PNHP

Uninsured veterans

Uninsured veterans

Over 2,200 veterans died in 2008 due to lack of health insurance

Physicians for a National Health Program
Press Release
November 10, 2009

A research team at Harvard Medical School estimates 2,266 U.S. military veterans under the age of 65 died last year because they lacked health insurance and thus had reduced access to care. That figure is more than 14 times the number of deaths (155) suffered by U.S. troops in Afghanistan in 2008, and more than twice as many as have died (911 as of Oct. 31) since the war began in 2001.

The Harvard group analyzed data from the U.S. Census Bureau’s March 2009 Current Population Survey, which surveyed Americans about their insurance coverage and veteran status, and found that 1,461,615 veterans between the ages of 18 and 64 were uninsured in 2008. Veterans were only classified as uninsured if they neither had health insurance nor received ongoing care at Veterans Health Administration (VA) hospitals or clinics.

“Like other uninsured Americans, most uninsured vets are working people – too poor to afford private coverage but not poor enough to qualify for Medicaid or means-tested VA care,” said Dr. Steffie Woolhandler, a professor at Harvard Medical School. While many Americans believe that all veterans can get care from the VA, even combat veterans may not be able to obtain VA care, Woolhandler said.

Dr. David Himmelstein, the co-author of the analysis and associate professor of medicine at Harvard, commented, “On this Veterans Day we should not only honor the nearly 500 soldiers who have died this year in Iraq and Afghanistan, but also the more than 2,200 veterans who were killed by our broken health insurance system.”

https://pnhp.org/news/2009/november/over_2200_veterans_.php

And…

A Word, Mr. President

By Bob Herbert
The New York Times
November 9, 2009

Reforming the chaotic and unfair health care system in the U.S. is an important issue. But in terms of pressing national priorities, the most important are the need to find solutions to a catastrophic employment environment that is devastating American families and to end the folly of an 8-year-old war that is both extremely debilitating and ultimately unwinnable.

If you were to take a walk around one of the many military medical centers, like Landstuhl in Germany or Walter Reed in Washington, your heart would break at the sight of the heroic young men and women who have lost limbs (frequently more than one) or who are blind or paralyzed or horribly burned. Hundreds of thousands have suffered psychological wounds. Many have contemplated or tried suicide, and far too many have succeeded.

“Mr. President,” I would say, “we’ll never be right as a nation as long as we allow this to continue.”

http://www.nytimes.com/2009/11/10/opinion/10herbert.html?hp

Comment:

By Don McCanne, MD

How can we continue to support a fragmented, dysfunctional financing system that allows some of our veterans (not to mention tens of thousands of others of us) to die merely because we have placed a higher priority on nurturing the private insurance industry than we have on improving access for everyone through a more effective health care financing system? Our veterans. How can we let them down like this?

On a personal note, Veterans Day has always been a difficult day for me. In August of 1964, when I was driving from California to Texas to report for duty as an Army medical officer, we heard on the radio that our close friend, Dick Sather, was the Navy pilot who was just shot down and killed in the Gulf of Tonkin incident. (The other pilot shot down, Everett Alvarez, was held captive for over eight years.)

I was already a pacifist, but strictly on an ethical and not a religious basis. I believe, like so many others, that war is not healthy for children and other living things. The very worst possible way to negotiate international disagreements is to engage in war. And yet the United States does it over and over again. The school yard excuse, “but they started it,” doesn’t even seem to apply anymore.

After medical officer basic training in San Antonio, my first assignment to season me before being sent overseas, was as a battalion surgeon in Fort Hood, Texas. Yes, that Fort Hood.

Now you understand why I seem to be off message – the combination of my Veterans Day grief, the tragic slaughter that just occurred at my former military base, and now this new report on the unnecessary deaths of so many veterans due to a broken health insurance system.

Veterans Day is a day to think about the impact on not just our veterans but all of us, of record unemployment, war, and the unfair health care system that Bob Herbert writes about. We can fix all of them.

So what are we doing? More government money for Wall Street, and less for jobs. More troops for the war in Afghanistan, instead of withdrawal. More money for private insurers, while health care becomes ever less affordable for patients.

Is this what our veterans were fighting for?

Over 2,200 veterans died in 2008 due to lack of health insurance

Harvard researchers say 1.46 million working-age vets lacked health coverage last year, increasing their death rate

Immediate Release
Nov. 10, 2009

Contacts:
Steffie Woolhandler, M.D., M.P.H.
David Himmelstein, M.D.
Mark Almberg, Physicians for a National Health Program, (312) 782-6006, mark@pnhp.org

A research team at Harvard Medical School estimates 2,266 U.S. military veterans under the age of 65 died last year because they lacked health insurance and thus had reduced access to care. That figure is more than 14 times the number of deaths (155) suffered by U.S. troops in Afghanistan in 2008, and more than twice as many as have died (911 as of Oct. 31) since the war began in 2001.

The researchers, who released their analysis today [Tuesday], pointedly say the health reform legislation pending in the House and Senate will not significantly affect this grim picture.

The Harvard group analyzed data from the U.S. Census Bureau’s March 2009 Current Population Survey, which surveyed Americans about their insurance coverage and veteran status, and found that 1,461,615 veterans between the ages of 18 and 64 were uninsured in 2008. Veterans were only classified as uninsured if they neither had health insurance nor received ongoing care at Veterans Health Administration (VA) hospitals or clinics.

Using their recently published findings in the American Journal of Public Health that show being uninsured raises an individual’s odds of dying by 40 percent (causing 44,798 deaths in the United States annually among those aged 17 to 64), they arrived at their estimate of 2,266 preventable deaths of non-elderly veterans in 2008. (See table.)

“Like other uninsured Americans, most uninsured vets are working people – too poor to afford private coverage but not poor enough to qualify for Medicaid or means-tested VA care,” said Dr. Steffie Woolhandler, a professor at Harvard Medical School who testified before Congress about uninsured veterans in 2007 and carried out the analysis released today [Tuesday]. “As a result, veterans go without the care they need every day in the U.S., and thousands die each year. It’s a disgrace.”

Dr. David Himmelstein, the co-author of the analysis and associate professor of medicine at Harvard, commented, “On this Veterans Day we should not only honor the nearly 500 soldiers who have died this year in Iraq and Afghanistan, but also the more than 2,200 veterans who were killed by our broken health insurance system. That’s six preventable deaths a day.”

He continued: “These unnecessary deaths will continue under the legislation now before the House and Senate. Those bills would do virtually nothing for the uninsured until 2013, and leave at least 17 million uninsured over the long run. We need a solution that works for all veterans – and for all Americans – single-payer national health insurance.”

While many Americans believe that all veterans can get care from the VA, even combat veterans may not be able to obtain VA care, Woolhandler said. As a rule, VA facilities provide care for any veteran who is disabled by a condition connected to his or her military service and care for specific medical conditions acquired during military service.

Woolhandler said veterans who pass a means test are eligible for care in VA facilities, but have lower priority status (Priority 5 or 7, depending upon income level). Veterans with higher incomes are classified in the lowest priority group and are not eligible for VA enrollment.

*****
Some sources for possible patient stories are available upon request. Please contact Mark Almberg at (312) 782-6006 or mark@pnhp.org.

Physicians for a National Health Program (www.pnhp.org) is an organization of 17,000 doctors who support single-payer national health insurance, often called an improved Medicare for All. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.

Age Number of
Uninsured Veterans, 2008
Percent of Uninsured who
are Veterans		 Deaths/100,000 Population Excess Deaths Among All Uninsured Americans Excess Deaths Among Uninsured Veterans, 2008
18 to 24* 54,022
0.65% 81.4 2,388 16
25 to 34 224,351 2.06% 104.4 3,842 79
35 to 44 300,859 3.68% 193.3 5,685 209
45 to 54 426,348 5.90% 432.0 10,201 602
55 to 64 456,034 10.32% 906.9 13,175 1,360
Total
(Under 65)		 1,461,615 3.70% 44,798 2,266
Total
(All Ages) 		1,540,795 3.84%

eHealth is ready to connect America

eHealth Views Passage of House Health Reform Bill as “Historic Step Toward Connecting All Americans to Coverage”

CNNMoney.com
November 8, 2009
Health Insurance Exchanges Are Key
The following is (from) a statement from Gary Lauer, chairman and CEO of eHealth, Inc., regarding tonights passage of the U.S. House of Representatives’ health reform legislation:
“eHealth’s experience over the past decade in connecting nearly two million Americans to coverage through our national online marketplace proves that exchanges do work. By employing multiple paths to coverage, including exchanges, and online solutions like ours, we can optimize enrollment and provide the uninsured with the most choices and flexibility.
“The technologies that have been developed by private sector players, such as eHealth, are key to ensuring Americans find and receive the coverage this legislation would mandate.
“eHealth looks forward to being an active partner in implementing meaningful health reform legislation, and is poised and ready to connect the uninsured to coverage quickly.”
http://money.cnn.com/news/newsfeeds/articles/marketwire/0556598.htm
eHealth is “Ready to Connect America to Coverage:”
http://www.ready2connect.org/

And…

H.R. 3962 – AFFORDABLE HEALTH CARE FOR AMERICA ACT

SEC. 305. OUTREACH AND ENROLLMENT OF EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS IN EXCHANGE-PARTICIPATING HEALTH BENEFITS PLAN.
USE OF OTHER ENTITIES.–In carrying out this subsection, the Commissioner may work with other appropriate entities to facilitate the dissemination of information under this subsection and to provide assistance as described in paragraph (2).
From paragraph (2): (C) assist Exchange-eligible individuals in selecting Exchange-participating health benefits plans and obtaining benefits through such plans.
http://thomas.loc.gov/

eHealth is ready to become the nation’s broker for private health insurance. Watching the two minute video at the “Ready to Connect” link above will demonstrate just how ambitious their plans are.
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.

Is the House Health Care Bill Better than Nothing?

By Marcia Angell, M.D.
Physician, Author, Senior Lecturer, Harvard Medical School
The Huffington Post
November 8, 2009

Well, the House health reform bill — known to Republicans as the Government Takeover — finally passed after one of Congress’s longer, less enlightening debates. Two stalwarts of the single-payer movement split their votes; John Conyers voted for it; Dennis Kucinich against. Kucinich was right.

Conservative rhetoric notwithstanding, the House bill is not a “government takeover.” I wish it were. Instead, it enshrines and subsidizes the “takeover” by the investor-owned insurance industry that occurred after the failure of the Clinton reform effort in 1994. To be sure, the bill has a few good provisions (expansion of Medicaid, for example), but they are marginal. It also provides for some regulation of the industry (no denial of coverage because of pre-existing conditions, for example), but since it doesn’t regulate premiums, the industry can respond to any regulation that threatens its profits by simply raising its rates. The bill also does very little to curb the perverse incentives that lead doctors to over-treat the well-insured. And quite apart from its content, the bill is so complicated and convoluted that it would take a staggering apparatus to administer it and try to enforce its regulations.

What does the insurance industry get out of it? Tens of millions of new customers, courtesy of the mandate and taxpayer subsidies. And not just any kind of customer, but the youngest, healthiest customers — those least likely to use their insurance. The bill permits insurers to charge twice as much for older people as for younger ones. So older under-65’s will be more likely to go without insurance, even if they have to pay fines. That’s OK with the industry, since these would be among their sickest customers. (Shouldn’t age be considered a pre-existing condition?)

Insurers also won’t have to cover those younger people most likely to get sick, because they will tend to use the public option (which is not an “option” at all, but a program projected to cover only 6 million uninsured Americans). So instead of the public option providing competition for the insurance industry, as originally envisioned, it’s been turned into a dumping ground for a small number of people whom private insurers would rather not have to cover anyway.

If a similar bill emerges from the Senate and the reconciliation process, and is ultimately passed, what will happen?

First, health costs will continue to skyrocket, even faster than they are now, as taxpayer dollars are pumped into the private sector. The response of payers — government and employers — will be to shrink benefits and increase deductibles and co-payments. Yes, more people will have insurance, but it will cover less and less, and be more expensive to use.

But, you say, the Congressional Budget Office has said the House bill will be a little better than budget-neutral over ten years. That may be, although the assumptions are arguable. Note, though, that the CBO is not concerned with total health costs, only with costs to the government. And it is particularly concerned with Medicare, the biggest contributor to federal deficits. The House bill would take money out of Medicare, and divert it to the private sector and, to some extent, to Medicaid. The remaining costs of the legislation would be paid for by taxes on the wealthy. But although the bill might pay for itself, it does nothing to solve the problem of runaway inflation in the system as a whole. It’s a shell game in which money is moved from one part of our fragmented system to another.

Here is my program for real reform:

Recommendation #1: Drop the Medicare eligibility age from 65 to 55. This should be an expansion of traditional Medicare, not a new program. Gradually, over several years, drop the age decade by decade, until everyone is covered by Medicare. Costs: Obviously, this would increase Medicare costs, but it would help decrease costs to the health system as a whole, because Medicare is so much more efficient (overhead of about 3% vs. 20% for private insurance). And it’s a better program, because it ensures that everyone has access to a uniform package of benefits.

Recommendation #2: Increase Medicare fees for primary care doctors and reduce them for procedure-oriented specialists. Specialists such as cardiologists and gastroenterologists are now excessively rewarded for doing tests and procedures, many of which, in the opinion of experts, are not medically indicated. Not surprisingly, we have too many specialists, and they perform too many tests and procedures. Costs: This would greatly reduce costs to Medicare, and the reform would almost certainly be adopted throughout the wider health system.

Recommendation #3: Medicare should monitor doctors’ practice patterns for evidence of excess, and gradually reduce fees of doctors who habitually order significantly more tests and procedures than the average for the specialty. Costs: Again, this would greatly reduce costs, and probably be widely adopted.

Recommendation #4: Provide generous subsidies to medical students entering primary care, with higher subsidies for those who practice in underserved areas of the country for at least two years. Costs: This initial, rather modest investment in ending our shortage of primary care doctors would have long-term benefits, in terms of both costs and quality of care.

Recommendation #5: Repeal the provision of the Medicare drug benefit that prohibits Medicare from negotiating with drug companies for lower prices. (The House bill calls for this.) That prohibition has been a bonanza for the pharmaceutical industry. For negotiations to be meaningful, there must be a list (formulary) of drugs deemed cost-effective. This is how the Veterans Affairs System obtains some of the lowest drug prices of any insurer in the country. Costs: If Medicare paid the same prices as the Veterans Affairs System, its expenditures on brand-name drugs would be a small fraction of what they are now.

Is the House bill better than nothing? I don’t think so. It simply throws more money into a dysfunctional and unsustainable system, with only a few improvements at the edges, and it augments the central role of the investor-owned insurance industry. The danger is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we’ve tried health reform and it didn’t work. But the real problem will be that we didn’t really try it. I would rather see us do nothing now, and have a better chance of trying again later and then doing it right.

Read more at: http://www.huffingtonpost.com/marcia-angell-md/is-the-house-health-care_b_350190.html&cp

CNA/NNOC Statement On The Withdrawal Of The House Single Payer Amendment

Medical News Today
Nov. 9, 2009

On the eve of what would have been the first national vote on single-payer legislation Rep. Anthony Weiner’s single-payer/Medicare for all amendment was withdrawn Friday, November 6.

The vote for Congressman Weiner’s single-payer amendment would have allowed advocates to have their representatives on record as single-payer supporters. The announcement of the withdrawal of the amendment also followed an 11th hour decision by the House leadership to drop an amendment sponsored by Rep. Dennis Kucinich that had been in the bill since July to remove legal barriers for states that choose to enact single payer/Medicare for all state bills.

The California Nurses Association/National Nurses Organizing Committee commends the thousands of nurses and other grassroots activists who have participated in rallies, marches, sit-ins, and flooded Congressional offices with calls over the past few weeks and months in support of single payer and the amendments.

The outcome on the Weiner and Kucinich amendments is the latest in year-long maneuvers by the Obama administration to take single payer off the table, to exclude single payer advocates from participation in the Congressional debate and White House healthcare forums, and to twist arms behind the scenes to block both the Kucinich and Weiner amendments.

Regrettably, the administration and Congressional leadership efforts to silence the voices of advocates of the most comprehensive, most cost effective, most humane reform reinforced the extensive corporate lobbying of the insurance industry and its corporate allies. The private insurance industry alone has sent 3,000 lobbyists to Capitol Hill this year, spending $1.4 million dollars a day to shape reform that protects their profits and reinforces the broken, insurance-based healthcare system.

Only the remarkable, and persistent effort of our members and allies has kept the flame of the single payer/Medicare for all movement moving forward in Congress. And, we’re not done.

Our focus now turns to two remaining efforts for single-payer in this Congress. Sen. Bernie Sanders will introduce S 703 in coming weeks. In addition, Rep. Kucinich’s amendment to allow states to more easily implement a single-payer system may be reinserted into the bill during the conference committee between the House and Senate. All of these efforts are crucial to building the movement for the best solution to our healthcare crisis – single-payer national healthcare.

While the current bills will provide limited assistance for some, the inconvenient truth is they fall far short in effective controls on skyrocketing insurance, pharmaceutical and hospital costs, do little to stop insurance companies from denying needed medical care recommended by doctors, and provide little relief for Americans with employer-sponsored insurance worried about health security for themselves and their families.

People are suffering – they die needlessly. The Democrats, who control the White House and Congress, bear the responsibility for changing that. Republicans cheerlead to deny care and humanity. The Democrats act as though they care and block the best solution. The heroes in this debate are the Medicare for all proponents who have stood by the American families.

We will continue to press for guaranteed healthcare in Congress. Further, the outstanding state based campaigns for single payer bills in California, Pennsylvania, Maine, Illinois, and other states will continue.

We concur with Healthcare-NOW, “Let us not forget how far we have come. Either now or later, a single-payer national healthcare system must come to the table. We will keep building the movement to make that happen.”

http://www.medicalnewstoday.com/articles/170272.php

Massa says he can't support health care bill

By Patti Singer
Rochester (N.Y.) Democrat And Chronicle
November 6, 2009

The day before the much-anticipated vote on health care reform in the House of Representatives, Eric Massa, D-Corning, said that the Affordable Health Care for America Act gives too much to the insurance industry, doesn’t do enough to control costs, and he can’t support it.

“At the highest level this bill will enshrine in law the monopolistic powers of the private health insurance industry,” Massa said in a telephone news conference this morning. “There’s no other way to look at it.”

Massa said that the bill “fails to address the fundamental question before the American people, and that is, how do you control the costs of health care?”

Speaking in strong, deliberate tones, Massa said that the bill also does not address ways to incorporate medical malpractice reform or ways to reduce or eliminate waste and fraud. “Since it doesn’t address those cost factors, I do not understand how it will help the American people.” He also reiterated his concerns over the constitutionality of a mandate for people to purchase insurance.

He said that H.R. 3962 may provide more access to insurance in the short-term for some Americans. “But at the end of the day, I believe we put our system in peril for the majority.” Massa said he remains committed to a government role in facilitating greater access to health care.

On Thursday, it was reported that Rep. Chris Lee, R-Clarence, Erie County would vote no, Rep. Dan Maffei, D-DeWitt, Onondaga County, was undecided and Rep. Louise Slaughter, D-Fairport, would vote for the bill.

Massa said he had spent the past week studying 1,990-page H.R. 3962 (http://docs.house.gov/rules/health/111_ahcaa.pdf) and was not aware of positions of other Democrats or how his dissenting vote would reflect on the upstate delegation. “I speak for myself. … Everybody loves an independent member of Congress, until you’re independent.”

The freshman congressman also said he would not be swayed by an expected audience on Saturday with President Barack Obama, who has put health care reform atop his domestic agenda. “I have respect for the chief executive, but I don’t work for him. I work for people of the 29th Congressional District.”

This summer, Massa stirred emotions when he said that he would vote against the interest of his district if he felt that what he was doing was helpful. At the time, he was referring to H.R. 3200.

“That’s what leadership is all about,” he said, not going in the direction of “whoever’s yelling at you. If you’re not strong in confidence, you should never get involved in representative democracy.”

Squandered a golden opportunity regarding U.S. health care

Letter to the Editor
South Maryland Newspapers
Friday, Nov. 6, 2009

In the spirit of full disclosure, I support a single-payer national health program. That said, my comments are focused on HR 3962, the Affordable Health Care for America Act. I agree with Wendell Potter, the former head of public relations for CIGNA, that this legislation could more accurately be titled “The Private Health Insurance Profit Protection and Enhancement Act.”

The readers should know that this legislation was written by the insurance industry, for the insurance industry. We are being mandated to purchase a defective product from an industry that has demonstrated for the past 60 years that it puts profits before patients. Even the so-called public option will be administered by the private insurance industry and will enroll, at most, 6 million people in a multitude of anemic markets; it will not be a robust Medicare-like market at all.

This public option is like sending in a peewee football team to compete with the NFL. It will not compete with the private insurance industry; it will become the default insurer for our sickest, least profitable citizens, leaving the younger, mandated, profitable citizens to enroll in the private plans provided in the exchange.

As Winston Churchill said, “You can count on the American people to do the right thing, but only after they’ve exhausted all the other possibilities.”

Rep. Steny Hoyer, as House majority leader, has squandered a golden opportunity and chosen to hide behind the hackneyed rhetoric of his party — blah, blah, blah, politically feasible, blah, blah, blah.

Dr. Carol A. Paris
Leonardtown, MD

How Much Lying Will It Take To Break Your Confidence?

By Donna Smith
November 7, 2009

So, I wake this morning to see that Speaker Pelosi lied again about why she just could not allow a single-payer amendment to survive the legislative effort in the House on healthcare reform.

Early in the week she said that she couldn’t let the Kucinich amendment survive because it broke the President’s promise that “you can keep what you have if you like it.” See my blog on Michael Moore’s Mike & Me blog for my remarks on that subject.

So, out went the amendment voted into the bill with those ever-prized bi-partisan votes that would have allowed states whose voters and lawmakers pass single-payer plans to be granted necessary federal waivers to do so (read that again, folks, lest you miss the House’s direct squelching of the right you have in our own states to determine the best policy).

Then yesterday we read that praise-worthy as Anthony Weiner’s single-payer substitute amendment was–the one promised to a vote by Speaker Pelosi last July–that it just couldn’t be offered because that would mean the Speaker would have to allow other amendments too–like the abortion funding amendment.

Sorry, she told Mr. Weiner, but I have to be fair about this. The fluttering began and they all praised one another for being so damned agreeable.

Pelosi praises Weiner.

But read it, don’t weep. She’s decided–as Gomer Pyle would say “Surprise, surprise, surprise…”–to allow right-wing crazies another shot in offering their anti-abortion funding amendment.

I say don’t weep because at some point you actually get mad enough to call them out. If an anti- reproductive rights funding amendment becomes law in this bill, it is a slap in the face to so many various groups that it isn’t to be believed. The Republicans and the Blue Dogs do their own big share of lying when they pretend to care about life. Come on, we all know that’s just not reality.

So long as they are passing laws on the federal level that allow 45,000 people to die every year in this nation because they have not been allowed to receive the healthcare that was available to those with the means to pay for it, these folks have no claim to any right to life at all. And so long as they are passing laws on the federal level that allow me and millions of others to go bankrupt even with the health insurance they are forcing us all to buy, they have no claim to protecting my hard work and effort to achieve my own American dream.

Tell the truth, at least. This is all about protecting power and re-election and the money that fuels that process. Damn the people. They’ll just plan to buy us back to the polls with the crappy campaign ads that will commence shortly after the last chorus of “Jingle Bells” in December. And the insurance companies are going to have a very happy holiday season indeed.

Donna Smith is a community organizer for California Nurses Association and national co-chair of PDA’s Healthare NOT Warfare campaign.

eHealth is ready to connect America

eHealth Views Passage of House Health Reform Bill as "Historic Step Toward Connecting All Americans to Coverage"

CNNMoney.com
November 8, 2009

Health Insurance Exchanges Are Key

The following is (from) a statement from Gary Lauer, chairman and CEO of eHealth, Inc., regarding tonights passage of the U.S. House of Representatives’ health reform legislation:

“eHealth’s experience over the past decade in connecting nearly two million Americans to coverage through our national online marketplace proves that exchanges do work. By employing multiple paths to coverage, including exchanges, and online solutions like ours, we can optimize enrollment and provide the uninsured with the most choices and flexibility.

“The technologies that have been developed by private sector players, such as eHealth, are key to ensuring Americans find and receive the coverage this legislation would mandate.

“eHealth looks forward to being an active partner in implementing meaningful health reform legislation, and is poised and ready to connect the uninsured to coverage quickly.”

http://money.cnn.com/news/newsfeeds/articles/marketwire/0556598.htm

eHealth is “Ready to Connect America to Coverage:”
http://www.ready2connect.org/

And…

H.R. 3962 – AFFORDABLE HEALTH CARE FOR AMERICA ACT

SEC. 305. OUTREACH AND ENROLLMENT OF EXCHANGE-ELIGIBLE INDIVIDUALS AND EMPLOYERS IN EXCHANGE-PARTICIPATING HEALTH BENEFITS PLAN.

USE OF OTHER ENTITIES.–In carrying out this subsection, the Commissioner may work with other appropriate entities to facilitate the dissemination of information under this subsection and to provide assistance as described in paragraph (2).

From paragraph (2): ( C ) assist Exchange-eligible individuals in selecting Exchange-participating health benefits plans and obtaining benefits through such plans.

http://thomas.loc.gov/

Comment:

By Don McCanne, MD

eHealth is ready to become the nation’s broker for private health insurance. Watching the two minute video at the “Ready to Connect” link above will demonstrate just how ambitious their plans are.

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.

Massa says he can’t support health care bill

By Patti Singer
Rochester (N.Y.) Democrat And Chronicle
November 6, 2009

The day before the much-anticipated vote on health care reform in the House of Representatives, Eric Massa, D-Corning, said that the Affordable Health Care for America Act gives too much to the insurance industry, doesn’t do enough to control costs, and he can’t support it.

“At the highest level this bill will enshrine in law the monopolistic powers of the private health insurance industry,” Massa said in a telephone news conference this morning. “There’s no other way to look at it.”

Massa said that the bill “fails to address the fundamental question before the American people, and that is, how do you control the costs of health care?”

Speaking in strong, deliberate tones, Massa said that the bill also does not address ways to incorporate medical malpractice reform or ways to reduce or eliminate waste and fraud. “Since it doesn’t address those cost factors, I do not understand how it will help the American people.” He also reiterated his concerns over the constitutionality of a mandate for people to purchase insurance.

He said that H.R. 3962 may provide more access to insurance in the short-term for some Americans. “But at the end of the day, I believe we put our system in peril for the majority.” Massa said he remains committed to a government role in facilitating greater access to health care.

On Thursday, it was reported that Rep. Chris Lee, R-Clarence, Erie County would vote no, Rep. Dan Maffei, D-DeWitt, Onondaga County, was undecided and Rep. Louise Slaughter, D-Fairport, would vote for the bill.

Massa said he had spent the past week studying 1,990-page H.R. 3962 (http://docs.house.gov/rules/health/111_ahcaa.pdf) and was not aware of positions of other Democrats or how his dissenting vote would reflect on the upstate delegation. “I speak for myself. … Everybody loves an independent member of Congress, until you’re independent.”

The freshman congressman also said he would not be swayed by an expected audience on Saturday with President Barack Obama, who has put health care reform atop his domestic agenda. “I have respect for the chief executive, but I don’t work for him. I work for people of the 29th Congressional District.”

This summer, Massa stirred emotions when he said that he would vote against the interest of his district if he felt that what he was doing was helpful. At the time, he was referring to H.R. 3200.

“That’s what leadership is all about,” he said, not going in the direction of “whoever’s yelling at you. If you’re not strong in confidence, you should never get involved in representative democracy.”

Rep. Weiner withdraws single payer amendment

Rep. Weiner Withdraws Single Payer Amendment from Current Health Care Debate

Representative Anthony Weiner
Press Release
November 6, 2009
Today, Representative Anthony Weiner (D – Brooklyn and Queens), a member of the House Energy and Commerce Health Subcommittee, released the following statement on his decision to withdraw his single payer amendment to H.R. 3962, the House health care reform bill:
“I have decided not to offer a single payer alternative to the health reform bill at this time. Given how fluid the negotiations are on the final push to get comprehensive health care reform that covers millions of Americans and contains costs through a public option, I became concerned that my amendment might undermine that important goal.”
“I am going to continue to press the case for health care reform in every venue I can. And I also will continue to press for a smarter, less-expensive, more-comprehensive alternative to the employer-based health insurance system we have today.”
“I’ve discussed the issue with Speaker Pelosi, Chairman Waxman, and agree with them that the health reform bill is so close it deserves every chance to gain a majority.”
http://weiner.house.gov/news_display.aspx?id=1368

And…

Pelosi Statement on Congressman Anthony Weiner’s Single Payer Alternative

Speaker Nancy Pelosi
Press Release
November 6, 2009
Washington, D.C. — Speaker Nancy Pelosi issued the following statement today on Congressman Anthony Weiner’s single payer alternative:
“Within the next few days, the House will vote on the most comprehensive health care legislation in our history. Our bill will provide affordability to the middle class, security to our seniors, and responsibility to our children by not adding a dime to the deficit. While our bill contains unprecedented reforms, including an end to discrimination for pre-existing conditions and a prohibition on raising rates or dropping coverage if you become ill, our bill cannot include provisions some strongly advocated. The single payer alternative is one of those provisions that could not be included in H.R. 3962, but which has generated support within the Congress and throughout the country.
“Congressman Anthony Weiner has been a forceful and articulate advocate for the single payer approach and our legislation. His decision not to offer a single payer amendment during consideration of H.R. 3962 is a correct one, and helps advance the passage of important health reforms by this Congress. While single payer, like other popular proposals, is not included in the consensus bill we will vote on this week, Congressman Weiner has been a tireless and effective advocate for progress on health care, and his work has been a vital part of achieving health care reform.”
http://speaker.house.gov/newsroom/pressreleases?id=1438

And…

Chairman Waxman’s Statement on Rep. Weiner’s Single-Payer Amendment

Chairman Henry A. Waxman
Committee on Energy and Commerce
November 6, 2009
Today Chairman Henry A. Waxman released a statement in response to Rep. Anthony Weiner’s decision not to offer a single-payer amendment to the House Democratic health care legislation.
“Rep. Anthony Weiner has been one of the most tireless and effective advocates for health care reform. His decision not to offer his amendment on the floor was a difficult one for him, and for supporters of the measure. I believe Rep. Weiner’s choice will be enormously helpful in passing the health care reform package. His step is a correct and courageous one. I thank Rep. Weiner for it, and look forward to working with him closely. Rep. Weiner deserves a great deal of credit for helping to make quality, affordable health care more available to millions of Americans.”
http://energycommerce.house.gov/index.php?option=com_content&view=article&id=1808:-chairman-waxmans-statement-on-rep-weiners-single-payer-amendment&catid=155:statements&Itemid=55

Comment by Ida Hellander, M.D., Executive Director, Physicians for a National Health Program:
Next steps and interpretation –
1) The fact that single payer got so far along in the House is a testament to the strength of our single payer movement. The huge number of calls by single payer advocates in support of single payer and the Weiner amendment in recent days have been noted by several members of Congress.
2) It appears that nobody, particularly the President, expected our single payer option to be alive in the Congress for so long. As you know, they attempted to keep it “off the table” from the very beginning.
3) The President was directly involved in the decision to not hold a vote on the Weiner single payer amendment, and Weiner will be meeting with him later today. Stay tuned.
4) We need to increase pressure on the Congress and the White House for Medicare for All through lobbying, civil disobedience, media outreach, and grassroots organizing. Sen. Sanders will call for a vote on single payer in the Senate – this could come up anytime in the next month. Encourage your Senator to support the Sanders bill and also an amendment he will offer for a state single payer option. The California Nurses Association/NNOC has already started lobbying visits in the Senate in D.C.
5) We have been asked how to tell members to vote on the House bill. Our response is that the bill is “like aspirin for breast cancer.”

The reform that's missing

By Rhonda Swan
Palm Beach Post
Thursday, November 05, 2009

Perhaps “death panels” weren’t such a bad idea.

For private health insurance companies.

If ever there was a useless entity, it’s a business that earns profits for doing nothing.

Wait. I take that back. They do something. They decide who lives and who dies. Paper-pushers with no medical training choose what is and isn’t medically necessary for millions of people on whom they’ve never laid eyes. And for that, their employers rake it in.

United Health Group reported net income of nearly $3 billion in 2008; Aetna Inc. reported $1.3 billion, Humana Inc. came in at $647 million. Their CEOs had total compensation of $3.2 million, $24.3 million and $4.7 million, respectively. Their profits were down sharply compared with 2007 because of the recession. Still, it’s not a bad haul for being nothing more than middlemen.

“What product does this industry sell?” Dr. Howard A. Green, director of the dermatology division at St. Mary’s Medical Center in West Palm Beach, asked in an interview. “They don’t do health care, they don’t do access to health care because we have so many uninsured and underinsured. They remove too much money from health care, and therefore make it inefficient and ineffective.”

In an article for On Call: The Journal of Palm Beach County Medical Society, Dr. Green maintains that shutting down private health insurance corporations is the first step to creating comprehensive quality health care. “Without the inefficiencies and burden to productivity of private insurance corporations,” he wrote, “we can deliver efficient and effective comprehensive health care with great savings and no sacrifice of jobs.”

The U.S. House is expected today to take up the 2,032-page health reform bill proposed by Democrats. A national insurance plan is a key element, though this version is far from the single-payer Medicare for All program that Dr. Green and Physicians for a National Health Program endorse.

Such a plan, which eliminates private profits, would be real reform. Yet it hasn’t even come up for discussion, not this year or in 1994 under President Clinton, the last administration to attempt reform. No one in the White House or Congress has had the guts to take on private insurers, even though they clearly are the problem.

The major reform proposals focus more on private insurers than actual health care delivery. Forcing insurers to cover sick people. Getting insurers to compete and lower costs. Doling out subsidies to insurers so we can afford their high prices.

Why not just get rid of them? All they do is take our money and then show us the hand when we expect something in return like … medical treatment.

Opponents of the so-called public option say they fear a “government takeover” of health care that would put private insurers out of business. So what!

The fact that we are the very government that would “take over” our health care system under which doctors and hospitals would remain private gets lost.

As does the fact that we are a capitalist society where businesses that can’t compete go out of business every day. And for-profit insurers just can’t compete.

A Harvard Medical School and Public Citizen study found that health insurance bureaucracy – billing, sales and marketing, profits and executive pay, which have nothing to do with health care – costs $399.4 billion a year. Money that could insure every American.

Insurers also spend millions legally bribing Congress and the White House to protect their profits. But who is protecting us from them? Harvard researchers found that medical problems caused 62 percent of all personal bankruptcies in 2007. Of those, 60 percent had private medical insurance. “It’s unethical,” said Dr. Green. “It’s a crime to bankrupt someone because they’re sick.”

It should be. Private insurance companies are too big, too inefficient and too heartless not to fail.

Rhonda Swan is an editorial writer for The Palm Beach Post. Her e-mail address is rhonda_swan@pbpost.com

http://www.palmbeachpost.com/opinion/content/opinion/epaper/2009/11/05/a14a_swancol_1106.html