Chapter – Page 487

Medicine As A Beleaguered Profession

By Andrew D. Coates, M.D., F.A.C.P.
WAMC Northeast Public Radio, August 3, 2013

A young friend and keen analyst of social change made the observation that it seems that physicians, when it comes to the contemporary state of our profession, seem a bit in shock, as if suffering a grief reaction. She referenced the stages of grief elucidated by Elisabeth Kubler-Ross — denial, anger, bargaining, depression and acceptance.

Last week I mentioned an anecdote from a recent essay in the Journal of the American Medical Association in which a medical school Dean asked the incoming class for a show of hands by those who had been advised by at least one physician not to go into medicine — and 4 out of 5 hands went up across the room. I can attest to the veracity of this anecdote from my own experiences with medical students and colleagues.

Physicians find the profession of medicine in a beleaguered state as the environment and framework in which we practice has shifted around us. The solo practice physician worthy of a Normal Rockwell painting has become a fossil of the past. Physician-run group practices are now also on the endangered species list, as hospitals, corporations, insurance companies and Wall Street investors purchase or develop physician groups.

For example, at the end of April this year Forbes magazine reported “in the [United States] where healthcare faces sweeping changes accelerated by the Affordable Care Act,” private equity investors have been “making serial acquisitions of smaller medical practices that they roll up into larger, more efficient groups. In particular, [private equity] funds are assembling groups of practitioners, both in traditional hospital-centered specialties in such areas as radiology and neonatology as well as in emerging fields of hospital-focused specialization like neurology and general surgery.”

Once upon a time physicians commanded almost total control over who we worked with, what kind of equipment we needed, how we wanted to spend our day. Now doctors are among the employees, not just of hospitals and non-profit organizations, and not only for-profit entities, but finance capital itself. As physicians experience these changes — and weigh what it means to care for our patients within these new environs designed to serve the interests of private equity — we find the potential for conflict between the loyalty owed to our patients and their interests, and the loyalty demanded by our employer.

The American Medical Association last November emphasized the impact of these changes upon physicians by adopting a set of guiding principles for physicians entering into contractual and employment agreements in order to protect the paramount responsibility to patients and the best interests of patients. That the American Medical Association took the time to “address some of the unique challenges to professionalism and the practice of medicine arising in the face of physician employment,” seems to me a fair gauge of the pressures upon physicians brought by the “sweeping changes” like the ones Forbes magazine describes.

These pressures will likely intensify unless profit-seeking itself is removed from healthcare, removed from caregiving. What’s more, to throw the sweeping changes toward the “profitization” of caregiving into full reverse is entirely practical. A bill before Congress, the Expanded and Improved Medicare For All Act, would ban for-profit medicine.

This week Professor Gerald Friedman, economist of the University of Massachusetts, presented the findings of his analysis of the legislation at a Congressional briefing. Not only would profiteering be removed from our healthcare system, upgrading the nation’s Medicare program and expanding it to cover people of all ages would yield more than a half-trillion dollars in efficiency savings in its first year of operation, enough to pay for high-quality, comprehensive health benefits for all residents of the United States at a lower cost to most individuals, families and businesses.

With a solution at hand perhaps it is not too much to invoke Kubler- Ross’s paradigm of denial, anger, bargaining, depression and acceptance as an analogy, for the societal moment seems to me precipitous. Yet for medicine as a profession although the diagnosis is grave and life-altering, I believe the prognosis is excellent. How we will carry on in the interests of our patients will ultimately win out.

Four out of five of our students may have been warned to stay away from medicine, yet the chose our profession anyway. Physicians and physicians-to-be remain profoundly motivated by the service we perform to our fellow human beings. That spirit will help us lead our system to the kind of real reform we need.

Your doctor copays are too high!

We’ve chosen a cost-sharing system of high-deductible health care. Here’s why it’s grossly unfair to Americans

By Adam Gaffney
Salon, August 5, 2013

Until recently, the high-deductible health insurance plan – pay less up front, and more when you get sick – was something of a novelty product, marketed to the young and healthy. Now, however, high-deductibles are rapidly going mainstream – whether for young or old, professionals or poor alike.

Let’s say that you are in the market for a health insurance plan for your family. Perusing the choices on United Health’s website, you play it safe, avoid the plan labeled “high-deductible,” and settle on the company’s “comprehensive plan,” so-called “Copay Select.”

You expect a hefty annual premium, but are surprised to learn that after the premium is paid, you will still have a sizable deductible – money to be paid out-of-pocket for services ranging from lab tests to surgery – starting at $1,000 and ranging up to $12,500 per year. You may then be susceptible to “co-insurance” – additional out-of-pocket expenses of up to 30% of your medical bills –with maximums reaching as high as $10,000 per year. Then there are copays for visits to the doctor, as well as four “tiers” of cost sharing for prescription drugs.

Realizing that such expenses might turn a medical illness into a financial catastrophe, you consider waiting to 2014, when you can buy health insurance through the new exchanges created under the Affordable Care Act (ACA). You would, however, be disappointed to learn that the mid-level “silver” plans offered on the exchange are only required to cover 70% of your annual health care expenses. Out-of-pocket “cost-sharing” – in the form of copays, deductibles, or co-insurance – could go as high as $12,700 a year for your family, depending on your income.

Now those fortunate enough to have insurance through their employer might hope to be free from this phenomenon. The protection, however, is only partial, as plans in the employer market have been trending in a similar direction for years. Between 2006 and 2012, for instance, the percentage of covered workers with a deductible of $1,000 or more tripled, as did those with a deductible of more than $2,000.

Even those sufficiently impoverished to be eligible for public assistance are not immune: in January, the administration moved to allow states to charge Medicaid patients higher copayments for drugs, emergency room use and doctor’s visits.

Welcome to Copay Country.

To understand the origins of this new era of “cost-sharing,” we have to look back to the 1970s, when the rising costs of American health care became for the first time the predominant concern of policymakers.

During that decade, accelerating health care inflation was superimposed on economy wide-stagflation, a situation that only got worse after the expiration of Nixon’s health care sector price controls in 1974. From 1970 to 1980 health care spending jumped from $75 billion to $256 billion, an increase from 7.2 to 9.2% of GDP. The health care cost crisis was born.

The idea of “cost sharing” is neither a new idea, nor a universal one. Nixon’s 1971 health care plan, for instance, featured deductibles and copayments as well as a cap on annual expenses. The British National Health Service, conversely, has since its inception made health care free at the point of service.

Those who support cost sharing argue that it reduces overall health care spending by deterring patients from seeking unnecessary health care, or – more recently – by pursuing less expensive care from competing providers. Those who oppose cost sharing, on the other hand, argue that the incentive to save could also serve as a disincentive to seek care, as well as a financial liability for many working class families.

To address these concerns, in the late 1970s the federal government funded the “Rand Health Insurance Experiment,” a difficult-to-perform study that has not been repeated, and which continues to inform discussions on the topic today. The experiment assigned – at random – 3958 people aged 14 to 61 to one of four categories of health insurance: a “free plan” with no cost sharing, and three other plans with variable degrees of cost-sharing in the form of copays, deductibles and co-insurance.

Some of the results were predictable. Those who had to pay each time they used health care, for instance, used less of it, making about a third-fewer visits to the doctor and being hospitalized about a third less. But notably, for the group as a whole, such cost sharing didn’t seem to worsen overall health outcomes. The experiment has subsequently been used to argue that there was a potential free lunch to be had: cost sharing could decrease overall spending, and no one would get hurt in the process.

Of course, there was some fine print. First, even at the time of publication, when the researchers looked specifically at the group of patients with low income and elevated health risks, the results were concerning: within this group, those who were in the cost sharing plans, as compared to the free plans, had worse vision as well as higher blood pressure. In fact, the researchers calculated that they had an increased risk of dying as a result of cost sharing.

Furthermore, later evaluations demonstrated that while cost sharing clearly reduced health care usage, it reduced both “appropriate care” (for instance, effective care for acute conditions) and “inappropriate care,” not a surprising fact given that patients generally trust the advice of their physicians, and are usually not equipped to decide which care is necessary and which is dispensable.

More modern research on cost sharing has raised even more concerns. When it comes to prescription drugs, for instance, a 2007 study in the Journal of the American Medical Association demonstrated that cost sharing results in lower rates of medication usage, with worse adherence to prescribed regimens. Additionally, those with higher cost sharing seemed to use more non-drug medical services – in particular patients with heart failure and schizophrenia – suggesting that not taking medications might be increasing medical costs in other ways.

Cost sharing frequently also puts individuals and families in extremely unenviable situations: should I go for the follow-up CT scan and make sure that some small growth isn’t developing into a cancer, or should I pay my rent? A 2011 study published in the journal Health Affairslooked at the effect of “high-deductible plans” (defined as plans with a $1,000 or more deductible) on families in which one member was chronically ill. Almost half of the families with a high-deductible plan – more than double that of families in traditional plans – had substantial financial burdens, such as having difficulty paying basic bills or having to set up payment plans. Cost sharing may also cause some families to avoid care altogether: a 2012 study published by some of the same researchers demonstrated that high-deductible plans were associated with an increase in delayed or forgone care, both for adults and chi
ldren.

Cost sharing, it is becoming increasingly clear, may not be a free lunch after all, particularly for those who have to pay for it.

But putting aside the empiric data for a moment, there is also something deeply counterintuitive about the underlying logic of cost sharing: that someone who is sick – frequently operating under significant physical, psychological, or financial constraints – will be able to impartially dissect the rationale for his or her doctor’s recommendations, parse the nuances of the frequently controversial and incomplete medical evidence, and safely decline only the unneeded medical interventions. That the same individual – so the theory goes – will simultaneously engage in a lifelong hunt for high-quality but bargain-priced deals among competing groups of laboratories, doctors, pharmacies, drug-manufacturers, hospitals, dialysis providers, imaging centers, and medical supply companies.

Such an expectation is – to put it modestly – entirely unrealistic. But even worse, it is grossly unfair to the sick patient.

Regardless, unless things change, the future promises only more and more cost sharing. In addition to the trends already in place, in 2018 another provision of the ACA will go into effect – a 40% excise tax on high-cost insurance plans, defined as family plans costing more than $27,500, or individual plans costing more than $10,200. These are no doubt very expensive plans by today’s dollars, and if this provision went into effect today, few would be affected. But over the years, as a result of continued health sector inflation, more and more plans will begin to hit that ceiling. And when they do, it will not be in the employer’s or insurer’s interest for them to go any higher: further increases in the cost of care will simply take the form of more and more cost sharing. As the New York Times reported in May, many companies are already increasing copays and deductibles now, so that they can remain below the threshold when 2018 hits.

Understanding the logic of this tax is crucial: its purpose is not to raise revenue, but to contain costs by limiting the scope of benefits under these so-called “cadillac plans.” But the problem is that costs are contained only by dumping more of the price of care onto us when we get sick, forcing us to either decline care, or theoretically to find cheaper alternatives.

The logic of cost sharing is therefore essentially the logic of health care consumerism, increasingly a dominant mantra in political and health policy circles. Make the patient a consumer, and the system will be saved.

Yet, the United States already has more health care “consumerism” and cost sharing than other developed countries – and yet we have much higher costs. The truth is that there are safer and better-proven methods of cost control that we could employ, and which wouldn’t involve making a patient pay every time he or she gets sick.

We could, for instance, allow Medicare to directly bargain with drug companies over prescription drug prices, as other wealthy countries already do: by one estimate, the savings from this reform alone could range from $230 to $541 billion over ten years.

More ambitiously, we could work towards a “single payer system,” which could save billions through reduced administrative and clerical expenditures, while allowing costs to be directly controlled through global budgets and fee schedules. Gerald Friedman, an economist at the University of Massachusetts at Amherst, recently estimated the savings of such a system at $592 billion annually.

At the same time, we are of course obliged to continue to move away from procedures and tests with high cost and little health benefit, both through physician and patient education.

But rather than borrow these and other ideas from better performing health care systems, we are only making our system more and more like itself.

“Copay Country,” in other words, is not an inevitability – it is a choice. But is it really the country we want to become?

Adam Gaffney is a physician and writer in Massachusetts.

Low-socioeconomic patients with high-deductibles receive less high-severity emergency care

Low-Socioeconomic-Status Enrollees In High-Deductible Plans Reduced High-Severity Emergency Care

By J. Frank Wharam, Fang Zhang, Bruce E. Landon, Stephen B. Soumerai and Dennis Ross-Degnan
Health Affairs, August 2013

Abstract

One-third of US workers now have high-deductible health plans, and those numbers are expected to grow in 2014 as implementation of the Affordable Care Act continues. There is concern that high-deductible health plans might cause enrollees of low socioeconomic status to forgo emergency care as a result of burdensome out-of-pocket costs. We analyzed emergency department (ED) visits and hospitalizations over two years among enrollees insured in high-deductible plans through small employers in Massachusetts. We found that plan members of low socioeconomic status experienced 25–30 percent reductions in high-severity ED visits over both years, while hospitalizations declined by 23 percent in year 1 but rose again in year 2. Similar trends were not found among high-deductible plan members of high socioeconomic status. Our findings suggest that plan members of low socioeconomic status at small firms responded inappropriately to high-deductible plans and that initial reductions in high-severity ED visits might have increased the need for subsequent hospitalizations. Policy makers and employers should consider proactive strategies to educate high-deductible plan members about their benefit structures or identify members at higher risk of avoiding needed care. They should also consider implementing means-based deductibles.

http://content.healthaffairs.org/content/32/8/1398.abstract

Comment:

By Don McCanne, M.D.

People of low-socioeconomic status who have high-deductible health plans have 25 to 30 percent fewer emergency department visits for high-severity medical conditions – conditions with a high probability of needing ED-level care within twelve hours. That can’t be good.

Since similar trends were not found in people of high-socioeconomic status, the authors suggest that deductibles should be means-based – lower deductibles for those of low-socioeconomic status. But that would add more administrative complexity to our system already overburdened with administrative excesses.

The purpose of the deductibles is to reduce health care spending, but we don’t want to do that by not taking care of individuals with high-severity medical conditions. It would be far more efficient to simply eliminate deductibles for everyone and use better, patient-friendly methods of controlling spending. That’s what single payer is all about – people getting the health care they need while making it affordable for everyone.

'Cadillac tax' threatening public union health benefits

Health Care Law Raises Pressure on Public Unions

By Kate Taylor
The New York Times, August 4, 2013

Cities and towns across the country are pushing municipal unions to accept cheaper health benefits in anticipation of a component of the Affordable Care Act that will tax expensive plans starting in 2018.

The so-called Cadillac tax was inserted into the Affordable Care Act at the advice of economists who argued that expensive health insurance with the employee bearing little cost made people insensitive to the cost of care. In public employment, though, where benefits are arrived at through bargaining with powerful unions, switching to cheaper plans will not be easy.

Steven Kreisberg, the director of collective bargaining and health care policy at the American Federation of State, County, and Municipal Employees, said the term Cadillac tax was misleading, because it “connotes a certain aspect of luxury in these health plans that is just factually incorrect.”

Cities including New York and Boston, and school districts from Westchester County, N.Y., to Orange County, Calif., are warning unions that if they cannot figure out how to rein in health care costs now, the price when the tax goes into effect will be steep, threatening raises and even jobs.

“I think it was misguided all along,” Robert B. Reich, the former labor secretary, said in an e-mail. When the law was being written, he said, he worried that the tax was “a blunt instrument that could too easily become a bargaining chit for cutting back benefits of workers.”

“Apparently, that’s what it’s become,” Mr. Reich, who is a professor of public policy at the University of California, Berkeley, said.

Under the tax, plans that cost above a certain threshold in 2018 — $10,200 annually for individual plans and $27,500 for family plans, with slightly higher cutoffs for retirees and those in high-risk professions like law enforcement — will be taxed at 40 percent of their costs in excess of the limit. (The thresholds will rise with inflation after 2018.)

State and local governments across the country tend to offer more expensive health plans than private businesses do, and workers often accept smaller wage increases to retain their benefits. Because of this, state and local government employees are expected to be disproportionately represented among those whose plans will be subject to the tax.

So the administration of Mayor Michael R. Bloomberg, in its final months in office, is asking municipal unions to agree to seek new bids for the city’s health insurance business, hoping to lower premiums. But lower-cost plans are likely to involve greater out-of-pocket costs and more limited networks of doctors, and so far, the response from labor has been cool.

Jonathan Gruber, an economist at the Massachusetts Institute of Technology who was a paid consultant to the Obama administration on health care policy, said forcing state and local governments to rein in health care costs was exactly what the tax was intended to do.

http://www.nytimes.com/2013/08/05/nyregion/health-care-law-raises-pressure-on-public-employees-unions.html?nl=todaysheadlines&emc=edit_th_20130805&_r=0&pagewanted=all

Obama demands tax on Cadillac plans

Comment by Don McCanne
Quote of the Day, January 7, 2010

What is the deal on the excise tax on high-premium “Cadillac” health plans, and why is President Obama pushing this tax so vigorously in the final stages of enacting health care reform?

Well, he is pushing it because his advisers tell him that it would help to achieve his first and foremost goal of slowing the increase in health care spending. The rhetoric being used implies that taxing high-premium plans would reduce the waste of paying for extravagant, non-essential benefits that are of little practical value. We’ll first dismiss this misperception and then follow with an explanation of why this form of cost management results in detrimental health outcomes.

The so-called Cadillac plans are merely plans with high premiums. The Health Affairs article by Jon Gabel and his colleagues (at link below) demonstrates that only 3.7 percent in the variation in premiums can be explained by the actuarial value inherent in the benefit design. In most instances, the higher premiums are not due to “Cadillac” benefits, but they are due to other factors, such as the type of industry providing the employment and the medical costs in the region.

Employers will not want to pay the excise tax, so they will demand from the insurers premiums that are at or below the tax threshold. Insurers will not simply reduce the premiums and continue to offer the same benefit packages. They will lower their benefits, lowering the actuarial value of the plans. There is absolutely no doubt that high and ever-increasing deductibles will be the norm.

The philosophy of controlling health care spending by shifting the financial burden to individuals and families is the most serious defect in the legislation before Congress. The excise tax on high-premium plans is only an example of this shift. The most glaring example is that the national standard proposed for basic plans has an actuarial value set at the unacceptably low level of 70 percent or even less. Making insured individuals pay money they don’t have to access care that is unaffordable is the worst way to control health care spending.

https://pnhp.org/news/2010/january/obama-demands-tax-on-cadillac-plans

Comment:

By Don McCanne, M.D.

Many of the health policies in Obamacare are not only highly flawed, they were known to be so as the Act was being crafted. The tax on Cadillac plans – standard full benefit plans that are expensive only because health care is expensive – is one of these we-told-you-so, seriously flawed policies.

Unions representing public employees have been more successful in maintaining the actuarial value of their plans, that is, ensuring that the plans will prevent financial hardship for those who need health care. Now Obamacare has provided local governments with a tool – the Cadillac tax – to bring employees’ health plans into compliance with high-deductible, low actuarial value underinsurance plans that have become the norm in the individual insurance market and are becoming more prevalent in the workplace. It is well established that these plans cause worse health outcomes and greater financial hardship.

It is complete nonsense to take good plans and wreck them so that they’ll all be equally bad, when what we need to do is to provide everyone with protection against financial hardship when accessing essential health care services. This is precisely what the health policies of the single payer model are designed to do. Let’s get our policies right.

Health Care Law Raises Pressure on Public Unions

By Kate Taylor
The New York Times, Aug. 4, 2013

“Every municipality with a generous health care plan is doing the math on this,” said J. D. Piro, a health care lawyer at a human resources consultancy, Aon Hewitt.

But some prominent liberals express frustration at seeing the tax used against unions in negotiations.

“Apparently, that’s what it’s become,” Mr. Reich, who is a professor of public policy at the University of California, Berkeley, said.

New York City expects its two most popular employee health plans to reach taxable Cadillac levels by 2018 or shortly after. This year, the city projects that it will pay a total of $7,128 for individuals and $18,249 for families in its most popular plan, including the costs the city pays into union welfare funds to cover prescription drug benefits. That is above the national average for employer-sponsored health care coverage, which last year was $5,615 for single coverage and $15,745 for family coverage, according to a 2012 Kaiser Family Foundation survey.

The total health care cost for the city’s nearly 300,000 municipal employees, pre-Medicare-age retirees and their dependents is expected to approach $8 billion by 2018.

In a letter in April to the head of a labor coalition, Caswell F. Holloway IV, deputy mayor for operations, said the Cadillac tax would cost New York City $22 million in 2018, increasing to $549 million in 2022. (This year, the total city budget, excluding federal and state aid, is just over $50 billion.)

“We know that, on the current trajectory, we’re going to be hit with that tax and it would increase very steeply,” Mr. Holloway said.

So the administration of Mayor Michael R. Bloomberg, in its final months in office, is asking municipal unions to agree to seek new bids for the city’s health insurance business, hoping to lower premiums. It has already achieved one small victory, getting the city’s current primary insurer to freeze premiums for one year if it keeps the city’s business, the mayor said on Friday.

But lower-cost plans are likely to involve greater out-of-pocket costs and more limited networks of doctors, and so far, the response from labor has been cool.

Ninety-five percent of city employees and 93 percent of retirees are in the two largest plans, which require employees to pay nothing toward their premiums. According to the Kaiser Family Foundation survey, the average contribution by public employees throughout the country is 12 percent for individual plans and 23 percent for family plans.

Harry Nespoli, the chairman of the Municipal Labor Committee, the labor coalition that negotiates with the city on health care, said that he was concerned about the tax, but also that the burden of any cuts would fall largely on workers at the bottom of the pay scale.

Mr. Nespoli said his staff was looking over the request for proposals that the city had written, but he said he was skeptical that the process of seeking new health insurance could be completed before the next administration.

“We’re not going to turn around and do a $7 billion contract that affects our members for the next 10 years out without looking at it very carefully,” he said.

Most of Boston’s 20,000 employees are currently in plans that by 2018 would exceed the tax threshold. The city and its unions are preparing a request for proposals for new insurance coverage.

“The tax is going to be a hit, and, if you’re not expecting it, it’s going to be very shocking,” said Meredith Weenick, the chief financial officer for Boston.

Jim Finley, the executive director of the Connecticut Conference of Municipalities, said he thought it would be hard for Connecticut towns and cities to get their unions to agree to cheaper health care benefits to avoid the tax.

“In the end, it’s the taxpayer that’s going to bear that burden,” Mr. Finley said.

In Orange County, Calif., the Newport Mesa Unified School District warned employees during contract negotiations that if the district’s health care costs continued rising at the current rate, the district could face a $2.3 million burden from the tax in 2018.

The teachers’ union ultimately agreed to accept greater out-of-pocket costs to reduce the increase in its premium this year to 3 percent from 6 percent, but union leaders said they resented the district’s using the threat of the tax as a negotiating tactic.

Municipal unions opposed the inclusion of the tax in the health care law, and it was partly their efforts that succeeded in delaying its effective date until 2018.

The announcement last month that the Obama administration would delay by a year the mandate that larger employers offer coverage to their workers does not affect the timing of the excise tax, although it may provide encouragement to those who hope that the assessment will be delayed or scrapped altogether.

“Some skeptics, and I’m not one of them, say that that’s why the tax was put into effect in 2018 — that it’s far enough away that people can consider whether or not they really want it to go into effect,” Mr. Piro, the health care lawyer, said.

“This is intended to shift compensation away from excessively generous health insurance toward wages,” he said.

In New York, if the Bloomberg administration does not succeed in getting new health insurance before
the end of the year, the problem will fall in the lap of the next mayor.

Mr. Holloway said the Bloomberg administration, like many city governments, had long been concerned about the rising cost of health care and its impact on the budget.

But the 2018 tax “adds a sense of real urgency to getting a handle on this,” he said.

“We’ve got to start thinking about this now,” he continued. “Why is it that my plan is so expensive per person? What are the ways that we could get that under control?”

http://www.nytimes.com/2013/08/05/nyregion/health-care-law-raises-pressure-on-public-employees-unions.html?pagewanted=all&_r=0

Steve Auerbach on Stossel

A Healthy Debate

Stossel
Fox Business Channel, April 25, 2013

On John Stossel’s show, pediatrician Steve Auerbach debates orthopedist Lie Hieb.

7 minute video:

http://www.youtube.com/watch?v=ZDTWu9lxARI

Comment:

By Don McCanne, M.D.

Steve Auerbach is a member of the executive board of the N.Y. Metro chapter of Physicians for a National Health Program (PNHP) which supports a single payer system – an improved Medicare for all. John Stossel, the moderator, is a libertarian, and, as such, is not supportive of government programs such as single payer. Lee Hieb is a past president of the Association of American Physicians and Surgeons (AAPS) which supports a free market medical system and is opposed to government or corporate intervention.

The debate, such as it is, is no contest. Considering the limited time, Dr. Auerbach presents a convincing case for single payer reform, whereas Stossel gains no ground with his libertarian pitches, and Dr. Hieb is simply not credible as she presents the AAPS distortions and untruths.

In this video, Dr. Auerbach provides us with lessons on taking the higher moral ground.

Speakers Bureau – South

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

Pippa Abston, MD, PhD, FAAP – pediatrics, Huntsville, AL.

Dr. Pippa Abston is a general pediatrician and assistant professor of pediatrics at the University of Alabama at Birmingham School of Medicine at the Huntsville Campus. She is involved in a variety of community activities, including work with Partnership for a Drug Free Community, health ministries at United Church of Huntsville, and the local chapter of NAMI (National Alliance on Mental Illness). She is on the board of the Alabama Chapter of the American Academy of Pediatrics).

Dr. Abston is a member of the board of directors of Physicians for a National Health Program and she currently serves as physician coordinator for North Alabama Healthcare for All, a chapter of PNHP. She has been a speaker and panelist on healthcare reform locally and has assisted with training new members. In 2010, she received the Dr. Quentin Young Health Activist Award. Her healthcare reform blog is carried by Left in Alabama and Medpedia, and she has recently published a book, “Who is My Neighbor? A Christian Response to Healthcare Reform.”

Garrett Adams, MD, MPH – pediatrics/infectious diseases, Louisville, Ky.

Dr. Garrett Adams is a pediatrician specializing in infectious disease and infectious disease epidemiology in Louisville, KY. He received his undergraduate and master’s degrees from Vanderbilt University and medical degree from Wake Forest University. He completed his residency at Vanderbilt University Hospital and the Children’s Hospital of Los Angeles.

Dr. Adams is retired from full-time faculty at the University of Louisville School of Medicine where he was chief of pediatric infectious diseases and medical director of communicable diseases at the Louisville Metro Health Department. Since retiring, he has founded the Beersheba Springs Medical Clinic, a comprehensive ambulatory clinic in the underserved community of Beersheba Springs, Tennessee.

For forty years Dr. Adams attended the health care needs of sick children and their young families. During his career he witnessed deterioration in health care access and health care delivery in the United States. He is a past president of Physicians for a National Health Program.

Howard Brody, MD, PhD – bioethics, Houston

Dr. Howard Brody is director of the Institute for Medical Humanities at the University of Texas Medical Branch. Previously, he was University Distinguished Professor of Family Practice, Philosophy, and the Center for Ethics and Humanities in the Life Sciences at Michigan State University, East Lansing. He served as Director of MSU’s Center for Ethics and Humanities from 1985 to 2000.

Dr. Brody has written numerous books and articles on medical ethics, family medicine, and philosophy of medicine. Current research interests include the importance of an interdisciplinary humanities base for bioethics, ethical issues in primary care, community engagement in bioethics, and professional integrity in both medical practice and clinical research.

Dr. Brody was elected president of the Society for Health and Human Values (now part of the American Society for Bioethics and Humanities) in 1988-89. In 1993-94, Dr. Brody served as Senior Scholar in Residency for the American Academy of Family Physicians at the Agency for Health Care Policy and Research in Rockville, MD; he also chaired the Michigan Commission on Death and Dying. In 1995, he was elected to the Institute of Medicine of the National Academy of Sciences. He has been invited to lecture in Great Britain, New Zealand, Norway, Denmark, Germany, Argentina, Japan, and China. His work has been translated into six languages.

Olveen Carrasquillo, MD, MPH – internal medicine, Miami

Dr. Olveen Carrasquillo is professor of medicine and public health sciences and chief of the division of general internal medicine at the University of Miami’s Miller School of Medicine. He is also director of the division of health services research and policy in the Department of Public Health Sciences. He directs the community engagement and cultural diversity program of the Miami Clinical and Translational Science Institute and leads Florida’s only primary care research fellowship program.

A national leader in primary care and health disparities, Dr. Carrasquillo has conducted extensive research on health insurance and access to care among minority and other vulnerable populations. At the Miller School, he is leading several NIH-funded randomized studies examining community-based strategies to improve healthcare among racially and ethnically diverse populations. Dr. Carrasquillo was previously a faculty member at Columbia University’s College of Physicians and Surgeons, where he was director of their NIH-funded P60 Center of Excellence in Health Disparities Research and also director of the primary care program, a combined research training program involving general medicine, pediatrics and family medicine.

Dr. Carrasquillo has served on various NIH and Agency for Healthcare Research and Quality study sections and is now completing a four-year term on the National Advisory Committee for the U.S. Department of Health and Human Services’ Office of Minority Health. His research has been published in a variety of journals including the New England Journal of Medicine, Journal of the American Medical Association, and American Journal of Public Health, and he is often called upon by the media to discuss his research as well as health care topics of particular relevance to the Hispanic community including being a frequent guest on Univision and Telemundo.

Dr. Carrasquillo is active in various organizations, including numerous current and past leadership roles in the Society of General Internal Medicine, Physicians for a National Health Program and the National Hispanic Medical Association. He is a co-founder of Latinos for National Health Insurance, where he is currently acting president and policy director.

Carol Paris, MD – psychiatry, Nashville

Dr. Carol Paris is the president of Physicians for a National Health Program. She is a recently retired psychiatrist who worked for more than 25 years in private practice, community mental health, prison psychiatry, and academia. In the course of her experience, much of which was in Maryland, she became an outspoken critic of the private-insurance-based U.S. health care system.

In May 2009, she and seven others stood up, one by one, at a U.S. Senate Finance Committee hearing on health care reform chaired by Sen. Max Baucus to ask why there wasn’t a single advocate for single-payer health care on the 41-member panel. In an action that received national media attention, Baucus had all eight peaceful protesters, including Dr. Paris, arrested. (Charges were eventually reduced, requiring only community service.)

Dr. Paris subsequently toured the country as part of the “Mad as Hell Doctors” campaign for single payer, and spent a year as a consultant psychiatrist in New Zealand, where she experienced a single-payer system firsthand. She currently resides in Nashville, Tenn., where her primary interests include strategic activism, recruiting and mentoring medical students and early career physicians for leadership positions within PNHP, and building coalitions to strengthen the single-payer movement’s impact on the national health care debate. Dr. Paris obtained her medical degree from West Virginia University School of Medicine.

Arthur J. Sutherland III, MD, FACC – cardiology, Memphis

Dr. Art Sutherland is a retired physician and founder of the Sutherland Cardiology Clinic. He practiced cardiology in Memphis for 33 years and was the founder and director of the Methodist Healthcare Cardiac Laboratories.

Dr. Sutherland is currently working with the Healthy Memphis Common Table as a board member and as coordinator of the obesity and diabetes prevention initiative. This initiative is aligned to reduce the obesity and diabetic epidemics and to improve the quality of care in treating diabetics. Improving health literacy and elimination of social and health disparities are also high priority agenda issues.

Dr. Sutherland is a member of the Memphis School of Servant Leadership. He is currently serving as chairman of the Tennessee chapter of Physicians for a National Health Program and is a member of the national board of directors.

Dr. Sutherland received his undergraduate degree from Vanderbilt University and medical degree from the University of Tennessee. He completed an internship at the University of Pennsylvania Hospital and residency at the University of Tennessee Health Sciences Center. He is a diplomate of the American Board of Internal Medicine and a fellow of the American College of Cardiology.

Ed Weisbart, MD, CPE, FAAFP – family medicine, St. Louis

Dr. Ed Weisbart chairs the Missouri chapter of Physicians for a National Health Program, a 30 year-old non-profit research and education organization of more than 21,000 physicians, medical students, health professionals, and others who support single-payer national health insurance.

He is an assistant professor of clinical medicine at Washington University in St. Louis. He volunteers in a variety of safety net clinics and other non-profits across the St. Louis area, and as a volunteer physician recruiter for free clinics across the nation. He serves as vice president of the Consumers Council of Missouri.

He received his medical degree at the University of Illinois in Chicago in 1979, completed his family medicine residency and a fellowship in family medicine education at Michigan State University in 1982, and practiced family medicine at Rush Medical Center in Chicago for 20 years. He served as chief medical officer of Express Scripts from 2003 to 2010.

Dr. Weisbart has had several articles published in both national medical journals and local media outlets regarding the health care needs of the uninsured.

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

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

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

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

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

Speakers Bureau – West

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

Cecile Rose, MD, MPH – environmental/occupational medicine, Denver

Dr. Cecile Rose is professor of medicine at the University of Colorado Denver and director of the occupational and environmental medicine clinic at National Jewish Health. She holds a secondary appointment in the Colorado School of Public Health. She has been named among Denver’s Top Doctors by 5280 magazine and America’s Top Doctors by US News & World Report and Castle Connolly Medical Ltd. Dr. Rose is a past president of Physicians for a National Health Program.

Dr. Rose has been involved in collaborative research in noninfectious granulomatous lung diseases including sarcoidosis and hypersensitivity pneumonitis (with particular focus on hot tub, swimming pool and bioaerosol-related cases). Her other research focuses on mining-related lung diseases including silicosis and radiogenic diseases of uranium miners and millers; laboratory-animal allergen and endotoxin exposures; and flavor-related lung diseases.

Dr. Rose has a long-standing interest in occupational and environmental lung diseases. She has particular experience in hypersensitivity pneumonitis (HP) and in the pneumoconioses, including diagnosis, causation, management and prevention. She also is committed to the diagnosis and management of patients with sarcoidosis.

Vincent J. Markovchick, MD, FAAEM, FACEP – emergency, Denver

Dr. Vince Markovchick is professor emeritus of emergency medicine at the University of Colorado Denver School of Medicine and past director of emergency medical services at Denver Health Medical Center. He is the former Denver health director of emergency medical services. He is the co-author of “Emergency Medicine Secrets, 5th Edition.”

Dr. Markovchick has been instrumental in the development of emergency medicine for more than three decades. He has been an oral board examiner for the American Board of Emergency Medicine, president of the Colorado chapter of the ACEP, co-editor of the Annals of Emergency Medicine, vice-president of the Colorado Trauma Institute, medical director of the Denver Fire Department, emergency physician to Pope John Paul II and World Youth Day, president of the American Board of Emergency Medicine, and chairman of the ACEP academic affairs committee, among many other positions.

Dr. Markovchick’s many awards include the Emergency Medicine Residents’ Association’s Excellence in Teaching Award, the Denver Health and Hospitals’ Outstanding Career Service Faculty Teaching Award, ACEP’s Outstanding Contribution to Education Award, the Peter Rosen Leadership Award, and the Alumni Achievement Award from Temple University School of Medicine. He was appointed the first emeritus professor of emergency medicine by the University of Colorado School of Medicine.

John P. Geyman, MD – family medicine, Seattle

Dr. John Geyman is professor emeritus of family medicine at the University of Washington School of Medicine in Seattle, where he served as chairman of the department of family medicine from 1976 to 1990. A family physician with over 25 years in academic medicine, he has also practiced in rural communities for 13 years.

He was the founding editor of the Journal of Family Practice from 1973 to 1990 and the editor of the Journal of the American Board of Family Practice from 1990 to 2003. His most recent books include “Breaking Point: How the Primary Care Crisis Endangers the Lives of Americans” and “Hijacked: the Road to Single Payer in the Aftermath of Stolen Health Crae Reform.”

Dr. Geyman is a past president of Physicians for a National Health Program and a member of the Institute of Medicine.

David McLanahan, MD – surgery, Seattle

Dr. David McLanahan is surgeon emeritus at Pacific Medical Center and clinical associate professor emeritus at the University of Washington School of Medicine. He was previously chief of general surgery at Pacific Medical Center. In 2002, he published, with Sandra McLanahan, “Surgery and its Alternatives; How to Make the Right Choices for Your Health.”

Dr. McLanahan received his medical degree from the Temple University School of Medicine and completed his internship at the U.S. Public Health Service Hospital at Staten Island and residency at Staten Island University Hospital. He is a diplomat of the National Board of Medical Examiners and the American Board of Surgery. Dr. McLanahan also serves as coordinator of the Western Washington chapter of Physicians for a National Health Program.

Paul Gorman, MD, FACP, FACMI – internal medicine, Portland

Dr. Paul Gorman is professor in the Department of Medicine and the Department of Medical Informatics and Clinical Epidemiology at Oregon Health & Science University (OHSU). He is also assistant dean for rural medical education. A fellow of the American College of Physicians and a fellow of the American College of Medical Informatics, he is board-certified in internal medicine and serves on the teaching faculty at OHSU as well as at Providence Portland Medical Center.

Dr. Gorman completed formal training at Rush Medical College in Chicago, then learned about the realities of primary care while in private practice on the Oregon coast. He currently divides his time between research focused on how clinicians use information and technology; teaching medical students, residents, and graduate students; and clinical care, supervising residents and students in hospital and primary care settings. Dr. Gorman serves as chair of the OHSU School of Medicine curriculum committee, and he has been deeply involved with faculty teams developing a new medical school curriculum.

Stephen B. Kemble, MD – internal medicine/psychiatry, Honolulu

Dr. Steve Kemble attended medical school at the John A. Burns School of Medicine when it was a 2-year school, and completed medical school at Harvard. He trained in both internal medicine and psychiatry. Dr. Kemble is a psychiatrist in private practice and also teaches psychiatric aspects of general medical care to internal medicine residents. He is an Assistant Clinical Professor of both Medicine and Psychiatry at the University of Hawaii School of Medicine.

Dr. Kemble is a past president of both the Hawaii Psychiatric Medical Association and the Hawaii Medical Association. He has a longstanding interest in health care reform, and he has been appointed to the Hawaii Health Authority, charged with overall health planning for the State of Hawaii and with designing a universal health care system covering everyone in the State. Dr. Kemble serves as a board adviser to Physicians for a National Health Program.

Henry Abrons, MD, MPH – pulmonary and critical care medicine, Berkeley, CA

Dr. Hank Abrons is a retired physician in Berkeley, CA. He was previously associate professor of medicine at West Virginia University, where his research focused on epidemiology, physiology and clinical features of occupational lung disease. His clinical practice focused on critical care, chronic lung disease and cystic fibrosis. Prior to his appointment at WVU, Dr. Abrons worked three years in the U.S. Public Health Service.

Dr. Abrons received his undergraduate degree from Harvard College, medical degree from Case Western Reserve University, and master’s degree from the University of Illinois. He is president of the California chapter of Physicians for a National Health Program and a member of PNHP’s board of directors.

Kevin Grumbach, MD, FAAFP – family medicine, San Francisco

Dr. Kevin Grumbach is professor and chair of the department of family and community medicine at the University of California, San Francisco School of Medicine. He is co-director of the UCSF Center for Excellence in Primary Care and co-director of the Community Engagement and Health Policy Program for the UCSF Clinical and Translational Science Institute. He practices family medicine at the Family Health Center at San Francisco General Hospital.

Dr. Grumbach is the co-author, with Dr. Thomas Bodenheimer, of “Understanding Health Policy – A Clinical Approach,” now in its sixth edition, and “Improving Primary Care: Strategies and Tools for a Better Practice.” He has written or contributed to over 100 articles in the medical literature. He has served as an advisor to congressional committees and government agencies on primary care and health reform. Dr. Grumbach was a co-founder of the California Physicians’ Alliance, which merged with Physicians for a National Health Program in 1993 to become the California chapter of PNHP.

James G. Kahn, MD, MPH – preventive medicine/epidemiology/biostatistics, San Francisco

Dr. Jim Kahn is a professor at the Philip R. Lee Institute for Health Policy Studies, the AIDS Research Institute, and the department of epidemiology and biostatistics, all at the University of California San Francisco. He is also past president of the California chapter of Physicians for a National Health Program.

Dr. Kahn is an expert in policy modeling in health care, cost-effectiveness analysis, and evidence-based medicine. He is the lead instructor in cost-effectiveness analysis in the medical school at UCSF. Dr. Kahn also served on a National Academies of Science/Institute of Medicine committee on the public financing and delivery of HIV care.

Dr. Kahn received his medical degree from Albert Einstein College of Medicine and his master’s degree from the University of California, Berkeley. He completed a residency in preventive medicine at UC Berkeley, an international health fellowship for the CDC and the Ministry of Health, Central African Republic, and a fellowship at the Institute for Health Policy Studies, UCSF.

Don McCanne, MD – family medicine, San Juan Capistrano, Calif.

Dr. Don McCanne is a retired family physician in San Juan Capistrano, Calif., and serves as senior health policy fellow for Physicians for a National Health Program. He is also a past president of PNHP.

For decades, Dr. McCanne allotted half of his practice hours to indigent patients, and he was cited by the San Clement City Council as being “outspoken, especially when it involves the elderly and under-privileged, because he believes that the ability to pay should not be the major criterion for receiving healthcare.” Dr. McCanne is a tireless supporter of single-payer and has spoken and written extensively on the uninsured, health care costs, and health care policy. He authors a popular health policy “Quote of the Day.”

Paul Y. Song, MD – radiation oncology, Los Angeles

Dr. Paul Song is a board-certified radiation oncologist, biotech executive, and health care reform activist.

He is a national board member of Physicians for a National Health Program and serves as co-chair for the Campaign for a Healthy California. He served as executive chairman of the 1.2 million-member Courage Campaign from 2013 to March 2016. He also served as the very first visiting fellow on health care policy in the California Department of Insurance for 2013.

Dr. Song is the chief medical officer of ATGen Global and Cynvenio Biosystems. He recently left the faculty at the Samuel Oschin Cancer Center at Cedars Sinai Medical Center and currently volunteers his time seeing Medicaid and uninsured patients at California Hospital.

He attended the University of Chicago where he graduated with honors and received his medical degree from George Washington University. He completed his residency in radiation oncology at University of Chicago Medical Center.

Dr. Song serves on the boards of People for the American Way, The Asian Pacific American Institute for Congressional Studies, Liberty in North Korea, and The Eisner Pediatric and Family Medical Center.

Speakers Bureau – Midwest

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

David Ansell, MD, MPH, FACP – internal medicine, Chicago

Dr. David Ansell is the Senior Vice President for Community Health Equity at Rush University Medical Center in Chicago.

He is an internal medicine physician, trained at Cook County Hospital in the late 1970s, where he spent 17 years holding a number of positions including chief of general medicine/primary care. After leaving County, he spent 10 years as chair of the department of internal medicine at Mount Sinai Hospital, located in one of the highest hardship communities in Chicago. He has been particularly involved in health equity work, bringing attention to higher rates of breast cancer mortality for African-American women in Chicago. In 2007 he co-founded the Metropolitan Chicago Breast Cancer Taskforce, a not-for-profit that focuses on eliminating the racial disparities in breast cancer mortality.

He is the author of numerous papers and book chapters on health disparities. In 2011 he published an acclaimed memoir based on his experiences as a doctor in Chicago, County: Life, Death and Politics at Chicago’s Public Hospital. His most recent book, The Death Gap: How Inequality Kills, was released by the University of Chicago Press in 2017.

Dr. Ansell is a graduate of SUNY Upstate Medical University and received his Masters of Public Health from the University of Illinois School of Public Health.

Claudia M. Fegan, MD, CHCQM, FACP – internal medicine, Chicago

Dr. Claudia Fegan is national coordinator of Physicians for a National Health Program. In her current and past leadership roles in PNHP she has appeared on national television and radio programs on behalf of the organization, and has testified before congressional committees on a wide range of health care issues. She has lectured extensively to both medical and community audiences on health care reform in the U.S. and Canada, and is a co-author of the book “Universal Healthcare: What the United States Can Learn from Canada” and a contributor to “10 Excellent Reasons for National Health Care.”

Dr. Fegan is executive medical officer for the Cook County Health and Hospital System and chief medical officer at John H. Stroger Jr. Hospital of Cook County. She is also president of the Chicago-based Health and Medicine Policy Research Group. In 2016, Modern Healthcare named Dr. Fegan one of “10 Minority Executives to Watch,” noting her achievements in the medical profession and her single-payer activism.

Dr. Fegan received her undergraduate degree from Fisk University and her medical degree from the University of Illinois College of Medicine. She is also certified in health care quality and management and is a diplomate of the American Board of Quality Assurance and Utilization Review Physicians.

Joshua Freeman, MD – family medicine, Kansas City, KS.

Dr. Josh Freeman is the Alice M. Patterson, MD, and Harold L. Patterson, MD Professor and Chair of the department of family medicine and chief of family medicine at the University of Kansas Hospital. He serves nationally as a member of the board of trustees of Roosevelt University in Chicago. He is assistant editor of the journal Family Medicine and is on the board of Southwest Boulevard Family Care.

Dr. Freeman is co-faculty advisor for the JayDoc Student-run Free Clinic, and for the Community Leadership track longitudinal elective. He served as chair of the Steering Committee for Curricular Change (2003-05), and is an elected member of the executive committee of the Faculty Council. He was a Fulbright Scholar in São Paulo, Brazil in 2003, and consults there frequently on establishment of family medicine in that country.

In 2007-08, Dr. Freeman completed the joint American Council on Education fellowship to train leaders in higher education and the STFM Foundation Bishop Fellowship. His host institution was the University of New Mexico, where his mentor was Paul Roth, MD, dean of the medical school and Executive Vice President for Health Sciences. He received STFM’s highest honor, the Recognition Award, in 2006. He served nationally as secretary/treasurer for STFM in 2012.

Ana Malinow, MD, MS – pediatrics, Pittsburgh

Dr. Ana Malinow is a pediatrician and associate residency program director at Children’s Hospital of Pittsburgh of UPMC. Prior to moving to Pittsburgh, Dr. Malinow was associate professor of pediatrics at Baylor College of Medicine and attending physician in the pediatric emergency and ambulatory center at Ben Taub General Hospital, where most of her patients were uninsured. Dr. Malinow is the recipient of numerous teaching awards, including for grand rounds presentations on health care. She was named one of Houston’s top female physicians by Health and Fitness Sports Magazine.

Born in Buenos Aires, Argentina, Dr. Malinow earned a bachelor’s degree from the University of California at Davis and a master’s degree in creative writing before completing her medical education at Case Western Reserve University. She completed residency in pediatrics at Rainbow Babies and Children’s Hospital. She also holds a master’s degree in health care policy and management from Carnegie Mellon University.

Dr. Malinow is a past president of Physicians for a National Health Program and co-founder of Health Care for all Texas, a grassroots organization that promotes single-payer national health insurance. She is also co-founder of Doctors for Change, an organization of health care professionals that organize for improved access to health care in Houston and Harris county.

James C. Mitchiner, MD, MPH, FACEP – emergency, Ann Arbor, MI

Dr. James Mitchiner is currently an attending emergency physician at St. Joseph Mercy Hospital in Ann Arbor, Michigan. In addition, he has an academic appointment at the University of Michigan Medical School.

A past president of the Michigan College of Emergency Physicians, Dr. Mitchiner has served the American College of Emergency Physicians as the chair of its State Legislative and Regulatory Committee, and as a member of the Task Force on Health Care and the Uninsured. In 2008 he served as president of the Washtenaw County Medical Society.

Dr. Mitchiner received his medical degree from the University of Illinois College of Medicine and received a master’s degree in health management and policy from the University of Michigan School of Public Health.

Peter Orris, MD, MPH, FACP, FACOEM – internal and occupational medicine, Chicago

Dr. Peter Orris, a founding member of PNHP, is professor and chief of Occupational and Environmental Medicine for the University of Illinois Hospital and Health Sciences System. He has been an attending physician in the Division of Occupational Medicine at the Stroger Hospital of Cook County (formerly Cook County Hospital) for over three decades, where he practiced and taught internal and occupational medicine on the teaching services. He maintains an active clinical and teaching practice and holds professorships as well in internal and preventive medicine at Rush University Medical College and the Northwestern University Feinberg School of Medicine. His research and teaching have focused on international health care systems, occupational and community effects of toxic chemicals, and more recently sustainable health care and climate change.

Dr. Orris has served as an adviser to many labor organizations, corporations, and nonprofit groups. On an international level he has been an adviser to the World Health Organization, Pan American Health Organization, World Medical Association, World Federation of Public Health Associations, and Health Care Without Harm. He has a long history of advocacy for elimination of profits and racism in health care and opposing corporate policies that poison the environment of the developing world.

He an active member of the American Public Health Association, and serves on the council of the Chicago Medical Society and as a delegate to the Illinois State Medical Society. Dr. Orris graduated Harvard College in 1967, Yale School of Public Health in 1970, and the Chicago Medical School of the Rosalind Franklin University in 1975.

Susan Rogers, MD, FACP – internal medicine, Chicago

Dr. Susan Rogers, recently retired, is a volunteer attending hospitalist and internist at the John H. Stroger Jr. Hospital of Cook County. She previously was co-director of medical student programs for the Department of Medicine. She is also assistant professor of medicine at Rush University, where she is active on the committee of admissions, and assistant professor of medicine at Rosalind Franklin University. She has received numerous teaching awards from Stroger Hospital, Rush University, and Rosalind Franklin University. A sample of Dr. Rogers’ grand rounds at the University of Illinois College of Medicine at Urbana-Champaign is available here.

Dr. Rogers received her medical degree from the University of Illinois College of Medicine and completed her residency at Cook County Hospital, where she served as chief resident. She is a national board member of Physicians for a National Health Program and a past co-president of Health Care for All Illinois. She previously served on the boards of the Near North Health Service Corp, a FQHC in Chicago, and Ancona School. Dr. Rogers is a member of the American College of Physicians, the Society of General Internal Medicine, and the National Medical Association.

Johnathon Ross, MD, MPH internal medicine, Toledo, Ohio

Dr. Johnathon Ross is associate clinical professor of medicine at the University of Toledo and practices and teaches general internal medicine at St. Vincent Mercy Medical Center. He is a past president of Physicians for a National Health Program.

A graduate of Cornell University, Dr. Ross received his medical degree from the Medical College of Ohio at Toledo his master’s degree in health policy and administration from the School of Public Health of the University of Michigan.

Dr. Ross has served as a family physician in a small rural community in upstate New York as a member of the National Health Service Corps; as medical director for several organizations; and as chairman of the department of internal medicine at St. Vincent. He has been a member of the executive committee of medical staff at St. Vincent, a board member of its PHO, and chairman of several committees of the hospital, the HMO, and the PHO focused on quality improvement. He has served as a member of the Ohio State Medical Board and helped establish the educational requirements and scope of practice for licensed physician assistants in Ohio.

Ann Settgast, MD, DTM&H – internal medicine, Minneapolis

Dr. Ann Settgast graduated from Creighton University School of Medicine in 1999 and completed her residency in internal medicine at the University of Minnesota. Following a chief residency year, she obtained her diploma in tropical medicine & hygiene at the Liverpool School of Tropical Medicine. She then worked with Medecins Sans Frontieres (Doctors without Borders) in a visceral leishmaniasis project in rural Ethiopia.

Since returning to Minnesota in 2006 she has worked as a general internist, providing primary care to a foreign-born population at the Center for International Health in St. Paul. She also spends two months per year doing inpatient hospitalist work at Regions Hospital. She is a member of the University of Minnesota’s global health faculty and holds a teaching position in the residency continuity clinic. Dr. Settgast is a past co-chair of the Minnesota chapter of Physicians for a National Health Program and a member of the national board of directors.

Susan P. Steigerwalt, MD, FACP – nephrology, Detroit

Dr. Susan Steigerwalt is associate professor of medicine at the University of Michigan and a nephrologist and clinical hypertension specialist with St. Clair Specialty Physicians in Detroit, where she is director of research and the hypertension clinic.

Dr. Steigerwalt received her medical degree from University of Michigan Medical School and completed her residency at Detroit General Hospital, where she served as chief resident. She held fellowships at Wayne State University and Henry Ford Hospital.

A past president of Physicians for a National Health Program, Dr. Steigerwalt has been active in the single-payer movement in Michigan and nationally since 1992. She is a fellow of the American College of Physicians and the American Society of Hypertension, and she has been named a “Best Doctor” by Hour Detroit magazine.

Robert C. Stone, MD, FACEP – emergency medicine, Bloomington, Ind.

Dr. Rob Stone is the director and founder of Hoosiers for a Commonsense Health Plan (hchp.info) and the state coordinator in Indiana for Physicians for a National Health Program. Since 2009 he has been a member of PNHP’s board of directors. Dr. Stone practiced emergency medicine at Indiana University Health Bloomington Hospital from 1983 to 2011. He currently serves as the medical director of palliative care at the hospital. Dr. Stone has been a national leader in the movement to divest from for-profit health insurance and is the national coordinator for the Divestment Campaign for Healthcare (HealthCareNotWealthCare.US). He lectures to medical and lay audiences on health care reform throughout Indiana and beyond, and has received several statewide and national awards for his advocacy work. During the heat of the health care debate in June 2009, he presented to the Blue Dog Democratic Caucus in Washington.

Born and raised in Evansville, Ind., he graduated from Dartmouth College Phi Beta Kappa, and obtained his medical degree from the University of Colorado Medical School.

Philip A. Verhoef, MD, PhD – critical care medicine, Chicago

Dr. Phil Verhoef is assistant professor of medicine and an intensivist in the adult and pediatric ICUs at the University of Chicago. He is a national board adviser to Physicians for a National Health Program and president of the Illinois Single Payer Coalition.

Dr. Verhoef completed medical and graduate training at Case Western Reserve University, followed by residency in internal medicine and pediatrics at UCLA and subspecialty ICU fellowship training at the University of Chicago. He current research is in the immunology of sepsis in the ICU. He has been published in the Annals of Internal Medicine, Chest, the Chicago Sun-Times, Springfield Journal-Register, and kevinmd.com.

Ed Weisbart, MD, CPE, FAAFP – family medicine, St. Louis

Dr. Weisbart has had several articles published in both national medical journals and local media outlets regarding the health care needs of the uninsured.

Speakers Bureau – Northeast

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Margaret Flowers, MD – pediatrics, Baltimore

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

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

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

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

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

Adam Gaffney, MD – pulmonary and critical care medicine, Boston

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

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

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

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

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

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

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

Donald E. Moore, MD, MPH – general medicine, New York City

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

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

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

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

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

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

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

Elizabeth R. Rosenthal, MD – dermatology, New York

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

Gordon Schiff, MD – internal medicine, Boston

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

EHealth moves in for the kill

EHealth Wins Approval to Sell Obamacare Health Plans

By Alex Wayne
Bloomberg, July 31, 2013

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

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

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

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

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

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

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

Comment:

By Don McCanne, M.D.

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

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

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

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

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

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

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

Study: Single-payer healthcare system would save billions

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

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

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

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

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

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

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

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

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

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

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Obama demands tax on Cadillac plans

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