Resource – Page 765

SilverSneakers benefit for Medicare Advantage plans

Blue Shield of California to Offer Award-Winning Fitness Program to Medicare Beneficiaries in San Bernardino

Blue Shield of California
January 18, 2010
Blue Shield of California announced today that it will expand its contract with Healthways, Inc. to offer the SilverSneakers® Fitness Program to Blue Shield Medicare Advantage members in San Bernardino County. SilverSneakers, which Blue Shield already offers in Los Angeles and Orange counties, is the nation’s leading exercise program for older adults.
Using the SilverSneakers premier network, Blue Shield of California members get access to a variety of participating fitness and wellness facilities throughout the country, including such popular locations as Curves® and Bally Total Fitness®. Many sites offer amenities such as exercise equipment, treadmills and free weights, and the signature SilverSneakers fitness classes.
https://www.blueshieldca.com/bsc/newsroom/pr/sneakers_011810.jhtml
SilverSneakers: http://www.silversneakers.com/Home.aspx

Healthways SilverSneakers is a membership fitness program for seniors provided as a free benefit by many Medicare Advantage programs throughout the nation. It is not a benefit that is allowed in the traditional Medicare program.
We certainly applaud seniors who participate in programs designed to maintain physical fitness and general wellness. But there are two features of this program that should outrage taxpayers.
1) These programs are funded by government overpayments made to the private Medicare Advantage plans. Though some of the overpayments are used for additional benefits, much is wasted in excessive administrative costs and profits. Not only should taxpayers object to the waste, they should also object to a program that provides extra benefits limited to private plan enrollees but not available to those in the traditional Medicare program. If the extra benefits are appropriate, then all Medicare beneficiaries should receive them. If they are not appropriate, then no taxpayer funds should be used for these benefits. In either case, the overpayments directed to the private plans should either be redistributed amongst all Medicare beneficiaries or retained in our Medicare reserves. Regardless, the private Medicare Advantage plans should be eliminated as the wasteful intermediaries that they’ve proven to be.
2) Which of our seniors would find the SilverSneakers program to be an attractive benefit? Obviously only the healthiest without infirmities that would prevent them from participating in the exercise programs. SilverSneakers is being selectively marketed to the healthiest, lowest-cost seniors, even though their private plans are being paid much more than we spend taking care of patients in the traditional Medicare program which includes a disproportionate share of chronically ill patients. The taxpayers take care of the sick, while they doubly overpay the private plans to take care of the lower-cost healthier individuals.
The Republicans are feigning outrage by protesting that the proposal before Congress would “cut Medicare spending” by partially reducing some of the overpayments to the Medicare Advantage plans. Well, the Democrats actually are wrong. In a brave show of timidity, they suggest tweaking the Medicare Advantage overpayments, when they should show the temerity to throw those crooks out and use the funds to improve benefits in the traditional Medicare program.
While they’re at it, they should throw out the crooks running the rest of the private plans, and establish an improved Medicare program for all of us.
What about the seniors who would lose their SilverSneakers membership? They can buy a program directly from Curves or Bally Total Fitness, thereby eliminating both the SilverSneakers and the Medicare Advantage middlemen. Or better yet, they can organize their own fitness groups and continue to exercise – for free!

Message from Massachusetts

By Marcia Angell, MD
Former editor-in-chief, New England Journal of Medicine | Senior Lecturer, Harvard Medical School
Huffington Post, January 21, 2010

Well, that was a game-changer! But don’t misinterpret it (and don’t blame Martha Coakley’s lackluster campaign). Scott Brown’s victory was not about the principles of either party, nor was it about the size of government, nor even about health reform, except indirectly. It was about disillusionment and anger with government.

When Obama became president, there was a euphoric sense that we really would see “change you can believe in.” Yes, there were unrealistic expectations — in the words of John Stewart’s “senior black correspondent,” a belief in “miracle Negroes,” even though they’re “just guys.” But for the most part, people did not expect overnight solutions. What they counted on was that Obama would set to work keeping his campaign promises, and do so in a forthright and transparent way.

So what happened? Right out of the chute, he signaled that there might be very little change. After appointing the usual Goldman Sachs crowd as advisors, he showered money on Wall Street unconditionally, while doing relatively little for people who were losing their houses and jobs. Nor did he do much for the states, whose budget woes people feel directly and are a big part of what happened on Tuesday. He did some good things, of course, but they were mostly small and on the margins.

And the campaign promises? We still have both wars raging, with about the same number of troops, just re-distributed from Iraq to Afghanistan. We still have Guantanamo, we still have indefinite imprisonment without charges, and we almost certainly still have torture. As for transparency, there’s still not much of it. And the federal deficit continues to climb, despite the lack of palpable relief for Main Street. Not everyone knows all of this, or cares, but some people know each of these things, and together, they add up to a lot of disillusioned people.

As for health care, not many of the angry voters understand all the provisions of the Senate bill (who does?). But they do know that Obama has “pissed away” a year on it, as Theda Skocpol says, much of it devoted to obsequious courting of the likes of Ben Nelson and Joe Lieberman and Olympia Snow. That raised real questions about his abilities as a leader. And most people under 65 know that the reform would require them to buy commercial insurance, a prospect nearly everyone dislikes. Finally, they almost certainly have some inkling that the bill was written by lobbyists. After all, last spring the White House hosted a highly publicized photo-op and jamboree with the health industries, at which they pledged to work together.

Liberals are wrong to think that opposition to health reform is a rejection of big government. If health reform consisted of extending Medicare to everyone, people would be delighted. There are millions of 64-year-olds out there who can hardly wait to be 65. (And if the government created lots more jobs, they would be delighted by that, too.)

It’s not the size of government; it’s how well it works and on whose behalf. Many people no longer trust Obama to work in their interests, or even to tell the truth. They vote for Republicans mainly because they’re the only other game in town. But I don’t think that means they subscribe to Republican principles. In Massachusetts, Republicans constitute about 11 percent of voters, and I doubt whether that number will increase by much. People are rejecting both parties in droves and becoming independents, because they no longer believe government works for them, no matter which party is in charge. The same dynamic that swept Obama into office might well sweep him out.

It’s also mistake to lump all the protesters together as Sarah Palin yahoos. There are many of those, of course, but in addition there are many people who, even if they’re confused enough to vote Republican, have legitimate concerns, not all of them the same — including Ron Paul libertarians who want out of Iraq and Afghanistan, deficit hawks who worry about saddling their kids with more debt, and ordinary people who are just worried or desperate and don’t see any relief coming from government.

If they don’t draw the wrong lessons from the Scott Brown debacle, the Democrats might still recover. The problem is not that Obama tried to do too much, but that he compromised away his principles.

http://www.huffingtonpost.com/marcia-angell-md/message-from-massachusett_b_432074.html

President Obama is eager to see a better approach

State of the Union Address

President Barack Obama
The White House
January 27, 2010

But 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. (Applause.) Let me know. Let me know. (Applause.) I’m eager to see it.

http://www.whitehouse.gov/the-press-office/remarks-president-state-union-address

And…

Illinois AFL-CIO

Barack Obama
June 30, 2003

I happen to be a proponent of a single payer universal health care program. (applause) I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that’s what Jim is talking about when he says everybody in, nobody out. A single payer health care plan, a universal health care plan. And that’s what I’d like to see. But as all of you know, 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.

https://pnhp.org/news/2008/june/barack_obama_on_sing.php

Comment:

By Don McCanne, MD

Well?

Now, let's talk a real health care reform

By Clark Newhall
Salt Lake Tribune
01/22/2010

It has long been apparent that there was no consensus among progressives on the best way to achieve universal health care. From the very beginning, MoveOn and the labor movement gave lip service (sometimes) to single-payer ideas, but put their money behind whatever the president proposed.

As we now know, what the president proposed changed daily, shifting each time one or another well-heeled lobbying group demanded a “compromise.” Eventually there was no legislation that addressed health care, only legislation addressing health insurance. The Obama administration shifted its labeling from “health reform” to “health insurance reform.” After that, the supporters of President Barack Obama’s plan began to talk about jumping ship, but never got up the courage to actually do so.

Instead, despair at ever achieving universal equitable health care led to disgust with the blatant purchase of congressional votes and then disarray among those who voted and worked for Obama’s election.

The result is a Democratic senatorial candidate intended to replace Teddy Kennedy, but who lost to a Republican whom no one had ever heard of. The next result will be a dramatic loss of the Democratic majority in the Senate and probably in the House during the midterm elections. The final result will be the likely emergence of a challenger to Obama from within the Democratic Party and, ultimately, the election of a Sarah Palin lookalike (if not Palin herself) as the next president in 2012.

What a horror show!

At this point, despair, disgust and disarray may be all that will save us from driving over a cliff with the Palinistas. How so?

With a Republican elected in Massachusetts, say goodbye to any health legislation that can be styled as reform. Even without a new Republican senator, health reform may never have been enacted. No matter how much Obama pushes Congress, the disarray among progressives guarantees that no one on the left will like what is proposed for passage. Even those who say “something is better than nothing” only say so out of a forlorn loyalty to the idea that a defeat for Obama’s health legislation is a defeat for Obama.

I think not. The best thing that could happen to Obama (and America) is for the Congress to fail at passing any health legislation. That would give Obama the chance to do now what he should (and could) have done at the beginning. That will give everyone the chance to say “OK, we now know that the system is beyond any rational attempt to repair it. We are starting from scratch.”

That will give Democrats, Republicans, progressives and Tea Partyers the chance to talk about health care rather than health insurance. That will give citizens the chance to reconsider, regroup and perhaps even join together to promote the one plan that could conceivably gain the approval of most Americans, whatever their ideology — Medicare For All.

Don’t laugh at the idea of a progressive sitting down at a Tea Party. The opportunity is there. We have to change the dialogue from health insurance to health care. And then we have to show the Tea Partyers that they are better off when they enjoy the same type of health care that everyone else (rich and poor) also enjoys. Because very few of them (or of us, or of anyone) can be sure of equitable and reliable health care now, regardless of what kind of insurance anyone has. That is, very few of us except those already getting Medicare.

So it is time to show the Tea Partyers that we progressives can reject despair, disarray and disgust.

It is time to show them and ourselves that health care is what we should have been talking about all along. The argument is not about money. The argument is about whether we should all get health care — you, me, the guy next door, everybody.

Clark Newhall is a Salt Lake City physician and attorney.

Now, let’s talk a real health care reform

By Clark Newhall
Salt Lake Tribune
01/22/2010

What a horror show!

At this point, despair, disgust and disarray may be all that will save us from driving over a cliff with the Palinistas. How so?

So it is time to show the Tea Partyers that we progressives can reject despair, disarray and disgust.

Clark Newhall is a Salt Lake City physician and attorney.

Malpractice lessons from Texas

Liability Limits in Texas Fail to Curb Medical Costs

by David Arkush, Peter Gosselar, Christine Hines and Taylor Lincoln
Public Citizen
December 2009

Supporters of limiting health providers’ liability have touted Texas’ medical malpractice experiment as the solution for improving national health care. For example, Minnesota Rep. Michele Bachmann held up Texas as a successful liability “pilot program” in an address in September, stating, “The state of Texas did a wonderful job of lawsuit reform and actually saw medical costs come down. We know it works.”

But most of the claims touting positive effects of the Texas law – which took effect in September 2003 and included a $250,000 per defendant liability cap – are flatly contradicted by the data.

By the measures commonly used to evaluate health care – such as cost, the uninsured rate, and access to care – Texas has regressed since its liability law took effect. Collectively, these measures show that Texas has one of the worst health care systems in the United States. Moreover, since 2003 Texas has either failed to improve or grown even worse compared to other states on almost every measure.

Since the liability laws took effect:

* The cost of health care in Texas (measured by per patient Medicare reimbursements) has increased at nearly double the national average;
* spending increases for diagnostic testing (measured by per patient Medicare reimbursements) have far exceeded the national average;
* the state’s uninsured rate has increased, remaining the highest in the country;
* the cost of health insurance in the state has more than doubled;
* growth in the number of doctors per capita has slowed; and
* the number of doctors per capita in underserved rural areas has declined.

http://www.citizen.org/documents/Texas_Liability_Limits.pdf

Comment:

By Don McCanne, MD

The Republican grandstanding has been sending a message calling for a blanket rejection of any reform advanced by the Democrats, and instead substituting the opening of insurance markets across state borders and the enactment of malpractice reform.

Since expanding insurance markets across state borders is not the topic of today’s message, we’ll quickly dismiss it as an unsound policy that would flood the market with less expensive underinsurance products that would fail to provide financial security for those who need health care. That is the worst possible way to expand health care coverage.

Regarding malpractice, when Republicans and some Democrats (except those beholden to trial attorneys) call for reducing health care spending through malpractice reform, they don’t really mean reform. They are merely calling for a cap on general damages (pain and suffering), such as the $250,000 cap enacted in Texas. They contend that this would reduce costs by eliminating excessive awards for “junk lawsuits,” and especially by reducing the pressure on physicians to order unnecessary tests. Many contend that the excess CYA testing is a major cause of our very high health care spending.

So what has happened in Texas after the cap was applied? Health care costs have increased at double the national average! Spending increases for diagnostic testing have far exceeded the national average! The cost of health insurance has more than doubled!

As an isolated policy, malpractice caps were ineffective in reducing spending and diagnostic testing in Texas. The issue of general damages needs to be addressed as part of a process leading to comprehensive malpractice reform, but it should be dismissed as the be all and end all for comprehensive health system reform.

The debate over malpractice should not distract us from our mission to support comprehensive reform that would ensure that absolutely everyone receives the health care that they need, under a financing system that eliminates the burden of medical debt. (Hint: a single payer national health program – an improved Medicare for all)

Malpractice lessons from Texas

Liability Limits in Texas Fail to Curb Medical Costs

by David Arkush, Peter Gosselar, Christine Hines and Taylor Lincoln
Public Citizen
December 2009
Supporters of limiting health providers’ liability have touted Texas’ medical malpractice experiment as the solution for improving national health care. For example, Minnesota Rep. Michele Bachmann held up Texas as a successful liability “pilot program” in an address in September, stating, “The state of Texas did a wonderful job of lawsuit reform and actually saw medical costs come down. We know it works.”
But most of the claims touting positive effects of the Texas law – which took effect in September 2003 and included a $250,000 per defendant liability cap – are flatly contradicted by the data.
By the measures commonly used to evaluate health care – such as cost, the uninsured rate, and access to care – Texas has regressed since its liability law took effect. Collectively, these measures show that Texas has one of the worst health care systems in the United States. Moreover, since 2003 Texas has either failed to improve or grown even worse compared to other states on almost every measure.
Since the liability laws took effect:
* The cost of health care in Texas (measured by per patient Medicare reimbursements) has increased at nearly double the national average;
* spending increases for diagnostic testing (measured by per patient Medicare reimbursements) have far exceeded the national average;
* the state’s uninsured rate has increased, remaining the highest in the country;
* the cost of health insurance in the state has more than doubled;
* growth in the number of doctors per capita has slowed; and
* the number of doctors per capita in underserved rural areas has declined.
http://www.citizen.org/documents/Texas_Liability_Limits.pdf

The malpractice system does not serve injured patients well. It needs to be reformed. It needs to be redesigned with incentives to reduce exposure to error, and to appropriately compensate patients when error does occur, all in a non-hostile environment that serves the interests of both patients (compensation for injury) and health care professionals (performance enhancement). This is not the topic of today’s message.
The Republican grandstanding has been sending a message calling for a blanket rejection of any reform advanced by the Democrats, and instead substituting the opening of insurance markets across state borders and the enactment of malpractice reform.
Since expanding insurance markets across state borders is not the topic of today’s message, we’ll quickly dismiss it as an unsound policy that would flood the market with less expensive underinsurance products that would fail to provide financial security for those who need health care. That is the worst possible way to expand health care coverage.
Regarding malpractice, when Republicans and some Democrats (except those beholden to trial attorneys) call for reducing health care spending through malpractice reform, they don’t really mean reform. They are merely calling for a cap on general damages (pain and suffering), such as the $250,000 cap enacted in Texas. They contend that this would reduce costs by eliminating excessive awards for “junk lawsuits,” and especially by reducing the pressure on physicians to order unnecessary tests. Many contend that the excess CYA testing is a major cause of our very high health care spending.
So what has happened in Texas after the cap was applied? Health care costs have increased at double the national average! Spending increases for diagnostic testing have far exceeded the national average! The cost of health insurance has more than doubled!
As an isolated policy, malpractice caps were ineffective in reducing spending and diagnostic testing in Texas. The issue of general damages needs to be addressed as part of a process leading to comprehensive malpractice reform, but it should be dismissed as the be all and end all for comprehensive health system reform.
The debate over malpractice should not distract us from our mission to support comprehensive reform that would ensure that absolutely everyone receives the health care that they need, under a financing system that eliminates the burden of medical debt. (Hint: a single payer national health program – an improved Medicare for all)

UnitedHealth wields a machete

Insurer Steps Up Fight to Control Health Care Cost

By Anemona Hartocollis
The New York Times
January 24, 2010

A front in the national health care battle has opened in New York City, where a major hospital chain and one of the nation’s largest insurance companies are locked in a struggle over control of treatment and costs that could have broad ramifications for millions of people with private health insurance.

The fight is between Continuum Health Partners, a consortium of five New York hospitals, including Beth Israel Medical Center and St. Luke’s-Roosevelt Hospital Center, both major teaching hospitals, and UnitedHealthcare.

The prestigious hospitals and the major health insurer have been in bitter contract negotiations, not just over rates but also over UnitedHealthcare’s demand that the hospitals notify the insurance company within 24 hours after a patient’s admission. If a hospital failed to do so, UnitedHealthcare would cut its reimbursements for the patient by half.

UnitedHealthcare says the proposed rule is meant to improve the quality of care and cut costs by allowing insurance case managers to jump in right away. The hospitals say that having their reimbursement cut in half is too much to pay for a clerical error, and that the revenue drain would ultimately hurt their patients.

The dispute signals a “ratcheting up” of a long tradition of insurers trying to cut costs, said Jeffrey Rubin, an economics professor at Rutgers University.

http://www.nytimes.com/2010/01/25/health/policy/25insure.html?ref=health&pagewanted=all

Comment:

By Don McCanne, MD

The leadership of America’s Health Insurance Plans (AHIP) and Physicians for a National Health Program (PNHP) do agree on one crucial point: the current health care reform proposal does very little to control the intolerable escalation of health care costs. Both agree that Congress must provide the remedies to control spending and improve health care value.

What will occur without government action? Cost containment will remain in the hands of the private insurance industry. The tools at their disposal are very intrusive and are what resulted in the managed care backlash by unhappy patients and their providers. With the continuing increase in costs and the need to avoid pricing premiums totally out of the market, more intensive and extensive intrusions can be anticipated.

Look at this provision that UnitedHealth is demanding in its contract negotiations with a prominent New York hospital chain. If a hospital commits the clerical error of failing to notify UnitedHealth of a patient’s admission within the first 24 hours, the hospital is penalized 50 percent of its already reduced contracted rate! When the insurer is notified, they have the “insurance case managers jump in right away.” Although they claim that it is to improve quality, no sane person is deceived by the budget machete that they wield.

Without effective reform, it will get much worse since premium increases must be limited – they’re already too high – so insurers will be left with no alternative but to whack away at spending. Whacking spending means whacking patient care. Insurers really don’t want to do that. It is not for altruistic reasons, but it is rather the fear that their business model could suffer irreparable harm under the wrath of enraged patients and their health care providers (not that it hasn’t already).

It is no wonder that AHIP wants Congress to enact cost containment so the government becomes the bad guys. But do they really expect Congress to establish a government bureaucracy of machete-wielding case managers while the insurance industry gets a free ride? Yet that is the form of cost containment that fits with the model in which the private insurers retain control of the funds.

We’ll say it again. Private health insurance plans are an obsolete model of financing health care. Affordable premiums, adequate benefits, and affordable out-of-pocket costs are incompatible under the private insurance model because of the very high health care prices in the United States.

Methods of cost containment is where PNHP and AHIP part ways. PNHP recommends eliminating the obsolete private insurance industry and replacing it with a single payer national health program – an improved Medicare for everyone.

An improved Medicare for all would save hundreds of billions of dollars in wasted administrative excesses. Although some claim that this is a one-time benefit, it is a profound waste that never returns, providing savings every year thereafter. The system would be operated under a global budget, adjusted for demographics, inflation, and beneficial advances in technology, maintaining spending at a sustainable level. Hospitals would be funded through global budgets, eliminating the need for armies of clerks attempting to obtain reimbursement from a multitude of payers for each itemized expenditure of the hospital. Health professionals would negotiate compensation to meet their costs and provide fair profits. Bulk purchasing at negotiated rates would enable fair pricing for pharmaceuticals and medical supplies. Capital improvements would be separately budgeted to correct for both excessive and deficient supply side capacity, avoiding excess costs by improving efficiency.

The differences could not be more clear. Private insurers want government interventions to protect their businesses. Advocates of an improved Medicare for all want everyone to have the health care that they need, while making the health care system affordable for all – individuals, businesses, and the government and its taxpayers.

Thank you for writing your representatives!

We must act now if we want to get corporate greed and waste out of the system.
We must act now if we want to save the lives of the thousands upon thousands that die each year because of a failing healthcare system driven by profit.
We are the people, patients, families, and communities that face the burden of a failing system and we want it to change!
And we need your help. Don’t wait. Act now. Contact your representative by phone and email, and make sure that they know that you demand a better system.
Act now and demand the only reform that is universal, high quality, and affordable because it eliminates insurance industry waste and greed.
Support SB 810 and don’t let corporate interests get away with destroying healthcare reform.
Fight for California. Fight for Single Payer. And Act now!

For more information please visit PNHP.org

Better odds for Medicare for all?

By Kristen Gerencher
MarketWatch, Jan. 22, 2010

[The following is an excerpt from an article titled “Unexpected lessons from Massachusetts” about the impact of Scott Brown’s election to the Senate from Massachusetts. For the full article, click on the link at the end.]

The message from Massachusetts voters was “rather muddled,” said Dr. Steffie Woolhandler, professor of medicine at Harvard University and an internist in Boston.

“It’s not that people in Massachusetts are profoundly unhappy with the [reform] in Massachusetts but seem to feel it’s irrelevant,” said Woolhandler, co-founder of Physicians for a National Health Program.

People are rightfully concerned that the benefits of the bills are too meager compared with the costs, she said.

A Medicare-for-all approach would produce hundreds of billions of dollars in annual savings due to the lower administrative costs that come from cutting out the middleman, Woolhandler said.

“I know that’s not what the private insurance industry wants to hear and they’re very powerful, but the only way that we can afford universal health care is through a Medicare-for-all model,” she said.

“We need to learn from other countries what works, and the message is national nonprofit health insurance works and what they’re doing in Washington and what we’ve done in Massachusetts is not the solution.”

Woolhandler said she didn’t root for Scott Brown’s victory, but that his election raised the chances for a Medicare-for-all approach down the line “because it’s obvious we have to do something else, something different from what we’ve been doing.”

Such a large-scale change is less of a long shot now, [John] Holahan [director of the Health Policy Center at the Urban Institute in Washington] said. If health reform dies this year, within a decade there will be demand at least for Medicare as an option, with income subsidies similar to what’s in the current bills — and the potential for Medicare for all isn’t out of the question either, he said.

“I almost think you’d have to because of the budget implications and the health implications and financial pressure on health-care institutions,” Holahan said. “If the uninsured rate goes to 60, 70 million over next decade, that’s an awful lot of people who can’t afford to pay.”

Kristen Gerencher is a reporter for MarketWatch in San Francisco. MarketWatch is part of the Wall Street Journal Digital Network.

http://www.marketwatch.com/story/why-health-reform-may-survive-browns-win-2010-01-22?pagenumber=1

'Single-Payer' left out of health care debate, but many doctors want it in

By Mike Rose
Austin (Minn.) Daily Herald, Jan. 23, 2010

When the current health care debate began in earnest last year, one potential topic of discussion was largely left out — “single-payer” insurance.

Perhaps most indicative of the exclusion were remarks early in the debate from Sen. Max Baucus, D-Mont., who chairs the Senate Finance Committee and has been an influential player in the health care reform process. On several occasions, the senator said everything was on the table, except for the possibility of establishing a national health insurance plan that would supplant private insurers.

Leaving single-payer off the table, said Dr. Quentin Young, has been a great injustice.

“The health care system is going to hell rapidly,” the retired Chicago physician said. “(And single-payer) is mentioned only in passing.”

Young is working to change that. He is currently the national coordinator for Physicians for a National Health Program, a 23-year-old non-profit that counts 17,000 doctors as its members.

The organization is not alone in pushing for single-payer health insurance, but PNHP is among a number of groups focusing on the issue through the lens of the medical profession.

“Physician support (of single-payer) is getting stronger every day,” Young claims. “We’re doing a good job of publicizing.”

Numbers seem to support Young’s claim. According to a survey done by the Indiana University School of Medicine in 2007, 59 percent of physicians in the country supported legislation to establish national health insurance — up 10 percent from five years earlier. In Minnesota, 64 percent of doctors polled in 2007 said they favored a single-payer plan, according to an article in the journal Minnesota Medicine.

The doctor said the reason for moving toward national health insurance is simple — it would expand coverage to more people and reduce administrative costs that come from a complex private insurance industry.

But Young said his organization is willing to accept options short of a full-fledged single-payer plan, as long as coverage increases and prices decrease.

“We’re not single-payer or nothing,” he said. “We certainly welcome other reforms.”

However, that doesn’t include reforms in front of Congress now, Young said — the doctor believes the proposed legislation would do more harm than good.

“They’re both bad,” he said of the House and Senate health care bills. “They’re not tiny steps forward, (but rather) important steps backward.”

Dr. Ann Settgast, a St. Paul-based physician who is also in PNHP, said perhaps proposed legislation making its way through committees in the Minnesota Legislature could pave the way for national health insurance.

The state House and Senate health care reform bills, known collectively as the Minnesota Health Plan, would make Minnesota a single-payer state.

With 71 co-authors in the Legislature, Settgast said it is clear the plan has initial support. Now, she wants to see it move forward and see Minnesota become a pioneer by instituting a single-payer system.

If it does pass, Settgast said it could start a ripple effect, leading other states and perhaps the country as a whole to adopt similar measures.

Like the Chicago-based Dr. Young, Settgast said she sees more and more support along these lines, though she acknowledges true change will come slowly.

“Single-payer is very well supported,” Settgast said, though adding that “it was needed years ago. The sooner the better.”

Both Settgast and Young say the main obstacle to a single-payer plan is the health insurance industry. Settgast for one said groups like PNHP simply can’t compete with insurance lobbyists in Washington.

“Certainly, if your campaign contributions are resting on (insurance industry) money” that makes it hard to listen to other sides, she said. “The single-payer voice is largely underrepresented in the debate.”

But Robert Zirkelbach, strategic communications director for America’s Health Insurance Plans, the country’s largest health insurance trade association, said the industry has not been a “bully” during the reform debate.

Instead, he said AHIP represents the majority of Americans who don’t believe in a single-payer plan.

“The American people do not support a government takeover of the health insurance system,” Zirkelbach said.

The spokesman said the private insurance industry has pioneered a number of innovative health care ideas, adding that a vast majority of Americans were satisfied with their current plans.

A single-payer insurance system, Zirkelbach said, would not lower costs and would only reduce services.

“Moving toward an entirely government-run system would turn back the clock on health care,” he said.

Editor’s note: This is the last in a three-part series examining the health care debate from the perspectives of different social groups.

http://www.austindailyherald.com/news/2010/jan/23/heath-care-perspectives-part-3/

‘Single-Payer’ left out of health care debate, but many doctors want it in