As the economy slows down, and more Americans are facing the potential financial burdens of inadequate health insurance coverage or no coverage at all, it is urgent that a common plan be formulated to initiate a popular campaign that can finally move society to take action in support of universal health care.

As we have seen, the road to health care reform has had many turns, including many dead ends. Various campaigns and many initiatives have been tried; we traveled in many different directions but have not found the way. Although our vision and determination to make quality health care a right of every citizen is just and unwavering, we have been unable to formulate a plan and unleash a campaign that could move society to take action in support of universal health care. In contrast to past movements for social justice, our efforts to find an effective approach have eluded us for over half a century. Let no one be in doubt – there has been no predominant social movement for universal health care, merely sporadic and episodic campaigns and demands for health care justice, allowed to ignite, flame brightly, sputter, and die out.

The vital approach begins with our willingness to recognize and accept the lessons of past movements for social justice, equality and rights which require that those who support reform must finally agree to seek common ground, unite, plan and act together and move in the same direction in building a uniform popular movement for universal health care. It is only through strategically using combined talents and resources and a central plan that the isolated cries for health care reform can enlist the support and mighty roar of many Americans from coast to coast, thus initiating a true movement.

The whole answer, the whole truth, is no different from before. Our struggle for rights in health care is a part of America’s unfinished work; it should be perpetuated in accordance with the nation’s long historic journey for justice, and demands – as with past movements -that those whose rights are being denied must take part.

We are trying to determine if you might be interested in being involved in this new effort to seek common ground in order to build a nationwide grassroots movement for universal health care.

Philip Pollner, M.D. Nancy Wooten, Ph.D. Don McCanne, M.D.

Those who are interested please respond by email to leadcoal@aol.com or call Dr. Pollner at 302-266-7373 evenings (EST).

Please forward this message to friends, colleagues and to the leadership of organizations that might share our vision.

As the economy slows down, and more Americans are facing the potential financial burdens of inadequate health insurance coverage or no coverage at all, it is urgent that a common plan be formulated to initiate a popular campaign that can finally move society to take action in support of universal health care.

As we have seen, the road to health care reform has had many turns, including many dead ends. Various campaigns and many initiatives have been tried; we traveled in many different directions but have not found the way. Although our vision and determination to make quality health care a right of every citizen is just and unwavering, we have been unable to formulate a plan and unleash a campaign that could move society to take action in support of universal health care. In contrast to past movements for social justice, our efforts to find an effective approach have eluded us for over half a century. Let no one be in doubt – there has been no predominant social movement for universal health care, merely sporadic and episodic campaigns and demands for health care justice, allowed to ignite, flame brightly, sputter, and die out.

The vital approach begins with our willingness to recognize and accept the lessons of past movements for social justice, equality and rights which require that those who support reform must finally agree to seek common ground, unite, plan and act together and move in the same direction in building a uniform popular movement for universal health care. It is only through strategically using combined talents and resources and a central plan that the isolated cries for health care reform can enlist the support and mighty roar of many Americans from coast to coast, thus initiating a true movement.

The whole answer, the whole truth, is no different from before. Our struggle for rights in health care is a part of America’s unfinished work; it should be perpetuated in accordance with the nation’s long historic journey for justice, and demands – as with past movements -that those whose rights are being denied must take part.

We are trying to determine if you might be interested in being involved in this new effort to seek common ground in order to build a nationwide grassroots movement for universal health care.

Philip Pollner, M.D. Nancy Wooten, Ph.D. Don McCanne, M.D.

Those who are interested please respond by email to leadcoal@aol.com or call Dr. Pollner at 302-266-7373 evenings (EST).

Please forward this message to friends, colleagues and to the leadership of organizations that might share our vision.

July 2, 2001
Patients’ Rights

RAY SUAREZ: Dr. Angell (Marcia Angell, former editor of the New England Journal of Medicine), let me close with you. You’ve talked a little bit about where incentives, in your view, are misled. What about liabilities?

DR. MARCIA ANGELL: We have to look at the motivations, the incentives that cause care to be denied. If you talk, if you focus too much on the suits after the care has been denied, it’s like trying to put a band-aid on a gaping wound. You have to look at why the care was denied in the first place. It’s a little late in the day when you get to the point of suing. Now, let me answer Mr. Moffit (Robert Moffit, Heritage Foundation) because while he and I agreed on the diagnosis of patients’ rights bills and the fact that it would increase the number of uninsured we certainly disagree on the remedy. And I’m appalled to hear him imply that Medicare is somehow inefficient. It has far lower overhead costs than the private managed care system, far lower, 2 or 3 percent as compared with about 30 percent, and in fact, his solution that you would throw individuals out into this treacherous private healthcare insurance market is a recipe for disaster. What we need, in essence, is Medicare for everyone. We need a single payer system, Medicare for everyone. Medicare is the most efficient part of our health care system and it’s certainly the most popular. That’s what we ought to be looking toward.

RAY SUAREZ: Well, that places the debate on a very, very different footing, and we’re not going to be able to have that one right now, but thank you all for joining us tonight.

The entire transcript and audio is available at: http://www.pbs.org/newshour/bb/health/july-dec01/patients_7-2.html

July 2, 2001
Patients’ Rights

RAY SUAREZ: Dr. Angell (Marcia Angell, former editor of the New England Journal of Medicine), let me close with you. You’ve talked a little bit about where incentives, in your view, are misled. What about liabilities?

DR. MARCIA ANGELL: We have to look at the motivations, the incentives that cause care to be denied. If you talk, if you focus too much on the suits after the care has been denied, it’s like trying to put a band-aid on a gaping wound. You have to look at why the care was denied in the first place. It’s a little late in the day when you get to the point of suing. Now, let me answer Mr. Moffit (Robert Moffit, Heritage Foundation) because while he and I agreed on the diagnosis of patients’ rights bills and the fact that it would increase the number of uninsured we certainly disagree on the remedy. And I’m appalled to hear him imply that Medicare is somehow inefficient. It has far lower overhead costs than the private managed care system, far lower, 2 or 3 percent as compared with about 30 percent, and in fact, his solution that you would throw individuals out into this treacherous private healthcare insurance market is a recipe for disaster. What we need, in essence, is Medicare for everyone. We need a single payer system, Medicare for everyone. Medicare is the most efficient part of our health care system and it’s certainly the most popular. That’s what we ought to be looking toward.

RAY SUAREZ: Well, that places the debate on a very, very different footing, and we’re not going to be able to have that one right now, but thank you all for joining us tonight.

The entire transcript and audio is available at: http://www.pbs.org/newshour/bb/health/july-dec01/patients_7-2.html

The New York Times
July 2, 2001

Uwe Reinhardt, Princeton University, on the patients’ rights legislation:

“I think it was a ridiculous diversion of political energy that distracts from the truly shocking problems of the American health care system — the uninsured, the elderly without drugs and the medical error problem.”

http://www.nytimes.com/2001/07/02/politics/02AGEN.html

The New York Times
July 2, 2001

Uwe Reinhardt, Princeton University, on the patients’ rights legislation:

“I think it was a ridiculous diversion of political energy that distracts from the truly shocking problems of the American health care system — the uninsured, the elderly without drugs and the medical error problem.”

http://www.nytimes.com/2001/07/02/politics/02AGEN.html

Los Angeles Times
June 24, 2001
Opinion
Our national interest has become little more than making it easier for people to pursue their material dreams.
By Neal Gabler, a senior fellow at the Norman Lear Center at USC Annenberg

“… to be a nation a people must have a sense of something other than their own self-interest. It is a message the current president might well heed, for without it… we are not citizens, only consumers.”

(The entire article can be accessed at www.latimes.com, click “Archives,” and enter “Neal Gabler” into the search box. A one-time registration is required.)

Medical Economics
June 18, 2001
Letters to the Editors

I read with interest the April 23 “Memo From the Editor” regarding the roundtable discussion on the state of our nation’s health care. While I respect the members of that select panel, I don’t think it should have dismissed a universal national health plan as passé.

I, along with nearly 10,000 other disgruntled physicians, belong to Physicians for a National Health Program (www.pnhp.org). We readily acknowledge that the US health care system is seriously flawed. Despite the fact that this country spends far more on health care than any other industrialized nation, over 42 million Americans have no health care coverage.

I agree that Hillary Clinton’s plan was flawed, but we’ve got to do something other than apply more Band-Aids to remedy our current mess. While Congress has already passed a gigantic tax cut, and is considering a multitrillion-dollar defense shield, we still have not acted to ensure that every citizen has adequate access to health care.

Howie Wolf, MD
Lafayette, CO
Lobo985@home.com

Editor’s Note: For the roundtable discussion itself, see “What it will take to fix the system.”

Part I of the roundtable discussion is now available at: http://me.pdr.net/me/public.htm?path=content/journals/m/data/2001/0618/round1.html

The New York Times
June 26, 2001

To the Editor:

Re “A Wrong Turn on Patients’ Rights,” by Marcia Angell (Op-Ed, June 23):

Dr. Angell is right when she says “a single-payer system that covers everyone” offers the only solution to this country’s deepening health care crisis. As long as we permit corporate medicine to squander precious resources on marketing, excessive administrative costs and profits, patients will be left in the lurch.

We should do what every other industrialized country in the world does: guarantee health care to all. Although we support patients’ rights legislation like the Kennedy-McCain bill, it won’t provide insurance for the 43 million uninsured or prevent employers and H.M.O.’s from continuing to cut back benefits.

OLIVER FEIN, M.D. JOANNE LANDY New York, June 23, 2001

The writers are, respectively, chairman and executive director, Physicians for a National Health Program, New York chapter.

The concluding remarks from the original Op-Ed by Marcia Angell, M.D, former editor of the New England Journal of Medicine.:

“The answer is a single-payer system that covers everyone and more efficiently uses the resources we allocate to health care. That is tantamount to extending Medicare to all Americans. Medicare is not perfect, but it provides a uniform set of benefits to nearly everyone who qualifies, and it does so far more efficiently than the private employment-based system. Extending and improving Medicare would be simpler and more realistic than trying to shore up a fundamentally irrational system by measures like patients’ rights bills.”

The entire article is available at: http://www.nytimes.com/2001/06/23/opinion/23ANGE.html

The New York Times
June 26, 2001

To the Editor:

Re “A Wrong Turn on Patients’ Rights,” by Marcia Angell (Op-Ed, June 23):

Dr. Angell is right when she says “a single-payer system that covers everyone” offers the only solution to this country’s deepening health care crisis. As long as we permit corporate medicine to squander precious resources on marketing, excessive administrative costs and profits, patients will be left in the lurch.

We should do what every other industrialized country in the world does: guarantee health care to all. Although we support patients’ rights legislation like the Kennedy-McCain bill, it won’t provide insurance for the 43 million uninsured or prevent employers and H.M.O.’s from continuing to cut back benefits.

OLIVER FEIN, M.D. JOANNE LANDY New York, June 23, 2001

The writers are, respectively, chairman and executive director, Physicians for a National Health Program, New York chapter.

The concluding remarks from the original Op-Ed by Marcia Angell, M.D, former editor of the New England Journal of Medicine.:

“The answer is a single-payer system that covers everyone and more efficiently uses the resources we allocate to health care. That is tantamount to extending Medicare to all Americans. Medicare is not perfect, but it provides a uniform set of benefits to nearly everyone who qualifies, and it does so far more efficiently than the private employment-based system. Extending and improving Medicare would be simpler and more realistic than trying to shore up a fundamentally irrational system by measures like patients’ rights bills.”

The entire article is available at: http://www.nytimes.com/2001/06/23/opinion/23ANGE.html

Mark Hannay, Director, Metro New York Health Care for All Campaign:

“The author of the latest Kaiser Family Foundation study re: the private individual health insurance market (Karen Pollitz) did a briefing for legislative staff here in NY (Albany) last week, and showed that while you are right, a universal public program is ultimately the only long-term solution, in the shorter-term, there are steps states can take to stabilize and make their individual markets work successfully to some degree. These include: community rating, guaranteed issue, standardized comprehensive products, re-insurance & risk-sharing/adjustment mechanisms, public subsidies to insurers who end up with a disproportionate share of high-cost people, and not allowing opt-outs for special categories of individuals (e.g., sole proprietors into the small group market) but rather keeping the market whole as much as possible.

“In fact, NY is one of the few (only?) states to have taken these various steps, and as a consequence, unlike in the states she looked at, ALL the persons profiled in her study would be able to get comprehensive coverage without having to pay more or suffer a loss in benefits in NY. However, they would still have to pay high premiums of $4,000+ annually for individuals (more than double that for families), which is a never-ending battle — this year the average rate increases in NY so far are 20-30%+, with some rates going up as much as 75+%!

“In NY, most of our ‘reforms’ were fought against the initial opposition of the insurance industry, who were neutralized once we assured them that they’d not be put at an undue disadvantage and the state would help them shoulder the burden. After all, this market is disproportionately comprised of high-volume health care users (i.e., the chronically ill and disabled) who buy in this market because they MUST have this coverage to literally survive and often have no other alternatives, and so they scrape the pennies together somehow because it is THE most expensive way to buy insurance.

“All this is by way of saying that there are things which can be done to somewhat alleviate the crisis for people in the individual market, but clearly a long-term systemic solution is called for (i.e., universal health care.) If you want to see what’s coming down the road for the rest of us as the American health care system continues to collapse, take a look at the individual market in most states. The modus operandi? Once you get sick and need coverage which you will actually use, you either can’t get it at all, or can’t get it for what you need it for, and you’ll pay through the nose regardless.

“Makes sense huh? Kick ’em while they’re down!”

For the full KFF report: http://www.kff.org/content/2001/20010620a/indivifull2.PDF

Comment: Mark has pointed out the fact that a tightly regulated insurance market, as in Albany, has the distinct advantage of assuring the theoretical availability of coverage for everyone. The crucial tradeoff is that the very high premiums that result create significant financial barriers to coverage for young and healthy consumers, along with everyone else. Once again this demonstrates the pressing need to eliminate the waste of our private health plan bureaucracies, to pay for health care in a fair and just manner through progressive funding, and to contain costs through mechanisms that improve the allocation of our health care dollars. Mark has shown us that application of rational health policies in our current health care market still fails to address the issue of affordability, and that there is no way to escape the reality that we really do need publicly administered, universal health insurance. We are getting closer to a rational system, and some day we’ll get it right.

Institue for Public Accuracy
June 19, 2001

Quentin Young, M.D., National coordinator of Physicians for a National Health Program:

“The heart of our problem is the takeover of health care by corporate interests. Having the right to sue an HMO is an attempt to seek justice after the HMO has inflicted the harm. But we have to stop the harm. We have an urgent need to establish universal coverage, like Medicare for all.”

http://www.accuracy.org/new.htm