By Bonnie Washuk , Staff Writer
Lewiston Sun Journal
Thursday, November 29, 2007

LEWISTON – As he talked about how medical bills ravaged his parents’ lives, Jesse Stevens of Auburn teared up. The room grew quiet. Everyone paid attention.

Bills they couldn’t afford prompted Stevens’ parents to move out of the family home and into a mobile home, Stevens said.

Nick Peddle of Gorham said his grandfather is in his 70s and still working. He can’t retire because he needs the health coverage, Peddle said.

Vivian Ocharsky of Auburn said when her husband had stomach cancer, their insurance company refused certain chemotherapy treatment that could have prolonged his life. After he died in 2000, the insurance company canceled her policy, “leaving me with nothing.” She had medical bills she couldn’t afford, contributing to her losing their home.

With insurance companies, hospitals, doctors and drug makers focused on profits instead of patients, health care has become unaffordable, not just to those without insurance but to those with it, said people who crowded into a labor union hall Tuesday night.

A full house turned out to watch Michael Moore’s documentary, “Sicko,” hosted by the Western Maine Labor Council, the Maine People’s Alliance and the Maine State Nurses Association.

After the film, the collective mood was anger. Americans should demand change from politicians, Ocharsky and Stevens said. But Stevens predicted that 99 percent of those there Tuesday night wouldn’t do anything differently Wednesday.

“Please prove me wrong,” he said.

A majority in the room did sign two petitions.

One, for H.R. 676, would create a national health insurance program. Under that legislation people are covered “cradle to grave. You get a card, you go to the doctor and you don’t get a bill,” said Peter Kellman of the Southern Maine Labor Council. The biggest way the plan is paid for is through payroll taxes, Kellman said. “Right now you pay 1.45 percent to Medicare. That goes up to 4.75, and that’s it.”

There are no insurance premiums or co-pays because there are no insurance companies, Kellman said. Now, 30 percent of health costs come from “insurance paperwork,” he said. Labor unions are collecting signatures for H.R. 676 to send to U.S. Rep. Mike Michaud, D-Maine.

The second petition demands that Maine lawmakers approve universal single-payer health care. The petition says the system is broken and a new system is needed that’s accountable and puts patients before profits.

The Maine People’s Alliance goal is to get 15,000 signatures statewide to give to Maine legislators in January. “We want to make it clear it’s not just a few hundred MPA members” hurting from unaffordable care, said MPA’s Androscoggin Valley community organizer Kate Brennan.

“Far too many people in Lewiston-Auburn are uninsured or underinsured,” Brennan said. “People are having to sell the only home they ever owned to pay their health care bills. Or people are not getting the care they need, yet facing 10 or 13 percent annual increases in their policies.”

Labor unions are promoting a single, government-run health system because unaffordable care has become a problem even for those with jobs and insurance, said Matt Schlobohm of the Western Maine Labor Council.

It used to be that unions negotiated for wages, working conditions and benefits, but now health care dominates contract talks, he said. And as union members reach retirement age, more are finding they can’t afford to retire, especially if their spouse is ill or isn’t of Medicare age, Schlobohm said.

The goal of showing “Sicko” is to educate people about the crisis and show how single-payer systems work in other countries, he said. The movie strikes a chord for anyone who can’t afford care or who’s been denied care, Schlobohm said. “It speaks to them that this is wrong.”

The Maine State Nurses Association plans to promote a single-payer system by hosting “Sicko” house parties, said organizer Cathy Jo Herlihy

By Susanne L. King
Berkshire Eagle
Wednesday, November 28

For all you boomers who are looking retirement in the eye, cast your gaze on a recent Boston Globe article entitled “Blue Cross gave chairman $16.4 million in retirement pay.” William C. Van Faasen, 58, collected those benefits in 2006, even though he didn’t leave the company. He merely stepped down as chief executive of Blue Cross and Blue Shield of Massachusetts, but retained his position as chairman, receiving nearly $3 million in salary and bonuses the same year he collected retirement benefits. This astonishing gift went to the chairman of a non-profit organization that does not pay income taxes to a state that is trying to provide universal health insurance to its citizens.

According to a survey conducted by the non-partisan research group, the Employee Benefit Research Institute, the rising costs of health care are cutting into the ability of workers to contribute to their retirement accounts. The researchers found that 63 percent of Americans have experienced an increase in costs they had to pay under their health plans in the past year. Of those, more than 50 percent reduced their household savings because of increased health care costs, and 30 percent decreased the amount they saved they saved for retirement.

On the other hand, Van Faasen retires at an early age, wealthy beyond one’s wildest dreams thanks to our health care dollars. And we work longer and find it harder to fund our retirement years.

Massachusetts, meanwhile, is having trouble finding enough money for its new health care program, as more previously uninsured people have signed up for the government-subsidized health plans than was anticipated. The Berkshire Eagle reported last week that the state may need an additional $146 million to pay for the program this fiscal year.

In a separate article, The Eagle also reported that insurance companies estimated that prices for the Commonwealth Choice health plans that are not subsidized by the state will be raised 10-12 percent by the insurance companies next year. In addition, the cheapest and most heavily subscribed plan will be dropped. The lack of affordability of the insurance plans for the state, individuals, and businesses makes Van Faasen’s salary and retirement benefit package, and Blue Cross /Blue Shield’s non-profit status, even more astonishing.

If we had a single-payer health insurance program, either in our state or nationwide, insurance companies, with their bloated administrative expenses that include CEO salaries and retirement benefits, would not exist. Health care funds would be administered by either the state or federal government, and administrative expenses would be 3 percent instead of more than 30 percent. Nationally, this would save $350 billion annually in administrative costs, enough to provide comprehensive health care for the 47 million uninsured people in our country. Everyone would be in the same risk pool, and cherry-picking of healthy workers by the insurance companies would not exist. There would be no drain of our hard-earned retirement funds to line the pockets of health insurance company executives.

Single-payer legislation in our state is called the Massachusetts Health Care Trust, Senate Bill 703 (full text at www.mass.gov/legis/bills/senate/185/st00/st00703.htm).

The federal legislation for single-payer health care is H.R. 766. You might be interested in the covered services in the state single-payer bill, in order to compare them to your current Massachusetts health insurance coverage. The benefits in the single-payer bill include prevention, diagnosis and treatment of illness and injury, both inpatient and outpatient, as well as mental health and dental care, acupuncture, physical therapy, chiropractic and podiatric treatment. Covered benefits also include all prenatal and maternity care, rehabilitation of sick and disabled persons, prescription drugs, and medical equipment and appliances-all the services that you would expect in a comprehensive health plan.

Of especial interest to all you baby boomers (and your children), other covered benefits are home health care, including personal care, and long-term care in nursing homes. The legislation specifically states: “No deductibles, co-payments, co-insurance, or other cost sharing shall be imposed with respect to covered benefits.” Now that would improve your retirement planning — no need to buy long-term care insurance and health insurance policies to supplement Medicare and pay for your prescriptions. If we did not have to fill the coffers of the insurance companies and their executives, we would all be better off financially.

Health insurance companies have money and powerful lobbying forces; you have your voice. Call, write or e-mail your legislators and tell them what you think.

Susanne L. King, M.D. is a Lenox practitioner.

By Mary Engel
Los Angeles Times Staff Writer
November 27, 2007

Illegal immigrants from Mexico and other Latin American countries are 50% less likely than U.S.-born Latinos to use hospital emergency rooms in California, according to a study published Monday in the journal Archives of Internal Medicine.

The cost of providing healthcare and other government services to illegal immigrants looms large in the national debate over immigration.

In Los Angeles County, much of the focus of that debate has been on hospital emergency rooms. Ten have closed in the last five years, citing losses from treating the uninsured, and those that remain open are notorious for backlogs.

By federal law, hospitals must treat every emergency, regardless of a person’s insurance — or immigration — status. Illegal immigrants, who often work at jobs that don’t offer health insurance, are commonly seen as driving both the closures and the crowding.

But the study found that while illegal immigrants are indeed less likely to be insured, they are also less likely to visit a doctor, clinic or emergency room.

“The current policy discourse that undocumented immigrants are a burden on the public because they overuse public resources is not borne out with data, for either primary care or emergency department care,” said Alexander N. Ortega, an associate professor at UCLA’s School of Public Health and the study’s lead author. “In fact, they seem to be underutilizing the system, given their health needs.”

Ira Mehlman, media director for the Federation for American Immigration Reform, a group that lobbies for tougher immigration controls, said that usage rates are just one measure of illegal immigrants’ effect on healthcare. The other factor, he said, is the cost to taxpayers, which Ortega’s study did not examine.

Cost estimates vary widely. A Rand Corp. study published last year in the journal Health Affairs put the cost of healthcare for illegal immigrants nationwide at $1.1 billion a year, excluding care for those younger than 18 and older than 64.

FAIR called the Rand number a “low-ball” estimate. Its own study of healthcare costs of illegal immigrants and their dependents, including U.S.-born children, estimated California’s portion alone to be about $1.5 billion a year.

Mehlman said $1.5 billion “is still a significant amount of money, unless you’re Bill Gates.”

Ortega’s study is not the first to find that illegal immigrants use fewer healthcare services than people born in the U.S. But his study used the largest sample, analyzing data from 42,044 participants of the 2003 California Health Interview Survey, a randomized telephone survey conducted by the UCLA Center for Health Policy Research and the California Department of Public Health.

And while other studies have attributed lower usage to immigrants simply being younger and healthier than the overall population, the study published Monday took into account age, health status, insurance status and poverty level. All such factors being equal, it found, immigrants still made fewer visits to physicians and were 30% less likely than U.S.-born Latinos to have a regular source of healthcare.

Dr. Felix Nuñez, a Los Angeles-based family physician and former medical director of the South Central Family Health Center, said the findings confirm what he sees in clinics.

Illegal immigrants are infrequent patients for primary care visits, he said, because being asked for ID cards, Social Security numbers and employment histories makes them nervous. They fear being reported to authorities, even though the information is used only to determine Medi-Cal eligibility or to set a sliding-scale fee.

What did surprise Nuñez was the relatively low use of emergency rooms by illegal immigrants.

“My gut would have told me that they’d be higher users of emergency services because they’re not coming in for routine, preventive care,” he said. “This kind of study is really important because it forces you to look at the data and rethink your assumptions.”

mary.engel@latimes.com

UCLA researchers find that Latinos in the U.S. illegally are 50% less likely to visit emergency rooms.

By Mary Engel
Los Angeles Times Staff Writer
November 27, 2007

Illegal immigrants from Mexico and other Latin American countries are 50% less likely than U.S.-born Latinos to use hospital emergency rooms in California, according to a study published Monday in the journal Archives of Internal Medicine.

The cost of providing healthcare and other government services to illegal immigrants looms large in the national debate over immigration.

In Los Angeles County, much of the focus of that debate has been on hospital emergency rooms. Ten have closed in the last five years, citing losses from treating the uninsured, and those that remain open are notorious for backlogs.

By federal law, hospitals must treat every emergency, regardless of a person’s insurance — or immigration — status. Illegal immigrants, who often work at jobs that don’t offer health insurance, are commonly seen as driving both the closures and the crowding.

But the study found that while illegal immigrants are indeed less likely to be insured, they are also less likely to visit a doctor, clinic or emergency room.

“The current policy discourse that undocumented immigrants are a burden on the public because they overuse public resources is not borne out with data, for either primary care or emergency department care,” said Alexander N. Ortega, an associate professor at UCLA’s School of Public Health and the study’s lead author. “In fact, they seem to be underutilizing the system, given their health needs.”

Ira Mehlman, media director for the Federation for American Immigration Reform, a group that lobbies for tougher immigration controls, said that usage rates are just one measure of illegal immigrants’ effect on healthcare. The other factor, he said, is the cost to taxpayers, which Ortega’s study did not examine.

Cost estimates vary widely. A Rand Corp. study published last year in the journal Health Affairs put the cost of healthcare for illegal immigrants nationwide at $1.1 billion a year, excluding care for those younger than 18 and older than 64.

FAIR called the Rand number a “low-ball” estimate. Its own study of healthcare costs of illegal immigrants and their dependents, including U.S.-born children, estimated California’s portion alone to be about $1.5 billion a year.

Mehlman said $1.5 billion “is still a significant amount of money, unless you’re Bill Gates.”

Ortega’s study is not the first to find that illegal immigrants use fewer healthcare services than people born in the U.S. But his study used the largest sample, analyzing data from 42,044 participants of the 2003 California Health Interview Survey, a randomized telephone survey conducted by the UCLA Center for Health Policy Research and the California Department of Public Health.

And while other studies have attributed lower usage to immigrants simply being younger and healthier than the overall population, the study published Monday took into account age, health status, insurance status and poverty level. All such factors being equal, it found, immigrants still made fewer visits to physicians and were 30% less likely than U.S.-born Latinos to have a regular source of healthcare.

Dr. Felix Nuñez, a Los Angeles-based family physician and former medical director of the South Central Family Health Center, said the findings confirm what he sees in clinics.

Illegal immigrants are infrequent patients for primary care visits, he said, because being asked for ID cards, Social Security numbers and employment histories makes them nervous. They fear being reported to authorities, even though the information is used only to determine Medi-Cal eligibility or to set a sliding-scale fee.

What did surprise Nuñez was the relatively low use of emergency rooms by illegal immigrants.

“My gut would have told me that they’d be higher users of emergency services because they’re not coming in for routine, preventive care,” he said. “This kind of study is really important because it forces you to look at the data and rethink your assumptions.”

mary.engel@latimes.com