, speaking out in support of the workers, and more.

Public employees and public programs have been under attack at the federal, state and local levels in the form of pay cuts, layoffs and privatization schemes on the heels of years of tax breaks for corporations and the wealthiest Americans. If these new attacks are allowed to succeed, poverty, health care costs and medical bankruptcies will increase, leading to greater human suffering and thousands of preventable deaths.

In the absence of a truly universal, comprehensive health system, programs such as Wisconsin’s BadgerCare, Medicaid and Medicare are critical safety nets that must be defended and preserved. These programs are not the cause of our rising health care costs, but are in fact victims of our irrational, fragmented and failed market-based model of health care financing.

Our nation’s public insurance programs have been steadily undermined by for-profit corporations – health insurers, Big Pharma, and medical equipment companies – who seek to enlarge their customer base so as to make even more profits off of people’s sickness.

Physicians for a National Health Program emphatically rejects the idea that corporations should make profits off of those who need health care. That’s why we favor an improved Medicare for all – single-payer national health insurance – as the remedy for our health care woes. By replacing private insurers with a streamlined, publicly financed system of care, we’ll have enough resources to provide comprehensive, first-dollar coverage to all. We will also acquire the tools we need to rein in costs.

But today our focus is on expressing our solidarity with the working people of Wisconsin and other states in their battle against untrammeled corporate power, union-busting and the assault on social insurance programs. Gov. Scott Walker, the billionaire Koch brothers and their ilk must not be allowed to push us backward.

Rest assured, physicians stand with you in your fight for the public’s health and democracy!

****

Massachusetts reform hasn’t stopped medical bankruptcies: Harvard study

A copy of the EMBARGOED manuscript of the study is available to the press. Please enter password below.

“Medical bankruptcy in Massachusetts: Has health reform made a difference?”
David U. Himmelstein, M.D., Deborah Thorne, Ph.D., and Steffie Woolhandler, M.D., M.P.H.

American Journal of Medicine, March 2011 (print edition).

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Health care debate a dull but worthwhile topic

By Charles McMahon
Opinion column, Seacoastonline.com (N.H.), Feb. 28, 2011

PORTSMOUTH, N.H. — Health care is not sexy.

The ongoing debate over health care coverage lacks all of the necessary components of what I would consider to be a sexy and spicy news story. Not only does it lack elements of mystery and suspense, but there is very little room for intrigue and excitement.

Unlike an occasional crime story or investigative report, issues pertaining to health care rarely seem to drum up a lot of interest and almost never end up in the newspaper’s online most-viewed list.

In other words, a headline that reads “Health care plan explained” doesn’t necessarily jump off the page and suck readers in.

While I’ll be the first to acknowledge my lack of excitement when asked to cover something related to health care, that doesn’t necessarily mean I don’t understand and appreciate its importance and the place it has in the news.

I doubt many readers would argue against the fact that making health care affordable and accessible are perhaps some of the most important issues facing Americans today.

I think the more than 50 Seacoast residents who showed up to the public library Wednesday night for a presentation called Health Care Reform in 2011 and Beyond would agree with me.

The need for a conversation on further reform in the area of health care was made very evident this week in Portsmouth.

On one front, you had Dr. Thomas Clairmont asking the City Council to endorse debate on a movement to create a single-payer system.

In his plea to the city, Clairmont said the move could save the city some major money given the fact that insurance premiums have risen on average over 10 percent every year since 2000.

Having practiced medicine in Portsmouth since 1980, Clairmont said if nothing is done now, the rate of increase, compounding every year, will bring Portsmouth taxpayers a health care bill of $40.4 million in 2020 and $127 million in 2030.

The city could hit $1 billion for health care in 2050, according to Clairmont.

Katie Robbins, national organizer for Healthcare-NOW!, was in Portsmouth as well this week, helping promote the passage of the national, single-payer health care legislation.

Robbins said Portsmouth was perfect for the debate because of how progressive the community is. Not only would the single-payer system allow for universal and guaranteed health coverage for all U.S. citizens, but it would also provide for comprehensive health coverage filled with choices and would be good for the economy, Robbins said.

Currently, nearly one-third of all Americans are either uninsured or underinsured, Robbins said, adding that the proposed system would help solve that problem.

While I don’t proclaim to know everything about health care, I think ideas like creating a single-payer system may have some merit.

Perhaps we’ve reached a point in society where we have no other choice but to look outside of the box and consider all options.

I think City Councilor Bob Lister said it best when he stood up before the crowd of people Wednesday night and proclaimed the so-called fixed costs were a major speed bump in developing a fiscally responsible budget.

“It diverts our mission,” he said.

Lister said he attended the event because he knew it was time to look at other options. He should be applauded for that.

Portsmouth Herald reporter Charles McMahon can be reached at 570-2234 or cmcmahon@seacoastonline.com.

Healthcare scare tactics sickening

By Steven Cotterill
Letters, The Shepherdstown (W.Va.) Chronicle, Feb. 18, 2011

So many myths are found within the letter from Mr. Schmidt that appeared in The Shepherdstown Chronicle on 02/04/11 that it is very hard to know exactly where to begin.

Given however that I have intimate knowledge of the British system of healthcare (I lived in England until the age of 18, since coming to America in 1983 have travelled back numerous times, and have many family members over there still), I will start with Mr. Schmidt’s contention that the failed British healthcare system is in the process of being dismantled.

Not only is this a complete fallacy, but the British, quite rightly, remain as proud of their system of healthcare delivery as many Americans are of representative democracy or jazz. The larger fallacy in Mr. Schmidt’s letter regarding England is that some type of nationalized healthcare system results in complete socialized medicine, which in turn leads to socialism itself. The last time I checked England presently has a coalition government consisting mainly of members of the conservative party, with some liberals added to complete the numbers needed for holding office. Even the very conservative Margaret Thatcher, in her time in office in the 1980s, only tinkered with the efficiency of the national healthcare system, and never seriously considered abandoning it altogether.

A more centralized healthcare system, which the healthcare reform act of last year didn’t even come close to approaching, no more represents the beginnings of socialism than reading Nietzsche turns you into a nihilist. The one does not lead to the other.

The last myth about nationalized healthcare found within Mr. Schmidt’s letter is that it would lead to government bureaucrats rationing care based on age and quality of life issues. In England today doctors make all decisions about healthcare, not government bureaucrats. Unfortunately in America today we actually have rationing, and most insidiously of all, it is based not on doctors’ opinions, but on private insurance profit.

The danger of Mr. Schmidt’s letter, and similar ones found throughout print media in the last few years, is that it promotes the completely false idea that the healthcare legislation act passed in 2010 led to the government take over of healthcare. Even the millions of us who wish for a system of “Improved Medicare for All” (publicly funded, privately delivered), also known as “Single Payer,” don’t want to see government running the healthcare system, and rather see the 2010 legislation as yet another handout for the private insurance industry.

The sadness of Mr. Schmidt’s letter is that the scare tactics used by him and others over the healthcare debate of recent years, hurts millions of Americans who desperately need quality care delivered at low cost. This has been achieved in England, Canada, France and a host of other advanced industrialized nations, without the creeping socialism mentioned in Mr. Schmidt’s letter. If we are not careful this country will slide back into the Red Scare era of the late 1940s and 1950s, when name calling and “guilt by association” destroyed lives and families, and prevented social progress seen in many European countries at the time, from occurring in America until many years later.

Steven Cotterill is a resident of Charles Town, W.Va.

http://shepherdstownchronicle.com/page/content.detail/id/501737/Healthcare-scare-tactics-sickening.html

Single-payer health care system ideal for Alaskans

By DR. JULIAN GONZALEZ
Anchorage Daily News, Feb. 25, 2011

It seems Gov. Sean Parnell has drunk the tea party Kool-Aid about health care reform in order to be “Republican Fashionable.” You would think he would at least consider the health care reform instituted by fellow Republican and former governor Mitt Romney in Massachusetts, a plan not unlike the Patient Protection and Affordable Care Act (PPACA). But, that’s OK, because only 14 percent of Massachusetts physicians think their state’s model would be viable for the rest of the country (Massachusetts Medical Society “Physician Workforce Survey”, 2010). However, 66 percent preferred either a single-payer plan or a private-public insurance option.

In a sense, I’m in the governor’s camp in that I also don’t like the PPACA, or “Obamacare” as it is affectionately known, but not for the same reasons. Basically, it doesn’t go far enough; it doesn’t increase accessibility, quality of care or contain medical costs. Alaska can do better, though, it can do what Vermont is planning: getting a federal waiver and implementing a single-payer program.

Multiple studies by independent organizations such as the Commonwealth Fund and Organization For Economic Cooperation And Development (OECD), have compared the health care outcomes of industrialized countries and have demonstrated that for the high cost of our health care, $7,290 per capita, the highest of all the developed countries (Canada comes next with $4,790) we consistently trail in health outcomes such as life expectancy at birth, asthma mortality, infant mortality rate, chronic disease care, etc., as well as access to affordable, quality care.

Gov. Parnell seems to believe that clinging to the present status quo of insurance-dominated health care, and the addition of technology, such as electronic medical records and telemedicine, neither which has been shown to improve health outcomes, will take care of our problems. But insurance companies are the problem. It’s because of insurance companies that people are more likely to incur higher medical expenses, spend more time on paperwork, have more claims denied, have more health care dollars go to administrative work and profits, and limit both physician and patient choices in their needed health care. Insurance companies are a profit-driven middleman that produces nothing.

In 2009, in the middle of one of our worst economic periods, the five largest health insurers, CIGNA, Humana, WellPoint, United Health and Aetna, garnered combined record profits of $12.2 billion; up 56 percent from the previous year. How many people lost their homes due to medical bills or were denied claims during that same time period?

Last year there were 50.7 million Americans who were uninsured, an increase of 4.3 million per the Census Bureau. Alaska was one of 16 states that experienced a big jump in the uninsured (109, 000 in 2006 versus 122,000 in 2009). Here in Anchorage we have a growing community of seniors on Medicare who cannot find a primary doctor as more and more in the private sector stop taking Medicare. There are also a large immigrant population, a homeless population and many people with chronic diseases that find themselves in the same situation. Most are relegated to a community clinic that is underfunded, understaffed, and overwhelmed where patients have difficulty getting an appointment. Many end up in the emergency rooms.

All this means increased long-term costs to the society because of diseases missed and chronic-care issues that were not adequately addressed.

“Socialized medicine” was coined by the insurance industry when President Truman proposed single-payer health care in the 1950s; it’s time to put that bogeyman to rest. We already have vibrant single-payer plans in Alaska in the Native Health Care system, the military and the V.A., which cover a large portion of our 700,000 people, and give quality care. If we are truly as independent and unique as we Alaskans like to think of ourselves, we should encourage our governor and legislators to act creatively and boldly. A single payer health care plan is smart, efficient, cost effective, humane and takes the burden off of employers and business. Let’s drink water … it’s healthier than Kool-Aid.

Julian Gonzalez is a family physician who has worked in Native care, military care and trained in a country with universal health care coverage. He is a member of Physicians for Social Responsibility (PSR), Physicians for Human Rights (PHR) and Physicians for a National Health Program (PNHP). He lives in Anchorage.

http://www.adn.com/2011/02/25/1723361/single-payer-health-care-system.html

When health insurance isn't for sale

Letters
The New York Times, Feb. 28, 2011

The key phrase in Donna Dubinsky’s article (“Money Won’t Buy You Health Insurance”) is, “If we are not going to have universal coverage.” Any reform that doesn’t offer nonprofit, quality, affordable universal access is inferior and fraught with serious problems, not to mention the complexity and unfairness of for-profit insurance.

Until we reform Medicare and create Medicare for all, including the option to buy private insurance as we do with public and private education, the nation will suffer with the ever-growing injustices of the lack of access to care for more and more Americans, skyrocketing inflation of health care costs and the worst outcomes among all the developed nations on the planet.

Jerry Frankel
Houston
The writer is a urologist.

http://www.nytimes.com/2011/02/28/opinion/l28health.html

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