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Albany Catholic
August 6, 2008

ALBANY, N.Y. — On Saturday, Sept. 13, single payer advocates from across New York will meet here to form a new statewide organization. Our aim: to build an unbeatable movement for a single payer public system that would fully fund comprehensive health care, including prescription drugs, for all. We invite all single-payer supporters to join us!

Private insurance has no legitimate role to play in the care of patients. We believe it must be replaced by a public program of health financing. Under a single-payer health care system, we’ll spend our health care dollars on care, not on bureaucratic waste, profit-making and corporate gain.

Our grassroots movement has gained momentum in 2008. Healthcare-NOW and other groups organized a nationwide protest on June 19 in support of single-payer health care. The U.S. Conference of Mayors, the New York State Assembly, and a growing number of unions and central labor bodies have all endorsed H.R. 676, the National Health Insurance Act.

New studies found that a majority of physicians support national health insurance. And there is renewed support for single-payer among important groups like the League of Women Voters, the Unitarian Universalist Association and the Presbyterian Church USA.

Looking ahead, health care will continue to be a central issue in the presidential election. And New York State, with a new governor and a changing Senate, has initiated an official evaluation and discussion of proposals for universal health care. Now is the time to strengthen grassroots activism in support of a single national, publicly-financed health care plan.

Already a wide diversity of groups and individuals across New York are working for H.R. 676, and also for a New York state-based single payer system. We have worked together spontaneously, organically, and successfully. We also work with many other groups that promote “universal health care” or “affordable health care,” but not necessarily single payer. We are appreciative of their efforts. But the evidence is convincing that single payer reform is crucial for our state and our nation.

A formal statewide grassroots coalition will allow us to share resources, local news, publications, speakers and more. We have much to learn from one another – and from other successful state-based single payer organizations. Together we can build a vigorous single payer voice in every county in New York State–and, ultimately, a new health care system.

Please join us!

New York State Nurses Association * Mike Keenan, President, Troy Area Labor Council, AFL-CIO * Kathleen Scales, Executive Director, Capital District Area Labor Federation, AFL-CIO * Healthcare-NOW * Health Care Work Group of Otsego, Delaware & Chenango Counties * Mark Dunlea, Executive Director, Hunger Action Network of New York State * Tompkins County Health Care Task Force * Senior Legislative Action Committee of Sullivan County * League of Women Voters of Saratoga County * Patricia Friedland, member, Healthcare-NOW * Rev. Cass Shaw, Albany Presbytery * Long Island Coalition for a National Health Plan * Citizens for Universal Healthcare, Kingston * Joel Schwartz, President, CSEA Local 446, Staten Island Council * Christy Staats, Clifton Park Single Payer Committee * Barbara Warren, Executive Director, Citizens’ Environmental Coalition * Jeff Vogel, Delegate Assembly member, 1199 United Healthcare Workers East / SEIU * New York Metro, Syracuse, Capital District, and Finger Lakes chapters of Physicians for a National Health Program * Douglas Delong, MD, Physicians for a National Health Program, Cooperstown * Richard Propp, MD, Capital District Alliance for Universal Healthcare, Inc. * Doug Bullock, 8^th District Representative, Albany County Legislature * Rochester Interfaith Health Care Coalition * New York Statewide Senior Action

SINGLE PAYER NEW YORK

Founding conference

Albany Medical College

Saturday September 13th

10am to Noon — Healthcare-NOW Roadshow, featuring Donna Smith of “Sicko”

Noon — lunch, please RSVP if you would like a box lunch

1pm to 4pm – organizing and strategy meeting

To join Single Payer New York, and for further details about September

13th, please contact one of the following:

Dr. Andy Coates pnhpcapitaldistrict @gmail.com
Rebecca Elgie healthylink@ earthlink.net
Mark Dunlea dunleamark@aol. com
Courtney Morrow pnhpmetro@nyc. rr.com

By RICHARD PROPP
Albany Times Union
First published: Sunday, August 3, 2008

Dear Medicare:

Happy birthday!

Since I first met you on July 31, 1965, I have been smitten with your looks, your fairness, your support of the elderly without regard to social or economic status, skin color, ethnicity, intellectual IQ, emotional IQ, address, clubs, choice of transportation, hobbies, reading list, or favorite restaurant. You took care of our grandparents, our parents, and now you are taking care of us!

Your birth was not without pain. Some of the Southern congressmen could not stand the idea of people with differing skin colors being in the same hospital room. Eventually President Lyndon Johnson, his staff, and senior citizen groups, wore down Congress, the insurance industry, the unions, and the American Medical Association, and Medicare, health care for all Americans aged 65 and over, became law. It was implemented in July of 1966. Health care was not just a necessity, it was now a right for these folks.

In July of 1965, I was moonlighting as a substitute physician in Ravena in southern Albany County with Dr. John Mosher and Dr. Ira Lefevre while I was chief resident at Albany Hospital, now known, of course, as Albany Medical Center Hospital. (Dr. Richard T. Beebe was chief of medicine at Albany Hospital and allowed us to make ends meet in this way.) More than half of our patients in Ravena who were over 65 couldn’t pay for their needed medical care and instead left vegetables and chickens at Mrs. Mosher’s back door. When Medicare came in, it allowed older folks to be treated as paying patients, restoring their dignity and their ability to be diagnosed and treated at an early stage of their illness. Countless lives were saved and diseases prevented. Practitioners and hospitals flourished.

Through the years, dear Medicare, you have been declared broke and broken, and somehow in response to pressure by physicians and patients, wise and compassionate politicians have patched you up and you carry on.

In 2003 you were “modernized” by radical conservatives and the drug and insurance companies, and, frankly, you were exploited. We are just now waking up to the fact that the real goal of this “modernization” was privatization. We are now paying private insurance companies 13 percent more to deliver benefits to those 65 and older through these private Medicare Advantage plans than through traditional Medicare. This wasteful and unnecessary payment scheme was highlighted in the recent struggle over Medicare physician reimbursement rates and hopefully will be addressed through the political process over the next year.

Those of us who believe health care is not just a necessity, but should become a right for all, hope that sometime soon you will have a baby and expand your family!

That baby is already in gestation stage as HR676, Expanded and Improved Medicare for All.

More than 90 members of Congress have signed on in support of this legislation, and there is a strong and growing wave of grass-roots support, as well as in the medical community, local governmental entities, and the labor movement. Your overhead of 4 percent, dear Medicare, is one-sixth that of private insurance plans, and one third that of not-for-profit plans. Among its many benefits, socially and economically, single payer improved and expanded Medicare for all would eliminate the huge administrative expense in time and staff to deal with myriad insurance company plan requirements and reduce overhead. Hospitals would have a guaranteed budget, and rural and urban physicians and other practitioners will have patients for whom they will get full reimbursement. At least 22,000 lives will be saved and over 500,000 medical bankruptcies will be avoided each year. Job mobility and the economy will improve as health insurance becomes separated from employment.

New opposition groups are arising, however, who are very clever about espousing “universal health care”, but, upon scrutiny, what they are really supporting are private insurance-based plans and the status quo.

This is really like putting lipstick on a pig. Even with lipstick, pigs are still pigs.

Forcing everyone into private insurance plans is not the solution to our health care crisis for anyone except the insurance industry. We, your family, dear Medicare, seek to expose these efforts as the cynical delay and denial tactics they represent. We will not let your estimable reputation and outstanding 43 years of success be besmirched, or curtailed by your undermining and privatizing adversaries.

Medicare, we still love you.

Happy birthday, and many more!

Dr. Richard Propp is chair of the Capital District Alliance for Universal Healthcare, Inc.

By Amanda Gardner
HealthDay Reporter
August 4, 2008

MONDAY, Aug. 4 (HealthDay News) — One out of every three working-age, uninsured Americans suffers from a chronic illness and isn’t getting the medical care they need, a new report shows.

Although the study didn’t specifically look at the health consequences of lack of insurance and lack of access to medical care, it’s reasonable to assume that these factors would lead to various medical complications, said the authors of a study published in the Aug. 5 issue of the Annals of Internal Medicine.

“This is something that is very true in my clinical experience,” said Dr. Andrew Wilper, instructor in medicine at the University of Washington in Seattle. “The uninsured can’t get in to see the doctor, they miss medications, their blood pressure is out of control and, really, you see devastating consequences.” Wilper was a fellow in general internal medicine at Harvard Medical School while conducting the study.

Another expert agreed that a lack of insurance along with chronic illness can be a potentially lethal combination.

“These people are going to end up with complications of their illnesses prematurely. They will be disabled early. They will probably die younger. It is a major public health disaster,” said Dr. Oliver Fein, president-elect of Physicians for a National Health Program and professor of clinical medicine and public health at Weill Cornell Medical College of Cornell University in New York City. “Longer-term, there will be expensive admissions to hospitals, usually through the emergency department, due to diabetes out of control and congestive heart failure because of hypertension.”

Information on the number of Americans without health insurance (about 47 million in 2006, up from 31 million in 1987) is plentiful. Less clear has been how many of these individuals suffer from chronic medical conditions, although some, including policymakers, have suggested that many are healthy.

Using data from interviews with almost 12,500 people aged 18 to 64 who had participated in the National Health and Nutritional Examination Survey (NHANES), the authors conclude that an estimated 11.4 million working-age Americans with at least one of seven chronic medical conditions do not have health insurance.

This included 16.1 percent of the 7.8 million people with cardiovascular disease, 15.5 percent of the 38.2 million people with hypertension and 16.6 percent of the 8.5 million people with diabetes.

Other conditions examined were asthma, high cholesterol, chronic obstructive pulmonary disease or a previous diagnosis of cancer.

“We found some pretty striking differences when we compared uninsured individuals with one of these seven conditions with insured individuals with one of the conditions,” Wilper said.

About 26 percent of uninsured people reported no standard site of care, versus only 6.2 percent of those who had insurance. More than 22 percent of uninsured individuals reported no visits to a health professional in the past year compared to 6.2 percent of insured people, and 7.1 percent of uninsured people with a chronic condition reported that the emergency room was their standard site of medical care, versus 1.1 percent of those carrying insurance.

“These are conditions that we take care of in the clinic. We know that we can prevent disabling complications or catastrophe if we are able to manage these conditions,” Wilper said.

“None of it is surprising,” said Greg Scandlen, founder and director of Consumers for Health Care Choices, a nonprofit advocacy group for health-care consumers. “It is interesting that chronic conditions are more common among people with insurance than without. But that isn’t surprising either. People with a chronic condition are likely to place a higher value on their coverage and work harder to get and keep it,” he said.

“But having insurance is not likely to prove to be a panacea for these folks,” Scandlen added. “People with chronic conditions who are insured are not doing so well, either. We do not do a very good job of delivering chronic care in this country for anyone.”

The new findings corroborate those from a study published July 22 in Health Affairs, which concluded that access to care among uninsured, nonelderly U.S. adults with chronic conditions actually got worse between 1997 and 2006.

http://health.usnews.com/articles/health/healthday/2008/08/04/one-third-of-uninsured-are-chronically-ill.html

By Anne Harding
Reuters
Mon Aug 4, 2008 5:40pm EDT

NEW YORK (Reuters Health) – An estimated 11.4 million Americans with at least one chronic illness have no health insurance, new research published in the Annals of Internal Medicine shows.

These people are much less likely to have a regular place to get medical care, much less likely to have seen a doctor in the past year, and much more likely to use the emergency room than chronically ill people who are insured, Dr. Andrew P. Wilper and colleagues from Cambridge Health Alliance/Harvard Medical School in Cambridge, Massachusetts, found.

“Primary care doctors know that people who don’t have access to health care due to health insurance suffer,” Wilper, who is now with the University of Washington School of Medicine in Seattle, told Reuters Health. “We wanted to study that issue and bring public attention to it.”

He and his colleagues analyzed data from the National Health and Nutritional Examination Survey for 1999-2004, which included 12,486 men and women 18 to 64 years old. Based on this nationally representative sample, they calculated that 16.1 percent of people with heart disease, 15.5 percent of those with high blood pressure, and 16.6 percent of diabetics are uninsured.

Among the uninsured, 22.6 percent had not visited a physician in the previous 12 months, compared to 16.2 percent of insured chronically ill people.

The corresponding percentages for those lacking a regular site receiving health care were 22.6 percent and 6.2 percent, and for those using the emergency room for regular care the numbers were 7.1 percent and 1.1 percent.

After the researchers adjusted for age, gender and race or ethnicity, they found that the chronically ill uninsured patients were four to six times more likely than sick patients with insurance to have these access problems.

People with chronic illnesses who don’t receive regular medical care run the risk of “catastrophic consequences,” Wilper said.
For example, individuals whose diabetes isn’t under control may wind up on dialysis for the rest of their lives, or need to have a limb amputated. Improving access to care could “prolong their life and prevent disabling complications and a lot of needless suffering,” he added.

In an editorial accompanying Wilper’s study, Dr. Marshall H. Chin of the University of Chicago writes, “Health care insurance reform is necessary for good care for chronic disease.” However, he adds, it won’t be enough until efforts are made to tackle disparities in health care.

Wilper noted that while both US presidential candidates are talking about health care reform, neither has a plan that will solve the issue of inadequate access to health care among chronically ill Americans. “Regardless of who wins the presidential election, for example, we won’t see the problem that we defined here go away.”

SOURCE: Annals of Internal Medicine, August 5, 2008.

http://www.reuters.com/article/healthNews/idUSKRA47698620080804?pageNumber=1&virtualBrandChannel=0

Harvard Medical Labcast

Click here to listen to the podcast (mp3)

Stephanie Woolhandler, an associate professor of medicine at the HMS-affiliated Cambridge Health Alliance, investigates disparities and inequalities in healthcare and medicine. In recent years, she has published studies on the relative cost and effectiveness of the Canadian healthcare system. In published editorials and on Capitol Hill, Dr. Woolhandler has argued for full-scale reform of the current system here in the U.S. Last year, she uncovered insurance shortfalls for American military veterans, and her most recent research found unexpected disparities in the way free prescription drug samples are distributed.

As part of her ongoing efforts to increase care for the underserved, Dr. Woolhandler helped found Physicians for a National Health Program in 1986. The group is a single-issue organization that advocates single-payer national health insurance for all Americans.

By William Klepack
Guest Column
The Ithaca Journal
July 31, 2008

In early July, Congress passed a bill to prevent a scheduled cut in Medicare payments to doctors. Although I am pleased with the outcome of this vote, there are several reasons that senior citizens should be concerned about the political maneuvering affecting their care that surrounded this bill and be very interested in single-payer health care.

First, Senators voting against the bill were protecting insurance industry profits at the expense of seniors. The bill reduced insurance company profits by an amount necessary to balance the Medicare budget. Senators voting against this bill were, effectively, manipulating seniors’ health care to benefit the insurance companies’ bottom line.

Second, seniors should be upset because this was just the most recent threat in a long pattern of erosion of payments to their personal physicians, and this trend is starting to have an impact on seniors’ access to care. Primary care doctors (family physicians and internists) have worked tirelessly on behalf of Medicare patients, even as Medicare compensation for their services has stagnated since 2001. Physicians have experienced large increases in overhead costs during that period, and primary care doctors simply cannot continue to sustain their businesses when costs rise and payments do not keep pace with both those costs and inflation.

The result of this ongoing trend is that seniors are having more difficulty finding a physician. In March, the Medical Group Management Association reported that nearly 24 percent of all physicians had begun limiting or not accepting new Medicare patients. In December, the Medicare Payment Advisory Commission reported that, nationally, three out of 10 Medicare patients had trouble finding a primary care physician.

Since having access to health care is the single most important factor influencing health, these adverse trends point out serious problems with our current system.

Seniors should support single-payer health care because, under such a system, patients’ access to health care would not be subject to manipulation for insurance company profits. Private insurance companies would not be raking in exorbitant profits — profits that deliver no health care.

Another reason seniors should support single-payer health care is because a health-ministry-type system would no longer be the political football that the current system has been in recent years. If a nonpolitical health ministry were making health care funding decisions, then the power of the insurance industry to influence legislation ensuring their profits would cease.

Seniors should also support single-payer health care because it would establish payment levels that enable their doctors to keep their doors open and simultaneously make the health care dollar deliver more health care. A national board charged with negotiating with physicians would come to an agreement on rates.

The current Medicare insurance card has no value unless there is a doctor in the house. We not only need a doctor in the house; we need every dollar to go farther in delivering care.

Dr. William Klepack is a family physician practicing in Dryden and is medical director of the Tompkins County Health Department. The opinions expressed above are his personal ones and do not reflect Health Department or Tompkins County policy.

http://www.theithacajournal.com/apps/pbcs.dll/article?AID=/20080731/OPINION02/807310306