PNHP

Physicians' Group Decries 2.4 Million Rise in Number of Americans Lacking Health Insurance

Physicians' Group Decries 2.4 Million Rise in Number of Americans Lacking Health Insurance

Doctors Describe Human Toll, Especially for Children and Minorities As Employers Drop Coverage and Incremental Reforms Fail

SEPTEMBER 30, 2003, CHICAGO, IL�The number of Americans without health insurance jumped sharply for the second year in a row, up 2.4 million to 43.6 million,15.2% of the population, according to a report released by the U.S. Census Bureau today. Members of Physicians for a National Health Program offered graphic descriptions of the human toll behind these numbers.

This month in Dyersburg, Tennessee, a 26 year old patient was turned down for coverage by the state�s TennCare program after losing his job and workplace-based insurance. Denied access to mental health care, his psychiatric condition worsened and he took a room full of college students hostage, severely injuring two classmates before being killed by police.

�In a small town, everyone is affected by a tragedy like this,� said retired Tennessee pediatrician Dr. Jim Hudson. �This is criminal, that in the wealthiest country in the world, we don�t assure access to basic life-saving care.�

Minorities have been particularly hard hit. One-in-three Latinos are uninsured (32.4%, including 25% of Latinos who were born in the US), as are one-in-five blacks (20.2%). �Latinos suffer staggering health consequences from being uninsured,� said Dr. Olveen Carrasquillo, a leading academic researcher on the uninsured at Columbia University in New York. �Diabetes is 2-3 times more common in Latinos, which can cause blindness, kidney failure, and leg amputation if untreated. Asthma is 3-5 times more common in Latino kids.�

The proportion of all children who are uninsured held steady at 11.6%. 8.5 million children remain uninsured, a graphic illustration of the failure of incremental reforms, such as the Children�s Health Insurance Program which is supposed to sharply reduce the number of uninsured children.

Texas residents are the worst insured in the nation, with one in four (24.1%) lacking any health coverage. �Over 50% of my young patients are uninsured,� said Houston pediatrician Dr. Ana Malinow, who easily recalls a half-dozen patients with terrible complications from being uninsured, including a two year old with a chronic ear infection and perforated eardrum whose family can�t afford the $1,000 deposit required for surgery. �In Texas, a simple ear infection in a child may not be properly treated for years, causing preventable hearing loss, speech deficits, and lifelong learning problems. The �leave no child behind� state is frighteningly callous when it comes to children�s health, and it�s no better for the adults I see in my volunteer work at a local shelter. The health care system in Texas is failing everybody.�

In Chicago, Dr. Claudia Fegan (who is also incoming president of Physicians for a National Health Program) runs the outpatient clinics for one of the city�s busiest safety-net hospitals. �People who thought they�d never be here find themselves begging for care. Yesterday a woman who had recently suffered a stroke sat crying outside my office in a wheelchair. Another hospital had discharged her and brought her here via ambulance. They told her she had to come here to receive her medications and follow-up care. We took care of her but we do not have any more available appointments for new patients until 2004. Where are people supposed to go?�

In Massachusetts, Dr. Steffie Woolhandler is in charge of quality reviews for the Department of Medicine at Cambridge Hospital. �I review the cases of people who should not have died to find out what went wrong. Too often the problem was that the patient didn�t have insurance and delayed care,� said Dr. Woolhandler. She cited the case of an uninsured health care professional who died of a treatable cancer before her biopsy results had even come back from the laboratory. �She correctly diagnosed herself with a liver problem based on her symptoms. She thought if she quit drinking she�d improve on her own. If she�d come in sooner, we could have treated the lymphoma we found in her liver.�

�The incremental reforms of the past two decades have failed,� said Dr. Carrasquillo. �The economic boom of the 1990�s barely dented the number of uninsured. The last three years of recession has exposed the cracks in our unsound health system. The number of people without insurance is skyrocketing, while benefits for people who still have coverage are shrinking rapidly. This should be a wake-up call to all political and health care leaders, including Latino leaders, that the time for bold solutions is now.�

Physicians for a National Health Program has more than 11,000 members across the country which advocates national health insurance for the U.S. PNHP members take care of the uninsured in every state and medical specialty. To interview a PNHP physician about the problems of lacking health insurance and options for reform, contact Ida Hellander at (312) 782-6006 or
pnhp@aol.com .

Small Towns Struggle to Find Dentists

IN SOME AREAS, PEOPLE MUST WAIT MONTHS FOR APPOINTMENTS OR TRAVEL LONG DISTANCES. SOME MEDICAID FAMILIES CAN’T GET TREATED AT ALL.

By David Crary
Associated Press Writer of LA Times
September 28, 2003

BERLIN, N.H. – Every few days, an agonized child or adult shows up at the emergency room of this mill town’s lone hospital, seeking relief from a pain that should have been treated elsewhere.

They have an abscess or a toothache, long-festering and suddenly unbearable. They turn to ER doctors, who can do little beyond supplying antibiotics, because Berlin – like hundreds of communities nationwide – has too few dentists.

Home to 10,600 people – just two of them dentists – in far-northern New Hampshire, Berlin is one of 1,480 areas in the United States designated by federal authorities as suffering from a dentist shortage. That number has nearly doubled since 1990.

In some areas, even patients with private dental insurance have to wait months for an appointment or travel long distances to a dentist with an open slot. Many low-income families have it worse: Their Medicaid coverage often isn’t enough to gain access to already busy dentists.

Loretta Morrissette, who runs an oral health program in Berlin’s public schools, sees the damage close-up in children whose parents can’t afford dental visits or can’t find a dentist who accepts new patients. She cited one mother who called 22 dental offices in one morning, many of them in distant towns, without getting an appointment for her child.

“If the children had early intervention, they could be helped before they get to the point of pain,” said Morrissette, a dental hygienist with Coos County Family Health Services. “They end up with an abscess two years down the road and a four-surface filling instead of one little one. It’s traumatic.”

Morrissette’s program tries to help children in kindergarten through third grade get dental treatment, although more than 70 students with cavities had to be placed on a slow-moving waiting list this year.

“I get an unbelievable amount of calls from parents wanting services, hoping for something that I can’t offer,” she said. “If they have a child in second grade and one in sixth, it’s very hard to tell them there’s no access for that older one.”

Dr. William Kassler, New Hampshire’s state medical director, said nearly 20% of the state’s 1.2 million residents live in communities with too few dentists. Many of those towns, Berlin among them, have unfluoridated water, causing higher cavity rates among children who then lack ready access to treatment.

As one of 16 states with no dental school, New Hampshire struggles to recruit newcomers to serve needy towns or replace the many dentists nearing retirement. The dentists who do come – like their peers elsewhere- generally prefer relatively well-to-do communities, not rural areas and poor urban neighborhoods with the most need.

Like many other states, New Hampshire is trying to ease the shortages by offering to repay the student loans of young dentists willing to work in underserved areas. Under another new program, the state will pay the malpractice insurance and license fees of retired dentists willing to donate at least 100 hours a year to treat needy patients.

“All states are struggling with these issues,” said Kassler, whose own family had to wait nine months for dental appointments after moving to New Hampshire five years ago. “It’s something that cries out for national policy intervention.”

Nationwide, there are about 152,000 active dentists, more than one-third of them over age 55, according to the American Dental Assn. Experts estimate that dentists’ ranks will begin to decline in about 10 years as the number of dental school graduates – now about 4,000 annually – falls below the number of dentists leaving the work force due to retirement or other reasons.

To reverse the trend, dental schools would need to graduate more students. But many of the nation’s 56 dental schools are struggling to maintain current operations; there are more than 350 vacant faculty positions because of an exodus of teachers into better-paying private practice.

Even now, there are severe shortages of dentists in certain regions – a huge swath of the Great Plains, southern Texas, much of Nevada, northern Maine and poor, rural counties in many other states. The U.S. Department of Health and Human Services says more than 31 million people live in shortage areas; officials estimate that 4,650 dentists would be needed to provide the proper level of service.

Senate Minority Leader Tom Daschle (D-S.D.) drew attention to the dentist shortage while touring his home state last month. “I’ve heard horror stories from South Dakotans who were forced to travel more than 100 miles for a simple dental procedure,” he said.

A recent South Dakota Dental Assn. survey projected that the number of practicing dentists in the state under age 65 could drop from 308 now to 217 by 2020.

Many of the nation’s problem areas have large minority populations, yet only 3.4% of the nation’s dentists are black and 3.3% are Latino.

Dr. Eugene Kruysman, one of the two practicing dentists in Berlin, has hired a headhunter agency to recruit an associate to help him with his overbooked practice. He is unable to take on new patients and even his regulars sometimes have to wait several months for a routine visit.

Kruysman, 49, has been practicing profitably in Berlin for 22 years; he raves about the appreciative attitude of his patients and the outdoor attractions of the surrounding White Mountains. But he knows that it won’t be easy to lure an associate to an economically struggling town several hours’ drive from the nearest big cities.

“It’s tough to draw someone up here,” he said. “The problem only worsens the more remote the location.”

He serves on a local dental-care task force and pitches in by treating some low-income emergency patients. His regulars include some Medicaid-covered families. But he knows that many children and adults in the area are suffering from lack of dental care.

“I don’t have an answer,” he said. “I see no solution to this shortage anywhere on the horizon.”

Canada's council for health policy and accountability

Toronto Star
Sep. 26, 2003
Ottawa, provinces agree to national health council

The federal government and provinces have reached agreement on the creation
of a 27-member national health council, a key source said today.

The council, which would monitor health policy and accountability, would be comprised of a chairperson, 13 government representatives and 13 people
from outside government.

Roy Romanow recommended the council last year in his royal commission
report on the future of health care.

click here to view the article

Comment: Imagine a national health council in the United States monitoring
health policy and accountability. Just to begin with, what would such a commission have to say about our very high costs in the face of the profound
deficiencies and inequities in our system?

Such a council would be invaluable to help fine tune a comprehensive health
care system such as Canada’s. But, in the United States, we don’t need to
fine tune a system. We need to establish a system. The sooner the better.

Sat, 27 Sep 2003 11:06:15 -0700
Subject: qotd: Federal regulations produce a return on our investment

The White House
Office of Management and Budget
Informing Regulatory Decisions: 2003 Report to Congress on the Costs and Benefits of Federal Regulations and Unfunded Mandates on State, Local, and
Tribal Entities.

OMB reviewed 107 major Federal rulemakings finalized over the previous ten
years (October 1, 1992 to September 30, 2002). The estimated total annual
quantified benefits of these rules range from $146 billion to $230 billion, while the estimated total annual quantified costs range from $36 billion to $42 billion.

Table 2: Estimates of the Total Annual Benefits and Costs of Major Federal Rules, October 1, 1992 to September 30, 2002 (millions of 2001 dollars):

Health & Human Services
Benefits: 9,129 to 11,710
Costs: 3,165 to 3,334

Environmental Protection Agency
Benefits: 120,753 to 193,163
Costs: 23,359 to 26,604

(six other agencies are listed, and each shows a significantly greater benefit than cost.) http://www.whitehouse.gov/omb/inforeg/2003_cost-ben_final_rpt.pdf

Comment: One of the most common objections to the role of government is the cost of regulatory requirements. Although the social benefits of many regulations may be priceless, it is very reassuring to know that President Bush’s OMB has provided a report that demonstrates that the regulations of each agency also produce a significantly greater dollar value in benefits than are the costs of fulfilling the regulations.

Although the greatest return has been through EPA regulations, agencies such as HHS have also produced a positive dollar return on the regulatory requirements.

The benefits of regulatory oversight are further evidence that our government is not our enemy. And we could benefit even more if we would begin to use a Universal, “government-run,” social insurance program to improve the value of our health care investment.

Canada’s council for health policy and accountability

Toronto Star
Sep. 26, 2003
Ottawa, provinces agree to national health council

The federal government and provinces have reached agreement on the creation
of a 27-member national health council, a key source said today.

The council, which would monitor health policy and accountability, would be comprised of a chairperson, 13 government representatives and 13 people
from outside government.

Roy Romanow recommended the council last year in his royal commission
report on the future of health care.

click here to view the article

Comment: Imagine a national health council in the United States monitoring
health policy and accountability. Just to begin with, what would such a commission have to say about our very high costs in the face of the profound
deficiencies and inequities in our system?

Such a council would be invaluable to help fine tune a comprehensive health
care system such as Canada’s. But, in the United States, we don’t need to
fine tune a system. We need to establish a system. The sooner the better.

Sat, 27 Sep 2003 11:06:15 -0700
Subject: qotd: Federal regulations produce a return on our investment

The White House
Office of Management and Budget
Informing Regulatory Decisions: 2003 Report to Congress on the Costs and Benefits of Federal Regulations and Unfunded Mandates on State, Local, and
Tribal Entities.

OMB reviewed 107 major Federal rulemakings finalized over the previous ten
years (October 1, 1992 to September 30, 2002). The estimated total annual
quantified benefits of these rules range from $146 billion to $230 billion, while the estimated total annual quantified costs range from $36 billion to $42 billion.

Table 2: Estimates of the Total Annual Benefits and Costs of Major Federal Rules, October 1, 1992 to September 30, 2002 (millions of 2001 dollars):

Health & Human Services
Benefits: 9,129 to 11,710
Costs: 3,165 to 3,334

Environmental Protection Agency
Benefits: 120,753 to 193,163
Costs: 23,359 to 26,604

(six other agencies are listed, and each shows a significantly greater benefit than cost.) http://www.whitehouse.gov/omb/inforeg/2003_cost-ben_final_rpt.pdf

Comment: One of the most common objections to the role of government is the cost of regulatory requirements. Although the social benefits of many regulations may be priceless, it is very reassuring to know that President Bush’s OMB has provided a report that demonstrates that the regulations of each agency also produce a significantly greater dollar value in benefits than are the costs of fulfilling the regulations.

Although the greatest return has been through EPA regulations, agencies such as HHS have also produced a positive dollar return on the regulatory requirements.

The benefits of regulatory oversight are further evidence that our government is not our enemy. And we could benefit even more if we would begin to use a Universal, “government-run,” social insurance program to improve the value of our health care investment.

Canada's MRI and CT scanners

Canada Newswire
Sept. 24, 2003
Release from Canadian Institute for Health Information (CIHI)
CIHI report shows dramatic increase in MRI, CT scans and scanners

A new national report on medical imaging by the Canadian Institute for Health Information (CIHI) shows the supply of MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) scanners and the number of scans performed have risen dramatically in the past decade, and that the distribution of major imaging equipment varies across the country.

A recent Statistics Canada survey found that 6.7% of Canadians age 15 and
over – a total of 1.7 million people – had a non-emergency MRI, CT, or angiography in 2001. Provincial data show volumes have risen sharply in
recent years.

Canada had a total of 147 MRI scanners in January 2003 compared to 30 in
1993, an increase of nearly 400%. The number of CT scanners rose by about
50% over the same period, from 216 in 1993 to 326 in January 2003. The country also had 594 nuclear medicine cameras, 165 angiography suites,
94 Catheterization labs, and 14 PET scanners in January 2003. Canada’s MRI and CT machines are, on average, newer than those in Europe.

Waiting for Care: The 2001 Statistics Canada Health Services Access Survey
found that about half of Canadians aged 15 and older who reported receiving
a non-emergency CT, MRI, or angiography waited three weeks or less. Most
(55%) waited less than a month; about 5% waited six months or more. One-quarter of those who were tested felt their wait was unacceptable; about
one in six (16%) said the wait affected their lives. Most (68%) of those who
said the wait affected them said it caused worry, anxiety, or stress.

http://www.newswire.ca/releases/September2003/25/c4564.html

Comment: One of the most common arguments presented against the adoption of a single payer system in the United States is that there are unacceptable
queues or delays for services in any universal, government funded program.
Perhaps the most frequent example given is the unacceptable delays in diagnostic imaging in Canada due to the fact that they do not have enough CT or MRI scanners to meet their needs. This report reveals that, in the past decade, great progress has been made by Canada in addressing this problem.

Emergency imaging is always available without delay. And, by 2001, three-fourths of Canadians who had elective scans do not believe that they were subjected to unacceptable delays. Since the release of the Romanow report, an even greater effort has been made to ensure adequate capacity.

Canada’s access to imaging is not bad and is improving dramatically. Contrast that to imaging in the United States. We have the capacity, but the uninsured and many of the under-insured cannot afford CT or MRI scans. Tens of millions of Americans are not even allowed a place in the queue.

Which system is better: a lower cost system that recognizes a capacity problem and takes measures to resolve that, or a higher cost system that has adequate capacity but nevertheless engages in wholesale rationing based on ability to pay?

Canada’s MRI and CT scanners

Canada Newswire
Sept. 24, 2003
Release from Canadian Institute for Health Information (CIHI)
CIHI report shows dramatic increase in MRI, CT scans and scanners

A new national report on medical imaging by the Canadian Institute for Health Information (CIHI) shows the supply of MRI (Magnetic Resonance Imaging) and CT (Computed Tomography) scanners and the number of scans performed have risen dramatically in the past decade, and that the distribution of major imaging equipment varies across the country.

A recent Statistics Canada survey found that 6.7% of Canadians age 15 and
over – a total of 1.7 million people – had a non-emergency MRI, CT, or angiography in 2001. Provincial data show volumes have risen sharply in
recent years.

Canada had a total of 147 MRI scanners in January 2003 compared to 30 in
1993, an increase of nearly 400%. The number of CT scanners rose by about
50% over the same period, from 216 in 1993 to 326 in January 2003. The country also had 594 nuclear medicine cameras, 165 angiography suites,
94 Catheterization labs, and 14 PET scanners in January 2003. Canada’s MRI and CT machines are, on average, newer than those in Europe.

Waiting for Care: The 2001 Statistics Canada Health Services Access Survey
found that about half of Canadians aged 15 and older who reported receiving
a non-emergency CT, MRI, or angiography waited three weeks or less. Most
(55%) waited less than a month; about 5% waited six months or more. One-quarter of those who were tested felt their wait was unacceptable; about
one in six (16%) said the wait affected their lives. Most (68%) of those who
said the wait affected them said it caused worry, anxiety, or stress.

http://www.newswire.ca/releases/September2003/25/c4564.html

Comment: One of the most common arguments presented against the adoption of a single payer system in the United States is that there are unacceptable
queues or delays for services in any universal, government funded program.
Perhaps the most frequent example given is the unacceptable delays in diagnostic imaging in Canada due to the fact that they do not have enough CT or MRI scanners to meet their needs. This report reveals that, in the past decade, great progress has been made by Canada in addressing this problem.

Emergency imaging is always available without delay. And, by 2001, three-fourths of Canadians who had elective scans do not believe that they were subjected to unacceptable delays. Since the release of the Romanow report, an even greater effort has been made to ensure adequate capacity.

Canada’s access to imaging is not bad and is improving dramatically. Contrast that to imaging in the United States. We have the capacity, but the uninsured and many of the under-insured cannot afford CT or MRI scans. Tens of millions of Americans are not even allowed a place in the queue.

Which system is better: a lower cost system that recognizes a capacity problem and takes measures to resolve that, or a higher cost system that has adequate capacity but nevertheless engages in wholesale rationing based on ability to pay?

B. Capell responds on the importance of lobbying

Beth Capell, Ph.D. responds on the AAHP/HIAA merger and the importance
of lobbying:

The budgets listed (in yesterday’s message on the AAHP/HIAA merger) probably do NOT include campaign contributions as your comment implies.Instead, these budgets are devoted to lobbying, providing information and “research” that supports lobbying, and activating grassroots presence (though perhaps not that either: it would depend on how these associations structure what they do: the overhead on grassroots could be modest and most of the cost of that effort could be buried within the budgets of individual companies).

Woody Allen says that 90% of life is just showing up. The same is true for moving an idea through the political process. Showing up counts. A lot. The insurers are ubiquitous on health issues–not just universal coverage, but Medicare prescription drugs and probably a dozen other key issues. And they are omnipresent: that’s what $30-$40 million in lobbying presence means: it means that every member of Congress who thinks a thought about health care knows who the insurance lobbyists are and probably what they will think about an issue.

PNHP has a plan for affordable health care for all—but members of Congress won’t know about it or take it seriously without an effective lobbying presence and without grassroots capacity to back that up. An occasional appearance on public television or an article in a medical journal (not widely read on Capitol Hill) are good but not sufficient. It is not a matter of matching the insurance industry dollar for dollar: after all, we beat them on HMO reform in California with far less capacity than that–but we (you, me, lots of other people and a number of key organizations) were there day after day for five years to win that fight. A fight at the national level requires commensurately greater capacity.

Good ideas are important but not sufficient. Just showing up counts for a lot in advocacy. Creating that presence, that showing up is what organizing is about.

Beth Capell, Ph.D., political science, lobbyist for California Physicians Alliance, Health Access California and others.

Editorial in Science calls for Debate on Single Payer National Health Insurance

Editorial in Science calls for Debate on Single Payer National Health Insurance
September 25, 2003

“Physicians have a responsibility to help solve the problem of inequities in our health care system.” (excerpt)

September 25, 2003— An editorial in this week’s issue of Science Magazine authored by former US Surgeon General Dr. Julius B. Richmond and Harvard economist Rashi Fein calls on American physicians to become active in the debate over health reform.

Dr. Richmond is a professor of Health Policy at Harvard Medical School. He served as Surgeon General in the Carter Administration. Dr. Fein is a Professor of the Economics of Medicine at Harvard Medical School. The Science Magazine editorial comes as rising health costs and premiums, and the increasing number of uninsured have stimulated a new round of health reform initiatives.

The editorial comments on the “Proposal of the Physicians’ Working Group for Single-Payer National Health Insurance” (NHI), a proposal endorsed by more than 10,000 physicians which was published last month in the Journal of the American Medical Association (JAMA, 8/13/03). The Physicians’ Proposal critiqued the health reform plans that have been offered by the Bush administration and the presidential candidates and concluded that the times call for a single-payer, government-administered, but privately-delivered system of health care.

“Our health system is deteriorating rapidly,” said Dr. Quentin Young, an author of the Physicians’ Proposal and National Coordinator of Physicians for a National Health Program. “By admonishing all professionals to become engaged, Richmond and Fein render a great service to the nation.”

# # #

Physicians for a National Health Program is an organization of 11,000 physicians that support universal access to health care. The group is headquartered in Chicago and has chapters across the United States (www.pnhp.org). A copy of the Physicians’ Proposal is available at www.physiciansproposal.org along with a list of endorsers.

To interview the authors contact Ida Hellander at tel: 312.782.6006 or pnhp@aol.com

To obtain an advance copy of the Science Magazine Health Insurance in the USA editorial, contact Kristina Smith at (202) 326-6440.

A formidable insurance lobby

The Hill
September 23, 2003
Insurance trade groups OK merger
AAHP and HIAA consolidates Hill lobbying efforts
By Michael S. Gerber

Washington, D.C.’s two largest health insurance trade groups (The American
Association of Health Plans (AAHP) and Health Insurance Association of America (HIAA)) announced Monday that their boards of directors had approved a merger…

Leading the new association in its efforts on Capitol Hill to promote
private insurers will be Karen Ignagni, who currently serves as president
and CEO of AAHP.

The two associations’ similar agendas in Washington make it easy to merge
the policy shops. Both have been pressing for a larger role for private insurers in the Medicare prescription drug package as well as increased
payments to HMOs.

AAHP and HIAA spent a combined $9.3 million on lobbying last year,according
to records filed with the Senate.Each group’s budget is around $20 million, according to the Government Affairs Yellow Book published by Leadership Directories.

AAHP currently employs a staff of 120 and HIAA 80, Ignagni said.(AAHP Chairman William) McCallum said the new organization’s budget would be about 40 percent greater than AAHP’s.

http://www.hillnews.com/business/092303_merger.aspx

Comment: So what? Well, AAHP/HIAA and its membership owns a controlling
interest in Congress. That’s what.

When our goal is to try to provide everyone with health insurance, why should we be concerned that this industry has a favored position with Congress? It’s because our current fragmented system of funding care through private and public programs has resulted in unacceptable waste, deficiencies and inequities in our system. Congress continues to perpetuate policies that protect and enhance private health plans at the cost of health care equity for all of us.

AAHP/HIAA’s $40 million budget can secure its position quite solidly in the
hallways and lobby rooms of Congress. In contrast, we have no significant
sources of funds. All we can offer is a plan to provide affordable, comprehensive health care for everyone. Unfortunately, policy position papers don’t have the color and smell of fresh U.S. Treasury ink that serves as an effective attractant to too many of the creatures of Congress.

MASS-CARE

The Committee for Health Care for Massachusetts is a statewide effort being led by the people of Massachusetts, including health professionals, community leaders, organizations, patients and their families to ensure that no state resident go without affordable, comprehensive and equitably financed health insurance.

click hereto view

Medicaid becoming merely a means tested certification

Kaiser Commission on Medicaid and the Uninsured (KCMU)
News release on Medicaid reductions
September 22, 2003

In the Past Three Years, Two-thirds of States Have Reduced Eligibility and
Restricted Health Care Benefits for Families and Low-Income Seniors-Not Just
Curbing Payments

With most states coping with their fourth year of fiscal stress, all 50 states and the District of Columbia (DC) have planned or implemented Medicaid cost containment actions for fiscal year (FY) 2004.

Diane Rowland, executive director of KCMU:”The duration of the state fiscal crisis is impacting Medicaid coverage broadly and deeply-and it’s not just actions curbing provider payments or controlling prescription drug costs that we have heard about consistently.

When 34 states have reduced eligibility and even more have restricted needed
health care benefits in at least one of the last three years and there is little short-term hope of states recovering their revenue losses, we have to be concerned about low-income seniors and families getting less health care or losing it altogether.”

http://www.kff.org/content/2003/20030922/prls922.pdf

Comment: As long as Medicaid remains a welfare program for very low income individuals, it will always be used as tool to balance budgets in difficult economic times, even though it is a chronically underfunded program.

Having a Medicaid card alone does not ensure access to adequate health care.

Medicaid is becoming less and less a form of insurance, and more and
more a certification process declaring the individual has been subjected to
means testing and is incapable of paying for medical care. Providers are now
in a position of either accepting losses because of their belief that everyone
should have medical care, or refusing to provide care because the insurer
(state and federal government) has failed to adequately fund the actual costs of care.

If we had an egalitarian system of social insurance, the political will
would be there to ensure that the system would be adequately funded for all
of us. Wouldn’t that be better?

50 percent employee contribution to health care!?

The Providence Journal
September 21, 2003
There’s no shelter from this storm
By John Kostrzewa

Employees used to contribute about 15 percent of the cost of health care. Now, the contribution has risen to 25 percent to 35 percent. And health-care consultants forecast it will grow to 50 percent at some companies.

Some workers are cutting back on health care and elective Surgeries, deciding to live with the bad knee rather than get a replacement. Or they are deciding to postpone the eye exam to avoid the copay. Or they are going without health insurance.
No relief is on the horizon.

http://www.projo.com/business/content/projo_20030921_jk21x.777bd.html

Comment: Current health care reform efforts continue down this path of shifting costs to patients. But is this really reform? Reform is defined as a change for the better. Reducing affordable access to beneficial health care services is a change for the worse.

Let’s dump this movement to shift costs to patients and get on with the process of real reform!