EMBARGOED UNTIL 12:01 a.m. EST
February 14, 2005

Contact: David Himmelstein, MD
Steffie Woolhandler, MD
(617) 497-1268
(617) 312-0970
Nicholas Skala (312) 781-6006
nick@pnhp.org

1,700 Doctors: “Bankruptcy Bill Threatens Patients”

Harvard Study Shows Legislation a Danger to Millions Bankrupted by Medical Bills
Physicians Urge Congress to Reject S. 256

On the heels of a major Harvard University study showing that half of all personal bankruptcies are due to illness or medical bills, more than 1,700 American physicians signed a letter released today opposing legislation that would remove protection from patients financially ruined by medical costs.

Bankruptcy law currently offers some protection to the millions of Americans affected by medical bankruptcies each year. If passed, the bill would effectively close bankruptcy as an option and allow creditors to take the homes, cars and other assets of families who suffer a serious illness or injury.

“It’s a sad fact that bankruptcy courts have become the last line of defense for the victims of our broken health system,” said Dr. David Himmelstein, an Associate Professor of Medicine at Harvard Medical School and lead author of the study. “For many families affected by a costly illness, the limited protections of bankruptcy are the only chance to get back on their feet.”

In the letter to the leaders of the Senate Judiciary Committee, which is currently considering the bill, the doctors expressed concern that the new bankruptcy rules would further restrict the ability of patients suffering from medical costs to get needed care for themselves and their families.

“Medical debtors’ access to care is already severely compromised: more than 60 percent go without a needed doctor visit and half don’t fill a prescription because of the costs,” said Dr. Steffie Woolhandler, who is also an Associate Professor of Medicine at Harvard and co-author of the study. “For those unable to seek relief from their debts, the situation will undoubtedly get worse,” she said.

The epidemic of medical bankruptcies, which affect 2 million Americans (including 700,000 children) every year, emphasizes the need for comprehensive health insurance coverage under a national health insurance plan according to the signers, who include former U.S. Surgeon General Julius Richmond.

“Current insurance policies offer paltry protection for the average American,” said Dr. Quentin Young, National Coordinator of Physicians for a National Health Program. “Most of those who are bankrupted by medical bills are middle class people who had coverage but were ruined by the massive holes in their policies. Rejecting this new bankruptcy legislation is just the first step we need to take in healing our sick health system. We need a system of universal, comprehensive Medicare for all.”

A full list of signers of the letter can be viewed at: www.pnhp.org/signers

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Physicians for a National Health Program is an organization of 13,000 physicians advocating for non-profit national health insurance. PNHP has chapters and spokespersons across the country. For contacts, call (312) 782-6006

By Ceci Connolly
Washington Post Staff Writer
Friday, February 11, 2005; Page E01

American manufacturers are losing their ability to compete in the global marketplace in large measure because of the crushing burden of health care costs, General Motors Corp. chairman and chief executive G. Richard Wagoner Jr. said yesterday as he called on corporate and government leaders to find “some serious medicine” for the nation’s ailing health system.

In a speech at the Economic Club of Chicago, the auto executive, who is responsible for providing health insurance for more people than any other private employer in the nation, graphically detailed how rising medical bills are eating into his company’s bottom line and ultimately threatening the viability of most U.S. firms”The cost of health care in the U.S. is making American businesses extremely uncompetitive versus our global counterparts,” he said. “In the U.S., health care costs have been rising at double-digit rates for many years. In 2003, they were about 15 percent of GDP, at least 30 percent higher than the next-most-expensive country.”

“Failing to address the health care crisis would be the worst kind of procrastination,” Wagoner said, “the kind that places our children and our grandchildren at risk and threatens the health and global competitiveness of our nation’s economy.”

After spending several years on the health policy sidelines, Wagoner is launching a mini media blitz, hoping the competitiveness argument will be the one that finally prompts lawmakers to take on an increasingly expensive system rife with inefficiencies and inequities. Wagoner said he intends to press his case personally in Washington and with the nation’s governors.

Though self-interest may be at the heart of Wagoner’s crusade, he and a range of corporate leaders and policy analysts warned that GM’s woes are a harbinger of what lies ahead.

“GM is the canary in the coal mine for Medicare and everyone else,” said Sean P. McAlinden, chief economist at the nonprofit Center for Automotive Research. “There are many, many more companies out there in trouble because of health care costs than just the auto, steel and airline industries.”

McAlinden, a labor expert sympathetic to union views, said many in Washington have mistakenly concluded that GM and other carmakers are simply whining about costly union contracts.

“GM and the United Auto Workers didn’t cause this double-digit inflation in health care,” he said. And if GM pushed for sharp reductions in health benefits, the powerful union would likely strike and send the company into Chapter 11 bankruptcy protection, he predicted.

Last year the automaker, known for its innovative approach to health care, spent $5.2 billion to cover 1.1 million retirees, employees and their families. Prescription drugs cost GM $1.9 billion, and the company projects overall medical spending will increase by $400 million this year. That could be offset by a provision in the Medicare drug benefit to pick up a portion of firms’ retiree drug costs.

But the figure that prompted Wagoner to raise his voice is $1,500. That is the amount of money added to the price of every single vehicle to cover health care, a cost that his foreign competitors do not bear.

Paul Hughes-Cromwick, senior analyst at the nonprofit Altarum Institute in Ann Arbor, Mich., said executives are alarmed that benefit costs are rising far more rapidly than wages. Total compensation costs for U.S. firms rose about 3.7 percent in 2004, mirroring previous years, he said, citing Bureau of Labor Statistics data. But salaries increased just 2.4 percent, while benefit costs rose 6.9 percent. The gap is the largest he has seen in two decades.

“That huge benefit hit is chewing up the salaries and wages we would be receiving,” he said. “That’s the key.”

Yesterday, Wagoner broke his silence on an idea proposed by Sen. John F. Kerry (D-Mass.) in the 2004 presidential campaign, saying he supports some type of national catastrophic reinsurance program. Senate Majority Leader Bill Frist (R-Tenn.) has also endorsed the concept of a separate government-backed insurance pool to cover the most expensive medical cases.

“If we can create a comprehensive insurance model to better share these catastrophic costs among all consumers, then we can take a big step toward providing affordable health care coverage for all our citizens,” Wagoner said.

Wagoner and fellow executives find much to be frustrated with in the health care system.

“It’s simply not acceptable for over 45 million Americans to be without health care coverage,” he said, echoing a point made recently by Jack O. Bovender Jr., chief executive of health care giant HCA Inc. “And it’s unfair for those of us who do provide health care benefits to have to pay higher bills to cover the costs of the uninsured. Talk about ‘no good deed goes unpunished.’ ”

The business leaders cannot understand why the health care industry has been slow to institute the sort of technological changes that helped them improve quality and reduce costs.

“Only in health care does bad service and bad quality get paid for in the same manner as good service and good quality,” said Humana Inc. chief executive Michael B. McCallister, chairman of the Business Roundtable’s health care task force.

The CEOs agree that the double-digit premium increases will continue as long as individuals are sheltered from the true cost of health care.

“Companies, to manage health care costs, are going to have to have employees who understand that this is something you are consuming and you have a responsibility for,” Wal-Mart Stores Inc. chief executive H. Lee Scott Jr. said in an interview.

Staff writer Michael Barbaro contributed to this report.

Published on Thursday, February 10, 2005 by CommonDreams.org
Progressives and Democrats: Assert Your Brand!
by Thom Hartmann
 
Politics is all about branding. And brands are not about issues or details – they’re about identity.

When progressives and Democrats think of how Bush voters understand the word “Republican,” they assume these folks are thinking “pro-life”; “moral values”; privatization and deregulation; “free trade”; lower taxes; and stripping power from what Republicans call “special interests,” like labor unions and groups advocating rights for women, gays, and other minorities.

But that’s not the picture average Americans think of when they hear the words “Republican” or “conservative.”

Instead, like any good brand, the words “Republican” and “conservative” evoke feelings as much as pictures. The main feeling is one of identity: “My tribe.” The main picture is the brand’s logo – the American flag. At a deeper level, they carry pictures, stories, and feelings of NASCAR, Budweiser, the American flag, “standing tough” and “standing tall” in the world, and pulling yourself up by your bootstraps

Not only are most Republican voters largely unaware of the details of the issues facing our nation, studies show that most are badly misinformed. In some part this is the fault of the media, but the larger reason is that when a person has bonded to a brand, it becomes part of their identity. They then develop a psychologically sophisticated and largely unconscious internal system to filter out and reject contradictory information.

Progressives, liberals, and Democrats have failed to apply this simple reality, and therefore have allowed conservatives to define our brands for us. The very sophisticated effort to do this has been led by Gingrich, Luntz, and Limbaugh, three men who understand the psychology of branding, and have used it to sell the Republican party and the word “conservative” to Americans with all the zeal – and all the cash – used by other famous brands like Coke, Levi’s, and Wal-Mart.

This is not rocket science, and it’s not a secret. There’s an entire industry devoted to teaching these concepts (in which I worked for two decades). So why haven’t progressives and Democrats figured this out?

We’re still letting cons define our brand for us, and they’re still doing it aggressively. In the month of February, 2005, timed to coincide with the Academy Awards, a con group has rented prominent billboards in Hollywood that will show a smiling picture of George W. Bush with the slogan: “Thank you, Hollywood!”. In a row under the prominent and smiling Bush are less flattering photos of Michael Moore, Whoopi Goldberg, Ben Afleck, and other outspoken liberals.

There are no Democratic billboards showing the biggest supporters of the Republican Party – corporate fat-cats like Ken Lay, with private jets and limousines, living in baronial mansions.

In classic marketing theory, there are two foundational concepts. Features (“what is it?”) without benefits (“why should I care?”) lack relevance. And, benefits without features lack credibility.

Once these are mastered, you “chunk up” (to use NLP terminology) to branding: “Features and benefits without identification (“Who am I when I use this product?”) lack “stickiness” or persistence.

Progressives and Democrats are still working on features – the details of programs.

Most progressives know all the features they’re interested in: Universal single payer health care, a viable social safety net, prison and sentencing reform, a livable wage, support for unions and the repeal of Taft-Hartley and its heirs, voting (and voting machine) reforms, revoking corporate personhood and getting corporate money out of politics, moral leadership in the world, and working for a reduction of crime and poverty at home and towards stable, lasting worldwide peace (to name a few).

But there’s no “benefit statement” in lists like these. Sure, some people think they’re obvious, but the cons know – as does any good marketer – that you have to lead with the benefit, and only then do you follow with the features. Sell “lower taxes” to everybody before rolling out tax cuts for the wealthy. Sell “personal accounts” for Social Security before rolling out benefit cuts for future generations. Sell “protect your children” before rolling out homophobia and theocracy.

And, even worse, the left hasn’t yet defined its brand.

What is our logo? Bill Moyers briefly talked about wearing a flag on his lapel, trying to re-brand the flag as the logo of the liberals, but because there was no national effort behind it, it died.

What is our identity? The cons have succeeded in making much of America think that to be liberal is to either be a wealthy actor or a scruffy gadfly. While many people wouldn’t mind being either, few identify themselves in such terms.

The largest lights of the Democratic Party – it’s founder, Thomas Jefferson, and it’s two most famous recent presidents, FDR and LBJ – knew their brand and their identity, and brought the majority of Americans along with them. The largest landslide Democratic election victories of the 20th century were FDR’s after he introduced the New Deal, and LBJ’s after he introduced the Great Society. Their logo was the flag, and their identity was average working people, and those who aspire to the economic and educational middle class.

Jefferson not only defined the identity of the Democratic Party that he founded – the longest-lasting political party in world history – but defined the identity of America as well. He defined us in positive terms (what we’re for) in the Declaration of Independence, as well as in contrasting terms (what we’re against like the “ban on monopolies in commerce” he tried to write into the Bill of Rights).

For example, in a February 8, 1786 letter to James Madison, Jefferson made clear his thoughts on what he considered a great international immorality-national belligerence that leads to a war of choice.

“And it should ever be held in mind,” Jefferson wrote, “that insult and war are the consequences of a want of respectability in the national character.”

Later, Madison – also a member of Jefferson’s Democratic Republican Party (which dropped the “Republican” from its name in the 1830s, although the www.whitehouse.gov website now lists Jefferson, Madison, Monroe, and John Quincy Adams – the first four Democratic presidents – as “Republicans”) would write, “No nation could preserve its freedom in the midst of continual warfare.”

FDR brought us back to Jefferson’s ideals with his third inaugural address, sometimes called his “Four Freedoms speech,” on January 6, 1941, when he said:

“The basic things expected by our people of their political and economic systems are simple. They are :

“Equality of opportunity for youth and for others.

“Jobs for those who can work.

“Security for those who need it.

“The ending of special privilege for the few.

“The preservation of civil liberties for all.

“The enjoyment of the fruits of scientific progress in a wider and constantly rising standard of living.

“These are the simple, the basic things that must never be lost sight of in the turmoil and unbelievable complexity of our modern world. The inner and abiding strength of our economic and political systems is dependent upon the degree to which they fulfill these expectations.”

In that, FDR created a brand, a packaging concept, a place for people to anchor their identity. It’s name was the New Deal, but it was far more inclusive than just that.

Twenty-three years later, in his first State of the Union speech after the death of JFK, Lyndon B. Johnson said:

“This administration today, here and now, declares unconditional war on poverty in America. …

“These programs are obviously not for the poor or the underprivileged alone. Every American will benefit by the extension of social security to cover the hospital costs of their aged parents. Every American community will benefit from the construction or modernization of schools, libraries, hospitals, and nursing homes, from the training of more nurses and from the improvement of urban renewal in public transit.”

In declaring his Great Society program and starting the Medicare program, LBJ cut poverty in America in half. And he, too, created a brand. (Had he not gotten caught up in Vietnam, he may now be remembered as one of our greatest presidents, as the impact of his social programs on America were tremendous.)

And, like Jefferson, both FDR and LBJ were overwhelmingly re-elected by the American people after declaring sweeping social programs that benefited average working people and those who aspired to the middle class.

The brand – the identity – of progressive ideals doesn’t need to be reinvented. It’s been with us since the founding of this nation. It long predates the Republican’s Faustian deal with the Robber Barons and war profiteers. And when the Democratic Party has been strongest, it’s been because Democrats have asserted a clear brand that stood in opposition to Republicans and their fat-cat owners. We are the – truly – We the People.

If the Democratic Party is to survive, it must embrace the progressive concepts that led to its founding in the late 1700s. It must tell average Americans what’s in it for them, and once again give Americans a “brand” with which they can identify. It must stop playing defense, letting the Republicans define the agenda of public debate, and instead reinvigorate traditional progressive rhetoric, legislation, and identity.

Democrats must reassert their brand, and establish their identity. To do this, the Party must say, loudly: “We’re for the average working stiff in America, and we’ll prove it by bringing jobs back from overseas by pulling out of the WTO and NAFTA, supporting organized labor, strengthening the social safety net, and keeping government from being a honey pot for either churches or corporations.” And then they must come up with a simple name for it, like Newt’s “Contract” or Roosevelt’s “New Deal” or LBJ’s “Great Society” to provide voters with a hook for identification.

They must further back this up by working with Greens and progressives for Instant Runoff Voting (IRV), the end of Republican-affiliated corporations programming our voting machines, and advocate social, economic, and environmental reforms – and bringing them into the Party.

Only then will the Party of Jefferson, Roosevelt, and Johnson again be able to advance social justice at home and peace around the world.

Thom Hartmann (thom at thomhartmann.com) is a Project Censored Award-winning best-selling author and host of a nationally syndicated daily progressive talk show. www.thomhartmann.com His most recent books are “The Last Hours of Ancient Sunlight,” “Unequal Protection,” “We The People,” “The Edison Gene”, and “What Would Jefferson Do?.”

By Mike Sweet

Ask anyone to describe someone who files for personal bankruptcy and the description most likely fits an uncomplimentary stereotype.

It’s someone who’s maxed out their credit cards buying things they didn’t need (even though their president said it was patriotic and would rescue the economy).

It would include those who took out a second mortgage on their house to consolidate bills or redecorate, or even a third mortgage to buy a summer home that they couldn’t live without because no one can own too much stuff in an ownership society.

It also can include people with all the above over-commitments, who in addition face those numbing SUV and gasoline payments and paying heating bills that literally go up in smoke, thanks to the Enrons of this world.

Generally, the bankruptcy filer is defined and denigrated as a lowlife who knowingly lived beyond their means and then tries to get out of paying their creditors, who bear neither burden nor guilt for encouraging them to overextend. The only pity permitted is for those unfortunates whose financial crisis is due to losing their job. And then it’s slim pity.

A new Harvard University study done by its law and medical schools has identified a major cause of bankruptcy -that has not been considered previously – medical costs.

Using 2001 data involving 1,771 bankruptcy cases, researchers found that illness and medical bills were the key factor in 54 percent of those bankruptcies.

Further eviscerating the everyone’s-a-deadbeat theory, the study found that most filers were middle class. They were buying homes and had college degrees and good jobs. Three of four had health insurance when they or their family member first got sick.

But as the coverage maxed out, or the insurers dropped them, or they lost their insurance along with their jobs and the ability to pay the premiums, the medical bills piled up beyond their ability to pay.

Steffie Woolhandler, the report’s co-author, concluded “Unless you’re rich, we found you’re one serious illness away from financial ruin.”

Many millions of Americans already knew that. They can do the math for income versus outgo. But they soldier on, making their daily commutes and praying that they don’t get sick or get their job cut in one of those mergers that delight Wall Street.

After a century of progress in which government and law made life better for people, we are headed back into that pre-20th century Darwinian netherworld of dog-eat-dog where we must all walk alone and die in silence, without protestation.

Big business rules. People are just worker bees to be used up. Government is there only to help the rich.

There are skeptics who reject the Harvard conclusion as political. Woolhandler and others invite flak because they belong to the National Health Program, whose members believe that “the only solution to solving the United States’ many health care problems is a single-payer system,” an idea many doctors agree with.

Woolhandler: “Every other developed nation in the world has a single-payer health-care system. There is no reason we can’t make it work in this country.”

Actually there is. It is the view of powerful conservatives like George W.Bush that such a system is socialism, which it would not have to be to work.

The only welfare conservatives countenance is for defense contractors, and for politicians, of course. After all, those taxpayer-paid salaries, generous pensions and health care are not earned in the Darwinian corporate world they insist everyone else must compete in.

Their benefits are provided by the painful contributions of a society that not only does not get equal benefits, but also endures hypocritical lectures about how they must fend for themselves.

And who are told if they go bankrupt or die for lack of health insurance, then so be it.