PNHP

League of Women Voters endorses single payer, Medicare for All

League of Women Voters endorses single payer, Medicare for All

June 16, 2010

Dear PNHP colleagues,

Good news!

The 150,000-member League of Women Voters called for “an improved Medicare for all,” i.e. for single-payer health reform, at its national convention on Monday.

The League’s action – the first major organizational endorsement of single payer since the passage of the Obama administration’s health bill in March – was facilitated by the work of PNHP members and other single-payer advocates across the country who have educated their colleagues in the League about the merits of single-payer national health insurance over a period of several years. Congratulations to all!

PNHP news release on the endorsement appears below; please feel free to bring it to the attention of your local media contacts.

Local chapters of the League, of which there are 900 nationwide, are presently holding public meetings and other forums about health care reform, including what the administration’s new health law contains and how it will likely play out.

We encourage PNHP members to participate in such League-sponsored meetings and to provide expert information about the single-payer alternative, possibly by serving as a panelist. You can locate a League chapter near you by going here.

PNHP slideshows and other resources are available for your use in this regard and in other contexts.

We also encourage you to explore all other opportunities of working in coalition with the League to further our common goal, single-payer Medicare for all.

Cordially,


Ida Hellander, M.D.
Executive Director


Quentin Young, M.D.
National Coordinator

League of Women Voters calls for ‘Medicare for all’

FOR IMMEDIATE RELEASE
June 16, 2010

Contact:
Karen Green Stone and Rob Stone, M.D.
Quentin Young, M.D., (312) 782-6006, info@pnhp.org
Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org

Noting the Obama administration’s new health law falls short of providing affordable care to all U.S. residents, the national convention of the League of Women Voters passed a resolution Monday calling on the group’s board to “advocate strongly” for “an improved Medicare for all.”

The convention’s 600 delegates, meeting in Atlanta on the group’s 90th anniversary, voted more than 2 to 1 in support of the measure. In the run-up to the national meeting, nearly identical resolutions were adopted by more than 50 local chapters and 11 state organizations of the League, which claims more than 150,000 members nationwide.

Although many other groups, including labor unions, religious denominations and medical associations, have gone on record in recent years in support of a single-payer health program, or an improved Medicare for all, the League’s action is believed to be the first national endorsement of its type since Congress passed the Patient Protection and Affordable Care Act in March.

“The League’s action is highly welcome and highly significant,” said Dr. Quentin Young, national coordinator of Physicians for a National Health Program, an organization of 17,000 doctors who support a single-payer system. “Among other things, it shows that its members are in tune with numerous polls indicating strong majority support for a government-sponsored, improved Medicare-for-all program.

“Such a program is urgently needed to bring to a close the economic and medical fiasco that is the tragic reality of our present health system – a condition which, sadly, the newly passed health law will not cure,” he said.

The convention vote took place shortly before the arrival of Kathleen Sebelius, President Obama’s secretary of health and human services, who was scheduled to address the gathering and to plug the administration’s new health law. When Sebelius arrived, she was greeted by delegates holding a banner that read, “LWV Supports Improved Medicare for All.”

While Sebelius was warmly received by the delegates, the Medicare-for-all message undoubtedly got through, Young said.

The health care resolution (see below) was promoted across the country by League members who built upon the group’s previous declaration that a viable health care plan should be universal, affordable, accessible and funded by taxation rather than by insurance premiums.

The resolution was introduced at the Atlanta meeting by Karen Green Stone of Bloomington, Ind., who argued that the new law lacks effective cost controls and does nothing to eliminate wasteful paperwork and bureaucracy in the U.S. health system.

Green Stone commented after the vote, “The delegates at the meeting understood that it has never been more important to push for a single-payer plan, an improved Medicare for all. They loved our new slogan in Indiana: ‘Health care reform: We’re still for it … and we’re not done yet!'”

Single-payer advocates say replacing the nation’s multiple private health insurers with a single streamlined, nonprofit, public insurance program would save about $400 billion annually in administrative costs, enough to provide all U.S. residents with comprehensive, quality care.

Health Care Resolution passed by LWVUS – June 14, 2010

Whereas the League of Women Voters of the United States believes quality health care at an affordable cost should be available to all U.S. residents; and

Whereas the current and proposed systems do not achieve the League goals of affordability and access to everyone; and

Whereas an improved Medicare for all, a publicly funded and privately delivered national health care plan, is consistent with this goal;

Therefore, be it resolved, we, the representatives of local and state Leagues assembled at the 2010 LWVUS Convention, call upon the LWVUS Board to advocate strongly for bills that legislate for improved Medicare for all.

Physicians for a National Health Program (www.pnhp.org) is an organization of more than 17,000 physicians who support a single-payer national health insurance program. To contact a physician-spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.

League of Women Voters calls for 'Medicare for all'

League of Women Voters calls for ‘Medicare for all’

Physicians for a National Health Program
June 16, 2010
Noting the Obama administration’s new health law falls short of providing affordable care to all U.S. residents, the national convention of the League of Women Voters passed a resolution Monday calling on the group’s board to “advocate strongly” for “an improved Medicare for all.”
Although many other groups, including labor unions, religious denominations and medical associations, have gone on record in recent years in support of a single-payer health program, or an improved Medicare for all, the League’s action is believed to be the first national endorsement of its type since Congress passed the Patient Protection and Affordable Care Act in March.
The resolution was introduced at the Atlanta meeting by Karen Green Stone of Bloomington, Ind., who argued that the new law lacks effective cost controls and does nothing to eliminate wasteful paperwork and bureaucracy in the U.S. health system.
Green Stone commented after the vote, “The delegates at the meeting understood that it has never been more important to push for a single-payer plan, an improved Medicare for all. They loved our new slogan in Indiana: ‘Health care reform: We’re still for it … and we’re not done yet!'”
https://pnhp.org/news/2010/june/league-of-women-voters-calls-for-medicare-for-all

And…

2010 Convention

League of Women Voters
Atlanta, Georgia
June 11-15, 2010
Motion #549-473, submitted by LWV of Bloomington-Monroe, IN.
Whereas the League of Women Voters of the United States believes quality health care at an affordable cost should be available to all U.S. residents; and
Whereas the current and proposed systems do not achieve the League goals of affordability and access to everyone; and
Whereas an improved Medicare for all, a publicly funded and privately delivered national health care plan, is consistent with this goal;
Therefore, be it resolved that we, the representatives of local and state Leagues assembled at the 2010 LWLVUS Convention, call upon the LWVUS Board to advocate strongly for bills that legislate for improved Medicare for all.
Motion APPROVED.
http://www.lwv.org/AM/Template.cfm?Section=Council_and_Convention&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=15476

And…

LWV Address by Health and Human Services Secretary Kathleen Sebelius

Closing remarks:
So I want to thank you for all your hard work on behalf of the Affordable Care Act.  It’s a tremendous accomplishment.
But I’m also here to tell you that our work isn’t over.  You understand this.  The League of Women Voters was created right before the passage of the 19th amendment.  Some people might have said it was a strange time to start a group focusing on women and democracy.  After all, women were already poised to get the right to vote.
But you knew that passing the amendment was just the first step.  There was still hard work to be done to fulfill its promise.  That’s also true for the Affordable Act.
We’re on the right track.  But we’ve still got a long way to go.  And we’ll need your help to get there.
http://www.lwv.org/AM/Template.cfm?Template=/CM/ContentDisplay.cfm&ContentID=15477

Once again, the League of Women Voters leads the way. Although they supported the Patient Protection and Affordable Care Act (PPACA), they realize that it falls far short of the League goals of affordability and access for everyone. Even HHS Secretary Kathleen Sebelius concedes that we still have a long way to go.
There are several beneficial measures in PPACA that we should continue to support. But the greatest deficiency in the act is that the PPACA financing model can never get us to an affordable system that includes everyone. The delegates at the LWV convention recognized this when they passed the resolution calling for the national LWV Board (LWVUS) to “advocate strongly for bills that legislate for improved Medicare for all,” since it would provide the financing infrastructure that we desperately need.
The individuals and organizations, who in the name of compromise abandoned support for a national health program, have achieved their lesser goal of passing something – anything – as long as the act provided some benefit. Now that it is clear that tweaks to PPACA will still leave us with only compromised “something – anything” policies, it’s time to remount the unified effort to enact an improved Medicare program that includes everyone. We need to give Kathleen Sebelius the tools that she needs to get us there, and that didn’t happen with PPACA.
The League of Women Voters has picked up the torch. Let’s join them. After all, as they say in Indiana, “Health care reform: We’re still for it … and we’re not done yet!”

League of Women Voters calls for ‘Medicare for all’

League of Women Voters calls for ‘Medicare for all’

Physicians for a National Health Program
June 16, 2010

Noting the Obama administration’s new health law falls short of providing affordable care to all U.S. residents, the national convention of the League of Women Voters passed a resolution Monday calling on the group’s board to “advocate strongly” for “an improved Medicare for all.”

Although many other groups, including labor unions, religious denominations and medical associations, have gone on record in recent years in support of a single-payer health program, or an improved Medicare for all, the League’s action is believed to be the first national endorsement of its type since Congress passed the Patient Protection and Affordable Care Act in March.

The resolution was introduced at the Atlanta meeting by Karen Green Stone of Bloomington, Ind., who argued that the new law lacks effective cost controls and does nothing to eliminate wasteful paperwork and bureaucracy in the U.S. health system.

Green Stone commented after the vote, “The delegates at the meeting understood that it has never been more important to push for a single-payer plan, an improved Medicare for all. They loved our new slogan in Indiana: ‘Health care reform: We’re still for it … and we’re not done yet!'”

https://pnhp.org/news/2010/june/league-of-women-voters-calls-for-medicare-for-all

And…

2010 Convention

League of Women Voters
Atlanta, Georgia
June 11-15, 2010

Motion #549-473, submitted by LWV of Bloomington-Monroe, IN.

Whereas the League of Women Voters of the United States believes quality health care at an affordable cost should be available to all U.S. residents; and

Whereas the current and proposed systems do not achieve the League goals of affordability and access to everyone; and

Whereas an improved Medicare for all, a publicly funded and privately delivered national health care plan, is consistent with this goal;

Therefore, be it resolved that we, the representatives of local and state Leagues assembled at the 2010 LWLVUS Convention, call upon the LWVUS Board to advocate strongly for bills that legislate for improved Medicare for all.

Motion APPROVED.

http://www.lwv.org/AM/Template.cfm?Section=Council_and_Convention&TEMPLATE=/CM/ContentDisplay.cfm&CONTENTID=15476

And…

LWV Address by Health and Human Services Secretary Kathleen Sebelius

Closing remarks:

So I want to thank you for all your hard work on behalf of the Affordable Care Act.  It’s a tremendous accomplishment.

But I’m also here to tell you that our work isn’t over.  You understand this.  The League of Women Voters was created right before the passage of the 19th amendment.  Some people might have said it was a strange time to start a group focusing on women and democracy.  After all, women were already poised to get the right to vote.

But you knew that passing the amendment was just the first step.  There was still hard work to be done to fulfill its promise.  That’s also true for the Affordable Act.

We’re on the right track.  But we’ve still got a long way to go.  And we’ll need your help to get there.

http://www.lwv.org/AM/Template.cfm?Template=/CM/ContentDisplay.cfm&ContentID=15477

Once again, the League of Women Voters leads the way. Although they supported the Patient Protection and Affordable Care Act (PPACA), they realize that it falls far short of the League goals of affordability and access for everyone. Even HHS Secretary Kathleen Sebelius concedes that we still have a long way to go.

There are several beneficial measures in PPACA that we should continue to support. But the greatest deficiency in the act is that the PPACA financing model can never get us to an affordable system that includes everyone. The delegates at the LWV convention recognized this when they passed the resolution calling for the national LWV Board (LWVUS) to “advocate strongly for bills that legislate for improved Medicare for all,” since it would provide the financing infrastructure that we desperately need.

The individuals and organizations, who in the name of compromise abandoned support for a national health program, have achieved their lesser goal of passing something – anything – as long as the act provided some benefit. Now that it is clear that tweaks to PPACA will still leave us with only compromised “something – anything” policies, it’s time to remount the unified effort to enact an improved Medicare program that includes everyone. We need to give Kathleen Sebelius the tools that she needs to get us there, and that didn’t happen with PPACA.

The League of Women Voters has picked up the torch. Let’s join them. After all, as they say in Indiana, “Health care reform: We’re still for it … and we’re not done yet!”

AMA health insurer report card

New AMA Health Insurer Report Card Finds Need For More Accuracy

AMA
June 14, 2010

The American Medical Association (AMA) today announced that one in five medical claims are processed inaccurately by health insurers, according to the AMA’s third annual check-up of the nation’s commercial health insurers and the systems they use to manage and pay claims. This was the key finding of the AMA’s 2010 National Health Insurer Report Card.

The AMA estimates that $777.6 million in unnecessary administrative cost could be saved if the health insurance industry improves claims processing accuracy by one percent. Increasing the health insurance industry’s accuracy rating to 100 percent would save up to $15.5 billion annually that could be better used to enhance patient care and help reduce overall health care costs.

http://www.ama-assn.org/ama/pub/news/news/2010-report-card.shtml

National Health Insurer Report Card
http://www.ama-assn.org/ama1/pub/upload/mm/368/2010-nhirc-results.pdf

Comment: 

By Don McCanne, MD

The private insurance industry is selling us administrative services at an outrageously high price. This report card confirms that we certainly are not receiving value. Not only are we paying them too much, but they also continue to do a lousy job at their most important function – claims processing. Their error rate results in an additional $15 billion annually in administrative waste that could be used for patient care, according to this AMA report.

This year the AMA did not report Medicare’s error rate, but, in the 2008 report card, Medicare’s compliance rate was vastly superior to all of the private insurers – over 98 Percent.

But the greatest argument for changing to an improved Medicare program that covers everyone is not the reduction in waste caused by private insurer claims processing errors which would save about $15 billion, rather it is the replacement of our dysfunctional, fragmented, private/public financing system with a single payer system which would save us about $400 billion annually.

Even if the private insurers could match the claims performance of Medicare, that wouldn’t fix our problems. It’s the financing model that needs to be changed. The $4 trillion that we could recover over the next decade would pay for the needed care for the uninsured and the growing numbers of underinsured. We would have solved our health care financing problems, and that would allow us to direct more of our attention and effort to much needed health system reform.

Medicare for all needed for mental health services

By F. Douglas Stephenson
Citrus County (Fla.) Chronicle, March 9, 2010

One reliable indicator of health care quality in any nation is life expectancy. Unfortunately, life expectancy in the USA ranks in the bottom quartile of a list of 229 industrialized nations, according to the Organization for Economic Cooperation and Development. Many of these same 29 nations also increased their investment in mental health services while, during the same period, the U.S. slashed its expenditures for psychiatric and mental health services.

Mentally ill patients have been dumped into our communities poorly prepared for them. Thousands of the mentally ill have joined the street people in many of our cities, and, reminiscent of Elizabeth England, the county jail has become the primary community facility for housing most mentally ill people in the United States.

Over 45 million US citizens now lack any kind of health insurance, and millions more have very inadequate coverage in the policies they now carry. Among these with incomes below the federal poverty line, a third had no health insurance. Statistics show that among Americans who are inadequately insured, a significant number are sicker and die younger than those who have insurance.

It is no mystery why this is happening in this country. Because the insurance industry so thoroughly dominates our health care system, the basic concept, purpose and system of health insurance is defined by them. The U.S. subscribes to a business model of health insurance that defines insurers as commercial entities. Private insurers maximize profits by mainly limiting benefits or by not covering people with health problems. Like all businesses, their goal is to make money.

Under the business model, the greed of casual inhumanity is built in and the common good of the citizens and nation is ignored; excluding the poor, the aged, the disabled and the mentally ill is sound business policy, since it maximizes profit.

In most other developed countries, however, the aim of health insurance is simply to promote a social service for universal access to affordable health care for all citizens, and not to generate profits for stockholders, CEOs and other private business entities. The U.S. is the only advanced country in the world with a health care system based on avoiding sick people.

Mental health treatment services in general and talk therapy in particular have been negatively affected by insurance and drug company domination of the US health care system. Talk therapy includes psychotherapy, psychoanalysis, counseling, marriage therapy, family therapy, group therapy, psycho-educational groups, addiction treatment groups and programs, parent training groups, anger management programs and many others.

There are dozens of effective means to deal with human distress that involve talk between qualified professionals and people seeking help. Talk therapy is not one-size-fits-all. It is focused on emotional problems in relationship with oneself or others.

Insurers, with their focus on profit, seek to spend as little as possible on your mental health care. Talk therapy sessions have been drastically cut by insurers. Privacy has been invaded and is no longer assured. Your choice of therapist is no longer under your control.

Likewise, drug companies with profit motive want to sell you drugs. Drugs and insurance companies with profit motive want to sell you drugs. Drug and insurance companies often view talk therapy and qualified practitioners as a threat to their control over the health care system. These companies insist that mental health problems are due to “biological imbalances” which require only expensive medications.

A systematic campaign to discredit the value and competence of talk therapists exists when drug and insurance companies assert, for example, that most types of long-term therapies are not “evidence based.” Insurance coverage for talk therapy has in fact steeply declined since the mid 1980s, from 6 percent to 2 percent of all insurance payments. People seeking talk therapy increasingly must pay for those services out of pocket.

Many people with emotional and psychological problems make good progress with talk therapy or with a combination of talk therapy and medication. While drugs can indeed by helpful, they alone do not “cure” emotional distress and sometimes have uncomfortable side effects. Certainly, there are biological aspects to many emotional and psychological problems, but biology is not the only cause (or cure) for these conditions.

Consumers of health care services do not have to be intimidated into accepting inadequate mental health treatment. Citizens have a right to demand effective clinical service. Tell your health care plan that you want adequate access to qualified talk therapists if you have emotional, addiction or marriage and family problems. Let your employer or human resource department know that you want a solid mental health benefit that includes comprehensive talk therapy services.

We now have over two decades of experience with the conversion of mental health care into a business. Our health care is being rationed, its care guidelines determined by profitability and secrecy decided in private corporate boardrooms.

To realize large profits demanded by Wall Street investors, our health system must attract the healthy and turn away the sick, disabled, the poor, many of the old, and the mentally ill. A 1997 study by the New England Journal of Medicine showed that a large number of Medicare HMOs engaged in favorable selection by “cherry picking” healthier individuals. Since 1987, the number of uninsured in the U.S. has grown by a million each year.

Our mental health care system needs to get private health insurance out of it. Little of value is offered by private insurance when 15 to 25 percent of the health care dollar is skimmed off for profit and overhead. If, for example, the existing Medicare program is now extended to all citizens, universal coverage, “Medicare for all,” for both mental and physical health is possible while strongly containing costs.

The transition to full enrollment in Medicare, for example, could be achieved by gradually dropping the eligibility age over five to ten years. Any losses in phasing out private health insurance industry jobs could be will offset by job gains in other American industries, especially since they would no longer by saddled with such high health insurance costs, as is now the case. Medicare is much more efficient than private insurance, with overhead now less than 4 percent. More importantly, it cannot deny care to those who need it the most, and administration by a single-payer public entity makes controlling costs more possible.

Nobel Prize recipient Bernard Lown, M.D., of the Harvard School of Public Health sums it up nicely: “One may only hope that Winston Churchill’s quip will soon be realized: ‘You can always count on Americans to do the right thing, after they have tried everything else.’ The United States has tried any number of bad solutions for providing its people with health care. Long overdue is the recognition that medicine is a necessary social service that should be accessible to all citizens.”

F. Douglas Stephenson, LCSW, LMFT, BCD, is a graduate of The University of Chicago and was a faculty member in the Department of Psychiatry, University of Florida. A psychotherapist in private practice in Citrus County since 1990, his offices are in Meadowcrest Doctor’s Park, Crystal River, 795-7070.

http://www.chronicleonline.com/cgi-bin/c2.cgi?071+article+Health+20100308143128071071003

AMA health insurer report card

New AMA Health Insurer Report Card Finds Need For More Accuracy

AMA
June 14, 2010
The American Medical Association (AMA) today announced that one in five medical claims are processed inaccurately by health insurers, according to the AMA’s third annual check-up of the nation’s commercial health insurers and the systems they use to manage and pay claims. This was the key finding of the AMA’s 2010 National Health Insurer Report Card.
The AMA estimates that $777.6 million in unnecessary administrative cost could be saved if the health insurance industry improves claims processing accuracy by one percent. Increasing the health insurance industry’s accuracy rating to 100 percent would save up to $15.5 billion annually that could be better used to enhance patient care and help reduce overall health care costs.
http://www.ama-assn.org/ama/pub/news/news/2010-report-card.shtml
National Health Insurer Report Card
http://www.ama-assn.org/ama1/pub/upload/mm/368/2010-nhirc-results.pdf

The private insurance industry is selling us administrative services at an outrageously high price. This report card confirms that we certainly are not receiving value. Not only are we paying them too much, but they also continue to do a lousy job at their most important function – claims processing. Their error rate results in an additional $15 billion annually in administrative waste that could be used for patient care, according to this AMA report.
This year the AMA did not report Medicare’s error rate, but, in the 2008 report card, Medicare’s compliance rate was vastly superior to all of the private insurers – over 98 Percent.
But the greatest argument for changing to an improved Medicare program that covers everyone is not the reduction in waste caused by private insurer claims processing errors which would save about $15 billion, rather it is the replacement of our dysfunctional, fragmented, private/public financing system with a single payer system which would save us about $400 billion annually.
Even if the private insurers could match the claims performance of Medicare, that wouldn’t fix our problems. It’s the financing model that needs to be changed. The $4 trillion that we could recover over the next decade would pay for the needed care for the uninsured and the growing numbers of underinsured. We would have solved our health care financing problems, and that would allow us to direct more of our attention and effort to much needed health system reform.

Insurers wipe out small business credits

Insurance premium hikes hit small business hard

By John Gonzales
San Francisco Chronicle
June 12, 2010

California small-business owners expected to be early beneficiaries of health care reform, with billions of dollars in federal tax relief becoming available this month to help them purchase medical coverage for their employees.

The credit is worth up to 35 percent of a small business’ premium costs.

But many said the tax credits granted under the legislation have run up against a new hurdle: a spate of rate increases by insurance companies, including 58 to 75 percent hikes levied recently by Blue Shield of California.

The company offered other coverage without the high rate increase, but included similar deductibles and added co-pays of about 20 percent. The Blue Shield hikes are in line with increases from all major insurers on small business health savings plans, said (Tom Epstein, vice president of Public Affairs for Blue Shield of California).

“Anthem Blue Cross offered this first,” he said. “Health Net followed us. Aetna and United offered products like this. Every one of these insurers had very substantial rate increases.”

“That money is going right back to the insurance companies,” said Brad Wing, co-owner of the San Francisco Advertiser, who received notice of his 58.3 percent increase in April.

“Normally, rates go up 10 to 15 percent and you can swallow it,” he said. “But at 58 percent, there’s just no way.”

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/06/12/BUGG1DONP4.DTL

Comment: 

By Don McCanne, MD

The Patient Protection and Affordable Care Act (PPACA) is supposed to make health care affordable, primarily by subsidizing private insurance plans. It begins immediately by offering small businesses a credit worth up to 35 percent of premium costs. With Blue Shield of California increasing rates by as much as 58 to 75 percent, how is the small business owner going to find relief when the insurer takes the full subsidy and charges what amounts to another 23 to 40 percent surcharge?

Several individuals who no longer want to hear our single payer message tell us that PPACA is now the law of the land, that private plans are here to stay, and that we need to quit attacking the private insurers and get on with making PPACA work.

When non-profit Blue Shield of California is the best the industry has to offer, how can we possibly ever make that work? We can’t. We need to quit supporting PPACA and get on with making an improved Medicare for all work!

Vermont to explore single-payer option

Governor allows into law a bill calling for creation of a commission to look at overhauling the state's health system.

By Chris Silva
American Medical News, June 11, 2010.

A new Vermont health care bill could lead to significant changes in the state’s delivery and payment structures, including a possible move toward a single-payer system. Governor Jim Douglas announced May 27 that he would allow the bill to become law without his signature.

Douglas, whose term ends in January 2011, said he chose not to put his signature on the bill because of his apprehension about two particular features — the exploration of a single-payer model and the requirement that pharmaceutical companies publicly release information on expenses related to free drug samples.

The law will create a health reform commission, which has until Feb. 1, 2011, to propose to the governor and general assembly three design options for creating a single system of health care in the state. It specifies that one of those options will include the design of a government-administered and publicly financed single-payer benefits system.

Douglas called the provision “a wasteful expense of time and scarce resources,” especially as Vermont would be prohibited by the federal health reform law from implementing any new system designs until 2017 at the earliest. The governor’s office said states could seek a waiver to that rule, but their chances of approval might be limited.

The law also bolsters the state’s medical home model by requiring insurance carriers to participate in the statewide expansion of the program, the Vermont Blueprint for Health. Also, hospitals will be required to establish and maintain interoperable connectivity to the state health information exchange network to support the Blueprint’s clinical data repository. The move is designed to make laboratory, hospital discharge and other data more readily available to physicians.

The Vermont Medical Society, which was involved in the drafting of the bill, said it is in favor of it, though it has not taken a stance on the single-payer provision.

“Ninety percent of the bill continues reform efforts that the medical society has been involved with, particularly around the patient-centered medical home, the statewide adoption and use of health information technology, and the piloting of different payment reform models,” said Paul Harrington, VMS’ executive vice president.

Some of the state’s physicians said they are excited about Vermont exploring the single-payer model.

“With a qualified consultant and the right governor, this just may get us to a better health care system than what the national health care bill will provide,” said family physician Deb Richter, MD, spokeswoman for the citizens group Vermont for Single Payer.

This content was published online only.

http://www.ama-assn.org/amednews/2010/06/07/gvsd0611.htm

Prominent physician tells Portsmouth Rotary Club single-payer system would extend care to all

By Jason Claffey
Foster’s Daily Democrat
Friday, June 11, 2010

PORTSMOUTH — The health care reform bill passed earlier this year — the largest expansion of coverage since Medicare was enacted in 1965 — did not go far enough, a prominent physician told the Portsmouth Rotary Club Thursday.

Dr. Oliver Fein, president of the Physicians for a National Health Program, argued a single-payer system would extend care to all Americans, slash billions of dollars in administrative waste, broaden patients’ choices of doctors, and increase the quality of care.

“It’s a much better deal,” said Fein, a general internist and professor at Cornell University’s Weill Medical College in New York.

He said a single-payer system, or “Medicare for all.” would save $400 billion, enough to cover 50 million uninsured Americans. The health care reform bill is projected to extend coverage to 32 million Americans by 2019.

Fein attended President Obama’s health care summit before the bill was passed. His and others’ advocacy of a single-payer system was watered down to a public option that would compete with private insurers, but Congress ultimately left it out of the final version of the bill.

Physicians for a National Health Program is comprised of 17,000 physicians still fighting for the single-payer system, which offers universal coverage through one insurance pool operated by the government.

Fein and representatives of the group were scheduled to canvas the state Thursday and Friday, making additional stops in Lebanon, Hanover, Concord.

One member of Physicians for a National Health Program is Portsmouth-based Dr. Tom Clairmont, who organized Fein’s appearance Thursday afternoon at the Redhook Ale Brewery.

Clairmont claimed premiums at his practice recently skyrocketed 22 percent.

Fein said that can be attributed to out-of-control administrative costs, which represent more than 30 percent of total health care costs.

“We have to deal with this huge waste in the health care system,” he said.

Private insurers limit a patient’s choice of doctors to those within their network; Fein said a single-payer system would allow patients to choose any doctor.

One drawback of transitioning to the single-payer model is there could be a dearth of primary-care physicians, Fein said, but that would be remedied by an “enormous incentive” to train more.

He argued the quality of care in America is lower compared to other countries with the single-payer model like Canada and the United Kingdom because private companies restrict access to their data for competitive reasons.

“We need a national system that allows data to be collected so quality can be measured,” he said.

He said the U.S. needs to move away from a premium-based system because, if nothing else, “The president of a company pays the same premium as the secretary.”

http://www.fosters.com/apps/pbcs.dll/article?AID=/20100611/GJNEWS_01/706119903

Insurers wipe out small business credits

Insurance premium hikes hit small business hard

By John Gonzales
San Francisco Chronicle
June 12, 2010
California small-business owners expected to be early beneficiaries of health care reform, with billions of dollars in federal tax relief becoming available this month to help them purchase medical coverage for their employees.
The credit is worth up to 35 percent of a small business’ premium costs.
But many said the tax credits granted under the legislation have run up against a new hurdle: a spate of rate increases by insurance companies, including 58 to 75 percent hikes levied recently by Blue Shield of California.
The company offered other coverage without the high rate increase, but included similar deductibles and added co-pays of about 20 percent. The Blue Shield hikes are in line with increases from all major insurers on small business health savings plans, said (Tom Epstein, vice president of Public Affairs for Blue Shield of California).
“Anthem Blue Cross offered this first,” he said. “Health Net followed us. Aetna and United offered products like this. Every one of these insurers had very substantial rate increases.”
“That money is going right back to the insurance companies,” said Brad Wing, co-owner of the San Francisco Advertiser, who received notice of his 58.3 percent increase in April.
“Normally, rates go up 10 to 15 percent and you can swallow it,” he said. “But at 58 percent, there’s just no way.”
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/06/12/BUGG1DONP4.DTL

The Patient Protection and Affordable Care Act (PPACA) is supposed to make health care affordable, primarily by subsidizing private insurance plans. It begins immediately by offering small businesses a credit worth up to 35 percent of premium costs. With Blue Shield of California increasing rates by as much as 58 to 75 percent, how is the small business owner going to find relief when the insurer takes the full subsidy and charges what amounts to another 23 to 40 percent surcharge?
Several individuals who no longer want to hear our single payer message tell us that PPACA is now the law of the land, that private plans are here to stay, and that we need to quit attacking the private insurers and get on with making PPACA work.
When non-profit Blue Shield of California is the best the industry has to offer, how can we possibly ever make that work? We can’t. We need to quit supporting PPACA and get on with making an improved Medicare for all work!

Castlight casts light on sick U.S. health system

Bringing Comparison Shopping to the Doctor’s Office

By Claire Cain Miller
The New York Times
June 10, 2010

The lack of price information in health care has been a big driver of ballooning health care costs, analysts say, because costs are opaque to patients and heavily subsidized by employers. The patient has no incentive or responsibility to keep costs down. But many employers are switching to health plans that require patients to pay more out of their own pockets.

A start-up financed by prominent venture capitalists and the Cleveland Clinic, Castlight Health, aims to change that by building a search engine for health care prices. Patients using Castlight could search for doctors that offer a service nearby and find out how much they will charge, depending on their insurance coverage.

Castlight has received money from investment firms including Venrock, Maverick Capital, Oak Investment Partners and from an unlikely source, the Cleveland Clinic.

Ideally, transparency in health care pricing could lead to higher-quality, lower-cost health care, and more patient involvement in buying health care, said Delos Cosgrove, chief executive of the Cleveland Clinic. “Because they begin to realize that a trip to the doctor is not free, they might stay home and take the aspirin instead of getting the neurologic work-up.”

Castlight sells its service to employers and charges by employee per month.

Safeway, the grocery chain, with 200,000 employees, has signed on as its first customer.

Safeway has been experimenting with ways to cut health costs, including by using Castlight. “I’m a big believer in trying to create market forces wherever you can and then let personal accountability really drive the result,” said Steven A. Burd, the chief executive of Safeway.

Castlight is working on a mobile version of the service to introduce next year so people can access the information from the exam table.

Price transparency could significantly change the way health care is bought in the United States. The notion “seems ridiculously simple and obvious, and in any other industry, you would say, ‘Duh, we already have that.’ But in health care, it’s revolutionary,” said Alan M. Garber, a professor of medicine and the director of the center for health policy at Stanford, as well as an investor in Castlight.

http://www.nytimes.com/2010/06/11/technology/11cost.html

Comment: 

By Don McCanne, MD

Our highly dysfunctional, fragmented health care financing system has opened innumerable opportunities for entrepreneurs to glom onto funds that should be going for health care, especially by diverting them to profoundly wasteful administrative services. One of the latest iterations is Castlight, an entity that is capitalizing on the perverse notion, promoted by the right-wing element in the policy community, that we can control health care costs by making patients more sensitive to prices.

The fact that there is much more money to be made in wasteful administrative services is supported by the faith that the venture capitalists have expressed in Castlight. They have put up the financing because they believe that creating a price shoppers portal can suck up more funds out of our health care system. Our entrepreneurs are there to be sure that the United States remains the world’s leader in blowing up health care budgets through administrative waste.

Castlight’s model begins with the flawed theory that price sensitivity will control health care costs. About four-fifths of health care is provided to the one-fifth of individuals who have the greatest health care needs. Price awareness by these individuals does not influence spending much since most of their care is provided after their deductibles and maximums are met. For the other one-fifth of individuals, only a small portion of their care would be amenable to price shopping, and the discounts that they would receive would have a negligible impact on our total national health expenditures.

Of more concern, requiring out-of-pocket spending as a consequence of accessing health care has been proven to cause individuals to forgo beneficial health care services. A policy that disincentivizes beneficial care should be rejected, especially when it is a policy that wouldn’t help much in our efforts to control spending anyway.

Prices are important. The two most significant reasons that we spend much more on health care in the United States than do other nations are our profound administrative waste, and our prices that are much higher than in all other countries. Did other nations price their health care more appropriately by exposing patients to prices? Of course not. They did it by using the monopsonistic power of their governments in setting prices that were fair for patients and yet adequate to ensure that the health care delivery system receives the funds it needs to function. For controlling administrative costs, they simply adopted sane methods of financing health care.

Perhaps the greatest concern over the Castlight start-up involves ethical issues. Let’s look at Delos Cosgrove, Steven Burd, and Alan Garber.

Although Cleveland Clinic is often touted as an efficient health delivery model, it seems appropriate to criticize it for investing in an entity that is going to profit by providing more excessive administrative services that would expand application of the flawed policy of shifting more costs to patients in need. Of particular concern is the position of their chief executive, Delos Cosgrove, who glibly suggests that price sensitivity could cause a patient to decline a neurological work-up and to go home and take an aspirin instead. Such an important decision should hardly be made on the basis of price shopping.

Steven Burd, chief executive of Safeway, has a track record of touting savings through “personal accountability.” He glosses over the fact that his savings resulted from switching his employees to high-deductible health plans. Now he is becoming a customer of Castlight thereby solidifying the policy that his employees may not receive care that they should have because they have a price barrier between them and health care.

But what about the ethics of Alan Garber, a professor of medicine and the director of the center for health policy at Stanford? Although very knowledgeable about the impacts of health policy, he is personally investing in a company that wastes more resources on excess administration and that he says is “revolutionary” in bringing transparency in support of the inappropriate price barriers that are being erected on the path to health care. Is that an ethical compromise for a health policy expert? As he says, “Duh.”

Doctor makes case for single-payer care

By Jennifer Feals
Portsmouth (N.H.) Herald, June 11, 2010

PORTSMOUTH — More than 100 business owners, health care professionals, patients and elected officials gathered Thursday to learn about a single-payer health care system, many stating their support.

Dr. Oliver Fein, president of Physicians for a National Health Program, presented “Everybody In, Nobody Out, One Group, One Plan, One Rate,” touting the need for a single-payer national system.

Fein referred to the system as “Medicare for all,” and said it would save $400 billion annually — enough to cover the nation’s 46 million uninsured — and addresses issues facing the health care system like access, choice and quality.

“If you look at the logic, it’s a no-brainer,” said Rich Holzen, of Kittery, Maine. “Yet, it has not been debated in public. People hear socialized medicine — that’s the bogeyman. But what was presented today clearly isn’t socialized medicine.”

PNHP is fighting the new health care law, which Fein said has good features but doesn’t do enough. While it offers expanded coverage, it is not universal, has no definition of benefits and is a handout to the private health insurance industry, he said.

“The legislation that passed really did not go far enough in terms of what we need and health care reform,” said Fein, professor of medicine and public heath at Weill Medical College at Cornell University.

The single-payer system would eliminate pre-existing conditions, co-payments and deductibles, and would cover all who need health insurance. It reduces costs, Fein said, by creating global budgets for hospitals, negotiated fees for providers, bulk purchasing of pharmaceuticals and the elimination of billing departments and administrative waste.

In addition to meeting with the group Thursday afternoon, Fein met with members of the Portsmouth Rotary earlier in the day. On Thursday evening, Fein spoke to physicians and patients at Dartmouth Medical School and Concord Hospital.

Members of the public, like Holzen, asked how they can get involved to help change the current system. Fein said contacting congressional representatives will be important, in addition to inviting PNHP supporters and doctors to speak to local groups and organizations.

State Rep. Rich DiPentima, D-Portsmouth, said the public is ahead of policy makers in understanding what health care changes need to take place. But implementing that change, he said, is going to be “tricky.”

“Because you have the negative and misinformation about the single-payer system,” he said. “It’s going to be an education opportunity. We really have to educate the public.”

State Sen. Martha Fuller Clark, D-Portsmouth, said she’s proud of the accomplishments of the new health care bill in that it gets coverage to those who don’t have it and ensures that patients who need coverage won’t be dropped.

But time will tell, she said, if elements of a single-payer program can be implemented into the system and how that would be done.

“This seems the right way to go, but the real question is how do we go about converting enough people and elected officials to put this in place,” she said.

Fuller Clark said the single-payer system is one she would support and work toward implementing, possibly even a combined effort between Maine, New Hampshire and Vermont for a pilot program.

http://www.seacoastonline.com/articles/20100611-NEWS-6110412