Jennifer Jacobs
Des Moines Register Staff Writer
December 10, 2007

A fact check is in order on a comment about medical bankruptcies that Bill Clinton and other leading Democrats keep making, two dueling experts say.

“Over half of all the bankruptcies in this decade can be tied to personal health emergencies,” the former president said Monday at a Hillary Clinton campaign rally in Ames.

And he’s said it before while stumping for his wife’s health care reform plan, which would require all Americans to carry health insurance either through the government or a private insurer.

“He’s wrong,” said Michael Millenson, a visiting scholar at Northwestern University’s Kellogg School of Management. “Well, it’s not that Bill Clinton is wrong, it’s that he’s quoting a piece of research which is wrong.”

Clinton’s reference was to a Harvard University study of medical bankruptcy that is widely quoted, including by Democratic presidential candidates John Edwards and Barack Obama.

Harvard professors David Himmelstein and Elizabeth Warren interviewed more than 1,700 families that were in bankruptcy courts across the country. About half of all families filing for bankruptcy did so in the aftermath of a serious medical problem, according to the findings, released in 2005.

But that figure was disputed by Millenson and Northwestern University professor David Dranove, who re-examined the study at the behest of the insurance industry. They said medical bills were a contributing factor in just 17 percent of the bankruptcies. And the Harvard researchers didn’t rule out other factors, such as job loss, college loans or housing costs, they found.

“Using their numbers is both factually inaccurate and politically unfortunate,” Millenson, an Obama supporter and volunteer, said in an interview Monday. “President Clinton and Hillary Clinton have a wonderful track record for trying to cover the uninsured. But when you go beyond the facts allowed, you give ammunition to those who are trying to minimize the problem of the uninsured.”

Hillary Clinton’s Iowa spokesman, Mo Elleithee, pointed out that the Clinton, Obama and Edwards campaigns have all cited this fact, and that it came from “a well-respected Harvard study.”

“I find it hard to believe that anyone would quarrel with the fact that skyrocketing health care costs have caused financial hardship for many American families,” Elleithee said. “That’s why Hillary Clinton has a plan to reduce health care costs while increasing both quality and access to all Americans.”

Himmelstein, reached by phone Monday at Harvard, said the study is accurate. The Northwestern academics misrepresented and manipulated the data, he said.

“President Clinton is correct,” Himmelstein said. “But he’s wrong in saying his wife’s plan would do something about it.”

Himmelstein is a passionate advocate for a system where the government insures everyone.

“I think Clinton’s plan is just an absolute fraud, and so is Edwards’ and Obama’s,” he said.

The “Swiss cheese coverage” of private insurance would still leave some Americans saddled with enormous bills, and those who lose their jobs would be particularly vulnerable to medical bankruptcy, he said.

Skip the back-and-forth, and these academics agree on some points. About 46 million Americans have no health insurance. And for the 250 million with insurance, high co-payments, deductibles and exclusions from coverage can harm their finances.

But the number of bankruptcies due to medical bills is unknown, said Millenson, who described himself and Dranove as “militant political moderates.”

Dranove recently started a year-long study on the issue, this time with a grant from the Robert Wood Johnson Foundation.

Angus Reid Global Monitor
Polls & Research
December 11, 2007

(Angus Reid Global Monitor) – Adults in the United States are divided on the way their medical services should operate, according to a poll by YouGov/Polimetrix released by The Economist. 42 per cent of respondents would prefer a plan that replaces the current health care system with a “single-payer” program where all health care costs are paid by the government, while 41 per cent would choose a plan that maintains the current system where most health care costs are paid by individuals or employers.

If a national heath plan were adopted over the next few years, 19 per cent of respondents expect better care than they currently have, 26 per cent think it would be the same, and 32 per cent predict it will be worse.

When asked whether the U.S. government should guarantee health insurance for all citizens–even if it means raising taxes–48 per cent of respondents agree with the rationale, while 36 per cent disagree.

Health care in the U.S. is based on a system of benefits provided by employers, as well as the Medicare and Medicaid programs which allocate health insurance for the elderly, disabled and poor. Around 47 million Americans are uninsured.

Texas congressman Ron Paul, who is running for the Republican Party’s presidential nomination in 2008, decried the idea of a government-administered system on his website, writing, “The federal government will not suddenly become efficient managers if universal health care is instituted. Government health care only means long waiting periods, lack of choice, poor quality and frustration. Socialized medicine will not magically work here.”

Polling Data

Would you prefer a plan that replaces the current health care system with a “single-payer” program where all health care costs are paid by the government or a plan that maintains the current system where most health care costs are paid by individuals or employers?

42% Prefer to have government pay all costs

41% Prefer to have individuals and employers pay more costs

16% Not sure

If a national health care plan is adopted in the next few years, do you think you personally would receive better or worse care than you receive now?

19% Better with a national health care plan

36% About the same

32% Worse with a national health care plan

13% Not sure

Should the U.S. government guarantee health insurance for all citizens, even if it means raising taxes?

48% Yes

36% No

16% Not sure

Source: YouGov/Polimetrix / The Economist
Methodology: Online interviews with 1,000 American adults, conducted on Dec. 3 and Dec. 4, 2007. No margin of error was provided.

By Daniel Gallington
The Washington Times
December 9, 2007

Absent another large-scale terrorist attack on U.S. soil, health insurance could easily be the issue that determines the 2008 election.

The health insurance issue set — by its very nature and history — favors the Democrats, who have already started telling voters “what they are going to get” under various new national health insurance schemes. So far, almost all the Republicans have been able to say is that the Democrats propose faceless socialized medicine, a la Canada, the Britain and Europe — and that it’s way too expensive and will require massive tax increases.

However, the Democrats aren’t proposing that — they are proposing almost everyone be required to buy private health insurance (Hillary Clinton) and/or that people who can’t afford it, especially children, would get private health insurance free or at low cost (Barack Obama).

One thing is certain: Private insurance companies are licking their chops over national insurance ideas that would have billions of dollars paid to them — no matter who pays. Another key issue associated with such proposals is whether the American heath care “system” can provide health care for everyone, even if there is a way to pay for it.

We can hope the debates on national health insurance — and health care — will get more responsible and informative. But there’s no assurance of that, judging from the content and coverage of the discussions so far. To start, the public is way “underinformed” on the basics of any kind of insurance.

For example, insurance companies make their money in three ways, only one of which has much to do with insuring risks:

(1) They typically own and manage vast real estate holdings, billions and billions of dollars worth, so they are indirect partners in lots of other kinds of businesses and ventures.

(2) They have billions and billions of dollars that they invest in stocks, bonds and other kinds of investments. In fact, insurance companies have always been among the largest “institutional investors” on Wall Street.

(3) They employ armies of actuary scientists, risk managers, lawyers and other experts to reduce the amount of money they have to pay for losses they have insured people against. They even take out insurance to cover their own liability exposure for catastrophic losses — this is called “reinsurance” and is huge financial industry in its own right.

Surprising to most people, the regulatory “turf” for insurance was divided up in the 1940s with a little known law, called the “McCarran Act,” the most important part of which cedes insurance regulation to the individual states.

So, could the establishment of a comprehensive heath insurance system for all Americans require — of necessity — a federal legislative revamping of the entire regulatory basis for one of the largest U.S. financial operations?

Sure it could, and one can only imagine the intensity of the lobbying efforts to influence how that regulatory turf would be recast. It would make all past lobbying campaigns in Washington look like skirmishes — this as the various insurance special interests lined up to protect their interests.

Accordingly — for a universal health insurance “solution” — the insurance industry will have in mind the kind of sweetheart deal they got in the past: They manage the programs and get lots of money from the government to do it — like Medicare, Medicaid and the Medicare Drug Program.

Think about it — these programs have been financial booms to the health insurance industry, primarily because the government has assumed the long-term obligation to pay for the highest risk groups: People over age 65. Accordingly, for any new national health insurance program — insurance companies will insist the government pay for those (a) who can’t otherwise pay their premiums, and (b) those in higher-or chronic-risk categories.

While the insurance industry certainly won’t mind if the federal government makes huge cash payments into their business system, they will mind if the government actually takes over — or manages — the health insurance business. Therefore — even if it becomes the cheapest and most efficient way for any part of a new health insurance system to work (for younger people, for example) it is unlikely to happen.

For proof of this, one need only look at how the intensively lobbied Congress “resolved” the recent addition of drug coverage (Medicare “D”) to the Medicare program: They were simply bought off by the drug companies (to make sure the highest prices for drugs were paid) and the insurance companies (to make sure there was enough money in the Medicare/Medicaid system to pay the new claims). Bottom line? All Congress really did was throw money — our money — at the insurance companies, and they love it.

In sum, how will individual voters, taxpayers and health insurance consumers figure in the new universal health insurance debate? The short answer is that they won’t: Just as the most expensive and least efficient alternatives for our other forms of government-sponsored health insurance (e.g., Medicare, Medicaid and Medicare “D”) have prevailed in the past — they will likely prevail again.

Daniel Gallington is a senior fellow at the Potomac Institute for Policy Studies in Arlington, Va.

By BRAD WARTHEN
Editorial Page Editor
The State
Posted on Sun, Dec. 09, 2007

CAN ANYONE among those with a chance of becoming president say “single-payer?” If not, forget about serious reform of the way we pay for health care.

It doesn’t even necessarily have to be “single-payer.” Any other words will do, as long as the plan they describe is equally bold, practical, understandable, and goes as far in uprooting our current impractical, wasteful and insanely complex “system.”

And the operative word is “bold.” Why? Because unless we start the conversation there, all we might hope for is that a few more of the one out of seven Americans who don’t have insurance will be in the “system” with the rest of us — if that, after the inevitable watering-down by Congress. And that’s not “reform.” Actual reform would rescue all of us from a “system” that neither American workers nor American employers can afford to keep propping up.

But the operative word to describe the health care plans put forward by the major, viable candidates is “timid.”

“Single-payer” is definitely not that — at least, not within an American context. Seen from the perspective of most advanced nations — which accept medical care as just another part of a nation’s infrastructure, like roads and post offices — it’s no big deal.

Not here, though — not by a long shot. Here, we have too many people preprogrammed to go ballistic at the mention of “single-payer.” That’s because of the identity of that payer.

It’s… well, it’s the government!

This column will now take a short break while libertarians run around shrieking until they turn blue and fall over… da-da-dum-dum, hmmm… readers might want to go look at the Sunday comics until we resume… da-dee-da-dahhh… Still screaming, so let’s get another cup of coffee… Ah, that’s good stuff…

OK, we’re back, and they’re still screaming, but we’ll just have to accept that they’re going to do that, and proceed.

“Government,” in America, is a word that we use for a free people banding together to do something that we can do far better working together than working separately. Some people don’t accept that fact. They seem to believe that “government” is some scary thing that intrudes on their lives from out there somewhere, like a spaceship full of aliens with ray guns that will turn us all into toads or something.

Those people are one of the two big reasons why you don’t hear any presidential candidates saying “single-payer” except Dennis Kucinich. You may recall recent reports that Mr. Kucinich had a close encounter with a UFO, and it was a positive experience, so I guess he’s just not scared of the aliens any more.

But the major candidates are. Or rather, they’re scared of being labeled as extremists. Also, they don’t want to offend the health insurance companies whose reason for being would disappear under “single-payer.”

Last week, I got a press release from a labor union that complained “that no Republican candidate has a plan to ensure all Americans have access to health care.” That’s true. But the union, which represents blue- and pink-collar workers in health care, was missing the fact that the leading Democrats are little better.

“Sens. Hillary Clinton and Barack Obama have been engaged in a bitter back-and-forth over whose health plan covers more people,” The Wall Street Journal reported last week. “Former Sen. John Edwards has jumped in, saying his plan is the best of all.”

But what they’re fighting over are plans that would pull varying numbers of the uninsured into the same overly expensive, wasteful, maddening system of private health insurance that the rest of us are caught in. Conveniently, they say their plans would be paid for by repealing the “Bush tax cuts for the wealthy.”

Maybe you could pay for a health plan that way — as long as it doesn’t provide real reform.

Make no mistake: A single-payer national health plan would cost a lot of money, and you would pay for it in new taxes. The good news is that most of us would probably still pay less than we currently pay in premiums.

According to the Web site of Physicians for a National Health Program, which promotes single-payer, “This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.”

But when not even touchy-feely liberal Democrats have the guts to say it’s worth paying a new tax to make health care affordable for all, even when that’s the hottest domestic issue among voters (which would not be the case if the insured majority were happy), we’re in trouble.

Little wonder that Dow Jones’ MarketWatch reported last week that “Those who hope the 2008 presidential election will finally bring about drastic health-care reform may well end up finding it’s a case of politics and business as usual, experts say.” The same article noted that Hillary Clinton has received $1.8 million in contributions from accident and health insurers, followed by Barack Obama with $1.45 million, Mitt Romney with $1.09 million and Rudy Giuliani with $1.08 million.

That, by the way, is money that you and I and the guy down the street paid for health care that didn’t go to health care.

Given the odds against substantive reform — between the government haters, the insurance industry and Big Pharma, all of whom have a demonstrated willingness to outlast the rest of us in any protracted political fight — the only way we’re going to see significant change is if a president is elected with a mandate for bold reform. Only a president is elected by the whole nation, so only a president would ever have that kind of juice.

Unfortunately, as previously noted, none of the viable candidates will say “single-payer.”

But I will: Single-payer. Single-payer, single-payer! Now, do you have anything better to say?

Posted by Marisa Treviño
29 November 2007

As the presidential debate deepens, or gets more desperate, it won’t be surprising to hear more and more candidates who are scared of the immigration issue spouting off just plain WRONG information.

What’s sad is that they and their staff are relying on sources whose only intent is not to present the facts but drive public opinion against any facet of humanely resolving the plight of undocumented immigrants.

Whenever studies are released actually supporting the true facts, these same sources are quick to pounce on it and tear it apart like African lions devouring a kill. They accuse the study’s authors of being biased or twisting the statistics in their favor.

So, it’s more than gratifying when two different entities on two different coasts of the nation, independently release studies that say the same thing: “Undocumented immigrants are not a burden on society.”

This week in California, the University of California’s School of Public Health released a report that found undocumented Latino immigrants do not cause a drag on the U.S. healthcare system as they are always being accused.

In fact, the vast majority of undocumented immigrants don’t even have a regular doctor or healthcare provider and only visit the ER as a last resort.

“Low rates of use of health-care services by Mexican immigrants and similar trends among other Latinos do not support public concern about immigrants’ overuse of the health care system,” the researchers wrote.

“Undocumented individuals demonstrate less use of health care than U.S.-born citizens and have more negative experiences with the health care that they have received,” they said.

It’s a finding that is repeated in today’s released study by the Immigration Policy Center (IPC), the think tank of the American Immigration Law Foundation.

The IPC study found that:

per capita health care expenditures were 55 percent lower for immigrants than for natives in 1998. On average, immigrants received about $1,139 in health care, compared with $2,546 for native-born residents. Although all immigrants are eligible for emergency medical services, they had lower expenditures for emergency room visits, doctor’s office visits, outpatient hospital visits, inpatient hospital visits, and prescription drugs.

But the IPC study doesn’t stop there.

It also addresses the accusations by defamation critics who say undocumented immigrants overuse government services, increase the poverty rate and don’t pay taxes. The IPC authors are puzzled at where the defamation critics are getting their “supposed” information.

Immigration increases the U.S. Gross Domestic Product by approximately $37 billion each year. And national and state studies find that immigrants pay more in taxes than they use in government services. As for undocumented immigrants, it is a myth that they do not pay taxes. Up to 75% of them pay federal and state income and payroll taxes and all immigrants (legal and undocumented) pay sales taxes and property taxes.

while the poverty rate for U.S.-born citizens increased slightly, it fell slightly for immigrants. And, as immigrants integrate into U.S. society, they work their way out of poverty. For example, the children and grandchildren of Hispanic immigrants have made great strides in closing the economic gap with native-born whites by getting an education, getting better jobs, and earning higher incomes than their parents and grandparents. As a case study, homeownership reflects the economic advancement of the immigrant population, and, in California, the homeownership rates for Latino immigrants rose from 16.4 percent among those who arrived in the U.S. in the last 10 years to 64.6 percent among those who have lived here for 30 years or more.

Some immigration critics exaggerate immigrants’ welfare use by measuring the welfare costs of “immigrant households.” These studies include welfare benefits paid to U.S.-citizen children as “immigrant welfare costs” if any member of the child’s household is an immigrant. But, in fact, most legal immigrants are not eligible for publicly financed benefits and undocumented immigrants are not eligible for any public benefits. In addition, the participation rates of non-citizens in some federal benefits programs have been declining.

Putting this study out there is like dangling fresh meat in front of those same hungry lions who can’t digest what the truth is.

Luckily, there’s a whole herd ready to deliver the same message until either the lions give up or wake up — their choice.

By BRAD WARTHEN
Editorial Page Editor
The State
Posted on Sun, Dec. 09, 2007

CAN ANYONE among those with a chance of becoming president say “single-payer?” If not, forget about serious reform of the way we pay for health care.

It doesn’t even necessarily have to be “single-payer.” Any other words will do, as long as the plan they describe is equally bold, practical, understandable, and goes as far in uprooting our current impractical, wasteful and insanely complex “system.”

And the operative word is “bold.” Why? Because unless we start the conversation there, all we might hope for is that a few more of the one out of seven Americans who don’t have insurance will be in the “system” with the rest of us — if that, after the inevitable watering-down by Congress. And that’s not “reform.” Actual reform would rescue all of us from a “system” that neither American workers nor American employers can afford to keep propping up.

But the operative word to describe the health care plans put forward by the major, viable candidates is “timid.”

“Single-payer” is definitely not that — at least, not within an American context. Seen from the perspective of most advanced nations — which accept medical care as just another part of a nation’s infrastructure, like roads and post offices — it’s no big deal.

Not here, though — not by a long shot. Here, we have too many people preprogrammed to go ballistic at the mention of “single-payer.” That’s because of the identity of that payer.

It’s… well, it’s the government!

This column will now take a short break while libertarians run around shrieking until they turn blue and fall over… da-da-dum-dum, hmmm… readers might want to go look at the Sunday comics until we resume… da-dee-da-dahhh… Still screaming, so let’s get another cup of coffee… Ah, that’s good stuff…

OK, we’re back, and they’re still screaming, but we’ll just have to accept that they’re going to do that, and proceed.

“Government,” in America, is a word that we use for a free people banding together to do something that we can do far better working together than working separately. Some people don’t accept that fact. They seem to believe that “government” is some scary thing that intrudes on their lives from out there somewhere, like a spaceship full of aliens with ray guns that will turn us all into toads or something.

Those people are one of the two big reasons why you don’t hear any presidential candidates saying “single-payer” except Dennis Kucinich. You may recall recent reports that Mr. Kucinich had a close encounter with a UFO, and it was a positive experience, so I guess he’s just not scared of the aliens any more.

But the major candidates are. Or rather, they’re scared of being labeled as extremists. Also, they don’t want to offend the health insurance companies whose reason for being would disappear under “single-payer.”

Last week, I got a press release from a labor union that complained “that no Republican candidate has a plan to ensure all Americans have access to health care.” That’s true. But the union, which represents blue- and pink-collar workers in health care, was missing the fact that the leading Democrats are little better.

“Sens. Hillary Clinton and Barack Obama have been engaged in a bitter back-and-forth over whose health plan covers more people,” The Wall Street Journal reported last week. “Former Sen. John Edwards has jumped in, saying his plan is the best of all.”

But what they’re fighting over are plans that would pull varying numbers of the uninsured into the same overly expensive, wasteful, maddening system of private health insurance that the rest of us are caught in. Conveniently, they say their plans would be paid for by repealing the “Bush tax cuts for the wealthy.”

Maybe you could pay for a health plan that way — as long as it doesn’t provide real reform.

Make no mistake: A single-payer national health plan would cost a lot of money, and you would pay for it in new taxes. The good news is that most of us would probably still pay less than we currently pay in premiums.

According to the Web site of Physicians for a National Health Program, which promotes single-payer, “This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.”

But when not even touchy-feely liberal Democrats have the guts to say it’s worth paying a new tax to make health care affordable for all, even when that’s the hottest domestic issue among voters (which would not be the case if the insured majority were happy), we’re in trouble.

Little wonder that Dow Jones’ MarketWatch reported last week that “Those who hope the 2008 presidential election will finally bring about drastic health-care reform may well end up finding it’s a case of politics and business as usual, experts say.” The same article noted that Hillary Clinton has received $1.8 million in contributions from accident and health insurers, followed by Barack Obama with $1.45 million, Mitt Romney with $1.09 million and Rudy Giuliani with $1.08 million.

That, by the way, is money that you and I and the guy down the street paid for health care that didn’t go to health care.

Given the odds against substantive reform — between the government haters, the insurance industry and Big Pharma, all of whom have a demonstrated willingness to outlast the rest of us in any protracted political fight — the only way we’re going to see significant change is if a president is elected with a mandate for bold reform. Only a president is elected by the whole nation, so only a president would ever have that kind of juice.

Unfortunately, as previously noted, none of the viable candidates will say “single-payer.”

But I will: Single-payer. Single-payer, single-payer! Now, do you have anything better to say?