PNHP

Health reform should start with moral question

pnhpf3a

Health reform should start with moral question

The Missoulian
Letter to the editor
Thursday, September 10, 2009

Amidst the give and take of the health care reform discussion is an underlying basic moral imperative: Does a wealthy country like the United States have an ethical obligation to provide access to health care to everybody?

If the U.S. made the moral choice to provide universal coverage, like other industrialized nations, then we too could design a fair, efficient and high-quality health care system for all Americans.

So the first question that must be answered by policy makers is, “Do we want to live in a society that lets tens of thousands of our neighbors die each year, and hundreds of thousands face financial ruin, because they can’t afford medical care when they are sick?”

Once answered that morally everybody should have a basic human right to health, aided through a system of health care, that is comprehensive, simple to administer, of lower cost, and universally available, we can move to the next step.

The concept of a unified system that works the same for everybody doesn’t necessarily equate to a single-payer system, although this seems to be the simplest and best. There are multi-payer systems that provide fairness and the administrative simplicity of a single payer structure: all patients treated the same and all the payers follow a coordinated set of rules and forms, and all providers fees adhere to a unified payment schedule. A unified system makes it easier to use digital record keeping. It eliminates cost shifting and an incentive for preventive health measures.

The fragmented system we have hasn’t worked. Financing health care must be a non-profit endeavor. A unified system creates a powerful political dynamic for managing cost. Universal coverage enhances health care results by improving the overall health of a nation. Incomplete coverage is a key reason 22,000 die every year from diseases that could have been treated if they’d had health insurance.

Because administrative costs and unnecessary care, combined with perverse incentives, are the major causes of the expense, the concept of a single payer system is mandatory. This is an anathema to free-market people, who are misleading the public by negative advertising, with denigration by politicians and others, labeling it “socialized medicine,” and “government interference.”

To get the truth out, there should be a new intense advertising campaign to educate the public about the benefits of this approach. A single payer system could be run by a federal board, independent of the government, appointed by the president and confirmed by the Senate. It could function with assistance of health care experts and be immune to political interference. Regional entities under the board’s aegis could manage the delivery of health care. Unnecessary care could be monitored so the link between income and generated procedures and tests could be curbed. There are many options for reimbursement to providers: capitation, global payments, salary system, pay for episodes of care, rewards for improved outcomes, and pay according to episodes of care. It’s interesting that 30 % of U.S. physicians are already on salary. Tort reform must also be addressed to eliminate the high cost of liability insurance, through a review panel of peers for malpractice claims.

All of this could be done by not spending any more than what we do now. It is more likely there would be a huge reduction in health care spending. It just doesn’t make sense to continue the partisan pursuit of complicated individual interests. Everyone needs to proclaim that there exists a moral imperative; that it does mean providing access to health care for everyone. It is relatively common sense to then formulate a government funded, unified system, with nonprofit financing and coverage for every citizen – a single-payer system.

Richard A. Damon, MD
Bozeman

Over 70 Labor Organizations Call on AFL-CIO Convention to Endorse HR 676

Kay Tillow
All Unions Committee For Single Payer Health Care–HR 676
09/10/09

Pittsburgh, PA — More than seventy labor organizations have submitted resolutions to the AFL-CIO Convention calling for the labor federation to endorse HR 676, single payer healthcare legislation introduced by Congressman John Conyers (D-MI).

Resolutions were submitted by five national and international unions including the International Longshore & Warehouse Union (ILWU), the International Alliance of Theatrical & Stage Employees (IATSE), the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), California School Employees Association (CSEA), and the International Federation of Professional & Technical Engineers (IFPTE).

Seven state AFL-CIO Federations submitted resolutions including Wisconsin, South Carolina, Maine, Michigan, Kentucky, California and Vermont.

The remaining resolutions were submitted by Central Labor Councils and Area Labor Federations in twenty states.

All resolutions, including one expected to be submitted by the Executive Council, will be referred to the Convention’s Legislative Policy Committee which is chaired by Leo Gerard, President of the United Steelworkers.

Healthcare is expected to be discussed on Tuesday September 15th after President Obama addresses the Convention.

HR 676 would institute a single payer health care system by expanding a greatly improved Medicare system to everyone residing in the U. S.

HR 676 would cover every person for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, and long term care.

HR 676 ends deductibles and co-payments. HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.

In the current Congress, HR 676 has 86 co-sponsors in addition to Conyers. Vermont Senator Bernie Sanders has introduced SB 703, a single payer bill in the Senate.

HR 676 has been endorsed by 566 union organizations in 49 states including 134 Central Labor Councils and Area Labor Federations and 39 state AFL-CIO’s (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC, MO, MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA, AK, MI, MT, NE, NY, NV & MA).

For further information, a list of union endorsers, or a sample endorsement resolution, contact:

c/o Nurses Professional Organization (NPO)
1169 Eastern Parkway, Suite 2218
Louisville, KY 40217
(502) 636 1551
Email: nursenpo@aol.com
http://unionsforsinglepayerHR676.org

Access to medical care a basic human right

Guest column
The Missoulian
Friday, September 11, 2009

The commercial aspects of restructuring the health care industry are receiving much attention. Those of us who have been involved in the actual delivery of medical care believe there is a principle underlying the entire enterprise. Understanding this principle provides perspective that helps to evaluate the business details in reform plans as they emerge in coming weeks.

We believe that the United States needs to join the vast majority of the developed world and acknowledge the principle that medical care is a basic human right.

Nations recognizing this truth include Australia, Austria, Britain, Canada, Denmark, France, Germany, Ireland, Japan, the Netherlands, New Zealand, Switzerland and Taiwan. The United States is unique among major industrialized nations in not recognizing health care as a basic right for all its citizens.

Here’s the choice: If you consider health care a market-driven commodity, you will be content to make modest changes around the edges of our present profit-driven system. If you consider health care to be a business, you will tolerate the perverse incentives that increase business volume and you will be content to continue our current method of rationing on the basis of purchasing power.

However, if you understand medical practice to be a profession responding to a basic human need, and hospital services to be a critical element of health care, you will insist on genuine, far-reaching reform with a goal of achieving universal access.

While we understand that there may be many ways to achieve meaningful reform, we endorse a strong public health insurance option as the centerpiece of an effective strategy that can provide for the general welfare and at the same time retain the freedom of choice that citizens desire.

We know that our country will be more productive, our businesses stronger and our futures brighter if all of us have access to care.

This guest column was signed by Drs. Randale Sechrest, Herbert Swick, Stephen Speckart, Megan Sarnecki, George Risi, Liz Rantz, Roger Munro, William Nichols, Jan B. Newman, Judy Olson, Byron Olson, Al Gabster, Patrick Davis, N. Nelle Cotton, Henry W. Busey, John Brown, Hal Braun, Ned Vasquez, Alison Fortney-Gorman, David Gorman and by Elizabeth Oleson and Lee Ann Bradley, PharmD.

Sarah Palin feeds the fact checkers

Obama and the Bureaucratization of Health Care

By Sarah Palin
The Wall Street Journal
September 9, 2009

Some 45 years ago Ronald Reagan said that “no one in this country should be denied medical care because of a lack of funds.” Each of us knows that we have an obligation to care for the old, the young and the sick. We stand strongest when we stand with the weakest among us.

Common sense tells us that the government’s attempts to solve large problems more often create new ones. Common sense also tells us that a top-down, one-size-fits-all plan will not improve the workings of a nationwide health-care system that accounts for one-sixth of our economy.

… many of the sick and elderly are concerned that the Democrats’ proposals will ultimately lead to rationing of their health care by — dare I say it — death panels?

http://online.wsj.com/article/SB20001424052970203440104574400581157986024.html

And…

A Time for Choosing

By Ronald Reagan
October 27, 1964

A young man, 21 years of age, working at an average salary — his Social Security contribution would, in the open market, buy him an insurance policy that would guarantee 220 dollars a month at age 65. The government promises 127. He could live it up until he’s 31 and then take out a policy that would pay more than Social Security. Now are we so lacking in business sense that we can’t put this program on a sound basis, so that people who do require those payments will find they can get them when they’re due — that the cupboard isn’t bare?

Barry Goldwater thinks we can.

At the same time, can’t we introduce voluntary features that would permit a citizen who can do better on his own to be excused upon presentation of evidence that he had made provision for the non-earning years? Should we not allow a widow with children to work, and not lose the benefits supposedly paid for by her deceased husband? Shouldn’t you and I be allowed to declare who our beneficiaries will be under this program, which we cannot do? I think we’re for telling our senior citizens that no one in this country should be denied medical care because of a lack of funds. But I think we’re against forcing all citizens, regardless of need, into a compulsory government program, especially when we have such examples, as was announced last week, when France admitted that their Medicare program is now bankrupt. They’ve come to the end of the road.

http://www.reagan.utexas.edu/archives/reference/timechoosing.html

Comment:

By Don McCanne, MD

The heated debate over health care reform was certainly not unexpected. What has been a surprise to many of us is the intensity of the nastiness of the opponents of reform.

In the past, politicians often supported their ideological positions through distortions created by carefully selecting favorable facts and discarding the unfavorable. In the current debate it seems like the ideologues opposed to reform are creating rhetoric that does not carry the burden of factual support. That flexibility allows an introduction of nastiness like we’ve never seen. That has extended all the way to Congress where we heard during President Obama’s address the shout from a Congressman, “You lie!”

The rhetoric is so bad that we have now introduced fact checkers – a problem in itself since since some dispute the facts that the fact checkers are using. Risking the possibility that my comments might be challenged based on my ideology (supporting health care for all), I’ll do my best to provide a little bit of honest fact checking here.

* Sarah Palin selected a quote from Ronald Reagan suggesting that we as a nation will stand together to see that no one in this country “be denied medical care because of a lack of funds.” It would be difficult to interpret this as representing anything other than unambiguous support for the concept of social insurance. Of course then she dispels that notion with her own anti-government rhetoric.

* Placing that same quote of Ronald Reagan in context, it was actually buried in his attack on Social Security, rejecting social insurance as a “compulsory government program.” Although he did say that no one should be denied medical care because of lack of funds, he did not tell us what the source of those funds would be.

* Ronald Reagan said, “… France admitted that their Medicare program is now bankrupt. They’ve come to the end of the road.” That was in 1964. This year, 2009, the conservative leaders in France have again stated that their health care program is bankrupt. Regardless, their health care system has been ranked number one by the World Health Organization, and it is funded at a fraction of what we spend per capita in the United States. The “bankrupt” rhetoric will always be with us, but what really counts is whether or not the system is providing everyone with the health care that they need.

* To prove what a bad deal Social Security is, Ronald Reagan used the example of a 21 year old with average wages. He said that a privately purchased insurance policy would provide a guarantee of 220 dollars a month at age 65, whereas Social Security would guarantee him only 127 dollars per month. As it happens, that 21 year old would be 66 now, and the average Social Security benefit for a retired worker is 1,153 dollars per month (SSA.gov). (I can hear the conservative actuaries saying, “But… but… you lie!”)

* Sarah Palin dared to repeat once again: “death panels.” Although we’ve been saturated with the fact checkers’ “pants on fire” ratings of this comment, that is no problem for the conservatives – the fact checkers lie.

The nastiness of this dialogue has seemed to lock us into a nonsensical “True! Lie!” debate over relatively peripheral issues. This is a debate that the conservatives will always win because it diverts us from the fundamentals of reform. In the meantime, behind the scenes the insurance industry has manipulated its own jackpot win while the noisy public debate has been taking place.

The tragedy is that the Democrats allowed themselves to be maneuvered into a position of a pseudo-bipartisan compromise that is based on a mandate to purchase private health plans that many middle-income Americans cannot afford.

Here is where the debate should have been:

* A Medicare for all program that automatically enrolls everyone is a truly universal program. TRUE!

* A mandate to purchase private health plans is a truly universal program. FALSE!

* The single payer model of reform includes policies that are effective in slowing the increase in health care costs to a sustainable level. TRUE!

* The current Democratic model of reform contains measures that are effective in slowing the increase in health care costs to a sustainable level. FALSE!

* A single universal risk pool that is funded through equitable tax policies will make health care affordable for each and every individual. TRUE!

* A multi-payer system of public and private programs funded from multiple sources, including a mandate to pay partially subsidized premiums for some, will make health care affordable for each and every individual. FALSE!

Come on! Let’s start debating the TRUTH, based on actual FACTS. Let’s advocate for affordable health care for everyone. A fact checker can’t challenge simple human decency.

Iowa reaction to Obama's speech

University psychiatrist: ‘Step back and start over’ 

Des Moines Register
Sept.10

Dr. Jess Fiedorowicz, a University of Iowa psychiatrist: He was not won over. Fiedorowicz favors a single-payer health care system, in which government insurance would cover everyone.

“President Barack Obama continues his struggle to foster what is likely to be an ineffective compromise between uncompromising parties,” he wrote after the speech. “Instead, we should step back and start over on health reform.”

Fiedorowicz called Obama’s proposal “a handout to the health-insurance industry.”

“A single-payer system is the only proposal to address the unnecessarily convoluted and complex system, which spends 31 cents of every health care dollar on overhead. … President Obama, however, dismissed single payer as ‘from the left’ and ‘a radical shift.’ However, a radical shift is necessary to reduce the overhead in our system.”

Opinion: Single-payer health care: dead in Washington, but alive in the states

Insurance companies may be winning the fight in Washington, but California and Vermont are on the cusp of comprehensive reform.

By Michael Corcoran
Opinion
Christian Science Monitor
September 10, 2009 edition

Boston – President Obama delivered a stirring address to Congress last night, but the federal government’s inability to truly overhaul our broken healthcare system — which now leaves more than 46 million uninsured — is becoming all the more apparent.

Speaking before a joint session of Congress, Obama declared that a public option to compete with private insurers, considered vital by many liberals, was merely a “means to an end,” and not essential to healthcare reform. Earlier this summer, a New York Times/CBS poll showed that 72 percent of Americans support a government-run healthcare plan. But Obama’s speech last night indicates that while a bill will probably pass, prospects for comprehensive reform — the kind millions of Americans voted for — have dimmed rapidly. Insurance companies, which have given large donations to both political parties, are winning the fight in Washington.

The inability of a popular president with substantial majorities in Congress to pass a progressive health bill is immensely frustrating to healthcare activists, and to all who gave Obama a mandate for change.

But their cause is not lost — they just need a new strategy.

Given the corporate world’s disproportionate influence over Washington, it is time to take the fight for public healthcare away from Congress and into statehouses across the country.

State governments are typically far more democratic that the federal government and the public has a much greater ability to penetrate the debate. Moreover, in some states there are already legislatures and grass-roots movements that are working to make a statewide “single-payer plan” — similar to Canada’s national health coverage — a reality.

Two state legislatures — Vermont and California — have, in fact, passed single-payer legislation in recent years only to have them vetoed by Republican governors. But California Gov. Arnold Schwarzenegger (R) is ineligible to run for a third term and Gov. Jim Douglas (R) of Vermont has decided not to seek reelection. Either of these states could soon become the first to pass a statewide, public healthcare system that covers everyone.

“I think it makes sense to push for single-payer on a state-wide level,” says Dr. Deb Richter, founder of Vermont Health Care for All. “It looks pretty grim in Washington … so we are mobilizing our forces.”

Healthcare activists in Vermont are now advocating for single-payer bills in the Senate and the House and plan to highlight the issue for the 2010 gubernatorial campaign. The Vermont Workers’ Center is more than a year into a “Healthcare Is a Human Right” campaign that is releasing reports and organizing rallies all over the state.

“We think this could really happen here,” says James Haslam, director of the Vermont Workers’ Center. “There is a lot of excitement around this issue. Vermont could become a model for the rest of the country.”

Indeed, Vermont may be the state best suited to tackle single-payer. According to a study commissioned by the Vermont Legislature in 2006, Vermont would save $51 million a year if it switched to single-payer. The state is also home to a supportive congressional delegation. Sen. Bernie Sanders, an independent who caucuses with the Democrats, has introduced legislation in the Senate that would enable states to have single-payer systems of their own.

There are also strong prospects for single-payer healthcare in California, where the legislature has twice passed single-payer, only to have it vetoed both times by Governor Schwarzenegger.

But Schwarzenegger has served two terms and will be replaced in 2010, a fact that has emboldened grass-roots activists. “The governor’s race is the next stage for the single-payer battle in California,” says Chuck Idelson, a spokesman for the California Nurses Association, which has been fighting for single-payer for years. “We need to elect a candidate that is open to single-payer.”

The California Nurses Association was also instrumental in lobbying for an amendment, added by Rep. Dennis Kucinich (D) of Ohio to a House version of the federal healthcare reform bill, that would remove potential legal impediments for states to pass single-payer bills by waiving federal exemptions that apply to employer-sponsored health plans from the federal Employee Retirement Income Security Act (ERISA).

“Even if we passed single-payer tomorrow, there would still be a protracted legal battle due to ERISA,” Idelson said. “That is why this amendment is so important as we push for single-payer.”

But whatever obstacles to statewide single-payer exist, they are small compared to the barriers faced in Washington, where the option was taken off the table before the national conversation began. And with vibrant single-payer movements taking place, not only in Vermont and California, but also New Mexico, Illinois, Pennsylvania, Montana, and elsewhere, it is clear that as long as Washington is impervious to change, the fight for public healthcare must be waged one state at a time.

Michael Corcoran is a journalist who focuses on business, media, and public affairs. He has written for The Nation, The Boston Globe, Extra!, Alternet, Campus Progress, and other publications.

Census Bureau report on health insurance coverage

Health Insurance Coverage: 2008

U.S. Census Bureau
September 10, 2009

* The percentage of people without health insurance in 2008 was not statistically different from 2007 at 15.4 percent. The number of uninsured increased to 46.3 million in 2008, from 45.7 million in 2007.

* The number of people with health insurance increased to 255.1 million in 2008 — up from 253.4 million in 2007. The number of people covered by private health insurance decreased to 201.0 million in 2008 — down from 202.0 million in 2007. The number of people covered by government health insurance increased to 87.4 million — up from 83.0 million in 2007.

* The percentage of people covered by private health insurance was 66.7 percent in 2008 — down from 67.5 percent in 2007. The percentage of people covered by employment-based health insurance decreased to 58.5 percent in 2008, from 59.3 percent in 2007. The number of people covered by employment-based health insurance decreased to 176.3 million in 2008, from 177.4 million in 2007.

* The percentage of people covered by government health insurance programs increased to 29.0 percent in 2008, from 27.8 percent in 2007. The percentage and the number of people covered by Medicaid increased to 14.1 percent and 42.6 million in 2008, from 13.2 percent and 39.6 million in 2007. The percentage and number of people covered by Medicare increased to 14.3 percent and 43.0 million in 2008, from 13.8 percent and 41.4 million in 2007.

* In 2008, the percentage and number of children under 18 without health insurance were 9.9 percent and 7.3 million, lower than they were in 2007 at 11.0 percent and 8.1 million. The uninsured rate and the number of uninsured for children are the lowest since 1987, the first year that comparable health insurance data were collected. Although the uninsured rate for children in poverty decreased to 15.7 percent in 2008, from 17.6 percent in 2007, children in poverty were more likely to be uninsured than all children.

* The uninsured rate and number of uninsured for non-Hispanic Whites increased in 2008 to 10.8 percent and 21.3 million, from 10.4 percent and 20.5 million in 2007. The uninsured rate and number of uninsured for Blacks in 2008 were not statistically different from 2007, at 19.1 percent and 7.3 million.

* The percentage of uninsured Hispanics decreased to 30.7 percent in 2008, from 32.1 percent in 2007. The number of uninsured Hispanics was not statistically different in 2008, at 14.6 million.

http://www.census.gov/hhes/www/hlthins/hlthin08.html

Comment:

By Don McCanne, MD

President Obama, in his speech before the joint session of Congress last evening, did not break new ground on the current proposal for reform being developed by Congress and the administration. So, based on the framework that has been advanced, what impact will the current proposal have on the numbers of uninsured?

* The primary reason for the excessive numbers of uninsured is that health care costs are now so high that premiums for adequate health plans are no longer affordable for low and middle income individuals. The policies in the current proposal designed to reduce health care spending are inadequate and will not have an impact on reducing the numbers of uninsured since it will be impossible to create less expensive plans that have adequate benefits.

* Although lower-income individuals will have greater access to Medicaid/CHIP and to larger subsidies to purchase private plans, the subsidies for average-income Americans will be inadequate to make the premiums and cost sharing affordable.

* Most small businesses will be exempt from the employer mandate and thus will not be a factor in increasing the rate of insurance coverage amongst their employees.

* Initially only uninsured individuals and small businesses will have access to the insurance exchange. Thus most Americans will not be able to select from an FEHBP-like menu of plans similar to the program that members of Congress now have.

* Because of a reluctance to increase revenues through the tax system and an insistence that the program not add to our budget deficits, Congress has restricted the amount of funds that will be available to expand Medicaid and to finance the premium subsidies for the private plans.

* Middle-income individuals will be mandated to purchase private health plans. Affordability of these plans for individuals and families will be determined by income levels, by the amount of the government subsidies used to purchase the plans, by adequacy of plan benefits, and by the amount of cost sharing required of those accessing care. Based on the preliminary numbers provided, serious affordability issues will be faced by a far greater number of middle-income individuals than are being projected by the architects of the proposal.

* Because of affordability issues, consideration is being given to allowing the purchase of underinsurance plans like those designed for the young invincibles. Because of the adverse health and financial impacts of relying on these deficient plans, these individuals should be counted amongst the uninsured from a policy design perspective.

* It has been agreed that the inadequacy of the government subsidies will require the issuance of hardship waivers for those who cannot afford their portion of the insurance premium, based on their incomes. Hardship waivers will become commonplace for those caught between low-income, where government support is generous, and high-income, where affordability is not a consideration. Those in the middle are the majority of Americans. Hardship waivers which relieve individuals of paying fines for the crime of being uninsured could become the standard for middle-income Americans.

An improved Medicare for all single payer program would automatically include everyone, and would be affordable for all of us. President Obama’s program will leave far too many out, and will fail to adequately address the high costs of health care.

Many believe that President Obama effectively used his address to set the stage for the final phases of the reform process, with no turning back. We desperately do need to push on with reform, but it needs to be reform that works.

When President Obama mentioned single payer last evening, there was an embarrassing smattering of applause. Democrats were there to support the president who supports a mandate to purchase private plans that you can’t afford. How embarrassing. Supporting a plan that serves the private insurance industry so well, at great cost to the American people.

So you disagree? You think that this will serve middle-income Americans well? Prove it! Demand a full study that calculates premiums for private plans with adequate benefits and adequate financial protection in the face of medical need and includes all risks in the pools, that determines the premiums as a percent of income at various income levels, that determines the size of the subsidy that would be required to make the balance of the premiums affordable at each income level, that determines the level of cost sharing that would be required of those with needs, that determines the true amount of public funding that would be necessary to support those premiums and cost sharing, and then describes precisely the sources of that public funding.

Those crafting reform can’t make the numbers work. If you can’t either, then join us in a march on Washington to demand that they enact reform with numbers that do work in providing all of us with the health care that we need. Sacrificing the insurers should not be an embarrassment to any of us. It should be a matter of pride.

Uninsured figures show mandate-based health reforms don't work

New uninsured figures show Massachusetts, touted as model for national reform, is failing to cover the uninsured

FOR IMMEDIATE RELEASE
Sept. 10, 2009

Contact:

Quentin Young, M.D., (312) 782-6006
David Himmelstein, M.D.
Steffie Woolhandler, M.D., M.P.H.
Don McCanne, M.D.
Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org

Official estimates released this morning by the Census Bureau showing a marginal increase in the number of Americans without health insurance in 2008 – now estimated at 46.3 million, up from 45.7 million in 2007 – masks the true dimensions of the problem, a national doctors’ group said.

Significantly, in Massachusetts, where an individual-mandate health reform law, much like what President Obama is proposing on a national scale, was passed in 2006, at least 352,000 people, or 5.5 percent of the population, remained uninsured in 2008. That number was actually (but non-significantly) higher than the number of uninsured in 2007, before strict enforcement of the individual and employer mandates went into effect.

“The legislation championed by the president and the congressional leadership is a virtual clone of the Massachusetts plan,” said Dr. Steffie Woolhandler, professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program (PNHP). “Today’s numbers show that plans that require people to buy private insurance don’t work. Obama’s plan to replicate Massachusetts’ reform nationally risks failure on a massive scale.”

Woolhandler said last year’s job losses in the recession, and the corresponding loss of health coverage by many workers and their families, are inadequately reflected in the new data. An estimated 2.6 million people lost their jobs in 2008, most of them toward the end of the year. Those who lost insurance at the end of the year would probably be counted as insured in the Census data, she said.

Census officials cited a drop of 1.1 million in the number of persons who were covered by employer-based insurance, continuing an 8-year trend. Whereas 64 percent of Americans had employer-based coverage in 1999, only 58.5 percent had such coverage in 2008.

Dr. Quentin Young, national coordinator of PNHP, said had it not been for a leap of approximately 4.4 million people newly covered by government programs like Medicaid and Medicare, the overall uninsured rate would have set a new record.

Young said the “tragic and painful persistence” of tens of millions of uninsured persons in the country is “completely unacceptable” and underscores the urgency of enacting a Medicare-for-all program.

“The only way to solve this problem is to insure everyone,” he said. “And the only way to insure everyone is to enact single-payer national health insurance, an improved Medicare for all. Even President Obama has acknowledged this fact.”Young noted that Rep. Anthony Weiner, D-N.Y., is introducing an amendment to the House leadership’s health reform bill, H.R. 3200, which would essentially delete its present language and substitute the language of Rep. John Conyers’ single-payer bill, H.R. 676. “It’s not too late for Congress to do the right thing,” Young said.

Dr. Don McCanne, senior policy fellow at PNHP, noted that the Census Bureau was once again silent on the pervasive problem of “underinsurance.” People are usually defined as underinsured if they spend 10 percent or more of their income (or 5 percent if they are low-income) on out-of-pocket medical expenses in the course of a year.

“Not having health insurance, or having poor quality insurance that doesn’t protect you from financial hardship in the face of medical need, is a source of mounting stress, anguish and poor medical outcomes for people across our country,” McCanne said. He noted that a recent study showed 62 percent of personal bankruptcies in the U.S. are now linked to medical bills or illness and three-quarters of those who went bankrupt had insurance when they got sick.

*****

State-by-state data on the uninsured from 2005-2009 can be found here: https://pnhp.org/uninsured2008/Uninsured-by-State-2005-2008.pdf

Physicians for a National Health Program (www.pnhp.org), a membership organization of over 17,000 physicians, supports a single-payer national health insurance program. To contact a physician-spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.

Iowa reaction to Obama’s speech

University psychiatrist: ‘Step back and start over’ 

Des Moines Register
Sept.10

Dr. Jess Fiedorowicz, a University of Iowa psychiatrist: He was not won over. Fiedorowicz favors a single-payer health care system, in which government insurance would cover everyone.

“President Barack Obama continues his struggle to foster what is likely to be an ineffective compromise between uncompromising parties,” he wrote after the speech. “Instead, we should step back and start over on health reform.”

Fiedorowicz called Obama’s proposal “a handout to the health-insurance industry.”

“A single-payer system is the only proposal to address the unnecessarily convoluted and complex system, which spends 31 cents of every health care dollar on overhead. … President Obama, however, dismissed single payer as ‘from the left’ and ‘a radical shift.’ However, a radical shift is necessary to reduce the overhead in our system.”

Single Payer Allies

PNHP has been leading the movement for single payer national health insurance for two decades. In 2005, PNHP National Coordinator Dr. Quentin Young helped found a sister organization for non-physicians, Healthcare-Now. If you know of another organization that would like to endorse single-payer, please contact us.

Among the many organizations endorsing single payer are: AFL-CIO, American Association of Community Psychiatrists, American Medical Women’s Association, American Medical Student’s Association, National Medical Association, American Nurses Association, American Public Health Association, Islamic Medical Association, Americans for Democratic Action, Church Women United, Consumer Federation of America, Consumers Union, Healthcare Now, National Assocation of Social Workers, National Council of Senior Citizens, National Family Farm Coalition, Neighbor to Neighbor, Older Women’s League, Screen Actor’s Guild, and the US Public Interest Research Group, and United Steelworkers Union.

National Organizations:

Healthcare-NOW!

Public Citizen

All Unions Committee for Single Payer Healthcare — HR 676

California Nurses Association/National Nurses Organizing Committee

Progressive Democrats of America

Single Payer Action

National Health Care for the Homeless Council

PNHP State Chapters and Contacts

Urge your rep to vote 'Yes' for single payer!

This fall presents a historic opportunity for members of Congress to go on the record in support of single-payer legislation.

Rep. Anthony Weiner (D-N.Y.) is introducing a substitute amendment to the House leadership’s bill, H.R. 3200, that would delete the language of that bill and substitute the provisions of H.R. 676, the single-payer, Medicare-for-All bill sponsored by Rep. John Conyers (D-Mich.). House Speaker Nancy Pelosi has promised a full floor vote on Weiner’s amendment in the weeks or months ahead.

The Weiner amendment, unlike the House leadership’s bill, assures universal, comprehensive, and high-quality coverage, free choice of doctor and hospital, and no co-pays or deductibles through a publicly financed system similar to Medicare. Because of the massive savings on private insurance overhead and paperwork, the Weiner amendment would entail no increase in U.S. health spending, in contrast to the House bill’s $1 trillion price tag over 10 years.

Write your representative today in support of the Weiner amendment. If you can, arrange a meeting with your congressperson; you can find tips on how to do so here and talking points here. Finally, please write to Rep. Weiner so he knows that he has our support in his fight for real health reform.

Rep. Dennis Kucinich (D-Ohio) successfully offered an amendment to the House leadership’s bill that, if incorporated into final legislation passed by the Congress and signed by the president, would allow states to adopt their own single-payer system if they chose to do so. Specifically, Kucinich’s amendment would waive certain ERISA provisions that could be used to obstruct such a move.

While PNHP works for a national single-payer program, and while we more specifically supports the passage of H.R. 676, we welcome any efforts to move toward single payer. We therefore encourage you to write your representative today in support of the Kucinich amendment.

Resources

Write your representative in support of the Weiner amendment

Weiner amendment overview by PNHP – August 25, 2009

Full text of Wiener amendment from the Committee on Energy and Commerce markup – July 31, 2009

A Superior System: Comparison between H.R. 3200 and single payer

How can we pay for National Health Insurance? – August 21, 2009

Meeting with legislators regarding the Weiner Amendment – August 25, 2009

What to do at disruptive town halls – August 25, 2009

Write your representative in support of the Kucinich amendment

Congressman Weiner on The Rachel Maddow Show – July 21, 2009

Congressman Weiner leaves Joe Scarborough speechless – July 18, 2009

Universal Health Care Pts 1 & 2

Two Harvard Medical professors critique our current system and offer a better vision

A downloadable MP3 and streaming version is available here:
http://www.humanmedia.org/catalog/program.php?cPath=40&products_id=276

Even with its dazzling technical advances and sophisticated medicines, health care increasingly frustrates Americans. Patients must contend with a system that won’t pay for some treatments, long waiting lists, rushed visits with doctors, copious paperwork and — of course — the ever-soaring cost of medical coverage and medications. Many doctors and nurses feel trapped in a structure they say sometimes prevents them from providing adequate care to their patients. One couple, both researchers at Harvard Medical School and both internists practicing at Cambridge Hospital in Massachusetts, are leaders in the movement among medical professionals to reform health care in America.

Dr. Steffie Woolhandler and Dr. David Himmelstein lead a campaign by doctors to reform health care which they see as needlessly expensive and corrupt. Together they founded Physicians for a National Health Program in 1987 which aims for a system where everyone is covered. They decry the soaring costs of health care — and how that hurts poor people who are uninsured — and many in the middle class who are under-insured. The doctors pull no punches in describing what they see as enormous waste in health care expenditures.

A National Public Radio program produced by David Freudberg, host of “Humankind,” Human Media / The Network Inc.

Visit www.humanmedia.org