Resource – Page 748

Politicians didn’t get it right

Seattle Times (print edition only)
March 22, 2010

Editor, The Times:

Regarding the insurance albatross the politicians just hung around our neck [“Historic health-care overhaul passes,” Seattle Times, page one, March 22]:

An estimated 23,000 unnecessary deaths annually will result from 23 million still uninsured nine years out;

Millions of middle-income people will be pressured to buy commercial policies that cost up to 9.5 percent of income but cover an average of only 70 percent of medical expenses;

Insurance firms [which give no care to anyone] will get at least $447 billion in taxpayer money in subsidies;

The bill will drain about $40 billion from Medicare payments to safety-net hospitals;

People with employer-based coverage will be locked into their plan’s limited network of providers;

Health-care costs will continue to skyrocket, like they did in Massachusetts;

There are loopholes in the pre-existing conditions regulations;

Women’s reproductive rights will be further eroded.

We needed and still need a single-payer, equal-access-for-all plan. Physicians for A National Health Program and United for Single Payer locally will continue to work on this until we get it right.

— Linda Jansen, Seattle

Louisville doctors, Humana react to healthcare bill

By Janelle MacDonald
WAVE NBC 3
Mar 22, 2010

LOUISVILLE, KY (WAVE) – The sweeping reform of the nation’s health care system has passed the House of Representatives and is ready for President Obama to sign into law. In Kentuckiana, reaction from doctors is mixed. Supporters showed a long list of healthcare professional organizations that backed the bill, but some doctors fear what it will do to their business and profession. Others say this bill didn’t go far enough to address the problems.

Dr. Adewale Troutman, director of Louisville Metro Health & Wellness, said there were obvious problems with the healthcare system as it stood.

“People are dying at unacceptably high rates due to the fact they don’t have health insurance,” said Troutman.

With coverage to 30 million more Americans, Troutman sees a lot of things to like in the newly passed healthcare reform bill.

“Removing a cap for a lifetime cap on what insurance money you spend, the preexisting condition piece is extremely important, not being able to drop somebody from coverage because now they’ve got something that costs money,” Troutman said.

But to call it comprehensive healthcare reform, Troutman said, “I think that the bill that was passed is a step in the right direction but we have a long, long, long way to go to turn this ship around so that we have equity, health equity for all populations.”

His former colleague, now retired Dr. Garrett Adams, puts it even more bluntly. According to Adams, it’s, “aspirin for cancer.”

Adams says the healthcare reform bill as passed won’t do anything to control costs.

“The bills will continue to go up,” said Adams. “The premiums will have to go up, there’s no way they won’t go up.”

As for the mandates for insurance coverage, Adams said, “people will buy the least expensive coverage that they can get and it’s not going to be enough. It’s skimpy coverage.”

In addition, Adams agrees with critics who say the new bill takes some healthcare decisions out of the hands of doctors and places it in the hands of the government.

“There are so many controls,” Adams said. “It’s very unfriendly, I think to physicians … It’s awkward, it’s complicated.”

Adams is a member of Physicians for a National Healthcare Program, which advocates for getting rid of the private, for-profit, insurance company system all together. Troutman says he is also in favor of a not-for-profit system. However, here in Louisville, a lot of jobs depend on the insurance industry.

Jim Turner, a spokesperson for Louisville-based Humana, said the bill could be good for the company because requiring everyone to get health insurance will add customers to the market and that could help Humana.

Turner also said the company is worried because the bill doesn’t do much to reduce healthcare costs and the cost of not having insurance – a government imposed penalty – isn’t strict enough.

“People could just say, ‘I’m not going to pay my fair share of premium,'” Turner said. “They could say, ‘I’m going to wait until I get sick, pay an extremely modest penalty, and then I’ll sign up,’ and if that does come to pass, that will actually destroy the whole basis of insurance.”

Turner also told us the bill will hurt the young and old more than others by putting new taxes on the young, and reducing Medicare advantage payouts for the elderly.

Information for this story also provided by Ryan Nash.

http://www.wave3.com/Global/story.asp?S=12185064

Research by Physicians for a National Health Program

Over the past two decades, PNHP research has influenced health policy and focused debate on the need for fundamental health care reform.

Administrative costs consume 31 percent of US health spending, most of it unnecessary. The US could save enough on administrative expenses (nearly $400 billion annually) with a single payer to cover all the uninsured.
Medical bills contribute to more than 60 percent of all bankruptcies. Three-fourths of those bankrupted had health insurance at the time they got sick.
Taxes already pay for over 60 percent of US health spending. Americans pay the highest health care taxes in the world. We pay for national health insurance, but don’t get it.
Despite spending far less per capita for health care, Canadians and residents of other developed countries are healthier and have better measures of access to health care than Americans.
Alternative health proposals for “universal coverage” do not work. State health reforms containing the key elements of the Obama health plan have failed to reduce the number of uninsured.
Computerized medical records and chronic disease management do not save money. The only way to slash administrative overhead and improve quality is with a single payer system.
Business pays less than 20 percent of our nation’s health bill. It is a misnomer that our health system is “privately financed” (60 percent is paid by taxes and the remaining 20 percent is out-of-pocket payments).
For-profit, investor-owned hospitals, HMOs and nursing homes have higher costs and score lower on most measures of quality than their non-profit counterparts.
Immigrants and emergency department visits by the uninsured are not the cause of high and rising health care costs.
Nearly 45,000 Americans die each year for lack of health insurance. The uninsured do not receive all the medical care they need – they live sicker and die younger. Those most in need of preventive services are least likely to receive them.
The US could save enough on administrative costs (over $400 billion annually) with a single payer to cover all the uninsured.

Full text and citations for each finding are available on our web site at www.pnhp.org/research.

Campaign for SB 810 – Single Payer Universal Health Care

California OneCare
Lily Tomlin as Ernestine
30 second video:

http://californiaonecare.org/365-ad-campaign/365-ad-archive/365-ad-35-2/

We have been saturated with commentary since the passage and signing of the trillion dollar Private Insurance Industry Stimulus legislation. Lily Tomlin provides us with a much needed break as she reminds us, in her own incomparable style, of the industry that Congress and the President have so richly rewarded.

US healthcare law 'poses long-term threats'

Al Jazeera English

Al Jazeera interviewed Matt Hendrickson, a doctor from California and PNHP member, who said the recently signed healthcare law is good for the short-term, but in the long run it could prove disastrous.

US healthcare law ‘poses long-term threats’

Al Jazeera English

Pro-single-payer doctors: Health bill leaves 23 million uninsured

A false promise of reform

For Immediate Release
March 22, 2010

Contact:
Oliver Fein, M.D.
Steffie Woolhandler, M.D., M.P.H.
David Himmelstein, M.D.
Margaret Flowers, M.D.
Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org

The following statement was released today by leaders of Physicians for a National Health Program, www.pnhp.org. Their signatures appear below.

As much as we would like to join the celebration of the House’s passage of the health bill last night, in good conscience we cannot. We take no comfort in seeing aspirin dispensed for the treatment of cancer.

Instead of eliminating the root of the problem – the profit-driven, private health insurance industry – this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers’ defective products, and turn over to them vast amounts of public money.

The hype surrounding the new health bill is belied by the facts:

About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.
Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.
Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.
The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.
People with employer-based coverage will be locked into their plan’s limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.
Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.
The much-vaunted insurance regulations – e.g. ending denials on the basis of pre-existing conditions – are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.
Women’s reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.

It didn’t have to be like this. Whatever salutary measures are contained in this bill, e.g. additional funding for community health centers, could have been enacted on a stand-alone basis.

Similarly, the expansion of Medicaid – a woefully underfunded program that provides substandard care for the poor – could have been done separately, along with an increase in federal appropriations to upgrade its quality.

But instead the Congress and the Obama administration have saddled Americans with an expensive package of onerous individual mandates, new taxes on workers’ health plans, countless sweetheart deals with the insurers and Big Pharma, and a perpetuation of the fragmented, dysfunctional, and unsustainable system that is taking such a heavy toll on our health and economy today.

This bill’s passage reflects political considerations, not sound health policy. As physicians, we cannot accept this inversion of priorities. We seek evidence-based remedies that will truly help our patients, not placebos.

A genuine remedy is in plain sight. Sooner rather than later, our nation will have to adopt a single-payer national health insurance program, an improved Medicare for all. Only a single-payer plan can assure truly universal, comprehensive and affordable care to all.

By replacing the private insurers with a streamlined system of public financing, our nation could save $400 billion annually in unnecessary, wasteful administrative costs. That’s enough to cover all the uninsured and to upgrade everyone else’s coverage without having to increase overall U.S. health spending by one penny.

Moreover, only a single-payer system offers effective tools for cost control like bulk purchasing, negotiated fees, global hospital budgeting and capital planning.

Polls show nearly two-thirds of the public supports such an approach, and a recent survey shows 59 percent of U.S. physicians support government action to establish national health insurance. All that is required to achieve it is the political will.

The major provisions of the present bill do not go into effect until 2014. Although we will be counseled to “wait and see” how this reform plays out, we cannot wait, nor can our patients. The stakes are too high.

We pledge to continue our work for the only equitable, financially responsible and humane remedy for our health care mess: single-payer national health insurance, an expanded and improved Medicare for All.

Oliver Fein, M.D.
President

Garrett Adams, M.D.
President-elect

Claudia Fegan, M.D.
Past President

Margaret Flowers, M.D.
Congressional Fellow

David Himmelstein, M.D.
Co-founder

Steffie Woolhandler, M.D.
Co-founder

Quentin Young, M.D.
National Coordinator

Don McCanne, M.D.
Senior Health Policy Fellow

******

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

Private insurer nightmare

Effects of health overhaul will take time to become clear

By Duke Helfand
Los Angeles Times
March 22, 2010

(The industry’s Washington lobbying arm, America’s Health Insurance Plans) ran ads in national newspapers last week criticizing the overhaul for failing to adequately contain costs. Without bolder action, it warned in its “Open Letter to the American People,” the country could face a healthcare cost “crisis similar to the financial crisis that has rocked our economy.”

“Virtually everyone believes that we have a huge number of issues that remain to be addressed,” said Jay Gellert, chief executive of Woodland Hills-based Health Net Inc. “If anyone thinks that just by passing this we’re going to solve the problems, they are seriously mistaken.”

http://www.latimes.com/business/la-fi-insure22-2010mar22,0,3396267.story

Comment:

By Don McCanne, MD

I had a nightmare last night. I dreamed that we reformed the financing of health care in America, but that we left the private insurance industry in charge. Oh, wait… Oh, no!

Private insurer nightmare

Effects of health overhaul will take time to become clear

By Duke Helfand
Los Angeles Times
March 22, 2010
(The industry’s Washington lobbying arm, America’s Health Insurance Plans) ran ads in national newspapers last week criticizing the overhaul for failing to adequately contain costs. Without bolder action, it warned in its “Open Letter to the American People,” the country could face a healthcare cost “crisis similar to the financial crisis that has rocked our economy.”
“Virtually everyone believes that we have a huge number of issues that remain to be addressed,” said Jay Gellert, chief executive of Woodland Hills-based Health Net Inc. “If anyone thinks that just by passing this we’re going to solve the problems, they are seriously mistaken.”
http://www.latimes.com/business/la-fi-insure22-2010mar22,0,3396267.story

I had a nightmare last night. I dreamed that we reformed the financing of health care in America, but that we left the private insurance industry in charge. Oh, wait… Oh, no!

Arizona shuts down CHIP, slashes Medicaid

Governor signs Ariz. budget-balancing bills

By Casey Newton
The Arizona Republic
March 18, 2010

Gov. Jan Brewer signed the fiscal 2011 budget on Thursday, enacting $1.1 billion in spending cuts and program eliminations.

The budget, passed last week by the Republican-led Legislature on largely party-line votes, drew criticism from opponents for what they called a disproportionate impact on the poor.

“I’m not sure how cutting three-quarters of a billion dollars from public education and kicking 300,000 people off of health care puts our state on the back on the road to recovery,” said Rep. Kyrsten Sinema, D-Phoenix. “In fact, it dismantles what we have been working for years to build in Arizona — a vibrant, healthy state where people want to live and work.”

One aspect of the budget expected to be challenged is a cut of $385 million to the state’s Medicaid program, the Arizona Health Care Cost Containment System.

The budget bills also eliminate KidsCare, which provided health care to 38,599 children of low-income parents.

Hours after she signed the budget, Brewer appeared at a news conference to urge opposition to federal health-care reform. Asked by reporters what the hundreds of thousands of Arizonans set to lose coverage this year should do, Brewer said they should use community health clinics and emergency rooms.

http://www.azcentral.com/news/election/azelections/articles/2010/03/18/20100318brewer-signs-budget-bills-arizona.html

Comment:

By Don McCanne, MD

Programs benefiting low income individuals and families, such as Medicaid and CHIP, are politically vulnerable to the whims of conservatives wielding budget cleavers. Gov. Jan Brewer of Arizona has just provided us with a prime example of that. Yet popular programs benefiting everyone, such as Medicare, are relatively impenetrable to the weapons of the conservatives.

The reform proposal likely to be enacted by Congress is heavily dependent on the expansion of Medicaid. Since it is a federal/state program, it requires the support of the government on both levels. In spite of the proposed increases in federal support, Gov. Brewer continues to urge opposition to the reform proposal. Low income families will remain vulnerable in her state as long as she and her Republican colleagues remain in charge.

Suppose Congress had included single payer in their deliberations and eventually decided that the benefits were too great to pass up ,and so enacted an improved Medicare program that covered everyone. Gov. Brewer and her ilk on the state level would be powerless to stop it. It would be so popular that conservatives who managed to take over the federal government would never be able to shut the program down.

Whether or not the current bill passes, we need to make every effort to replace our expensive, fragmented, often cruel, and relatively ineffectual system of health care financing with one that works for all of us – a single payer national health program – an improved Medicare for everyone.

Or failing that, as Gov. Brewer says, we could all just go to the emergency room when we can’t get into the clinic.

Vermont lawmakers hear about single-payer health care

By Terri Hallenbeck, Free Press Staff Writer
Burlington Free Press, March 19, 2010

MONTPELIER — An economist who helped Taiwan and other nations create their health care systems told Vermont lawmakers Thursday that a single-payer plan can lower costs, but is not necessarily a foolproof remedy.

William Hsiao, an economics professor at Harvard University, testified before House and Senate health committees as Vermont legislators look for ways to broaden health care coverage while also curbing escalating costs.

“Single-payer can actually lower the level of health spending,” he said of a system where there is a single insurance provider. “Single-payer is probably the most effective tool to reform health care delivery.”

Taiwan was able to shrink the number of uninsured residents from 45 percent to 5 percent in a year after creating a single-payer plan, Hsiao said. In the first two years, costs dropped 8 percent to 10 percent, he said.

A bill from the Senate Health and Welfare Committee would create a panel to come up with three options for a health care plan for Vermont. Committee Chairman Doug Racine, D-Chittenden, noted that that’s the approach Hsiao and others used in Taiwan.

The bill is pending before the Senate Appropriations Committee, which will decide whether to come up with $400,000 to pay for the panel’s work, as the bill seeks.

The bill carries an interesting political dynamic, as Racine, Appropriations Committee Chairwoman Susan Bartlett, D-Lamoille, and Senate President Pro Tempore Peter Shumlin, D-Windham, are all seeking the Democratic nomination for governor and seeking to distinguish themselves among likely Democratic voters for whom health care reform is a key topic. They all have a role in how this legislation proceeds.

Shumlin has ideas about the health care bill that vary slightly from Racine’s and said he would seek to amend Racine’s bill. Instead of a panel producing three options, Shumlin wants the Legislature to hire Hsiao to advise whether the state can create a system that provides universal access, curbs costs, offers quality care and is detached from a person’s employment. of one’s pay 15 years ago to 5.09 percent this year, he said.

Rep. George Till, D-Jericho, asked Hsiao whether a national system could work in a single state where many hospital patients come from neighboring states. Hsiao said he didn’t think the system would create as much savings, but thought it could produce some savings.

Taiwan’s system is different than Racine was expecting. Thirty percent of the cost is paid by the government, 35 percent by payroll taxes on employers and 35 percent by payroll taxes on employees, Hsiao said. Those without an employer pay a premium, except for low-income people, he said. There are co-pays for doctor, clinic and hospital visits and prescriptions, he said.

Shumlin said Hsiao’s trip to Vermont on Thursday came at no cost to the state.

Contact Terri Hallenbeck at 651-4887 or thallenb@bfp.burlingtonfreepress.com.

http://www.burlingtonfreepress.com/article/20100319/NEWS03/3190304/Vermont-lawmakers-hear-about-single-payer-health-care

What's In, What's Out in Health Care Reform Bill

Associated Press
The Huffington Post, March 19, 2010

WASHINGTON (AP) — Bye bye, Cornhusker Kickback. Hello, special treatment for Tennessee and North Dakota.

Democrats unveiling revisions Thursday to their health care overhaul bill decided to kill the extra $100 million in Medicaid funds for Nebraska that has become a symbol of backdoor deal making.

But the 153 pages of changes to the massive health care package include extra money for hospitals in Tennessee that serve large numbers of low-income patients. And though the bill would revamp the nation’s student loan system to make the government the only lender, one bank – the state-owned Bank of North Dakota – would be allowed to continue making student loans.

That provision ended up rubbing Sen. Kent Conrad, D-N.D., the wrong way. Fearing it would become a target by Republicans in what he said is “an overly heated partisan environment,” he asked the House late Thursday to remove it from the legislation.

Still alive is special spending for Louisiana, Connecticut, Montana and other states that was included in the health care bill that the Senate approved in December. The House may give it final approval this weekend.

Senior White House officials have sent mixed signals about the special deals. They initially demanded that they be eliminated, but by Sunday senior White House adviser David Axelrod said they only objected to provisions affecting just one state.

White House spokesman Robert Gibbs last week singled out projects from Montana and Connecticut as items President Barack Obama wanted removed. There was resistance, however, from two influential committee chairmen, Democratic Sens. Max Baucus of Montana and Christopher Dodd of Connecticut, and their projects have survived.

To help win the vote of Sen. Ben Nelson, D-Neb., the massive measure the Senate passed on Christmas Eve had included $100 million that only Nebraska would get in added federal Medicaid assistance.

Immediately mocked as the Cornhusker Kickback, critics called it the epitome of special Washington dealing, and even Nelson advocated ending his state’s special treatment. Under the changes announced Thursday, the Nebraska provision would be deleted and all states would get additional Medicaid help from Washington.
Story continues below

Also eliminated from the Senate measure was a provision allowing about 800,000 elderly Floridians to keep enhanced Medicare benefits that are being cut for residents of other states.

The changes also include an additional $99 million in 2012 and 2013 for Tennessee hospitals that treat many poor people.

Retiring Rep. Bart Gordon, D-Tenn., has fought for the funds for years to bring the state’s aid up to par with the rest of the country, spokeswoman Emily Phelps said. She said their inclusion had nothing to do with his announcement Thursday that he will vote for the final health legislation after opposing an earlier version in November.

The new package also promises new aid for colleges serving minority students, using money the government is supposed to save by no longer paying banks to make student loans. Included are annual payments of $100 million for schools with large numbers of Hispanic students, the same amount for colleges with many black students, and millions more for schools with large numbers of native Americans and other minorities.

Based on Thursday’s changes, the health legislation also:

-Retains $300 million in extra Medicaid aid for Louisiana, which had helped win support for the Senate health bill from Sen. Mary Landrieu, D-La. The state is still struggling to recover from Hurricane Katrina.

-Keeps $100 million included in the Senate bill that is expected to go for a public hospital in Connecticut sought by Dodd, who is retiring.

-Preserves language won by Baucus permitting many of the 2,900 residents of Libby, Mont., to qualify for Medicare benefits. Some of them have asbestos-related diseases from a now-shuttered mine.

-Provides an additional $8.5 billion over the next decade for 11 states and the District of Columbia to help them pay for the more generous Medicaid assistance they have been providing low-income residents. These states are Arizona, Delaware, Hawaii, Maine, Massachusetts, Minnesota, New York, Pennsylvania, Vermont, Washington and Wisconsin.

-Maintains a Senate-approved provision giving extra money for hospitals and doctors in North and South Dakota, Montana and Wyoming.

http://www.huffingtonpost.com/2010/03/19/whats-in-whats-out-in-hea_n_505288.html

Comment:

Effects of health overhaul will take time to become clear

Comment:

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