PNHP

America’s health care problems were not fixed by Affordable Care Act

America’s health care problems were not fixed by Affordable Care Act

By Ed Weisbart, M.D.
St. Louis Post-Dispatch, July 3, 2012

Many of my patients will benefit from the Affordable Care Act: A 25-year-old with sickle cell disease can keep his insurance. A 32-year-old mother can get contraception. And a 47-year-old hemophiliac doesn’t have to worry about being too sick for health insurance. I’m celebrating these things and others.

But now is not the time to breathe a sigh of relief. We haven’t fixed the crisis in health care. And we won’t, as long as our health care system remains dominated by private insurance companies.

Insurance companies limit our choices of doctors, drive Americans into bankruptcy and shorten our lives. None of this is necessary if we’d just improve Medicare and give it to all Americans. Our broken system is even deadlier if you’re poor. Now that it’s optional, our state House leadership has declared that it is not going to expand the roles of Medicaid, even with the federal government paying for it (“Medicaid expansion? Missouri GOP balking,” July 1).

This means that 300,000 of our friends and family members will not get even the minimal access to health care that Medicaid provides. Aside from being morally repugnant, we all pay for their strokes instead of their blood pressure pills. Those pills are cheap; recovering from a stroke is not. We need to demand our legislators expand Medicaid as provided under the ACA. We can save even more lives and money by fixing Medicare and providing it to all Americans. This isn’t about politics; it’s about our lives.

Dr. Ed Weisbart is a member of Physicians for a National Health Program – St. Louis. He resides in Olivette.

Read more: http://www.stltoday.com/news/opinion/mailbag/letters-to-the-editor-july/article_f0e5d9b8-aea1-5332-a8d3-dcb8edadf69e.html#ixzz1zZBXIQeH

The Affordable Care Act ruling won't heal our ailing health system

By Margaret Flowers, M.D.
Yubanet.com, July 2, 2012

As a physician, I find it very odd that the debate over the Affordable Care Act has focused on the effect the law will have on the presidential election rather than the impact it will have on patients, health professionals, and health outcomes.

The Supreme Court case reinvigorated debate over the Obama administration’s 2010 health care reform law. But we’re still getting partisan talking points instead of an honest review of the changes that are in store. This will likely worsen as we get closer to Election Day.

The new law is based on concepts developed by the Heritage Foundation, a conservative think tank. Republican presidential candidate Mitt Romney passed a very similar law for his state when he was the governor of Massachusetts. So while most Democrats are celebrating the Supreme Court decision to uphold the Affordable Care Act and Romney is saying he’d repeal it, consider this: Had a Republican passed this federal law, we would have the opposite situation.

Let’s put politics aside and look at the law from a policy standpoint. The big winners of the Supreme Court decision are the corporations who are profiting from the current health system — private health insurers, pharmaceutical companies, and corporate-owned hospitals and medical practices.

The Court has deemed it constitutional for the government to require people to spend up to 9 percent of their income to purchase private insurance despite it being a defective product. People with insurance continue to face financial barriers to care. They delay and avoid necessary care because of the cost of co-pays and deductibles.

When patients have a serious medical condition, they risk financial ruin. Illness and soaring medical costs are the greatest causes of bankruptcy in the United States, even though four out of five people experiencing medical bankruptcy have health insurance. Purchasing private insurance is going to be subsidized with taxpayer dollars. It will cost Uncle Sam an estimated half a trillion dollars between 2014 and 2019 to pay that tab, according to the Congressional Budget Office. The insurance mandate and these subsidies will create corporate welfare on steroids.

What will the insurance companies do with all that money? They’ll hold onto as much as they can by denying and restricting payment for care. And they’ll use those dollars to weaken regulations meant to protect patients.

When national health care reform is fully implemented in 2019, 26 million people will still lack coverage. And health costs will continue to rise because the law lacks proven cost controls.

While the law does include a few positive provisions, it won’t stop the deterioration of our health care system. We’ll continue to see unnecessary suffering and preventable death. This is unacceptable when we are already spending nearly twice as much per person on care each year as other industrialized nations with universal health systems and much better health outcomes.

The truth is that we can solve our health care crisis. The fastest way to accomplish this is to drop just two words from the Medicare Act — “over 65” — and immediately expand Medicare to every person. That would create a system that’s about health care, not corporate profits. A universal Medicare system would control costs and improve the quality of patient care.

Let’s demand Medicare for all now. The longer we wait, the more people will suffer and die needlessly.

Dr. Margaret Flowers is a pediatrician from Baltimore and co-director of ItsOurEconomy.US. Distributed via OtherWords (OtherWords.org).

http://yubanet.com/opinions/Margaret-Flowers-The-Affordable-Care-Act-ruling-won-t-heal-our-ailing-health-system.php#.T_IGv5GBq1c

The Affordable Care Act ruling won’t heal our ailing health system

By Margaret Flowers, M.D.
Yubanet.com, July 2, 2012

As a physician, I find it very odd that the debate over the Affordable Care Act has focused on the effect the law will have on the presidential election rather than the impact it will have on patients, health professionals, and health outcomes.

The Supreme Court case reinvigorated debate over the Obama administration’s 2010 health care reform law. But we’re still getting partisan talking points instead of an honest review of the changes that are in store. This will likely worsen as we get closer to Election Day.

The new law is based on concepts developed by the Heritage Foundation, a conservative think tank. Republican presidential candidate Mitt Romney passed a very similar law for his state when he was the governor of Massachusetts. So while most Democrats are celebrating the Supreme Court decision to uphold the Affordable Care Act and Romney is saying he’d repeal it, consider this: Had a Republican passed this federal law, we would have the opposite situation.

Let’s put politics aside and look at the law from a policy standpoint. The big winners of the Supreme Court decision are the corporations who are profiting from the current health system — private health insurers, pharmaceutical companies, and corporate-owned hospitals and medical practices.

The Court has deemed it constitutional for the government to require people to spend up to 9 percent of their income to purchase private insurance despite it being a defective product. People with insurance continue to face financial barriers to care. They delay and avoid necessary care because of the cost of co-pays and deductibles.

When patients have a serious medical condition, they risk financial ruin. Illness and soaring medical costs are the greatest causes of bankruptcy in the United States, even though four out of five people experiencing medical bankruptcy have health insurance. Purchasing private insurance is going to be subsidized with taxpayer dollars. It will cost Uncle Sam an estimated half a trillion dollars between 2014 and 2019 to pay that tab, according to the Congressional Budget Office. The insurance mandate and these subsidies will create corporate welfare on steroids.

What will the insurance companies do with all that money? They’ll hold onto as much as they can by denying and restricting payment for care. And they’ll use those dollars to weaken regulations meant to protect patients.

When national health care reform is fully implemented in 2019, 26 million people will still lack coverage. And health costs will continue to rise because the law lacks proven cost controls.

While the law does include a few positive provisions, it won’t stop the deterioration of our health care system. We’ll continue to see unnecessary suffering and preventable death. This is unacceptable when we are already spending nearly twice as much per person on care each year as other industrialized nations with universal health systems and much better health outcomes.

The truth is that we can solve our health care crisis. The fastest way to accomplish this is to drop just two words from the Medicare Act — “over 65” — and immediately expand Medicare to every person. That would create a system that’s about health care, not corporate profits. A universal Medicare system would control costs and improve the quality of patient care.

Let’s demand Medicare for all now. The longer we wait, the more people will suffer and die needlessly.

Dr. Margaret Flowers is a pediatrician from Baltimore and co-director of ItsOurEconomy.US. Distributed via OtherWords (OtherWords.org).

http://yubanet.com/opinions/Margaret-Flowers-The-Affordable-Care-Act-ruling-won-t-heal-our-ailing-health-system.php#.T_IGv5GBq1c

ObamaCare as Corporatists United

A Huge Bailout for Another Failing Industry

By Clark Newhall, M.D.
Counterpunch, June 29, 2012

In an eagerly anticipated opinion on the Patient Protection and Affordable Care Act, colloquially known as “Obamacare,” an unusual alignment of justices upheld the Act nearly entirely. The crucial part of the decision found the odd-bedfellows combination of Chief Justice Roberts joining the four “liberal” justices to uphold the “individual mandate,” the section of the law requiring all Americans to buy health insurance from private health insurance companies. The alignment is especially strange given the lengths to which Justice Roberts had to go to support his convoluted reasoning.

He accepted the argument that the individual mandate was unconstitutional as an exercise of the Commerce Clause because it required a commercial activity that had never hitherto existed, i.e. the purchase of health insurance by someone who had never purchased it. He accepted the argument that the individual mandate was unconstitutional as an exercise of the “Necessary and Reasonable” clause. And he rejected the argument that the payment of a penalty to the IRS by those who refused to comply with the individual mandate (“refuseniks”) was a “tax” subject to a law that says you first have to pay the tax before you can sue for a refund.

But then he turned about and found that the money that the IRS can take from a refusenik WAS a tax and NOT a penalty.  Under that reasoning, the “individual mandate” requiring everyone to buy health insurance from a private company becomes a “tax law” and therefore constitutional.

With this bizarre twisting of words, the Supreme Court has revealed the nature of 21st-century American political thought. Those who make, interpret and enforce the laws no longer lie on the “left-right” political continuum. Instead, they are in effect at right angles to that continuum.

The ideology that drives the Supreme Court, the political administration and the Congress is not Conservative or Liberal but can best be described as Corporatist. This is the ideology that affirms that “corporations are citizens, my friends.”  It is the ideology that drove the Roberts court to the odious Citizens United decision. It is the ideology behind a bailout for banks that are “too big to fail.” And it is the ideology that allows Congress to pass a law like the ACA that is essentially written by a favored industry.

The Corporatist ideology allows the Supreme Court to uphold the ACA despite the obvious and glaring consequence: forcing someone to buy health insurance is like forcing someone to buy a used Rambler — it’s a shoddy product at an inflated price, but you must pay a tax or swallow your anger and buy it from the smirking dealer down the street.

Why does Corporatism favor Obamacare?  Because Obamacare is nothing more than a huge bailout for another failing industry — the health insurance industry.

No health insurer could continue to raise premiums at the rate of two to three times inflation, as they have done for at least a decade. No health insurer could continue to pay $200 million-plus bonuses to top executives, as they have done repeatedly. No health insurer could continue to restrict Americans’ access to decent health care, in effect creating slow and silent “death panels.” No health insurer could do those things and survive.

But with the Obamacare act now firmly in place, health insurers will see a HUGE multibillion-dollar windfall in the form of 40 million or more new health insurance customers whose premiums are paid largely by government subsidies. That is the explanation for the numerous expansions and mergers you have seen in the health care industry in the past couple of years. You will see more of the same, and if you are a stock bettor, you would do well to buy stock in smaller health insurers, because they will be snapped up in a wave of consolidation that dwarfs anything yet seen in this country.

As I write this, I note that health industry stocks have taken a big jump on Wall Street.

What a surprise!

Clark Newhall, M.D., J.D., is executive director of Health Justice. Please reply to cnewhall@cnewhall.com.

http://www.counterpunch.org/2012/06/29/obamacare-as-corportists-united/

OECD 2012 Economic Survey of the United States

The United States needs to foster education and innovation to keep its cutting edge

OECD Economic Surveys: United States 2012
OECD, June 26, 2012
Particularly worrying is the performance in education, which is essential to provide workers with the skills necessary to become more productive and to adapt to technological change. Attainment in tertiary education stagnated over the past three decades while it grew significantly in almost every other OECD country. Today, 22 out of 30 OECD countries surveyed have more graduates in science and engineering among the 25 to 34 year old workers than the United States.
To prevent long-term unemployment from becoming chronic, the Survey suggests a greater focus on “active” labor market programs that help to facilitate job search and guide individuals towards training and education. These measures have proven to be effective even during periods of high unemployment and should complement existing “passive” benefit programs. The United States spends very little on activation policies relative to other OECD countries.
The Survey also highlights rising income inequality in the United States. The trend owes mainly to rising skill premiums and disproportionate income growth for top earners over the past two decades. High income inequality is also associated with low intergenerational social mobility. Children born to low-income parents in the U.S. find it more difficult to move up the social ladder than in most European OECD countries.
Providing equal access to high-quality elementary and secondary education is essential to addressing this challenge. The Survey also notes that the U.S. tax and benefits system is much less effective in reducing relative poverty than that of other OECD countries. This is largely the result of the limited and poorly targeted financial transfers to low-income households.
http://www.oecd.org/document/59/0,3746,en_21571361_44315115_50653435_1_1_1_1,00.html
OECD Economic Surveys: United States 2012 (122 pages)
http://www.keepeek.com/Digital-Asset-Management/oecd/economics/oecd-economic-surveys-united-states-2012_eco_surveys-usa-2012-en

So what does an economic survey of the United States have to do with health care? Simply that we cannot expect to have a superior health care system that serves everyone well if we don’t fulfill our citizen obligation to demand greater government oversight and intervention in education, employment, and especially in the intolerable rise in income inequality. Current trends in the United States are not encouraging.
Trying to fix health care alone without addressing our other serious economic deficiencies offers little hope of bringing to all of us a truly high performance  health care system. The Affordable Care Act, by establishing a standard of low actuarial value plans with excessive financial barriers to care will not enable the masses to have the same access to high quality care that the more affluent members of our society experience.
Why are we focusing on austerity when our potential is so great? We should reject political leaders who would foster yet more austerity. We need leaders who understand the importance of education, employment, and more equitable income distribution. That’s not only good for our economy, it’s good for our health as well.

After court ruling, problems remain

By Christine Adams, Ph.D.
Houston Chronicle, Letters, June 29, 2012

Regarding “Decision affirms division” (Page A1, Friday), the Supreme Court’s ruling to uphold the Affordable Care Act (ACA) does not solve our health care crisis. ACA does provide mild but temporary relief for many Americans (allowing children to remain on parents’ health insurance until age 26; eliminating pre-existing conditions exclusions, etc.).

However, single-payer national health insurance is the only solution to our health-care crisis. Only a single-payer national health care system can control costs without jeopardizing quality health care.

The U.S. is now an outlier compared to other industrialized nations by not providing guaranteed health security to all its citizens and legal residents. These nations spend half as much per person on health care as we do. (Germany just reported a surplus of $5.28 billion in its national health insurance program.)

Yet they still provide as good or better medical outcomes as we do. They can reduce costs without sacrificing quality because they have eliminated the root cause of out-of-control spiraling health care costs: for-profit health insurance companies that siphon off billions of dollars from health care each year for unnecessary expenses that have nothing to do with health care.

We need Congress to pass a single-payer national health insurance program so we can eliminate financial barriers to health care, improve efficiency, control costs and maintain high-quality health care.

Christine Adams is a licensed psychologist. She resides in Houston.

http://www.chron.com/opinion/letters/article/Letters-Mulling-over-health-law-ruling-3674585.php

The remedy for health care system is universal Medicare

By Jack Bernard
Kansas City Star, July 1, 2012

A physician friend recently said to me “Once every 15 years, health care reform comes around. If we do not succeed this time, we will have to wait another 15 years.”

Unfortunately, he is correct, and that is why it is good for Kansans that Obamacare (the Affordable Care Act) was passed and found constitutional. However flawed, it is better than nothing at all, especially for the 350,000 Kansas residents who are uninsured (according to the Kansas Health Institute).

Yes, Obamacare will eventually expand coverage and stop some of the most abusive insurance industry practices. But, was it the “right” prescription for both Kansas and the nation?

Obama won in 2008, advocating hope and change (although the Democrats lost in Kansas, as usual). The health care question was: “What can be done to get us on the correct path to have affordable, high-quality health care for our citizens?” With the public obviously ready for change, Obama and the Democratic majority had the opportunity of a lifetime. But they caved in to various political pressures and the lobbyists from the insurance and medical industries and deserted single payer insurance, their real preference.

The 2010 elections are past. The 2012 elections are looming large. The Republicans zeroed in on jobs and the terrible economy in 2010. The Democrats ran for cover, especially on health care. The economy, inherited or not, was the main cause of their defeat.

Would a different strategy on health reform, either universal Medicare or the Senate Majority Leader Harry Reid’s plan for covering those aged 55-64 through Medicare, have worked better for them? Given what happened, a 2010 rout of Democrats across the board, it clearly would have been worth a try for both electoral and technical reasons.

We did end up with a health care reform law. But, strangely enough, it was stolen from Romneycare and the Republican side of the aisle simply because of the political cost to the Democrats of inaction. It is a horse put together by a committee — ineffective, complex and political. If Romneycare is any indication, it will clearly not control costs to the taxpayer, the top health care concern of most Americans.

The public does not understand the new health care reform law’s true benefits, which are substantial in regard to access. Short-term, Democrats will again lose independent voters in many swing states vital to their 2012 chances.

Plus, this administration squandered the chance for real reform, a simple expansion of Medicare. The “government takeover” catch phrase scared them off.

Universal Medicare is a concept that makes sense technically and fiscally. The U.S. currently has per capita health expenditure costs double that of other developed nations on single-payer systems.

Medicare For All can be paid for through payroll and employer taxes, just like Medicare and Social Security are now. It is affordable because private insurance marketing and administrative costs (30 percent of the premium) are eliminated for employees and the firms employing them. Costs can be controlled through the Independent Payment Advisory Board, an independent panel set up under Obamacare. And, just like those programs, it would find immediate acceptance by the American public after implementation.

For more information on costs and benefits, please go to the website of Physicians for a National Health Program at www.pnhp.org.

Taking the long view, universal Medicare will eventually be implemented in the U.S., because of increasing premium costs and cost shifting if nothing else. But in 15 or 20 years, our health care cost and quality problems will be even worse because of congressional inaction.

Jack Bernard is a retired health care executive who worked with Kansas hospitals on planning and cost-containment issues. He now is a Republican county commissioner in Monticello, Ga., an Atlanta suburb.

Read more here: http://www.kansascity.com/2012/07/01/3683661/as-i-see-it-the-remedy-is-medicare.html#storylink=cpy

Republican health care executive on single payer

The remedy is universal Medicare

By Jack Bernard
The Kansas City Star, July 1, 2012

We did end up with a health care reform law. But, strangely enough, it was stolen from Romneycare and the Republican side of the aisle simply because of the political cost to the Democrats of inaction. It is a horse put together by a committee — ineffective, complex and political. If Romneycare is any indication, it will clearly not control costs to the taxpayer, the top health care concern of most Americans.

The public does not understand the new health care reform law’s true benefits, which are substantial in regard to access. Short-term, Democrats will again lose independent voters in many swing states vital to their 2012 chances.

Plus, this administration squandered the chance for real reform, a simple expansion of Medicare. The “government takeover” catch phrase scared them off.

Universal Medicare is a concept that makes sense technically and fiscally. The U.S. currently has per capita health expenditure costs double that of other developed nations on single-payer systems.

Medicare For All can be paid for through payroll and employer taxes, just like Medicare and Social Security are now. It is affordable because private insurance marketing and administrative costs (30 percent of the premium) are eliminated for employees and the firms employing them. Costs can be controlled through the Independent Payment Advisory Board, an independent panel set up under Obamacare. And, just like those programs, it would find immediate acceptance by the American public after implementation.

For more information on costs and benefits, please go to the web site of Physicians for a National Health Program at www.pnhp.org/.

Taking the long view, universal Medicare will eventually be implemented in the U.S., because of increasing premium costs and cost shifting if nothing else. But in 15 or 20 years, our health care cost and quality problems will be even worse because of congressional inaction.

(Jack Bernard is a retired health care executive who formerly worked with Kansas hospitals on planning and cost containment issues. He is now a Republican county commissioner in Monticello, Ga., a suburb of Atlanta.)

http://www.kansascity.com/2012/07/01/3683661/as-i-see-it-the-remedy-is-medicare.html

Comment: 

By Don McCanne, MD

This op-ed is of special significance for us for two reasons: 1) Medicare for All is not only a liberal/progressive issue as these are the words of a Republican health care executive, and 2) The efforts of PNHP to communicate the single payer message are gaining traction as he cites us as an authoritative source.

Jack Bernard is to be commended for his persistent efforts to inform the public on a better health care alternative. We need to renew and expand our important work on behalf of health care justice for all. It’s working.

Bernie Sanders, Nurses: We Still Need ‘Medicare for All’

By John Nichols
The Nation, June 28, 2012

There have been few steadier Congressional hands throughout the debate over health care reform than that of Vermont Senator Bernie Sanders. Principled in his support for the real reform of “Medicare for All,” yet pragmatic in his advocacy for Affordable Care Act provisions that expand public health programs and allow states to experiment with single-payer options, Sanders has been in the thick of every fight over President Obama’s signature reform. And the ensuing legislative and legal battles over its implementation.

What Sanders says about Thursday’s Supreme Court decision upholding the ACA provides important insights for progressives as they respond to a complex decision that, in the words of the National Nurses United union, “should not be seen as the end of the efforts by health care activists for a permanent fix of our broken health-care system.”

So what does Sanders say?

On the ruling, his line is upbeat:

“Today is a good day for millions of Americans who have pre-existing conditions who can no longer be rejected by insurance companies. It is a good day for families with children under 26 who can keep their children on their health insurance policies. It is a good day for women who can no longer be charged far higher premiums than men.

“It is a good day for 30 million uninsured Americans who will have access to health care. It is a good day for seniors who will continue to see their prescription drug costs go down as the so-called doughnut hole goes away. It is a good day for small businesses who simply cannot continue to afford the escalating costs of providing insurance for their employees. It is a good day for 20 million Americans who will soon be able to find access to community health centers.”

But that does not mean that Sanders is satisfied.

“In my view, while the Affordable Care Act is an important step in the right direction and I am glad that the Supreme Court upheld it, we ultimately need to do better,” the independent senator says. “If we are serious about providing high-quality, affordable health care as a right, not a privilege, the real solution to America’s health care crisis is a Medicare-for-all, single-payer system. Until then, we will remain the only major nation that does not provide health care for every man, woman and child as a right of citizenship.”

Sanders’s Vermont is taking the lead in seeking to implement a state-level single-payer system-much as Canadian provinces too the lead in the 1940s and 1950s in developing who would eventually be that country’s national health care system. The court’s ruling won’t slow that push down, and it could actually speed it up, as attention focuses on fights over state-run Medicaid programs. Sanders says, “I hope our state will be a model to show the rest of the nation how to provide better care at less cost to more people.”

Agreed. Amid the celebration of the Supreme Court ruling by those who did not want to go backward, there is a need for a firm focus on going forward. “Stepping up the fight for Medicare for All is even more critical in the midst of the still persistent economic crisis,” notes National Nurses United co-president Deborah Burger, RN, who noted that nurses have seen deep declines in health status among patients suffered the loss of jobs, homes and insurance coverage.

NNU notes that “the Affordable Care Act still leaves some 27 million people without health coverage, does little to constrain rising out of pocket health care costs, or to stop the all too routine denials of needed medical care by insurance companies because they don’t want to pay for it.”

It is for that reason that NNU co-president Jean Ross, RN, echoes Sanders: “The continuing fiscal crisis at all levels of government and the anemic economic recovery remind us that rising health care costs and shifting costs to workers burden our society, cause much of these fiscal problems, and limit the opportunities for working people. Only real cost control through a national health program can solve this crisis. Improved Medicare meets that challenge.”

“Medicare is far more effective than the broken private system in controlling costs and the waste that goes to insurance paperwork and profits, and it is universally popular, even among those who bitterly opposed the Obama law,” adds NNU co-president Karen Higgins, RN. “Let’s open it up to everyone, no one should have to wait to be 65 to be guaranteed health care.”

That’s correct.

The Supreme Court’s ruling can be celebrated on some levels, as Sanders well notes.

But the senator and his allies in the struggle for the real reform of Medicare for All speak a profound truth when they say, “We ultimately need to do better … the real solution to America’s health care crisis is a Medicare-for-all, single-payer system.”

http://www.thenation.com/blog/168649/bernie-sanders-nurses-we-still-need-medicare-all

Affordable Care Act: good news or bad?

By Samuel Metz, M.D.
The Oregonian, July 2, 2012

Is the Supreme Court decision upholding the Affordable Care Act good news or bad? It depends on who you are.

If you are President Obama, the news is good. The highest court in the land just validated the showpiece legislation of your first years in office. Election prospects just go brighter.

If you are Gov. John Kitzhaber or one of the 600,000 Oregonians in the Oregon Health Plan, the news is also good. This decision preserves critically important support from the ACA to the health care transformation process, a dramatic method of health care delivery with potential to provide better care at lower cost for 15 percent of Oregon’s population.

And if you are a health insurance executive, the news is spectacular. The Supreme Court just confirmed a law requiring every American to purchase your product regardless of price, or face a penalty. Protests on the Supreme Court steps were drowned out by the clinking of whiskey glasses in health insurance boardrooms around the country.

For the rest of us, however, it is bad news indeed. Yes, the ACA will dramatically increase the number of insurance policies sold, but it won’t make policies cheaper, nor will it make health care more affordable or more accessible.

In fact, the ACA will increase health care spending by $400 billion annually. This extra cost will not appear on the federal budget because costs are passed on to us, the patients, via compulsory purchases of insurance, increased premium prices and dramatically increased out-of-pocket spending.

Nor will the ACA protect American families from financial and medical catastrophe if one of us gets the wrong disease at the wrong time. Our most vulnerable families still face the unhappy choice of spending their last dollar on their mortgage or on their health care deductible.

Every industrialized country in the world provides better care to more people for less money than we do. None use our uniquely American style of private health insurance. Let’s get real: If we plan a radical and painful makeover of our disastrous health care system, doesn’t it make more sense to emulate these systems that work (using publicly funded universal health care) rather than one that doesn’t? And the one system that we absolutely know doesn’t work is the one we have now.

Unhappily, the ACA is guaranteed to produce one sure-fire result. Americans will become more dependent than ever before on private health insurance for their only access to health care. If you like what private health insurance has inflicted on our society up to now, just wait until you see what the newly approved ACA will do to us in the future.

Neither Congress nor the ACA will save us from health care Armageddon. We in Oregon must take charge of our future. It’s time to create our own reality-based, cost-effective, publicly funded universal health care system and say tell the Supreme Court and ACA to take a hike.

Dr. Samuel Metz is a Portland anesthesiologist and a member of Physicians for a National Health Program and Mad As Hell Doctors, both advocates for single-payer health care, and of Health Care for All Oregon, an umbrella organization advocating for publicly funded universal care for all Oregonians.

http://www.oregonlive.com/opinion/index.ssf/2012/07/affordable_care_act_is_bad_new.html

Aging Americans agree on Medicare

By Jack Bernard
USA Today, Letters, June 29, 2012

I can understand why my neighbors do not care for the individual health care mandate, but I do not understand what their problem is regarding national health insurance.

We have had national health insurance for nearly 50 years. We call it Medicare. Folks in my generation support it. Just ask the older demonstrators at the 2009 town-hall meetings who said, “Keep the government out of my Medicare.”

Yes, Medicare only covers people older than 65, but there is no magic in that number. With the risk spread among younger, healthier people, funding shortfalls will soon be a thing of the past.

The correct solution to covering the uninsured has never been ObamaCare. If the GOP were smart, it would just propose “Medicare for all” as an alternative.

Jack Bernard resides in Monticello, Ga.

http://www.usatoday.com/news/opinion/letters/story/2012-06-28/supreme-court-health-care-big-government/55901960/1

Expand Medicare to include all Americans

By Jonathan Kotch, M.D.
The Herald Sun (Durham, N.C.),

The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. Five Justices agreed that the penalty that someone must pay if for refusing to buy insurance is a tax that Congress has the power to impose.

The new law does a number good things that have already gone into effect, such as extending eligibility for health insurance coverage on their parents’ policies for more than 3 million children under 26 years of age. However, these improvements come with a cost, the cost of subsidizing an unnecessary health insurance industry which consumes 20 percent to 30 percent of our health care dollars for overhead and profit.

In fact, we don’t need health insurance at all. All we need is to apply our 47 years of experience with Medicare, one of the most popular social programs in the history of the United States, to make it even better, and to start it at birth instead of at age 65. With such an approach, all Americans would be included, health care costs could be contained, people would be able to choose their health care providers, and the emphasis on primary and preventive health services would improve the quality of care for all.

Jonathan Kotch, M.D., M.P.H., F.A.A.P., resides in Durham and works with For OccupyHealthandWellnessNC.org.

http://www.heraldsun.com/view/full_story/19150248/article-Letters–July-1