PNHP

Health and Wealth – To the Editor – NYT

Health and Wealth – To the Editor – NYT

The New York Times
July 6, 2001
Letters

To the Editor:

In a June 30 letter, a former chairman and chief executive of Aetna Inc. suggests that people pay for procedures not covered by their insurance plan or health maintenance organization. Maybe he can afford this, but most of us cannot. Therefore, insurers are making medical decisions when they deny coverage.

The United States outspends every nation on health care, yet health care here is ranked 37th in quality by the World Health Organization. Most Canadian and British citizens are satisfied with their national health care systems. While Canada often has long waiting lists, this is caused by a small population to share the costs and a shortage of physicians, which the United States does not have.

A single-payer plan is long over-due in the United States. Health care is a basic human right and an essential service well within the scope of government to provide.

ROBERTA PALMER, M.D. Tigard, OR

Comment: The New York Times has published innumerable letters advocating for single-payer health care reform. Isn’t it time for their editorial board to sit down with representatives of the single payer movement to consider their own endorsement of this imperative for health care justice?

Med Students Applaud Maine Efforts Towards Universal Health Care For All

RESTON, VIRGINIA

July 5 – In Maine, due to quickly rising premiums, both individuals and small employers are being crunched out of the health insurance market; consequently, one in three Mainers are either uninsured or underinsured. Governor Angus King and the state legislature recently created a commission charged with developing a plan for the implementation of a single-payer, universal health care system in Maine for presentation to the legislature in March 2002.

The American Medical Student Association (AMSA), the nation’s largest, independent medical student organization, enthusiastically commends the people of Maine, the state legislature, and the Governor for taking the bold step needed toward ensuring that all Mainers have access to comprehensive, high-quality health care. Maine has always demonstrated a pioneering spirit in health care, and this effort demonstrates Maine’s commitment to making high-quality health care accessible to everyone, said Jaya Agrawal, AMSA national president and a fourth-year medical student at Brown University. In a single-payer system, money is dedicated to the provision of health care, not insurance companies’ administrative costs, stock dividends, or CEO salaries, Agrawal continued. We know that with Maine’s continued determination, they will not merely demonstrate this fact, but ignore the special interests and become the first, but certainly not the last state, to implement a system that provides health care coverage of the highest quality for all residents of their state.

AMSA has supported a single payer health care system for more than 30 years. Just as medical students have been vocal proponents within the medical community of a Medicare-for-all system, Maine has led the nation in creating novel programs that serve as models for increased health care access. Recent studies in both Massachusetts and Maryland have shown that a single-payer system in those states would provide high quality health care for all citizens while saving millions of dollars.

We Pay for National Health Insurance but Don't Get It

Government Funds 60% of U.S. Healthcare Costs – Far Higher than Previously Believed

Harvard Study Finds Government Health Spending in U.S. Higher than in Any Other Nation:
“We Are Pay for National Health Insurance but Don’t Get It”

Government expenditures accounted for 59.8% of total U.S. health care costs in 1999, according to a Harvard Medical School study published today in the journal Health Affairs. At $2,604 per capita, government spending was the highest of any nation – including those with national health insurance. Indeed, government health spending in the U.S. exceeded total health spending (government plus private) in every other country except Switzerland. (Estimated total U.S. health spending for 2002 is $5,427 per capita, with government’s share being $3,245.)

The study analyzed data on spending for government health programs like Medicare, Medicaid and the Veterans Administration ($548.7 billion in 1999), as well as two categories that have previously been overlooked in calculating government health costs. (1) Expenditures to buy private insurance for government employees – e.g. members of Congress, firemen and school teachers – at a cost of $65.6 billion in 1999. And (2) tax subsidies for private coverage – which totaled $109.6 billion in 1999. Most of these tax subsidies go to the wealthiest Americans. The study found that government’s share of expenditures has nearly doubled since 1965, with tax subsidies and public employee benefit costs increasing fastest.

The hidden government health spending has a major impact on family budgets. In 1999, a family of four with average health costs spent $7,016 for their own health expenses and premiums (including what their employer paid). In addition, they paid $10,416 in health care taxes; $1,578 for tax subsidies, $943 for government workers’ coverage, and $7,895 for government health programs like Medicare and Medicaid. Even many uninsured families pay thousands of dollars in taxes for the health care of others.

Dr. Steffie Woolhandler, a study author and an Associate Professor of Medicine at Harvard, noted: “We pay the world’s highest health care taxes. But much of the money is squandered. The wealthy get tax breaks. And HMOs and drug companies pocket billions in profits at the taxpayers’ expense. But politicians claim we can’t afford universal coverage. Every other developed nation has national health insurance. We already pay for it, but we don’t get it.”

Dr. David Himmelstein, study co-author and a co-founder of Physicians for a National Health Program, commented: “Our study shows that universal coverage is affordable – without a big tax increase. Government already spends nearly enough, but its spending it wrong. National health insurance doesn’t mean spending more; it means spending wisely. We spend over $309 billion each year on paperwork in insurance companies, hospitals and doctors’ office – at least half of which could be saved through national health insurance. We spend $150 billion on medications, at prices 50% higher than Canadians pay for the same drugs. By slashing bureaucracy and drug prices we could save enough to cover all of the uninsured and improve coverage for the rest of us.”

“It’s an outrage that the American people pay sky high health care taxes – but 40 million of them are uninsured,” said Dr. Quentin Young, Past President of the American Public Health Association. “Health care should be every American’s right, just like schools, roads, defense, police and fire protection.”

IT'S TIME TO ESTABLISH A POPULAR GRASSROOTS MOVEMENT FOR UNIVERSAL HEALTH CARE

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.

IT’S TIME TO ESTABLISH A POPULAR GRASSROOTS MOVEMENT FOR UNIVERSAL HEALTH CARE

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.

PBS NewsHour – Patients' Rights

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

PBS NewsHour – Patients’ Rights

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

News Analysis: After Patients' Rights, Vast Needs and Higher Hurdles by Robin Toner

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

News Analysis: After Patients’ Rights, Vast Needs and Higher Hurdles by Robin Toner

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

A Nation Longing for a Higher Cause

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.)

Leaders in the fight for access to health care – Letters to the Editor – Medical Economics

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

Is a Patients' Rights Bill the Cure?

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