PNHP

NHIS uninsured report portends underinsurance for most

NHIS uninsured report portends underinsurance for most

Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2009

By Robin A. Cohen, Ph.D., Michael E. Martinez, M.P.H., M.H.S.A., and Brian W. Ward, Ph.D.
Centers for Disease Control and Prevention (CDC)
National Center for Health Statistics
June 16, 2010

In 2009:

46.3 million (15.4%) were uninsured at the time of the interview

58.5 million (19.4%) had been uninsured for at least part of the year

32.8 million (10.9%) had been uninsured for more than a year

Estimates of enrollment in HDHPs, CDHPs, and FSAs:

Based on data from the 2009 NHIS, 22.4% of persons under age 65 years with private health insurance were enrolled in a HDHP (high deductible health plan), including 6.3% who were enrolled in a CDHP (consumer-directed health plan) and 16.1% who were enrolled in a HDHP without a health savings account (HSA). Enrollment in HDHPs increased from 17.5% in 2007 to 22.4% in 2009. There was a significant increase in enrollment in HDHPs without HSAs and in CDHPs.

Based on data for 2009, among persons under age 65 with private health insurance, 20.2% with employment-based coverage were enrolled in a HDHP, compared with 46.9% of those with a private plan that was directly purchased or obtained through means other than employment. The percentage of persons covered by employment-based private plans that are HDHPs increased from 15.6% in 2007 to 20.2% in 2009. The percentage of persons covered by directly purchased private health plans that are HDHPs increased from 39.2% in 2007 to 46.9% in 2009. For persons under age 65, approximately 8% of private health plans are directly purchased. HDHPs constitute a growing share of both employment-based and directly purchased health plans.

In 2009, among persons under age 65 with private health insurance, 20.4% were in a family that had a FSA for medical expenses. This is an increase from 2007, when 16.7% of persons under age 65 with private insurance were in a family with a FSA.

http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201006.htm

Comment: 

By Don McCane, MD

Although the net loss in insurance coverage for 2009 left another 3 million individuals without coverage, the media response is tempered by the anticipated expansions in health care coverage under the Patient Protection and Affordable Care Act (PPACA). What is being missed in the media reports is a new trend revealed in this survey that will result in an exponential increase in the rates of underinsurance.

A few facts:

* 20.2% of individuals with employer-sponsored plans have high deductible health plans (HDHP)

* 46.9% of individuals with private plans purchased outside of employment have HDHPs

* 72% of those with HDHPs do not have health savings accounts

* PPACA will require plans to have an actuarial value of only 60 percent

Much has been written about how high deductible health plans (HDHPs) result in underinsurance for the majority of Americans, so little will be said here other than to point out that those with medical needs do not receive all of the care that they should have when faced with the financial barrier of a high deductible before they can access the benefits of their health plan. Insurance should improve access to necessary care rather than impair it.

Although the right-wingers in the policy community tout health savings accounts (HSAs) as the solution for making deductibles affordable, there are several flaws. First, close to three-fourths of HDHPs don’t even have an HSA component. For those that do, excess expensive and burdensome administration is being wasted on managing the HSAs which are really no different from the patient paying the expenses out of personal savings, except for the very modest tax advantage of the HSA. Whether in an HSA or in a personal savings account, it is still the patient’s own money that is being spent. If the HSA or the personal savings account were empty, as might be expected for individuals with medical problems, then the high deductible remains as a barrier to care.

Another approach is to set up a flexible spending account (FSA) instead of an HSA. One-fifth of individuals are in families that already have FSAs through their employment. These are even less rational than HSAs since it is the employee’s own pre-tax money that is deposited into the FSA, yet any funds remaining at the end of the year are forfeited. How smart is that?

There is a coalescence of trends that makes it likely that HDHPs will become the standard for most of us with private coverage. To slow the increase in insurance premiums, employers are starting to convert to HDHPs, and one-fifth of them have already done so. Plans in the individual market are much less affordable except for HDHPs. Almost half of those purchasing plans in the individual market have now switched to HDHPs. Because of concerns about high insurance premiums, the drafters of PPACA decided on an actuarial value of only 60 percent for private insurance plans (the patient pays 40 percent of the costs of care). Large deductibles and high coinsurance are used to keep the actuarial value down. Adverse selection of plans will low deductibles will cause a premium spiral that will make those plans unaffordable, forcing even more individuals to choose HDHPs. With these trends it seems that the future will hold little option for most of us not eligible for government programs, other than to enroll in HDHPs.

Since PPACA provides subsidies for both the premiums and out-of-pocket spending, does it even matter if the plans have high deductibles? Since the alleged purpose of high deductibles is to decrease the use of health care by making patients sensitive to health care prices, then it makes no sense to add the administrative excesses and expenses of removing a benefit in the form of the deductible and adding it back in in the form of administered subsidies if the patient ends up bearing only a negligible portion of the costs, thereby jettisoning price sensitivity. As the means- tested subsidies diminish, the deductibles may have more significance, but not for those who are responsible for most of our health care costs – the 20 percent who use 80 percent of our health care.

Will the insurance exchanges obviate the need for HDHPs? When they crafted the PPACA model, it was clear that premiums for comprehensive plans were already too high. That is why they decided on reducing the actuarial values of the plans – 60 percent for the least coverage, though premium subsidies will apply to silver plans with a 70 percent actuarial value. Silver plans will still require high deductibles since they fall short of the typical employer-sponsored plan with an actuarial value of 80 percent or more.

Since the cost sharing would still be excessive for most individuals and families, PPACA provides for cost sharing credits that would have the effect of increasing the actuarial value on a sliding scale based on income – 70 percent for those at 250-400% of the federal poverty level (FPL) and up to 94 percent for those with incomes at 100-150% FPL.

There is concern that the combined premium plus the cost sharing for the exchange plans is still too high for most families, but these are the levels that Congress decided would be necessary because of their arbitrary decision to limit how much of the costs would pass through the federal budget.

But what is really ridiculous is that merely to avoid an efficient system with a single, publicly financed universal risk pool, they designed an administratively complex system of variable actuarial values, with variable premium subsidies, with variable cost sharing credits, which will drive the plans to introduce high deductibles as the national standard, when high deductibles have already
been demonstrated to be a perverse policy for controlling costs.

Remember, by continuing on our current PPACA course, we are going to see an explosion in high deductible health plans, to the detriment of people who need health care. Of course, we could change course and enact an improved Medicare for all without any deductibles. We wouldn’t need price sensitivity if we had our own public health care monopsony.

NHIS uninsured report portends underinsurance for most

Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, 2009

By Robin A. Cohen, Ph.D., Michael E. Martinez, M.P.H., M.H.S.A., and Brian W. Ward, Ph.D.
Centers for Disease Control and Prevention (CDC)
National Center for Health Statistics
June 16, 2010
In 2009:
46.3 million (15.4%) were uninsured at the time of the interview
58.5 million (19.4%) had been uninsured for at least part of the year
32.8 million (10.9%) had been uninsured for more than a year
Estimates of enrollment in HDHPs, CDHPs, and FSAs:
Based on data from the 2009 NHIS, 22.4% of persons under age 65 years with private health insurance were enrolled in a HDHP (high deductible health plan), including 6.3% who were enrolled in a CDHP (consumer-directed health plan) and 16.1% who were enrolled in a HDHP without a health savings account (HSA). Enrollment in HDHPs increased from 17.5% in 2007 to 22.4% in 2009. There was a significant increase in enrollment in HDHPs without HSAs and in CDHPs.
Based on data for 2009, among persons under age 65 with private health insurance, 20.2% with employment-based coverage were enrolled in a HDHP, compared with 46.9% of those with a private plan that was directly purchased or obtained through means other than employment. The percentage of persons covered by employment-based private plans that are HDHPs increased from 15.6% in 2007 to 20.2% in 2009. The percentage of persons covered by directly purchased private health plans that are HDHPs increased from 39.2% in 2007 to 46.9% in 2009. For persons under age 65, approximately 8% of private health plans are directly purchased. HDHPs constitute a growing share of both employment-based and directly purchased health plans.
In 2009, among persons under age 65 with private health insurance, 20.4% were in a family that had a FSA for medical expenses. This is an increase from 2007, when 16.7% of persons under age 65 with private insurance were in a family with a FSA.
http://www.cdc.gov/nchs/data/nhis/earlyrelease/insur201006.htm

Although the net loss in insurance coverage for 2009 left another 3 million individuals without coverage, the media response is tempered by the anticipated expansions in health care coverage under the Patient Protection and Affordable Care Act (PPACA). What is being missed in the media reports is a new trend revealed in this survey that will result in an exponential increase in the rates of underinsurance.
A few facts:
* 20.2% of individuals with employer-sponsored plans have high deductible health plans (HDHP)
* 46.9% of individuals with private plans purchased outside of employment have HDHPs
* 72% of those with HDHPs do not have health savings accounts
* PPACA will require plans to have an actuarial value of only 60 percent
Much has been written about how high deductible health plans (HDHPs) result in underinsurance for the majority of Americans, so little will be said here other than to point out that those with medical needs do not receive all of the care that they should have when faced with the financial barrier of a high deductible before they can access the benefits of their health plan. Insurance should improve access to necessary care rather than impair it.
Although the right-wingers in the policy community tout health savings accounts (HSAs) as the solution for making deductibles affordable, there are several flaws. First, close to three-fourths of HDHPs don’t even have an HSA component. For those that do, excess expensive and burdensome administration is being wasted on managing the HSAs which are really no different from the patient paying the expenses out of personal savings, except for the very modest tax advantage of the HSA. Whether in an HSA or in a personal savings account, it is still the patient’s own money that is being spent. If the HSA or the personal savings account were empty, as might be expected for individuals with medical problems, then the high deductible remains as a barrier to care.
Another approach is to set up a flexible spending account (FSA) instead of an HSA. One-fifth of individuals are in families that already have FSAs through their employment. These are even less rational than HSAs since it is the employee’s own pre-tax money that is deposited into the FSA, yet any funds remaining at the end of the year are forfeited. How smart is that?
There is a coalescence of trends that makes it likely that HDHPs will become the standard for most of us with private coverage. To slow the increase in insurance premiums, employers are starting to convert to HDHPs, and one-fifth of them have already done so. Plans in the individual market are much less affordable except for HDHPs. Almost half of those purchasing plans in the individual market have now switched to HDHPs. Because of concerns about high insurance premiums, the drafters of PPACA decided on an actuarial value of only 60 percent for private insurance plans (the patient pays 40 percent of the costs of care). Large deductibles and high coinsurance are used to keep the actuarial value down. Adverse selection of plans will low deductibles will cause a premium spiral that will make those plans unaffordable, forcing even more individuals to choose HDHPs. With these trends it seems that the future will hold little option for most of us not eligible for government programs, other than to enroll in HDHPs.
Since PPACA provides subsidies for both the premiums and out-of-pocket spending, does it even matter if the plans have high deductibles? Since the alleged purpose of high deductibles is to decrease the use of health care by making patients sensitive to health care prices, then it makes no sense to add the administrative excesses and expenses of removing a benefit in the form of the deductible and adding it back in in the form of administered subsidies if the patient ends up bearing only a negligible portion of the costs, thereby jettisoning price sensitivity. As the means- tested subsidies diminish, the deductibles may have more significance, but not for those who are responsible for most of our health care costs – the 20 percent who use 80 percent of our health care.
Will the insurance exchanges obviate the need for HDHPs? When they crafted the PPACA model, it was clear that premiums for comprehensive plans were already too high. That is why they decided on reducing the actuarial values of the plans – 60 percent for the least coverage, though premium subsidies will apply to silver plans with a 70 percent actuarial value. Silver plans will still require high deductibles since they fall short of the typical employer-sponsored plan with an actuarial value of 80 percent or more.
Since the cost sharing would still be excessive for most individuals and families, PPACA provides for cost sharing credits that would have the effect of increasing the actuarial value on a sliding scale based on income – 70 percent for those at 250-400% of the federal poverty level (FPL) and up to 94 percent for those with incomes at 100-150% FPL.
There is concern that the combined premium plus the cost sharing for the exchange plans is still too high for most families, but these are the levels that Congress decided would be necessary because of their arbitrary decision to limit how much of the costs would pass through the federal budget.
But what is really ridiculous is that merely to avoid an efficient system with a single, publicly financed universal risk pool, they designed an administratively complex system of variable actuarial values, with variable premium subsidies, with variable cost sharing credits, which will drive the plans to introduce high deductibles as the national standard, when high deductibles have already been demonstrated to be a perverse policy for controlling costs.
Remember, by continuing on our current PPACA course, we are going to see an explosion in high deductible health plans, to the detriment of people who need health care. Of course, we could change course and enact an improved Medicare for all without any deductibles. We wouldn’t need price sensitivity if we had our own public health care monopsony.

Groups protest health care cuts outside Pawlenty's office

By Elizabeth Dunbar
Minnesota Public Radio, June 15, 2010

ST. PAUL, Minn. — A coalition of groups offered blood pressure, cholesterol and blood sugar screenings outside Gov. Tim Pawlenty’s office on Tuesday as part of a protest against cuts to a state health care program for the poor.

The Universal Health Care Action Network of Minnesota and other groups have set up free or low-cost clinics elsewhere before, but organizers said they came to the State Capitol to urge Pawlenty and others to see health care as a human right.

“Health care is a human right based on need. If you need care, you get care. It’s an entitlement and it’s a public good,” said Joel Albers, a pharmacist who is part of the Universal Health Care Action Network.

Four hospitals have agreed to participate in a scaled-back version of General Assistance Medical Care, but all of them are in the Twin Cities. The program uses a coordinated care delivery system, meaning hospitals would get a lump sum of money to care for a certain number of patients.

The new GAMC program was the result of negotiations between Pawlenty and the DFL-controlled Legislature to solve the state’s budget deficit. The changes took effect June 1.

Albers said the cuts will mean the program won’t meet the needs of the 30,000 or so low-income adults without children who are in the program.

“We do know that over time, when you make drastic cuts like this and people don’t have access,” he said, “Eventually that will lead to greater hospitalizations, greater emergency room visits and, frankly, increase morbidity and mortality.”

Dr. Elizabeth Frost, a family practice physician and a member of Physicians for a National Health Program, said the groups would like to see all Minnesotans covered by a plan paid for by state government.

That way, the state could eliminate many of the administrative costs for programs like GAMC and MinnesotaCare and focus on caring for everyone, she said.

“All this stress about signing people up, finding out who gets covered, who isn’t covered … all that waste would be eliminated,” Frost said. “We want to lead the nation and show that you can do government-funded health insurance and it can work and it can be very successful.”

http://minnesota.publicradio.org/display/web/2010/06/15/groups-protest-healthcare-cuts/

Groups protest health care cuts outside Pawlenty’s office

By Elizabeth Dunbar
Minnesota Public Radio, June 15, 2010

ST. PAUL, Minn. — A coalition of groups offered blood pressure, cholesterol and blood sugar screenings outside Gov. Tim Pawlenty’s office on Tuesday as part of a protest against cuts to a state health care program for the poor.

The Universal Health Care Action Network of Minnesota and other groups have set up free or low-cost clinics elsewhere before, but organizers said they came to the State Capitol to urge Pawlenty and others to see health care as a human right.

“Health care is a human right based on need. If you need care, you get care. It’s an entitlement and it’s a public good,” said Joel Albers, a pharmacist who is part of the Universal Health Care Action Network.

Four hospitals have agreed to participate in a scaled-back version of General Assistance Medical Care, but all of them are in the Twin Cities. The program uses a coordinated care delivery system, meaning hospitals would get a lump sum of money to care for a certain number of patients.

The new GAMC program was the result of negotiations between Pawlenty and the DFL-controlled Legislature to solve the state’s budget deficit. The changes took effect June 1.

Albers said the cuts will mean the program won’t meet the needs of the 30,000 or so low-income adults without children who are in the program.

“We do know that over time, when you make drastic cuts like this and people don’t have access,” he said, “Eventually that will lead to greater hospitalizations, greater emergency room visits and, frankly, increase morbidity and mortality.”

Dr. Elizabeth Frost, a family practice physician and a member of Physicians for a National Health Program, said the groups would like to see all Minnesotans covered by a plan paid for by state government.

That way, the state could eliminate many of the administrative costs for programs like GAMC and MinnesotaCare and focus on caring for everyone, she said.

“All this stress about signing people up, finding out who gets covered, who isn’t covered … all that waste would be eliminated,” Frost said. “We want to lead the nation and show that you can do government-funded health insurance and it can work and it can be very successful.”

http://minnesota.publicradio.org/display/web/2010/06/15/groups-protest-healthcare-cuts/

Arizona's immigration law and health care

By Paul T. Cheung
Denver Post, 06/16/2010

Even though the impact of Governor Brewer of Arizona signing S.B. 1070 into law may appear distant, the law has far reaching implications for the general public including here in Colorado.

Amid all the discussions of the legislation – including the marginalization of the Latino culture and society – few have noted its impact on health. Arizona S.B. 1070 will decrease health care usage, leading to increase public medical care spending, worse health outcomes, and lower immunization rates.

Take for example Juan, the owner of a local taqueria restaurant in Aurora, whom I met last month. He is a legal citizen facing a number of challenges in obtaining health care. For many years, he did not have regular access to a primary care physician and has relied on cultural remedies as his main source of care. Juan told me a common story. Care is difficult to come by for a multitude of reasons: time, money, lack of transportation, language barriers, and the complexity of navigating the maze that is the U.S. health system.

When Juan learned I was a medical student, he told me about his health. Several weeks ago, he was stricken with severe heart palpitations, night sweats, and chest pain. He waited three weeks before he decided to go see a doctor. Ultimately, the doctor that saw Juan diagnosed his high blood pressure and gave him a prescription to control it. Untreated, he was at significant risk for strokes and heart attacks. Juan waited to seek help because he does not have insurance and had no idea how to get an appointment with a Spanish-speaking physician.

To the long list of barriers Latinos face in getting care in this country, the Arizona immigration law adds another. Our health care system works best when chronic conditions such as high blood pressure, diabetes, and asthma are controlled. Had Juan suffered a stroke or heart attack from uncontrolled blood pressure, his medical costs would rise dramatically and ultimately be passed on to the community through taxes and higher insurance premiums. More importantly, Juan likely would have suffered long term health effects impacting the quality of his daily life.

On a broader level, the law will strain the relationship between the Latino community and health care providers. Important public health goals such as immunizations will be compromised. High immunization rates are important for children who are in close contact in school to prevent spread of disease. This law will prevent Latino families from bringing their children in to see the doctor and these unimmunized children will increase the presence of diseases like flu, measles, and mumps in the community. Fear and uncertainty about the health care providers’ role in enforcing the documentation requirement will foster distrust of physicians by Latino patients.

The Latino community already is facing numerous challenges in obtaining optimal care. Routine medical attention consistently leads to better control and treatment of chronic conditions like high blood pressure. Barriers to health care need to be removed.

As a medical student, I am concerned about how this new law will affect health in the community. As I progress into my clinical training, I am worried about meeting more patients like Juan – who nearly missed more serious health consequences from his untreated high blood pressure – because of barriers to care. Ultimately, such delays will lead to even more expensive health care for all.

Paul Cheung is a first year medical student at the University of Colorado School of Medicine and a resident of Aurora. EDITOR’S NOTE: This is an online-only column and has not been edited.

http://www.denverpost.com/commented/ci_15302543

Arizona’s immigration law and health care

By Paul T. Cheung
Denver Post, 06/16/2010

Even though the impact of Governor Brewer of Arizona signing S.B. 1070 into law may appear distant, the law has far reaching implications for the general public including here in Colorado.

Amid all the discussions of the legislation – including the marginalization of the Latino culture and society – few have noted its impact on health. Arizona S.B. 1070 will decrease health care usage, leading to increase public medical care spending, worse health outcomes, and lower immunization rates.

Take for example Juan, the owner of a local taqueria restaurant in Aurora, whom I met last month. He is a legal citizen facing a number of challenges in obtaining health care. For many years, he did not have regular access to a primary care physician and has relied on cultural remedies as his main source of care. Juan told me a common story. Care is difficult to come by for a multitude of reasons: time, money, lack of transportation, language barriers, and the complexity of navigating the maze that is the U.S. health system.

When Juan learned I was a medical student, he told me about his health. Several weeks ago, he was stricken with severe heart palpitations, night sweats, and chest pain. He waited three weeks before he decided to go see a doctor. Ultimately, the doctor that saw Juan diagnosed his high blood pressure and gave him a prescription to control it. Untreated, he was at significant risk for strokes and heart attacks. Juan waited to seek help because he does not have insurance and had no idea how to get an appointment with a Spanish-speaking physician.

To the long list of barriers Latinos face in getting care in this country, the Arizona immigration law adds another. Our health care system works best when chronic conditions such as high blood pressure, diabetes, and asthma are controlled. Had Juan suffered a stroke or heart attack from uncontrolled blood pressure, his medical costs would rise dramatically and ultimately be passed on to the community through taxes and higher insurance premiums. More importantly, Juan likely would have suffered long term health effects impacting the quality of his daily life.

On a broader level, the law will strain the relationship between the Latino community and health care providers. Important public health goals such as immunizations will be compromised. High immunization rates are important for children who are in close contact in school to prevent spread of disease. This law will prevent Latino families from bringing their children in to see the doctor and these unimmunized children will increase the presence of diseases like flu, measles, and mumps in the community. Fear and uncertainty about the health care providers’ role in enforcing the documentation requirement will foster distrust of physicians by Latino patients.

The Latino community already is facing numerous challenges in obtaining optimal care. Routine medical attention consistently leads to better control and treatment of chronic conditions like high blood pressure. Barriers to health care need to be removed.

As a medical student, I am concerned about how this new law will affect health in the community. As I progress into my clinical training, I am worried about meeting more patients like Juan – who nearly missed more serious health consequences from his untreated high blood pressure – because of barriers to care. Ultimately, such delays will lead to even more expensive health care for all.

Paul Cheung is a first year medical student at the University of Colorado School of Medicine and a resident of Aurora. EDITOR’S NOTE: This is an online-only column and has not been edited.

http://www.denverpost.com/commented/ci_15302543

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

Comment: 

By Don McCanne, MD

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://www.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

Comment: 

By Don McCanne, MD

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'

FOR IMMEDIATE RELEASE
June 16, 2010    

Contact:
Karen Green Stone and Rob Stone, M.D., grostone@gmail.com
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.

Humiliation and Shame: Part of Being Insured in America

By Donna Smith
CommonDreams.org, June 16, 2010

Oh, the things we did not fix in the healthcare bill are shocking. Just as seniors falling into the Medicare drug benefit donut hole begin to get the $250 checks meant to calm their fears about our new healthcare legislation, the rest of us would do well to remember the abuses of the for-profit healthcare system that will continue and even accelerate in the coming years.

Health insurance is not health care. Health insurance is a financial product marketed and sold to protect health and wealth which may do neither thing very well. I view it as a defective product. Yet, very soon we will be buying more of it and helping more of our fellow Americans buy more of it with the subsidies that support the great health insurance bailout that is being called “patient protection.”

Yesterday, I went to the doctor for an appointment I waited weeks to secure. I am insured. I have what some would say is fairly good insurance from one of the for-profit insurance giants. I waited patiently in the waiting room, and then was escorted to the exam room. There was a flurry of activity around me. A thorough history was taken. X-rays were taken. The nurse said, “Oh, honey, are you in pain? Those X-rays show some pretty awful deformity.” I said I have been hurting for years but that I have waited until I could stand no more to seek treatment. Most of the time I take large amounts of OTC anti-inflammatory medication and muddle through. It’s the American way. It’s the insured American’s way. It’s the working, insured American’s way.

The doctor buzzed in rather quickly and began discussing a treatment plan with me. Some immediate care to relieve some of the pain, and some longer term non-invasive care to see if we could avoid surgery. I was hopeful and thrilled though a bit worried about how it would feel to get shots in the joints of my feet to help the heel spurs and the bone pain. I’ve had shots in my knees, and it isn’t fun.

Suddenly, as quickly as I had felt the anticipation of some relief, the flurry of activity ground to a halt. The doctor left the room. Another office person came in. She said, “I’m sorry Ms. Smith. Your insurance will not cover what the doctor wants to try.” Matter of fact. She’s said these words before – many times. I ask how much it would cost to pay for it myself. She answers. I cannot pay that much. The visit is ending. The hope is shriveling. I could feel the muscles in my face tense as the humiliation spread through my body. This body, just moments ago worthy of plans to relieve pain and head for some better health, now was deemed unworthy of care. Shame. All that old shame I used to feel before our medical bankruptcy was rising in my gut. It hurt so badly. But I was determined not to show my anger or my sadness.

The doctor wandered by the room and saw me. He stepped in and gave me some soft inserts for my shoes. He said they won’t help much or for long, but that maybe it would be a little relief. He must have seen the look on my face and felt at least a little compassion. A little. I thanked him. But I could say little else, and I could not look him in the eye. I felt so ashamed, and I don’t even really understand why I’ve been so conditioned as a patient to feel it is my failure when these things happen.

On the way home, I alternated between sadness and anger. Clearly someone wasn’t being honest with me. Either the treatments this doctor was suggesting really aren’t a good idea (as the insurance company’s denial to pay would lead one to believe) and therefore are not approved for coverage or the insurance company just wants to push those costs onto patients who cannot usually afford them. Either way, I didn’t get the care I needed. Either way, I left hurting. Either way, I lose. The doctor made some money on the office visit and my co-pay at least. The insurance company avoided paying for anything beyond that.

My husband sat beside me in the car, sad and angry for me. As a person covered under one of our nation’s single-payer programs and a supplemental private policy, he has never heard the words I heard — he has never been denied care. He felt helpless for me. As I cried tears of rage, he sat silently.

And, so, how will any of this change under the new healthcare bill? It won’t. In fact, the pressure for insurance companies to deny more care will grow as they are compelled by law to take more people who have pre-existing conditions like having feet. Cherry picking the healthiest folks will require a bit more skillful contortions for the for-profit insurance companies, and doctors will leave more patients sitting on the edge of exam tables like naughty little children who do not deserve to be treated.

Healthcare is a basic human right in most of the rest of the modern world. Only in this nation do we believe that only the richest people deserve the best of care. It’s a wild twist on the old Bible lesson about it being tougher for a rich man to get to heaven than for a camel to get through the eye of a needle. We’ve made it harder for a working person or a poor person to get healthcare in America than for a rich man to get to heaven. We are a sick society indeed. No Golden Rule values herein.

Only when we finally decide that we believe in a compassionate and just healthcare system for all will we ever have the courage to change it. Right now we just don’t believe in that sort of system at all. As a patient, I am fodder. At least this morning I was able to turn my outrage back on the system that left me in that exam room alone and sucking back tears of anger. No one should go to a doctor to seek care and leave less well. That’s cruel and unusual.

I was raised to have more compassion than this for my fellow human beings, and I think most Americans were raised with similar values. How in the world did we get to a place where we participate in doing this to one another? Is this the system we want to leave to our children? Do you want to leave your child lacking care when he or she needs it? Your grandchild? Then, for heaven’s sake — for heaven’s sake — stand up and let’s get back to work to fix this mess. There is much to be done.

Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.

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!”