Single payer in stormy times, Medicare facing new threats

Aug. 10, 2011

Dear PNHP colleagues,

These are challenging times for advocates of single-payer health reform, we think you’ll agree.

Even as PNHP members vigorously celebrated the 46th anniversary of Medicare in opinion pieces, letters to the editor, blogs and on radio stations across the nation, noting the program’s merits and utility as a model for a universal, cost-effective single-payer system, Congress and the White House set up a “deficit reduction” process that will likely result in serious cuts to the program – with the prospect of even deeper cuts down the road.

The Budget Control Act, signed by President Obama last week, calls for an automatic 2 percent reduction in Medicare in the event that a newly created “supercommittee” of six Democrats and six Republicans can’t agree on a wider package amounting to at least $1.5 trillion in cuts in federal spending. This supercommittee can also recommend cuts to Medicaid and Social Security, among other programs.

Dr. Don McCanne, PNHP’s senior policy fellow, writes, “The probability of reaching a complex and controversial agreement that leaves Medicare totally unscathed is almost zero in this dysfunctional Congress.” He suggests the law will only accelerate efforts by Medicare’s opponents to undermine the program.

In the context of a troubled economy and deepening economic hardship, such cuts can only be expected to intensify the suffering of the U.S. population. Our New York Metro chapter issued a sharply critical statement on the legislation.

As indicated above, PNHP members have spoken out in defense of Medicare, even while acknowledging its limitations. See, for example, Dr. Ann Settgast’s recent op-ed in the Minneapolis Star Tribune, Dr. James Mitchiner’s op-ed at AnnArbor.com, or Dr. Hrayr Attarian’s letter in the Chicago Sun-Times. At least 15 similar articles by PNHPers appeared in newspapers nationwide over the past month.

Along the same lines, our sister organization Healthcare-Now helped organize at least 45 events in 21 states to celebrate Medicare’s anniversary and to call for the program’s improvement and expansion to cover everyone. Many PNHP members participated in these too, of course.

Polls, surveys and citizen juries have consistently shown our proposal – an improved Medicare for all – enjoys the support of about two-thirds of the public. And of course Medicare itself commands extremely high public approval ratings. For example, a July 18-20 CNN poll showed 87 percent oppose cutting Medicare to reduce the deficit. Yet pundits, lawmakers and the president seem remarkably cavalier about proposals that would undermine the program.

For further evidence of single payer’s robust support, please read this morning’s extraordinary endorsement of single payer by the editorial board of the St. Louis Post-Dispatch.

In view of these developments, we urge you to attend PNHP’s Annual Meeting on Oct. 29 in Washington, D.C., to help us strategize about the next steps forward for the single-payer movement. We also urge you to make a tax-deductible donation to PNHP so we can continue to educate the profession and the public about these critical issues.

(Incidentally, if you missed the stimulating PNHP dialogue about Medicare and single payer with Bruce Vladeck, the former head of Medicare and Medicaid, last month, you can listen to an audio recording of that conference call here.)

Finally, we’d like to draw your attention to a new study in the Annals of Emergency Medicine showing access to outpatient psychiatric care in the greater Boston area is severely limited, even for people with reputedly excellent private health insurance. Private insurers’ restrictive networks and their inadequate reimbursements to psychiatrists are at the root of the problem, the authors say.

The research was led by PNHP members Drs. J. Wesley Boyd, Rachel Nardin, Andrew Linsenmeyer, Steffie Woolhandler and David Himmelstein. Read PNHP’s news release on the study and the Boston Globe’s article, “Mental care can be hard to find, even for insured.” The research was also covered by CBS News and Time magazine.

Cordially,

Garrett Adams, M.D., M.P.H.
President
 
P.S. Again: Don’t forget to register for PNHP’s Annual Meeting in Washington on Oct. 29 at the Gallaudet University Kellogg Conference Hotel. Guest speakers include Phillip Longman, author of “Best Care Anywhere”; Canada’s distinguished health economist Robert G. Evans; and the U.K.’s Dr. Jacqueline Davis, a leader of Keep our NHS Public. You’ll be able to exchange experiences with fellow physicians and single-payer advocates from all over the country. We will host a Leadership Training Institute for a limited number of participants on the afternoon of Friday, Oct. 28. You won’t want to miss this extraordinary gathering. Register today.