PNHP

Recent Articles of Interest

Texas’ Abortion Law Could Worsen the State’s Maternal Mortality Rate

Posted

By Abigail Abrams
TIME, September 22, 2021

Texas’ controversial six-week abortion ban has been in effect just 21 days, and physicians and researchers are already warning that the impact could be dire: if the law remains in effect, Texas could see a significant increase in maternal mortality.

A new analysis from Dr. David Eisenberg, a board certified obstetrician-gynecologist who provides abortions in Missouri and Illinois, estimates that with the new law in effect, the state could see increases in maternal mortality of up to 15% overall, and up to 33% for Black women next year. The estimate is based on previous research that has established a clear link between abortion restrictions and maternal mortality. Black patients are often disproportionately impacted by abortion restrictions, and they are far more likely to die in to pregnancy-related deaths than white or Hispanic women.

“When you eliminate the ability for people who become pregnant to decide what’s best for them and their health and their family, it has a negative impact on the health of themselves, as well as their families and the communities they come from,” says Eisenberg, the former medical director of Planned Parenthood of the St. Louis Region and Southwest Missouri.

The Texas law, known as Senate Bill 8, prohibits abortion once an ultrasound detects cardiac activity. In practice, that means that no one in the state can provide an abortion after roughly six weeks into a pregnancy, which is before many people discover they are pregnant. In addition to the law’s impact on patients, its extreme limit could also cause many abortion clinics to close their doors, which would further reduce access to care for state residents.

While the Texas law is unprecedented in its private enforcement mechanism, many other states have passed limits on abortion in recent years, and researchers have shown that these are associated with negative health outcomes. In a study published in March in the journal Contraception, Eisenberg and his co-authors found that from 1995 to 2017, the maternal mortality rate increased most significantly in states that enacted the most restrictive abortion laws. In 2017, states that restricted abortion had a maternal death rate (28.5 maternal deaths per 100,000 live births) that was nearly double (15.7 maternal deaths per 100,000 live births) those that had passed laws protecting access to abortion.

In another study, published in the American Journal of Preventive Medicine in 2019, researchers looked at maternal mortality data from 38 states and Washington, D.C. and found that gestational limits on abortion and Planned Parenthood clinic closures each significantly increased maternal mortality. They found that laws restricting abortion based on gestational age ​​increased maternal mortality by 38% and that a 20% reduction in Planned Parenthood clinics increased a state’s maternal mortality rate by 8%.

Since the study was based on statistical analyses of state-level data, researchers could not look at complicating factors for each individual patient. But Summer Sherburne Hawkins, the study’s lead author and an associate professor at Boston College’s School of Social Work, says the analysis shows the direct impact of abortion restrictions like the one in Texas.

“Based on our research, restricting abortion based on gestational age, as has been done in Texas, will likely have detrimental effects on women’s health,” she says. “It could have increases in maternal mortality.”

Eisenberg’s new analysis builds on this idea and pulls from his previous research published in Contraception. He found the Global Health Data Exchange showed a 6% increase in maternal mortality in states that restricted abortion access relative to neutral states. The CDC WONDER database showed a 24% increase in states that restricted abortion access relative to neutral states. The median increase, 15%, is what he predicts could take place in Texas if its current abortion law remains in place.

Abortion providers in the state are already seeing patients who they fear could end up in dangerous circumstances. Dr. Bhavik Kumar, a staff physician at Planned Parenthood Center for Choice in Houston, says the law has forced him to turn away patients who will likely not be in a place to have a healthy pregnancy. Planned Parenthood has become a “traffic control” center with care coordinators helping people find resources to travel out of state for care or explore other options, he says. But not all patients can travel long distances to receive care.

Kumar says he saw a patient last week who is navigating a meth addiction and is homeless, who he doubts will be able to travel out of state to get an abortion. Another of his patients already has seven children, one of whom is in the hospital with a terminal illness. She likely will not be able to leave the state—and her children—to get an abortion either, but she also knows she will struggle to take care of another child, Kumar says.

The Texas law means these patients must make incredibly difficult choices as they seek care. If they cannot obtain abortions, they may be forced to deal with the mental and physical stress of carrying unwanted pregnancies to term.

“There’s also consequences with morbidity, meaning people having more complicated pregnancies that take a toll on their health, having more complications, and having a lower quality of life,” Kumar says. “And that’s not just for them. It’s also for their families and the children that they are forced to have.”

The U.S. faces a crisis of maternal mortality

The new Texas law is the latest in a wave of restrictions on abortion nationwide. For more than a decade, largely conservative states like Texas that have steadily implemented a series of laws and regulations making it more logistically and financially difficult for women to access all kinds of reproductive health care. Even amid this trend, Texas stands out as one of the most challenging places to obtain an abortion and to give birth to a child.

The U.S. has faced a crisis of maternal mortality for years. It has the highest rate of maternal mortality in the developed world, and the country’s numbers have worsened significantly over the last 30 years, according to a new report the U.S. Commission on Civil Rights released Sept. 15. This is in large part due to growing disparities in access to quality care for women of color. “As an individual, as a Texan, I’m appalled that, at a time where we need stronger hospitals and a higher quality of hospital care for Texans, we’re going in the wrong direction,” Norma Cantú, chair of the Commission on Civil Rights, said in response to a question from TIME last week.

The maternal mortality rate in Texas is already higher than the U.S. average, and Black women bear the brunt of this tragedy: they account for just 11% of live births, but make up 31% of maternal deaths in the state. In 2013, Texas created an expert committee to examine this issue. It found that many of the maternal deaths in Texas are preventable and recommended that the state extend health insurance coverage for poor mothers to one year after they have a baby. But lawmakers have not done that. Instead, in May the state passed a law extending Medicaid coverage for six months after childbirth.

Texas has the highest rate of uninsured residents in the country, the highest rate of uninsured women of childbearing age, and its leaders have refused to expand Medicaid under the Affordable Care Act, which would have allowed more low-income Texans to access the public health insurance program. Texas also has the strictest income limit for Medicaid eligibility in the country: a single Texan parent with three children must earn $277 or less a month to be eligible. During pregnancy, that cap increases to $4,373.

The new Texas abortion law is being challenged in court. The Department of Justice has asked a federal judge in the Western District of Texas to block the law while it sues Texas, and the next hearing is set for Oct. 1. But even if the law is temporarily blocked, it is written in a way that could make it difficult for abortion providers to resume their regular work until they have a final verdict.

The effects of even a temporary ban are likely to reverberate. When Texas enacted a law in 2013 that required abortion clinics to obtain admitting privileges at local hospitals and imposed other restrictions, half the clinics in the state closed. Even after the Supreme Court ruled that law unconstitutional in 2016, few clinics returned. As a result, huge swaths of the state became abortion deserts. Under the new law, the average Texan must drive 14 times farther than they had to previously to access an abortion.

In recent weeks, lawmakers from other conservative states have said they see Texas as a model and hope to pass similar legislation, and in December, the conservative Supreme Court is scheduled to hear a case about an abortion restriction in Mississippi. While those who oppose abortion are celebrating what they see as a win for their movement, physicians and researchers like Eisenberg—as well as residents in conservative states—say they are bracing for a coming wave of maternal deaths.

https://time.com…

Medicare for All Explained Podcast: Episode 64

Posted

This article includes audio

July 15, 2021

Podcast host Joe Sparks returns with additional highlights of some of the most important points from Medicare for All Explained, including:

  • Why single-payer healthcare was a revelation for Stephanie Nakajima;
  • How fire departments provide a good example of why we need public funding for healthcare…Dr. George Bohmfalk describes how fire departments came about and how that relates to health care and Medicare for All; and
  • How the experience of Jean Ross, president of National Nurses United, led her to support Medicare for All.

“Highlights, Vol. 1” can be found HERE. Additional episodes will be uploaded twice monthly. Subscribe in iTunes, or access a complete archive of the podcast, below.

https://medicareforallexplained.podbean.com

PNHP President Dr. Susan Rogers on SB8, Texas abortion ban legislation

Posted

Thursday, Sept. 2, 2021
Media contact: Clare Fauke, PNHP communications specialist, clare@pnhp.org

Statement from Dr. Susan Rogers, president of Physicians for a National Health Program:

“The Supreme Court’s decision to uphold Texas’ near-total abortion ban (SB8) is a public health emergency. SB8 would force those seeking abortion care to travel hundreds of additional miles — an impossible barrier for low-income Texans who must either carry their pregnancies to term, or risk death or mutilation from self-induced abortions. Lives are at stake, since state-level abortion bans strongly correlate with increased maternal mortality. In addition, SB8’s primitive enforcement mechanism puts a bounty on health care providers, who have endured decades of attacks simply for providing constitutionally protected care. As physicians, we call on the courts to immediately block the implementation of this law, and on our national leaders to guarantee full access and coverage for all reproductive health care, including abortion.”

Physicians for a National Health Program (www.pnhp.org) is a nonprofit research and education organization whose more than 24,000 members support single-payer national health insurance.

Recent Members in the news

Dr. Ana Malinow on “Thom Hartmann Program”

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This article includes video

PNHP past president Dr. Ana Malinow appeared on the “Thom Hartmann Program” on September 20, 2021. Dr. Malinow sounded the alarm about Direct Contracting Entities (DCEs), which grew out of a Trump Administration pilot program and which pose a grave threat to the Traditional Medicare program.

She encouraged viewers to register for a September 23 webinar to learn more about this latest Medicare privatization threat…and what can be done to stop it.

Dr. Adam Gaffney on “All In”

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This article includes video

PNHP immediate past president Dr. Adam Gaffney appeared on “All In” on MSNBC on August 12, 2021. Dr. Gaffney pushed back against a proposal to charge unvaccinated Americans higher health insurance premiums. He argued that more expansive access to vaccines (and access to medical care in general, under Medicare for All), coupled with occupational mandates, would be more effective.

Dr. Paul Song on “Rising Up With Sonali”

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This article includes video

PNHP national board member (and PNHP-California president) Dr. Paul Song appeared on “Rising Up With Sonali” on Free Speech TV and Pacifica radio stations on July 28, 2021. Dr. Song discussed a series of nationwide marches for Medicare for All held the previous weekend, the prospects for a state-based single-payer program in California, and the urgent need to get people vaccinated against COVID-19.

Recent Quote of the Day

John Geyman: The Medical-Industrial Complex…plus exciting changes at qotd

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“America’s Mighty Medical-Industrial Complex: Negative Impacts and Positive Solutions”

By John Geyman

This book has three goals: (1) to bring an historical perspective to how medicine and health care have evolved over the last 100 years, including the transformation of their original ethic of service with a moral purpose and how that ethic has been compromised by corporate greed; (2) to describe where an engulfing medical-industrial complex has brought us in terms of decreasing access to affordable health care, unacceptable quality of care, profiteering and fraud; and (3) to consider whether and how our unsustainable health care system can be brought into line against this deepening crisis in serving the needs of our people.

Copernicus Healthcare: http://www.copernicus-healthcare.org

Amazon: https://www.amazon.com…

Comment:

By Don McCanne, M.D.

Most of us want a health care system that has a mission to maintain and improve our health, yet we have a system that has lost its way in that its mission places a priority on advancing the interests of the medical-industrial complex at the cost of compromising our health care. John Geyman explains how we got there and how detrimental the impact has been. Although the political barriers to reform seem almost insurmountable, he does show us that there is a path to the essential reform that we need to bring health care justice to all. By understanding the source and nature of the dysfunctions, we can find our way out.

Exciting changes at qotd

As some of you may have heard, the interruption in the Quote of the Day messages was due to a TIA/stroke suffered by the author. Fortunately, the recovery has been dramatic, though incomplete. As a result, after two decades of daily commentaries in his retirement years, it is time for a change.

Future messages will be from noted health policy experts within and outside of PNHP. We will be receiving the latest from the best. With this change in format, we will also be changing the name to “Health Justice Monitor.” Launch is planned for next week.

I hope that you are as excited as I am as I become a consumer rather than a producer of the latest in health policy science. The more we understand, the sooner we will have health care justice for all.

Peace,
Don McCanne

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

Quote of the Day interlude

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By Don McCanne, M.D.

Quote of the Day will take a brief interlude. We are refining our approach to communicating information to educate and advocate for single payer and health care justice for all.

See you soon.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

More trouble: Drug industry consolidation

Posted

Over 30 years, dramatic consolidation has meant higher prices, fewer treatment options and less incentive to innovate

By Robin Feldman
The Washington Post, April 6, 2021

In the past few decades, three waves of mergers have substantially increased concentration in the pharmaceutical industry.

All told, between 1995 and 2015, the 60 leading pharmaceutical companies merged to only 10.

As a result, now only a handful of manufacturers are responsible for sourcing the vast majority of prescription drugs: Just four companies, for example, produced more than 50 percent of all generic drugs in 2017.

Drug companies were drawn to merging because of the lure of increased market power, improved synergies, larger economies of scale and more diverse product portfolios.

In the period following merger waves one and two, the industry generated fewer new molecular entities each year compared to pre-merger levels. Merged drug companies also spent proportionally less on research than their non-merged competitors.

Consolidation also enabled drugmakers to directly quell competition through what were known as “killer acquisitions,” in which they acquired innovative peers solely to stop potential competition.

In short, consumers were the losers from the two waves of drug company mergers. They confronted higher prices and fewer choices — and saw companies exploring fewer paths that might produce breakthroughs. To make matters worse, around 2010, another wave of mergers began.

As with the earlier waves, giant drug companies have merged. But in a new twist, in recent years, most consolidation has featured bigger players acquiring smaller start-ups. The difference reflects a dramatic shift in the structure of the pharmaceutical industry. Faced with stagnating research productivity, large drugmakers now rely on outsourcing their new drug research to start-ups and other small pharmaceutical firms.

Increasingly, these smaller players specialize in high-risk research and early drug development, with larger firms then gobbling them up and navigating the FDA’s regulatory process. For example, 63 percent of all new molecular entities in 2018 came from smaller biopharma firms, compared with just 31 percent in 2009.

The end result of now three waves of pharmaceutical consolidation is decreased or diverted new drug innovation, fewer treatment options and higher prices. Consumers have lost as firms fuse together to bolster the bottom line.

Robin Feldman is director of the UC Hastings Center for Innovation.

https://www.washingtonpost.com…

Comment:

By Don McCanne, M.D.

Yesterday we discussed consolidation of UnitedHealth/Optum and how it has become a mega-corporation of the medical-industrial complex. Today’s selection discusses consolidation within the pharmaceutical industry. The article describes how we can expect decreased or diverted drug innovation, fewer treatment options, and above all, higher prices. Works for the industry, but not so well for the people.

We’re just trying to introduce single payer Medicare for All. How much impact can that have on these mega-corporations? Where is our government in all of this? Aren’t they supposed to protect us? Maybe we’re aiming too low by advocating for a social insurance program. Maybe we should be taking over the industry so that we can gear it up to better serve us, the people. International comparisons do rate national health services very high in performance. Maybe if we talk about it a little more we can convince them that Medicare for All is a compromise that they can live with. We think we can too.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

Recent State Single Payer News

N.Y. Assembly passes universal health care bill

Posted

By Dan Goldberg
Capital New York, May 27, 2015

The state Assembly on Wednesday voted for a single-payer health bill, the first time in more than two decades the chamber has taken up the measure.

The vote was 89-47, an overwhelming but largely symbolic step toward universal health insurance. The bill now heads to the Republican-controlled Senate where it is not expected to pass.

Assemblyman Richard Gottfried, chair of the health committee, gave an impassioned speech on the floor in support of the New York Health Act, arguing that it was long past time for New Yorkers to rid themselves of the intrusive insurance companies whose goal is to deny claims rather than provide care.

“You do not have to be an Einstein to understand New York Health is the right choice for New York,” Gottfried said.

Gottfried, a Democrat from Manhattan, spent the legislative session barnstorming the state, trying to gain support for his bill, which would be funded through a progressive income tax and payroll assessments. There would be a net savings of $45 billion in health spending by 2019, Gottfried said, based on an analysis from Dr. Gerald Friedman, a professor at the University of Massachusetts at Amherst, though that figure was attacked by Republicans.

The bill, Gottfried said, would lower costs by getting rid of insurance companies. It would lower administrative costs and allow doctors to focus their time on treating patients instead of fighting for reimbursements.

“What will bring down health care costs is taking out of the equation the more than 20 percent we now spend on administrators whose job it is to fight with insurance companies,” he said.

The plan’s benefits, Gottfried said, would be more generous than any plan on the current market, and there would be no co-pays or deductibles. The bill would also require a care coordinator for every member, though that coordinator is not empowered to choose the type of care a patient receives.

For some Republicans, it was all too good to be true.

“This bill promises remarkable things for New York State residents,” said Assemblyman Andy Goodell, a Republican from Chautauqua. “It says providers, ‘you’ll be paid a lot more money,’ and it says to the employees ‘you’ll contribute a lot less money,’ and it says to the patients ‘you’ll have much broader access,’ and to the employers ‘you’ll pay $45 billion less.’ My background is in math and economics and I haven’t been able to figure out how this all works. … There is no free lunch, there is no free health care.”

Leslie Moran, spokeswoman for the New York Health Plan Association, which represents insurers, said the bill “represents an unrealistic, utopian view of a universal health care system where everyone would be covered, everything would be covered and the system would magically pay for it all.”

One problem, pointed out by Republicans, is that the offering, while generous, is the opposite of what public health officials are pushing, including those in the Cuomo administration, who have professed that insurance systems, and high deductibles and co-pays help ensure people use the health system judiciously instead of opting for more, often unnecessary, care.

“There is a role for insurance companies,” state health commissioner Dr. Howard Zucker said Wednesday before the debate.

The last time a universal health care bill was on the Assembly floor was 1992. It passed but the debate was sidelined because of federal efforts to reform health care, which ultimately failed under the Clinton administration.

The passing of the Affordable Care Act, which subsidizes private insurance for people below a certain income level, was a valid effort, Gottfried said, but ultimately served to highlight why the system needs to be entirely scrapped.

“I think the A.C.A. has made it clear to people … there are profound problems in our health care system that cannot be addressed by incremental change in that system,” Gottfried said.

Wiping out an industry — even the insurance industry — was not seen as popular by many Republicans who worried about the loss of jobs and what might happen should this plan fail.

Goodell asked why the state should go down this road when when Medicaid — a government run insurance program for lower-income residents — is expensive, burdensome and not well liked.

“Why would we want to expand that type of approach,” he asked.

Gottfried responded that his bill would improve Medicaid by putting everyone into one pot. He would, he said, eliminate the two-tiered system. There’d be no greater risk of fraud under this law than in the current Medicaid program.

Republicans also pointed out how much was left to be done. The income tax rates have yet to be decided, but would likely cost the highest earners more than they currently pay for health insurance, while subsidizing lower income residents.

The analysis provided by Gottfried estimates no income tax on the first $25,000, an income tax of 9 percent on income between $25,0001 and $50,000, graduating to 16 percent tax for income over $200,000.

The legislation is also not specific on how to deal with residents of New York State who retire to another state.

That would have to be resolved at a later date, Gottfried said.

“Though we have numerous pages on this legislation, we have numerous holes also,” said Al Graf, a Republican from Holbrook. “There is no way I can go back to my constituents and tell them you may have coverage in the future. … This is an exercise in insanity.”

Moran said there is no certainty that providers would accept government set reimbursement, though Gottfried said almost all would receive more for their services than they are currently being paid.

The bill also “completely disregards the economic contribution of health plans — both to the state and to local communities,” Moran said.

Joseph Borelli, a Republican from Staten Island, cited Vermont, which tried and failed to enact a single-payer health system.

Vermont’s collapse has been a cautionary tale for even the most enthusiastic supporters of government sponsored health insurance, but Gottfried was having none of it.

“New York … bears no resemblance to Vermont,” Gottfried said. “The bill bears very little resemblance to Vermont. Their financing system is different. The two have absolutely nothing to do with one another, nothing! Why don’t you ask me whether New York will flood Just like Texas flooded if we enact this plan. The weather in Texas has as much to do with this as Vermont does.”

Read the bill here: http://bit.ly/1JVUg1I

http://www.capitalnewyork.com/article/albany/2015/05/8568890/assembly-pa…

N.Y. Assembly votes for universal health coverage

By Michael Virtanen, Associated Press
Democrat & Chronicle (Rochester, N.Y.), May 27, 2015

ALBANY – The New York Assembly voted 89-47 on Wednesday for legislation to establish publicly funded universal health coverage in a so-called single payer system.

All New Yorkers could enroll. Backers said it would extend coverage to the uninsured and reduce rising costs by taking insurance companies and their costs out of the mix.

With no patient premiums, deductibles or co-payments for hospital and doctor visits, testing, drugs or other care, New York Health would pay providers through collectively negotiated rates. It would be funded through a progressive payroll tax paid 80 percent by employers and 20 percent by employees.

Also, waivers would be sought so federal funds now received for New Yorkers in Medicare, Medicaid and Child Health Plus would apply.

“Employers are shifting more and more health care costs to workers or are dropping it entirely,” said Assemblyman Richard Gottfried, chief sponsor. “The only ones who benefit are the insurance companies.”

The Manhattan Democrat estimated universal care would save New Yorkers more than $45 billion annually, cutting the statewide total cost for health care to about $255 billion in 2019.

Assembly Republicans doubted Gottfried’s estimate and questioned what would happen to everyone now employed by insurance companies.

“All I can say right now I think this is the last think New York state needs as far as an additional cost,” said Assemblywoman Jane Corwin, an Erie County Republican. She said they’re still trying to grapple now with the cost of the federal Affordable Care Act. That extended health care coverage to about 1 million New Yorkers, more than half in Medicaid and the others in private insurance with possible tax subsidies to offset costs.

An identical bill hasn’t advanced in the state Senate and isn’t expected to before the legislative session ends in June. Senate Health Committee Chairman Kemp Hannon said Wednesday that Gottfried’s bill faces two major hurdles, resistance from senior citizens to giving up Medicare for a new state program and obtaining federal waivers to apply Medicaid and Medicare funding to support it.

http://www.democratandchronicle.com/story/news/local/2015/05/27/assembly…

Single-Payer Health-Care Bill to be Introduced in Pa.

Posted

Berks Community Television (Reading, Pa.), Oct. 25, 2015

HARRISBURG, Pa. – A bill to create a single-payer health-care system in Pennsylvania will be introduced in the state Legislature by the end of the month.

The legislation is being introduced by Representative Pamela DeLissio of Philadelphia and was crafted with the assistance of HealthCare 4 ALL PA, a not-for-profit advocacy group. David Steil, past president of that organization, says the bill is simply called the Pennsylvania Health Care Plan.

“What it does is create a health-care system that includes every resident of Pennsylvania, that is publicly funded and privately delivered,” says Steil.

The cost of the program would be covered by increased taxes, which Steil acknowledges may present a significant obstacle to passage by the state Legislature.

The plan would increase the state personal income tax by an additional three percent, substantially less than most pay for private insurance. It would also add a 10 percent payroll tax on businesses which, as Steil points out, is much less than what businesses spend on health insurance now.

“The average cost for health care benefits for companies that provide health care is about 17 percent of payroll,” he says. “So at 10 percent of payroll, the saving is significant.”

Similar legislation has been introduced in each legislative session since 2007.

Most recently it was introduced as Senate Bill S-400. None of the earlier versions have not gotten very far. Raising taxes is a hard sell, especially to conservative lawmakers. But Steil insists they’re asking the wrong question.

“The question each one has to ask is not just ‘look at the taxes’ because there are taxes to it, it’s not free,” he says. “The question is, ‘How much less than you’re currently paying is this plan to you?'”

Steil says the bill would also eliminate health-insurance costs on pension plans and vehicle insurance, making the potential savings even larger.

http://www.bctv.org/special_reports/health/pa-legislature-introduces-sin…

Single-Payer Health-Care Bill to be Introduced in Pa.

Posted

Berks Community Television (Reading, Pa.), Oct. 25, 2015

HARRISBURG, Pa. – A bill to create a single-payer health-care system in Pennsylvania will be introduced in the state Legislature by the end of the month.

The legislation is being introduced by Representative Pamela DeLissio of Philadelphia and was crafted with the assistance of HealthCare 4 ALL PA, a not-for-profit advocacy group. David Steil, past president of that organization, says the bill is simply called the Pennsylvania Health Care Plan.

“What it does is create a health-care system that includes every resident of Pennsylvania, that is publicly funded and privately delivered,” says Steil.

The cost of the program would be covered by increased taxes, which Steil acknowledges may present a significant obstacle to passage by the state Legislature.

The plan would increase the state personal income tax by an additional three percent, substantially less than most pay for private insurance. It would also add a 10 percent payroll tax on businesses which, as Steil points out, is much less than what businesses spend on health insurance now.

“The average cost for health care benefits for companies that provide health care is about 17 percent of payroll,” he says. “So at 10 percent of payroll, the saving is significant.”

Similar legislation has been introduced in each legislative session since 2007.

Most recently it was introduced as Senate Bill S-400. None of the earlier versions have not gotten very far. Raising taxes is a hard sell, especially to conservative lawmakers. But Steil insists they’re asking the wrong question.

“The question each one has to ask is not just ‘look at the taxes’ because there are taxes to it, it’s not free,” he says. “The question is, ‘How much less than you’re currently paying is this plan to you?'”

Steil says the bill would also eliminate health-insurance costs on pension plans and vehicle insurance, making the potential savings even larger.

http://www.bctv.org/special_reports/health/pa-legislature-introduces-single-payer-health-care-bill/article_a41a6da0-7996-11e5-b8a4-2ba3ba19b536.html