http://www.politico.com/wuerker/
“Health reform stalls” by Matt Wuerker
http://www.politico.com/wuerker/
Obama’s former doctor critical of White House health care plan
From Jim Acosta
CNN
July 30, 2009
WASHINGTON (CNN) — President Obama often talks about all of the forces lining up against his health care plan. But there’s one critic who has remained relatively mum in the debate.
David Scheiner, a Chicago, Illinois-based doctor, has taken a hard look at the president’s prescription for health care reform and sees bad medicine.
“This isn’t that kind of health care program that I think is going to work,” he said.
So what makes Scheiner so special? He was Obama’s personal physician for 22 years, and voted for the former Illinois senator in the 2008 presidential election.
Scheiner thinks the president’s plan doesn’t go far enough.
“If I had to say the single one thing which is the worst part of it, is that private insurers continue to be a part of the health scheme,” he said. “Everybody keeps saying we don’t want the government getting involved in health care. [But] the government is involved in Medicare, and it works.”
Scheiner would rather see the nation adopt a single-payer system like the ones in Canada and Europe. The financing system relies on one “payer” — which could be a government-run agency — to fund all health care costs billed by doctors, hospitals and other health professionals.
The benefits, advocates say, is that pricey administrative costs are cut, resulting in large savings to patients.
It’s something that an up-and-coming coming state Sen. Obama talked about six years ago.
“I happen to be a proponent of a single-payer universal health care plan. … But as all of you know, we may not get there immediately, because first we’ve got to take back the White House, and we’ve got take back the Senate, and we’ve got to take back the House,” Obama said in 2003.
But that position evolved during the campaign.
“If I were designing a system from scratch, then I’d probably set up a single-payer system. But the problem is we’re not starting from scratch,” Obama said in Albuquerque, New Mexico, in August 2008.
Now, the president favors giving Americans the option of joining a government-run plan that would compete with private insurers. Video Watch more on the health care debate »
“Nobody is talking about some government takeover of health care. I’m tired of hearing that,” Obama said in Raleigh, North Carolina, on Thursday.
But Scheiner says that nobody has seen the details of that option, making it a hard sell for the president.
“We don’t even fully know what the public option is going to be. If the public option is too good, patients who are sick will flock to it, and I’m not sure it will be able to support itself.”
Scheiner almost had a chance to confront the president with his concerns. He was invited to a recent televised town hall meeting with Obama, but he says he was dropped from the program.
“I just hope that the Congress, the American public and the president will hear some of my words,” he said. “We’ve got to do something better.”
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Scheiner will finally get a chance to have his say Friday. He and other doctors who support a single-payer system are gathering in Washington to meet with lawmakers and rally supporters.
He may not be the president’s doctor anymore, but Scheiner says he’s trying to save the patient before it’s too late.
http://www.cnn.com/2009/POLITICS/07/30/obama.doctor/index.html
Obama's former doctor critical of White House health care plan
From Jim Acosta
CNN
July 30, 2009
WASHINGTON (CNN) — President Obama often talks about all of the forces lining up against his health care plan. But there’s one critic who has remained relatively mum in the debate.
David Scheiner, a Chicago, Illinois-based doctor, has taken a hard look at the president’s prescription for health care reform and sees bad medicine.
“This isn’t that kind of health care program that I think is going to work,” he said.
So what makes Scheiner so special? He was Obama’s personal physician for 22 years, and voted for the former Illinois senator in the 2008 presidential election.
Scheiner thinks the president’s plan doesn’t go far enough.
“If I had to say the single one thing which is the worst part of it, is that private insurers continue to be a part of the health scheme,” he said. “Everybody keeps saying we don’t want the government getting involved in health care. [But] the government is involved in Medicare, and it works.”
Scheiner would rather see the nation adopt a single-payer system like the ones in Canada and Europe. The financing system relies on one “payer” — which could be a government-run agency — to fund all health care costs billed by doctors, hospitals and other health professionals.
The benefits, advocates say, is that pricey administrative costs are cut, resulting in large savings to patients.
It’s something that an up-and-coming coming state Sen. Obama talked about six years ago.
“I happen to be a proponent of a single-payer universal health care plan. … But as all of you know, we may not get there immediately, because first we’ve got to take back the White House, and we’ve got take back the Senate, and we’ve got to take back the House,” Obama said in 2003.
But that position evolved during the campaign.
“If I were designing a system from scratch, then I’d probably set up a single-payer system. But the problem is we’re not starting from scratch,” Obama said in Albuquerque, New Mexico, in August 2008.
Now, the president favors giving Americans the option of joining a government-run plan that would compete with private insurers. Video Watch more on the health care debate »
“Nobody is talking about some government takeover of health care. I’m tired of hearing that,” Obama said in Raleigh, North Carolina, on Thursday.
But Scheiner says that nobody has seen the details of that option, making it a hard sell for the president.
“We don’t even fully know what the public option is going to be. If the public option is too good, patients who are sick will flock to it, and I’m not sure it will be able to support itself.”
Scheiner almost had a chance to confront the president with his concerns. He was invited to a recent televised town hall meeting with Obama, but he says he was dropped from the program.
“I just hope that the Congress, the American public and the president will hear some of my words,” he said. “We’ve got to do something better.”
advertisement
Scheiner will finally get a chance to have his say Friday. He and other doctors who support a single-payer system are gathering in Washington to meet with lawmakers and rally supporters.
He may not be the president’s doctor anymore, but Scheiner says he’s trying to save the patient before it’s too late.
http://www.cnn.com/2009/POLITICS/07/30/obama.doctor/index.html
It's Medicare's 44th Birthday!
Dear Healthcare-NOW! Supporter:
Today, single-payer supporters from all over the country are celebrating the 44th birthday of one of the nation’s most popular public programs: Medicare.
On this anniversary of Medicare, we are calling for an end to a wasteful private health financing model based on earning profits through the restriction and denial of needed health care.
Take Action
It’s Medicare’s 44th Birthday! Call Congress today!
Tell them we want improved and expanded Medicare for all (national, single-payer healthcare).
Call the Capitol Switchboard at 866-338-1015.
This could be done through the passage of HR 676, “Expanded and Improved Medicare for All,” or S 703, “American Health Security Act.”
We need your help in telling members of Congress that the people want single-payer now.
Please, call your Senators and Representative today.
If you don’t know your Congress Members, or want to email them rather than call, go to www.VoteSmart.org. Otherwise, call the Capitol Switchboard at 866-338-1015.
Make these four requests:
1. If you haven’t, cosponsor single-payer legislation today. (HR 676 for Reps. and S. 703 for Senators)
2. Join Senators Schumer, Harkin, and Sanders in asking the CBO to score single-payer legislation. Past cost-benefit analyses (including from the CBO) reflect the cost neutrality of a single-payer system, and savings of healthcare dollars overall.
3. Vote for single-payer amendments to current legislation going through House and Senate committees. The grassroots movement is closely watching the outcomes of the votes on single-payer amendments. This will be documented and remembered in the midterm elections.
4. Refuse to accept campaign contributions from the healthcare industry and support publicly funded elections. The receipt of healthcare industry dollars is a conflict of interest as you vote on healthcare policy.
We are greatly concerned that the current legislation will not be universal, protect individuals from bankrupting medical bills, or guarantee needed healthcare to people. Even with proposed private insurance reform, the quality of coverage available will vary significantly depending on ability to pay, which is flagrantly discriminatory. Healthcare is not a product, it is a necessity, and all deserve equal access to care. In addition, there are no realistic cost-containment measures.
A single-payer system of publicly-financed and privately-delivered care solves all of these issues and provides true health security. It is the only proposal that is both socially and fiscally responsible.
Thanks for all that you do,
Healthcare-NOW! National Staff
It’s Medicare’s 44th Birthday!
Dear Healthcare-NOW! Supporter:
Today, single-payer supporters from all over the country are celebrating the 44th birthday of one of the nation’s most popular public programs: Medicare.
On this anniversary of Medicare, we are calling for an end to a wasteful private health financing model based on earning profits through the restriction and denial of needed health care.
Take Action
It’s Medicare’s 44th Birthday! Call Congress today!
Tell them we want improved and expanded Medicare for all (national, single-payer healthcare).
Call the Capitol Switchboard at 866-338-1015.
This could be done through the passage of HR 676, “Expanded and Improved Medicare for All,” or S 703, “American Health Security Act.”
We need your help in telling members of Congress that the people want single-payer now.
Please, call your Senators and Representative today.
If you don’t know your Congress Members, or want to email them rather than call, go to www.VoteSmart.org. Otherwise, call the Capitol Switchboard at 866-338-1015.
Make these four requests:
1. If you haven’t, cosponsor single-payer legislation today. (HR 676 for Reps. and S. 703 for Senators)
2. Join Senators Schumer, Harkin, and Sanders in asking the CBO to score single-payer legislation. Past cost-benefit analyses (including from the CBO) reflect the cost neutrality of a single-payer system, and savings of healthcare dollars overall.
3. Vote for single-payer amendments to current legislation going through House and Senate committees. The grassroots movement is closely watching the outcomes of the votes on single-payer amendments. This will be documented and remembered in the midterm elections.
4. Refuse to accept campaign contributions from the healthcare industry and support publicly funded elections. The receipt of healthcare industry dollars is a conflict of interest as you vote on healthcare policy.
We are greatly concerned that the current legislation will not be universal, protect individuals from bankrupting medical bills, or guarantee needed healthcare to people. Even with proposed private insurance reform, the quality of coverage available will vary significantly depending on ability to pay, which is flagrantly discriminatory. Healthcare is not a product, it is a necessity, and all deserve equal access to care. In addition, there are no realistic cost-containment measures.
A single-payer system of publicly-financed and privately-delivered care solves all of these issues and provides true health security. It is the only proposal that is both socially and fiscally responsible.
Thanks for all that you do,
Healthcare-NOW! National Staff
President Obama’s hardship waivers
TIME’s Exclusive Interview with President Obama
By Karen Tumulty
TIME
July 29, 2009
Karen Tumulty: But some things have changed. I mean, for instance you were very much against an individual mandate. Could you describe how your thinking has evolved on this issue…
President Obama: I feel pretty good that I’ve been pretty consistent on this. The individual mandate is probably the one area where I basically changed my mind. The more deeply I got into the issue, the more I felt that the dangers of adverse selection justified us creating a system that shares responsibility, as long as we were actually making health insurance affordable and there was a hardship waiver for those who, even with generous subsidies, couldn’t afford it. And that remains my position.
Karen Tumulty: What about — you mentioned that subsidies have to be there. What’s — you’re hearing now — 300% [that the government would provide assistance to people earning up to 300% of poverty]. Is that enough? Is that really —
President Obama: Until I actually see the numbers, I don’t want to give a definitive answer on that. I do think that if we can figure out what is a fair, appropriate percentage of your income that you’re paying on health care, and peg it — peg subsidies so that it’s meeting that test, potentially with some regional variation then we’ll get it right. And I think that the committees are working on that. That’s the kind of detail that we had anticipated working through in conference. If it turns out that Congress just can’t get there and that’s the holdup, then we’ll give a very definitive idea of where we need to go on it.
http://www.time.com/time/politics/article/0,8599,1913410-1,00.html
Comment:
By Don McCanne, MD
Detail? Figuring out how to make insurance affordable if it is to protect families from the financial burden of the $16,771 already being spent on average for health care? 300 percent of poverty? 400 percent of poverty?
Play with the numbers all you want. Using the model of reform selected by the President and Congress automatically limits the total subsidies to an amount that will not increase the deficit in the federal budget. Even if the majority of employers continue to displace wage or salary increases in exchange for health benefits, the number of hardship waivers issued will have to be much larger than most are projecting. If employers finally bail out, the majority of us would require hardship waivers.
You don’t believe me? Do the numbers, starting with the amount of money they propose to spend on subsidies.
Obama’s longtime doctor says healthcare reform plan falls short
Dr. David Scheiner of Chicago advocates a single-payer government system. He calls Obama’s plan too timid, saying it reflects politics, not the president’s ideals.
By Mike Dorning
Los Angeles Times
July 29, 2009
Reporting from Washington — The Chicago doctor who treated President Obama for more than two decades has a prescription for healthcare reform: a British- or Canadian-style single-payer system.
Dr. David Scheiner, 70, will advocate such a plan at a rally Thursday on the National Mall.
In an interview, he described the president as a “beloved” patient in “superb” health.
“He was always on time,” Scheiner said. “He just sat in the waiting room with everyone else, even when he was a senator. He never went up to the desk and pulled rank.”
But he criticized Obama’s healthcare plan as too timid, arguing that the White House plan reflected politics more than the president’s ideals.
“It’s a bad program. I don’t think it’s what he feels in his heart is necessary. I think it’s what he feels politically is the best way,” said Scheiner, who acknowledged that he had not discussed the subject with Obama directly.
Scheiner argued that the “public option” Obama favors, in which a government-run insurance program would compete with private insurers, does not go far enough. The public option has been one of the most controversial parts of Obama’s plan, with insurers and conservatives vigorously opposing it.
Scheiner said a single-payer government-run system would cut costs by reducing the administrative overhead that doctors and other health providers must maintain to meet complex reimbursement rules from different insurance companies. A government program also would have greater leverage in negotiating lower drug prices with pharmaceutical companies, he said.
He argued that such a system would lead to better care for lower-income people and end what he said was a pernicious insurance-industry practice: discouraging patients from getting necessary treatment by setting up obstacles, and boosting profits in the process.
“They make it frustrating so he doesn’t get it easily and maybe he’ll go away,” Scheiner said.
Critics’ contention that a single-payer system would constrain patient choices is misplaced, he said.
“The government never gets in my way,” he said. “Forty years I’ve been working [with] Medicare, never. Who gets in my way all the time? Private insurance companies. Somehow that message is not getting across.”
mdorning@tribune.com
Obama’s Doctor: President’s Vision For Health Care Bound To Fail
By Sam Stein
Huffington Post
July 29, 2009
The man Barack Obama consulted on medical matters for over two decades said on Tuesday that the president’s vision for health care reform is bound for failure.
Dr. David Scheiner, a 70-year Chicago-based physician who treated Obama for more than 20 years, said he was disheartened by the health care legislation his former patient is championing, calling it piecemeal and ineffectual.
“I look at his program and I can’t see how it’s going to work,” Scheiner told the Huffington Post. “He has no cost control. There would be no effective cost control in his program. The [Congressional Budget Office] said it’s going be incredibly expensive … and the thing that I really am worried about is, if it is the failure that I think it would be, then health reform will be set back a long, long time.”
Scheiner, who prefers a more progressive approach to reform, was hesitant about trying to divine the president’s motives, although he said he believed that “in his heart of hearts” Obama “may well like a single-payer program.”
“His pragmatism is what is overwhelming him.” Scheiner added: “I think he’s afraid that he can’t get anything through if he doesn’t go through this incredibly compromised program.”
Admitting that he was not a political practitioner, Scheiner said he felt compelled to speak out because of his unique relationship with the president and this critical moment in the health care debate. A champion of a single-payer health care system, Scheiner noted repeatedly that he came to the debate from the perspective of having dealt with the hassles and pitfalls of the current system. His speaking out is part of a larger effort, launched by Physicians for a National Health Program, to push Congress to consider single-payer as an alternative to current reform proposals.
As Scheiner sees it, all alternatives simply fall short. Keeping private insurers in the market, he warns, would simply maintain burdensome administrative costs. He argued further that the pharmaceutical industry is not being asked to make “any kind of significant sacrifices” in the current round of reform negotiations. As for a public health care option, Scheiner insists that the proposal remains vague and inadequate.
“First of all, they haven’t really gone into great detail about the public option,” he said. “How much is it going to cost, are they going to really undercut private health insurance by a considerable amount? Will there be any restriction that you can get for public option?”
Despite his policy critiques, Scheiner’s affection for his long-time patient is quite obvious. He recalled the president as being “gracious” and “never pulling rank” when he came to his office. “Part of my shtick, is I sing songs and I love humor,” Scheiner said. “I remember last time I saw him I told him a joke, he said, ‘Doc, you told me that joke before.’ I was so impressed he can remember my bad jokes — this guy has to be really bright.”
During the course of the campaign, Scheiner became one of the many mini-celebrities in Obama’s orbit. When the then-Senator released a one-page summary documenting his health, criticism for its brevity was laid on the doc’s doorstep.
“The guy was healthy, you know,” Scheiner recalled. “What can you say? His only problem was that he smoked … But there wasn’t that much to say. If I had added anything it would have been pure drivel. There wasn’t anything serious in his record. He’d never had anything. The guy is built like a rock, he could probably bench-press me…
“I think my most impressive time was when Jon Stewart actually mocked my report,” he added. “I thought that was wonderful.”
All of which makes his current criticism of Obama’s health care policies all the more difficult. While Scheiner raved about the president’s intellectual curiosity, he was at loss for words as to why Obama had consulted with private industry executives more than primary care physicians. And while he spoke glowingly about the president’s oratorical talents, he expressed disappointment that Obama had not done more to explain the benefits of single-payer coverage to the American public.
The White House has said that the president moved away from a single-payer approach both because of philosophical objections (consumers should be allowed to keep their coverage) as well as political realities (limited support for the proposal in Congress). The administration’s position increasingly resembles the maxim, Don’t let the perfect be the enemy of the good.
“It’s a good question,” Scheiner said, when asked if having watered-down reform become law was better than getting a single-payer system stalled in Congress. “Is something better than nothing? That is a hard one for me. That is a difficult one, because, in the end, I think [Obama’s] program is going to fail.”
http://www.huffingtonpost.com/2009/07/29/obamas-doctor-presidents_n_246870.html
President Obama's hardship waivers
TIME's Exclusive Interview with President Obama
By Karen Tumulty
TIME
July 29, 2009
Karen Tumulty: But some things have changed. I mean, for instance you were very much against an individual mandate. Could you describe how your thinking has evolved on this issue…
President Obama: I feel pretty good that I’ve been pretty consistent on this. The individual mandate is probably the one area where I basically changed my mind. The more deeply I got into the issue, the more I felt that the dangers of adverse selection justified us creating a system that shares responsibility, as long as we were actually making health insurance affordable and there was a hardship waiver for those who, even with generous subsidies, couldn’t afford it. And that remains my position.
Karen Tumulty: What about — you mentioned that subsidies have to be there. What’s — you’re hearing now — 300% [that the government would provide assistance to people earning up to 300% of poverty]. Is that enough? Is that really —
President Obama: Until I actually see the numbers, I don’t want to give a definitive answer on that. I do think that if we can figure out what is a fair, appropriate percentage of your income that you’re paying on health care, and peg it — peg subsidies so that it’s meeting that test, potentially with some regional variation then we’ll get it right. And I think that the committees are working on that. That’s the kind of detail that we had anticipated working through in conference. If it turns out that Congress just can’t get there and that’s the holdup, then we’ll give a very definitive idea of where we need to go on it.
http://www.time.com/time/politics/article/0,8599,1913410-1,00.html
Comment:
By Don McCanne, MD
Detail? Figuring out how to make insurance affordable if it is to protect families from the financial burden of the $16,771 already being spent on average for health care? 300 percent of poverty? 400 percent of poverty?
Play with the numbers all you want. Using the model of reform selected by the President and Congress automatically limits the total subsidies to an amount that will not increase the deficit in the federal budget. Even if the majority of employers continue to displace wage or salary increases in exchange for health benefits, the number of hardship waivers issued will have to be much larger than most are projecting. If employers finally bail out, the majority of us would require hardship waivers.
You don’t believe me? Do the numbers, starting with the amount of money they propose to spend on subsidies.
Single-payer system cuts barriers to care
By Beth Cardosi
TheSunNews
Wed, Jul. 29, 2009
I’m a physician in South Carolina. I have firsthand experience regarding our broken, wasteful health care system.
On a daily basis I care for the uninsured who have no jobs (often because of layoffs or illness) and have no money or access to health care providers. These people often come to the emergency departments with minor issues that could be handled simply as an outpatient if there were a place for them to be treated, or they are seen with life-threatening illnesses because they couldn’t receive the proper treatment for their chronic illness (i.e. high blood pressure and diabetes) or couldn’t receive preventive care and now have untreatable cancer. These people show up where the care is the most expensive because they won’t get turned away.
But what I find happening more these days is that these numbers are growing. People often have jobs that don’t cover health care, or it’s too expensive for the small-business owner to afford (small businesses are paying twice what large businesses pay for the same coverage). People can’t afford their medications or even their co-payments for office visits if they are lucky enough to have insurance.
I believe America should join the rest of the developed world and provide a single-payer system. I left private practice because I spent hours doing paperwork for insurance companies, was on the phone trying to get tests paid for and had to change medications all the time because insurance would not pay for them. The amount of bureaucracy is nothing for patients with Medicare compared with private health insurance companies. Insurance companies have entire departments whose only function is to find ways to deny payment. Conversely, hospitals have entire departments trying to get paid from insurance companies – now that is a waste of precious resources. Nonmedical insurance company staff, not government, stand between the doctor and their patient’s care.
So, why are people afraid to change the health care system? Not only do people fear change (even in a dysfunctional system) but because media is bombarding them with how bad and expensive a public option or single-payer program would be. Who pays for those ads and funds our political leaders? The same companies who are making huge profits on the suffering of people – and I ask you: If our health care system is so great, why are we 17th in the world for infant mortality and 30th in the world for life expectancy?
I believe our health care system can be cured by taking the profit motive out of the system – like other countries do. This will make it affordable, cheaper and provide access for all. Imagine a country where you can get care without showing your insurance card first.
The writer lives in Myrtle Beach.
http://www.thesunnews.com/opinion/story/1001358.html
Obama's longtime doctor says healthcare reform plan falls short
Dr. David Scheiner of Chicago advocates a single-payer government system. He calls Obama's plan too timid, saying it reflects politics, not the president's ideals.
By Mike Dorning
Los Angeles Times
July 29, 2009
Reporting from Washington — The Chicago doctor who treated President Obama for more than two decades has a prescription for healthcare reform: a British- or Canadian-style single-payer system.
Dr. David Scheiner, 70, will advocate such a plan at a rally Thursday on the National Mall.
In an interview, he described the president as a “beloved” patient in “superb” health.
“He was always on time,” Scheiner said. “He just sat in the waiting room with everyone else, even when he was a senator. He never went up to the desk and pulled rank.”
But he criticized Obama’s healthcare plan as too timid, arguing that the White House plan reflected politics more than the president’s ideals.
“It’s a bad program. I don’t think it’s what he feels in his heart is necessary. I think it’s what he feels politically is the best way,” said Scheiner, who acknowledged that he had not discussed the subject with Obama directly.
Scheiner argued that the “public option” Obama favors, in which a government-run insurance program would compete with private insurers, does not go far enough. The public option has been one of the most controversial parts of Obama’s plan, with insurers and conservatives vigorously opposing it.
Scheiner said a single-payer government-run system would cut costs by reducing the administrative overhead that doctors and other health providers must maintain to meet complex reimbursement rules from different insurance companies. A government program also would have greater leverage in negotiating lower drug prices with pharmaceutical companies, he said.
He argued that such a system would lead to better care for lower-income people and end what he said was a pernicious insurance-industry practice: discouraging patients from getting necessary treatment by setting up obstacles, and boosting profits in the process.
“They make it frustrating so he doesn’t get it easily and maybe he’ll go away,” Scheiner said.
Critics’ contention that a single-payer system would constrain patient choices is misplaced, he said.
“The government never gets in my way,” he said. “Forty years I’ve been working [with] Medicare, never. Who gets in my way all the time? Private insurance companies. Somehow that message is not getting across.”
mdorning@tribune.com