PNHP

Stein's Law – hitting the wall

Stein's Law – hitting the wall

Herb Stein's Unfamiliar Quotations

By Herbert Stein
Slate
May 16, 1997

If something cannot go on forever, it will stop.
–Stein’s Law, first pronounced in the 1980s

This proposition, arising first in a discussion of the balance-of-payments deficit, is a response to those who think that if something cannot go on forever, steps must be taken to stop it–even to stop it at once.

http://www.slate.com/id/2561/

And…

Huge Deficits May Alter U.S. Politics and Global Power

By David E. Sanger
The New York Times
February 1, 2010

… as Prof. James K. Galbraith of the University of Texas puts it, “Forecasts 10 years out have no credibility.”

Simply projecting that health care costs will rise unabated is dangerous business.

His greatest hope, Mr. Galbraith said, was Stein’s law, named for Herbert Stein, chairman of the Council of Economic Advisers under Presidents Richard M. Nixon and Gerald R. Ford.

Stein’s law has been recited in many different versions. But all have a common theme: If a trend cannot continue, it will stop.

http://www.nytimes.com/2010/02/02/us/politics/02deficit.html?hp

And…

The Long-Term Outlook for Health Care Spending

Congressional Budget Office
November 2007

Projections of Health Spending

Over the past 30 years, total national spending on health care has more than doubled as a share of GDP. Under the assumptions described (in this CBO report), according to CBO’s projections, that share will double again by 2035, to 31 percent of GDP. Thereafter, health care costs continue to account for a steadily growing share of GDP, reaching 41 percent by 2060 and 49 percent by the end of the 75-year projection period.

http://www.cbo.gov/ftpdocs/87xx/doc8758/Intro.shtml
Graph: http://www.cbo.gov/ftpdocs/87xx/doc8758/Figure4.gif

And…

GOP House Issues Conference

January 29, 2010

Congressman Paul Ryan (speaking to President Obama):  … Medicare, as you know, is a $38 trillion unfunded liability…

http://www.whitehouse.gov/the-press-office/remarks-president-gop-house-issues-conference

Comment: 

By Don McCanne, MD

At over $2.5 trillion (almost 18 percent of our GDP), the level of health care spending in the United States this year is almost intolerable. Yet we hear predictions that health care will represent half of our GDP by 2082, and that Medicare will accumulate a deficit of $38 trillion.

Thank goodness for Stein’s Law. We will never see these numbers for the simple reason that this rate of increase cannot go on forever. It will stop once it hits the wall.

Herbert Stein, being from the Chicago School of Economics (think Milton Friedman), did not believe that steps must be taken to intervene since the problem would take care of itself. Although that is true, the problem with this sterile, amoral view, common amongst those of the Chicago School, is that it ignores the consequences of a spontaneous economic process devoid of the input from the heart and soul of beneficent public stewards.

To be clear, in the economics of health care, Stein’s Law does not represent one point in the expansion of health care spending at which everything stops and the health care system collapses. Nor does it represent a single point at which expansion stops and spending becomes static. Rather it represents a multitude of various walls for various payers, including individuals, employers and the various levels of government, each of which has its own wall as a barrier represented by Stein’s Law.

In our fragmented system of financing health care, Stein’s Law is already in play. Tens of millions are no longer able to afford health insurance. Tens of millions more are no longer able to afford adequate insurance products and must face the financial hardships of the underinsurance products that have been the response of competing insurers in our market economy in health care. The rate of employer-sponsored coverage has been declining because too many businesses, especially small businesses, have already hit the wall. Many states are struggling with the need to reduce Medicaid payments to providers in order to try to include more under the umbrella, while watching the safety-net of providers crumble from protracted financial losses. Even the federal government is struggling to find ways to fill the void in the face of massive budget deficits.

With Stein’s Law, we can predict that the rate of spending increases will very soon slow down, but under our current financing system, that will inevitably result in more financial hardship, suffering, and even death as health care access becomes ever less affordable.

Suppose the Senate bill passes, along with the reconciliation tweaks, then what will happen? Since our beneficent stewards in Congress neglected their duties, failing to adopt policies that would slow the growth in health care spending, health care costs will continue to test Stein’s Law.

Some of the multitude of walls will move, but none of them will go away. The states will see their walls move further out with the infusion of Medicaid funds. The federal government will see its wall move closer, signaled by the shrill cacophony of the budget hawks. Employers will not see their wall move much, but they will continue to barrel forward, eventually hitting it one by one.

But what about our hard-working, middle-income Americans? The wall will be moved much closer. For several reasons, mostly related to costs, there will be an attrition of employer-sponsored plans. Since the subsidies to purchase private plans will be less than the employer contributions, fewer individuals and families will be able to afford the plans. To slow the rise in premiums, more benefits will be stripped out. The Obama administration would accelerate this deterioration in benefits by imposing an excise tax on the plans as “the most effective way to control costs.” The Obama/Orszag policy of controlling costs by erecting financial barriers to necessary health care is a very sick policy indeed. The legislation before Congress adds afterburners to middle-income Americans only accelerating their trip to Stein’s impenetrable wall.

When our economic models have immoral consequences, we should abandon the amoral models of the Chicago School, and move to normative economics. It is not a sin for an economist to have a heart.

Under a single payer national health program – an improved and expanded Medicare for all – Stein’s wall will still be there. But instead of letting the entire system crash into the wall, our own beneficent public stewards – if we elect ones with a heart – will be there to make sure that everyone receives the care that they need. The resources that we use may take us up to the wall, but we won’t be crashing into it.

Every other industrialized nation has an impenetrable Stein wall, but by using normative economics, they don’t sacrifice their citizens by slamming them into that wall.

Stein’s Law – hitting the wall

Herb Stein’s Unfamiliar Quotations

By Herbert Stein
Slate
May 16, 1997

If something cannot go on forever, it will stop.
–Stein’s Law, first pronounced in the 1980s

This proposition, arising first in a discussion of the balance-of-payments deficit, is a response to those who think that if something cannot go on forever, steps must be taken to stop it–even to stop it at once.

http://www.slate.com/id/2561/

And…

Huge Deficits May Alter U.S. Politics and Global Power

By David E. Sanger
The New York Times
February 1, 2010

… as Prof. James K. Galbraith of the University of Texas puts it, “Forecasts 10 years out have no credibility.”

Simply projecting that health care costs will rise unabated is dangerous business.

His greatest hope, Mr. Galbraith said, was Stein’s law, named for Herbert Stein, chairman of the Council of Economic Advisers under Presidents Richard M. Nixon and Gerald R. Ford.

Stein’s law has been recited in many different versions. But all have a common theme: If a trend cannot continue, it will stop.

http://www.nytimes.com/2010/02/02/us/politics/02deficit.html?hp

And…

The Long-Term Outlook for Health Care Spending

Congressional Budget Office
November 2007

Projections of Health Spending

Over the past 30 years, total national spending on health care has more than doubled as a share of GDP. Under the assumptions described (in this CBO report), according to CBO’s projections, that share will double again by 2035, to 31 percent of GDP. Thereafter, health care costs continue to account for a steadily growing share of GDP, reaching 41 percent by 2060 and 49 percent by the end of the 75-year projection period.

http://www.cbo.gov/ftpdocs/87xx/doc8758/Intro.shtml
Graph: http://www.cbo.gov/ftpdocs/87xx/doc8758/Figure4.gif

And…

GOP House Issues Conference

January 29, 2010

Congressman Paul Ryan (speaking to President Obama):  … Medicare, as you know, is a $38 trillion unfunded liability…

http://www.whitehouse.gov/the-press-office/remarks-president-gop-house-issues-conference

Comment: 

By Don McCanne, MD

At over $2.5 trillion (almost 18 percent of our GDP), the level of health care spending in the United States this year is almost intolerable. Yet we hear predictions that health care will represent half of our GDP by 2082, and that Medicare will accumulate a deficit of $38 trillion.

Thank goodness for Stein’s Law. We will never see these numbers for the simple reason that this rate of increase cannot go on forever. It will stop once it hits the wall.

Herbert Stein, being from the Chicago School of Economics (think Milton Friedman), did not believe that steps must be taken to intervene since the problem would take care of itself. Although that is true, the problem with this sterile, amoral view, common amongst those of the Chicago School, is that it ignores the consequences of a spontaneous economic process devoid of the input from the heart and soul of beneficent public stewards.

To be clear, in the economics of health care, Stein’s Law does not represent one point in the expansion of health care spending at which everything stops and the health care system collapses. Nor does it represent a single point at which expansion stops and spending becomes static. Rather it represents a multitude of various walls for various payers, including individuals, employers and the various levels of government, each of which has its own wall as a barrier represented by Stein’s Law.

In our fragmented system of financing health care, Stein’s Law is already in play. Tens of millions are no longer able to afford health insurance. Tens of millions more are no longer able to afford adequate insurance products and must face the financial hardships of the underinsurance products that have been the response of competing insurers in our market economy in health care. The rate of employer-sponsored coverage has been declining because too many businesses, especially small businesses, have already hit the wall. Many states are struggling with the need to reduce Medicaid payments to providers in order to try to include more under the umbrella, while watching the safety-net of providers crumble from protracted financial losses. Even the federal government is struggling to find ways to fill the void in the face of massive budget deficits.

With Stein’s Law, we can predict that the rate of spending increases will very soon slow down, but under our current financing system, that will inevitably result in more financial hardship, suffering, and even death as health care access becomes ever less affordable.

Suppose the Senate bill passes, along with the reconciliation tweaks, then what will happen? Since our beneficent stewards in Congress neglected their duties, failing to adopt policies that would slow the growth in health care spending, health care costs will continue to test Stein’s Law.

Some of the multitude of walls will move, but none of them will go away. The states will see their walls move further out with the infusion of Medicaid funds. The federal government will see its wall move closer, signaled by the shrill cacophony of the budget hawks. Employers will not see their wall move much, but they will continue to barrel forward, eventually hitting it one by one.

But what about our hard-working, middle-income Americans? The wall will be moved much closer. For several reasons, mostly related to costs, there will be an attrition of employer-sponsored plans. Since the subsidies to purchase private plans will be less than the employer contributions, fewer individuals and families will be able to afford the plans. To slow the rise in premiums, more benefits will be stripped out. The Obama administration would accelerate this deterioration in benefits by imposing an excise tax on the plans as “the most effective way to control costs.” The Obama/Orszag policy of controlling costs by erecting financial barriers to necessary health care is a very sick policy indeed. The legislation before Congress adds afterburners to middle-income Americans only accelerating their trip to Stein’s impenetrable wall.

When our economic models have immoral consequences, we should abandon the amoral models of the Chicago School, and move to normative economics. It is not a sin for an economist to have a heart.

Under a single payer national health program – an improved and expanded Medicare for all – Stein’s wall will still be there. But instead of letting the entire system crash into the wall, our own beneficent public stewards – if we elect ones with a heart – will be there to make sure that everyone receives the care that they need. The resources that we use may take us up to the wall, but we won’t be crashing into it.

Every other industrialized nation has an impenetrable Stein wall, but by using normative economics, they don’t sacrifice their citizens by slamming them into that wall.

Stein's Law – hitting the wall

Herb Stein’s Unfamiliar Quotations

By Herbert Stein
Slate
May 16, 1997
If something cannot go on forever, it will stop.
–Stein’s Law, first pronounced in the 1980s
This proposition, arising first in a discussion of the balance-of-payments deficit, is a response to those who think that if something cannot go on forever, steps must be taken to stop it–even to stop it at once.
http://www.slate.com/id/2561/

And…

Huge Deficits May Alter U.S. Politics and Global Power

By David E. Sanger
The New York Times
February 1, 2010
… as Prof. James K. Galbraith of the University of Texas puts it, “Forecasts 10 years out have no credibility.”
Simply projecting that health care costs will rise unabated is dangerous business.
His greatest hope, Mr. Galbraith said, was Stein’s law, named for Herbert Stein, chairman of the Council of Economic Advisers under Presidents Richard M. Nixon and Gerald R. Ford.
Stein’s law has been recited in many different versions. But all have a common theme: If a trend cannot continue, it will stop.
http://www.nytimes.com/2010/02/02/us/politics/02deficit.html?hp

And…

The Long-Term Outlook for Health Care Spending

Congressional Budget Office
November 2007
Projections of Health Spending
Over the past 30 years, total national spending on health care has more than doubled as a share of GDP. Under the assumptions described (in this CBO report), according to CBO’s projections, that share will double again by 2035, to 31 percent of GDP. Thereafter, health care costs continue to account for a steadily growing share of GDP, reaching 41 percent by 2060 and 49 percent by the end of the 75-year projection period.
http://www.cbo.gov/ftpdocs/87xx/doc8758/Intro.shtml
Graph: http://www.cbo.gov/ftpdocs/87xx/doc8758/Figure4.gif

And…

GOP House Issues Conference

January 29, 2010
Congressman Paul Ryan (speaking to President Obama):  … Medicare, as you know, is a $38 trillion unfunded liability…
http://www.whitehouse.gov/the-press-office/remarks-president-gop-house-issues-conference

At over $2.5 trillion (almost 18 percent of our GDP), the level of health care spending in the United States this year is almost intolerable. Yet we hear predictions that health care will represent half of our GDP by 2082, and that Medicare will accumulate a deficit of $38 trillion.
Thank goodness for Stein’s Law. We will never see these numbers for the simple reason that this rate of increase cannot go on forever. It will stop once it hits the wall.
Herbert Stein, being from the Chicago School of Economics (think Milton Friedman), did not believe that steps must be taken to intervene since the problem would take care of itself. Although that is true, the problem with this sterile, amoral view, common amongst those of the Chicago School, is that it ignores the consequences of a spontaneous economic process devoid of the input from the heart and soul of beneficent public stewards.
To be clear, in the economics of health care, Stein’s Law does not represent one point in the expansion of health care spending at which everything stops and the health care system collapses. Nor does it represent a single point at which expansion stops and spending becomes static. Rather it represents a multitude of various walls for various payers, including individuals, employers and the various levels of government, each of which has its own wall as a barrier represented by Stein’s Law.
In our fragmented system of financing health care, Stein’s Law is already in play. Tens of millions are no longer able to afford health insurance. Tens of millions more are no longer able to afford adequate insurance products and must face the financial hardships of the underinsurance products that have been the response of competing insurers in our market economy in health care. The rate of employer-sponsored coverage has been declining because too many businesses, especially small businesses, have already hit the wall. Many states are struggling with the need to reduce Medicaid payments to providers in order to try to include more under the umbrella, while watching the safety-net of providers crumble from protracted financial losses. Even the federal government is struggling to find ways to fill the void in the face of massive budget deficits.
With Stein’s Law, we can predict that the rate of spending increases will very soon slow down, but under our current financing system, that will inevitably result in more financial hardship, suffering, and even death as health care access becomes ever less affordable.
Suppose the Senate bill passes, along with the reconciliation tweaks, then what will happen? Since our beneficent stewards in Congress neglected their duties, failing to adopt policies that would slow the growth in health care spending, health care costs will continue to test Stein’s Law.
Some of the multitude of walls will move, but none of them will go away. The states will see their walls move further out with the infusion of Medicaid funds. The federal government will see its wall move closer, signaled by the shrill cacophony of the budget hawks. Employers will not see their wall move much, but they will continue to barrel forward, eventually hitting it one by one.
But what about our hard-working, middle-income Americans? The wall will be moved much closer. For several reasons, mostly related to costs, there will be an attrition of employer-sponsored plans. Since the subsidies to purchase private plans will be less than the employer contributions, fewer individuals and families will be able to afford the plans. To slow the rise in premiums, more benefits will be stripped out. The Obama administration would accelerate this deterioration in benefits by imposing an excise tax on the plans as “the most effective way to control costs.” The Obama/Orszag policy of controlling costs by erecting financial barriers to necessary health care is a very sick policy indeed. The legislation before Congress adds afterburners to middle-income Americans only accelerating their trip to Stein’s impenetrable wall.
When our economic models have immoral consequences, we should abandon the amoral models of the Chicago School, and move to normative economics. It is not a sin for an economist to have a heart.
Under a single payer national health program – an improved and expanded Medicare for all – Stein’s wall will still be there. But instead of letting the entire system crash into the wall, our own beneficent public stewards – if we elect ones with a heart – will be there to make sure that everyone receives the care that they need. The resources that we use may take us up to the wall, but we won’t be crashing into it.
Every other industrialized nation has an impenetrable Stein wall, but by using normative economics, they don’t sacrifice their citizens by slamming them into that wall.

Stein’s Law – hitting the wall

Herb Stein’s Unfamiliar Quotations

By Herbert Stein
Slate
May 16, 1997

If something cannot go on forever, it will stop.
–Stein’s Law, first pronounced in the 1980s

This proposition, arising first in a discussion of the balance-of-payments deficit, is a response to those who think that if something cannot go on forever, steps must be taken to stop it–even to stop it at once.

http://www.slate.com/id/2561/

And…

Huge Deficits May Alter U.S. Politics and Global Power

By David E. Sanger
The New York Times
February 1, 2010

… as Prof. James K. Galbraith of the University of Texas puts it, “Forecasts 10 years out have no credibility.”

Simply projecting that health care costs will rise unabated is dangerous business.

His greatest hope, Mr. Galbraith said, was Stein’s law, named for Herbert Stein, chairman of the Council of Economic Advisers under Presidents Richard M. Nixon and Gerald R. Ford.

Stein’s law has been recited in many different versions. But all have a common theme: If a trend cannot continue, it will stop.

http://www.nytimes.com/2010/02/02/us/politics/02deficit.html?hp

And…

The Long-Term Outlook for Health Care Spending

Congressional Budget Office
November 2007

Projections of Health Spending

Over the past 30 years, total national spending on health care has more than doubled as a share of GDP. Under the assumptions described (in this CBO report), according to CBO’s projections, that share will double again by 2035, to 31 percent of GDP. Thereafter, health care costs continue to account for a steadily growing share of GDP, reaching 41 percent by 2060 and 49 percent by the end of the 75-year projection period.

http://www.cbo.gov/ftpdocs/87xx/doc8758/Intro.shtml
Graph: http://www.cbo.gov/ftpdocs/87xx/doc8758/Figure4.gif

And…

GOP House Issues Conference

January 29, 2010

Congressman Paul Ryan (speaking to President Obama):  … Medicare, as you know, is a $38 trillion unfunded liability…

http://www.whitehouse.gov/the-press-office/remarks-president-gop-house-issues-conference

At over $2.5 trillion (almost 18 percent of our GDP), the level of health care spending in the United States this year is almost intolerable. Yet we hear predictions that health care will represent half of our GDP by 2082, and that Medicare will accumulate a deficit of $38 trillion.

Thank goodness for Stein’s Law. We will never see these numbers for the simple reason that this rate of increase cannot go on forever. It will stop once it hits the wall.

Herbert Stein, being from the Chicago School of Economics (think Milton Friedman), did not believe that steps must be taken to intervene since the problem would take care of itself. Although that is true, the problem with this sterile, amoral view, common amongst those of the Chicago School, is that it ignores the consequences of a spontaneous economic process devoid of the input from the heart and soul of beneficent public stewards.

To be clear, in the economics of health care, Stein’s Law does not represent one point in the expansion of health care spending at which everything stops and the health care system collapses. Nor does it represent a single point at which expansion stops and spending becomes static. Rather it represents a multitude of various walls for various payers, including individuals, employers and the various levels of government, each of which has its own wall as a barrier represented by Stein’s Law.

In our fragmented system of financing health care, Stein’s Law is already in play. Tens of millions are no longer able to afford health insurance. Tens of millions more are no longer able to afford adequate insurance products and must face the financial hardships of the underinsurance products that have been the response of competing insurers in our market economy in health care. The rate of employer-sponsored coverage has been declining because too many businesses, especially small businesses, have already hit the wall. Many states are struggling with the need to reduce Medicaid payments to providers in order to try to include more under the umbrella, while watching the safety-net of providers crumble from protracted financial losses. Even the federal government is struggling to find ways to fill the void in the face of massive budget deficits.

With Stein’s Law, we can predict that the rate of spending increases will very soon slow down, but under our current financing system, that will inevitably result in more financial hardship, suffering, and even death as health care access becomes ever less affordable.

Suppose the Senate bill passes, along with the reconciliation tweaks, then what will happen? Since our beneficent stewards in Congress neglected their duties, failing to adopt policies that would slow the growth in health care spending, health care costs will continue to test Stein’s Law.

Some of the multitude of walls will move, but none of them will go away. The states will see their walls move further out with the infusion of Medicaid funds. The federal government will see its wall move closer, signaled by the shrill cacophony of the budget hawks. Employers will not see their wall move much, but they will continue to barrel forward, eventually hitting it one by one.

But what about our hard-working, middle-income Americans? The wall will be moved much closer. For several reasons, mostly related to costs, there will be an attrition of employer-sponsored plans. Since the subsidies to purchase private plans will be less than the employer contributions, fewer individuals and families will be able to afford the plans. To slow the rise in premiums, more benefits will be stripped out. The Obama administration would accelerate this deterioration in benefits by imposing an excise tax on the plans as “the most effective way to control costs.” The Obama/Orszag policy of controlling costs by erecting financial barriers to necessary health care is a very sick policy indeed. The legislation before Congress adds afterburners to middle-income Americans only accelerating their trip to Stein’s impenetrable wall.

When our economic models have immoral consequences, we should abandon the amoral models of the Chicago School, and move to normative economics. It is not a sin for an economist to have a heart.

Under a single payer national health program – an improved and expanded Medicare for all – Stein’s wall will still be there. But instead of letting the entire system crash into the wall, our own beneficent public stewards – if we elect ones with a heart – will be there to make sure that everyone receives the care that they need. The resources that we use may take us up to the wall, but we won’t be crashing into it.

Every other industrialized nation has an impenetrable Stein wall, but by using normative economics, they don’t sacrifice their citizens by slamming them into that wall.

The President at the GOP House Issues Conference

Remarks by the President at GOP House Issues Conference

The White House
January 29, 2010

Congressman Price (Dr. Tom Price from Georgia):  Mr. President, multiple times, from your administration, there have come statements that Republicans have no ideas and no solutions.  In spite of the fact that we’ve offered, as demonstrated today, positive solutions to all of the challenges we face, including energy and the economy and health care, specifically in the area of health care — this bill, H.R.3400, that has more co-sponsors than any health care bill in the House, is a bill that would provide health coverage for all Americans; would correct the significant insurance challenges of affordability and preexisting; would solve the lawsuit abuse issue, which isn’t addressed significantly in the other proposals that went through the House and the Senate; would write into law that medical decisions are made between patients and families and doctors; and does all of that without raising taxes by a penny.

But my specific question is, what should we tell our constituents who know that Republicans have offered positive solutions to the challenges that Americans face and yet continue to hear out of the administration that we’ve offered nothing?

The President:  It’s not enough if you say, for example, that we’ve offered a health care plan and I look up — this is just under the section that you’ve just provided me, or the book that you just provided me — summary of GOP health care reform bill:  “The GOP plan will lower health care premiums for American families and small businesses, addressing America’s number-one priority for health reform.”  I mean, that’s an idea that we all embrace.  But specifically it’s got to work.  I mean, there’s got to be a mechanism in these plans that I can go to an independent health care expert and say, is this something that will actually work, or is it boilerplate?

If I’m told, for example, that the solution to dealing with health care costs is tort reform, something that I’ve said I am willing to work with you on, but the CBO or other experts say to me, at best, this could reduce health care costs relative to where they’re growing by a couple of percentage points, or save $5 billion a year, that’s what we can score it at, and it will not bend the cost curve long term or reduce premiums significantly — then you can’t make the claim that that’s the only thing that we have to do.  If we’re going to do multi-state insurance so that people can go across state lines, I’ve got to be able to go to an independent health care expert, Republican or Democrat, who can tell me that this won’t result in cherry-picking of the healthiest going to some and the least healthy being worse off.

So I am absolutely committed to working with you on these issues, but it can’t just be political assertions that aren’t substantiated when it comes to the actual details of policy.  Because otherwise, we’re going to be selling the American people a bill of goods.  I mean, the easiest thing for me to do on the health care debate would have been to tell people that what you’re going to get is guaranteed health insurance, lower your costs, all the insurance reforms; we’re going to lower the costs of Medicare and Medicaid and it won’t cost anybody anything.  That’s great politics, it’s just not true.

So there’s got to be some test of realism in any of these proposals, mine included.  I’ve got to hold myself accountable, and guaranteed the American people will hold themselves — will hold me accountable if what I’m selling doesn’t actually deliver.

http://www.whitehouse.gov/the-press-office/remarks-president-gop-house-issues-conference

Comment: 

By Don McCanne, MD

The President enters the Republicans’ den, and politics broke out. At least that’s the impression you might have from the media coverage of the President’s appearance at the GOP House Issues Conference. But this was not simply an exchange of partisan political rhetoric; it was a plea by President Obama to set aside rhetorical grandstanding and to join together in a fair, credible, and objective discussion of the impact of the actual policies under consideration.

Did that happen? It is puzzling how Congressman Tom Price, a physician, could state directly to the President that their Republican bill “would provide health coverage for all Americans.” That goes beyond political grandstanding for the benefit of the television cameras. That is shameless, arrogant lying to the President of the United States and to the American people. It is impossible to have a constructive dialogue with liars.

President Obama is right when he states that these proposals must pass the test of realism, while at the same time holding himself accountable. But realism alone isn’t enough. The policies must be effective and efficient. Yet the President and Congress abandoned those health care reform policies that pass the tests with the highest scores, and accepted flawed, lower-scoring policies that were believed to comply better with the political tests, though that political support is waning.

When objectivity and realism demonstrate that the Democratic proposal falls far short, and when better, proven policies would bring affordable care to everyone, we should hold the President and Congress accountable. But we should also support them politically when they throw the liars out so they can get on with the reform that we need.

One more lie. Congressman Price said that H.R.3400 “has more co-sponsors than any health care bill in the House.” It has 52 cosponsors. Congressman John Conyers’ H.R. 676, “United States National Health Care Act or the Expanded and Improved Medicare for All Act,” has 87 cosponsors.

More importantly, Conyers’ bill is based on sound health policy that would actually work, whereas Price’s bill is based on feeble policies that will have almost no impact on the problems we face in health care. But their bill does provide them with rhetoric they can use for political grandstanding, even if based on lies (e.g., “provides health coverage for all Americans”).

Fact Sheet: The California Universal Healthcare Act

Affordable Health Insurance for All Californians

SB 810 (LENO)

February, 2009

En Español

Background:  Health care costs are crushing California’s economy and the state budget, forcing steep annual cuts in health care access and quality for Californians and their employers.  Health insurance premiums annually grow 4 times faster than wages, and have risen 87% since 2000 [1].

There are now 7 million uninsured Californians, but as insurance companies reduce health coverage, polls show that most insured Americans are now worried about how to pay for their health care if they get sick.

The U.S. spends more on health care—and gets less for it—than any other wealthy country. The $2.5 trillion that we spend every year (17.6% of our GDP)[2], is twice as costly as other wealthy nations, but it buys us a health care system ranked 37th by the World Health Organization. Alarmingly, studies repeatedly show that the quality of care in the U.S. is falling behind other wealthy nations.

California spent an estimated $212 billion in healthcare last year[3]. This is plenty of money to provide every resident of the state with excellent healthcare, ensure fair and reliable reimbursements to doctors, nurses and other providers, and guarantee a high quality of care for all.

SB 810 (Leno), the California Universal Healthcare Act would provide fiscally sound, affordable healthcare to all Californians, give every Californian the right to choose his or her own physician and control health cost inflation.

Truly Universal: Eligibility is based on residency, instead of on employment or income. Under the Act, all residents are covered. No California resident will ever again lose his or her health insurance because of unaffordable insurance premiums, because he or she changes or loses a job, goes to or graduates from college or has a pre-existing medical condition.

Shared Responsibility: Under the Act everyone – individuals, employers and government pays something in and everyone gets healthcare.

Affordable: The plan involves NO NEW SPENDING on healthcare. The system will be paid for by federal, state and county monies already being spent on healthcare and by affordable insurance premiums that replace all premiums, deductibles, out-of-pocket payments and co-pays now paid by employers and consumers.

Total Choice: Under SB 810, delivery of care remains as it is; a competitive mix of public and private providers. All consumers have complete freedom to choose their healthcare providers. No more restrictive HMO networks.

Fair Reimbursements: The Act requires actuarially sound reimbursements for providers. Doctors, nurses, hospitals and other healthcare providers will receive fair and reasonable reimbursements for all covered services they provide. No more uncompensated care.

Efficient: The Act eliminates waste by consolidating the functions of many insurance companies into one comprehensive insurance plan, saving the state and consumers billions of dollars each year. Currently about half of every dollar spent on healthcare is squandered on clinical and administrative waste, insurance company profits, and overpriced pharmaceuticals. The Act is based on a model that has been estimated to save California about $20 billion through reduced administrative costs in the first year alone.

Under the Act, California will use its purchasing power to buy prescription drugs and durable medical equipment in bulk. It has been estimated that this model of systemwide bulk purchasing could save California $5.2 billion in the first year.

Most importantly, the Act will make our healthcare system more reliable and secure by stabilizing the growth in health spending; linking spending increases to state GDP and population growth, employment rates and other relevant demographic indicators.

The Act will combine needed cost controls with medical standards that use the best available medical science, and place an emphasis on preventative and primary care to improve California’s overall health in a way that also saves billions of dollars.

The Act utilizes proven financial incentives that support the delivery of high quality care, including bonuses for providers working in rural or under-served areas. The plan invests in needed healthcare infrastructure such as electronic claims and reimbursement systems and statewide medical databases that improve healthcare quality.

Benefits: Coverage includes all care prescribed by a patient’s healthcare provider that meets accepted standards of care and practice.

Specifically, coverage includes hospital, medical, surgical, and mental health; dental and vision care; prescription drugs and medical equipment such as hearing aids; emergency care including ambulance; skilled nursing care after hospitalization; substance abuse recovery programs; health education and translation services, including services for those with hearing and vision impairments; transportation needed to access covered services, diagnostic testing; and hospice care.

For more information contact Sara Rogers at (916) 651-4646 or sara.rogers@sen.ca.gov, or Zak Meyer-Krings at (916) 651-4003 or zak.meyer-krings@sen.ca.gov.

~~~~~

1 Kaiser Family Foundation.  Employer Health Benefits 2006 Annual Survey.

2 [Health Affairs 28, no. 2 (2009): w346-w357 (published online 24 February 2009; 10.1377/hlthaff.28.2.w346)]

3 Lewin Group Costs and Economic Impacts Analysis. January 2005.

La Propuesta de Ley de Cuidado Médico Universal para California

Seguro Médico Asequible para Todos los californianos

SB 810 (LENO)

HOJA INFORMATIVA

Antecedentes: El costo del cuidado médico está restringiendo la economía de California y el presupuesto del estado, forzando recortes considerables cada año al acceso y calidad del cuidado médico para californianos y sus empleadores. Primas de seguro médico crecen cuatro veces más rápido que los sueldos cada año y han aumentado un 87% desde el año 2000 [1]. Siete millones de californianos carecen de seguro médico, mientras que las compañías de seguros disminuyen su cobertura médica. Como resultado, encuestas nacionales indican que la mayoría de americanos asegurados están preocupados por como pagaran su cuidado médico si se enferman.

Los E.E.U.U. gasta más en cuidado médico –y recibe menos –que cualquier otro país avanzado. Los $2.5 billones de dólares que gastamos cada año (un 17.6% de nuestro producto interior bruto, PIB) [2], es dos veces más costoso que otros países avanzados, pero nos otorga un sistema de salud que se clasificó 37º por la Organización Mundial de Salud. Alarmantemente, los estudios siguen indicando que la calidad del cuidado medico en los E.E.U.U. se está quedando atrás de los otros países avanzados.

Es mas, california gastó aproximadamente $212 mil millones en cuidado médico el año pasado [3]. Este dinero es más que suficiente para proporcionarle a cada residente del estado un cuidado médico de calidad, y asegurar reembolsos justos y fiables a doctores, enfermeras, y otros proveedores.

SB 810 (Leno), la propuesta de ley de Cuidado Médico Universal de California proporcionaría un cuidado médico fiscalmente sano y asequible para todos los californianos, le daría a cada californiano el derecho de escoger su doctor, y controlaría la inflación en costos de salud.

Verdaderamente Universal: Elegibilidad se basa en residencia, en ves de empleo o ingresos. Bajo esta propues
ta de ley, todos los residentes recibirán cobertura medica. Ningún residente de California jamás perderá su seguro médico a causa de primas de seguro inasequibles, cambio o perdida de su trabajo, o por tener una condición médica preexistente.Asequible: El plan no requiere GASTOS NUEVOS para el cuidado médico. Se pagará a través de fondos federales, estatales, y del condado que actualmente se gastan en el cuidado médico y con primas de seguro asequibles que reemplazaran todas las primas, los deducibles, los gastos por cuenta propia (o pagos directos), y los pagos compartidos que ahora son pagados por los empleadores y consumidores.

Elección Completa: Bajo la propuesta de ley SB 810, la entrega de cuidado médico sigue siendo la misma, una mezcla competitiva de proveedores públicos y privados. Todos los consumidores tienen plena libertad para elegir sus proveedores de cuidado médico –doctores, clínicas, hospitales, etc. Ya no habrá redes de aseguradores restrictivas.

Reembolsos Justos: Esta propuesta de ley exige reembolsos adecuados para los proveedores. Doctores, clínicas, hospitales y otros proveedores de cuidado médico recibirán reembolsos justos y razonables por todos los servicios que proporcionan. Ya no habrá cuidado médico sin compensación justa.

Eficaz: Esta propuesta elimina desperdicios de fondos mediante la consolidación de las funciones de varias compañías de seguros en un plan de seguro integral, ahorrándole al estado y a los consumidores mil millones de dólares cada año. Actualmente, cerca de la mitad de cada dólar gastado en el cuidado médico se malgasta en desperdicios clínicos y administrativos, ganancias para las compañías de seguros, y en farmacéuticos demasiado caros. En reducir o eliminar estos malgastos, se estima que esta propuesta ahorrara a California cerca de $20 mil millones en solo el primer año.

Mediante SB 810, California hará uso de su poder adquisitivo para comprar en mayoreo medicamentos y equipo médico duradero. Se ha estimado que este modelo de compras por mayoreo podría ahorrarle a California $5.2 mil millones en el primer año.

De mayor importancia, esta propuesta hará que nuestro sistema de cuidado médico sea más confiable y seguro. Estabilizará el crecimiento de los gastos médicos, conectando los aumentos de gastos con el crecimiento de la población, los niveles de empleo y otros índices económicos pertinentes.

La propuesta de ley combinará controles de costos necesarios con normas médicas que utilizan la mejor ciencia médica disponible, y también pondrá un énfasis en el cuidado primario y preventivo para reducir problemas médicos para ahorrar mil millones de dólares.

SB 810 utiliza incentivos financieros comprobados que apoyan la entrega de cuidado médico de alta calidad, incluyendo beneficios para los proveedores que trabajan en áreas rurales o en comunidades de bajos recursos sin suficiente atención medica. El plan invierte en los sistemas de reclamaciones y reembolsos electrónicos, y un sistema estatal de datos médicos que mejoran la calidad del cuidado médico.

Beneficios: La cobertura incluye todo el cuidado medico prescrito para el paciente por su doctor o proveedor que cumple con las normas de cuidado y prácticas aceptadas.

Específicamente, la cobertura incluye cuidado de hospital, atención médica, atención quirúrgica y cuidado de salud mental; cuidado dental y de visión; medicamentos recetados y equipo médico; cuidado de emergencia incluyendo la atención de ambulancias, y cuidado de enfermería especializada después de la hospitalización; programas para la recuperación del abuso de sustancias; educación sobre la salud y servicios de traducción, incluyendo los servicios para las personas con discapacidad auditiva y de vista; el transporte para acceder a los servicios necesarios; pruebas diagnósticas; y atención en hospitales para enfermos terminales.

Para más información, comuníquese con: Sara Rogers al (916) 651-4646 o sara.rogers@sen.ca.gov, o con Zak Meyer-Krings al (916) 651-4003 o zak.meyerkrings@sen.ca.gov.

~~~~~

1 Kaiser Family Foundation. Employer Health Benefits 2006 Annual Survey.

2 [Health Affairs 28, no. 2 (2009): w346-w357 (published online 24 February 2009; 10.1377/hlthaff.28.2.w346)] http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.2.w346

3 Lewin Group Costs and Economic Impacts Analysis. January 2005. Responsabilidad Compartida: Bajo esta propuesta de ley todos –individuos, empleadores, y el gobierno –pagan una parte y todos los residentes reciben cuidado médico.

Let Him Know

By Katie Robbins
MichaelMoore.com
February 1st, 2010

After a sobering loss for Democrats in the special election held to replace Sen. Ted Kennedy in Massachusetts, probing exit polls about health reform show that the win of Republican Scott Brown who pledged to cast the vote that would kill national health reform, didn’t come from people who thought the national legislation was going too far, but that it wasn’t going far enough.  Among Brown voters, 36 percent thought it didn’t go far enough.  Among voters who stayed home and opposed health care, a full 53 percent said they opposed the Senate bill because it didn’t go far enough.

The people in the commonwealth of Massachusetts have been living for three years with the same reform the national legislation is modeled after…and it isn’t working.  Even though more people have insurance through the mandate and subsidies for private plans, it fails to provide universal access to health care.  In addition, health costs continue to sky rocket, as it does little to guarantee that people can clear the hurdles of copays and deductibles in order to actually access health care when they need it.

A recent article from the Massachusetts state treasurer, Timothy P. Cahill, cites a recent study prepared by Drs. Rachel Nardin, David Himmelstein, and Steffie Woolhandler of Harvard Medical School showing that the least expensive plan available to a middle-income, 56-year-old individual costs $4,872 in annual premiums. That does not include a $2,000 deductible if the person actually gets sick, or the 20 percent of the person’s medical costs — up to $3,000 a year — he or she is required to pay, meaning that an individual’s total annual bill for health care could reach $9,872.

Cahill continues, “Rather than providing a solution, the Massachusetts health care laws have only created more problems, both on the state’s balance sheet and in struggling households across the state. Our residents deserve accessible, affordable health care that will not jeopardize the Commonwealth’s fiscal health, goals we cannot attain under the current system.”

To really understand the message coming from Massachusetts, let’s take a look back at the historic election in November 2008, two years after “health reform” was implemented in the state when voters turned out in record numbers to support the election of now President Obama and his message of change.   A little highlighted ballot initiative at the time reveals an insight into popular opinion on the state’s health plan.   In all ten legislative districts in the commonwealth, local ballot initiatives supporting single payer and opposing individual mandates passed by landslide margins.  With almost all precincts tallied, roughly 73 percent of 181,000 voters in the ten districts voted YES to the following:

“Should the representative from this district be instructed to support legislation creating a cost-effective single payer health insurance system that is available to all residents, and oppose laws penalizing those who fail to obtain health insurance?”

The measure passed with margins ranging from 65 to 82 percent in support of single-payer health care.

Unfortunately, the clear support for single-payer in Massachusetts and around the country falls on deaf ears of the current administration.  President Obama, in his recent remarks in the State of the Union address, opened the door for further discussion on the health care debate.  He said, “If anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.”

The growing movement for universal and improved Medicare has been trying to “let him know” for some time now, and will continue to do so.  Drs. Margaret Flowers and Carol Paris were recently arrested for responding to the President’s call for better ideas on how to reform the health care system.   Dr. Flowers left practice as a pediatrician because she was unable to provide quality care in this system.  They are now urging everyone to join them in letting President Obama know about Medicare for All.

We must find strength and power in our unified demand for improved Medicare for all.  Together, let’s raise our voices and let the President know that Medicare for all, a single-payer national health care plan, will meet his goals of a health plan that will save billions of dollars, tens of thousands of lives, cover everyone, strengthen Medicare, and guarantee free choice of doctor and hospital in access of quality, comprehensive health care with no financial barriers.

Please join Drs. Flowers and Paris, and the growing movement of patients, nurses, and physicians in telling President Obama that we know of a better plan for the nation than the failure in Massachusetts – Medicare 2.0 – improved Medicare for everyone.

Email him or call the White House today.

We’ve got to let him know.

http://www.michaelmoore.com/words/mike-friends-blog/let-him-know

Better approach to health care: A single payer solution for Obama

By John Marty
MinnPost
Friday, January 29, 2010

An open letter in response to President Obama’s State of the Union request for a better approach to health care reform:

Dear President Obama,

During your State of the Union address, you explained why you are fighting for health care reform, expressed frustration at the lack of success, and invited others to suggest a better approach.

I’m taking you up on that invitation and offer a bold suggestion:

Take a look at our Minnesota Health Plan — a proposal that covers everyone, saves money, and creates a logical health care system to replace the dysfunctional non-system which currently exists. It is a proposal that would provide health care to everyone, not merely health insurance for many. Our MN Health Plan (mnhealthplan.org) could be readily adapted as a nation-wide plan. It would meet each of the five requirements you mentioned in your State of the Union request:

Bring Down Premiums. Most Americans would see a big reduction in premiums because the plan would be significantly cheaper than our current health care non-system. Because the premiums for the MHP would be based on ability to pay, everyone’s premiums would be affordable. Some would pay more, but overall, costs would go down. Most people would save money, while getting the care they need and deserve. The total costs for the plan would be less than we now are paying for premiums, co-pays, deductibles, and taxes for medical programs.

Bring Down the Deficit. By keeping people healthier and by delivering quality health care efficiently, it would save hundreds of billions of dollars for the federal government, and even more for states. For example, by covering chemical dependency treatment and providing comprehensive mental health services, it would cut crime and human service costs (such as out-of-home placement of children), some of the biggest and fastest growing expenses facing state and local governments.

Cover the Uninsured. It would cover the uninsured and the under-insured. In fact it would cover everyone – 100 percent of the public.

Strengthen Medicare for Seniors (and everyone else). It would cover prescription drugs — with no “doughnut hole.” It would cover long term care, in-home care, dental, eye care, physical therapy, and medical supplies — it would cover all medical needs. And, they would have their choice of doctor, hospital, clinic, dentist — complete freedom to choose their medical providers.

Stop Insurance Company Abuses. There would be no “pre-existing conditions” to worry about, no underwriting, no denials of coverage, no “out of network” problems. I like to use the analogy of police and fire protection. When you return home to find a burglary in process and call 911, the police dispatcher does not ask if you qualify. They do not ask if you have police insurance. They do not ask whether your policy covers home burglary. They don’t ask if you have pre-existing conditions that would disqualify you. They don’t waste time and money having you fill out forms so your insurance company can be billed. The police response does not depend on your insurance status. Everyone is treated equally. It’s the American way. It is time to treat health care the same way.

As a 23 year member of the Minnesota Senate, let me comment briefly on the politics of this proposal:

The MHP is a single payer proposal. You have acknowledged that single payer is the only way to cover everyone. Seven years ago you said that single payer health care is “what I’d like to see. But… we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.” Now that we have taken back the White House and the Congress, it is time to act.

I recognize, as you do, that you do not have the votes to pass truly universal health care at this time. The insurance and pharmaceutical industries contribute so much to members of Congress — they control the debate — so health care for everyone isn’t even on the table.

This, however, is your opportunity for leadership. If you propose and fight for health care for all, as FDR did with Social Security in 1935, the voters would respond. If you don’t win this year, ask the American people to elect candidates who will stand with you. Make it the issue of the campaign: Health Care for All vs. Health Insurance for Some. Instead of losing Democratic members of Congress this year — as Massachusetts illustrates — you would gain votes and could actually pass the bill next year.

Dr. Martin Luther King stated, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”

Almost a half century later, we still have not addressed the injustice in health care that Dr. King described as the most inhumane. Ignoring this injustice is immoral and it is economically unsustainable. People are hurting, some are literally dying, businesses are folding, and it is crushing our national economy.

Please, restore the hope that you raised in all of us, bring back the inspiration that made the American people so excited by your inauguration. I urge you to step back, reconsider, introduce a health care plan that is truly universal, and fight for it.

Justice requires no less.

State Sen. John Marty, DFL-Roseville, is a candidate for governor.

http://www.minnpost.com/community_voices/2010/01/29/15447/better_approach_to_health_care_a_single_payer_solution_for_obama

The President at the GOP House Issues Conference

Remarks by the President at GOP House Issues Conference

The White House
January 29, 2010
Congressman Price (Dr. Tom Price from Georgia):  Mr. President, multiple times, from your administration, there have come statements that Republicans have no ideas and no solutions.  In spite of the fact that we’ve offered, as demonstrated today, positive solutions to all of the challenges we face, including energy and the economy and health care, specifically in the area of health care — this bill, H.R.3400, that has more co-sponsors than any health care bill in the House, is a bill that would provide health coverage for all Americans; would correct the significant insurance challenges of affordability and preexisting; would solve the lawsuit abuse issue, which isn’t addressed significantly in the other proposals that went through the House and the Senate; would write into law that medical decisions are made between patients and families and doctors; and does all of that without raising taxes by a penny.
But my specific question is, what should we tell our constituents who know that Republicans have offered positive solutions to the challenges that Americans face and yet continue to hear out of the administration that we’ve offered nothing?
The President:  It’s not enough if you say, for example, that we’ve offered a health care plan and I look up — this is just under the section that you’ve just provided me, or the book that you just provided me — summary of GOP health care reform bill:  “The GOP plan will lower health care premiums for American families and small businesses, addressing America’s number-one priority for health reform.”  I mean, that’s an idea that we all embrace.  But specifically it’s got to work.  I mean, there’s got to be a mechanism in these plans that I can go to an independent health care expert and say, is this something that will actually work, or is it boilerplate?
If I’m told, for example, that the solution to dealing with health care costs is tort reform, something that I’ve said I am willing to work with you on, but the CBO or other experts say to me, at best, this could reduce health care costs relative to where they’re growing by a couple of percentage points, or save $5 billion a year, that’s what we can score it at, and it will not bend the cost curve long term or reduce premiums significantly — then you can’t make the claim that that’s the only thing that we have to do.  If we’re going to do multi-state insurance so that people can go across state lines, I’ve got to be able to go to an independent health care expert, Republican or Democrat, who can tell me that this won’t result in cherry-picking of the healthiest going to some and the least healthy being worse off.
So I am absolutely committed to working with you on these issues, but it can’t just be political assertions that aren’t substantiated when it comes to the actual details of policy.  Because otherwise, we’re going to be selling the American people a bill of goods.  I mean, the easiest thing for me to do on the health care debate would have been to tell people that what you’re going to get is guaranteed health insurance, lower your costs, all the insurance reforms; we’re going to lower the costs of Medicare and Medicaid and it won’t cost anybody anything.  That’s great politics, it’s just not true.
So there’s got to be some test of realism in any of these proposals, mine included.  I’ve got to hold myself accountable, and guaranteed the American people will hold themselves — will hold me accountable if what I’m selling doesn’t actually deliver.
http://www.whitehouse.gov/the-press-office/remarks-president-gop-house-issues-conference

The President enters the Republicans’ den, and politics broke out. At least that’s the impression you might have from the media coverage of the President’s appearance at the GOP House Issues Conference. But this was not simply an exchange of partisan political rhetoric; it was a plea by President Obama to set aside rhetorical grandstanding and to join together in a fair, credible, and objective discussion of the impact of the actual policies under consideration.
Did that happen? It is puzzling how Congressman Tom Price, a physician, could state directly to the President that their Republican bill “would provide health coverage for all Americans.” That goes beyond political grandstanding for the benefit of the television cameras. That is shameless, arrogant lying to the President of the United States and to the American people. It is impossible to have a constructive dialogue with liars.
President Obama is right when he states that these proposals must pass the test of realism, while at the same time holding himself accountable. But realism alone isn’t enough. The policies must be effective and efficient. Yet the President and Congress abandoned those health care reform policies that pass the tests with the highest scores, and accepted flawed, lower-scoring policies that were believed to comply better with the political tests, though that political support is waning.
When objectivity and realism demonstrate that the Democratic proposal falls far short, and when better, proven policies would bring affordable care to everyone, we should hold the President and Congress accountable. But we should also support them politically when they throw the liars out so they can get on with the reform that we need.
One more lie. Congressman Price said that H.R.3400 “has more co-sponsors than any health care bill in the House.” It has 52 cosponsors. Congressman John Conyers’ H.R. 676, “United States National Health Care Act or the Expanded and Improved Medicare for All Act,” has 87 cosponsors.
More importantly, Conyers’ bill is based on sound health policy that would actually work, whereas Price’s bill is based on feeble policies that will have almost no impact on the problems we face in health care. But their bill does provide them with rhetoric they can use for political grandstanding, even if based on lies (e.g., “provides health coverage for all Americans”).

What I Have Learned “Doing Civil Disobedience for Single Payer”

By Dr. Carol Paris

“People should go where they are not supposed to go, say what they are not supposed to say, and stay when they are told to leave.”  –Howard Zinn

Well, that quote pretty well sums up “what to do”.  But my biggest challenge is “how”.  Specifically, how do I neutralize some pretty powerful fear?

I was scared Friday when I joined Margaret Flowers to attempt to deliver a message to the President.  My thoughts raced.  We’re talking secret service. 

“How do I get myself into these things?” 
“This is crazy.” 
“This is pointless.” 
“I can’t even make sensible statements; I know what I want to say but I’m so nervous.” 
“Other people are so much more knowledgeable and speak so much more eloquently.”
“But I am doing it!”

We stood in front of the Harbor Hotel in Baltimore clutching a banner that read “Letting you know.  Medicare for all” and Margaret’s letter for the President written in response to his appeal for solutions to health reform.  The hotel manager, police and secret service surrounded us and asked us to move.

If you watch the video, you’ll see that there was a point, a moment, which felt suspended in time, when Margaret looked at me and I looked at her and we both knew “we ain’t goin’ across the street.”

The feeling associated with that awareness was not fear, or anger, or self-righteous indignation.  It was a feeling of quiet liberation.  The things I was saying to myself, thoughts powerful enough to imprison me in a jailhouse of fear, had been neutralized.  In their place was a calm determination to trust my intuition. 

My gut told me “so be it.  You’re doing the best you can.  This is a no-brainer.  Gotta do it.  Margaret and I have been needing some quiet time to catch-up; might as well be in a police station.”

My gut has a great sense of humor.

Fear overcomes me when I listen to my head; calm enfolds me when I listen to my gut.

So, for what it is worth, here are few tips for “doing cd for Single Payer”:

1. Ignore your head.  That means, all those familiar thoughts that leave you feeling fearful and bad.

2. Listen to your gut.  You know it’s your gut talking if you start feeling calmness, clarity, and quiet determination.

3. We need people engaging in “gut-driven” cd to right all kinds of wrongs.  Be authentic; for many of us, the gut issue is Medicare For All.  If yours is the environment, then do cd for that. 

4. Don’t try this alone.  Take a friend. Or several.

5. Do the best you can.  Speak from your heart.  Once you’re in handcuffs, the worst is over.  The “authorities” aren’t your enemy; most will treat you respectfully and the ones who don’t are just having a bad day.  Don’t take it personally.

6. I like to take a “token” with me, tucked in my pocket with my driver’s license. For me, it’s a picture of my grandchildren and the holy card from my father’s funeral.  It reminds me that he would be proud of me and that I’m doing this for the people who inspire me–my family and my patients.

7. If you have the choice of doing cd in the winter or the summer, definitely choose summer!  Wear layers either way because it’s cold in jail.

Remember that we all have talents to contribute.  Without Bill Hughes taking the video, our action wouldn’t have been as fruitful.  Without Kevin Zeese, we’d have worried about our families and “legal stuff.”  Without Mark Almberg, we wouldn’t have a press release.  Without researchers like David Himmelstein and Steffie Woolhandler, we wouldn’t have compelling data to support us.  We draw support from each other.

As Margaret Mead said:  Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it is the only thing that ever has.”

Sen.-elect Brown may be health care reform’s unwitting savior

By Barbara Power
Nashua (N.H.) Telegraph
Sunday, January 31, 2010

Do you have reliable, affordable, high-quality health care, guaranteed for life?

Do all of your children? Parents? Grandchildren? Friends and neighbors?

If so, congratulations.

If not, like many of us here in New Hampshire, you probably lie awake late into the night sometimes worrying about what kind of havoc an illness or accident might wreak on your family’s finances.

Next time you can’t sleep, do what I do and try running these numbers through your head:

  • $936,267,403: The amount donated to Congress by the health care industry.
  • $20,915,072: The amount donated to President Barack Obama by the health care industry.
  • 15,385: The average number of Americans who lost their health insurance each day in 2009.
  • 3,330: The number of health care industry lobbyists who played a role in writing the current health care “reform” bill.
  • 428 percent: The increase in profits at 10 of the nation’s largest health insurance companies between 2000 and 2007.
  • 72 percent: The percentage of Americans who support universal health care coverage, according to a CBS News/NY Times poll.
  • 51.9 percent: The percentage of votes won by Massachusetts’ newest senator, Scott Brown, as he took the late Ted Kennedy’s seat and eliminated the Democrat’s filibuster-proof margin.

Ironically, it’s this last number that stands the best chance of saving us from all the others. But only if we stand up right now and demand our rights as Americans.

Political pundits are struggling to make sense of the Massachusetts vote, which ended a 50-year winning streak for the Democrats and which by all accounts will jeopardize the passage of Obama’s health care reform bill.

Good.

Because I want health care reform. My friends and colleagues want it. My kids really want it. And 72 percent of Americans want it, too.

But the current bill is utterly unworthy of the word “reform.” Every life-saving ounce of real reform was either suppressed in advance, stripped from the legislation, or bargained away in the usual political haggling on the Hill.

Washington might think it can dress up this considerably flawed, deeply unpopular piece of compromise as “reform,” but the American people are far too smart for that. For starters, this bill:

n Relies on a rapacious industry to ensure that our quality of and access to health care are on an equal footing with their profit margins.

n Forces us to purchase health insurance without any safeguards against insurance companies dropping unprofitable patients or raising premium costs, deductibles and co-pays.

n And requires us to pay for this on “lay-away” with health care benefits kicking in only well after we start paying the premiums.

Congress and the administration are hurriedly considering a number of ways to get this bill passed into law before Brown – who may go down in history as health care reform’s unwitting savior – is sworn into office.

Their window of opportunity is a few weeks at most. Which means it is time to do or die – time to kill this miserable excuse for health care reform and create something that will truly improve this nation’s health and well being.

“Of all of the forms of inequality,” said the Rev. Dr. Martin Luther King Jr., “injustice in health care is the most shocking and inhumane.”

It is the right of every American – rich or poor, young or old, rural or urban – to have access to affordable, quality health care. Seriously, what’s the point of being the world’s most powerful and wealthy nation if we won’t take decent care of our people?

Universal single-payer health care will cut overhead and administrative costs, premiums, waste, duplication, lawsuits and the growing expense of insurance company liaison staff.

Most importantly, universal health care will once and for all cut off the control of our health care by the profit-motivated health care insur-ance industry and put it in the hands of a government of, for and by the people.

The current bills that have passed in Congress do none of the above. And no matter how they are mish-mashed together, the outcome will never come near to producing what a universal single-payer health care program guarantees.

We need to kill the congressional health care conciliation bill and demand that our elected representatives go back to the drawing board and produce what we sent them there to do, not what the 3,000-plus lobbyists bought with their $9 million-plus dollars.

Thanks, Sen.-elect Brown, for giving us another chance to get it right!

Barbara J. Power, of Deering, is co-chair of Granite State Physicians for a National Health Program.

http://www.nashuatelegraph.com/opinion/perspectives/590775-263/sen.-elect-brown-may-be-health-care-reforms.html