PNHP

AHCA or BCRA: “Murder for hire”

AHCA or BCRA: “Murder for hire”

A Health Care War On The Poor

By Kathleen Sebelius and Ron Pollack
Health Affairs Blog, June 27, 2017

Many criticisms have been leveled against the House-passed American Health Care Act (AHCA) and the Better Care Reconciliation Act- the new Senate health bill offered by Majority Leader Mitch McConnell. The unmistakable hallmark of these bills, however, is that they constitute a very cruel war on the poor. By far, no demographic group would be hurt more by these legislative proposals than low-income people. They are the bulls-eye!

As the non-partisan Congressional Budget Office (CBO) found, over the next decade the largest cutback in the Senate and House bills are reductions to the safety-net Medicaid program (a $772 billion cut in the Senate bill, and an $834 billion cut in the House bill).

Additionally, there are significant cuts to the subsidies that were designed to make private insurance premiums and cost-sharing affordable for low- and moderate-income families, with $424 billion cut in the Senate bill and $276 billion cut in the House bill.

These decreases, which would cause enormous harm to low-income families, are obviously not part of an overall scheme to promote fiscal prudence since both the Senate and House bills lavish huge tax benefits to the rich and special interest groups. The Senate provides $541 billion in such tax benefits, and the House provides $664 billion.

According to CBO, the proposals in both the Senate and House bills would cause huge numbers of people to become uninsured within a decade. The Senate bill would cause 22 million to lose coverage, and the House bill would force 23 million into the ranks of the uninsured. In total, at least 49 million would be uninsured – more than the aggregate population of almost half (24) the states in our nation.

The bottom line is clear: While both the House and Senate bills provide unneeded tax help for wealthier people, the Republicans’ war on the poor would cause many and very severe casualties on people with greatest needs. Hopefully senators of good will call for an immediate and complete cease fire.

***

Health Affairs Reader Response:

By Robert Stone, M.D.

“War on the Poor” is strong language, and sometimes strong language is appropriate to a discussion, even in as sober a journal as Health Affairs. I would use even stronger language. The 6/27/17 Annals of Internal Medicine article “The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly” is the most definitive peer-reviewed publication yet showing that removing healthcare coverage for millions of Americans will lead to thousands of preventable deaths per year. What do we stand for as a nation? This is a murderous bill. The bill, either House or Senate version is a huge tax cut for the wealthy, paid for by the middle class and the poor. Why is there such a rush to pass it without discussion and debate? It appears to me the reason for that is because Senators’ wealthy donors want to see the tax cuts. Therefore, you could call this bill not only murderous, but “Murder for hire.”

http://healthaffairs.org…

***

Comment:

By Don McCanne, M.D.

Rob Stone is one of us. He has been a very active participant and a thought leader in PNHP for a couple of decades. His message for us today is that we have to start saying it like it is. The fact that so many Senators are on record as being willing to enact legislation that will kill thousands of Americans in exchange for payments from wealthy donors who want the associated tax cuts, that does constitute “Murder for hire.”

The politicians are not alone in this conspiracy. We can no longer accept an “arm’s length” excuse to allow these wealthy donors to escape blame. The work of Gilens and Page has shown that it is these very individuals who drive the process (link below). They are the ones who are hiring the murderers (though Gilens and Page would confine their rhetoric to benign academic language). And, yes, the members of Congress are murderers when they enact policies that they know will kill people.

At PNHP we have been gentlepersons as we advocate for policies that will enhance health, reduce physical suffering, and prevent financial hardship for all residents of America (and next, the world). Yet we see policies perpetuated that inflict so much harm (and, by no coincidence, at a great financial cost), and we complain that their policies are wrong and that we have better policies. Is arguing policy enough when it is devoid of warranted intense emotional expression?

But something has been happening. Americans now understand that the improvements of Obamacare are grossly deficient since too many people are unable to receive or afford the medical care that they need. Bernie Sanders came along and told us that expanding Medicare to include everyone through a single payer system would make health care affordable and accessible to all. Those of us who have long supported those views have joined him a clarion call for health care justice for all.

Although single payer sounded like a pretty good idea to those who hadn’t given it much thought, many were still hoping Trump and the Republicans could bring us health care nirvana through repeal and replace. But now Americans have had a rude awakening in discovering that the repeal and replace movement of the past six years has been a fraud. The Republicans finally had to bring their proposal out from the closet for what they hoped would be quick action before rushing home to pick up their checks from their wealthy donors. But we peeked! The American people have now found out that the replacement would make access and affordability much worse – not at all what they were asking for when they supported the campaign to repeal Obamacare.

Of course we do not want to change our policy positions on single payer. We have what America needs. But it may help to deliver the message if we turn up the volume on our rhetoric, just like Rob Stone has done in today’s message. However, a crucial caveat is that it is absolutely imperative that we be extremely meticulous in the accuracy of our rhetoric in order to maintain the credibility that we have established. This is not a name calling contest. But when policies kill, we need to say so. If in doubt, don’t, but when there is absolutely no doubt, say it.

Many positive terms have been used in the labeling of legislation in order to hide the negative impact: “affordable” when health care remains unaffordable, “better care” when more people lose their care, “access” when increased financial barriers impair access, and even “American” when the policies supported are un-American. Although the words themselves are not bad words, they are tarnished when used in dishonest rhetoric (although “American” still seems to hold its own in spite of current day challenges).

That said, we cannot let negativity drown out our very positive message of  guaranteed, affordable health care for all – the single payer message. That needs to be front and center, but how do we do that? Well, we are already doing it by having been meticulous with the truth. When we say “an improved Medicare for all” people understand that we are referring to a revered program that will be further improved and made available to all. Even the term “single payer” – a neutral technical policy term – has been used extensively as part of the positive message of health care for all.

With our continued efforts to deliver this very positive message, “single payer” and “improved Medicare for all” are rightfully taking their place on the top shelf in the rhetoric library, alongside “Mom” and “apple pie” – a nice thought as we celebrate our nation’s birthday.

Martin Gilens and Benjamin I. Page, “Testing Theories of American Politics: Elites, Interest Groups, and Average Citizens”:
https://www.cambridge.org…

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

Polling: How you discuss single payer matters

The Economist/YouGov Poll
April 2-4, 2017

81. Do you favor or oppose expanding Medicare to provide health insurance to every American?

60% – Favor strongly or favor somewhat

23% – Oppose strongly or oppose somewhat

https://d25d2506sfb94s.cloudfront.net…

***

The Economist/YouGov Poll
June 25-27, 2017

61. Do you favor or oppose creating a single-payer health care system, in which all Americans would get their health insurance from one government plan that is financed by taxes?

44% – Favor strongly or favor somewhat

31% – Oppose strongly or oppose somewhat

https://d25d2506sfb94s.cloudfront.net…

***

Comment:

By Don McCanne, M.D.

During a time when there is a crescendo of support for single payer/Medicare for All, the Economist/YouGov polls suggest that support declined during the past couple of months. There is a lesson here, but it is not that single payer support is fading.

The single payer policy community would recognize these two questions as being essentially the same from a policy perspective. But the layman hears the first question as being the expansion of Medicare to cover everyone (Medicare for All), whereas the second question is about single payer, government, and taxes (single payer). The first is about a popular insurance program which we have all earned and eventually participate in, and would it be that everyone could be included. The second is about government taking over health care and us being taxed for it when the insurance benefit at work seems to be working just fine, and the boss is already paying for most of it anyway. At least that’s often the perception.

We already knew this. “Medicare for all” polls better than does “single payer.” What is reassuring is that people are beginning to understand the single payer concept well enough such that there is more support than opposition, even if it is a government program for which we will be taxed. The term “single payer” is out there and will be used by friend and foe alike, so people have to understand that it refers to an improved version of Medicare in which everyone gets to participate.

The lesson? We should not only continue with but we should expand our education and advocacy activities through coalitions and grassroots efforts. The people are getting the word. Support is burgeoning. Soon the public will be immunized against the soundbites of the opponents.

Do members of Congress deserve government subsidized health insurance?

Tie Congress’s Paychecks to Our Good Health

By Nicholas Kristof
The New York Times, June 29, 2017

Members of Congress are paid $174,000 a year, while members of Poland’s lower house of Parliament are paid $32,300 a year.

Hmm. It looks as if we’re getting ripped off. Members of Congress seem to underperform compared to members of Parliament in Poland and across the democratic world.

Conservatives are right to worry that feeding at the government trough breeds dependency and laziness. So I suggest we introduce pay for performance, using metrics like, say, health.

I cite Poland because so many Poles (including the Krzysztofowicz family, later renamed Kristof) came to America for a better life, yet today American babies are one-third more likely to die in their first year of life than Polish children are (and twice as likely as Italian, Portuguese and Czech babies!).

Meanwhile, the U.S. spends far more on health care — an average of nearly $10,000 per person — than other countries do. Poland spends just $1,680 per person.

This is a stain on America. Choose almost any modern country, and its people pay less for health care and its children are more likely to survive.

In short, we as taxpayers are getting cheated.

But ultimately the United States should follow the example of every other advanced country and ensure health coverage for all. “We’re going to have insurance for everybody,” President Trump promised a week before taking office. Now he backs plans that would lead to 22 million fewer people having coverage. But if Taiwan, Slovenia, Spain, Japan and just about every other modern country can have coverage for everyone, so can we.

And, members of Congress, here’s the deal: If you ever adopt Medicare for all, I’ll endorse a pay-for-performance pay raise for all of you along with guaranteed, subsidized health insurance.

Oh, never mind. That, you already have.

https://www.nytimes.com…

***

Comment:

By Don McCanne, M.D.

Right now many members of Congress are fighting the concept that health care should be an entitlement (some would say a right). Not only do they offer no realistic assistance for the 28 million who remain uninsured, some members are supporting policies that would cause another 22 million to lose their insurance. If they really believe that not everyone is entitled to have insurance then why do most of us believe that these well paid members of Congress are somehow entitled to generous health care plans, largely funded by us taxpayers?

I could write much more about this, but isn’t that observation enough? Some deserve health care at our expense and others don’t?

A benefit for the privileged? An entitlement? A right? For a few? For everyone?

Do we really have to play rhetorical games to come to the conclusion that everyone should have health care? If we believe that, and most Americans do, then we need to hire members of Congress who agree with us and get rid of those members who think that they are more entitled to health care than the rest of us.

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

The real debate: Single payer vs. ACA/AHCA/BCRA

The Senate’s Secretly Bipartisan Health Bill

By Avik Roy
The New York Times, June 26, 2017

In 2010, when Democrats passed the Affordable Care Act, Republicans complained that they did so with no Republican support. Democrats responded by pointing out that the centerpiece of their plan — tax credits to buy private insurance — came from a Republican governor, Mitt Romney of Massachusetts.

Something similar is happening today. Democrats are denouncing the partisan nature of the Republican effort to repeal and replace Obamacare. They’re right to note that if the new bill passes the Senate, it will do so along party lines.

But the core planks of the Senate Republicans’ health bill — the Better Care Reconciliation Act — borrow just as much from Democratic ideas as Obamacare borrowed from Republican ones.

The bipartisan heritage of the bill does not eliminate areas of philosophical disagreement between conservatives and progressives. It increases the role of private insurers, and decreases the role of state-run Medicaid programs in covering the uninsured. It reduces federal spending on health care, whereas Obamacare increased it. The Senate bill repeals or rolls back all of the A.C.A.’s tax increases.

But think about it this way. Imagine an alternate universe in which, in 2009, Democrats and Republicans passed a bipartisan health bill. That bipartisan bill — let’s call it the Baucus-Collins Act — expanded coverage to tens of millions of Americans through a system of means-tested, age-adjusted tax credits in a voluntary-but-regulated individual insurance market where insurers were required to charge the same premiums to the sick and the healthy and guarantee coverage for those with pre-existing conditions.

In the Baucus-Collins Act, this increased spending on the uninsured was paid for through reforms of the Medicare program. In addition, the alternate-universe bill enacted a near-replica of Mr. Clinton’s proposal for Medicaid reform in order to make the program fiscally sustainable over the long term. The act also capped the previously unlimited tax break for employer-sponsored health insurance, albeit at a high threshold.

Democrats and Republicans would be celebrating historic reforms that expanded coverage in a fiscally responsible way. Both blue states like California and red states like Texas would see substantial coverage gains. And we might be talking about further bipartisan efforts to strengthen the Baucus-Collins Act.

What I’ve just described as a bipartisan achievement is, in effect, the synthesis of Obamacare and the Senate Republican health care bill.

***

NYT Reader Comments

By Don McCanne, M.D.

Avik Roy’s framing is that there are two polarized partisan views of reform and that somewhere in the middle is the compromise on which we can all agree. Nonsense.

If we are to use linear polarization to frame the debate, then the two sides are health care policies that benefit the patients – all patients – versus health care policies that cater to special interests, whether they be the medical-industrial complex or the political ideologues.

The similarities noted by Roy are due to the fact that the neoliberal views of the Democrats are not that far from the conservative views of the Republicans, in spite of all the noise generated by this debate. Trying to establish policies that benefit the various special interests results in the profoundly expensive, highly wasteful, inequitable, fragmented, dysfunctional system that we have.

A well designed single payer system takes care of patients first, with much greater efficiency, effectiveness, and equity. The special interests that might otherwise appropriately benefit would do well in such a system though they would have to set aside personal greed and vacuous ideology.

https://www.nytimes.com…

***

The other reform model: Single payer

“If the GOP does not disengage the country’s health-care system from the disaster of Obamacare, we are headed for the misery of single-payer.”
Hugh Hewitt, The Washington Post, June 27, 2017
https://www.washingtonpost.com…

“Senator Elizabeth Warren now says Democrats should endorse a government-run, single-payer health insurance system for the upcoming 2018 midterm elections and beyond.”
Boston Globe, June 27, 2017
https://www.bostonglobe.com…

“Sen. John Thune (R-S.D.) said, ‘If we don’t get this done and we end up with Democratic majorities in ‘18, we’ll have single payer. That’s what we’ll be dealing with.’ Sen. Pat Roberts (R-Kan.) added that Congress has to pass an unpopular far-right bill, no matter what, because the alternative is single payer, ‘and that’s socialized medicine.’”
MSNBC, June 27, 2017
http://www.msnbc.com…

“Republicans have opened up the space for Democrats to go much further than they’ve been willing to before. It’s not impossible to foresee Democrats winning the House in 2018, then taking the presidency and the Senate in 2020 — and then taking the first steps toward making single-payer health care in America a reality.”
Paul Waldman, The Washington Post, June 27, 2017
https://www.washingtonpost.com…

“It wasn’t long ago that the mere mention of single-payer inspired gasps of horror among centrists and conservatives. Now, not so much.”
Caroline Baum, MarketWatch, June 28, 2017
http://www.marketwatch.com…

“Tom (Sullivan) warned that, if the GOP fails to pass a sufficient healthcare plan in the near future, a single-payer healthcare system in the United States could be inevitable.”
Tom Sullivan Show, Fox News Radio, June 27, 2017
https://radio.foxnews.com…

“Plans that are not single-payer, quite simply, are motivated by greed and fueled by ignorance. And they are cruel.”
Joshua Gear, Press Herald, June 26, 2017
http://www.pressherald.com…

“Anyone who argues in 2017 that single-payer health care is unfeasible is either ignorant, malignant, depraved enough to rationalize profit from human suffering, or absent of the basic moral imagination to aspire to something better.”
Timothy Faust, Jacobin, June 26, 2017
https://www.jacobinmag.com…

“With my limited knowledge, I think (single payer) probably is the best system.”
Warren Buffett, PBS NEWSHOUR, June 26, 2017
http://www.pbs.org…

***

Comment:

By Don McCanne, M.D.

The issue is simple. The nation is dissatisfied with the deficiencies of the Affordable Care Act, and now they realize that the repeal and replace movement was never founded on sound health policies and would leave us mired in the same old system. The Democratic and Republican politicians are quibbling over details of a dysfunctional, fragmented, inequitable health care financing system that costs too much and delivers too little. Now, more than ever before, the nation is realizing that the other real option is, instead, a single payer national health program – an improved Medicare for all.

Again, the real debate is not between the twins of ACA vs. AHCA/BCRA, but rather it is between our terribly mediocre health care financing system vs. single payer – improved Medicare for all.

The momentum for single payer is greatly intensifying. Next week members of Congress are returning to their districts as they try to reorganize their concepts and strategy on health care reform. They need to hear loudly and clearly our voice on health care justice for all – single payer!

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

The real debate: Single payer vs. ACA/AHCA/BCRA

The Senate’s Secretly Bipartisan Health Bill

By Avik Roy
The New York Times, June 26, 2017

In 2010, when Democrats passed the Affordable Care Act, Republicans complained that they did so with no Republican support. Democrats responded by pointing out that the centerpiece of their plan — tax credits to buy private insurance — came from a Republican governor, Mitt Romney of Massachusetts.

Something similar is happening today. Democrats are denouncing the partisan nature of the Republican effort to repeal and replace Obamacare. They’re right to note that if the new bill passes the Senate, it will do so along party lines.

But the core planks of the Senate Republicans’ health bill — the Better Care Reconciliation Act — borrow just as much from Democratic ideas as Obamacare borrowed from Republican ones.

The bipartisan heritage of the bill does not eliminate areas of philosophical disagreement between conservatives and progressives. It increases the role of private insurers, and decreases the role of state-run Medicaid programs in covering the uninsured. It reduces federal spending on health care, whereas Obamacare increased it. The Senate bill repeals or rolls back all of the A.C.A.’s tax increases.

But think about it this way. Imagine an alternate universe in which, in 2009, Democrats and Republicans passed a bipartisan health bill. That bipartisan bill — let’s call it the Baucus-Collins Act — expanded coverage to tens of millions of Americans through a system of means-tested, age-adjusted tax credits in a voluntary-but-regulated individual insurance market where insurers were required to charge the same premiums to the sick and the healthy and guarantee coverage for those with pre-existing conditions.

In the Baucus-Collins Act, this increased spending on the uninsured was paid for through reforms of the Medicare program. In addition, the alternate-universe bill enacted a near-replica of Mr. Clinton’s proposal for Medicaid reform in order to make the program fiscally sustainable over the long term. The act also capped the previously unlimited tax break for employer-sponsored health insurance, albeit at a high threshold.

Democrats and Republicans would be celebrating historic reforms that expanded coverage in a fiscally responsible way. Both blue states like California and red states like Texas would see substantial coverage gains. And we might be talking about further bipartisan efforts to strengthen the Baucus-Collins Act.

What I’ve just described as a bipartisan achievement is, in effect, the synthesis of Obamacare and the Senate Republican health care bill.

***

NYT Reader Comments

By Don McCanne, M.D.

Avik Roy’s framing is that there are two polarized partisan views of reform and that somewhere in the middle is the compromise on which we can all agree. Nonsense.

If we are to use linear polarization to frame the debate, then the two sides are health care policies that benefit the patients – all patients – versus health care policies that cater to special interests, whether they be the medical-industrial complex or the political ideologues.

The similarities noted by Roy are due to the fact that the neoliberal views of the Democrats are not that far from the conservative views of the Republicans, in spite of all the noise generated by this debate. Trying to establish policies that benefit the various special interests results in the profoundly expensive, highly wasteful, inequitable, fragmented, dysfunctional system that we have.

A well designed single payer system takes care of patients first, with much greater efficiency, effectiveness, and equity. The special interests that might otherwise appropriately benefit would do well in such a system though they would have to set aside personal greed and vacuous ideology.

https://www.nytimes.com…

***

The other reform model: Single payer

“If the GOP does not disengage the country’s health-care system from the disaster of Obamacare, we are headed for the misery of single-payer.”
Hugh Hewitt, The Washington Post, June 27, 2017
https://www.washingtonpost.com…

“Senator Elizabeth Warren now says Democrats should endorse a government-run, single-payer health insurance system for the upcoming 2018 midterm elections and beyond.”
Boston Globe, June 27, 2017
https://www.bostonglobe.com…

“Sen. John Thune (R-S.D.) said, ‘If we don’t get this done and we end up with Democratic majorities in ‘18, we’ll have single payer. That’s what we’ll be dealing with.’ Sen. Pat Roberts (R-Kan.) added that Congress has to pass an unpopular far-right bill, no matter what, because the alternative is single payer, ‘and that’s socialized medicine.’”
MSNBC, June 27, 2017
http://www.msnbc.com…

“Republicans have opened up the space for Democrats to go much further than they’ve been willing to before. It’s not impossible to foresee Democrats winning the House in 2018, then taking the presidency and the Senate in 2020 — and then taking the first steps toward making single-payer health care in America a reality.”
Paul Waldman, The Washington Post, June 27, 2017
https://www.washingtonpost.com…

“It wasn’t long ago that the mere mention of single-payer inspired gasps of horror among centrists and conservatives. Now, not so much.”
Caroline Baum, MarketWatch, June 28, 2017
http://www.marketwatch.com…

“Tom (Sullivan) warned that, if the GOP fails to pass a sufficient healthcare plan in the near future, a single-payer healthcare system in the United States could be inevitable.”
Tom Sullivan Show, Fox News Radio, June 27, 2017
https://radio.foxnews.com…

“Plans that are not single-payer, quite simply, are motivated by greed and fueled by ignorance. And they are cruel.”
Joshua Gear, Press Herald, June 26, 2017
http://www.pressherald.com…

“Anyone who argues in 2017 that single-payer health care is unfeasible is either ignorant, malignant, depraved enough to rationalize profit from human suffering, or absent of the basic moral imagination to aspire to something better.”
Timothy Faust, Jacobin, June 26, 2017
https://www.jacobinmag.com…

“With my limited knowledge, I think (single payer) probably is the best system.”
Warren Buffett, PBS NEWSHOUR, June 26, 2017
http://www.pbs.org…

***

Comment:

By Don McCanne, M.D.

The issue is simple. The nation is dissatisfied with the deficiencies of the Affordable Care Act, and now they realize that the repeal and replace movement was never founded on sound health policies and would leave us mired in the same old system. The Democratic and Republican politicians are quibbling over details of a dysfunctional, fragmented, inequitable health care financing system that costs too much and delivers too little. Now, more than ever before, the nation is realizing that the other real option is, instead, a single payer national health program – an improved Medicare for all.

Again, the real debate is not between the twins of ACA vs. AHCA/BCRA, but rather it is between our terribly mediocre health care financing system vs. single payer – improved Medicare for all.

The momentum for single payer is greatly intensifying. Next week members of Congress are returning to their districts as they try to reorganize their concepts and strategy on health care reform. They need to hear loudly and clearly our voice on health care justice for all – single payer!

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

Senate GOP health care bill estimated to kill 28,600 more in U.S. each year & drop 22M from insurance

Interview With Dr. Steffie Woolhandler

By Amy Goodman
Democracy Now!, June 27, 2017

PNHP Note: To view video of this interview, click here.

Twenty-two million Americans would lose their health insurance under the Senate Republicans’ healthcare bill over the next decade. That’s according to the Congressional Budget Office, which released its assessment on Monday. Following the report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Republican leaders had been pushing for a vote as early as today, ahead of the July 4 recess. On Monday, the American Medical Association came out against the Senate bill, writing in a letter to Senate leaders, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels.” For more, we speak with Dr. Steffie Woolhandler, a professor at CUNY-Hunter College and a primary care physician. She is a lecturer at Harvard Medical School and the co-founder of Physicians for a National Health Program.

TRANSCRIPT
This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: Twenty-two million Americans would lose their insurance under the Senate Republicans’ healthcare bill just over the next decade. In addition, Medicaid would see a $772 billion cut over the next decade, while wealthy Americans would receive $541 billion in tax cuts. This is according to the Congressional Budget Office, which released its assessment of the Republican healthcare bill in the Senate Monday.

Following the release of the CBO report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Senator Ron Johnson of Wisconsin has suggested he, too, would oppose voting on the bill. Republican leaders had been pushing for a vote this week, ahead of the July 4th recess.

The Republican bill also faces major opposition from all Senate Democrats, a slew of governors from both parties, the majority of the healthcare industry, hospitals, doctors, nurses, patient advocacy groups, the U.S. Conference of Catholic Bishops, and even members of the far-right Koch brothers’ political network, who claim the legislation is not sufficiently conservative.

This is Vermont Senator Bernie Sanders speaking Monday on the Senate floor.

SEN. BERNIE SANDERS: Mr. President, today’s Congressional Budget Office analysis of the Trump-McConnell healthcare bill gives us 22 million reasons why this legislation should not see the light of day. What CBO tells us, in truth, is that this bill really has nothing to do with healthcare. Rather, it is an enormous transfer of wealth from the sick, the elderly, the children, the disabled and the poor into the pockets of the wealthiest people in this country. Mr. President, according to CBO—and that report just came out a few hours ago—this bill would throw 22 million Americans off of health insurance, cut Medicaid by over $770 billion, defund Planned Parenthood and substantially increase premiums for older Americans. … Mr. President, this, in fact, is a barbaric and immoral piece of legislation.

AMY GOODMAN: On Monday, the American Medical Association came out against the Senate bill. In a letter to Senate leaders, the AMA wrote, quote, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels,” unquote.

Meanwhile, a stunning new study in the Annals of Internal Medicine is estimating some 28,600 people could die early deaths if they lose health insurance.

We’re joined now by the author of the study, Dr. Steffie Woolhandler, professor at CUNY-Hunter College, primary care physician, lecturer at Harvard Medical School and co-founder of Physicians for a National Health Program.

Welcome to Democracy Now!

DR. STEFFIE WOOLHANDLER: My pleasure.

AMY GOODMAN: Tell us what you found.

DR. STEFFIE WOOLHANDLER: We reviewed the world’s scientific literature on the relationship between health insurance and mortality. And there is really now a scientific consensus that being uninsured raises the death rates. It raises your death rates by between 3 and 29 percent. And the math on that is that if you take health insurance away from 22 million people, about 29,000 of them will die every year, annually, as a result. That’s what we found by reviewing the literature. There was a similar review in New England Journal of Medicine. We punished our own study in the Annals of Internal Medicine, which is the official organ of the American College of Physicians, the nation’s largest medical specialty society. So, being uninsured raises your death rate. That is established scientific consensus. And many of the Republicans have been trying to say, “Oh, you can take away health insurance from 22 million people, and nothing will happen.” That’s simply contradicted by the scientific consensus.

AMY GOODMAN: And explain how people die as a result.

DR. STEFFIE WOOLHANDLER: Well, people might have an acute illness, like major trauma. You get hit by a car, and you have to go to the hospital. If you’re uninsured and you have major trauma, your death rates are higher. You might have an illness like breast cancer. If you’re uninsured and you have breast cancer, your death rates are higher. But mostly this has to do with that routine medical care to treat high blood pressure, to treat diabetes, before they cause complications, and to prevent those serious complications and deaths. Seems like hypertension, high blood pressure, is probably the largest single contributor to deaths among uninsured people. You need to be taking medicines to control high blood pressure to prevent strokes and heart attacks and death.

AMY GOODMAN: So this number, 22 million people will lose their health insurance over the next 10 years, and then it only goes up from there.

DR. STEFFIE WOOLHANDLER: Well, according to the Congressional Budget Office, yes, it goes up from there, because the Medicaid cuts in the Senate bill are delayed, but then they’re very, very deep. They’re even deeper over the long run than what was in the House bill. So, Medicaid is going to be cut not just for poor people, but for people in nursing homes. You know, most people in a nursing home eventually have to rely on Medicaid to pay the bill, because nursing home care takes all your money, and you have to rely on Medicaid. If you have a disabled child, you have to rely on Medicaid. If you have a relative who has serious mental illness or substance abuse, they’re going to be relying on Medicaid. So it takes money from all of these people, not just the folks who are poor now, to give this giant tax cut to the top 1 percent of taxpayers.

AMY GOODMAN: I wanted to turn to a comment made by the Idaho Republican Congressman Raúl Labrador during a town hall meeting last month. He came under fire for his answer to this question from an audience member.

AUDIENCE MEMBER: You are mandating people on Medicaid accept dying. You are making a mandate that will kill people.

REP. RAÚL LABRADOR: No, no one wants anybody to die. You know, that line is so indefensible. Nobody dies because they don’t have access to healthcare.

AMY GOODMAN: “Nobody dies because they don’t have access to healthcare.” Dr. Steffie Woolhandler?

DR. STEFFIE WOOLHANDLER: Well, Raúl Labrador said it. Senator Ted Cruz has said that. Marco Rubio has said that. Secretary Tom Price, the secretary of health and human services, has implied that, that you can be uninsured and nothing happens. That’s simply not true. The science is showing us that if you lack health insurance, you don’t get the care you need to stay healthy, and that people die earlier as a result. And I think it’s a—the Republicans recognize this is a very dangerous idea for them, that people are going to die because of their behavior. But that’s what the scientific consensus is saying.

AMY GOODMAN: So, what has to happen now?

DR. STEFFIE WOOLHANDLER: Well, right now, the betting markets are saying it’s 50/50 that this Senate bill will pass. So when something’s 50/50, that means now is the time to mobilize. You know, you can call your senator. You can call your congressman. You can demonstrate. There’s demonstrations all over the country about this bill. You can tweet about it. You can tell your friends about it. But now is the time to really get active on this issue.

We also need to be saying, “Let’s move forward to single payer, that covers everyone, not backward through this repeal.” You know, even under the Affordable Care Act, 28 million Americans have no health insurance. Many Americans are underinsured. They have insurance they can’t afford to use because of gaps in their coverage, like copayments, deductibles and uncovered services. So we need to be fighting this Republican step backward, but also saying to our Democratic legislators, “We need to be moving forward to single payer,” that will actually improve care for all Americans.

AMY GOODMAN: You were never an advocate of Obamacare. And now, what will happen? I mean, even if they don’t vote on it, the gutting of the health insurance—of health insurance today is, you know, moving full speed ahead. So what does it look like even if this bill doesn’t move forward?

DR. STEFFIE WOOLHANDLER: Well, there’s more support for the Medicare-for-all, single-payer idea than ever in history. Polls are showing 56 percent of the American people support the idea. The majority of House Democrats have endorsed the Conyers bill, HR 676, a Medicare-for-all bill. More than half of House Democrats have endorsed that bill, about 112. Senator Sanders is putting a bill into the Senate in July. So this is a great time for people to be saying, “We need to move forward from the ACA to single payer.”

AMY GOODMAN: And what would Medicare for all look like?

DR. STEFFIE WOOLHANDLER: OK.

AMY GOODMAN: How would that happen?

DR. STEFFIE WOOLHANDLER: OK, well, it would be expanded and improved Medicare for all. You would get a Medicare card the day you were born, and have it your entire life. All medically necessary care would be covered by a tax-funded Medicare-for-all program, that’s—it would be a lot cheaper over the long run, because you save so much money on administrative costs. All that billing and insurance enrollment is extremely expensive in the United States, consuming 31 percent of total U.S. health spending, according to our research that’s appeared in New England Journal of Medicine. By going to a simple single-payer system, you could save about half of it, about $500 billion a year, which you could use to get to universal healthcare and to remove copayments and deductibles from people who now have them.

So, a single—that’s what’s happened in other countries. Canada has a single-payer system—doesn’t work perfectly, but it does cover everyone. Scotland has a single-payer system. Much of Western Europe has single-payer systems. They cover everyone. They live two years longer. They pay less for healthcare than we do.

AMY GOODMAN: Well, now, this is important, because you talked about mortality, if this bill were to pass and become law, that close to 29,000 people a year could die, more Americans could die. What is our mortality rate with our insurance system compared to others?

DR. STEFFIE WOOLHANDLER: Well, Americans live two to three years shorter than people in Canada, just across the border, with very similar culture, very similar lifestyle, yet we live two years shorter. Similarly, we live about two years shorter than people in many Western European countries. And some of the studies we reviewed in our article actually look at the international evidence, which, again, is totally consistent with the idea that being uninsured is bad for your health, it can cause deaths, and that being fully covered for all medically necessary care, as would happen under Medicare for all, makes people healthier, and it prolongs their life.

AMY GOODMAN: I wanted to turn to President Trump being interviewed recently by Peter Hegseth of Fox & Friends.

PRESIDENT DONALD TRUMP: Because I want to see—I want to see—and I speak from the heart—that’s what I want to see. I want to see a bill with heart.

AMY GOODMAN: Your response?

DR. STEFFIE WOOLHANDLER: Well, Trumpcare has no heart whatsoever. The House bill was going to throw 23 million people off insurance. The Senate bill is going to throw 22 million off in 10 years but then keep throwing more off. You know, they’re going to make health insurance worse for people with private coverage by getting rid of the rules about what has to be covered, so your private insurance will no longer have to cover maternity care. They’re actually robbing money from the Medicare trust fund. They’re taking $117 billion out of the Medicare trust fund, which pays for the health insurance when people turn 65. $117 billion is taken out of that trust fund to give tax cuts to the top 1 percent of taxpayers. That is not heart. That’s the opposite of heart.

AMY GOODMAN: Well, I thank you very much for being with us, Dr. Steffie Woolhandler, professor at CUNY-Hunter College here in New York, primary care physician, lecturer at Harvard Medical School, co-founder of Physicians for a National Health Program. And we’ll link to her report on the mortality that would be related to the Republican healthcare bill becoming law. Roughly 28,600 more Americans could die per year.

https://www.democracynow.org…

Dr. Steffie Woolhandler on ‘Democracy Now!’

PNHP co-founder Dr. Steffie Woolhandler appeared on “Democracy Now!” on June 27, 2017, to discuss the deadly impact of being uninsured. She pointed to a review of studies, published in the Annals of Internal Medicine, that confirmed thousands of Americans die each year because they lack health insurance.

Insurance rescinded: People will die

H.R. 1628, Better Care Reconciliation Act of 2017

Congressional Budget Office, June 26, 2017

CBO and JCT estimate that enacting the Better Care Reconciliation Act of 2017 would reduce federal deficits by $321 billion over the coming decade and increase the number of people who are uninsured by 22 million in 2026 relative to current law.

Because nongroup insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law.

https://www.cbo.gov…

***

The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?

By Steffie Woolhandler, M.D., M.P.H.; David U. Himmelstein, M.D.
Annals of Internal Medicine, June 27, 2017

Abstract

About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine’s conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.

From the Discussion

The evidence accumulated since the publication of the IOM’s report in 2002 supports and strengthens its conclusion that health insurance reduces mortality. Several newer observational and quasi-experimental studies have found that uninsurance shortens survival, and a few with null results used confounded or questionable adjustments for baseline health. The results of the only recent RCT, although far from definitive, are consistent with the positive findings from cohort and quasi-experimental analyses.

Several factors complicate efforts to determine whether uninsurance increases mortality. Randomly assigning people to uninsurance is usually unethical, and quasi-experimental analyses rest on unverifiable assumptions. Deaths are rare and mortality effects may be delayed, mandating large studies with long follow-up. Many people cycle into and out of coverage, diluting the effects of insurance. And statistical adjustments for baseline health usually rely on participants’ self-reports, which may be influenced by coverage. Hence, such adjustments may under- or overadjust for differences between insured and uninsured persons.

Our focus on mortality should not obscure other well-established benefits of health insurance: improved self-rated health, financial protection, and reduced likelihood of depression. Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.

Overall, the case for coverage is strong. Even skeptics who suggest that insurance doesn’t improve outcomes seem to vote differently with their feet. As one prominent economist (Paul Krugman) recently asked, “How many of the people who write such things… choose to just not bother getting their healthcare?”

http://annals.org…

***

Comment:

By Don McCanne, M.D.

Although the precise numbers are somewhat elusive, this comprehensive review of existing studies confirms that health insurance reduces mortality. The Congressional Budget Office concludes that another 22 million people will be uninsured compared to current law if the Better Care Reconciliation Act were enacted and implemented. If this Republican repeal and replace bill becomes law, more people will die as a result.

Obviously the reduction in mortality is not the sole function of insurance. As the authors of this Annals of Internal Medicine article state, “Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.” Importantly, it also provides financial protection, which otherwise would deteriorate under the Republican proposal. (The full landmark article by Steffie Woolhandler and David Himmelstein is available for free at the link above.)

If there ever was a time to intensify the policy debate, this is it. The repeal and replace movement became popular because of the acknowledged deficiencies of the Affordable Care Act – leaving millions uninsured, millions more with inadequate financial protection, perpetuation of a dysfunctional insurance market that takes away choices, while failing to remedy the profound administrative waste that uniquely characterizes the U.S. health care financing system.

The Republicans have done us a favor by showing us that replacement policies that assume perpetuation of our fragmented infrastructure of private plans and public programs cannot remedy the profound deficiencies in our system. With six years of debate, the policies proposed do not correct the fundamental flaws in the financing infrastructure and actually would only compound the problems, including increasing mortality caused by being uninsured.

It is not as if we do not understand optimal health policy. We do. A well designed single payer national health program – an improved Medicare for all – would ensure that all of us would have the essential health care services that we need in a system that would be affordable for each of us. And, oh yes, nobody would die simply because they were uninsured.

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

Insurance rescinded: People will die

H.R. 1628, Better Care Reconciliation Act of 2017

Congressional Budget Office, June 26, 2017

CBO and JCT estimate that enacting the Better Care Reconciliation Act of 2017 would reduce federal deficits by $321 billion over the coming decade and increase the number of people who are uninsured by 22 million in 2026 relative to current law.

Because nongroup insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law.

https://www.cbo.gov…

***

The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?

By Steffie Woolhandler, M.D., M.P.H.; David U. Himmelstein, M.D.
Annals of Internal Medicine, June 27, 2017

Abstract

About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine’s conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.

From the Discussion

The evidence accumulated since the publication of the IOM’s report in 2002 supports and strengthens its conclusion that health insurance reduces mortality. Several newer observational and quasi-experimental studies have found that uninsurance shortens survival, and a few with null results used confounded or questionable adjustments for baseline health. The results of the only recent RCT, although far from definitive, are consistent with the positive findings from cohort and quasi-experimental analyses.

Several factors complicate efforts to determine whether uninsurance increases mortality. Randomly assigning people to uninsurance is usually unethical, and quasi-experimental analyses rest on unverifiable assumptions. Deaths are rare and mortality effects may be delayed, mandating large studies with long follow-up. Many people cycle into and out of coverage, diluting the effects of insurance. And statistical adjustments for baseline health usually rely on participants’ self-reports, which may be influenced by coverage. Hence, such adjustments may under- or overadjust for differences between insured and uninsured persons.

Our focus on mortality should not obscure other well-established benefits of health insurance: improved self-rated health, financial protection, and reduced likelihood of depression. Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.

Overall, the case for coverage is strong. Even skeptics who suggest that insurance doesn’t improve outcomes seem to vote differently with their feet. As one prominent economist (Paul Krugman) recently asked, “How many of the people who write such things… choose to just not bother getting their healthcare?”

http://annals.org…

***

Comment:

By Don McCanne, M.D.

Although the precise numbers are somewhat elusive, this comprehensive review of existing studies confirms that health insurance reduces mortality. The Congressional Budget Office concludes that another 22 million people will be uninsured compared to current law if the Better Care Reconciliation Act were enacted and implemented. If this Republican repeal and replace bill becomes law, more people will die as a result.

Obviously the reduction in mortality is not the sole function of insurance. As the authors of this Annals of Internal Medicine article state, “Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.” Importantly, it also provides financial protection, which otherwise would deteriorate under the Republican proposal. (The full landmark article by Steffie Woolhandler and David Himmelstein is available for free at the link above.)

If there ever was a time to intensify the policy debate, this is it. The repeal and replace movement became popular because of the acknowledged deficiencies of the Affordable Care Act – leaving millions uninsured, millions more with inadequate financial protection, perpetuation of a dysfunctional insurance market that takes away choices, while failing to remedy the profound administrative waste that uniquely characterizes the U.S. health care financing system.

The Republicans have done us a favor by showing us that replacement policies that assume perpetuation of our fragmented infrastructure of private plans and public programs cannot remedy the profound deficiencies in our system. With six years of debate, the policies proposed do not correct the fundamental flaws in the financing infrastructure and actually would only compound the problems, including increasing mortality caused by being uninsured.

It is not as if we do not understand optimal health policy. We do. A well designed single payer national health program – an improved Medicare for all – would ensure that all of us would have the essential health care services that we need in a system that would be affordable for each of us. And, oh yes, nobody would die simply because they were uninsured.

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

Senate GOP health care bill estimated to kill 28,600 more in U.S. each year & drop 22M from insurance

Interview With Dr. Steffie Woolhandler

By Amy Goodman
Democracy Now!, June 27, 2017

PNHP Note: To view video of this interview, click here.

Twenty-two million Americans would lose their health insurance under the Senate Republicans’ healthcare bill over the next decade. That’s according to the Congressional Budget Office, which released its assessment on Monday. Following the report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Republican leaders had been pushing for a vote as early as today, ahead of the July 4 recess. On Monday, the American Medical Association came out against the Senate bill, writing in a letter to Senate leaders, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels.” For more, we speak with Dr. Steffie Woolhandler, a professor at CUNY-Hunter College and a primary care physician. She is a lecturer at Harvard Medical School and the co-founder of Physicians for a National Health Program.

TRANSCRIPT
This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: Twenty-two million Americans would lose their insurance under the Senate Republicans’ healthcare bill just over the next decade. In addition, Medicaid would see a $772 billion cut over the next decade, while wealthy Americans would receive $541 billion in tax cuts. This is according to the Congressional Budget Office, which released its assessment of the Republican healthcare bill in the Senate Monday.

Following the release of the CBO report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Senator Ron Johnson of Wisconsin has suggested he, too, would oppose voting on the bill. Republican leaders had been pushing for a vote this week, ahead of the July 4th recess.

The Republican bill also faces major opposition from all Senate Democrats, a slew of governors from both parties, the majority of the healthcare industry, hospitals, doctors, nurses, patient advocacy groups, the U.S. Conference of Catholic Bishops, and even members of the far-right Koch brothers’ political network, who claim the legislation is not sufficiently conservative.

This is Vermont Senator Bernie Sanders speaking Monday on the Senate floor.

SEN. BERNIE SANDERS: Mr. President, today’s Congressional Budget Office analysis of the Trump-McConnell healthcare bill gives us 22 million reasons why this legislation should not see the light of day. What CBO tells us, in truth, is that this bill really has nothing to do with healthcare. Rather, it is an enormous transfer of wealth from the sick, the elderly, the children, the disabled and the poor into the pockets of the wealthiest people in this country. Mr. President, according to CBO—and that report just came out a few hours ago—this bill would throw 22 million Americans off of health insurance, cut Medicaid by over $770 billion, defund Planned Parenthood and substantially increase premiums for older Americans. … Mr. President, this, in fact, is a barbaric and immoral piece of legislation.

AMY GOODMAN: On Monday, the American Medical Association came out against the Senate bill. In a letter to Senate leaders, the AMA wrote, quote, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels,” unquote.

Meanwhile, a stunning new study in the Annals of Internal Medicine is estimating some 28,600 people could die early deaths if they lose health insurance.

We’re joined now by the author of the study, Dr. Steffie Woolhandler, professor at CUNY-Hunter College, primary care physician, lecturer at Harvard Medical School and co-founder of Physicians for a National Health Program.

Welcome to Democracy Now!

DR. STEFFIE WOOLHANDLER: My pleasure.

AMY GOODMAN: Tell us what you found.

DR. STEFFIE WOOLHANDLER: We reviewed the world’s scientific literature on the relationship between health insurance and mortality. And there is really now a scientific consensus that being uninsured raises the death rates. It raises your death rates by between 3 and 29 percent. And the math on that is that if you take health insurance away from 22 million people, about 29,000 of them will die every year, annually, as a result. That’s what we found by reviewing the literature. There was a similar review in New England Journal of Medicine. We punished our own study in the Annals of Internal Medicine, which is the official organ of the American College of Physicians, the nation’s largest medical specialty society. So, being uninsured raises your death rate. That is established scientific consensus. And many of the Republicans have been trying to say, “Oh, you can take away health insurance from 22 million people, and nothing will happen.” That’s simply contradicted by the scientific consensus.

AMY GOODMAN: And explain how people die as a result.

DR. STEFFIE WOOLHANDLER: Well, people might have an acute illness, like major trauma. You get hit by a car, and you have to go to the hospital. If you’re uninsured and you have major trauma, your death rates are higher. You might have an illness like breast cancer. If you’re uninsured and you have breast cancer, your death rates are higher. But mostly this has to do with that routine medical care to treat high blood pressure, to treat diabetes, before they cause complications, and to prevent those serious complications and deaths. Seems like hypertension, high blood pressure, is probably the largest single contributor to deaths among uninsured people. You need to be taking medicines to control high blood pressure to prevent strokes and heart attacks and death.

AMY GOODMAN: So this number, 22 million people will lose their health insurance over the next 10 years, and then it only goes up from there.

DR. STEFFIE WOOLHANDLER: Well, according to the Congressional Budget Office, yes, it goes up from there, because the Medicaid cuts in the Senate bill are delayed, but then they’re very, very deep. They’re even deeper over the long run than what was in the House bill. So, Medicaid is going to be cut not just for poor people, but for people in nursing homes. You know, most people in a nursing home eventually have to rely on Medicaid to pay the bill, because nursing home care takes all your money, and you have to rely on Medicaid. If you have a disabled child, you have to rely on Medicaid. If you have a relative who has serious mental illness or substance abuse, they’re going to be relying on Medicaid. So it takes money from all of these people, not just the folks who are poor now, to give this giant tax cut to the top 1 percent of taxpayers.

AMY GOODMAN: I wanted to turn to a comment made by the Idaho Republican Congressman Raúl Labrador during a town hall meeting last month. He came under fire for his answer to this question from an audience member.

AUDIENCE MEMBER: You are mandating people on Medicaid accept dying. You are making a mandate that will kill people.

REP. RAÚL LABRADOR: No, no one wants anybody to die. You know, that line is so indefensible. Nobody dies because they don’t have access to healthcare.

AMY GOODMAN: “Nobody dies because they don’t have access to healthcare.” Dr. Steffie Woolhandler?

DR. STEFFIE WOOLHANDLER: Well, Raúl Labrador said it. Senator Ted Cruz has said that. Marco Rubio has said that. Secretary Tom Price, the secretary of health and human services, has implied that, that you can be uninsured and nothing happens. That’s simply not true. The science is showing us that if you lack health insurance, you don’t get the care you need to stay healthy, and that people die earlier as a result. And I think it’s a—the Republicans recognize this is a very dangerous idea for them, that people are going to die because of their behavior. But that’s what the scientific consensus is saying.

AMY GOODMAN: So, what has to happen now?

DR. STEFFIE WOOLHANDLER: Well, right now, the betting markets are saying it’s 50/50 that this Senate bill will pass. So when something’s 50/50, that means now is the time to mobilize. You know, you can call your senator. You can call your congressman. You can demonstrate. There’s demonstrations all over the country about this bill. You can tweet about it. You can tell your friends about it. But now is the time to really get active on this issue.

We also need to be saying, “Let’s move forward to single payer, that covers everyone, not backward through this repeal.” You know, even under the Affordable Care Act, 28 million Americans have no health insurance. Many Americans are underinsured. They have insurance they can’t afford to use because of gaps in their coverage, like copayments, deductibles and uncovered services. So we need to be fighting this Republican step backward, but also saying to our Democratic legislators, “We need to be moving forward to single payer,” that will actually improve care for all Americans.

AMY GOODMAN: You were never an advocate of Obamacare. And now, what will happen? I mean, even if they don’t vote on it, the gutting of the health insurance—of health insurance today is, you know, moving full speed ahead. So what does it look like even if this bill doesn’t move forward?

DR. STEFFIE WOOLHANDLER: Well, there’s more support for the Medicare-for-all, single-payer idea than ever in history. Polls are showing 56 percent of the American people support the idea. The majority of House Democrats have endorsed the Conyers bill, HR 676, a Medicare-for-all bill. More than half of House Democrats have endorsed that bill, about 112. Senator Sanders is putting a bill into the Senate in July. So this is a great time for people to be saying, “We need to move forward from the ACA to single payer.”

AMY GOODMAN: And what would Medicare for all look like?

DR. STEFFIE WOOLHANDLER: OK.

AMY GOODMAN: How would that happen?

DR. STEFFIE WOOLHANDLER: OK, well, it would be expanded and improved Medicare for all. You would get a Medicare card the day you were born, and have it your entire life. All medically necessary care would be covered by a tax-funded Medicare-for-all program, that’s—it would be a lot cheaper over the long run, because you save so much money on administrative costs. All that billing and insurance enrollment is extremely expensive in the United States, consuming 31 percent of total U.S. health spending, according to our research that’s appeared in New England Journal of Medicine. By going to a simple single-payer system, you could save about half of it, about $500 billion a year, which you could use to get to universal healthcare and to remove copayments and deductibles from people who now have them.

So, a single—that’s what’s happened in other countries. Canada has a single-payer system—doesn’t work perfectly, but it does cover everyone. Scotland has a single-payer system. Much of Western Europe has single-payer systems. They cover everyone. They live two years longer. They pay less for healthcare than we do.

AMY GOODMAN: Well, now, this is important, because you talked about mortality, if this bill were to pass and become law, that close to 29,000 people a year could die, more Americans could die. What is our mortality rate with our insurance system compared to others?

DR. STEFFIE WOOLHANDLER: Well, Americans live two to three years shorter than people in Canada, just across the border, with very similar culture, very similar lifestyle, yet we live two years shorter. Similarly, we live about two years shorter than people in many Western European countries. And some of the studies we reviewed in our article actually look at the international evidence, which, again, is totally consistent with the idea that being uninsured is bad for your health, it can cause deaths, and that being fully covered for all medically necessary care, as would happen under Medicare for all, makes people healthier, and it prolongs their life.

AMY GOODMAN: I wanted to turn to President Trump being interviewed recently by Peter Hegseth of Fox & Friends.

PRESIDENT DONALD TRUMP: Because I want to see—I want to see—and I speak from the heart—that’s what I want to see. I want to see a bill with heart.

AMY GOODMAN: Your response?

DR. STEFFIE WOOLHANDLER: Well, Trumpcare has no heart whatsoever. The House bill was going to throw 23 million people off insurance. The Senate bill is going to throw 22 million off in 10 years but then keep throwing more off. You know, they’re going to make health insurance worse for people with private coverage by getting rid of the rules about what has to be covered, so your private insurance will no longer have to cover maternity care. They’re actually robbing money from the Medicare trust fund. They’re taking $117 billion out of the Medicare trust fund, which pays for the health insurance when people turn 65. $117 billion is taken out of that trust fund to give tax cuts to the top 1 percent of taxpayers. That is not heart. That’s the opposite of heart.

AMY GOODMAN: Well, I thank you very much for being with us, Dr. Steffie Woolhandler, professor at CUNY-Hunter College here in New York, primary care physician, lecturer at Harvard Medical School, co-founder of Physicians for a National Health Program. And we’ll link to her report on the mortality that would be related to the Republican healthcare bill becoming law. Roughly 28,600 more Americans could die per year.

https://www.democracynow.org…

Priceless benefits would come from single-payer health care system

It’s part of the same moral responsibility that Americans share for public safety and education.

By Joshua Gear, M.D.
Portland (Maine) Press Herald, June 26, 2017

As a piece of legislation intended to provide affordable, quality health care to the greatest number of Americans, the Affordable Care Act has failed miserably. Twenty million Americans remain uninsured and tens of millions more with insurance have trouble affording their co-pays or deductibles. Half a million Americans with health insurance coverage declare bankruptcy every year as a result of medical expenses.

The ACA has been a disaster for providing affordable coverage, but soon our health care system will be in worse shape. Far worse. The “death spiral” of health care coverage, stimulated by a Republican Party hell-bent on undermining any legislation promoted by Barack Obama, has accelerated.

Both the House and Senate versions of the American Health Care Act attempt to stall that death spiral, but the trade-off they offer is less coverage and a certain increase in pain, suffering and premature death to older Americans as well as those who struggle the most to pay their bills. The beneficiaries of the AHCA through tax cuts and subsidies are the super wealthy, the health insurance industry and Big Pharma.

Only weeks after championing the House version and then celebrating its passage in the Rose Garden, President Trump recognized that what House Speaker Paul Ryan, et al., had crafted was “mean” – a remarkable admission for a man who has a profound aversion for the truth.

The Senate version, crafted in secret by 13 hand-picked older white men, was finally offered up four days ago, giving the other 87 members less than a week to critique, discuss and amend before being asked to pass it. Any reasonable person would agree that this is not only unprecedented but also a dangerous way to legislate.

Though their version in many ways is even more “mean” than the House version, those 13 senators may have managed to make it more palatable by extending time lines and shuffling numbers. So it may well pass.

Regardless of how this plays out, whether we continue with the ACA or get some version of the AHCA, America in general and the poor, the elderly and the middle class in particular, will not do well in regard to having their health care needs met over the next several years.

It’s important to recognize that the United States pays nearly two times more in health care costs than any other industrialized country while having far worse outcomes on most measures of care, and still we leave over 10 percent of our citizens without access to care because of lack of insurance.

Being uninsured means being unable to treat chronic conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, schizophrenia, addictions, Crohn’s disease – and the list goes on and on. Failure to treat these chronic conditions results in pain, suffering, expensive trips to the emergency room and premature death. The financial costs are huge to the taxpayers, but they pale in comparison to the emotional costs paid by individuals and families of those with pre-existing conditions.

Call it what you will, but “single-payer” or “Medicare for all” or “socialized medicine” would guarantee quality health care for every American, and it would provide it for a fraction of the cost we pay for health care today. Why? Because a single-payer system would not be burdened by financially supporting insurance or pharmaceutical industries that take advantage of our campaign finance and lobbying laws and in doing so manage to generate enormous profits through limiting patients’ access to care or life-saving treatment.

Our elected officials, on both sides of the aisle, have become intoxicated by the money poured into their campaigns and have become dependent on that money to get re-elected. Their primary focus is to stay employed, i.e., to get re-elected, and access to quality health care by their constituents can be damned.

We guarantee our children access to a quality education through high school for good reason: It makes for a better society and a more robust economy.

And you would not deprive your neighbors a quick response from the local fire department if their house were on fire. If you did, lives could be destroyed or lost and businesses and communities decimated.

Is it any less cruel or ill-advised to deprive those same neighbors access to health care?

Our country needs an affordable, effective health care system. Plans that are not single-payer, quite simply, are motivated by greed and fueled by ignorance. And they are cruel.

There is no question that the ACA needs to be repealed and replaced. It needs to be replaced with comprehensive, universal coverage that is affordable and compassionate. Single-payer.

http://www.pressherald.com…

Dr. David Himmelstein on ‘CBS Evening News’

PNHP co-founder Dr. David Himmelstein appeared on the “CBS Evening News” on June 26, 2017, to discuss the broad scientific consensus that there is a link between a lack of health insurance and mortality. He noted, as part of a larger segment, that the uninsured tend to forego care for even the most serious medical conditions.