PNHP

CaliforniaChoice holds down premium increases, but at a cost

CaliforniaChoice holds down premium increases, but at a cost

PR Newswire
Jun. 29, 2004
CaliforniaChoice Announces Zero to Single-Digit Increases in Health
Insurance Premiums

At a time when employers throughout California continue to experience significant increases in their health insurance premiums, CaliforniaChoice today announced a zero percent increase for one HMO carrier and single-digit increases for almost everyone else participating in their small-group health purchasing alliance. CaliforniaChoice is the state’s leading authority on small-group (employers with 2-50 employees) healthcare benefits.

Employers find purchasing health coverage an easy business decision to make thanks to CaliforniaChoice’s unique budgeting process. Instead of the health plan telling the employer how much they have to pay under the old “defined-benefit” model, it is the employer who determines precisely what they are capable and willing to spend on their employee’s health insurance. Employers establish this fixed budget — which is known as their “defined contribution” — and in doing so achieve cost controls and budget predictability.

Using their employer’s contribution as a sort of “voucher,” employees are then empowered to choose from multiple HMO and PPO carriers within the CaliforniaChoice spectrum of health plans. All of these health plans compete for business based on provider network, drug formulary, geographic convenience, reputation and, of course, price. Employees who want “richer” benefits than the employer is willing to fund simply contribute the difference out of their own pocket.

In 2002, the Health Insurance Association of America honored CaliforniaChoice with its prestigious “Innovators Award,” an annual recognition for a select company whose contributions have led to “true industry advancement.”

http://fsnews.findlaw.com/articles/prnewswire/20040629/29jun2004050042.html

Comment: Since CaliforniaChoice uses existing HMO and PPO plans, including Blue Shield and Kaiser Permanente, it functions as an additional middleman in the health care funding arena. Although they claim to reduce administrative costs, their model, as an additional administrative intermediary, is unlikely to do so.

Most small businesses that do not currently offer their employees health benefit programs are not expected to do so merely because products are available that slow the rate of premium increases. These products are still unaffordable for many, and they will not motivate employers who simply do not care about their employees’ welfare. Instead, the defined contribution products offered by CalifoniaChoice will result in a shift from coverage through traditional defined benefit programs which provide more comprehensive coverage. The current epidemic of under-insurance will explode with these newer products.

Personal bankruptcy due to medical bills accumulated by individuals who have health insurance have already become commonplace. With the increase in defined contribution products, we can anticipate a further expansion in the need for bankruptcy services. Perhaps CaliforniaChoice will now also qualify for the “Innovators Award” from the National Association of Consumer Bankruptcy Attorneys.

News Observer

July 4, 2004

News Observer, North Carolina

By VICKI CHENG, Staff Writer

Dr. Wes Wallace thinks we need cleaner air. He’s in favor of nuclear disarmament. And he thinks all people, even the impoverished, deserve decent health care.

But the UNC-Chapel Hill emergency room doctor does more than just talk about these ideals.

“He’s the physician, I think, that we all want to be, and aspire to be,” says Dr. Judith Tintinalli, who heads the department of emergency medicine at UNC-Chapel Hill.

Wallace is preparing to leave late this week for a two-week trip to the rural community of Bongo, Panama, near the Costa Rican border. There he will lead a team of volunteer health-care providers who will treat children for malnutrition and intestinal parasites. They will provide blood-pressure medicine to adults who make $4 or $5 a day and can’t afford the drugs. They will examine people who bring their children in on horseback or come in on foot.

Wallace will also take small gifts to John Wesley Gonzales, who is named for him. He delivered the baby on a folding table one evening six years ago as the clinic was closing for the day.

This will be Wallace’s sixth trip to Panama to provide free health care, through a group organized by the University United Methodist Church in Chapel Hill. The volunteers pay about $1,500 each. They sleep in a church dormitory or a basic hotel in a nearby town, where they count themselves lucky to have hot water.

“I guess at this point, I either have to go or I have to find someone else to go,” Wallace says. “They’re expecting us.”

Wallace, 56, grew up in Gainesville, Texas. His father was a doctor. “Growing up, I saw that he had a pretty tough life,” Wallace says. “I didn’t think I wanted to be a physician.”

So when it was time for Wallace to go to college at Texas Tech University, he studied speech and theater. He worked as a disc jockey. He thought about broadcast journalism. But he wound up at the Pacific School of Religion in Berkeley, Calif. There he volunteered as a chaplain intern in the emergency department of an Oakland hospital that treated many indigent patients. And he was hooked.

“I find it enormously interesting and exciting,” Wallace says of emergency medicine. “It is frequently a very direct way to make people’s lives better, or to save people’s lives. … I am frequently tired, but I am never bored. Something interesting or exciting is always happening.”

In the 1980s, it seemed to Wallace that one of the most pressing issues on the planet was the possibility of nuclear war. In 1989, he became president of Physicians for Social Responsibility, a national organization that promotes policies to protect people from weapons of mass destruction. It is an affiliate of the International Physicians for the Prevention of Nuclear War, which won the Nobel Peace Prize in 1985.

“One of the main reasons that I became a physician was to make life better for people, to help people enjoy the full measures of their lives, and to do that while minimizing their suffering,” Wallace says. “It seemed like everything … I was doing could be rendered meaningless in 15 minutes if we didn’t manage to pull back from the nuclear abyss.”

Dr. Adam Goldstein, an associate professor of family medicine at UNC-CH, says Wallace is well known among Triangle doctors active in social causes.

“I think it’s rare to combine compassion with comprehensive knowledge of a topic, and then advocacy on that topic,” Goldstein says. “He certainly does that. For medical students in training, they need to understand you can do all three. As a physician, you’re going to have leadership opportunities. If you want to step up, you can do whatever it is you want to do.”

About 12 years ago, Wallace left his native Texas and settled in Chapel Hill, where his wife grew up. In the late 1990s, he was one of the doctors actively involved in the N.C. Ad Hoc Committee to Defend Health, which spoke out against insurance companies’ growing control over medical decisions.

He testified about the health dangers of polluted air before a state House committee working on clean-air legislation. And he was appointed by Gov. Jim Hunt to the Smart Growth Commission, charged with finding ways to manage growth and its impact on people and the environment.

Last year, Wallace gave a lecture at UNC-CH on health-care reform in the United States. He believes that the nation should move toward a national health insurance plan similar to Canada’s. Forty-five million people in the United States have no health insurance, he says.

“Spending the amount of money that we now spend on health care, we could cover everyone in this country,” he says. “But the way our health-care situation is arranged now, there’s such an enormous amount of waste that we don’t do that.”

Still, Wallace doesn’t come off as preachy, his colleagues say.

“There are people that you meet and you say, ‘They are radical. They are obsessed,’ ” Tintinalli says. “He doesn’t try to strong-arm you, or convince you about his ideals. He basically lives them.”

To accommodate his social activism, Wallace works part-time at UNC-CH.

“I try to be modest in my use of financial resources,” he says. “I’d rather have the time than the money.”

He has also been studying Spanish intensively over the past four years, sitting in on undergraduate classes at UNC and traveling to Mexico for Spanish immersion courses. He speaks it well enough now to communicate with his patients in Panama, and with Hispanic immigrants who end up in the emergency room at UNC. And he’s finding other uses for his new skill: His newest project is to travel to Mexico to help train doctors there in emergency medicine.

Jan Sassaman, who organizes the annual trips to Panama for the Chapel Hill church, said he’s not surprised that Wallace volunteers year after year.

“Wes is a pretty down-to-earth guy,” the Chapel Hill resident says. “His priorities are not materialistic.”

Biographical Data:

WESLEY M. WALLACE

BORN: Sept. 26, 1947

EDUCATION: Texas Tech University, 1969; certificate in theological studies, Pacific School of Religion, 1970; Baylor College of Medicine, 1975; internship through the Central Texas Medical Foundation, 1976

JOB: Associate professor of emergency medicine, UNC-CH

FAMILY: Married to Raine Lee, trained as a lawyer. They live in Chapel Hill.

HOBBIES: Outdoor activities, including hiking, canoeing and birding

SPECIAL SKILLS: Expert in treating snake bites and other wilderness mishaps

MIGHT HAVE BECOME: An actor. Before enrolling in medical school, he lived in Canada for a year, where he acted in several radio dramas and had a small part in “Jerry Potts and the ’74s,” a film about the Northwest Mounted Police, now known as the Mounties.

The Truth About the Drug Companies

“The Truth About the Drug Companies” By Marcia Angell

New York Review of Books – Volume 51, July 15, 2004

1. Every day Americans are subjected to a barrage of advertising by the pharmaceutical industry. Mixed in with the pitches for a particular drug–usually featuring beautiful people enjoying themselves in the great outdoors–is a more general message. Boiled down to its essentials, it is this:

“Yes, prescription drugs are expensive, but that shows how valuable they are.
Besides, our research and development costs are enormous, and we need to cover them somehow. As ‘research-based’ companies, we turn out a steady stream of innovative medicines that lengthen life, enhance its quality, and avert more expensive medical care. You are the beneficiaries of this ongoing achievement of the American free enterprise system, so be grateful, quit whining, and pay up.” More prosaically, what the industry is saying is that you get what you pay for.

Please click here to read the review

Tweak HSAs to create IMAs?

American Medical News
July 5, 2004
Physicians want HSA access for Medicare recipients
By Katherine Vogt

The AMA will work to ensure that Medicare-eligible individuals have access to health savings accounts and will also study alternative means of financing health care.

The policies, passed at the AMA’s Annual Meeting in June, seek to help fine-tune health savings accounts, which were created under last year’s Medicare reform act. While the AMA supports HSAs as an option for consumers, the law “could use some tweaking,” said Duane M. Cady, MD, chair-elect of the AMA Board of Trustees.

“Health savings accounts are clearly part of our overall program for health system reform,” Dr. Cady said. “[But] we need to get it right.”

Under current law, HSAs are available only to people younger than 65. But in 2005, the Centers for Medicare & Medicaid Services is expected to establish Medicare savings accounts, which are essentially HSAs for Medicare participants. The AMA resolution calls on the organization to monitor the pending regulations to ensure that Medicare participants can take advantage of these tax-saving tools.

In a separate action, AMA delegates voted to further study alternative means for financing health care. The resolution sprang from a call to improve HSAs. That original call included a push to seek legislation establishing a new kind of account called an “individual medical account” that could be created without requiring consumers to have high-deductible insurance.

While the final resolution did not specifically address the idea of individual medical accounts, it left the door open for further study.

http://www.ama-assn.org/amednews/2004/07/05/gvsc0705.htm

Comment: Ā Health savings accounts (HSAs) are funded through regressive tax policies that benefit the wealthy. Under these policies, lower income individuals pay more for their health care than do the wealthy. Eliminating the requirement for high deductible insurance coverage would only increase the inequities of these policies targeted to selectively benefit the wealthy.

AMA members who support health savings accounts (HSAs) and individual medical accounts (IMAs) do so because they perceive them to be income sources that have no restrictions on fees nor on which services would be covered.

Try this. Write a list of the issues that must be addressed in health care reform. As a starter, I’ll suggest a few: the uninsured, inadequate coverage, affordability, accessibility, inequitable funding, flawed distribution of capacity, deficient support for a primary care infrastructure, inadequate IT support for error reduction, elimination of administrative waste, and the list goes on. Go ahead and add to the list some of your other concerns about our health care system. Then when you are finished, look over your list. Do you find on there the need to make health care purchases a better bargain for the rich than for the rest of us? Do you find on there the need to replace risk pools with individual accounts which remove all constraints on physicians’ fees and services?

The difference is clear. The AMA advocates for doctors; PNHP advocates for patients.

A Second Opinion

June 28, 2004
OP-ED COLUMNIST
A Second Opinion
By BOB HERBERT

In an article a few years ago in The Journal of the American Medical Association, Dr. Barbara Starfield of the Johns Hopkins School of Medicine took a look at the overall health of the American people, and compared conditions here to those in other industrialized countries.

What she found was disturbing.

“The fact is that the U.S. population does not have anywhere near the best health in the world,” she wrote. “Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators.”

She said the U.S. came in 13th, dead last, in terms of low birth weight percentages; 13th for neonatal mortality and infant mortality over all; 13th for years of potential life lost (excluding external causes); 11th for life expectancy at the age of 1 for females and 12th for males; and 10th for life expectancy at the age of 15 for females and 12th for males. She noted in the article that more than 40 million Americans lacked health insurance (the figure is about 43 million now) and she described the state of Americans’ health as “relatively poor.”

“U.S. children are particularly disadvantaged,” she said, adding, “But even the relatively advantaged position of elderly persons in the United States is slipping. The U.S. relative position for life expectancy in the oldest age group was better in the 1980’s than in the 1990’s.”

The article was published in the summer of 2000. At the time Japan ranked highest among developed countries in terms of health, and the United States ranked among the lowest.

Last week I talked with Dr. Starfield, an internationally respected physician, professor and researcher, and asked whether the situation had improved over the last four years.

“It’s getting worse,” she said, noting, “We’ve done a lot more studies in terms of the international comparisons. We’ve done them a million different ways. The findings are so robust that I think they’re probably incontrovertible.”

The U.S. has the most expensive health care system on the planet, but millions of Americans without access to care die from illnesses that could have been successfully treated if diagnosed in time. Poor people line up at emergency rooms for care that should be provided in a doctor’s office or clinic. Each year tens of thousands of men, women and children die from medical errors and many more are maimed.

But when you look for leadership on these issues, you find yourself staring into the void. If you want to get physicians’ representatives excited, ask them about tort reform, not patient care. Elected officials give lip service to health care issues, but at the end of the campaign day their allegiance goes to the highest bidders, and they are never the people who put patients first.

To get a sense of just how backward we’re becoming on these matters, consider that in places like Texas, Florida and Mississippi the politicians are dreaming up new ways to remove the protective cloak of health coverage from children, the elderly and the poor. Texas and Florida have been pulling the plug on coverage for low-income kids. And Mississippi recently approved the deepest cut in Medicaid eligibility for senior citizens and the disabled that has ever been approved anywhere in the U.S.

Even the affluent are finding it more difficult to obtain access to care. For patients with insurance the route to treatment is often a confusing maze of gatekeepers and maddening regulations. The costs of insurance are shifting from employers to employees, and important health decisions are increasingly being made by bureaucrats and pitchmen interested solely in profits. In the maddening din that passes for a national conversation in this country, distinguished voices like Dr. Starfield’s are not easily heard.

Echoing so many other patient advocates, she continues to call for movement on two crucial needs: coverage for the many millions who currently do not have access to care, and the development of a first-rate primary care system, which would bring a sense of coherence to a health care environment that is both chaotic and wildly expensive. “We don’t have any national health policy at all in this country,” said Dr.Starfield.

And there is no sign of that changing anytime soon.

51 Legislators Pledge their Support in Writing!!

51 Legislators Pledge their Support in Writing!!
ConCon next Wednesday Ʊ July 7th.

Dear Affordable Health Insurance Supporter,

Your hard work and determination has paid off! 51 Legislators have pledged in writing to vote YES on the Constitutional Amendment for Affordable Health Insurance.

50 is what we need to get through this ConCon and spark a vigorous debate for reform. 51 votes will prevent amendments completely replacing the language you support. But it isnĆ­t enough to guarantee a vote or to prevent every amendment.

Last week, because of your hard work, the Legislature received over 500 Vote Yes Letters and a substantial number of calls. The result? 5 legislators who had made oral commitments to vote YES put their promise in writing. The ConCon reconvenes July 7th at 1:00 pm. We can win a vote if it happens. Our goal is still 101 written pledges to guarantee a vote and to control amendments.

Many legislators have said they will vote YES. We want them to put it in writing. So please keep the calls and letters coming. Ask your family, friends, neighbors and co-workers to call their legislators.

We need you to:
Call the State House switchboard at (617) 722-2000 and ask for your Legislators.
1. Tell them who you are and where you live so they’ll know you’re a constituent;
2. Ask them to Vote YES on the Affordable Health Insurance Amendment in the next ConCon; and
3. Call the Campaign at (617) 868-1280, or email us back and tell us what happened. If you have already called – organize friends, neighbors and co- workers to call their legislators.

Or take a minute to download Vote YES Letters asking your Senator and Representative to vote YES on Affordable Health Insurance for everyone. Sign one. Have family, friends, neighbors and co-workers sign one. Bring them to your local 4th of July parade. Send or fax (617-868-1363) them back to us. We’ll make sure YOUR legislators get your message! Time’s short. So please do it today!

Send a Vote YES Letter
Click Here to Send your Legislators a Vote YES Letter http://healthcareformass.org/get-involved/index.shtml

Need to find your Legislators?
Click here to conveniently find your legislator’s contact information http://www.wheredoivotema.com/bal/myelectioninfo.php

New Bedford Resolution: Last week, the New Bedford City Council unanimously passed a resolution endorsing the Constitutional Amendment for Affordable Health Insurance. A similar resolution of support is now pending before the Boston City Council. Thanks to everyone who has encouraged their local officials to endorse this amendment. ItĆ­s not too late to ask your City Council. We have sample language.

Special Event: A Tribute To Steve Collins, Executive Director of Mass. Human Services Coalition tomorrow (Tuesday, June 29th) from 5:30 Ʊ 7:30 pm at the Women’s Industrial and Educational Union, 356 Boylston Street, Boston. Steve is gravely ill. He has an aggressive form of cancer that will take his life in a very short time. Steve has long been a tireless and effective advocate for those in need. Please join the many in celebrating Steve and sharing some comfort with those who love and admire him. For more information or to make an online tax-deductible contribution, visit>> http://www.ForSteve.org or call MHSC at 617-482-6119. Checks, made payable to MHSC, may be sent to: For Steve, PO Box 390773, Cambridge, MA 02139.

Thank you for being a critical part of this historic campaign.

Sincerely,

Barbara Roop, PhD, JD :: Campaign Co-Chair
John Goodson, MD :: Campaign Co-Chair
Michael B. Carr, JD :: Campaign Coordinator
Ann Eldridge Malone, RN, MSN :: Campaign Outreach Coordinator
Sandy Eaton, RN :: Campaign Outreach Committee
Robert Gaw, President, NASRO :: Campaign Outreach Committee

Please go to our contact page>> http://healthcareformass.org/contact/index.shtml for email addresses to any of our Campaign personnel.

Visit Our Web Site: http://www.HealthCareForMass.org

Americans believe health insurers are doing a bad

HarrisInteractive
Health Care News
Editor: Humphrey Taylor, Chairman of The Harris Poll
June 22, 2004
Reputations of Pharmaceutical and Health Insurance Companies Continue Their Downward Slide

In this year’s survey, 44% of all adults think the pharmaceutical companies are doing a good job for their consumers (and 48% think they are doing a bad job). In 1997, fully 79% thought the industry was doing a good job.

Health insurance companies were never as popular, during the last seven years, as pharmaceutical companies, but in 1997 a 55% majority believed they were doing a good job for their consumers. …only 36% now give them good marks – 19 points lower than seven years ago.

Some members of the public see a difference between managed care and health insurance companies, even though virtually all insurance companies now sell managed care, and it really is just one industry. Only 30% of the public give managed care companies good marks… For the past two years, managed care has been tied for last place with the tobacco companies.

http://www.harrisinteractive.com/news/newsletters/healthnews/HI_HealthCareNews2004Vol4_Iss11.pdf

Comment: In this survey of the public view of 15 industries, they were asked, “Do you think health insurance companies (or one of 14 other industries) generally do a good or bad job of serving their consumers?”

With pharmaceutical firms, other surveys have indicated that the public believes that drug prices in the U.S. are too high. We now need government intervention in drug pricing, through bulk purchasing and/or regulation, balancing value for purchasers with fair profits for the manufacturers.

The public clearly recognizes that the insurance plans are not serving us well. This is further reinforced by a plethora of studies confirming that private insurers provide essentially no value when judged by cost and quality. Administrative costs are outrageous. And, rather than pooling risk, they serve as wasteful middlemen for healthier individuals as they dump the more costly patients into taxpayer funded programs or, worse, out into the street. Destroying the fundamental functions of insurance certainly results in impaired quality of their insurance products. High costs with poor quality, by definition, destroys value. In contrast, administrative efficiency and a universal risk pool, features of a single payer system, would provide the value that we now need in health care coverage.

Since the public recognizes that private insurers are serving us poorly, why do they keep electing politicians that support policies that nurture this industry at a great cost to the rest of us?

The fact that we need change, isn’t that like a… well… Duh!

California's single payer bill passes Assembly Health Committee

California’s single payer bill passes Assembly Health Committee
Wed, 23 Jun 2004
(These two releases were distributed by e-mail and are not currently available by a link, therefore they are presented here in their unedited versions. Please excuse the length of this important message.)

California State Senator Sheila Kuehl
FOR IMMEDIATE RELEASE
June 22, 2004

CONTACT: Sara Rogers 916 445 1353 or Robin Podolsky 310 441 9084

KUEHL’S STATEWIDE HEALTH COVERAGE BILL TAKES HISTORIC STEP FORWARD IN ASSEMBLY HEALTH COMMITTEE

Senate Bill 921, authored by State Senator Sheila Kuehl (D-23) which would
provide comprehensive health benefits to every Californian at no new cost to
California’s general fund, has been passed by the State Assembly Health Committee by a vote of 12 to 5.

SB 921 would create a single, streamlined reimbursement system for medical
care in California that has been projected to save the state about $14 billion dollars in administrative healthcare costs alone. These and other substantial savings make it possible to insure every resident of California with a comprehensive health plan that would include medical, dental, vision, mental health and prescription drug coverage among benefits.

Because SB 921 would cover every Californian, it would offer each patient the freedom to choose among all healthcare providers. Healthcare provision would remain subject to competition and in private hands. The legislation would also require the State of California to use its purchasing power to negotiate directly with pharmaceutical companies to buy prescription drugs in bulk, thus drastically lowering their cost.

“I’m very grateful to my colleagues in the Assembly Health Committee for voting to extend healthcare coverage to every Californian,” said Senator Kuehl. “SB 921 will make it possible for every Californian to keep their health care coverage even if they change jobs; start a business; start a family; continue our education; or travel out of state. Our important relationships with the doctors we trust will not be interrupted. People with undetected chronic illnesses will get the care they need to avert the heartache and economic burden of medical catastrophes. This bill will save our state money and improve the quality of life for all of us.”

Today, approximately 1 out of 5 Californians is uninsured, and, nationally, catastrophic medical illness remains the leading cause of personal bankruptcy. Most uninsured Californians are employed but either cannot afford the medical insurance offered to them at work or are not offered healthcare benefits through their job. Analysts agree that the costs of healthcare are propelled upward by the overuse of emergency room care (the most expensive kind of healthcare delivery) by people who are not insured and do not receive regular medical attention. Doctors and hospitals also report that, as insurance premiums rise in cost, the reimbursements paid by private insurance companies to medical providers are shrinking.

Cost Controls in SB 921 would mean that businesses would not be burdened
with suddenly rising health care premiums; would no longer have the responsibility for negotiating complicated health care benefits packages for
their employees; and would also insure the self-employed.

SB 921 would also relieve doctors and hospitals of the administrative costs
associated with multiple insurance plans. Since all patients will be insured, healthcare providers will not have to worry about uninsured patients being unable to pay for the care they receive. Physicians will have a direct voice in the amount of reimbursement they receive. Those reimbursements will reflect the actual costs, on a regional basis, of providing care, and they will come on time. Doctors, not insurance companies, will be in charge of deciding what is medically appropriate for patients.

SB 921 will be funded with those federal and state dollars already earmarked
for healthcare, along with a means-based, equitable tax. Individuals and
employers will pay into the plan based on what they can afford, not what
insurance companies want to charge. This tax will replace all premiums, deductibles, co-pays and out-of-pocket expenses. For most taxpayers and businesses, this will lead to sizeable savings.

PAGEBREAK

HEALTH ACCESS UPDATE
Tuesday, June 22nd, 2004

UNIVERSAL COVERAGE BILL PASSES ASSEMBLY HEALTH COMMITTEE

In a boost to the goal of quality, affordable health care for all, SB 921 (Kuehl), a groundbreaking bill to establish a universal single-payer health system in California, was passed in Assembly Health Committee Tuesday. Having passed the full Senate last year, this new vote raises the profile of this comprehensive health reform solution. The vote was not a given: When Senator Sheila Kuehl decided to schedule the bill in this committee a few weeks ago, she did not know if she would get the votes.

SUPPORT TESTIMONY: Senator Kuehl opened her testimony by stating how “very proud” she was to author SB 921. After describing the “perfect storm” crisis in health care, she described that the bill “imagines a system that provides
high quality, affordable health care for all.” Her stated emphatically that “this bill is possible,” pointing to Medicare and the Veterans Administration.

Dr. L. Paul Smith, who practiced and taught at McGill University in Canada
and now is a member of AARP California, followed on that point, stating that “America is no stranger to single-payer health plans.” He mentioned key benefits of such a plan, including universality, comprehensiveness, and consolidated administration, leading to cost effectiveness. Dr. Bill Durston, a Sacramento emergency room doctor also with significant credentials, talked of his personal experiences, both with uninsured and underinsured patients. He also highlighted the significant administrative hassles of the current system.

Dozens of organizations came forward to declare their support, as Senator Kuehl joked, half in fun and full in earnest, “I apologize that there are over 500 organizations in support of this bill.” When closing on the bill, she again stated how she had “never seen anything” like the support SB921 has, and simply said that this the bill “is in the interest of California.”

OPPOSITION TESTIMONY: Opposition witnesses used several arguments. The Chamber of Commerce representative stated “we do not support the concept of universal health coverage.” The Chamber stated their belief that the bill would entail “significant costs” beyond what Californians currently spend, but did not produce research to back up that argument. She referred to the recent Oregon ballot initiatives for a single-payer plan, where 79% of the state voted no. She claimed that SB 921 does “nothing to address the underlying cost of health care.”

A representative of health plans challenged the belief that “in order to get to universal coverage, you must junk the concept of private competition.” He argued that we all rely on vital services, such as “food, clothing, and housing,” which are “delivered best by a private, competitive approach.” Finally, he cited that this was a “danger” in thinking there were “easy options” to the health care crisis, and that instead, there are “very difficult tradeoffs.”

Other business associations railed against “government-run health care,” and
instead argued for health savings accounts and association health plans. Representations of manufacturers pointed out that the bill removes employers
from the “control and cost of utilization of health care,” and the employer would be stuck with “whatever bill that the state sent them.” Health underwriters noted that the United States spends more than most countries with single-payer systems, and “what services will be rationed to reduce our costs?”

LEGISLATOR COMMENTS: Assemblyman Frommer raised concerns that there were “no limits on revenues collected,” “no controls on costs,” and “a Cadillac benefits package.” He also questioned the timing, with the upcoming referendum to repeal SB 2, the Health Insurance Act passed last year. Senator Kuehl responded that she was a co-author of SB 2 and strongly supported its passage and will work to defend it this fall, and that there is no contradiction to support both.

Assemblywoman Goldberg referred to her experiences in Los Angeles with a
health system that is unraveling: “If we don’t do something, nobody will
have health care.” Assemblyman Dymally supported the bill and urged the
people to challenge the monied interests.

Assemblyman Richman stated that he supports “universal coverage” but does
not support a single-payer system, and does not believe the terms are interchangeable. He raised concerns about “no limits what the income tax
would be, the payroll tax,” etc. He cited provider rate reimbursement concerns, citing the low reimbursement in Medi-Cal, another “government run” health insurer. Senator Kuehl responded that she was not surprised that a program directed at the poor is “nickel and dimed,” and the bill seeks to insulate the health plan from the political concerns of the Governor and legislature.

Assemblywoman Wolk stated she would support the bill to “move it forward,”
but had concerns about it being “not cooked,” especially with the lack of
clarity on the revenues to fund the system, and the potential legal challenges. Having lived in other countries, she also has expressed concerns about “the choices and limitations that others live with that would not be put up with here” in America. Finally, Assemblywoman Rebecca Cohn, Chair of the Assembly Health Committee, gave her support, “since everybody has a body,” and each body eventually breaks down.

NEXT STEPS: The bill will not move forward this year. Senator Kuehl will
continue to work to develop the revenue package to fund the health system,
based in part on economic studies are in the works. This will be a challenge: while the tax system to fund this universal health plan would replace the billions Californians currently spend in premiums, deductibles, and other costs, it still would be considered a tax increase and thus need a two-thirds vote. Yet Senator Kuehl has committed to reintroduce this bill next year, and the organizing and advocacy from this session has created a strong base of support to move forward.

For the text of SB 921 and related legislative documents:
http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_921&sess=CUR&house=B&search_type=email

Comment: This historic action establishes, with no doubt whatsoever, the
credibility of the single payer model of reform. When legislators seriously examine all of the options, the superiority of the single payer model is evident.

Unfortunately, peculiarities of the California legislative process will prevent the passage of SB 921 in this session. California requires a two-thirds vote in both the Assembly and the Senate to pass any measure that involves a tax increase. California’s legislative districting process has established safe districts which allows the parties to nominate ideological extremists. The Republicans vote as a solid block on all tax measures, and they constitute more than one-third of each chamber.

But the significance of this landmark event cannot be overstated. Legislators can learn the complexities of our health care financing structure, and they can identify solutions that would rectify many of the inherent flaws in the system.

This victory should provide an incentive for you to pull out all stops in your efforts to educate your colleagues and the public on the model of reform that will finally bring health care justice to America: a single payer system for everyone.

Please share this message with others who care.

California’s single payer bill passes Assembly Health Committee

California’s single payer bill passes Assembly Health Committee
Wed, 23 Jun 2004
(These two releases were distributed by e-mail and are not currently available by a link, therefore they are presented here in their unedited versions. Please excuse the length of this important message.)

California State Senator Sheila Kuehl
FOR IMMEDIATE RELEASE
June 22, 2004

CONTACT: Sara Rogers 916 445 1353 or Robin Podolsky 310 441 9084

KUEHL’S STATEWIDE HEALTH COVERAGE BILL TAKES HISTORIC STEP FORWARD IN ASSEMBLY HEALTH COMMITTEE

Senate Bill 921, authored by State Senator Sheila Kuehl (D-23) which would
provide comprehensive health benefits to every Californian at no new cost to
California’s general fund, has been passed by the State Assembly Health Committee by a vote of 12 to 5.

SB 921 would create a single, streamlined reimbursement system for medical
care in California that has been projected to save the state about $14 billion dollars in administrative healthcare costs alone. These and other substantial savings make it possible to insure every resident of California with a comprehensive health plan that would include medical, dental, vision, mental health and prescription drug coverage among benefits.

Because SB 921 would cover every Californian, it would offer each patient the freedom to choose among all healthcare providers. Healthcare provision would remain subject to competition and in private hands. The legislation would also require the State of California to use its purchasing power to negotiate directly with pharmaceutical companies to buy prescription drugs in bulk, thus drastically lowering their cost.

“I’m very grateful to my colleagues in the Assembly Health Committee for voting to extend healthcare coverage to every Californian,” said Senator Kuehl. “SB 921 will make it possible for every Californian to keep their health care coverage even if they change jobs; start a business; start a family; continue our education; or travel out of state. Our important relationships with the doctors we trust will not be interrupted. People with undetected chronic illnesses will get the care they need to avert the heartache and economic burden of medical catastrophes. This bill will save our state money and improve the quality of life for all of us.”

Today, approximately 1 out of 5 Californians is uninsured, and, nationally, catastrophic medical illness remains the leading cause of personal bankruptcy. Most uninsured Californians are employed but either cannot afford the medical insurance offered to them at work or are not offered healthcare benefits through their job. Analysts agree that the costs of healthcare are propelled upward by the overuse of emergency room care (the most expensive kind of healthcare delivery) by people who are not insured and do not receive regular medical attention. Doctors and hospitals also report that, as insurance premiums rise in cost, the reimbursements paid by private insurance companies to medical providers are shrinking.

Cost Controls in SB 921 would mean that businesses would not be burdened
with suddenly rising health care premiums; would no longer have the responsibility for negotiating complicated health care benefits packages for
their employees; and would also insure the self-employed.

SB 921 would also relieve doctors and hospitals of the administrative costs
associated with multiple insurance plans. Since all patients will be insured, healthcare providers will not have to worry about uninsured patients being unable to pay for the care they receive. Physicians will have a direct voice in the amount of reimbursement they receive. Those reimbursements will reflect the actual costs, on a regional basis, of providing care, and they will come on time. Doctors, not insurance companies, will be in charge of deciding what is medically appropriate for patients.

SB 921 will be funded with those federal and state dollars already earmarked
for healthcare, along with a means-based, equitable tax. Individuals and
employers will pay into the plan based on what they can afford, not what
insurance companies want to charge. This tax will replace all premiums, deductibles, co-pays and out-of-pocket expenses. For most taxpayers and businesses, this will lead to sizeable savings.

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HEALTH ACCESS UPDATE
Tuesday, June 22nd, 2004

UNIVERSAL COVERAGE BILL PASSES ASSEMBLY HEALTH COMMITTEE

In a boost to the goal of quality, affordable health care for all, SB 921 (Kuehl), a groundbreaking bill to establish a universal single-payer health system in California, was passed in Assembly Health Committee Tuesday. Having passed the full Senate last year, this new vote raises the profile of this comprehensive health reform solution. The vote was not a given: When Senator Sheila Kuehl decided to schedule the bill in this committee a few weeks ago, she did not know if she would get the votes.

SUPPORT TESTIMONY: Senator Kuehl opened her testimony by stating how “very proud” she was to author SB 921. After describing the “perfect storm” crisis in health care, she described that the bill “imagines a system that provides
high quality, affordable health care for all.” Her stated emphatically that “this bill is possible,” pointing to Medicare and the Veterans Administration.

Dr. L. Paul Smith, who practiced and taught at McGill University in Canada
and now is a member of AARP California, followed on that point, stating that “America is no stranger to single-payer health plans.” He mentioned key benefits of such a plan, including universality, comprehensiveness, and consolidated administration, leading to cost effectiveness. Dr. Bill Durston, a Sacramento emergency room doctor also with significant credentials, talked of his personal experiences, both with uninsured and underinsured patients. He also highlighted the significant administrative hassles of the current system.

Dozens of organizations came forward to declare their support, as Senator Kuehl joked, half in fun and full in earnest, “I apologize that there are over 500 organizations in support of this bill.” When closing on the bill, she again stated how she had “never seen anything” like the support SB921 has, and simply said that this the bill “is in the interest of California.”

OPPOSITION TESTIMONY: Opposition witnesses used several arguments. The Chamber of Commerce representative stated “we do not support the concept of universal health coverage.” The Chamber stated their belief that the bill would entail “significant costs” beyond what Californians currently spend, but did not produce research to back up that argument. She referred to the recent Oregon ballot initiatives for a single-payer plan, where 79% of the state voted no. She claimed that SB 921 does “nothing to address the underlying cost of health care.”

A representative of health plans challenged the belief that “in order to get to universal coverage, you must junk the concept of private competition.” He argued that we all rely on vital services, such as “food, clothing, and housing,” which are “delivered best by a private, competitive approach.” Finally, he cited that this was a “danger” in thinking there were “easy options” to the health care crisis, and that instead, there are “very difficult tradeoffs.”

Other business associations railed against “government-run health care,” and
instead argued for health savings accounts and association health plans. Representations of manufacturers pointed out that the bill removes employers
from the “control and cost of utilization of health care,” and the employer would be stuck with “whatever bill that the state sent them.” Health underwriters noted that the United States spends more than most countries with single-payer systems, and “what services will be rationed to reduce our costs?”

LEGISLATOR COMMENTS: Assemblyman Frommer raised concerns that there were “no limits on revenues collected,” “no controls on costs,” and “a Cadillac benefits package.” He also questioned the timing, with the upcoming referendum to repeal SB 2, the Health Insurance Act passed last year. Senator Kuehl responded that she was a co-author of SB 2 and strongly supported its passage and will work to defend it this fall, and that there is no contradiction to support both.

Assemblywoman Goldberg referred to her experiences in Los Angeles with a
health system that is unraveling: “If we don’t do something, nobody will
have health care.” Assemblyman Dymally supported the bill and urged the
people to challenge the monied interests.

Assemblyman Richman stated that he supports “universal coverage” but does
not support a single-payer system, and does not believe the terms are interchangeable. He raised concerns about “no limits what the income tax
would be, the payroll tax,” etc. He cited provider rate reimbursement concerns, citing the low reimbursement in Medi-Cal, another “government run” health insurer. Senator Kuehl responded that she was not surprised that a program directed at the poor is “nickel and dimed,” and the bill seeks to insulate the health plan from the political concerns of the Governor and legislature.

Assemblywoman Wolk stated she would support the bill to “move it forward,”
but had concerns about it being “not cooked,” especially with the lack of
clarity on the revenues to fund the system, and the potential legal challenges. Having lived in other countries, she also has expressed concerns about “the choices and limitations that others live with that would not be put up with here” in America. Finally, Assemblywoman Rebecca Cohn, Chair of the Assembly Health Committee, gave her support, “since everybody has a body,” and each body eventually breaks down.

NEXT STEPS: The bill will not move forward this year. Senator Kuehl will
continue to work to develop the revenue package to fund the health system,
based in part on economic studies are in the works. This will be a challenge: while the tax system to fund this universal health plan would replace the billions Californians currently spend in premiums, deductibles, and other costs, it still would be considered a tax increase and thus need a two-thirds vote. Yet Senator Kuehl has committed to reintroduce this bill next year, and the organizing and advocacy from this session has created a strong base of support to move forward.

For the text of SB 921 and related legislative documents:
http://www.leginfo.ca.gov/cgi-bin/postquery?bill_number=sb_921&sess=CUR&house=B&search_type=email

Comment: This historic action establishes, with no doubt whatsoever, the
credibility of the single payer model of reform. When legislators seriously examine all of the options, the superiority of the single payer model is evident.

Unfortunately, peculiarities of the California legislative process will prevent the passage of SB 921 in this session. California requires a two-thirds vote in both the Assembly and the Senate to pass any measure that involves a tax increase. California’s legislative districting process has established safe districts which allows the parties to nominate ideological extremists. The Republicans vote as a solid block on all tax measures, and they constitute more than one-third of each chamber.

But the significance of this landmark event cannot be overstated. Legislators can learn the complexities of our health care financing structure, and they can identify solutions that would rectify many of the inherent flaws in the system.

This victory should provide an incentive for you to pull out all stops in your efforts to educate your colleagues and the public on the model of reform that will finally bring health care justice to America: a single payer system for everyone.

Please share this message with others who care.

Georgia's single payer study

Georgia’s single payer study

The Atlanta Journal-Constitution
6/22/04
‘Single-payer’ Georgia health plan pushed
By Andy Miller

A proposal for a Medicare-like system that would give health insurance coverage to all Georgia residents would cut total health spending for the state by about $716 million annually, according to study released Monday by a consumer group.

The proposed, government-run “single-payer” plan would be financed by a combination of payroll taxes, increases in tobacco and alcohol taxes, a 1 percent sales tax and a tax on individuals, said Georgians for a Common Sense Health Plan, a group that promotes health coverage for all residents.

But all current payments by employers and individuals, including health insurance premiums and co-pays, would be eliminated under the consumer group’s SecureCare program. Most families earning $75,000 or less would pay less under the proposal, said Rita Valenti, a registered nurse and former state legislator who’s a founder of the Common Sense group.

The study, conducted by the Virginia-based Lewin Group, a health care consulting firm, was financed by a grant from the nonprofit Healthcare Georgia Foundation, a private organization whose mission, in part, is to expand access to affordable, quality health care.

“On paper, there’s a lot of merit to it,” said Ken Thorpe, an Emory University health policy expert and former health official in the Clinton administration. “The politics is always the thing that bottles it up. You’re moving money from the private sector to the public sector.”

http://www.ajc.com/news/content/business/0604/22insurance.html

Comment: How many more studies do we need before we act? Where is our effort to change the politics?

Walkers Cross the Longfellow Bridge for Health Care

Trying To “Bridge the Gap”: Fighting For Health Care For All

Richard Gilluly
06/23/2004

Walkers Cross the Longfellow Bridge for Health Care

Many hundreds of people representing groups as diverse as the Massachusetts Nurses Association, the Harvard Medical School, labor unions, members of the Boston City Council and the Massachusetts Senior Action Council rallied in Boston Saturday to protest the fact 82 million Americans lacked health insurance at some point during the past two years — and that some 43 million permanently lack it.

“The figure includes about 600,000 uninsured people in Massachusetts, and millions more of us are struggling to keep the coverage we have,” said Jon Weissman of Springfield, who coordinated Western Massachusetts participation in the rally on behalf of a group called Jobs with Justice.

The Purpose of the rally was not just to protest the present system but also to advocate elimination of the vast and costly array of 1,100 health insurance companies, health maintenance organizations and other private groups involved in the health care payment system and replace them with a single-payer system operated by state or federal governments, speakers said.

Letter Carriers Walk for Health CareReputable economists quoted in such publications as the Journal of the American Medical Association and The New England Journal of Medicine believe savings from a single-payer system would more than generate enough revenue to provide health insurance for all Americans, speakers said.

Western Massachusetts, including Franklin County and West County, was well-represented on a blessedly cool, cloudy late Saturday morning as the colorful group of demonstrators, waving banners and placards, marched a mile and a half from Kendall Square in Cambridge across the Longfellow Bridge to the Boston Common — where many more already had gathered.

“Bridging the Gap” was the theme of the rally, which meant that for millions of Americans the lack of health-care insurance is a great gap that stands between them and the health care they, and especially their children, desperately need, said speakers. Similar marches were held all over the nation, including one across the Golden Gate Bridge in San Francisco in which Sen. John F. Kerry (D-Mass.), presumptive Democrat nominee for the presidency, was scheduled to march.

“Health Care is a right, we’re ready to fight” was one of many chants heard from the marchers, but while that may have had a ring reminiscent of earlier, more unkempt demonstrations, this was a very serious demonstration, indeed, with a very large middle-class component.

Among the speakers at the Boston Commons, for example, was self-employed physical therapist Nancy Bullett of North Adams, who told the crowd that not only are her patients increasingly hard-pressed, and often unable, to pay for the treatment they need but that she and her two children lack coverage themselves, because premiums of over $800 a month are too high for her to pay.

Her children, she said, are on a waiting list for a state program, the Children’s Medical Security Plan (CSMP), and there are 14,900 kids on that waiting list statewide. While the Legislature last week passed a bill which would immediately fully fund CSMP, Ms. Bullett said she is not placing any bets yet.. “It did pass,” she said, “but now it has to go to Governor Romney.” Whether he will sign it was unknown at press time.

A USA Today story handed out at the demonstration reported that one in three Americans younger than 65 were uninsured for a time during 2002 and 2003, according to a study commissioned by Families USA. Half were uninsured for at least nine months and two-thirds for at least six months, the story said.

And while most Americans over 65 have some health insurance through Medicare, that, too, is threatened, declared speakers, including Isaac BenEzra of Amherst, president of the Massachusetts Senior Action Council, who said many thousands of people in the US die annually because of the “collateral damage” inflicted by runaway prescription drug prices charged by “monopolistic” pharmaceutical companies, and because they lack health insurance.

And Ms. Bullett told West County News that the recently-passed Medicare “reform” bill, which has drawn strong opposition from health activists, would cut payments for rehabilitation of seniors, including physical therapy and speech therapy for stroke victims. The mechanism for the cuts would be a new Medicare rule limiting combined payments for both kinds of therapy to $1,500 a year. Currently, there is no limit. “It’s so bizarre,” she said, “None of us can afford to get sick.”

Stressed again and again were two other factors, first that America’s failure to provide needed health care to people on a timely basis ultimately costs far more, because treatment is offered only in overcrowded emergency rooms after an emergency medical crisis already is occurring.

Second, as Harold Cox, member of the Cambridge health Board and president of the Massachusetts Public Health Association, pointed out, preventive medicine is neglected under our current system, because uninsured people do not receive screening for a variety of diseases, including breast cancer and prostate cancer. Besides, he said, people with contagious diseases, such as AIDS, do not receive the treatment and education they need to prevent the contagion from spreading. “Our health care system is sick,” Mr. Cox said bluntly.

Union members, including John Hogan of Local 2222 of the International Brotherhood of Electrical Workers, told of the fact that employer-union contract disputes these days almost always occur over health insurance benefits that formerly were routinely paid by employers but often are no longer. Contract disputes over health insurance began to occur frequently in the late 1980s, he said, “but the situation is much worse now.”

Speakers also pointed out that a single-payer system is not, as detractors claim, “socialism,” because while government would operate the health-care payment system under single-payer, most doctors, hospitals and other providers would remain independent entities, as they are now. A bill currently wending its way through the Massachusetts Legislature contemplates such a system for Massachusetts.

Western Massachusetts marchers numbered 60 and included students, seniors, and in-between, with members of the following organizations struggling with the health care system:

Alliance for Injured Workers
Arise for Social Justice
Franklin/Hampshire Health Care Coalition
International Brotherhood of Teamsters Local 404
Mass. Senior Action Council
National Association of Letter Carriers Branch 46
Odyssey Bookshop
Service Employees International Union Local 2020
Social Workers for Peace and Justice
United Auto Workers Local 2322

article posted on www.pvaflcio.org
Pioneer Valley, Massachusetts, AFL-CIO

Brokaw's show points Physicians' support for singlepayer

Source: NBC Nightly News (6:30 PM ET) – NBC
June 22, 2004 Tuesday

BROKAW: Robert, clearly not very many doctors are going to want to deal with 250 different health-care plans. What’s the American medical community doing about this growing mountain of red tape?

BAZELL: Well, some doctors are so disgusted, they’re beginning to support the idea of a single payer, whether it’s the government or some other entity.