PNHP

Urgent message to single payer supporters Join us for Obama regional governor's health care summit in Vermont to Insist on Single Payer

Urgent message to single payer supporters Join us for Obama regional governor's health care summit in Vermont to Insist on Single Payer

Dear Friend:

Vermont Governor Jim Douglas and Massachusetts Governor Deval Patrick have been asked by President Obama to host a regional New England health care summit at the University of Vermont on March 17th. We do not expect to be invited not do we expect single payer to be considered.

At the recent White House summit on health reform the first person to speak at the close of the forum was the head of the American Health Insurers Plans. The rest of those in attendance were mostly lobbyists from special interest groups. The single payer view was all but excluded.

In fact, no single payer advocate was invited until thousands of messages reached the White House, including word that doctors were going to protest on the sidewalk. At the end of the day prior to the summit, the White House quickly invited a solitary physician to represent the view of a large majority of physicians and a overwhelming majority of Americans: we need single payer national health insurance now.

When it comes to the debate in Washington, DC, single payer stands ignored, like the elephant in the room, in spite of all of the evidence that it saves money, contains future spending, will include everyone and will improve the economy. But with the last minute invitation to the White House we learned an important lesson:

We can make a difference! Right now we are the marginalized majority. We might expect this treatment from the Bush administration. But it is unforgivable from President Obama. The majority of Americans want a single payer health care system in the United States. The majority of doctors want single payer. The President has promised an open, transparent process, with all proposals considered. It is time to insist that single payer be a part of this process.

We are organizing a peaceful and respectful protest in front of the summit meeting at the University of Vermont Davis Center in Burlington, Vermont at 12 noon. If there ever was a day to drop what you are doing and come, this is it. There will be national and local media there. We need hundreds of people to come from all over New England and New York. We urge health professionals to come and bring your white coats and stethoscopes.

For more information email Deb Richter
vthca@sover.net
Call 802-371-7764
www.savevermonthealhcare.org

NOTE: The Davis Center is on Main Street but its entrance faces into the campus.

Ideas for signs:

The Marginalized Majority Wants Single Payer

Yes we can! Support single payer bills H100/S88 (Vermont) and HR 676 (US Congress)

Single payer = $billions in savings and health care for all

Private insurance = high costs and millions uninsured

Health care is a public good — support single payer

Health care is a public good, not a commodity

Take the profit out of health care — support single payer

Single payer-the Most Fiscally Conservative Plan

We are NOT # 1 but could be with Medicare for All

You want to help the middle class? Pass single payer

You want to help business? Pass single payer

You want to help the economy ? Pass single payer

Obama says single payer is the best option

It is our money . We want it to pay for health care not health insurance

We can afford health care for all, not health insurance for all

Doctors want single payer

Nurses want single payer

Americans want single payer

PR: Single-payer health reform supporters to rally at March 12 White House-sponsored forum in Dearborn, Mich.

Physicians and 'Medicare for All' reform advocates decry outsized role of corporate interests at regional meeting on health reform

MEDIA ADVISORY
March 10, 2009

Contacts:
Johnathon Ross, M.D., PNHP
Bob Sisler, LMSW, chairman of Local 6000 UAW Retirees S.E. chapter
Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org

What
Press conference and rally to express support for single-payer health reform and to protest the “marginalization of majority opinion” at Thursday’s White House Forum on Health Care Reform at the Ford Conference Center in Dearborn, Mich., at 1 p.m. EDT, and at other presidential health forums.

Spokespersons for Physicians for a National Health Program (PNHP) and other advocates of single-payer national health insurance, sometimes called an improved Medicare for All, will decry the outsized role of the private health insurance industry, Big Pharma, and other representatives of corporate medicine at the White House-sponsored forum, one of five that are being across the country. Rally organizers charge the guest list is heavily laden with for-profit interests who care more about safeguarding their profits than delivering health care.

While acknowledging that a very small number of single-payer supporters have been invited to the forum, physicians wearing their white coats and other health reform advocates will assert that national health insurance is being accorded a minor, marginalized role at the forum, even though surveys show two-thirds of Americans and 59 percent of U.S. physicians support it. They will also present forum conveners with letters signed by members of Detroit-area churches in support of H.R. 676, the U.S. National Health Care Act, a single-payer bill sponsored by Rep. John Conyers Jr. (D-Mich.).

Rally participants will demand that the single-payer model be “on the table” as a full-fledged option and given pride of place, given its proven effectiveness in providing universal, comprehensive care; its ability to contain costs; and the fact that its annual savings in administrative costs — $400 billion — will mean that it will require no increase in health spending.

Who
Johnathon Ross, M.D., an internist at St. Vincent Mercy Medical Center, a 500-bed teaching hospital in Toledo, Ohio, who has many patients in Michigan. He is also an associate professor of medicine at the University of Toledo, and a past president of Physicians for a National Health Program, a national organization of 15,000 doctors who support single-payer national health insurance.

James Mitchiner, M.D., emergency physician and St. Joseph Mercy Hospital in Ann Arbor and immediate past president Washtenaw County Medical Society.

Representatives of labor and faith communities.

When
1 p.m. EDT, Thurs., March 12

Where
Ford Conference Center, 1151 Village Rd., Dearborn, Mich., immediately outside main entrance.

Nurse’s insurance nightmare makes her a single-payer advocate

By Michael Vitez
Philadelphia Inquirer
Sat, Mar. 7, 2009

Marilyn Cawthon has been a nurse for 30 years. “All my life I provided health care to people,” she said recently. “I thought when I needed it, it would be there and wouldn’t drive me broke or crazy.”

It nearly did both.

Cawthon got the heart care she needed, but insurance refused to pay – and she was billed $24,000.

Now an intensive care nurse at Lower Bucks Hospital in Bristol Township, Cawthon, 57, ultimately got her insurer to pay – four years later.

Her experience turned her into a foot soldier in the fight to bring single-payer universal health care to the United States.

She will be handing out literature today when U.S. Rep. John Conyers (D., Mich.), sponsor of H.R. 676, a bill to create a single-payer system, holds a town-hall meeting at 10:30 a.m. at Thomas Jefferson University, 11th and Locust Streets.

Conyers will be at the University of Pennsylvania Newman Center, 3720 Chestnut St., at 1 p.m. for a second town meeting.

“Trying to talk to insurance companies, sending certified letters, calling on the phone, talking to people who said they’d take care of this only to have them never take care of this,” Cawthon explained, “I felt like I was in a maze.”

“When people are sick,” she added, “the last thing they should be worrying about is money. They should be worrying about getting better. The way it is now . . . people are worried about how they are going to pay for it. And that shouldn’t be.”

Single payer is a dramatic change favored by millions of Americans and thousands of health-care professionals, but not supported by President Obama. He is determined to bring about health-care reform this year, but says the United States isn’t ready for that option.

Under a single-payer plan, Americans would contribute to a health-care trust fund through a variety of means, such as a payroll tax, and this fund would pay doctors, hospitals and nursing homes for care. Patients could still choose doctors. There would be no need for insurers.

“The president said, if we were starting from scratch, that would be an excellent way to go,” said Melody Barnes, head of Obama’s Domestic Policy Council, “but at this point, we have to build on our current employment-based system to move forward.”

Obama said Thursday, “I think most of us would agree that if we want to cover all Americans, we can’t make the mistake of trying to fix what isn’t broken. So if somebody has insurance they like, they should be able to keep that insurance.”

Opponents of the single-payer plan say it will result in longer waits to get into hospitals and to see specialists. Since health care will appear to be free, they say, demand will rise, and the government will ration care to control costs, leading to a chronic shortage of physicians.

Cawthon is undaunted. Understanding what she went through might explain why.

Roll back to 2000. Cawthon was a single mother, divorced, supporting two children.

She was suffering from shortness of breath. Her father died of a heart attack at 45, so she knew not to mess around. She went for a stress test in September. Positive.

That day, she quit smoking.

She needed a cardio-catheterization – doctors would go in and check the arteries and valves of her heart, looking for blockages. She scheduled the test for January 2001. She didn’t want to have it before then, because her older daughter was expecting a baby.

In December, a month before the procedure, Cawthon left her job in home health with Jefferson, where she had Personal Choice insurance coverage.

In her new job as a contract nurse, she wouldn’t have insurance. So she thought about keeping her coverage through Jefferson for 18 months, as allowed by the federal COBRA law. She would just pay the premiums out of pocket, rather than having Jefferson pay.

But on Dec. 18, Cawthon called Blue Cross and asked about an individual plan.

About 170 million Americans get group insurance through their jobs. About 17 million buy insurance through individual plans on the open market.

In Pennsylvania, if a person is healthy, individual plans can be cheaper than paying to continue coverage under a group plan through COBRA.

As a single mother, Cawthon was always looking for ways to economize, she said. She signed up.

She wanted to make sure that if she switched plans, she’d still be covered for her surgery.

A letter from Independence arrived Jan. 2, the day before her procedure.

“The requested service has been approved.”

Another paragraph began:

“This letter is not a determination of eligibility or a guarantee of payment.”

Did these mean opposite things? She was confused.

She went ahead the next day and the procedure went well. Her doctor found a clogged artery, did angioplasty to unblock it, put in a stent. She is grateful and thinks this prevented a heart attack.

On Jan. 22, three weeks later, Cawthon received a one-page form letter from Temple University Hospital. It read:

“We have been notified by Blue Cross that your claim for benefits has been DENIED. The reason for this denial is: claim was denied for pre-xcondition. This bill, in the amount of $24,471.82, is now your responsibility.”

Cawthon lit a cigarette.

Here is what happened:

When an American is covered in a group plan through an employer, the insurer cannot deny coverage because of a preexisting condition.

But when a person seeks an individual plan, in Pennsylvania and 43 other states, coverage can be denied for a preexisting condition.

One trigger allowing an insurer to deny coverage is a lack of insurance in the previous two years.

Before Cawthon worked at Jefferson, she’d gone through February, March and April of 2000 without insurance. That allowed Independence to look at her medical history, see she had a heart ailment, and deny her coverage.

Hence, the $24,000 bill.

The confusing letter she received the day before her procedure confirmed that she needed help, but also said coverage couldn’t be guaranteed. Cawthon said she didn’t understand.

It gets more complicated.

The law gave Cawthon 63 days after she left Jefferson to get covered under COBRA.

Temple sent Cawthon the bill. But she didn’t get an official denial from the insurer for nine months – too late to go back and get the surgery covered under COBRA. She was stuck with a $24,000 bill she said she couldn’t pay.

The debt ruined her credit rating. The interest rate of her car loan was 16 percent.

On Nov. 20, 2004, she read a newspaper story about G. Fred DiBona, president and chief executive officer of Independence, and his fight with cancer and determination to live.

Cawthon wrote him that night. She hoped he would beat the cancer. She also told him, “I counted on your insurance company to help me out, and it’s been a nightmare.”

A letter came back, signed by Fred DiBona. He said he’d look into it. He died soon after. But he had been good to his word.

On Jan 19, 2005, a letter came from the insurer: “A decision has been made to … have the claim reprocessed for payment. . . . This . . . is a one-time exception.”

Marilyn cried that day.

She interprets the letter as: “In honor of Fred, we’re going to give you a break.”

Elizabeth Williams, an Independence spokeswoman, said that wasn’t the reason. The denial “was accurate,” Williams said, “but the period between when she had the surgery and October, when she got that letter, that’s an unnecessary delay.”

All this led Cawthon to support a single-payer plan, she said, to hand out literature today. Every day, she helps save lives. Only now, she often wonders, “Are these patients going to go through the same thing I went through?”

“The whole thing is about quality of life,” she said. “You don’t want to give patients another heart attack when you start pummeling them with bills.”

http://www.philly.com/philly/hp/news_update/20090307_Nurse_s_insurance_nightmare_makes_her_a_single-payer_advocate.html

AHIP's phony epiphany

Insurers’ commitment to healthcare reform is only skin-deep

The industry claims to have had a change of heart, but its position hasn’t changed at all.

By Michael Hiltzik
Los Angeles Times
March 9, 2009
In December, the industry’s trade group, AHIP (for America’s Health Insurance Plans) revealed that it had experienced an epiphany and decided for the first time to support the principle of universal healthcare — insuring everyone in America, regardless of health condition.
It described its change of heart as the product of three years of sedulous soul-searching by AHIP’s board of directors, who claimed to have “traveled the country and engaged in conversations about healthcare reform with people from all walks of life.”
As a connoisseur of health insurance lobbying practices, however, I withheld judgment until I could scan the fine print. What I found by reading AHIP’s 16-page policy brochure was that its position hadn’t changed at all. Its version of “reform” comprises the same wish list that the industry has been pushing for decades.
Briefly, the industry wants the government to assume the cost of treating the sickest, and therefore most expensive, Americans. It wants the government to clamp down hard on doctors’ and hospitals’ fees. And it wants permission to offer stripped-down, low-benefit policies freed from pesky state regulations limiting their premiums.
… AHIP Chief Executive Karen Ignagni (told) the Obama summit: “You have our commitment to play, to contribute and to help pass healthcare reform this year.”
Ignagni can afford to be gracious because no specific reform plan is yet on the table. But veterans of the last reform battle warn that the moment concrete proposals appear, the insurance industry will deploy in force to kill anything that threatens its profitability and freedom of movement, such as an expansion of public insurance programs or tighter federal regulations.
Veterans of earlier healthcare battles justly wonder if the industry is merely trying to get in front of the parade, the better to lead it into a dead end.
“It might be that they think reform is inevitable,” says (Jonathan Oberlander, a healthcare reform expert at the University of North Carolina), observing that the industry made very similar noises at the outset of the Clinton effort, before the slaughter started. “I’d say buyer beware. We’ve been there before with them.”
http://www.latimes.com/business/la-fi-hiltzik9-2009mar09,0,4220704.column

And…

In Divide Over Health Care Overhaul, 2 Major Unions Withdraw From a Coalition

By Robert Pear
The New York Times
March 6, 2009
Two labor unions have pulled out of a broad coalition seeking agreement on major changes in the health care system. The action, by the American Federation of State, County and Municipal Employees and the Service Employees International Union, shows the seeds of discord behind the optimistic talk at a White House conference on health care this week.
The most active participants in the coalition include Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group, and Billy Tauzin, president of the Pharmaceutical Research and Manufacturers of America, which represents drug companies.
http://www.nytimes.com/2009/03/07/us/politics/07health.html?ref=washington

In December, when America’s Health Insurance Plans (AHIP) released their new report indicating that they were fully committed to reform that would cover everyone, I responded in a Quote of the Day (12/4/08) with the following: “You could not possibly describe a proposal that would better serve the interests of the private insurance industry. They would create a standard of underinsurance, require all of us to purchase their products, and pretend to address affordability issues through tax credits.”
Michael Hiltzik has provided for us a great service by actually reading AHIP’s report – carefully. He confirmed that this industry, which has been so destructive to health care reform efforts in the past, hadn’t changed its position at all.
Yet Washington has rolled out the red carpet for Karen Ignagni, AHIP’s president. She appears at almost every forum on reform and is presented with the microphone with some fanfare, even if she was not scheduled in the agenda. The intensity of the efforts to keep the private insurance industry in control of the process might best be exemplified by President Obama’s Health Care Summit. In closing remarks, President Obama handed the microphone off to Karen Ignagni so that she could express for the national audience AHIP’s phony epiphany.
Robert Pear’s report on the split in a major coalition on reform exposes the sharp contrast between AHIP’s sick-sweet public rhetoric on cooperation, and its back-stabbing, cut-throat, behind-the-scenes negotiations on the specifics of reform.
AFSCME and SEIU, the two unions that pulled out of the negotiations, serve as a proxy that represents the only special interest that really matters – the patients. After half a year of intensive negotiations with AHIP, PhRMA, the United States Chamber of Commerce, and others, it was clear that the insurance industry would not compromise its business interests for the benefit of patients. AFSCME and SEIU had to walk out.
The coalition plans to issue recommendations later this month in a report that reflects “the lowest common denominator,” undoubtedly more sick-sweet rhetoric crafted by AHIP.
(Theoretically the consumers were represented by Ronald Pollack of Families USA, but he has lost all credibility because of his years of insistence that we follow a strange-bedfellows strategy – a process which tragically has only perpetuated health reform inertia. Jonathan Oberlander cautions that “we’ve been there before with them,” but Ronald Pollack’s learning curve is flat. )
Michael Hiltzik is to be praised for his leadership. We can only hope that other influential members of the media follow his example. All they need to do is carefully read AHIP’s own report on its change of heart, and see what it really says. (Hint: I couldn’t find a heart anywhere in the report.)
AHIP’s phony epiphany:
http://www.americanhealthsolution.org/assets/Uploads/healthcarereformproposal.pdf

AHIP's phony epiphany

Insurers' commitment to healthcare reform is only skin-deep

The industry claims to have had a change of heart, but its position hasn’t changed at all.

By Michael Hiltzik
Los Angeles Times
March 9, 2009

In December, the industry’s trade group, AHIP (for America’s Health Insurance Plans) revealed that it had experienced an epiphany and decided for the first time to support the principle of universal healthcare — insuring everyone in America, regardless of health condition.

It described its change of heart as the product of three years of sedulous soul-searching by AHIP’s board of directors, who claimed to have “traveled the country and engaged in conversations about healthcare reform with people from all walks of life.”

As a connoisseur of health insurance lobbying practices, however, I withheld judgment until I could scan the fine print. What I found by reading AHIP’s 16-page policy brochure was that its position hadn’t changed at all. Its version of “reform” comprises the same wish list that the industry has been pushing for decades.

Briefly, the industry wants the government to assume the cost of treating the sickest, and therefore most expensive, Americans. It wants the government to clamp down hard on doctors’ and hospitals’ fees. And it wants permission to offer stripped-down, low-benefit policies freed from pesky state regulations limiting their premiums.

… AHIP Chief Executive Karen Ignagni (told) the Obama summit: “You have our commitment to play, to contribute and to help pass healthcare reform this year.”

Ignagni can afford to be gracious because no specific reform plan is yet on the table. But veterans of the last reform battle warn that the moment concrete proposals appear, the insurance industry will deploy in force to kill anything that threatens its profitability and freedom of movement, such as an expansion of public insurance programs or tighter federal regulations.

Veterans of earlier healthcare battles justly wonder if the industry is merely trying to get in front of the parade, the better to lead it into a dead end.

“It might be that they think reform is inevitable,” says (Jonathan Oberlander, a healthcare reform expert at the University of North Carolina), observing that the industry made very similar noises at the outset of the Clinton effort, before the slaughter started. “I’d say buyer beware. We’ve been there before with them.”

http://www.latimes.com/business/la-fi-hiltzik9-2009mar09,0,4220704.column

And…

In Divide Over Health Care Overhaul, 2 Major Unions Withdraw From a Coalition

By Robert Pear
The New York Times
March 6, 2009

Two labor unions have pulled out of a broad coalition seeking agreement on major changes in the health care system. The action, by the American Federation of State, County and Municipal Employees and the Service Employees International Union, shows the seeds of discord behind the optimistic talk at a White House conference on health care this week.

The most active participants in the coalition include Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group, and Billy Tauzin, president of the Pharmaceutical Research and Manufacturers of America, which represents drug companies.

http://www.nytimes.com/2009/03/07/us/politics/07health.html?ref=washington

Comment:

By Don McCanne, MD

In December, when America’s Health Insurance Plans (AHIP) released their new report indicating that they were fully committed to reform that would cover everyone, I responded in a Quote of the Day (12/4/08) with the following: “You could not possibly describe a proposal that would better serve the interests of the private insurance industry. They would create a standard of underinsurance, require all of us to purchase their products, and pretend to address affordability issues through tax credits.”

Michael Hiltzik has provided for us a great service by actually reading AHIP’s report – carefully. He confirmed that this industry, which has been so destructive to health care reform efforts in the past, hadn’t changed its position at all.

Yet Washington has rolled out the red carpet for Karen Ignagni, AHIP’s president. She appears at almost every forum on reform and is presented with the microphone with some fanfare, even if she was not scheduled in the agenda. The intensity of the efforts to keep the private insurance industry in control of the process might best be exemplified by President Obama’s Health Care Summit. In closing remarks, President Obama handed the microphone off to Karen Ignagni so that she could express for the national audience AHIP’s phony epiphany.

Robert Pear’s report on the split in a major coalition on reform exposes the sharp contrast between AHIP’s sick-sweet public rhetoric on cooperation, and its back-stabbing, cut-throat, behind-the-scenes negotiations on the specifics of reform.

AFSCME and SEIU, the two unions that pulled out of the negotiations, serve as a proxy that represents the only special interest that really matters – the patients. After half a year of intensive negotiations with AHIP, PhRMA, the United States Chamber of Commerce, and others, it was clear that the insurance industry would not compromise its business interests for the benefit of patients. AFSCME and SEIU had to walk out.

The coalition plans to issue recommendations later this month in a report that reflects “the lowest common denominator,” undoubtedly more sick-sweet rhetoric crafted by AHIP.

(Theoretically the consumers were represented by Ronald Pollack of Families USA, but he has lost all credibility because of his years of insistence that we follow a strange-bedfellows strategy – a process which tragically has only perpetuated health reform inertia. Jonathan Oberlander cautions that “we’ve been there before with them,” but Ronald Pollack’s learning curve is flat. )

Michael Hiltzik is to be praised for his leadership. We can only hope that other influential members of the media follow his example. All they need to do is carefully read AHIP’s own report on its change of heart, and see what it really says. (Hint: I couldn’t find a heart anywhere in the report.)

AHIP’s phony epiphany:
http://www.americanhealthsolution.org/assets/Uploads/healthcarereformproposal.pdf

Portsmouth doctor: Obama hears my views on health care reform

By Michael Mccord
Portsmouth Herald
March 6, 2009

PORTSMOUTH — Though he didn’t attend President Barack Obama’s health care forum in Washington on Thursday, Dr. Thomas Clairmont felt that he was heard — after fearing the health care reform proposal he supports would not be part of the discussion.

Clairmont, a Portsmouth primary care physician, contacted the Herald Tuesday and said he was concerned that the Obama administration would brush aside a government-managed, single-payer health care plan advocated by Clairmont and 15,000 other doctors and medical professionals through the Physicians for a National Health Program organization.


Dr. Thomas P. Clairmont, a Portsmouth primary
care physician, said, “I can explain our proposal
in 10 seconds. It will cost 4.5 percent in taxes
and there will be no premiums, no pre-existing
condition restriction and no tying health care to
employment.” Don Clark photo

But on Wednesday, the White House extended invitations to Rep. John Conyers, D-Mich., the most prominent sponsor of single-payer health care legislation in Congress, and Dr. Oliver Fein, PNHP president, to speak and make a single-payer presentation.

Clairmont believes the White House reacted correctly to the volume of letters, e-mails, blog posts and media coverage about the lack of single-payer representation at the White House Forum on Health Reform, which included members of Congress, medical professionals, hospital executives, health insurance and drug company representatives, and lobbyists from dozens of other business and consumer organizations.

“What we want is a fair hearing,” said Clairmont, who led a December health care forum in Portsmouth, one of 4,000 such forums held nationwide which sent findings to the Obama transition team. He said the Portsmouth gathering and many more across the country showed strong support for a single-payer solution to the health care crisis.

Clairmont said that single-payer is the best approach to deal with a health care system that, according to the Centers for Medicare and Medicaid Services, in 2009 will cost the country $2.5 trillion, or about 15.5 percent of the country’s gross domestic product. Health care spending per person is estimated at $8,100 per person — while more than 47 million Americans have no health insurance.

“I can explain our proposal in 10 seconds,” Clairmont said. “It will cost 4.5 percent in taxes and there will be no premiums, no pre-existing condition restriction and no tying health care to employment. Because we eliminate health insurance companies, we can save $360 billion a year in administrative costs. Why are our premiums paying for the bonuses of health insurance industry executives?”

Clairmont said that politics and ideology need to step aside to allow for a serious debate. “We should be able to do side by side comparisons to see what’s best for the country,” he said.

In his opening remarks at the summit, Obama said that health care reform can no longer be delayed because it has become a drag on the entire economy as health care premiums continue to rise for businesses and their employees.

“In this effort, every voice must be heard. Every idea must be considered. Every option must be on the table. There will be no sacred cows in this discussion,” Obama said. “Each of us must accept that none of us will get everything we want, and no proposal for reform will be perfect.”

Sen. Jeanne Shaheen, D-N.H., attended the forum and said that many ideas will come into play as the health care reform effort moves from the White House to lawmakers in Congress.

“I did meet last week in New Hampshire with supporters of the single-payer system,” Shaheen said during a conference call with reporters Thursday. “They have a very interesting proposal, and it will certainly be looked at. I think everything is going to be on the table.”

Rep. Chellie Pingree, D-Maine, is a co-sponsor of Conyers’ single-payer legislation, but one of Pingree’s ultimate goals, said spokesman Willy Ritch, “is to see the sort of reform that will lower the cost of health care for those who are already insured, improves the overall quality of care and provides guaranteed access for every family.”

A Canadian Comments on Experiences with Single Payer System in Canada

Posted By Chris Dinn
March 5, 2009

http://prospect.org/csnc/blogs/ezraklein_archive?month=03&year=2009&base_name=let_single_payer_free

As a Canadian who watched and helped his sister go through 5 years of elite treatment medical treatment for a rare brain tumor, I consider myself experienced with the single-payer approach and I have generally great things to say about it.

First things first, and this is a hugely important factor, Canada’s health care system is PROVINCIALLY RUN. That is to say, constitutionally, it’s not the purview of the federal government, it’s the explicit responsibility of the provinces. Over the years, various federal governments have issued transfers to the provinces explicitly for health care, but the responsibility for delivery remains with the provinces.

Additionally, as Ezra noted once upon a time in a review of international health care systems, the providers in a single payer system are private. This is an important distinction. Doctors in Canada are small business-people competing for customers. Canadians choose which doctor to visit and the doctor with the most visits gets better reimbursement from the province.

Get that? That’s provinces competing to do the best job on health care management (keeping costs down) with doctors and hospitals competing to get the most visitors, to keep business booming and government reimbursements coming.

The upside of this is that it promotes competition for efficiency of delivery. In fact, Canada’s entire system evolved that way, beginning as a Saskatewan program pioneered by Tommy Douglas.

Now, before you write off the single payer system (I’m looking at you wisewon), keep in mind that not only did Canadians recently vote Tommy Douglas the greatest Canadian in a recent CBC reality show (http://www.cbc.ca/greatest/), but he’s also Keifer Sutherland’s grandfather (no lie).

We should be honest about the downsides of a single-payer system. Despite the sundry downsides you may here from US commentators, criticisms in Canada come from mainly two areas.

First is equal access. In Canada it doesn’t really matter how rich you are or how much money you have to throw at your medical problems, you get treated in the same line as the poor farmer, the homeless guy and the suburban middle-class family who need the same treatment. To you, maybe, this is a bug. To me, it’s a feature. The idea that in Canada we treat our poor in the same order we treat the rich seems an impressive display of equality when it matters the most.

The second is for wait times. This is not a material concern to this discussion. If you want to know why read http://www.prospect.org/cs/articles?article=the_health_of_nations.

While there are some exceptions to these rules, such as Canada’s rare and controversial private clinics, the system generally works as advertised.

As an example, in 1996, when she was 10 years old my sister was diagnosed (in Newfoundland) with a rare brain tumor. She was treated in Newfoundland, but when a better treatment became available in Toronto the provincial government sent her to Toronto for the care and covered its cost. Had a better program existed in an American children’s hospital, she could’ve been treated there.

My family was middle class for our rural community, but would hardly qualify as rich. My parents had a combined income of under $100,000 yearly, but my sister received three rounds of neurosurgery, three rounds of chemotherapy and a three-weeks-in-isolation bone marrow transplant. All without my parents paying out of pocket for anything.

In the US people go bankrupt in situations like this. In Canada, they live through it. My parents are now happily in retirement and relatively well financed.

Meanwhile an exgirlfriend of mine from Wisconsin needed her wisdom teeth out. Her plan was to go get the treatment and stiff the hospital on the bill. She said future creditors would understand, since medical bills are often skipped out on.

I’m not an American, and I don’t know how typical or a-typical that is, but it definitely happened.

Are you still telling me the Canadian approach is completely the wrong solution? I’m sorry, but I just can’t take Americans with a straight face on that point.

AHIP’s phony epiphany

Insurers’ commitment to healthcare reform is only skin-deep

The industry claims to have had a change of heart, but its position hasn’t changed at all.

By Michael Hiltzik
Los Angeles Times
March 9, 2009

In December, the industry’s trade group, AHIP (for America’s Health Insurance Plans) revealed that it had experienced an epiphany and decided for the first time to support the principle of universal healthcare — insuring everyone in America, regardless of health condition.

It described its change of heart as the product of three years of sedulous soul-searching by AHIP’s board of directors, who claimed to have “traveled the country and engaged in conversations about healthcare reform with people from all walks of life.”

As a connoisseur of health insurance lobbying practices, however, I withheld judgment until I could scan the fine print. What I found by reading AHIP’s 16-page policy brochure was that its position hadn’t changed at all. Its version of “reform” comprises the same wish list that the industry has been pushing for decades.

Briefly, the industry wants the government to assume the cost of treating the sickest, and therefore most expensive, Americans. It wants the government to clamp down hard on doctors’ and hospitals’ fees. And it wants permission to offer stripped-down, low-benefit policies freed from pesky state regulations limiting their premiums.

… AHIP Chief Executive Karen Ignagni (told) the Obama summit: “You have our commitment to play, to contribute and to help pass healthcare reform this year.”

Ignagni can afford to be gracious because no specific reform plan is yet on the table. But veterans of the last reform battle warn that the moment concrete proposals appear, the insurance industry will deploy in force to kill anything that threatens its profitability and freedom of movement, such as an expansion of public insurance programs or tighter federal regulations.

Veterans of earlier healthcare battles justly wonder if the industry is merely trying to get in front of the parade, the better to lead it into a dead end.

“It might be that they think reform is inevitable,” says (Jonathan Oberlander, a healthcare reform expert at the University of North Carolina), observing that the industry made very similar noises at the outset of the Clinton effort, before the slaughter started. “I’d say buyer beware. We’ve been there before with them.”

http://www.latimes.com/business/la-fi-hiltzik9-2009mar09,0,4220704.column

And…

In Divide Over Health Care Overhaul, 2 Major Unions Withdraw From a Coalition

By Robert Pear
The New York Times
March 6, 2009

Two labor unions have pulled out of a broad coalition seeking agreement on major changes in the health care system. The action, by the American Federation of State, County and Municipal Employees and the Service Employees International Union, shows the seeds of discord behind the optimistic talk at a White House conference on health care this week.

The most active participants in the coalition include Karen M. Ignagni, president of America’s Health Insurance Plans, a trade group, and Billy Tauzin, president of the Pharmaceutical Research and Manufacturers of America, which represents drug companies.

http://www.nytimes.com/2009/03/07/us/politics/07health.html?ref=washington

Comment:

By Don McCanne, MD

In December, when America’s Health Insurance Plans (AHIP) released their new report indicating that they were fully committed to reform that would cover everyone, I responded in a Quote of the Day (12/4/08) with the following: “You could not possibly describe a proposal that would better serve the interests of the private insurance industry. They would create a standard of underinsurance, require all of us to purchase their products, and pretend to address affordability issues through tax credits.”

Michael Hiltzik has provided for us a great service by actually reading AHIP’s report – carefully. He confirmed that this industry, which has been so destructive to health care reform efforts in the past, hadn’t changed its position at all.

Yet Washington has rolled out the red carpet for Karen Ignagni, AHIP’s president. She appears at almost every forum on reform and is presented with the microphone with some fanfare, even if she was not scheduled in the agenda. The intensity of the efforts to keep the private insurance industry in control of the process might best be exemplified by President Obama’s Health Care Summit. In closing remarks, President Obama handed the microphone off to Karen Ignagni so that she could express for the national audience AHIP’s phony epiphany.

Robert Pear’s report on the split in a major coalition on reform exposes the sharp contrast between AHIP’s sick-sweet public rhetoric on cooperation, and its back-stabbing, cut-throat, behind-the-scenes negotiations on the specifics of reform.

AFSCME and SEIU, the two unions that pulled out of the negotiations, serve as a proxy that represents the only special interest that really matters – the patients. After half a year of intensive negotiations with AHIP, PhRMA, the United States Chamber of Commerce, and others, it was clear that the insurance industry would not compromise its business interests for the benefit of patients. AFSCME and SEIU had to walk out.

The coalition plans to issue recommendations later this month in a report that reflects “the lowest common denominator,” undoubtedly more sick-sweet rhetoric crafted by AHIP.

(Theoretically the consumers were represented by Ronald Pollack of Families USA, but he has lost all credibility because of his years of insistence that we follow a strange-bedfellows strategy – a process which tragically has only perpetuated health reform inertia. Jonathan Oberlander cautions that “we’ve been there before with them,” but Ronald Pollack’s learning curve is flat. )

Michael Hiltzik is to be praised for his leadership. We can only hope that other influential members of the media follow his example. All they need to do is carefully read AHIP’s own report on its change of heart, and see what it really says. (Hint: I couldn’t find a heart anywhere in the report.)

AHIP’s phony epiphany:
http://www.americanhealthsolution.org/assets/Uploads/healthcarereformproposal.pdf

A Victory For Single Payer?

Having initially excluded all advocates for single payer national healthcare from the White House Summit on Healthcare Reform, and after protest from activists, the Obama administration reconsidered and invited Rep John Conyers, author of HR 676 the single payer bill pending in Congress, and also a representative of Physicians for a National Health Care Program, to the summit attended by over 120 people Thursday.

Dr. Quentin Young, the founder and National Coordinator of Physicians for a National Health Program, explores Obama’s views on single payer and the battle for healthcare reform.

Report of Health Care Community Discussions

Report of Health Care Community Discussions

HealthReform.gov
March 5, 2009
In December 2008, the Presidential Transition Team invited Americans to host and participate in Health Care Community Discussions to talk about how to reform health care in America.
IV. Solutions to the Problems in the U.S. Health Care System
B. Roles in a Reformed U.S. Health Care System
Role of Government v. Market
The real debate was over the balance of government versus the market in insuring Americans. Supporters of a single-payer system submitted numerous reports, in part due to the encouragement by advocacy groups to participate in Health Care Community Discussions. Under most versions of a single-payer system, the government would replace private insurers in organizing, financing, and paying for health care. Its specifics, and arguments for and against it, are described below (see Single-Payer System box).
http://www.healthreform.gov/reports/index.html

That’s it. In this long report, this is the paragraph that expresses the ubiquitous single payer presence at these meetings. (The single payer box mentioned was not posted on this web version of the report.)
For those who were expecting a Quote of the Day on today’s White House Health Care Reform Summit, here is the the full discussion of single payer:

Report of Health Care Community Discussions

Report of Health Care Community Discussions

HealthReform.gov
March 5, 2009

In December 2008, the Presidential Transition Team invited Americans to host and participate in Health Care Community Discussions to talk about how to reform health care in America.

IV. Solutions to the Problems in the U.S. Health Care System

B. Roles in a Reformed U.S. Health Care System

Role of Government v. Market

The real debate was over the balance of government versus the market in insuring Americans. Supporters of a single-payer system submitted numerous reports, in part due to the encouragement by advocacy groups to participate in Health Care Community Discussions. Under most versions of a single-payer system, the government would replace private insurers in organizing, financing, and paying for health care. Its specifics, and arguments for and against it, are described below (see Single-Payer System box).

http://www.healthreform.gov/reports/index.html

Comment:

By Don McCanne, MD

That’s it. In this long report, this is the paragraph that expresses the ubiquitous single payer presence at these meetings. (The single payer box mentioned was not posted on this web version of the report.)

For those who were expecting a Quote of the Day on today’s White House Health Care Reform Summit, here is the the full discussion of single payer:

Single-payer isn't socialism

Letter to the Editor
Seattle Post-Intelligencer
February 27, 2008

As a long-time Seattle physician, I was pleased that the P-I supports health care reform toward a single-payer system (Opinion, Wednesday). Most Americans now fully understand that our health care delivery system is too expensive, too complex, too fragmented and overwhelmingly frustrating. Although some still believe that America has the best health care in the world, the truth is that our reimbursement system is killing us. The “health” of a country’s healthcare system can be inferred by looking at how we treat our most precious citizens: our children. International ranking of infant mortality by our own CIA now places the United States at 42 out of 222 countries, behind Hong Kong, Portugal, Korea, Macau, most of Europe and Cuba! In 1989, the United States was ranked at 19th. To allow this decline to continue is a moral outrage.

Many fear that a single-payer model is “Socialized Medicine.” In fact, a single simplified health care finance system is good for business. Our employment-linked health insurance system may have worked fine during the Cold War era, but today it is crippling American business. Businesses leaders and labor unions understand that shifting to a government-sponsored single-payer system isn’t a form of socialism. It is a more cost-effective, fair and universal system that can help restore our ability to compete in today’s international market place. This will preserve American business and American jobs.

Lastly, some fear universal healthcare would lead to rationing of benefits. But rationing is already being done by our insurance industry disguised under the euphemism of “medical necessity” or “covered service.” I am outraged when my patients tell me they can not get the medication or treatment they need because their insurance company will not cover it and they can not afford to pay out of pocket. It is time for our leaders to put aside fear and radically transform our healthcare finance system toward a single-payer system for our children and our future. It is economically and morally the healthy step to take.

B. Jason MacLurg, M.D.
Seattle, WA